White Matter

白质
  • 文章类型: Systematic Review
    鉴于神经胶质瘤细胞倾向于沿着WM束浸润和迁移,导致脱髓鞘和轴突损伤,扩散张量成像(DTI)是一种有前途的工具,可用于识别肿瘤周围脑区(PBZ)或在整个相邻白质区域的一定距离内复发的主要“高风险区域”。我们的系统评价是回答以下研究问题:在脑肿瘤患者中,与常规成像技术相比,DTI是否能够识别肿瘤周围脑区(PBZ)区域更容易发生局部(靠近手术腔)或远程复发?我们进行了全面的文献检索,以确定符合PRISMA-P(系统评价和荟萃分析方案的首选报告项目)指南的相关研究。15篇论文被认为与我们的研究问题相符,并包括在内。为了提高论文的可读性,我们将我们的发现分为两个不同的组:第一个研究DTI在检测PBZ亚区域浸润和局部复发中的作用(n=8),第二组探讨了DTI检测白质道浸润和远程复发的可行性(n=7)。DTI值和,在更广泛的框架内,影像组学调查可以提供精确的,逐个体素洞察PBZ的状态和复发。更好地定义PBZ内和沿着WM束有潜在复发风险的区域将允许靶向治疗。
    Given that glioma cells tend to infiltrate and migrate along WM tracts, leading to demyelination and axonal injuries, Diffusion Tensor Imaging (DTI) emerged as a promising tool for identifying major \"high-risk areas\" of recurrence within the peritumoral brain zone (PBZ) or at a distance throughout the adjacents white matter tracts. Of our systematic review is to answer the following research question: In patients with brain tumor, is DTI able to recognizes within the peri-tumoral brain zone (PBZ) areas more prone to local (near the surgical cavity) or remote recurrence compared to the conventional imaging techniques?. We conducted a comprehensive literature search to identify relevant studies in line with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. 15 papers were deemed compatible with our research question and included. To enhance the paper\'s readability, we have categorized our findings into two distinct groups: the first delves into the role of DTI in detecting PBZ sub-regions of infiltration and local recurrences (n = 8), while the second group explores the feasibility of DTI in detecting white matter tract infiltration and remote recurrences (n = 7). DTI values and, within a broader framework, radiomics investigations can provide precise, voxel-by-voxel insights into the state of PBZ and recurrences. Better defining the regions at risk for potential recurrence within the PBZ and along WM bundles will allow targeted therapy.
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  • 文章类型: Journal Article
    脑部医学图像分割是医学图像处理中的一项关键任务,在中风等疾病的预测和诊断中发挥着重要作用,老年痴呆症,和脑肿瘤。然而,由于不同扫描仪之间的站点间差异很大,因此不同来源的数据集之间的分布差异很大,成像协议,和人口。这导致实际应用中的跨域问题。近年来,已经进行了许多研究来解决大脑图像分割中的跨域问题。
    本评论遵循系统评论和荟萃分析(PRISMA)的首选报告项目的标准,用于数据处理和分析。我们从PubMed检索了相关论文,WebofScience,和IEEE数据库从2018年1月到2023年12月,提取有关医疗领域的信息,成像模式,解决跨域问题的方法,实验设计,和来自选定论文的数据集。此外,我们比较了中风病变分割方法的性能,脑白质分割和脑肿瘤分割。
    本综述共纳入并分析了71项研究。解决跨域问题的方法包括迁移学习,规范化,无监督学习,变压器型号,和卷积神经网络(CNN)。在ATLAS数据集上,领域自适应方法显示,与非自适应方法相比,卒中病变分割任务总体改善约3%.然而,鉴于当前研究中基于MICCAI2017中白质分割任务的方法和BraTS中脑肿瘤分割任务的方法的数据集和实验方法的多样性,直观地比较这些方法的优缺点是具有挑战性的。
    尽管已经应用了各种技术来解决大脑图像分割中的跨域问题,目前缺乏统一的数据集和实验标准。例如,许多研究仍然基于n折交叉验证,而直接基于跨站点或数据集的交叉验证的方法相对较少。此外,由于大脑分割领域的医学图像类型多种多样,对性能进行简单直观的比较并不容易。这些挑战需要在未来的研究中解决。
    UNASSIGNED: Brain medical image segmentation is a critical task in medical image processing, playing a significant role in the prediction and diagnosis of diseases such as stroke, Alzheimer\'s disease, and brain tumors. However, substantial distribution discrepancies among datasets from different sources arise due to the large inter-site discrepancy among different scanners, imaging protocols, and populations. This leads to cross-domain problems in practical applications. In recent years, numerous studies have been conducted to address the cross-domain problem in brain image segmentation.
    UNASSIGNED: This review adheres to the standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) for data processing and analysis. We retrieved relevant papers from PubMed, Web of Science, and IEEE databases from January 2018 to December 2023, extracting information about the medical domain, imaging modalities, methods for addressing cross-domain issues, experimental designs, and datasets from the selected papers. Moreover, we compared the performance of methods in stroke lesion segmentation, white matter segmentation and brain tumor segmentation.
    UNASSIGNED: A total of 71 studies were included and analyzed in this review. The methods for tackling the cross-domain problem include Transfer Learning, Normalization, Unsupervised Learning, Transformer models, and Convolutional Neural Networks (CNNs). On the ATLAS dataset, domain-adaptive methods showed an overall improvement of ~3 percent in stroke lesion segmentation tasks compared to non-adaptive methods. However, given the diversity of datasets and experimental methodologies in current studies based on the methods for white matter segmentation tasks in MICCAI 2017 and those for brain tumor segmentation tasks in BraTS, it is challenging to intuitively compare the strengths and weaknesses of these methods.
    UNASSIGNED: Although various techniques have been applied to address the cross-domain problem in brain image segmentation, there is currently a lack of unified dataset collections and experimental standards. For instance, many studies are still based on n-fold cross-validation, while methods directly based on cross-validation across sites or datasets are relatively scarce. Furthermore, due to the diverse types of medical images in the field of brain segmentation, it is not straightforward to make simple and intuitive comparisons of performance. These challenges need to be addressed in future research.
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  • 文章类型: Journal Article
    认知挑战和大脑结构变化在自闭症谱系障碍(ASD)中很常见,但在中老年自闭症成年人中很少探索。年轻自闭症患者和老年痴呆症患者之间重叠的认知缺陷提出了一个重要问题:早期发育过程中认知能力和大脑结构受损是否会促使自闭症成年人更容易受到病理性衰老的影响,还是保护它们不进一步衰退?要回答这个问题,我们综合了目前ASD患者衰老的理论模型,并进行了系统的文献综述(1980年1月1日-2024年2月29日)和荟萃分析,以总结中老年孤独症患者认知和大脑偏差的实证研究.我们探索了支持ASD中不同衰老理论的发现,并解决了研究局限性和未来方向。这篇综述揭示了自闭症社区提出的对衰老问题知之甚少的后果,为未来的研究铺平道路,以确定能够最好地预测发病的敏感和可靠的措施。programming,ASD病理性衰老的预后。
    Cognitive challenges and brain structure variations are common in autism spectrum disorder (ASD) but are rarely explored in middle-to-old aged autistic adults. Cognitive deficits that overlap between young autistic individuals and elderlies with dementia raise an important question: does compromised cognitive ability and brain structure during early development drive autistic adults to be more vulnerable to pathological aging conditions, or does it protect them from further decline? To answer this question, we have synthesized current theoretical models of aging in ASD and conducted a systematic literature review (Jan 1, 1980 - Feb 29, 2024) and meta-analysis to summarize empirical studies on cognitive and brain deviations in middle-to-old aged autistic adults. We explored findings that support different aging theories in ASD and addressed study limitations and future directions. This review sheds light on the poorly understood consequences of aging question raised by the autism community to pave the way for future studies to identify sensitive and reliable measures that best predict the onset, progression, and prognosis of pathological aging in ASD.
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  • 文章类型: Journal Article
    痴呆症,特别是阿尔茨海默病(AD),与可修改的风险因素有联系,特别是缺乏体力活动。然而,认知益处通常归因于有氧运动,阻力运动(RE)受到的关注较少。这篇综述旨在通过评估RE对与AD相关的大脑结构和认知缺陷的影响来解决这一差距。利用结构神经影像学从随机对照试验(RCT)中汲取见解,讨论了RE对AD影响的脑结构的具体影响及其与认知功能的相关性。初步研究结果表明,RE在老年人中诱导大脑结构改变,可以降低AD的风险或减轻AD的进展。重要的是,RE的影响似乎遵循剂量-反应效应,逆转病理结构的变化和改善相关的认知功能,如果进行至少6个月,每周至少两次,对那些已经经历认知能力下降的人影响最大。虽然人们热切期待更多的研究,这篇综述有助于在AD相关脑结构和功能变化的背景下,深入了解RE对认知健康的潜在益处。
    Dementia, particularly Alzheimer\'s Disease (AD), has links to several modifiable risk factors, especially physical inactivity. When considering the relationship between physcial activity and dementia risk, cognitive benefits are generally attributed to aerobic exercise, with resistance exercise (RE) receiving less attention. This review aims to address this gap by evaluating the impact of RE on brain structures and cognitive deficits associated with AD. Drawing insights from randomized controlled trials (RCTs) utilizing structural neuroimaging, the specific influence of RE on AD-affected brain structures and their correlation with cognitive function are discussed. Preliminary findings suggest that RE induces structural brain changes in older adults that could reduce the risk of AD or mitigate AD progression. Importantly, the impacts of RE appear to follow a dose-response effect, reversing pathological structural changes and improving associated cognitive functions if performed at least twice per week for at least six months, with greatest effects in those already experiencing some element of cognitive decline. While more research is eagerly awaited, this review contributes insights into the potential benefits of RE for cognitive health in the context of AD-related changes in brain structure and function.
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  • 文章类型: Journal Article
    目的:本研究的主要目的是评估偏头痛患者白质高信号(WMHs)的患病率,并比较成年男性和女性患者的发现。还分析了特定的症状和合并症,以确定它们是否与WMH患病率或偏头痛患者的性别有关。我们假设女性的WMHs患病率更高,经历更频繁和更严重的偏头痛,并且比男性更可能有与偏头痛相关的某些合并症。
    背景:已提出偏头痛患者中WMHs的患病率增加,尽管基于人群的MRI研究的数据并未很好地支持这种关系。男性和女性之间大脑形态的差异具有研究意义,一般人群中女性的WMHs患病率较高。偏头痛患者相对于脑成像中WMHs数量的性别差异和各种合并症尚未得到充分研究。
    方法:这是一项针对177名年龄在18岁及以上的偏头痛患者的横断面研究,这些患者于2000年1月1日至2017年1月1日在利哈伊谷弗莱明神经科学研究所的头痛中心就诊。从电子病历中提取患者的基线特征,包括人口统计,审查系统文件,和核磁共振成像的大脑成像。变量包括头痛严重程度,头部疼痛的频率,失眠,和合并症(焦虑,抑郁症,糖尿病,高脂血症,高血压,和颈部疼痛)也分析了与WMHs的存在的关联。
    结果:发现女性的WMHs数量明显高于男性(中位数3[IQR:0-7]与0[IQR:0-3],p=0.023)。患有WMHs的患者比没有WMHs的患者更有可能患高血压(39.8%的WMHs患者与20.3%无WMHs,p=0.011),便秘(20.9%vs.8.3%,p=0.034),和睡眠障碍(55.7%vs.37.3%,p=0.022)。患有偏头痛的女性比男性更容易发生便秘(20.0%vs.2.9%,p=0.015)。没有研究偏头痛的特征(频率,严重程度,光环的存在)在性别之间是不同的,它们与WMHs的存在也没有显着关联。
    结论:这项研究表明,女性偏头痛患者可能比男性偏头痛患者更容易发生WMHs和便秘。偏头痛的频率和严重程度在性别之间没有差异,它们与WMHs的存在也没有显着关联。这项研究的发现不支持偏头痛患者WMH发展的特定病因,这与一般人群的发现不同。需要进一步的研究。
    OBJECTIVE: The primary objective of this study was to evaluate the prevalence of white matter hyperintensities (WMHs) in patients who experience migraine and compare findings between adult male and female patients. Specific symptoms and comorbidities also were analyzed to determine whether they were associated with WMH prevalence or the sex of patients with migraine. We hypothesized that females would have a higher prevalence of WMHs, experience more frequent and more severe migraine headaches, and be more likely to have certain comorbidities associated with migraine than males.
    BACKGROUND: An increased prevalence of WMHs in patients with migraine has been proposed, although this relation is not well-supported by data from population-based MRI studies. The difference in brain morphology between males and females is of research interest, and females in the general population appear to have a higher prevalence of WMHs. Sex differences and various comorbidities in patients with migraine relative to the number of WMHs on brain imaging have not been fully investigated.
    METHODS: This was a cross-sectional study of 177 patients aged 18 years and older with a diagnosis of migraine who were seen in the Lehigh Valley Fleming Neuroscience Institute\'s Headache Center between January 1, 2000, and January 1, 2017. Patients\' baseline characteristics were extracted from electronic medical records, including demographics, review of systems documentation, and brain imaging from MRI. Variables including headache severity, frequency of head pain, insomnia, and comorbidities (anxiety, depression, diabetes, hyperlipidemia, hypertension, and neck pain) also were analyzed for associations with the presence of WMHs.
    RESULTS: Females were found to have a significantly higher number of WMHs than males (median 3 [IQR: 0-7] vs. 0 [IQR: 0-3], p = 0.023). Patients with WMHs were significantly more likely than those without WMHs to have hypertension (39.8% of patients with WMHs vs. 20.3% without WMHs, p = 0.011), constipation (20.9% vs. 8.3%, p = 0.034), and sleep disorder (55.7% vs. 37.3%, p = 0.022). Females with migraine were significantly more likely to experience constipation than males (20.0% vs. 2.9%, p = 0.015). None of the migraine characteristics studied (frequency, severity, presence of aura) were different between sexes, nor were they significantly associated with the presence of WMHs.
    CONCLUSIONS: This study suggests that females with migraine may be more likely to have WMHs and experience constipation than males with migraine. Migraine frequency and severity were not different between sexes, nor were they significantly associated with the presence of WMHs. The findings of this study do not support a specific etiology of WMH development in individuals with migraine that differs from findings in the general population. Further studies are warranted.
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  • 文章类型: Journal Article
    背景:基于磁共振成像(MRI)的成像技术可用于评估感染和炎症背景下的白质(WM)结构和微结构完整性。这项范围审查的目的是评估使用WM神经成像方法的工作范围,以了解先天性和围产期病毒感染或暴露对发育中的大脑的影响。
    方法:本范围审查是根据Arksey和O\'Malley框架进行的。在WebofScience上进行了文献检索,Scopus和PubMed提供截至2022年1月从数据库概念发表的主要研究文章。包括评估在先天性和围产期病毒感染或暴露中使用基于MRI的WM成像技术的研究。结果按年龄和感染进行分组。
    结果:共确定了826篇文章进行筛选,包括28篇最终文章。纳入研究中的先天性和围产期感染为巨细胞病毒(CMV)感染(n=12),人类免疫缺陷病毒(HIV)感染(n=11)或暴露(n=2)或合并(n=2),和单纯疱疹病毒(HSV)感染(n=1)。所代表的基于MRI的WM成像方法包括结构MRI以及扩散加权和扩散张量MRI(DWI/DTI)。最常报告的扩散度量组差异的区域包括小脑区,HIV感染儿童和未感染HIV暴露儿童的皮质脊髓束和联合纤维WM束。在定性成像研究中,WM高信号是CMV感染儿童和HSV感染儿童中最常见的脑异常。
    结论:有证据表明,WM成像技术可以作为评估先天性感染和围产期病毒暴露对发育中大脑影响的诊断和评估工具发挥作用。识别WM高强度的高灵敏度表明,结构性脑MRI是评估先天性CMV感染儿童的有用神经诊断方式。而与HIV相关的DTI变化表明,分数各向异性等指标有可能成为神经HIV中细微损害或WM损害的特异性标志物。
    BACKGROUND: Magnetic Resonance Imaging (MRI)-based imaging techniques are useful for assessing white matter (WM) structural and microstructural integrity in the context of infection and inflammation. The purpose of this scoping review was to assess the range of work on the use of WM neuroimaging approaches to understand the impact of congenital and perinatal viral infections or exposures on the developing brain.
    METHODS: This scoping review was conducted according to the Arksey and O\' Malley framework. A literature search was performed in Web of Science, Scopus and PubMed for primary research articles published from database conception up to January 2022. Studies evaluating the use of MRI-based WM imaging techniques in congenital and perinatal viral infections or exposures were included. Results were grouped by age and infection.
    RESULTS: A total of 826 articles were identified for screening and 28 final articles were included. Congenital and perinatal infections represented in the included studies were cytomegalovirus (CMV) infection (n = 12), human immunodeficiency virus (HIV) infection (n = 11) or exposure (n = 2) or combined (n = 2), and herpes simplex virus (HSV) infection (n = 1). The represented MRI-based WM imaging methods included structural MRI and diffusion-weighted and diffusion tensor MRI (DWI/ DTI). Regions with the most frequently reported diffusion metric group differences included the cerebellar region, corticospinal tract and association fibre WM tracts in both children with HIV infection and children who are HIV-exposed uninfected. In qualitative imaging studies, WM hyperintensities were the most frequently reported brain abnormality in children with CMV infection and children with HSV infection.
    CONCLUSIONS: There was evidence that WM imaging techniques can play a role as diagnostic and evaluation tools assessing the impact of congenital infections and perinatal viral exposures on the developing brain. The high sensitivity for identifying WM hyperintensities suggests structural brain MRI is a useful neurodiagnostic modality in assessing children with congenital CMV infection, while the DTI changes associated with HIV suggest metrics such as fractional anisotropy have the potential to be specific markers of subtle impairment or WM damage in neuroHIV.
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  • 文章类型: Systematic Review
    目的:扩散张量成像(DTI)和死后研究的证据表明,双相情感障碍(BD)患者存在白质(WM)缺陷。也观察到外周血生物标志物的变化;然而,评估大脑改变与外围之间潜在关系的研究很少。本系统综述的目的是研究BD中血液生物标志物与WM之间的关系。
    方法:PubMed,Embase,和PsycINFO用于进行文献检索。包括报告原始数据的横断面或纵向研究,这些数据调查了BD中基于血液的生物标志物和WM(通过神经影像学)。
    结果:在检索到的3,750项研究中,包括23个。发现几类生物标志物与BD中的WM具有显著关系。这些包括细胞因子和生长因子(白细胞介素-8[IL-8],肿瘤坏死因子α[TNF-a],和胰岛素样生长因子结合蛋白3[IGFBP-3]),先天免疫系统(自然杀伤细胞[NK]),代谢标志物(脂质过氧化物酶,胆固醇,甘油三酯),犬尿氨酸(Kyn)途径(5-羟基吲哚乙酸,犬尿酸[Kyna]),和各种基因多态性(血清素-转运蛋白连接的启动子区)。
    结论:本系统综述显示,基于血液的生物标志物与BD中观察到的WM缺陷标志物相关。鼓励研究这些特异性生物标志物的潜在临床效用的纵向研究。
    OBJECTIVE: Evidence from diffusion tensor imaging (DTI) and postmortem studies has demonstrated white-matter (WM) deficits in bipolar disorder (BD). Changes in peripheral blood biomarkers have also been observed; however, studies evaluating the potential relationship between brain alterations and the periphery are scarce. The objective of this systematic review is to investigate the relationship between blood-based biomarkers and WM in BD.
    METHODS: PubMed, Embase, and PsycINFO were used to conduct literature searches. Cross-sectional or longitudinal studies reporting original data which investigated both a blood-based biomarker and WM (by neuroimaging) in BD were included.
    RESULTS: Of 3,750 studies retrieved, 23 were included. Several classes of biomarkers were found to have a significant relationship with WM in BD. These included cytokines and growth factors (interleukin-8 [IL-8], tumor necrosis factor alpha [TNF-a], and insulin-like growth factor binding protein 3 [IGFBP-3]), innate immune system (natural killer cells [NK]), metabolic markers (lipid hydroperoxidase, cholesterol, triglycerides), the kynurenine (Kyn) pathway (5-hydroxyindoleacetic acid, kynurenic acid [Kyna]), and various gene polymorphisms (serotonin-transporter-linked promoter region).
    CONCLUSIONS: This systematic review revealed that blood-based biomarkers are associated with markers of WM deficits observed in BD. Longitudinal studies investigating the potential clinical utility of these specific biomarkers are encouraged.
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  • 文章类型: Journal Article
    量化为白质高强度(WMH)的白质损伤可能会加重认知和运动障碍,但是WMH负担是否以及如何影响帕金森病(PD)中的这些问题尚不完全清楚。这项研究旨在通过系统评价和荟萃分析来研究WMH与PD认知和运动表现之间的关系。我们比较了认知谱中的WMH负担(认知正常,轻度认知障碍,痴呆)在PD中,包括对照。将PD中的运动体征与低/负和高/正WMH负荷进行比较。我们比较了有和没有转换为MCI或痴呆的PD的基线WMH负担。使用MEDLINE和EMBASE数据库进行文献检索,结果包括50项数据提取研究。与没有PD的个体(即对照)相比,在PD的个体中发现WMH负担增加,并且在PD的认知谱中(即PD,PD-MCI、PDD)。具有高/阳性WMH负担的PD个体的全球认知更差,执行功能,和注意。同样,与WMH负荷低/负的个体相比,WMH高/阳性的PD表现出更差的运动体征。从我们的搜索中只检索到三项纵向研究,他们显示PD转化为MCI或痴呆症,基线时WMH负荷没有显著升高,尽管随访期间未提供WMH负荷变化的数据.我们得出结论,基于横断面研究,WMH负担似乎随着PD认知和运动状态的恶化而增加。
    White matter damage quantified as white matter hyperintensities (WMH) may aggravate cognitive and motor impairments, but whether and how WMH burden impacts these problems in Parkinson\'s disease (PD) is not fully understood. This study aimed to examine the association between WMH and cognitive and motor performance in PD through a systematic review and meta-analysis. We compared the WMH burden across the cognitive spectrum (cognitively normal, mild cognitive impairment, dementia) in PD including controls. Motor signs were compared in PD with low/negative and high/positive WMH burden. We compared baseline WMH burden of PD who did and did not convert to MCI or dementia. MEDLINE and EMBASE databases were used to conduct the literature search resulting in 50 studies included for data extraction. Increased WMH burden was found in individuals with PD compared with individuals without PD (i.e. control) and across the cognitive spectrum in PD (i.e. PD, PD-MCI, PDD). Individuals with PD with high/positive WMH burden had worse global cognition, executive function, and attention. Similarly, PD with high/positive WMH presented worse motor signs compared with individuals presenting low/negative WMH burden. Only three longitudinal studies were retrieved from our search and they showed that PD who converted to MCI or dementia, did not have significantly higher WMH burden at baseline, although no data was provided on WMH burden changes during the follow up. We conclude, based on cross-sectional studies, that WMH burden appears to increase with PD worse cognitive and motor status in PD.
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  • 文章类型: Systematic Review
    背景:多发性硬化(MS)是一种慢性神经退行性疾病,会影响中枢神经系统(CNS)并导致进行性临床残疾和认知功能下降。目前,没有特定的影像学参数可用于预测MS患者的纵向残疾.磁共振成像(MRI)已将影像学异常与MS的临床和认知障碍联系起来。在这项研究中,我们旨在评估MRI在预测残疾方面的有效性,临床进展,和MS的认知能力下降
    方法:在本研究中,根据PRISMA指南,我们全面搜索了科学网,PubMed,和Embase数据库,以识别在复发释放和渐进形式的MS中采用常规MRI的相关文章。经过严格的筛选,选择符合预定纳入标准的研究进行数据提取,并评估潜在偏倚来源.
    结果:从数据库搜索中检索到总共3028条记录。经过严格的筛选,53条记录符合标准并纳入本研究。中枢神经系统结构如白质的损伤和改变,灰质,call体,丘脑,和脊髓,可用于预测残疾进展。与MS进展相关的几个预后因素,包括皮质病变的存在,灰质体积的变化,全脑萎缩,call体指数,丘脑体积的改变,脊髓横截面积的病变或改变。对于MS患者的认知障碍,可靠的预测因子包括皮质灰质体积,脑萎缩,病变特征(T2-病变负荷,temporal,额叶,和小脑病变),白质病变体积,丘脑体积,和call体密度。
    结论:这项研究表明,MRI可用于预测认知功能下降,残疾进展,随着时间的推移,MS患者的疾病进展。
    BACKGROUND: Multiple Sclerosis (MS) is a chronic neurodegenerative disorder that affects the central nervous system (CNS) and results in progressive clinical disability and cognitive decline. Currently, there are no specific imaging parameters available for the prediction of longitudinal disability in MS patients. Magnetic resonance imaging (MRI) has linked imaging anomalies to clinical and cognitive deficits in MS. In this study, we aimed to evaluate the effectiveness of MRI in predicting disability, clinical progression, and cognitive decline in MS.
    METHODS: In this study, according to PRISMA guidelines, we comprehensively searched the Web of Science, PubMed, and Embase databases to identify pertinent articles that employed conventional MRI in the context of Relapsing-Remitting and progressive forms of MS. Following a rigorous screening process, studies that met the predefined inclusion criteria were selected for data extraction and evaluated for potential sources of bias.
    RESULTS: A total of 3028 records were retrieved from database searching. After a rigorous screening, 53 records met the criteria and were included in this study. Lesions and alterations in CNS structures like white matter, gray matter, corpus callosum, thalamus, and spinal cord, may be used to anticipate disability progression. Several prognostic factors associated with the progression of MS, including presence of cortical lesions, changes in gray matter volume, whole brain atrophy, the corpus callosum index, alterations in thalamic volume, and lesions or alterations in cross-sectional area of the spinal cord. For cognitive impairment in MS patients, reliable predictors include cortical gray matter volume, brain atrophy, lesion characteristics (T2-lesion load, temporal, frontal, and cerebellar lesions), white matter lesion volume, thalamic volume, and corpus callosum density.
    CONCLUSIONS: This study indicates that MRI can be used to predict the cognitive decline, disability progression, and disease progression in MS patients over time.
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  • 文章类型: Meta-Analysis
    N-乙酰天冬氨酸(NAA)是神经元完整性和代谢的标志物。神经元可塑性和代谢低下与重度抑郁症(MDD)病理生理学有关。为了测试大脑NAA浓度是否在MDD过程中逐渐降低,我们对质子磁共振波谱(1H-MRS)研究进行了预注册的荟萃分析,比较了慢性MDD(n=1308)和首发抑郁症(n=242)患者的NAA浓度与健康对照(HC,n=1242)。使用每个大脑区域的随机效应模型对62项研究进行了荟萃分析。与额叶内的HC相比,慢性MDD中的NAA浓度显着降低(Hedges\'g=-0.330;p=0.018),枕叶(Hedges\'g=-0.677;p=0.007),丘脑(对冲=-0.673;p=0.016),额叶(Hedges\'g=-0.471;p=0.034)和脑室周围白质(Hedges\'g=-0.478;p=0.047)。我们强调了有关首发抑郁症患者NAA水平的知识差距。敏感性分析表明,抗抑郁治疗可以逆转额叶的NAA改变。我们强调了体素灰质的场强和校正,作为NAA水平检测的调节剂。未来的研究应评估NAA改变在疾病的早期阶段及其纵向进展。
    N-acetyl aspartate (NAA) is a marker of neuronal integrity and metabolism. Deficiency in neuronal plasticity and hypometabolism are implicated in Major Depressive Disorder (MDD) pathophysiology. To test if cerebral NAA concentrations decrease progressively over the MDD course, we conducted a pre-registered meta-analysis of Proton Magnetic Resonance Spectroscopy (1H-MRS) studies comparing NAA concentrations in chronic MDD (n = 1308) and first episode of depression (n = 242) patients to healthy controls (HC, n = 1242). Sixty-two studies were meta-analyzed using a random-effect model for each brain region. NAA concentrations were significantly reduced in chronic MDD compared to HC within the frontal lobe (Hedges\' g = -0.330; p = 0.018), the occipital lobe (Hedges\' g = -0.677; p = 0.007), thalamus (Hedges\' g = -0.673; p = 0.016), and frontal (Hedges\' g = -0.471; p = 0.034) and periventricular white matter (Hedges\' g = -0.478; p = 0.047). We highlighted a gap of knowledge regarding NAA levels in first episode of depression patients. Sensitivity analyses indicated that antidepressant treatment may reverse NAA alterations in the frontal lobe. We highlighted field strength and correction for voxel grey matter as moderators of NAA levels detection. Future studies should assess NAA alterations in the early stages of the illness and their longitudinal progression.
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