Journal of neuroimaging : official journal of the American Society of Neuroimaging
-
Despite multimodal treatment of glioblastoma (GBM), recurrence beyond the initial tumor volume is inevitable. Moreover, conventional MRI has shortcomings that hinder the early detection of occult white matter tract infiltration by tumor, but diffusion tensor imaging (DTI) is a sensitive probe for assessing microstructural changes, facilitating the identification of progression before standard imaging. This sensitivity makes DTI a valuable tool for predicting recurrence. A systematic review was therefore conducted to investigate how DTI, in comparison to conventional MRI, can be used for predicting GBM progression. ⋯ These findings suggest that DTI metrics may be useful for guiding surgical and radiotherapy planning for GBM patients, and for informing long-term surveillance. Understanding the current state of the literature pertaining to these metrics' trends is crucial, particularly as DTI is increasingly used as a treatment-guiding imaging modality.
-
Multiple sclerosis-related cognitive impairment (MSrCI) affects most patients with multiple sclerosis (MS), significantly contributing to disability and socioeconomic challenges. MSrCI manifests across all disease stages, mainly impacting working memory, information processing, and attention. To date, the underlying mechanisms of MSrCI remain unclear, with its pathogenesis considered multifactorial. ⋯ Key findings ifrom rs-fMRI studies reveal disruptions in brain connectivity and hub integration, leading to CI due to decreased network efficiency. tb-fMRI studies highlight abnormal brain activation patterns in pwMS, with evidence of increased fMRI activity in earlier disease stages as a beneficial compensatory response, followed by reduced activation correlating with increased lesion burden and cognitive decline as the disease progresses. This suggests a gradual exhaustion of compensatory mechanisms over time. These findings support fMRI not only as a diagnostic tool for MSrCI but also as a potential imaging biomarker to improve our understanding of disease progression.
-
The role of high-resolution nerve ultrasound (HRUS) in the diagnosis of chemotherapy-induced polyneuropathy is unclear. The present prospective longitudinal controlled study evaluates the utility of HRUS in vincristine-induced polyneuropathy (VIPN). ⋯ At mid-treatment, there is an increase in the total CSA at entrapment sites parallel to an increase in clinical symptoms. In individual nerve sites, HRUS does not detect significant signs of VIPN. NCSs exhibit signs of a predominantly sensory axonal polyneuropathy. The clinical examination remains the most sensitive tool in the early detection of VIPN.
-
Comparative Study
Comparison of antithrombogenic coated and uncoated flow diverters in ruptured and unruptured cerebral aneurysms.
Flow diversion has become a key treatment option for complex intracranial aneurysms. Recent advancements include coated flow diverters (FDs), designed to potentially reduce the need for dual antiplatelet therapy, thereby removing the associated secondary risks while maintaining patency and low complication rates. Comparing coated and uncoated FDs may offer insights into long-term outcomes and treatment optimization. ⋯ We observed favorable occlusion rates for both coated and uncoated FDs. The role of dual antiplatelet therapy remains debated. Large multicenter studies are essential to evaluate the patency of coated compared to uncoated FDs and determine whether they can reduce thrombogenicity, potentially allowing for less or no antiplatelet therapy in emergencies.
-
Neuromyelitis optica spectrum disorder (NMOSD) affects the optic nerves and spinal cord but can also cause focal brain inflammation. Subcortical pathology may contribute to the etiology of cognitive deficits in NMOSD. Using myelin water imaging, we investigated cerebral normal-appearing white matter (NAWM) and thalamic metrics and their association with cognition in NMOSD participants compared to healthy controls (HC). ⋯ NAWM in NMOSD demonstrates diffuse abnormalities with increased water content and demyelination, suggesting a diffuse disease process overlooked by focal inflammation measures. Increased water content, as a biomarker for diffuse thalamic pathology, may partially explain cognitive impairment in NMOSD.