T1 hypointense brain lesions in NMOSD and its relevance with disability: a single institution cross-sectional study.

BACKGROUND: T1 hypointense lesions are considered a surrogate marker of tissue destruction. Although there is a shortage of evidence about T1 hypointense brain lesions, black holes, in patients with Neuromyelitis Optica Spectrum Disorder (NMOSD), the clinical significance of these lesions is not well determined. OBJECTIVES: The impact of T1 hypointense brain lesions on the clinical status and the disability level of patients with NMOSD was sought in this study. METHODS: A total of 83 patients with the final diagnosis of NMOSD were recruited. Aquaporin-4 measures were collected. The expanded disability status scale (EDSS) and MRI studies were also extracted. T1 hypointense and T2/FLAIR hyperintense lesions were investigated. The correlation of MRI findings, AQP-4, and EDSS was assessed. RESULTS: T1 hypointense brain lesions were detected in 22 patients. Mean ± SD EDSS was 3.7 ± 1.5 and significantly higher in patients with brain T1 hypointense lesions than those without them (p-value = 0.01). Noticeably, patients with more than four T1 hypointense lesions had EDSS scores ≥ 4. The presence of T2/FLAIR hyperintense brain lesions correlated with EDSS (3.6 ± 1.6 vs 2.3 ± 1.7; p-value = 0.01). EDSS was similar between those with and without positive AQP-4 (2.7 ± 1.6 vs. 3.2 ± 1.7; p-value = 0.17). Also, positive AQP-4 was not more prevalent in patients with T1 hypointense brain lesions than those without them (50.9 vs 45.4%; p-value = 0.8). CONCLUSION: We demonstrated that the presence of the brain T1-hypointense lesions corresponds to a higher disability level in NMOSD.

Simple and Complex Wheel Running Effect on Depression, Memory, Neuroinflammation, and Neurogenesis in Alzheimer's Rat Model.

INTRODUCTION: The aim of this study was to investigate 12 wk of simple and complex voluntary wheel running on Alzheimer's disease (AD), associated biomarkers, and behaviors. METHODS: Sixty male Wistar rats were randomly divided into six groups: healthy control (Con-Sed), AD only (AD-Sed), simple wheel control (SWC), complex wheel control (CWC), simple wheel AD (SWAD), and complex wheel AD (CWAD). Novelty-suppressed feeding test and the Morris water maze test were used to evaluate depression and memory, respectively. Ki67 was measured in the hippocampus, whereas interleukin (IL)-1ß and neural/glial antigen 2 (NG2) were measured in both the hippocampus and the prefrontal cortex. One-way ANOVA with Tukey's post hoc test was performed. RESULTS: AD-Sed group had significantly lower spacial memory ( P < 0.001) compared with Con-Sed. Simple and complex wheel running attenuated these deficits in the SWAD and CWAD groups, respectively ( P < 0.001). Only the CWAD group had significantly improved novelty-suppressed feeding test time compared with AD-Sed ( P < 0.001), equivalent to the healthy wheel running groups. AD-Sed has significantly higher hippocampal concentrations of Ki67 ( P = 0.01) compared with the Con-Sed. Both SWAD and CWAD had significantly reduced Ki67 with similar concentrations compared with the SWC and CWC groups ( P > 0.05). AD-Sed animals also presented with significantly higher hippocampal and prefrontal cortex concentrations of IL-1ß compared with Con-Sed ( P < 0.001). SWAD and CWAD had no effect in changing these concentrations. Complex wheel running significantly increased NG2 in the healthy control and AD models, whereas simple wheel running significantly increased NG2 in the AD model. CONCLUSIONS: The results of our study suggest that complex wheel running might be more advantageous in promoting memory and neuroplasticity while reducing depression that is associated with AD.

Abbreviated breast MRI for evaluating breast cancer before initiation of neoadjuvant chemotherapy: A cross-sectional study.

Background: Although, there are accumulating evidence about diagnostic role of abbreviated breast magnetic resonance imaging (MRI) in screening setting, the implementation of abbreviated MRI in staging of breast cancer has been poorly elucidated. Objective: To evaluate the diagnostic performance of abbreviated breast MRI in estimating extent of disease before initiation of neoadjuvant chemotherapy. Methods: A total of 54 patients with biopsy-proven main lesion referred to evaluate by standard protocol breast MRI before initiation of neoadjuvant chemotherapy were retrospectively enrolled. From a standard protocol, a data set of abbreviated protocol consisting fat-saturated T1-weighted (T1W) pre-contrast and first two fat-saturated T1W post-contrast series with reconstruction of their subtraction including maximum intensity projection (MIP) were obtained and interpreted. The concordance rate of abbreviated with standard protocol (as a reference standard) were compared. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value were calculated, as well. Results: The maximum size of the main mass was 38.6 ± 17.3 and 40.7 ± 17.9 for abbreviated and standard protocol, respectively. All of the main mass was detected by abbreviated protocol with 100% concordance. Concordance was 98.1% and 94.4% in terms of multifocal/multicentric status and for estimating of NME, respectively. The abbreviated protocol has high sensitivity and specificity with more than 90% value regarding main mass detection, measurement of the maximum size of the main mass, determination of multifocal/multicenter status and NAC involvement. Conclusion: Abbreviated protocol may be a reliable surrogate for standard protocol breast MRI in evaluating extent of breast cancer.

Association between Serum HLA-G Levels in The First Trimester of Pregnancy and The Onset of Preeclampsia: A Systematic Review and Meta-analysis Study.

Human leukocyte antigen G (HLA-G) levels are among the biomarkers suggested for pre-eclampsia (PE). This study is aimed at determining the possible relationship between low soluble HLA-G (sHLA-G) levels in maternal blood at the beginning of pregnancy and subsequent PE. We searched the international scientific databases of Web of Science, Embase, PubMed, Cochrane, and Scopus. We extracted the studies investigating the relationship between the serum levels of HLA-G in the first trimester of pregnancy and the onset of PE using the appropriate keywords. The collected data were analyzed using the random-effects meta-analysis model and STATA (version 14). A total of 5 studies met the eligibility criteria, and the total sample size was 668 subjects. The mean and SD age of case subjects was 31.41 ± 4.16 years, while it was 30.56 ± 3.5 for control subjects. According to the findings, there was an inverse relationship between HLA-G serum level in the first trimester of pregnancy and the subsequent onset of PE, standard mean difference (SMD)=-1.51 [95% confidence interval (CI): -2.26, -0.75, I2=90.8%, P=0.000]. Based on these results, low sHLA-G level in early pregnancy has a positive correlation with subsequent PE, and the significant role of sHLA-G in the early stages of placentation can be proven.

The Value of Coronary Computed Tomography Angiography in Patients with a High Calcium Score.

Background: We aimed to assess the agreement between coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) to determine whether patients with a high coronary artery calcium score (CS) would benefit from CCTA. Methods: This cross-sectional study was conducted on patients suspected of having coronary artery disease. The patients underwent calcium scoring. The total CS and the number of calcified foci were determined. The calcium score index (CSI) was defined, and coronary arteries were evaluated by CCTA. ICA was performed, and reports of ICA were extracted. All the abovementioned variables were compared. For data analysis, the κ coefficient and the ROC curve were used. Results: The study population consisted of 195 patients: 124 men (63.6%) and 71 women (36.4%). The median (IQR) value of CS was 529 (229-1042), ranging from 17 to 4717. In all 195 patients, the concordance between the final impression of CCTA and ICA was 90.2%, while the number and type of involved territories were similar at 57.9%. The highest agreement was seen in the left main and right coronary arteries, whereas the lowest agreement was detected in the left anterior descending and the left circumflex artery. The patients were categorized into different CS groups, and in those with a high CS (>1000), the agreement between CCTA and ICA concerning final impression and involved territories was similar to the whole group of patients. Conclusion: CCTA in patients with a high CS, even exceeding 1000, remains beneficial as the noninvasive available method.