Diagnostic accuracy of contrast-enhanced dual-energy computed tomography for detecting metastatic lymph nodes in patients with malignant tumors: a systematic review and meta-analysis.

Background: This meta-analysis evaluated the diagnostic accuracy of contrast-enhanced dual-energy computed tomography (DECT) for detecting metastatic lymph nodes in patients with cancer. Methods: PubMed, Embase and Cochrane Library databases were searched for literature published from database inception until September 2022. Only studies that investigated the diagnostic accuracy of DECT for metastatic lymph nodes in patients with malignant tumors and surgically removed metastatic lymph nodes for pathological confirmation were included. The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool. The threshold effect was determined by calculating Spearman correlation coefficients and summary receiver operating characteristic (SROC) curve patterns. Deeks test was used to assess publication bias. Results: All of the included studies were observational studies. A total of 16 articles involving 984 patients were included (2,577 lymph nodes) in this review. A total of 15 variables were included in the meta-analysis, including 6 individual parameters and 9 combined parameters. Normalized iodine concentration (NIC) in the arterial phase combined with the slope in the arterial phase showed better identification of metastatic lymph nodes. The spearman correlation coefficient was -0.371 (P=0.468), and the SROC curve did not show a "shoulder-arm" shape, suggesting that there was no threshold effect and that heterogeneity was present. The combined sensitivity was 94% [95% confidence interval (CI): 86-98%], the specificity was 74% (95% CI: 52-88%), and the area under the curve was 0.94. The Deeks test suggested no significant publication bias in the included studies (P=0.06). Conclusions: NIC in arterial phase combined with the slope in the arterial phase has some diagnostic value in differentiating between metastatic and benign lymph nodes, but this should be further evaluated in additional studies with rigorous design and high homogeneity.

Cervical Posterior Spinal Artery Syndrome Caused By Spontaneous Vertebral Artery Dissection: Two Case Reports and Literature Review.

Herein, we described 2 patients with posterior spinal artery syndrome (PSAS) caused by vertebral artery dissection. The patients complained of sudden neck pain or walking instability. Neurological examination revealed sensory loss, muscle weakness, and sensory ataxia. Angiography showed double lumen sign or intimal flap in the vertebral artery. T2-weighted imaging and diffusion-weighted imaging of MRI showed a hyperintense lesion in the dorsal side of the cervical spinal cord at different times after onset. Both patients had good outcome after antiplatelet therapy and physiotherapy. A review of previously reported PSAS cases was also conducted in order to improve the understanding and awareness of this rare myelopathy.

Corrigendum: Decreased modulation by the risk level on the brain activation during decision making in adolescents with internet gaming disorder.

[This corrects the article DOI: 10.3389/fnbeh.2015.00296.].

Corrigendum: Altered Structural Correlates of Impulsivity in Adolescents with Internet Gaming Disorder.

[This corrects the article DOI: 10.3389/fnhum.2016.00004.].

microRNA-138 induces cell survival and reduces WNT/ß-catenin signaling of osteoarthritis chondrocytes through NEK2.

Osteoarthritis (OA) is a degenerative joint disease characterized by joint pain, stiffness, and function degeneration with high incidence. Recent studies have been inspired based on the association between microRNAs (miRs) and therapeutic research of OA. Hence, the present study evaluates the effects of miR-138 on chondrocyte proliferation, differentiation, and apoptosis through the WNT/ß-catenin signaling pathway in mice with OA by binding to NIMA-related kinase 2 (NEK2). Appropriate dataset was selected from the Gene Expression Omnibus database, and differentially expressed genes and potential miRNAs that could regulate NEK2 were explored. A mouse model of OA was established. The expressions of miR-138, NEK2, ß-catenin, GSK3ß, Bcl-2, Bcl-2-associated X protein (Bax), p53, MMP-13, Col2, and Aggrecan and the phosphorylation levels of ß-catenin were determined by the reverse transcription quantitative polymerase chain reaction and Western blot analysis. The 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and flow cytometry were employed to detect cell proliferation and apoptosis, respectively. The potential functional role of NEK2 was revealed to be related to the WNT/ß-catenin signaling pathway, and miR-138 was the putative regulator of NEK2. miR-138 expression was downregulated while expressions of NEK2 and ß-catenin as well as the phosphorylation levels of ß-catenin were upregulated in mice with OA. The chondrocytes treated with miR-138 mimic and siRNA-NEK2 exhibited reduced expressions of NEK2, ß-catenin, MMP-13, Bax, and p53 and elevated expressions of Col2, Aggrecan, and Bcl-2 as well as phosphorylation levels of ß-catenin along with enhanced chondrocytes' proliferation and suppressed cell apoptosis. Overexpression of miR-138 induces cell survival and reduces WNT/ß-catenin signaling of OA chondrocytes through NEK2. © 2019 IUBMB Life, 71(9):1355-1366, 2019.

Diffusion tensor imaging of the structural integrity of white matter correlates with impulsivity in adolescents with internet gaming disorder.

INTRODUCTION: Internet gaming disorder (IGD) is usually defined as the inability of an individual to control internet gaming resulting in serious negative consequences, and trait impulsivity has been viewed as a hallmark feature of IGD. Recent studies have suggested that the structural integrity of the white matter (WM) plays an important role in the neuromediation of an individual's impulsivity. However, no study has examined the association between WM integrity and impulsivity in IGD adolescents. METHODS: In this study, 33 adolescents with IGD and 32 healthy controls (HCs) were recruited, and the intergroup differences in the relationships between impulsivity and fractional anisotropy (FA) values across the whole brain WM were investigated using voxel-wise correlation analyses. RESULTS: Our results revealed significant intergroup differences in the correlations between impulsivity and the FA values of the right corticospinal tract (CST) and the right occipital WM. Region of interest-based tests revealed that the FA values of these clusters were positive or insignificantly correlated with impulsivity in the IGD adolescents contrasted to the significantly negative correlation in the HCs. CONCLUSIONS: This altered correlations in the IGD adolescents might reflect potential WM microstructural changes which may be associated with the greater impulsivity of IGD adolescents and provide possible therapeutic targets for interventions in this population.

Compensatory increase of functional connectivity density in adolescents with internet gaming disorder.

Behavioral studies have demonstrated visual attention bias and working memory deficits in individuals with internet gaming disorder (IGD). Neuroimaging studies demonstrated that individuals with IGD presented abnormalities in brain structures and functions including resting-state functional connectivity (rsFC) disturbance. However, most previous studies investigated IGD-related rsFC alterations by using hypothesis-driven methods with priori selection of a region of interest, which cannot provide a full picture of the rsFC changes in IGD individuals. In this study, we recruited 27 male IGD adolescents and 35 demographically matched healthy controls (HCs) to investigate abnormal connective property of each voxel within whole brain of IGD adolescents using resting-state functional connectivity density (rsFCD) method, and further to evaluate the relationship between altered rsFCD and behavioral performances of visual attention and working memory. The results exhibited no significant intergroup difference in behavioral performance (visual working memory and attention). The IGD adolescents exhibited higher global/long-range rsFCD in the bilateral dorsal lateral prefrontal cortex (DLPFC) and the right inferior temporal cortex (ITC)/fusiform compared with the HCs. Although no significant correlation survived after Bonferroni correction, higher global/long-range rsFCD of the bilateral DLPFC was correlated with the Young's internet addiction test (IAT) score and/or behavioral performance in IGD adolescents using an uncorrected threshold of P < 0.05. In conclusion, IGD adolescents demonstrated increased rsFCD in the brain regions involved in working memory, spatial orientation and attention processing, which indicated that increased rsFCD may reflect a compensatory mechanism for maintaining the normal behavioral performance in IGD adolescents compared with the HCs.

Effects of outcome on the covariance between risk level and brain activity in adolescents with internet gaming disorder.

Individuals with internet gaming disorder (IGD) often have impaired risky decision-making abilities, and IGD-related functional changes have been observed during neuroimaging studies of decision-making tasks. However, it is still unclear how feedback (outcomes of decision-making) affects the subsequent risky decision-making in individuals with IGD. In this study, twenty-four adolescents with IGD and 24 healthy controls (HCs) were recruited and underwent functional magnetic resonance imaging while performing the balloon analog risk task (BART) to evaluate the effects of prior outcomes on brain activity during subsequent risky decision-making in adolescents with IGD. The covariance between risk level and activation of the bilateral ventral medial prefrontal cortex, left inferior frontal cortex, right ventral striatum (VS), left hippocampus/parahippocampus, right inferior occipital gyrus/fusiform gyrus and right inferior temporal gyrus demonstrated interaction effects of group by outcome (P < 0.05, AlphaSim correction). The regions with interactive effects were defined as ROI, and ROI-based intergroup comparisons showed that the covariance between risk level and brain activation was significantly greater in adolescents with IGD compared with HCs after a negative outcome occurred (P < 0.05). Our results indicated that negative outcomes affected the covariance between risk level and activation of the brain regions related to value estimation (prefrontal cortex), anticipation of rewards (VS), and emotional-related learning (hippocampus/parahippocampus), which may be one of the underlying neural mechanisms of disadvantageous risky decision-making in adolescents with IGD.

Altered Structural Correlates of Impulsivity in Adolescents with Internet Gaming Disorder.

Recent studies suggested that internet gaming disorder (IGD) was associated with impulsivity and structural abnormalities in brain gray matter (GM). However, no morphometric study has examined the association between GM and impulsivity in IGD individuals. In this study, 25 adolescents with IGD and 27 healthy controls (HCs) were recruited, and the relationship between Barratt impulsiveness scale-11 (BIS) score and gray matter volume (GMV) was investigated with the voxel-based morphometric (VBM) correlation analysis. Then, the intergroup differences in correlation between BIS score and GMV were tested across all GM voxels. Our results showed that the correlations between BIS score and GMV of the right dorsomedial prefrontal cortex (dmPFC), the bilateral insula and the orbitofrontal cortex (OFC), the right amygdala and the left fusiform gyrus decreased in the IGD group compared to the HCs. Region-of-interest (ROI) analysis revealed that GMV in all these clusters showed significant positive correlations with BIS score in the HCs, while no significant correlation was found in the IGD group. Our findings demonstrated that dysfunction of these brain areas involved in the behavior inhibition, attention and emotion regulation might contribute to impulse control problems in IGD adolescents.

Estradiol prevents Aß 25 35-inhibited long-term potentiation induction through enhancing survival of newborn neurons in the dentate gyrus.

AIM AND METHODS: Estradiol (E2) is reported to attenuate ß-amyloid (Aß) accumulation and slow the progression of Alzheimer's disease (AD). This study explored the beneficial effect of E2 in AD using histological examination and electrophysiological recording technique in AD model mice created by intracerebroventricular injection of ß-amyloid 25-35 (Aß 25-35). RESULTS: Infusion of Aß 25-35 reduced the number of newborn neurons in the 2nd week after birth, a critical period for neurite growth, and impaired high-frequency stimulation-dependent long-term potentiation (LTP) induction in perforant path-granular synapses of hippocampal dentate gyrus (DG). Administration of E2 from the 2nd to 4th week after cell birth in Aß 25-35-mice ameliorated the impairment of newborn neurons and LTP induction in DG. Acute application of E2 failed to increase the newborn neurons and rescue LTP induction in the DG of Aß 25-35-mice. CONCLUSIONS: The effect of E2 in Aß 25-35-impaired LTP induction depends on its neuroprotection improvement.

Decreased modulation by the risk level on the brain activation during decision making in adolescents with internet gaming disorder.

Greater impulse and risk-taking and reduced decision-making ability were reported as the main behavioral impairments in individuals with internet gaming disorder (IGD), which has become a serious mental health issue worldwide. However, it is not clear to date how the risk level modulates brain activity during the decision-making process in IGD individuals. In this study, 23 adolescents with IGD and 24 healthy controls (HCs) without IGD were recruited, and the balloon analog risk task (BART) was used in a functional magnetic resonance imaging experiment to evaluate the modulation of the risk level (the probability of balloon explosion) on brain activity during risky decision making in IGD adolescents. Reduced modulation of the risk level on the activation of the right dorsolateral prefrontal cortex (DLPFC) during the active BART was found in IGD group compared to the HCs. In the IGD group, there was a significant negative correlation between the risk-related DLPFC activation during the active BART and the Barratt impulsivity scale (BIS-11) scores, which were significantly higher in IGD group compared with the HCs. Our study demonstrated that, as a critical decision-making-related brain region, the right DLPFC is less sensitive to risk in IGD adolescents compared with the HCs, which may contribute to the higher impulsivity level in IGD adolescents.

Increased iron level in motor cortex of amyotrophic lateral sclerosis patients: an in vivo MR study.

Amyotrophic lateral sclerosis (ALS) is one of the most common neurodegenerative disorders, but no definite mechanism has been defined on the loss of motor neurons in ALS and currently no therapy can block its progression. Many lines of evidence indicate that there is a disorder of iron homeostasis in ALS, and thus we sought to test the iron level in ALS patients by susceptibility weighted imaging (SWI). Sixteen ALS patients and 16 healthy persons underwent brain scans using SWI with a 3T Siemens MR scanner. The red nucleus, substantia nigra, globus pallidus, putamen, the head of caudate nucleus, and motor cortex were measured in the filtered phase images and analysed for their SWI phase values as relative marker for iron content. We found that phase shift values were significantly higher in the motor cortex of ALS patients by SWI, indicating increased iron level in this area. In contrast, we found that there were no differences of phase shift values between ALS patients and healthy controls in the other nuclei including the red nucleus, substantia nigra, globus pallidus, putamen and the head of the caudate nucleus. Furthermore, we found that there were no relationships between SWI signal and some clinical features of ALS. In conclusion, these results demonstrate that iron level increases in the motor cortex of ALS and that SWI is a reliable method to test iron in the brain.

Blood transfusion-related posterior reversible encephalopathy syndrome.

Neurological complications have rarely been described after blood transfusion. Posterior reversible encephalopathy syndrome (PRES) is a recently recognized entity affecting predominantly the posterior cerebral hemispheres. We report two distinctive cases with history of chronic anemia that developed headache, blurred vision and seizure after blood transfusion. Magnetic resonance imaging indicated vasogenic edema consistent with PRES.