Mediation of White Matter Alterations in the Association Between Ventricular Dilation and Cognitive Decline in Hydrocephalus Patients: An MRI Study.

BACKGROUND: Cognitive impairment is commonly observed in hydrocephalus patients. Ventricular enlargement compresses brain parenchyma, especially the white matter (WM). PURPOSE: To investigate whether the relationship between ventricular dilation and cognitive decline in hydrocephalus patients is mediated by WM alterations. STUDY TYPE: Retrospective. POPULATION: 51 communicating hydrocephalus patients (median age, 54 years), 50 obstructive hydrocephalus patients (median age, 49 years), and 53 control subjects (median age, 50 years). FIELD STRENGTH/SEQUENCE: Diffusion tensors imaging, 3D T1 BRAVO, 3D FIESTA, CUBE T2, and FLAIR sequences at 3T. ASSESSMENT: DTI parameters (skeletonized fractional anisotropy (FA), skeletonized mean diffusivity (MD), and peak width of skeletonized mean diffusivity p(PSMD)) were extracted using FSL software. Global, periventricular, and deep white matter hyperintensity (WMH) volumes, degree of ventricular enlargement (Evans index), and other conventional imaging markers (number of lacunes and perivascular spaces, intracranial and brain volume) were extracted using united imaging intelligence. Cognitive tests included Montreal cognitive assessment (MoCA), clock drawing test (CDT), and vocabulary fluency test (VFT). STATISTICAL TESTS: Multivariable linear regression analysis, mediation analyses, and dominance analysis. P-value <0.05 was considered significant. RESULTS: The degree of ventricular dilation, DTI parameters, and cognitive function scores were interrelated. The skeletonized FA values (ß = -0.0917, 95% confidence interval (CI): -0.205, -0.024) and normalized global WMH volume (ß = -0.0635, 95% CI: -0.13, -0.0005) together mediated 37.2% of the association between Evans index and MoCA. A comparable causal pathway was found for periventricular WMHs but not for deep WMHs. Dominance analysis indicated skeletonized FA values had a greater impact on cognition than WMH volume. The skeletonized FA values also mediated the association between Evans index and CDT (ß = -0.0897, 95% CI: -0.165, -0.026) and VFT (ß = -0.1589, 95% CI: -0.27, -0.083). CONCLUSION: WM alterations were causal mediators between ventricular dilation and cognitive decline in hydrocephalus patients. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 3.

A radiomics nomogram based on multiparametric MRI for diagnosing focal cortical dysplasia and initially identifying laterality.

BACKGROUND: Focal cortical dysplasia (FCD) is the most common epileptogenic developmental malformation. The diagnosis of FCD is challenging. We generated a radiomics nomogram based on multiparametric magnetic resonance imaging (MRI) to diagnose FCD and identify laterality early. METHODS: Forty-three patients treated between July 2017 and May 2022 with histopathologically confirmed FCD were retrospectively enrolled. The contralateral unaffected hemispheres were included as the control group. Therefore, 86 ROIs were finally included. Using January 2021 as the time cutoff, those admitted after January 2021 were included in the hold-out set (n = 20). The remaining patients were separated randomly (8:2 ratio) into training (n = 55) and validation (n = 11) sets. All preoperative and postoperative MR images, including T1-weighted (T1w), T2-weighted (T2w), fluid-attenuated inversion recovery (FLAIR), and combined (T1w + T2w + FLAIR) images, were included. The least absolute shrinkage and selection operator (LASSO) was used to select features. Multivariable logistic regression analysis was used to develop the diagnosis model. The performance of the radiomic nomogram was evaluated with an area under the curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration and clinical utility. RESULTS: The model-based radiomics features that were selected from combined sequences (T1w + T2w + FLAIR) had the highest performances in all models and showed better diagnostic performance than inexperienced radiologists in the training (AUCs: 0.847 VS. 0.664, p = 0.008), validation (AUC: 0.857 VS. 0.521, p = 0.155), and hold-out sets (AUCs: 0.828 VS. 0.571, p = 0.080). The positive values of NRI (0.402, 0.607, 0.424) and IDI (0.158, 0.264, 0.264) in the three sets indicated that the diagnostic performance of Model-Combined improved significantly. The radiomics nomogram fit well in calibration curves (p > 0.05), and decision curve analysis further confirmed the clinical usefulness of the nomogram. Additionally, the contrast (the radiomics feature) of the FCD lesions not only played a crucial role in the classifier but also had a significant correlation (r = -0.319, p < 0.05) with the duration of FCD. CONCLUSION: The radiomics nomogram generated by logistic regression model-based multiparametric MRI represents an important advancement in FCD diagnosis and treatment.

Synthetic phase-sensitive inversion-recovery vessel for assessing extramural venous invasion in patients with rectal cancer: imaging quality and added value to T2-wighted imaging.

OBJECTIVES: To evaluate the imaging quality of a synthetic phase-sensitive inversion recovery (SyPSIR) vessel and to add value to T2-weighted imaging (T2WI) for extramural venous invasion (EMVI) detection in patients with rectal cancer. METHODS: Participants in this retrospective study underwent preoperative synthetic MRI between October 2020 and April 2022. SyPSIR image reconstruction was performed with a single inversion time of 10 ms. A junior and a senior radiologist evaluated the imaging quality, including overall imaging quality scores, motion artifact scores, and relative image signal intensity contrast between the tumor and peritumoral vessels (SItumor-vessel), of both T2WI and SyPSIR vessels. Differences in imaging quality between the two methods were assessed using the Wilcoxon signed-rank test and two-sample t-test. EMVI scores were recorded for T2WI and T2WI+SyPSIR vessel. The area under the receiver operating characteristic curve (AUC) was calculated to evaluate the diagnostic performance. RESULTS: A total of 106 patients (35 EMVI+ and 71 EMVI-) were evaluated. There were no statistically significant differences in the overall image quality scores, motion artifacts, or SItumor-vessel (p = 0.08-0.93) between the T2WI and SyPSIR vessels. On combining T2WI and SyPSIR vessels, the AUC for pathological EMVI+ diagnoses increased from 0.65 to 0.88 for the junior radiologist and from 0.86 to 0.96 for the senior radiologist. Furthermore, the sensitivity of the analyses by junior and senior radiologists increased from 0.40 to 0.77 and 0.49 to 0.86, respectively. CONCLUSION: A SyPSIR vessel can provide additional information to improve the diagnostic efficiency of pathological EMVI in rectal cancer, which may be beneficial for individualized clinical treatment. KEY POINTS: • SyPSIR vessel and T2WI had similar imaging quality. • EMVI evaluation in SyPSIR vessel has a high inter-observer agreement. • The SyPSIR vessel has the potential to improve the diagnostic efficiency of EMVI detection in rectal cancer.

Aberrant brain functional and structural developments in MECP2 duplication rats.

Transgenic animal models with homologous etiology provide a promising way to pursue the neurobiological substrates of the behavioral deficits in autism spectrum disorder (ASD). Gain-of-function mutations of MECP2 cause MECP2 duplication syndrome, a severe neurological disorder with core symptoms of ASD. However, abnormal brain developments underlying the autistic-like behavioral deficits of MECP2 duplication syndrome are rarely investigated. To this end, a human MECP2 duplication (MECP2-DP) rat model was created by the bacterial artificial chromosome transgenic method. Functional and structural magnetic resonance imaging (MRI) with high-field were performed on 16 male MECP2-DP rats and 15 male wildtype rats at postnatal 28 days, 42 days, and 56 days old. Multimodal fusion analyses guided by locomotor-relevant metrics and social novelty time separately were applied to identify abnormal brain networks associated with diverse behavioral deficits induced by MECP2 duplication. Aberrant functional developments of a core network primarily composed of the dorsal medial prefrontal cortex (dmPFC) and retrosplenial cortex (RSP) were detected to associate with diverse behavioral phenotypes in MECP2-DP rats. Altered developments of gray matter volume were detected in the hippocampus and thalamus. We conclude that gain-of-function mutations of MECP2 induce aberrant functional activities in the default-mode-like network and aberrant volumetric changes in the brain, resulting in autistic-like behavioral deficits. Our results gain critical insights into the biomarker of MECP2 duplication syndrome and the neurobiological underpinnings of the behavioral deficits in ASD.

Ammonia nitrogen removal from coking wastewater and high quality gypsum recovery by struvite recycling by using calcium hydroxide as decomposer.

This study deals with the highly significant and cost-effective pretreatment of the high concentration of the Total Ammonia Nitrogen (TAN) in coking wastewater to improve the biodegradability. Struvite crystallization is a promising process for TAN removal, but the high operating cost hinders its application. To solve this problem, a novel struvite recycling process was proposed for pre-treating TAN present in the coking wastewater, within which struvite was decomposed in the solid-liquid system using Ca(OH)2 as the decomposer. The results indicates that 91% of ammonium in struvite could be stripped out from the decomposition solution, with Ca(OH)2:NH4+ in the molar ratio of 2:1, temperature at 35 °C and a gas to liquid volume ratio of 3500. The resulting solution, post the escape of the ammonia, was dissolved by sulfuric acid. Approximately 100% of the phosphate and magnesium were observed to be released from the insoluble phosphate compounds, resulting in the formation of high-purity gypsum. A TAN removal efficiency of 89% could be achieved by reusing the supernatant after the dissolution of the decomposition product, at pH 9.5 and the Mg:TAN:PO4-P molar ratio of 1.2:1:1. The pilot-scale test demonstrated that approximately 86% TAN was removed from the coking wastewater and the purity of recovered could reach over 99%. Further economic analysis proves that the operation cost of the proposed process is 0.55$ per m3 of coking wastewater, showing a 73% cost reduction when compared to struvite crystallization without recycling.

Differential coupling between subcortical calcium and BOLD signals during evoked and resting state through simultaneous calcium fiber photometry and fMRI.

Task based and resting state fMRI has been widely utilized to study brain functions. As the foundation of fMRI, the underlying neural basis of the BOLD signal has been extensively studied, but the detailed mechanism remains elusive, particularly during the resting state. To examine the neurovascular coupling, it is important to simultaneously record neural and vascular signals. Here we developed a novel setup of camera based, scalable simultaneous calcium fiber photometry and fMRI in rats. Using this setup, we recorded calcium signals of superior colliculus (SC) and lateral geniculate nucleus (LGN) and fMRI simultaneously during visual stimulation and the resting state. Our results revealed robust, region-specific coupling between calcium and BOLD signals in the task state and weaker, whole brain correlation in the resting state. Interestingly, the spatial specificity of such correlation in the resting state was improved upon regression of white matter, ventricle signals and global signals in fMRI data. Overall, our results suggest differential coupling of calcium and BOLD signals for subcortical regions between evoked and resting states, and the coupling relationship in the resting state was related with resting state BOLD preprocessing strategies.

Noninvasive identification of HER2-zero, -low, or -overexpressing breast cancers: Multiparametric MRI-based quantitative characterization in predicting HER2-low status of breast cancer.

PURPOSE: To evaluate the effectiveness of both synthetic magnetic resonance imaging (SyMRI) and conventional diffusion-weighted imaging (DWI) for identifying the human epidermal growth factor receptor 2 (HER2) status in breast cancer (BC) patients. METHOD: In this retrospective study, 114 women with DWI and SyMRI were pathologically classified into three groups: HER2-overexpressing (n = 40), HER2-low-expressing (n = 53), and HER2-zero-expressing (n = 21). T1 and T2 relaxation times and proton density (PD) were assessed before and after enhancement, and the resulting quantitative parameters produced by SyMRI were recorded as T1, T2, and PD and T1e, T2e, and PDe. Logistic regression was used to identify the best indicators for classifying patients based on HER2 expression. The discriminative performance of the models was evaluated using receiver operating characteristic (ROC) curves. RESULTS: Our preliminary study revealed significant differences in progesterone receptor (PR) status, Ki-67 index, and axillary lymph node (ALN) count among the HER2-zero, -low, and -overexpressing groups (p < 0.001 to p = 0.03). SyMRI quantitative indices showed significant differences among BCs in the three HER2 subgroups, except for ΔT2 (p < 0.05). our results indicate that PDe achieved an area under the curve（AUC）of 0.849 (95 % CI: 0.760-0.915) for distinguishing HER2-low and -overexpressing BCs. Further investigation revealed that both the PDe and ADC were indicators for predicting differences among patients with HER2-zero and HER2-low-expressing BC, with AUCs of 0.765(95 % CI: 0.652-0.855) and 0.684(95 % CI: 0.565-0.787), respectively. The addition of the PDe to the ADC improved the AUC to 0.825(95 % CI: 0.719-0.903). CONCLUSIONS: SyMRI could noninvasively and robustly predict the HER2 expression status of patients with BC.

Synthetic MRI quantitative parameters in discriminating stage T1 nasopharyngeal carcinoma and benign hyperplasia: Combination with morphological features.

PURPOSE: To investigate the feasibility of synthetic MRI (syMRI) quantitative parameters and its combination with morphological features in discriminating stage T1 nasopharyngeal carcinoma (T1-NPC) and benign hyperplasia (BH). MATERIAL AND METHODS: Eighty-eight patients with nasopharyngeal lesions (T1-NPC, n = 54; BH, n = 34) were retrospectively enrolled between October 2020 and May 2022. The syMRI quantitative parameters of nasopharyngeal lesions (T1, T2, PD, T1SD, T2SD, PDSD) and longus capitis (T1, T2, PD) were measured, and T1ratio, T2ratio and PDratio were calculated (lesion/longus capitis). The morphological features (lesion pattern, retention cyst, serrated protrusion, middle ear effusion, tumor volume, and retropharyngeal lymph node) were compared. Statistical analyses were performed using the independent sample t test, Chi-square test, logistic regression analysis, receiver operating characteristic curve (ROC), and DeLong test. RESULTS: The T1, T2, PD, T1SD, T1ratio, and T2ratio values of T1-NPC were significantly lower than those of BH. The morphological features (lesion pattern, retention cyst, retropharyngeal lymph node) were significant difference between these two entities. T2 value has the highest AUC in all syMRI quantitative parameters, followed by T1, T1ratio, PD, T2ratio and T1SD. Combined syMRI quantitative parameters (T2, PD, T1ratio) can further improve the diagnosis efficiency. Combined syMRI parameters and morphological feature (T2, PD, lesion pattern, retropharyngeal lymph node) has the excellent diagnostic efficiency, with AUC, sensitivity, specificity, and accuracy of 0.979, 96.30%, 97.06%, 96.77%. CONCLUSIONS: Synthetic MRI was helpful in distinguishing T1-NPC from BH, and combined syMRI quantitative parameters and morphological features has the optimal diagnostic performance.

Comparison of single-shot, FOCUS single-shot, MUSE, and FOCUS MUSE diffusion weighted imaging for pulmonary lesions: A pilot study.

Rationale and objectives: To compare the performance of SS, FOCUS SS, MUSE, and FOCUS MUSE DWI for pulmonary lesions to obtain a better technique for pulmonary DWI imaging. Materials and methods: 44 patients with pulmonary lesions were recruited to perform pulmonary DWI using SS, FOCUS SS, MUSE, and FOCUS MUSE sequences. Then, two radiologists with 12 and 10 years of chest MRI experiences assessed the overall image quality while another two radiologists both with 3 years of experiences evaluated the SNR, DR, and ADC of pulmonary lesions. Using interclass correlation coefficient (ICC) and kappa statistics to assess consistency of readers, Friedman test and Dunn-Bonferroni post hoc were used to calculate the difference between sequences. Mann-Whitney test and ROC curve were used to distinguish malignant from benign lesions. Results: All the assessed variables of the four sequences presented good to excellent intra-/inter-observer consistency. Compared with SS, FOCUS SS and MUSE, FOCUS MUSE demonstrated better image quality, including significantly higher 5-point Likert scale score (P < 0.001) and smaller DR (P < 0.001). SNR was comparable among SS, FOCUS SS, and FOCUS MUSE (P > 0.05) while MUSE presented with significantly higher SNR over them (P < 0.01). ADC of malignant was significantly smaller than that of benign for all the four sequences (P < 0.05). ROC analysis showed relatively better diagnostic performance of FOCUS MUSE (AUC = 0.820) over SS (AUC = 0.748), FOCUS SS (AUC = 0.778), and MUSE (AUC = 0.729) in distinguishing malignant from benign lesions. Conclusion: FOCUS MUSE possessed sufficient SNR and was better over SS, FOUCS SS, and MUSE for characterizing pulmonary lesions.

Three-dimensional pseudocontinuous arterial spin labeling with dual postlabeling delay for reflecting cerebral blood flow regulation in patients with hydrocephalus: a retrospective cross-sectional study.

Background: Three-dimensional pseudo-continuous arterial spin-labeling (3D pCASL) with dual postlabeling delay (PLD) captures both early and delayed cerebral blood flow (CBF), yet its potential in reflecting blood flow regulation in hydrocephalus patients remains uncertain. This study investigated the hemodynamic characteristics in patients with hydrocephalus and whether the difference in cerebral blood flow using short and long PLDs (ΔCBF = CBFPLD =2.5 s - CBFPLD =1.5 s) could reflect cerebral regulation and further aimed to demonstrate the associations between regional ΔCBF and the degree of ventricular dilatation. Methods: This retrospective study included consecutive patients with hydrocephalus and control participants attending The Second Affiliated Hospital of Nanchang University from December 2017 to December 2022. The CBF in 18 brain regions was manually delineated by two radiologists. Regional CBF and ΔCBF were compared via covariance analyses. The associations between ΔCBF and the degree of ventricular dilatation were investigated using linear regression analyses and interaction analysis. Results: In total, 58 patients with communicating hydrocephalus, 57 patients with obstructive hydrocephalus, and 52 controls were analyzed. CBF of the hydrocephalus groups was lower than that of the control group at the shorter PLD. CBF was higher at a longer PLD, with no difference between the hydrocephalus groups and the control group in some regions. The hydrocephalus groups showed a higher ΔCBF compared to the control group. Furthermore, in the left medial watershed (10.6±5.66 vs. 7.01±5.88 mL/100 g/min; P=0.038), communicating hydrocephalus exhibited greater ΔCBF than did obstructive hydrocephalus. ΔCBF of the right posterior external watershed [adjusted ß: 0.276; 95% confidence interval (CI): 0.047-0.505; P=0.019] and right parietal cortex (adjusted ß: 0.277; 95% CI: 0.056-0.498; P=0.015) in the obstructive hydrocephalus group and ΔCBF of the left internal watershed (adjusted ß: 0.274; 95% CI: 0.013-0.536; P=0.040) in the communicating hydrocephalus group were associated with the degree of ventricular dilatation, respectively. Conclusions: Patients with hydrocephalus showed cerebral regulation in maintaining adequate CBF, resulting in longer arterial transit times. The ability to regulate CBF in brain regions represented by the watershed was associated with the degree of ventricular dilation.

Cerebral blood flow alterations and host genetic association in individuals with long COVID: A transcriptomic-neuroimaging study.

Neuroimaging studies have indicated that altered cerebral blood flow (CBF) was associated with the long-term symptoms of postacute sequelae of SARS-CoV-2 infection (PASC), also known as "long COVID". COVID-19 and long COVID were found to be strongly associated with host gene expression. Nevertheless, the relationships between altered CBF, clinical symptoms, and gene expression in the central nervous system (CNS) remain unclear in individuals with long COVID. This study aimed to explore the genetic mechanisms of CBF abnormalities in individuals with long COVID by transcriptomic-neuroimaging spatial association. Lower CBF in the left frontal-temporal gyrus was associated with higher fatigue and worse cognition in individuals with long COVID. This CBF pattern was spatially associated with the expression of 2,178 genes, which were enriched in the molecular functions and biological pathways of COVID-19. Our study suggested that lower CBF is associated with persistent clinical symptoms in long COVID individuals, possibly as a consequence of the complex interactions among multiple COVID-19-related genes, which contributes to our understanding of the impact of adverse CNS outcomes and the trajectory of development to long COVID.

The value of myocardial contraction fraction and long-axis strain to predict late gadolinium enhancement in multiple myeloma patients with secondary cardiac amyloidosis.

The aim of this study is to assess the effectiveness of conventional and two additional functional markers derived from standard cardiac magnetic resonance (CMR) images in detecting the occurrence of late gadolinium enhancement (LGE) in patients with secondary cardiac amyloidosis (CA) related to multiple myeloma (MM). This study retrospectively included 32 patients with preserved ejection fraction (EF) who had MM-CA diagnosed consecutively. Conventional left ventricular (LV) function markers and two additional functional markers, namely myocardial contraction fraction (MCF) and LV long-axis strain (LAS), were obtained using commercial cardiac post-processing software. Logistic regression analyses and receiver operating characteristic (ROC) analysis were performed to evaluate the predictive performances. (1) There were no notable distinctions in clinical features between the LGE+ and LGE- groups, with the exception of a reduced systolic blood pressure in the former (105.60 ± 18.85 mmHg vs. 124.50 ± 20.95 mmHg, P = 0.022). (2) Patients with MM-CA presented with intractable heart failure with preserved ejection fraction (HFpEF). The LVEF in the LGE+ group exhibited a greater reduction (54.27%, IQR 51.59-58.39%) in comparison to the LGE- group (P < 0.05). And MM-CA patients with LGE+ had significantly higher LVMI (90.15 ± 23.69 g/m2), lower MCF (47.39%, IQR 34.28-54.90%), and the LV LAS were more severely damaged (- 9.94 ± 3.42%) than patients with LGE- (all P values < 0.05). (3) The study found that MCF exhibited a significant independent association with LGE, as indicated by an odds ratio of 0.89 (P < 0.05). The cut-off value for MCF was determined to be 64.25% with a 95% confidence interval ranging from 0.758 to 0.983. The sensitivity and specificity of this association were calculated to be 95% and 83%, respectively. MCF is a simple reproducible predict marker of LGE in MM-CA patients. It is a potentially CMR-based method that promise to reduce scan times and costs, and boost the accessibility of CMR.

Electrical 180° switching of Néel vector in spin-splitting antiferromagnet.

Antiferromagnetic spintronics have attracted wide attention due to its great potential in constructing ultradense and ultrafast antiferromagnetic memory that suits modern high-performance information technology. The electrical 180° switching of Néel vector is a long-term goal for developing electrical-controllable antiferromagnetic memory with opposite Néel vectors as binary "0" and "1." However, the state-of-art antiferromagnetic switching mechanisms have long been limited for 90° or 120° switching of Néel vector, which unavoidably require multiple writing channels that contradict ultradense integration. Here, we propose a deterministic switching mechanism based on spin-orbit torque with asymmetric energy barrier and experimentally achieve electrical 180° switching of spin-splitting antiferromagnet Mn5Si3. Such a 180° switching is read out by the Néel vector-induced anomalous Hall effect. On the basis of our writing and readout methods, we fabricate an antiferromagnet device with electrical-controllable high- and low-resistance states that accomplishes robust write and read cycles. Besides fundamental advance, our work promotes practical spin-splitting antiferromagnetic devices based on spin-splitting antiferromagnet.

Hypoconnectivity of the Amygdala in Patients with Low-Back-Related Leg Pain Linked to Individual Mechanical Pain Sensitivity: A Resting-State Functional MRI Study.

Purpose: To explore resting-state functional connectivity (rsFC) of the amygdala in patients with low-back-related leg pain (LBLP). Patients and Methods: For this prospective study, a total of 35 LBLP patients and 30 healthy controls (HCs) were included and underwent functional MRI and clinical assessments. Then, patients with LBLP were divided into acute LBLP (aLBLP) and chronic LBLP (cLBLP) subgroups. We further evaluated the between-group rsFC differences using left and right amygdala seeds in a whole-brain voxel analysis strategy. Finally, we performed correlation analysis between the rsFC values of altered regions and clinical indices. Results: Compared to HCs, hypoconnectivity of the amygdala was observed in LBLP patients (P < 0.01, with correction). The amygdala's rsFC pattern was different between aLBLP and cLBLP patients: decreased the amygdala's FC to the right putamen, to the right paracentral lobule (PCL), or to the right posterior temporal lobe in aLBLP patients, while right amygdala to the bilateral anterior cingulate cortex (ACC) and the left postcentral gyrus (PoCG) in cLBLP patients. Correlation analysis showed that lower rsFC of the left amygdala to the right PCL was correlated with the von Frey filament (vF) test values of the left lumbar (p = 0.025) and right lumbar (p = 0.019) regions, and rsFC of the right amygdala to the left PoCG was correlated with lower vF test values of the left lumbar (p = 0.017), right lumbar spine (p = 0.003); to right PoCG was correlated with calf (p = 0.015); the rsFC of the right amygdala to bilateral ACC was negatively correlated with the pain rating index (p = 0.003). Conclusion: LBLP patients showed amygdala hypoconnectivity, and the altered pattern of amygdala rsFC was different in the acute and chronic phases. Moreover, the amygdala hypoconnectivity was related to individual mechanical sensitivity (vF test) in LBLP patients.

Clinical and cognitive correlates tractography analysis in patients with white matter hyperintensity of vascular origin.

Purpose: White matter hyperintensity lesions (WMHL) in the brain are a consequence of cerebral small vessel disease and microstructural damage. Patients with WMHL have diverse clinical features, and hypertension, advanced age, obesity, and cognitive decline are often observed. However, whether these clinical features are linked to interrupted structural connectivity in the brain requires further investigation. This study therefore explores the white matter pathways associated with WMHL, with the objective of identifying neural correlates for clinical features in patients with WMHL. Methods: Diffusion magnetic resonance imaging (MRI) and several clinical features (MoCA scores, hypertension scores, body mass index (BMI), duration of hypertension, total white matter lesion loads, and education.) highly related to WMHL were obtained in 16 patients with WMHL and 20 health controls. We used diffusion MRI connectometry to explore the relationship between clinical features and specific white matter tracts using DSI software. Results: The results showed that the anterior splenium of the corpus callosum, the inferior longitudinal fasciculus, the anterior corpus callosum and the middle cerebellar peduncle were significantly correlated with hypertension scores (false discovery rate (FDR) = 0.044). The anterior splenium of the corpus callosum, the left thalamoparietal tract, the inferior longitudinal fasciculus, and the left cerebellar were significantly correlated with MoCA scores (FDR = 0.016). The anterior splenium of corpus callosum, inferior fronto-occipital fasciculus, cingulum fasciculus, and fornix/fimbria were significantly correlated with body mass index (FDR = 0.001). Conclusion: Our findings show that hypertension score, MoCA score, and BMI are important clinical features in patients with WMHL, hypertension degree and higher BMI are associated with whiter matter local disconnection in patients with WMHL, and may contribute to understanding the cognitive impairments observed in patients with WMHL.

Combined Cerebrospinal Fluid Hydrodynamics and Fourth Ventricle Outlet Morphology to Improve Predictive Efficiency of Prognosis for Chiari Malformation Type I Decompression.

OBJECTIVE: To identify the morphological characteristics together with cerebrospinal fluid (CSF) hydrodynamics on preoperative magnetic resonance imaging that improve the prediction of foramen magnum decompression (FMD) treatment outcome for Chiari malformations type I (CM-I) patients compared with the CSF hydrodynamics-based model. METHODS: This retrospective study included CM-I patients who underwent FMD, phase-contrast cine magnetic resonance, and static MR between January 2018 and March 2022. The relationships of the preoperative CSF hydrodynamic quantifications derived from phase-contrast cine magnetic resonance and morphological measurements from static magnetic resonance imaging, clinical indicators with different outcomes, were analyzed with logistic regression analysis. The outcomes were determined using the Chicago Chiari Outcome Scale. The predictive performance was evaluated with receiver operating characteristic, calibration, decision curves and area under the receiver operating characteristic curve, net reclassification index, and integrated discrimination improvement and was compared with CSF hydrodynamics-based model. RESULTS: A total of 27 patients were included. 17 (63%) had improved outcomes and 10 (37%) had poor outcomes. The peak diastolic velocity of the aqueduct midportion (odd ratio, 5.17; 95% confidence interval: 1.08, 24.70; P = 0.039) and the fourth ventricle outlet diameter (odd ratio, 7.17; 95% confidence interval: 1.07, 48.16; P = 0.043) were predictors of different prognoses. The predictive performance improved significantly than the CSF hydrodynamics-based model. CONCLUSIONS: Combined CSF hydrodynamic and static morphologic MR measurements can better predict the response to FMD. A higher peak diastolic velocity of the aqueduct midportion and broader fourth ventricle outlet were associated with satisfying outcomes after decompression in CM-I patients.

Treatment of anaerobic digester effluents of nylon wastewater through chemical precipitation and a sequencing batch reactor process.

Chemical precipitation, in combination with a sequencing batch reactor (SBR) process, was employed to remove pollutants from anaerobic digester effluents of nylon wastewater. The effects of the chemicals along with various Mg:N:P ratios on the chemical precipitation (struvite precipitation) were investigated. When brucite and H(3)PO(4) were applied at an Mg:N:P molar ratio of 3:1:1, an ammonia-removal rate of 81% was achieved, which was slightly more than that (80%) obtained with MgSO(4)·7H(2)O and Na(2)HPO(4)·12H(2)O at Mg:N:P molar ratios greater than the stoichiometric ratio. To further reduce the ammonia loads of the successive biotreatment, an overdose of phosphate with brucite and H(3)PO(4) was applied during chemical precipitation. The ammonia-removal rate at the Mg:N:P molar ratio of 3.5:1:1.05 reached 88%, with a residual PO(4)-P concentration of 16 mg/L. The economic analysis showed that the chemical cost of chemical precipitation could be reduced by about 41% when brucite and H(3)PO(4) were used instead of MgSO(4)·7H(2)O and Na(2)HPO(4)·12H(2)O. The subsequent biological process that used a sequencing batch reactor showed high removal rates of contaminants. The quality of the final effluent met the requisite effluent-discharging standards.

Abnormal cerebral micro-structures in end-stage renal disease patients related to mild cognitive impairment.

PURPOSE: To investigate the mediating effect of abnormal brain micro-structures on the relationship between clinical risk factors and mild cognitive impairment (MCI), and further predict individual cognitive function in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis. METHODS: In total, 40 ESRD patients and 30 healthy controls were prospectively enrolled in our study. All subjects completed diffusion kurtosis imaging (DKI) examinations and Montreal cognitive assessment (MoCA) test. Between-group differences in the DKI metrics were analyzed. In addition, the mediating effects of altered brain micro-structures on the association between clinical risk factors and MCI were determined by mediation analysis. Finally, cognitive function was predicted based on DKI metrics and clinical characteristics by applying the optimized least squares support vector regression machine. RESULTS: We observed disrupted brain micro-structures in ESRD patients with MCI, as indicated by significantly altered DKI parameters. Significant correlations were found between the DKI metrics, clinical characteristics, and MoCA scores. In ESRD patients, low hemoglobin level and high serum creatine level were clinical risk factors for MCI. A decreased axial kurtosis value in the left hippocampus may partially mediate the impact of serum creatine on MCI. Furthermore, the prediction model could predict cognitive scores associated with ESRD with relatively high accuracy. CONCLUSION: Aberrant micro-structures partially mediated the association between clinical risk factors and MCI, which is a novel insight into the progression of cognitive dysfunction in ESRD patients. Combined DKI metrics and clinical characteristics could be used as features to efficiently predict cognitive function associated with ESRD.

Aberrant brain gray matter and functional networks topology in end stage renal disease patients undergoing maintenance hemodialysis with cognitive impairment.

Purpose: To characterize the topological properties of gray matter (GM) and functional networks in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis to provide insights into the underlying mechanisms of cognitive impairment. Materials and methods: In total, 45 patients and 37 healthy controls were prospectively enrolled in this study. All subjects completed resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion kurtosis imaging (DKI) examinations and a Montreal cognitive assessment scale (MoCA) test. Differences in the properties of GM and functional networks were analyzed, and the relationship between brain properties and MoCA scores was assessed. Cognitive function was predicted based on functional networks by applying the least squares support vector regression machine (LSSVRM) and the whale optimization algorithm (WOA). Results: We observed disrupted topological organizations of both functional and GM networks in ESRD patients, as indicated by significantly decreased global measures. Specifically, ESRD patients had impaired nodal efficiency and degree centrality, predominantly within the default mode network, limbic system, frontal lobe, temporal lobe, and occipital lobe. Interestingly, the involved regions were distributed laterally. Furthermore, the MoCA scores significantly correlated with decreased standardized clustering coefficient (γ), standardized characteristic path length (λ), and nodal efficiency of the right insula and the right superior temporal gyrus. Finally, optimized LSSVRM could predict the cognitive scores of ESRD patients with great accuracy. Conclusion: Disruption of brain networks may account for the progression of cognitive dysfunction in ESRD patients. Implementation of prediction models based on neuroimaging metrics may provide more objective information to promote early diagnosis and intervention.

Full activation pattern mapping by simultaneous deep brain stimulation and fMRI with graphene fiber electrodes.

Simultaneous deep brain stimulation (DBS) and functional magnetic resonance imaging (fMRI) constitutes a powerful tool for elucidating brain functional connectivity, and exploring neuromodulatory mechanisms of DBS therapies. Previous DBS-fMRI studies could not provide full activation pattern maps due to poor MRI compatibility of the DBS electrodes, which caused obstruction of large brain areas on MRI scans. Here, we fabricate graphene fiber (GF) electrodes with high charge-injection-capacity and little-to-no MRI artifact at 9.4T. DBS-fMRI with GF electrodes at the subthalamic nucleus (STN) in Parkinsonian rats reveal robust blood-oxygenation-level-dependent responses along the basal ganglia-thalamocortical network in a frequency-dependent manner, with responses from some regions not previously detectable. This full map indicates that STN-DBS modulates both motor and non-motor pathways, possibly through orthodromic and antidromic signal propagation. With the capability for full, unbiased activation pattern mapping, DBS-fMRI using GF electrodes can provide important insights into DBS therapeutic mechanisms in various neurological disorders.