Cognition and motion dysfunction-associated brain functional network disruption in diabetic peripheral neuropathy.

Neuroimaging studies have demonstrated extensive brain functional alterations in cognitive and motor functional areas in Type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN), suggesting potential alterations in large-scale brain networks related to DPN and associated cognition and motor dysfunction. In this study, using resting-state functional connectivity (FC) and graph theory computational approaches, we investigated the topological disruptions of brain functional networks in 28 DPN, 43 T2DM without DPN (NDPN), and 32 healthy controls (HCs) and examined the correlations between altered network topological metrics and cognitive/motor function parameters in T2DM. For global topology, NDPN exhibited a significantly decreased shortest path length compared with HCs, suggesting increased efficient global integration. For regional topology, DPN and NDPN had separated topological reorganization of functional hubs compared with HCs. In addition, DPN showed significantly decreased nodal efficiency (Enodal ), mainly in the bilateral superior occipital gyrus (SOG), right cuneus, middle temporal gyrus (MTG), and left inferior parietal gyrus (IPL), compared with NDPN, whereas NDPN showed significantly increased Enodal compared with HCs. Intriguingly, in T2DM patients, the Enodal of the right SOG was significantly negatively correlated with Toronto Clinical Scoring System scores, while the Enodal of the right postcentral gyrus (PoCG) and MTG were significantly positively correlated with Montreal Cognitive Assessment scores. Conclusively, DPN and NDPN patients had segregated disruptions in the brain functional network, which were related to cognition and motion dysfunctions. Our findings provide a theoretical basis for understanding the neurophysiological mechanism of DPN and its effective prevention and treatment in T2DM.

Advancing cerebral small vessel disease diagnosis: Integrating quantitative susceptibility mapping with MRI-based radiomics.

Cerebral small vessel disease (CSVD) is a neurodegenerative disease with hidden symptoms and difficult to diagnose. The diagnosis mainly depends on clinical symptoms and neuroimaging. Therefore, we explored the potential of combining clinical detection with MRI-based radiomics features for the diagnosis of CSVD in a large cohort. A total of 118 CSVD patients and 127 healthy controls underwent quantitative susceptibility mapping and 3D-T1 scans, and all completed multiple cognitive tests. Lasso regression was used to select features, and the radiomics model was constructed based on the regression coefficients of these features. Clinical cognitive and motor tests were added to the model to construct a hybrid model. All models were cross-validated to analyze the generalization ability of the models. The AUCs of the radiomics and hybrid models in the internal test set were 0.80 and 0.87, respectively. In the validation set, the AUCs were 0.77 and 0.79, respectively. The hybrid model demonstrated higher decision efficiency. The Trail Making Test, which enhances the diagnostic performance of the model, is associated with multiple brain regions, particularly the right cortical nuclei and the right fimbria. The hybrid model based on radiomics features and cognitive tests can achieve quantitative diagnosis of CSVD and improve the diagnostic efficiency. Furthermore, the reduced processing capacity due to atrophy of the right cortical nucleus and right fimbria suggests the importance of these regions in improving the diagnostic accuracy of the model.

Ultrafast Quasi-Solid-State Microwave Construction of Spongy Cobalt-Molybdenum Phosphide for Hydrogen Production Over Wide pH Range.

The developed strategies for synthesizing metal phosphides are usually cumbersome and pollute the environment. In this work, an ultrafast (30 s) quasi-solid-state microwave approach is developed to construct cobalt-molybdenum phosphide decorated with Ru (Ru/CoxP-MoP) featured porous morphology with interconnected channels. The specific nanostructure favors mass transport, such as electrolyte bubbles transfer and exposing rich active sites. Moreover, the coupling effects between metallic elements, especially the decorated Ru, also act as a pivotal role on enhancing the electrocatalytic performance. Benefiting from the effects of composition and specific nanostructure, the prepared Ru/CoxP-MoP exhibits efficient HER performance with a current density of 10 mA cm-2 achieved in 1 m KOH, 0.5 m H2SO4, seawater containing 1 m KOH and 1 m PBS, with overpotentials of 52, 59, 55, 90 mV, and coupling with good stability. This work opens a novel and fast avenue to design metal-phosphide-based nanomaterials in energy-conversion and storage fields.

Failure to achieve reduction on developmental dysplasia of hip: an ultrasound evaluation.

BACKGROUND: Ultrasound examination of the medial side of the hip joint has been rarely used to evaluate the status of developmental dysplasia of the hip (DDH) in Pavlik harness treatment according to the literature. PURPOSE: To analyze the effects of cartilaginous acetabulum, hip joint labrum, and acetabular tissue on the reduction of DDH. MATERIAL AND METHODS: A total of 50 cases (100 hips) were detected by the Graf method with a high-frequency linear transducer (L 5-12), and there were 59 dislocated hips and 41 non-dislocated hips. Patients were treated with a Pavlik harness. Ultrasound examination of the medial side of the hip joint was performed for follow-up. The hip joints were divided into three groups: the non-dislocated group; the reducible group; and the non-reducible group. RESULTS: The success rate of reduction was significantly higher when the acetabulum cartilage was located on the cephalic side (chi-square = 28.12, P < 0.001). The success rate was also significantly higher when the hip joint labrum was located on the cephalic side (chi-square = 17.21, P < 0.001). Type III and D had a higher success rate of reduction than type IV (P < 0.001). The pairwise comparison of the measurements of acetabular tissue between the non-dislocated group, the reducible group, and the non-reducible group showed statistical differences (P < 0.001). CONCLUSION: The present study confirmed that the location of acetabulum cartilage and hip joint labrum affected the outcome of treatment. The degree of dislocation and the amount of acetabular tissue were correlated with the success rate of treatment.

Disrupted topological organization of resting-state functional brain networks in cerebral small vessel disease.

We aimed to investigate alterations in functional brain networks and assess the relationship between functional impairment and topological network changes in cerebral small vessel disease (CSVD) patients with and without cerebral microbleeds (CMBs). We constructed individual whole-brain, region of interest (ROI) level functional connectivity (FC) networks for 24 CSVD patients with CMBs (CSVD-c), 42 CSVD patients without CMBs (CSVD-n), and 36 healthy controls (HCs). Then, we used graph theory analysis to investigate the global and nodal topological disruptions between groups and relate network topological alterations to clinical parameters. We found that both the CSVD and control groups showed efficient small-world organization in FC networks. However, compared to CSVD-n patients and controls, CSVD-c patients exhibited a significantly decreased clustering coefficient, global efficiency, and local efficiency and an increased shortest path length, indicating a disrupted balance between local specialization and global integration in FC networks. Although both the CSVD and control groups showed highly similar hub distributions, the CSVD-c group exhibited significantly altered nodal betweenness centrality (BC), mainly distributed in the default mode network (DMN), attention, and visual functional areas. There were almost no global or regional alterations between CSVD-n patients and controls. Furthermore, the altered nodal BC of the right anterior/posterior cingulate gyrus and left cuneus were significantly correlated with cognitive parameters in CSVD patients. These results suggest that CSVD patients with and without CMBs had segregated disruptions in the topological organization of the intrinsic functional brain network. This study advances our current understanding of the pathophysiological mechanisms underlying CSVD.

Cerebral Microbleeds Are Associated With Increased Brain Iron and Cognitive Impairment in Patients With Cerebral Small Vessel Disease: A Quantitative Susceptibility Mapping Study.

BACKGROUND: Cerebral microbleeds (CMBs) have been recognized to play an important role in cognitive impairment of cerebral small vessel disease (CSVD) patients. However, the mechanism of this effect is still unclear. PURPOSE: Comparing the susceptibility values in the selected subcortical gray matter structures of CSVD patients without CMBs (CSVD-N) and with CMBs (CSVD-C) as well as healthy controls (HCs). STUDY TYPE: Prospective. SUBJECTS: Sixty-nine CSVD patients and 28 HCs were included; 24 CSVD patients (34.78%) had CMBs and 45 CSVD patients (65.22%) had no CMBs. FIELD STRENGTH/SEQUENCE: All subjects were imaged on a 3.0 T MR scanner. The protocol consisted of a three-dimensional (3D) T1-weighted sequence and a 3D multi-echo gradient echo (mGRE) sequence. Brain QSM maps were computed from mGRE data using the morphology-enabled dipole inversion with automatic uniform cerebrospinal fluid zero reference algorithm (MEDI+0). ASSESSMENT: The mean susceptibility value within each region of interest was recorded. All participants underwent the cognitive assessment. Brain iron deposition burden of CMB lesions of every CSVD-C patient was computed. STATISTICAL TESTS: One-way analysis of variance test followed by Tukey's honest significance test and Kruskal-Wallis test were used with significance level of 0.05. Stepwise multivariate linear analysis was used to explore the factors influencing cognitive scores. RESULTS: Montreal cognitive assessment (MoCA), trail-making test (TMT)-A and TMT-B scores in the three groups were significantly different (all P < 0.05). Stepwise multivariate linear regression analysis revealed that the factors influenced MoCA scores were having CMBs (P < 0.05), white matter hyperintensities (P < 0.05), lacunes (P < 0.05) in brain, and the brain iron deposition burden of CMB lesions (P < 0.05) and for TMT scores (TMT-A + TMT-B), the influencing factors were age (P < 0.05), education years (P < 0.05), and the brain iron deposition burden of CMB lesions (P < 0.05). DATA CONCLUSION: The higher iron deposition burden of CMB lesions in brain may be an imaging quantitative marker of cognitive decline in patients with CSVD-C. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 2.

Oxygen extraction fraction (OEF) assesses cerebral oxygen metabolism of deep gray matter in patients with pre-eclampsia.

OBJECTIVES: The objective of this study was to compare oxygen extraction fraction (OEF) values in the deep gray matter (GM) of pre-eclampsia (PE) patients, pregnant healthy controls (PHCs), and non-pregnant healthy controls (NPHCs) to explore their brain oxygen metabolism differences in GM. METHODS: Forty-seven PE patients, forty NPHCs, and twenty-one PHCs were included. Brain OEF values were computed from quantitative susceptibility mapping (QSM) plus quantitative blood oxygen level-dependent magnitude (QSM + qBOLD = QQ)-based mapping. One-way ANOVA was used to compare mean OEF values in the three groups. The area under the curve of the mean OEF value in each region of interest was estimated using a receiver operating characteristic curve analysis. RESULTS: We found that the mean OEF values in the thalamus, putamen, caudate nucleus, pallidum, and substantia nigra were significantly different in these three groups (F = 5.867, p = 0.004; F = 5.142, p = 0007; F = 6.158, p = 0.003; F = 6.319, p = 0.003; F = 5.491, p = 0.005). The mean OEF values for these 5 regions were higher in PE patients than in NPHCs and in PHCs (p < 0.05). The AUC of these ROIs ranged from 0.673 to 0.692 (p < 0.01) and cutoff values varied from 35.1 to 36.6%, indicating that the OEF values could discriminate patients with and without PE. Stepwise multivariate analysis revealed that the OEF values correlated with hematocrit in pregnant women (r = 0.353, p = 0.003). CONCLUSION: OEF values in the brains of pregnant women can be measured in clinical practice using QQ-based OEF mapping for noninvasive assessment of hypertensive disorders. KEY POINTS: • Pre-eclampsia is a hypertensive disorder associated with abnormalities in brain oxygen extraction. • Oxygen extraction fraction (OEF) is an indicator of brain tissue viability and function. QQ-based mapping of OEF is a new MRI technique that can noninvasively quantify brain oxygen metabolism. • OEF values in the brains of pregnant women can be measured for noninvasive assessment of hypertensive disorders in clinical practice.

Special AT-rich Sequence Binding-Protein 1 (SATB1) Correlates with Immune Infiltration in Breast, Head and Neck, and Prostate Cancer.

BACKGROUND SATB1 is essential in gene regulation and associates with T cell development. Aberrant SATB1 expression has been reported in various neoplasms. However, correlations between SATB1 and tumor immune infiltration and prognosis in malignancies still remains unclear. MATERIAL AND METHODS We used Oncomine and the Tumor Immune Estimation Resource database to explore the expression of SATB1 in cancers. In addition, Kaplan-Meier plotter, PrognoScan, and Gene Expression Profiling Interactive Analysis were also used to assess the effects of SATB1 on clinical prognosis. Furthermore, correlations between cancer immune infiltration and SATB1 were analyzed via Tumor Immune Estimation Resource. RESULTS The results demonstrated that SATB1 correlates with prognosis in different types of cancers, such as breast invasive carcinoma (BRAC), head and neck cancer (HNSC), and prostate adenocarcinoma (PRAD). Decreased expression of SATB1 was associated with poor overall and progression-free survival of BRAC patients with positive estrogen receptor (ER) as well as mutated TP53. In addition, B cells, CD8+ T cells, CD4+ T cells, macrophages, neutrophils, and dendritic cells infiltration in BRAC, HNSC, and PRAD were also correlated with SATB1 expression level. Moreover, we found strong correlations between SATB1 and various immune markers for BRAC, HNSC, and PRAD. CONCLUSIONS In BRAC, HNSC, and PRAD patients, SATB1 has potential to serve as a prognostic indicator for predicting tumor immune infiltration and prognosis.

Bainbridge-ropers syndrome caused by loss-of-function variants in ASXL3: Clinical abnormalities, medical imaging features, and gene variation in infancy of case report.

BACKGROUND: Bainbridge-Ropers syndrome (BRPS) is a recently described developmental disorder caused by de novo truncating mutations in the Additional sex combs-like 3 (ASXL3) gene. Only four cases have been reported in China and are limited to the analysis of its clinical abnormalities, medical imaging features and gene variation. The aim of this study was to investigate the clinical phenotype, imaging manifestations and genetic characteristics of BPRS syndrome caused by ASXL3 gene mutation. Clinical data, medical imaging data and gene test results of BRPS in infant patients were retrospectively analyzed, and related literature was summarized. CASE PRESENTATION: At the age of 8 months, brain MRI showed that the subarachnoid space of the forehead was widened, part of the sulci was deepened, and the corpus callosum was thin. The development quotient (DQ) was determined using the 0~6-year-old pediatric examination table of neuropsychological development at 6 months and 8 months. The DQ of both tests was less than 69. Whole-exome sequencing revealed a heterozygous frameshift mutation c.3493_3494deTG in exon 12 of the ASXL3 gene, resulting in the amino acid change p. (Cys1165Ter). No variation was present at this site in her parents. Sanger sequencing of family members validated this analysis, suggesting a de novo mutation. The de novo ASXL3 mutations generated stop codons and were predicted, in silico, to generate a truncated ASXL3. CONCLUSIONS: The main clinical features of the patient included psychomotor development retardation, difficulty in feeding, hypotonia, and special facial features. MRI features showed that brain development lagged behind that of normal children. Genetic testing is helpful in the early diagnosis of BRPS.

Ambient air pollution and emergency department visits for asthma in Erie County, New York 2007-2012.

PURPOSE: 8% of the US population has asthma. Air pollution is linked to exacerbation in susceptible individuals. The objective was to identify air pollutants that increased the risk of asthma emergency department visits during a time wherein a polluting factory was criminally convicted, changing local air pollutant levels. METHODS: An ecological time-series design used a daily count of asthma emergency visits from 2007 to 2012 as the dependent variable. Independent variables air pollutants (NO2, PM2.5 CO, and O3), controlling for meteorological conditions, were analyzed using time-series and Poisson GLM models. RESULTS: 76,651 emergency asthma visits were included with an average of 35 visits per day (SD = 9.2, range 11-80) in a stationary time series. Increased visit volume in fall and spring had no associations to the air pollutants. Associations between individual air pollutants occurred in otherwise low-volume months for asthma emergency visits. The strongest relationship was an 11.6% increase in the asthma emergency visit rate during the month of June. In monthly groupings that removed most of the autumn and spring months, O3, PM2.5, CO, and NO2 were associated with 5, 4, 2, and 2% increases in asthma emergency visits, respectively. CO was the only pollutant with a negative association with asthma emergency visits, occurring in the month of April. CONCLUSIONS: Pollutants NO2, PM2.5 CO, and O3 were associated with increased emergency asthma visits in some, but not all months of the year. Air pollution's impact on asthma emergencies may be masked by other, more influential seasonal triggers, such as infections or allergies.

The consistency between measurements of the femoral neck anteversion angle in DDH on three-dimensional CT and MRI.

BACKGROUND: Three-dimensional computed tomography (3D CT) has been regarded by some investigators as the gold standard for measurements of the femoral neck anteversion angle (FNA) in developmental dysplasia of the hip (DDH), although a simple and reliable imaging method using a non-ionizing technique is needed. PURPOSE: To determine the consistency between measurements of the FNA in DDH using 3D CT and magnetic resonance imaging (MRI) and to estimate the precision, reliability, and reproducibility of MRI for the measurement of the FNA and assess whether MRI could replace 3D CT. MATERIAL AND METHODS: 3D CT and MRI were used to measure the FNA in 22 patients, including 18 girls and four boys, with a mean age of 3 years (age range, 1-7 years). All of the measurements were performed independently by two radiologists at different times. This exercise was repeated 2 weeks later by one of the radiologists. RESULTS: High consistency was found between the MRI and 3D CT measurements (intraclass correlation coefficient [ICC] of 0.906, P < 0.05). The mean inter-observer and intra-observer agreements were high for MRI (ICC = 0.948 and 0.964, respectively, P < 0.05 for both) and for 3D CT (ICC = 0.942 and 0.966, respectively, P < 0.05 for both). CONCLUSION: Compared with 3D CT, MRI provided a precise, reliable and reproducible method of measuring the FNA in DDH. MRI is recommended as an appropriate technique for measurement of the FNA in DDH, and this approach could replace 3D CT because it delivers no ionizing radiation and offers a better display of soft tissue pathological changes.

Asymmetry of cerebral blood flow measured with three-dimensional pseudocontinuous arterial spin-labeling mr imaging in temporal lobe epilepsy with and without mesial temporal sclerosis.

BACKGROUND: To investigate the asymmetry of quantitative cerebral blood flow (CBF) values in interictal temporal lobe epilepsy (TLE) patients with (TLE-MTS) and without (TLE-no) mesial temporal sclerosis. METHODS: Twenty-six TLE patients (14 TLE-MTS/12 TLE-no) and 22 controls were studied with a three-dimensional whole-brain pseudocontinuous arterial spin-labeling technique at 3.0 Tesla. Regions of interest were placed at the bilateral hippocampal heads, amygdalas and temporal lobes to get the average regional cerebral blood flow (rCBF) and calculate asymmetry indices (AIs). Statistical parametric mapping detected the whole-brain CBF changes of the two subgroups (right-sided). RESULTS: AIs of the hippocampus and amygdala in TLE-MTS and AIs of hippocampus in TLE-no were significantly different versus controls (P < 0.001, P = 0.001, and P = 0.013). The lateralizing sensitivity increased to 96.154% by combining structural MRI and AIs of rCBF with optimal cutoff values. Hypoperfusion regions in the right TLE-MTS mainly clustered in the bilateral temporal lobes, frontal lobes, insular lobes, and left caudate nucleus. The right TLE-no showed hypoperfusion in the bilateral temporal lobes, frontal lobes, right insular lobe, parietal lobe, occipital lobe, and caudate nucleus. CONCLUSION: Asymmetry of CBF in the TLE-MTS and TLE-no is different and improves MRI performance in lateralizing the TLE.

Characterizing the contrast of white matter and grey matter in high-resolution phase difference enhanced imaging of human brain at 3.0 T.

OBJECTIVES: The purpose of this study was to address the feasibility of characterizing the contrast both between and within grey matter and white matter using the phase difference enhanced (PADRE) technique. METHODS: PADRE imaging was performed in 33 healthy volunteers. Vessel enhancement (VE), tissue enhancement (TE), and PADRE images were reconstructed from source images and were evaluated with regard to differentiation of grey-to-white matter interface, the stria of Gennari, and the two layers, internal sagittal stratum (ISS) and external sagittal stratum (ESS), of optic radiation. RESULTS: White matter regions showed decreased signal intensity compared to grey matter regions. Discrimination was sharper between white matter and cortical grey matter in TE images than in PADRE images, but was poorly displayed in VE images. The stria of Gennari was observed on all three image sets. Low-signal-intensity bands displayed in VE images representing the optic radiation were delineated as two layers of different signal intensities in TE and PADRE images. Statistically significant differences in phase shifts were found between frontal grey and white matter, as well as between ISS and ESS (p < 0.01). CONCLUSIONS: The PADRE technique is capable of identifying grey-to-white matter interface, the stria of Gennari, and ISS and ESS, with improved contrast in PADRE and TE images compared to VE images. KEY POINTS: • Phase difference enhanced (PADRE) imaging can yield diverse contrasts between tissues • The PADRE technique utilizes the inherent variety of magnetic susceptibilities • PADRE MR imaging provides better visualization of certain cerebral anatomy in vivo • PADRE imaging is able to delineate the stria of Gennari in the primary visual cortex • PADRE imaging is able to identify the two optic radiation layers.

Reference ranges for atlantodental interval in adults and its variation with age and gender in a large series of subjects on multidetector computed tomography.

BACKGROUND: The atlanto-dental interval measurement in the cervical spine in young adults has been reported on multidetector computed tomography (MDCT), but has not been systematically assessed in all ages. PURPOSE: To evaluate the reference ranges for the atlanto-dental interval (ADI) in a large sample of adult patients on MDCT and to analyze the relationships of these measurements with gender and age of the patients as well as inter-observer performance. MATERIAL AND METHODS: First, a consecutive series of 700 Chinese patients aged over 18 years undergoing an upper cervical MDCT scan were divided equally into seven age groups. Second, the mid-sagittal image of the atlanto-dental joint was chosen for measurement and ADI was defined as the distance intercepted from the segment line linking the center of anterior atlas tubercle with that of posterior tubercle. Third, the correlation of ADI with age and gender was analyzed using linear regression analysis. Finally, the inter-observer performance was assessed using Bland and Altman's limits of agreement. RESULTS: The ADI was 1.77 ± 0.39 mm, 1.61 ± 0.37 mm, 1.58 ± 0.36 mm, 1.41 ± 0.29 mm, 1.31 ± 0.29 mm, 1.34 ± 0.28 mm, and 1.06 ± 0.47 mm in the age groups 18-24 years, 25-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, and older than 70 years, respectively. The range of ADI was 0.85-3.12 mm in the age group 18-39 years, 0.71-2.55 mm in the age group 40-59 years, and 0.00-2.37 mm in the age group older than 60 years. There was no difference between gender and ADI (r = 0.00, P = 1.000). ADI decreased linearly with age (r = -0.511, P = 0.000). The inter-observer performance was reliable. CONCLUSION: ADI measurements on MDCT linearly decrease with increasing age, and these are not affected by gender in adult patients. Different reference values might be used at different ages when diagnosing atlantoaxial anterior dislocation or subluxation.

Deep-gray nuclei susceptibility-weighted imaging filtered phase shift in patients with Wilson's disease.

BACKGROUND: Susceptibility-weighted imaging (SWI) is a useful tool for evaluating brain paramagnetic mineralization. The aim of this study was to evaluate SWI filtered phase shift in brain gray nuclei of Wilson's disease (WD). METHODS: Twenty-three WD patients and 23 age- and gender-matched healthy controls underwent SWI. Phase values of bilateral brain gray nuclei were measured on corrected phase image of all subjects. RESULTS: Compared with healthy controls, WD patients showed a trend of negative phase shift in all regions of interest, and significantly lower phase value was found in bilateral putamen (PU) (left P = 0.009, right P = 0.001), caudate (left P = 0.001, right P = 0.001), thalamus (TH) (left P < 0.001, right P < 0.001), red nucleus (left P = 0.031, right P = 0.049), and substantia nigra (left P = 0.003, right P = 0.047). The WD patients groups were divided into neurological, hepatic, and asymptomatic onset subgroups. And neurological onset patients had lower phase value than hepatic onset patients on bilateral PU (left P = 0.025, right P = 0.002) and TH (left P = 0.025, right P = 0.025). CONCLUSION: Abnormal negative phase value was significantly increased in brain gray nuclei of WD patients, giving evidence in vivo about paramagnetic mineralization accumulating in brain gray nuclei. The phase shift of SWI could be used as a potential biomarker to help in diagnosing and evaluating WD.

The prevalence of osteoarthritis of the atlanto-odontoid joint in adults using multidetector computed tomography.

BACKGROUND: The prevalence of osteoarthritis of the atlanto-odontoid joint has been reported by radiology, autopsy, and conventional computed tomography (CT), but the prevalence has not yet been assessed by multidetector computed tomography (MDCT). PURPOSE: To reveal the prevalence of osteoarthritis of the atlanto-odontoid joint and to analyze the inter-relationships among gender, age, and osteoarthritis with MDCT in adults. MATERIAL AND METHODS: First, a series of 700 selected domestic patients aged >18 years undergoing an upper cervical MDCT scan were divided equally into seven age groups. Second, using the postprocessing technique of multiplanar reconstruction, osteoarthritis of the atlanto-odontoid joint was viewed from any direction and classified into four grades, which were normal, mild, moderate, and severe. Lastly, the incidence of the different grades of osteoarthritis was assessed, and the reproducibility was tested. RESULTS: There was no significant difference between gender and osteoarthritis of atlanto-odontoid joint (P > 0.05). The rate of osteoarthritis was 16% in the age group 18-25 years, 23% in the age group 25-30 years, 33% in the age group 30-40 years, 54% in the age group 40-50 years, 70% in the age group 50-60 years, 87% in the age group 60-70 years, and 93% in the age group >70 years. Mild osteoarthritis appeared at the earliest at age 19.6 years, moderate osteoarthritis in at earliest at age 24.2 years, and severe osteoarthritis at the earliest at age 48.5 years. The inter-observer reliability was excellent (k = 0.86). CONCLUSION: Osteoarthritis of the atlanto-odontoid joint could be detected by MDCT in a young adult. It increased rapidly with increasing age on MDCT.

Decreased Local Specialization of Brain Structural Networks Associated with Cognitive Dysfuntion Revealed by Probabilistic Diffusion Tractography for Different Cerebral Small Vessel Disease Burdens.

To reveal the network-level structural disruptions associated with cognitive dysfunctions in different cerebral small vessel disease (CSVD) burdens, we used probabilistic diffusion tractography and graph theory to investigate the brain network topology in 67 patients with a severe CSVD burden (CSVD-s), 133 patients with a mild CSVD burden (CSVD-m) and 89 healthy controls. We used one-way analysis of covariance to assess the altered topological measures between groups, and then evaluated their Pearson correlation with cognitive parameters. Both the CSVD and control groups showed efficient small-world organization in white matter (WM) networks. However, compared with CSVD-m patients and controls, CSVD-s patients exhibited significantly decreased local efficiency, with partially reorganized hub distributions. For regional topology, CSVD-s patients showed significantly decreased nodal efficiency in the bilateral anterior cingulate gyrus, caudate nucleus, right opercular inferior frontal gyrus (IFGoperc), supplementary motor area (SMA), insula and left orbital superior frontal gyrus and angular gyrus. Intriguingly, global/local efficiency and nodal efficiency of the bilateral caudate nucleus, right IFGoperc, SMA and left angular gyrus showed significant correlations with cognitive parameters in the CSVD-s group, while only the left pallidum showed significant correlations with cognitive metrics in the CSVD-m group. In conclusion, the decreased local specialization of brain structural networks in patients with different CSVD burdens provides novel insights into understanding the brain structural alterations in relation to CSVD severity. Cognitive correlations with brain structural network efficiency suggest their potential use as neuroimaging biomarkers to assess the severity of CSVD.

Amygdala and cognitive impairment in cerebral small vessel disease: structural, functional, and metabolic changes.

Cerebral small vessel disease (CSVD) is a prevalent vascular disorder that has been consistently associated with vascular cognitive impairment (VCI). The diagnosis of CSVD continues to rely on magnetic resonance imaging (MRI). Epidemiological data indicate that the characteristic MRI features of CSVD, including white matter hyperintensity (WMH) and lacunar infarction, are very common among individuals over 40 years of age in community studies. This prevalence poses a significant burden on many low- and middle-income families. The amygdala plays a crucial role in integrating sensory and associative information to regulate emotional cognition. Although many previous studies have linked alterations in the amygdala to various diseases, such as depression, there has been little research on CSVD-associated alterations in the amygdala due to the complexity of CSVD. In this paper, we summarize the various imaging features of CSVD and discuss the correlation between amygdala changes and VCI. We also explore how new neuroimaging methods can assess amygdala changes early, laying a foundation for future comprehensive exploration of the pathogenesis of CSVD.

Aberrant brain structural-functional connectivity coupling associated with cognitive dysfunction in different cerebral small vessel disease burdens.

AIMS: Emerging evidence suggests that cerebral small vessel disease (CSVD) pathology changes brain structural connectivity (SC) and functional connectivity (FC) networks. Although network-level SC and FC are closely coupled in the healthy population, how SC-FC coupling correlates with neurocognitive outcomes in patients with different CSVD burdens remains largely unknown. METHODS: Using multimodal MRI, we reconstructed whole-brain SC and FC networks for 54 patients with severe CSVD burden (CSVD-s), 106 patients with mild CSVD burden (CSVD-m), and 79 healthy controls. We then investigated the aberrant SC-FC coupling and functional network topology in CSVD and their correlations with cognitive dysfunction. RESULTS: Compared with controls, the CSVD-m patients showed no significant change in any SC-FC coupling, but the CSVD-s patients exhibited significantly decreased whole-brain (p = 0.014), auditory/motor (p = 0.033), and limbic modular (p = 0.011) SC-FC coupling. For functional network topology, despite no change in global efficiency, CSVD-s patients exhibited significantly reduced nodal efficiency of the bilateral amygdala (p = 0.024 and 0.035) and heschl gyrus (p = 0.001 and 0.005). Notably, for the CSVD-s patients, whole-brain SC-FC coupling showed a significantly positive correlation with MoCA (r = 0.327, p = 0.020) and SDMT (r = 0.373, p = 0.008) scores, limbic/subcortical modular SC-FC coupling showed a negative correlation (r = -0.316, p = 0.025) with SCWT score, and global/local efficiency (r = 0.367, p = 0.009 and r = 0.353, p = 0.012) showed a positive correlation with AVLT score. For the CSVD-m group, whole-brain and auditory/motor modular SC-FC couplings showed significantly positive correlations with SCWT (r = 0.217, p = 0.028 and r = 0.219, p = 0.027) and TMT (r = 0.324, p = 0.001 and r = 0.245, p = 0.013) scores, and global/local efficiency showed positive correlations with AVLT (r = 0.230, p = 0.020 and r = 0.248, p = 0.012) and SDMT (r = 0.263, p = 0.008 and r = 0.263, p = 0.007) scores. CONCLUSION: Our findings demonstrated that decreased whole-brain and module-dependent SC-FC coupling associated with reduced functional efficiency might underlie more severe burden and worse cognitive decline in CSVD. SC-FC coupling might serve as a more sensitive neuroimaging biomarker of CSVD burden and provided new insights into the pathophysiologic mechanisms of clinical development of CSVD.

Ultrasound characteristics of extravaginal testicular torsion at different stages of disease progression.

Background: Extravaginal testicular torsion has profound clinical implications in neonates, but its ultrasound characteristics may vary at different disease stages. The purpose of this study was to identify the ultrasound characteristics of neonatal extravaginal testicular torsion and their diagnostic value at different disease stages. Methods: A retrospective analysis of the clinical and ultrasound examination data of 20 infants aged 1-75 days with surgically and pathologically confirmed unilateral extravaginal testicular torsion (10 right, 10 left) was conducted. The infants were divided into three stages based on the ultrasound characteristics: double-ring effusion, calcification of the tunica vaginalis, and testicular atrophy. Results: In the double-ring effusion stage, the affected testicles were enlarged with axial abnormalities, with the parenchymal testicular blood flow signal significantly reduced or absent. Twisted paratesticular masses and a "double-ring effusion sign" were visible. In the tunica vaginalis calcification stage, the affected testicles were slightly smaller, with axial abnormalities, absent blood flow signals in the testicular parenchyma, and strong echogenicity of the tunica vaginalis. In the testicular atrophy stage, the affected testicles were markedly smaller, with enhanced echogenicity in the tunica vaginalis and parenchyma, and absent blood flow signal in the testicular parenchyma. The volumes of the affected testicles gradually decreased from the stage of double-ring effusion to that of tunica vaginalis calcification, and then to testicular atrophy (P<0.05). Conclusions: Neonatal extravaginal testicular torsion at different disease stages has distinct ultrasound features, and color doppler ultrasound plays an important role in the diagnosis and treatment of extravaginal testicular torsion.