White Matter

白质
  • 文章类型: Journal Article
    作为阿尔茨海默氏症的潜在临床前阶段,主观认知功能下降(SCD)显示未来认知功能下降和转化为痴呆的风险更高.然而,目前尚不清楚SCD状态是否会增加淀粉样蛋白沉积背景下老年人的临床进展,脑血管疾病(CeVD),和精神症状。我们确定了99个正常对照(NC),15名SCD个体在未来2年内发展为轻度认知障碍(P-SCD),和ADNI数据库中54名SCD患者(S-SCD)的基线和2年随访数据。总白质高强度(WMH),深部(DWMH)和脑室周围(PWMH)区域的WMH,各组之间比较了逐体素灰质体积。此外,使用结构方程建模方法,我们构建了路径模型来纵向探索SCD相关的大脑变化,并确定基线SCD状态,年龄,抑郁症状影响参与者的临床结局。两组均显示较高的基线淀粉样蛋白PETSUVR,基线PWMH卷,与NC相比,PWMH体积随时间的增加更大。相比之下,与NC相比,仅P-SCD具有较高的基线DWMH体积和随时间增加较大的DWMH体积.在NC中没有观察到灰质体积和淀粉样蛋白的纵向差异,S-SCD,P-SCD我们的路径模型表明,SCD状态有助于未来的WMH进展。Further,基线SCD状态会增加未来认知能力下降的风险,由PWMH介导;基线抑郁症状直接影响临床结局。总之,S-SCD和P-SCD均表现出比NC更严重的CeVD。在P-SCD中CeVD负荷增加更为明显。与抑郁症状与痴呆严重程度进展的直接关联相反,SCD状态对未来认知功能减退的影响可能通过CeVD病理表现出来.我们的工作强调了多模态纵向设计在理解SCD轨迹异质性方面的重要性,为临床前阶段的分层和早期干预铺平了道路。实践要点:与NC相比,S-SCD和P-SCD在基线时表现出更严重的CeVD和更大的CeVD负荷增加,而P-SCD的负担更为明显。基线SCD状态增加了未来PWMH和DWMH体积累积的风险,由基线PWMH和DWMH体积介导,分别。基线SCD状态会增加未来认知能力下降的风险,由基线PWMH介导,而基线抑郁状态直接影响临床结局。
    As a potential preclinical stage of Alzheimer\'s dementia, subjective cognitive decline (SCD) reveals a higher risk of future cognitive decline and conversion to dementia. However, it has not been clear whether SCD status increases the clinical progression of older adults in the context of amyloid deposition, cerebrovascular disease (CeVD), and psychiatric symptoms. We identified 99 normal controls (NC), 15 SCD individuals who developed mild cognitive impairment in the next 2 years (P-SCD), and 54 SCD individuals who did not (S-SCD) from ADNI database with both baseline and 2-year follow-up data. Total white matter hyperintensity (WMH), WMH in deep (DWMH) and periventricular (PWMH) regions, and voxel-wise grey matter volumes were compared among groups. Furthermore, using structural equation modelling method, we constructed path models to explore SCD-related brain changes longitudinally and to determine whether baseline SCD status, age, and depressive symptoms affect participants\' clinical outcomes. Both SCD groups showed higher baseline amyloid PET SUVR, baseline PWMH volumes, and larger increase of PWMH volumes over time than NC. In contrast, only P-SCD had higher baseline DWMH volumes and larger increase of DWMH volumes over time than NC. No longitudinal differences in grey matter volume and amyloid was observed among NC, S-SCD, and P-SCD. Our path models demonstrated that SCD status contributed to future WMH progression. Further, baseline SCD status increases the risk of future cognitive decline, mediated by PWMH; baseline depressive symptoms directly contribute to clinical outcomes. In conclusion, both S-SCD and P-SCD exhibited more severe CeVD than NC. The CeVD burden increase was more pronounced in P-SCD. In contrast with the direct association of depressive symptoms with dementia severity progression, the effects of SCD status on future cognitive decline may manifest via CeVD pathologies. Our work highlights the importance of multi-modal longitudinal designs in understanding the SCD trajectory heterogeneity, paving the way for stratification and early intervention in the preclinical stage. PRACTITIONER POINTS: Both S-SCD and P-SCD exhibited more severe CeVD at baseline and a larger increase of CeVD burden compared to NC, while the burden was more pronounced in P-SCD. Baseline SCD status increases the risk of future PWMH and DWMH volume accumulation, mediated by baseline PWMH and DWMH volumes, respectively. Baseline SCD status increases the risk of future cognitive decline, mediated by baseline PWMH, while baseline depression status directly contributes to clinical outcome.
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  • 文章类型: Journal Article
    活跃的年轻拳击手与运动相关的脑震荡(SRC)的神经系统作用和潜在的病理生理机制仍然知之甚少。本研究旨在通过利用神经突取向弥散和密度成像(NODDI)对持续SRC的年轻拳击手进行神经突定向弥散和密度成像(NODDI),研究白质微观结构的损害,并评估SRC后淋巴功能的变化。总共招募了60名年轻参与者,包括30名被诊断患有SRC的拳击手和30名定期锻炼的健康个体。使用扩散指标对全脑白质损伤进行评估,而通过沿血管周围间隙(DTI-ALPS)指数的扩散张量成像(DTI)分析来评估淋巴功能。采用双样本t检验检验DTI和NODDI指标的组间差异。采用Spearman相关性和广义线性混合模型来研究SRC和NODDI测量的临床评估之间的关系。在SRC的年轻拳击手中,DTI和NODDI指标发生了显着变化。此外,SRC组的DTI-ALPS指数明显高于对照组(左侧:1.58vs.1.48,PFDR=0.009;右侧:1.61vs.1.51,PFDR=0.02)。此外,观察到DTI-ALPS指数与本研究人群中拳击手认知测试结果较差相关.活跃的年轻拳击手的重复SRC与弥漫性白质损伤和淋巴功能障碍有关,强调对大脑健康的有害影响。这些发现强调了长期监测拳击手神经健康的重要性。
    The neurological effects and underlying pathophysiological mechanisms of sports-related concussion (SRC) in active young boxers remain poorly understood. This study aims to investigate the impairment of white matter microstructure and assess changes in glymphatic function following SRC by utilizing neurite orientation dispersion and density imaging (NODDI) on young boxers who have sustained SRC. A total of 60 young participants were recruited, including 30 boxers diagnosed with SRC and 30 healthy individuals engaging in regular exercise. The assessment of whole-brain white matter damage was conducted using diffusion metrics, while the evaluation of glymphatic function was performed through diffusion tensor imaging (DTI) analysis along the perivascular space (DTI-ALPS) index. A two-sample t-test was utilized to examine group differences in DTI and NODDI metrics. Spearman correlation and generalized linear mixed models were employed to investigate the relationship between clinical assessments of SRC and NODDI measurements. Significant alterations were observed in DTI and NODDI metrics among young boxers with SRC. Additionally, the DTI-ALPS index in the SRC group exhibited a significantly higher value than that of the control group (left side: 1.58 vs. 1.48, PFDR = 0.009; right side: 1.61 vs. 1.51, PFDR = 0.02). Moreover, it was observed that the DTI-ALPS index correlated with poorer cognitive test results among boxers in this study population. Repetitive SRC in active young boxers is associated with diffuse white matter injury and glymphatic dysfunction, highlighting the detrimental impact on brain health. These findings highlight the importance of long-term monitoring of the neurological health of boxers.
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  • 文章类型: Journal Article
    心室复极延长与心血管疾病有关。我们试图研究老年人心室复极延长与轻度认知障碍(MCI)的关系以及潜在的潜在神经病理机制。这项横断面研究纳入了4328名无痴呆参与者(年龄≥65岁;56.8%为女性),他们接受了中国农村地区延缓痴呆和残疾的多领域干预措施的基线检查;其中,989进行了结构性脑磁共振成像(MRI)扫描。QT,QTc,JT,JTc,QRS间期来自12导联心电图。MCI,遗忘型MCI(aMCI),根据Petersen的标准定义非遗忘型MCI(naMCI)。灰质体积(GM),白质,脑脊液,总白质高强度(WMH),脑室周围WMH(PWMH),和深度WMH(DWMH)自动估计。使用逻辑和一般线性回归模型分析数据。延长QT,QTc,JT,和JTc间期与MCI和aMCI的可能性增加显着相关,但与naMCI无关(p<0.05)。在MRI子样本中,QT,QTc,JT,和JTc间隔与较大的WMH和PWMH总体积显着相关(p<0.05),但不是DWMH卷。检测到统计相互作用,因此,仅在有冠心病或无APOEε4等位基因的参与者中,QT和JT间期延长与GM体积减少显着相关(p<0.05)。在一般老年人群中,心室复极延长与MCI和脑微血管病变相关。这是在QT间期延长的老年人中进行认知评估和脑MRI检查的重要性的基础。
    Prolonged ventricular repolarization has been associated with cardiovascular disease. We sought to investigate the association of prolonged ventricular repolarization with mild cognitive impairment (MCI) and the potential underlying neuropathological mechanisms in older adults. This cross-sectional study included 4328 dementia-free participants (age ≥ 65 years; 56.8% female) in the baseline examination of the Multidomain INterventions to delay dementia and Disability in rural China; of these, 989 undertook structural brain magnetic resonance imaging (MRI) scans. QT, QTc, JT, JTc, and QRS intervals were derived from 12-lead electrocardiograph. MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) were defined following the Petersen\'s criteria. Volumes of gray matter (GM), white matter, cerebrospinal fluid, total white matter hyperintensities (WMH), periventricular WMH (PWMH), and deep WMH (DWMH) were automatically estimated. Data were analyzed using logistic and general linear regression models. Prolonged QT, QTc, JT, and JTc intervals were significantly associated with an increased likelihood of MCI and aMCI, but not naMCI (p < 0.05). In the MRI subsample, QT, QTc, JT, and JTc intervals were significantly associated with larger total WMH and PWMH volumes (p < 0.05), but not with DWMH volume. Statistical interactions were detected, such that prolonged QT and JT intervals were significantly associated with reduced GM volume only among participants with coronary heart disease or without APOE ε4 allele (p < 0.05). Prolonged ventricular repolarization is associated with MCI and cerebral microvascular lesions in a general population of older adults. This underlies the importance of cognitive assessments and brain MRI examination among older adults with prolonged QT interval.
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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
    目的:研究环境测量与脑容量及其潜在介质之间的关联。
    方法:这是一项前瞻性研究。
    方法:我们的分析包括来自英国生物银行的基线(2006年至2010年)的34,454名参与者(53.4%的女性),年龄在40-73岁之间。在2014年至2019年之间使用磁共振成像测量脑体积。
    结果:在基线评估8.8年后,与基线缓冲1000m处的绿色空间的更接近度与更大的大脑总量相关(覆盖率每增加10%,标准化β(95%CI):0.013(0.005,0.020)),灰质(0.013(0.006,0.020)),和协变量和空气污染调整后的白质(0.011(0.004,0.017))。在1000m处缓冲的自然环境的相应数字为0.010(0.004,0.017),0.009(0.004,0.015),和0.010(0.004,0.016),分别。对于缓冲在300m处的绿色空间和自然环境观察到类似的结果。缓冲在1000m处的绿色空间与总脑体积之间的关联的最强介质是吸烟(总方差的百分比(95%CI):7.9%(5.5-11.4%)),其次是平均球形细胞体积(3.3%(1.8-5.8%))。维生素D(2.9%(1.6-5.1%)),和血肌酐(2.7%(1.6-4.7%))。显着的介质组合解释了与总脑体积相关的18.5%(13.2-25.3%)和与灰质体积相关的32.9%(95%CI:22.3-45.7%)。由显著介质组合解释的自然环境与总脑容量之间的关联百分比(95%CI)为20.6%(14.7-28.1%)。
    结论:更高的绿色空间和环境覆盖率可能通过促进健康的生活方式和改善包括维生素D和红细胞指数在内的生物标志物来有益于大脑健康。
    OBJECTIVE: To examine the associaiton between environmental measures and brain volumes and its potential mediators.
    METHODS: This was a prospective study.
    METHODS: Our analysis included 34,454 participants (53.4% females) aged 40-73 years at baseline (between 2006 and 2010) from the UK Biobank. Brain volumes were measured using magnetic resonance imaging between 2014 and 2019.
    RESULTS: Greater proximity to greenspace buffered at 1000 m at baseline was associated with larger volumes of total brain measured 8.8 years after baseline assessment (standardized β (95% CI) for each 10% increment in coverage: 0.013(0.005,0.020)), grey matter (0.013(0.006,0.020)), and white matter (0.011(0.004,0.017)) after adjustment for covariates and air pollution. The corresponding numbers for natural environment buffered at 1000 m were 0.010 (0.004,0.017), 0.009 (0.004,0.015), and 0.010 (0.004,0.016), respectively. Similar results were observed for greenspace and natural environment buffered at 300 m. The strongest mediator for the association between greenspace buffered at 1000 m and total brain volume was smoking (percentage (95% CI) of total variance explained: 7.9% (5.5-11.4%)) followed by mean sphered cell volume (3.3% (1.8-5.8%)), vitamin D (2.9% (1.6-5.1%)), and creatinine in blood (2.7% (1.6-4.7%)). Significant mediators combined explained 18.5% (13.2-25.3%) of the association with total brain volume and 32.9% (95% CI: 22.3-45.7%) of the association with grey matter volume. The percentage (95% CI) of the association between natural environment and total brain volume explained by significant mediators combined was 20.6% (14.7-28.1%)).
    CONCLUSIONS: Higher coverage percentage of greenspace and environment may benefit brain health by promoting healthy lifestyle and improving biomarkers including vitamin D and red blood cell indices.
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  • 文章类型: Journal Article
    目的:确定主观认知下降(SCD)的个体在结构网络中是否具有全脑网络特征和脑内节点特征的变化,以及有无载脂蛋白E4(APOEε4)的SCD之间是否存在差异。
    方法:这项横断面研究包括36名无APOEε4的无SCD个体(健康对照,HC组),21名患有APOEε4的SCD患者(APOEε4+组),33例SCD无APOEε4(APOEε4组)。使用基于分数各向异性(FA)的确定性纤维跟踪方法构建白质结构网络。采用图论分析三组的全脑网络特征和脑内节点特征。
    结果:关于全脑网络特征,这三个群体在他们的结构网络中都表现出了小世界性。APOEε4+和APOEε4-组的聚类系数(Cp)和局部效率(Eloc)均显著低于HC组(p<0.05),但APOEε4+和APOEε4-组之间的Cp或Eloc没有显着差异。关于脑内结节特征,在一些大脑区域有显著差异,主要是默认模式网络(DMN),枕叶,颞叶,和皮质下区域。APOEeε4+组和APOEeε4-组的脑内结节特征变化不同。
    结论:患有SCD的个体表现出全脑网络特征和结构网络中脑内节点特征的变化。此外,APOEε4+和APOEε4-个体之间存在差异。
    OBJECTIVE: To determine whether individuals with subjective cognitive decline (SCD) have changes in whole-brain network characteristics and intracerebral node characteristics in the structural network, and whether there is a difference between SCD with and without Apolipoprotein E4 (APOEε4).
    METHODS: This cross-sectional study included 36 individuals without SCD without APOEε4 (healthy control, HC group), 21 individuals with SCD with APOEε4 (APOEε4+ group), and 33 individuals with SCD without APOEε4 (APOEε4- group). The white matter structural network was constructed using the fractional anisotropy (FA) based deterministic fiber tracking method. Graph theory was used to analyze the whole-brain network characteristics and intracerebral node characteristics of the three groups.
    RESULTS: Regarding the whole-brain network characteristics, all three groups exhibited small-worldness in their structural networks. The clustering coefficient (Cp) and local efficiency (Eloc) in the APOEε4+ and APOEε4- groups were significantly lower than in the HC group (p < 0.05), but no significant difference in Cp or Eloc was observed between the APOEε4+ and APOEε4- groups. Regarding intracerebral node characteristics, there were significant differences in some brain regions, mainly the default mode network (DMN), the occipital lobe, the temporal lobe, and subcortical regions. The change in intracerebral node characteristics was different between the APOEε4+ group and the APOEε4- group.
    CONCLUSIONS: Individuals with SCD demonstrate changes in whole-brain network characteristics and intracerebral node characteristics in the structural network. Moreover, differences exist between APOEε4+ and APOEε4- individuals.
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  • 文章类型: Journal Article
    感觉神经性听力损失(SNHL)可由多种先天性和获得性因素引起。及早发现是培养语言的关键,语言,和SNHL儿童的认知发展。在我们的研究中,我们利用合成磁共振成像(SyMRI)评估SNHL患儿脑内灰质和白质的改变.
    该研究涵盖了被诊断为SNHL的儿童和听力正常的对照组儿童{1.5个月大(n=52)和3个月大(n=78)}。参与者根据他们的听觉脑干反应(ABR)阈值进行分类,划分为正常的,温和,中度,和严重的亚组。包括临床参数并评估与SNHL的相关性。使用SyMRI扫描对大脑形态进行定量分析,产生大脑分割和弛豫时间的数据。通过单变量和多变量分析,确定了预测SNHL的独立因素。使用受试者工作特征(ROC)曲线评估预测模型的有效性,通过使用列线图来促进可视化。重要的是要注意,由于我们研究的限制,我们的样本量相对较小。
    新生儿高胆红素血症(NH)和内耳畸形(IEM)患儿在1.5和3个月组均与SNHL发病相关。在3个月组,中度和重度亚组在下丘(IC)表现出升高的定量T1值,外侧板面(LL),与正常组相比,小脑中梗(MCP)。此外,WMV,WMF,MYF,和MYV相对于正常组显著降低。此外,患有IEM的SNHL儿童在IC中具有较高的T1值,以及LL和降低的WMV,WMF,在3个月组中,与无IEM的SNHL儿童相比,MYV和MYF值。LL-T1和WMF是SNHL的独立危险因素。因此,设计了基于LL-T1和WMF的预测模型。训练集的ROC,验证集和外部集分别为0.865,0.806和0.736.
    T1定量值和脑容量分割的整合为跟踪受SNHL影响的儿童的脑发育和评估病情的严重程度提供了一个有价值的工具。
    UNASSIGNED: Sensorineural hearing loss (SNHL) can arise from a diverse range of congenital and acquired factors. Detecting it early is pivotal for nurturing speech, language, and cognitive development in children with SNHL. In our study, we utilized synthetic magnetic resonance imaging (SyMRI) to assess alterations in both gray and white matter within the brains of children affected by SNHL.
    UNASSIGNED: The study encompassed both children diagnosed with SNHL and a control group of children with normal hearing {1.5-month-olds (n = 52) and 3-month-olds (n = 78)}. Participants were categorized based on their auditory brainstem response (ABR) threshold, delineated into normal, mild, moderate, and severe subgroups.Clinical parameters were included and assessed the correlation with SNHL. Quantitative analysis of brain morphology was conducted using SyMRI scans, yielding data on brain segmentation and relaxation time.Through both univariate and multivariate analyses, independent factors predictive of SNHL were identified. The efficacy of the prediction model was evaluated using receiver operating characteristic (ROC) curves, with visualization facilitated through the utilization of a nomogram. It\'s important to note that due to the constraints of our research, we worked with a relatively small sample size.
    UNASSIGNED: Neonatal hyperbilirubinemia (NH) and children with inner ear malformation (IEM) were associated with the onset of SNHL both at 1.5 and 3-month groups. At 3-month group, the moderate and severe subgroups exhibited elevated quantitative T1 values in the inferior colliculus (IC), lateral lemniscus (LL), and middle cerebellar peduncle (MCP) compared to the normal group. Additionally, WMV, WMF, MYF, and MYV were significantly reduced relative to the normal group. Additionally, SNHL-children with IEM had high T1 values in IC, and LL and reduced WMV, WMF, MYV and MYF values as compared with SNHL-children without IEM at 3-month group. LL-T1 and WMF were independent risk factors associated with SNHL. Consequently, a prediction model was devised based on LL-T1 and WMF. ROC for training set, validation set and external set were 0.865, 0.806, and 0.736, respectively.
    UNASSIGNED: The integration of T1 quantitative values and brain volume segmentation offers a valuable tool for tracking brain development in children affected by SNHL and assessing the progression of the condition\'s severity.
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  • 文章类型: Journal Article
    淋巴功能障碍与认知能力下降有关,较高的脉络丛体积(CPV)与较慢的淋巴清除速率有关。然而,CPV之间的相互作用,淋巴功能,并且尚未对白质高信号(WMHs)中的认知障碍进行研究。在这项研究中,我们进行了神经心理学评估,T1加权三维(3D-T1)图像,在206名WMHs受试者和43名健康对照(HCs)的队列中进行扩散张量成像(DTI),以进一步探讨两者之间的关系。沿血管周围间隙的DTI分析(DTI-ALPS)指数,作为类淋巴功能的量度,是基于DTI计算的。重度WMHs在信息处理速度(IPS)方面的表现明显差于其他三组,以及在执行功能上比HCs和轻度WMHs。此外,重度WMHs比HCs和轻度WMHs表现出更低的DTI-ALPS指数和更高的CPV。中度WMHs的CPV高于HC和轻度WMHs。迷你精神状态检查,IPS,在WMHs患者中,执行功能与CPV呈负相关,而与DTI-ALPS指数呈正相关。淋巴功能部分介导CPV和IPS之间的关联,表明WMHs相关认知障碍的潜在机制。CPV可以作为有价值的预后标志物和作为WMHs相关认知障碍的有希望的治疗靶标的淋巴系统。
    Glymphatic dysfunction has been correlated with cognitive decline, with a higher choroid plexus volume (CPV) being linked to a slower glymphatic clearance rate. Nevertheless, the interplay between CPV, glymphatic function, and cognitive impairment in white matter hyperintensities (WMHs) has not yet been investigated. In this study, we performed neuropsychological assessment, T1-weighted three-dimensional (3D-T1) images, and diffusion tensor imaging (DTI) in a cohort of 206 WMHs subjects and 43 healthy controls (HCs) to further explore the relationship. The DTI analysis along the perivascular space (DTI-ALPS) index, as a measure of glymphatic function, was calculated based on DTI. Severe WMHs performed significantly worse in information processing speed (IPS) than other three groups, as well as in executive function than HCs and mild WMHs. Additionally, severe WMHs demonstrated lower DTI-ALPS index and higher CPV than HCs and mild WMHs. Moderate WMHs displayed higher CPV than HCs and mild WMHs. Mini-Mental State Examination, IPS, and executive function correlated negatively with CPV but positively with DTI-ALPS index in WMHs patients. Glymphatic function partially mediated the association between CPV and IPS, indicating a potential mechanism for WMHs-related cognitive impairment. CPV may act as a valuable prognostic marker and glymphatic system as a promising therapeutic target for WMHs-related cognitive impairment.
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  • 文章类型: Journal Article
    背景:血清尿酸(SUA)水平变化与大脑健康之间的关系在很大程度上是未知的。这项研究旨在检查SUA水平的长期变异性与神经影像学指标和认知功能的关系。
    方法:这项研究从多中心招募了1111名25-83岁的参与者,基于社区的队列研究。从2006年到2018年,每两年测量一次SUA浓度。我们测量了个体内SUA变异性,通过计算斜率值,包括变化的方向和幅度。SUA变异性与神经影像学标记物(脑宏观结构体积,微观结构完整性,白质高强度,以及脑小血管病的存在)和认知功能使用广义线性模型进行检查。进行中介分析以评估神经影像学标志物是否介导SUA变异与认知功能之间的关系。
    结果:与稳定组相比,SUA水平升高或降低的受试者均表现为脑白质体积较小(β=-0.25,95%置信区间[CI]-0.39~-0.11,β=-0.15,95%CI-0.29~-0.02).SUA逐渐增加的参与者表现出广泛破坏的微观结构完整性,具有较低的全球分数各向异性(β=-0.24,95%CI-0.38至-0.10),较高的平均扩散率(β=0.16,95%CI0.04至0.28)和径向扩散率(β=0.19,95%CI0.06至0.31)。SUA升高也与认知下降相关(β=-0.18,95%CI-0.32至-0.04)。白质萎缩和脑微结构完整性受损介导SUA增加对认知下降的影响。
    结论:SUA变化的幅度而不是方向对大脑健康起着至关重要的负面影响,特别是对于高尿酸血症的参与者。较小的脑白质体积和受损的微结构完整性介导了SUA水平升高和认知功能下降之间的关系。SUA水平的长期稳定性被推荐用于维持大脑健康和防止认知衰退。
    BACKGROUND: The relationship between variation in serum uric acid (SUA) levels and brain health is largely unknown. This study aimed to examine the associations of long-term variability in SUA levels with neuroimaging metrics and cognitive function.
    METHODS: This study recruited 1111 participants aged 25-83 years from a multicenter, community-based cohort study. The SUA concentrations were measured every two years from 2006 to 2018. We measured the intraindividual SUA variability, including the direction and magnitude of change by calculating the slope value. The associations of SUA variability with neuroimaging markers (brain macrostructural volume, microstructural integrity, white matter hyperintensity, and the presence of cerebral small vessel disease) and cognitive function were examined using generalized linear models. Mediation analyses were performed to assess whether neuroimaging markers mediate the relationship between SUA variation and cognitive function.
    RESULTS: Compared with the stable group, subjects with increased or decreased SUA levels were all featured by smaller brain white matter volume (beta =  - 0.25, 95% confidence interval [CI] - 0.39 to - 0.11 and beta =  - 0.15, 95% CI - 0.29 to - 0.02). Participants with progressively increased SUA exhibited widespread disrupted microstructural integrity, featured by lower global fractional anisotropy (beta =  - 0.24, 95% CI - 0.38 to - 0.10), higher mean diffusivity (beta = 0.16, 95% CI 0.04 to 0.28) and radial diffusivity (beta = 0.19, 95% CI 0.06 to 0.31). Elevated SUA was also associated with cognitive decline (beta =  - 0.18, 95% CI - 0.32 to - 0.04). White matter atrophy and impaired brain microstructural integrity mediated the impact of SUA increase on cognitive decline.
    CONCLUSIONS: It is the magnitude of SUA variation rather than the direction that plays a critical negative role in brain health, especially for participants with hyperuricemia. Smaller brain white matter volume and impaired microstructural integrity mediate the relationship between increased SUA level and cognitive function decline. Long-term stability of SUA level is recommended for maintaining brain health and preventing cognitive decline.
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  • 文章类型: Journal Article
    背景:已在强迫症(OCD)的皮质-纹状体-丘脑-皮质(CSTC)回路中发现了灰质(GM)的结构和功能异常。GM的结构和功能可能受到白质(WM)的结构和功能的影响。因此,探讨强迫症中WM的特点至关重要。
    方法:收集52例OCD患者和39例健康对照者(HC)的弥散张量成像和静息态功能磁共振成像数据。基于区域的空间统计,低频波动幅度(ALFF),利用结构-功能耦合方法探索WM的结构和功能。此外,使用Pearson相关性研究OCD的WM结构和功能异常与临床症状之间的关系。使用支持向量机评估是否可以通过改变的WM结构和功能来识别OCD患者。
    结果:与HC相比,包括上电晕辐射在内的四个团簇的较低的分数各向异性(FA)值,前日冕辐射,右上纵束,call体,左后日冕辐射,穹窿,和内囊的右前肢,左前丘脑辐射(ATR)中ALFF/FA放射减少,在OCD中观察到CSTC回路中左ATR和左背外侧前额叶皮层之间的功能连通性降低。左侧ATR中ALFF/FA的下降与强迫症的耶鲁-布朗强迫症量表强迫性思维得分和汉密尔顿焦虑量表得分呈负相关。此外,结合异常WM结构和功能的特征在以适当的精度(0.80)区分OCD与HC方面表现最好,灵敏度(0.82),以及特异性(0.80)。
    结论:目前的研究发现强迫症中WM的结构和功能发生了变化。此外,异常的WM结构-功能耦合可能导致OCD静息时CSTC电路内的GM连接异常。
    背景:用多模式磁共振成像(ChiCTR-COC-17013301)研究强迫症的脑网络机制。
    BACKGROUND: Abnormal structure and function of gray matter (GM) have been discovered in the cortico-striatal-thalamic-cortical (CSTC) circuit in obsessive-compulsive disorder (OCD). The GM structure and function may be influenced by the structure and function of the white matter (WM). Therefore, it is crucial to explore the characteristics of WM in OCD.
    METHODS: Diffusion tensor imaging and resting-state functional magnetic resonance imaging data of 52 patients with OCD and 39 healthy controls (HCs) were collected. The tract-based spatial statistics, amplitude of low-frequency fluctuations (ALFF), and structural-functional coupling approaches were utilized to explore the WM structure and function. Furthermore, the relationship between the abnormal WM structure and function and clinical symptoms of OCD was investigated using Pearson\'s correlation. Support vector machine was performed to evaluate whether patients with OCD could be identified with the changed WM structure and function.
    RESULTS: Compared to HCs, the lower fractional anisotropy (FA) values of four clusters including the superior corona radiata, anterior corona radiata, right superior longitudinal fasciculus, corpus callosum, left posterior corona radiata, fornix, and the right anterior limb of internal capsule, reduced ALFF/FA ratio in the left anterior thalamic radiation (ATR), and the decreased functional connectivity between the left ATR and the left dorsal lateral prefrontal cortex within CSTC circuit at rest were observed in OCD. The decreased ALFF/FA ratio in the left ATR negatively correlated with Yale-Brown Obsessive-Compulsive Scale obsessive thinking scores and Hamilton Anxiety Rating Scale scores in OCD. Furthermore, the features that combined the abnormal WM structure and function performed best in distinguishing OCD from HCs with the appropriate accuracy (0.80), sensitivity (0.82), as well as specificity (0.80).
    CONCLUSIONS: Current research discovered changed WM structure and function in OCD. Furthermore, abnormal WM structural-functional coupling may lead to aberrant GM connectivity within the CSTC circuit at rest in OCD.
    BACKGROUND: Study on the mechanism of brain network in obsessive-compulsive disorder with multi-model magnetic resonance imaging (ChiCTR-COC-17013301).
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