Journal of neuroimaging : official journal of the American Society of Neuroimaging
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As part of its technological sophistication, the International Space Station (ISS) Program operates a robust medical surveillance schedule for its rotating 6-person crew to control the known health risks and to address knowledge gaps related to human health in space flight environment. Recent evidence on visual impairment in a subset of ISS crew has renewed the interest in the effects of long-duration space flight on the central nervous system (CNS). Through retrospective analysis in a sample of 10 healthy astronauts, we demonstrate the utility of multimodal quantitative magnetic resonance imaging (qMRI) with diffusion tensor imaging (DTI)-based customized brain templates to examine the structural attributes of various CNS compartments in this occupational group. ⋯ The novelty of this exploratory report is in the demonstration of a qMRI toolset as a potential capability for characterization and surveillance of unique professional groups, and for future prospective examinations of the effects of various long-term exposures on CNS.
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The impact of blood-brain barrier (BBB) disruption can be detected by intraparenchymal hyperdense lesion on the computed tomography (CT) scan after endovascular stroke therapy. The purpose of this study was to determine whether early BBB disruption predicts intracranial hemorrhage and poor outcome in patients with acute ischemic stroke treated with mechanical thrombectomy. ⋯ Moderate BBB disruption is common after mechanical thrombectomy in a quarter of patients with acute ischemic stroke and increases the risk of intracranial hemorrhage and poor outcome.
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Interpreting the clinical significance of moderate-to-severe global cerebral atrophy (GCA) is a conundrum for many clinicians, who visually interpret brain imaging studies in routine clinical practice. GCA may be attributed to normal aging, Alzheimer's disease (AD), or cerebrovascular disease (CVD). Understanding the relationships of GCA with aging, AD, and CVD is important for accurate diagnosis and treatment decisions for cognitive complaints. ⋯ Moderate-to-severe GCA is most likely to occur in the presence of AD or CVD and should not be solely attributed to age when evaluating clinical imaging findings in the workup of cognitive complaints. Developing optimal diagnostic and treatment strategies for cognitive decline in the setting of GCA requires an understanding of its risk factors in the aging population.
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Late-onset adult Krabbe disease is a very rare demyelinating leukodystrophy, affecting less than 1 in a million people. Hematopoietic stem cell transplantation (HSCT) strategies can stop the accumulation of toxic metabolites that damage myelin-producing cells. We used quantitative advanced imaging metrics to longitudinally assess the impact of HSCT on brain abnormalities in adult-onset Krabbe disease. ⋯ Clinical evidence and stability of advanced MR measures related to myelin and axons supports HSCT as an effective treatment strategy for stopping progression associated with late-onset Krabbe disease.
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In this pilot study, we sought to investigate the pathological changes in the white matter (WM) of medically complex, combination antiretroviral therapy (cART)-treated patients with human immunodeficiency virus (HIV), comparing them to patients with long-standing, secondary progressive multiple sclerosis (SPMS). ⋯ We conclude that DKI-derived WMTI metrics may be a valuable tool in assessing the WM changes of medically complex HIV-infected individuals. While not powered to examine potential etiologies of WM changes in this pilot sample, regional variations in WMTI metrics were seen. When contrasted with changes consequent to chronic MS of similar duration, HIV and its comorbidities appear to result in similar degrees of axonal damage, but regionally variable amounts of myelin loss and extraxonal abnormality.