Neuroimaging clinics of North America
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Neuroimaging Clin. N. Am. · May 2015
ReviewPediatric and adult spinal tuberculosis: imaging and pathophysiology.
The prevalence of tuberculosis (TB) has increased in developing and developed countries as a consequence of the AIDS epidemic, immigration, social deprivation, and inadequate TB control and screening programs. Spinal TB may be osseous or nonosseous. ⋯ Nonspondylitic spinal TB is less well described in the literature, may develop in the absence of TB meningitis, and is often associated with meningovascular cord ischemia. Radiologists should be familiar with the spectrum of imaging findings, allowing early diagnosis and treatment of this serious condition.
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Multiple sclerosis (MS) is a common disease of the central nervous system, with various clinical symptoms and a heterogeneous disease course. MRI can depict focal and diffuse manifestations of the disease, and accurately measure progression over time. ⋯ More recent genome-wide association studies have revealed other genes to be related to disease susceptibility and severity, explaining part of the variability in symptoms, radiological manifestations and disease course. Studies relating genetics and imaging in MS are discussed in this paper.
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Gene expression is a process of DNA sequence reading into protein synthesis. In cases of problems in DNA repair/apoptosis mechanisms, cells accumulate genomic abnormalities and pass them through generations of cells. The accumulation of mutations causes diseases and even tumors. ⋯ Some trials are testing patients with epigenetic treatments. Epigenetic therapy must be used with caution because epigenetic processes and changes happen constantly in normal cells, giving rise to drug off-target effects. Scientists are making progress in specifically targeting abnormal cells with minimal damage to normal ones.
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Neuroimaging is a potentially valuable tool to link individual differences in the human genome to structure and functional variations, narrowing the gaps in the casual chain from a given genetic variation to a brain disorder. Because genes are not usually expressed at the level of mental behavior, but are mediated by their molecular and cellular effects, molecular imaging could play a key role. This article reviews the literature using molecular imaging as an intermediate phenotype and/or biomarker for illness related to certain genetic alterations, focusing on the most common neurodegenerative disorders, Alzheimer's disease (AD) and Parkinson disease.
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Imaging genomics combines imaging-defined phenotypes with molecular determinants of disease. Recent studies have examined the relationship between MRI-derived feature sets and gene expression in gliomas, including glioblastoma (GBM). ⋯ The combination of clinical, genetic, and imaging data has improved prognostic modeling and has identified potential therapeutic targets. Many challenges remain in fully leveraging the associations between such large datasets, but even current methodology shows promise in helping to craft individually tailored treatments to patients with brain tumors and other diseases.