Deep learning-based diagnosis of disease activity in patients with Graves' orbitopathy using orbital SPECT/CT.

PURPOSE: Orbital [99mTc]TcDTPA orbital single-photon emission computed tomography (SPECT)/CT is an important method for assessing inflammatory activity in patients with Graves' orbitopathy (GO). However, interpreting the results requires substantial physician workload. We aim to propose an automated method called GO-Net to detect inflammatory activity in patients with GO. MATERIALS AND METHODS: GO-Net had two stages: (1) a semantic V-Net segmentation network (SV-Net) that extracts extraocular muscles (EOMs) in orbital CT images and (2) a convolutional neural network (CNN) that uses SPECT/CT images and the segmentation results to classify inflammatory activity. A total of 956 eyes from 478 patients with GO (active: 475; inactive: 481) at Xiangya Hospital of Central South University were investigated. For the segmentation task, five-fold cross-validation with 194 eyes was used for training and internal validation. For the classification task, 80% of the eye data were used for training and internal fivefold cross-validation, and the remaining 20% of the eye data were used for testing. The EOM regions of interest (ROIs) were manually drawn by two readers and reviewed by an experienced physician as ground truth for segmentation GO activity was diagnosed according to clinical activity scores (CASs) and the SPECT/CT images. Furthermore, results are interpreted and visualized using gradient-weighted class activation mapping (Grad-CAM). RESULTS: The GO-Net model combining CT, SPECT, and EOM masks achieved a sensitivity of 84.63%, a specificity of 83.87%, and an area under the receiver operating curve (AUC) of 0.89 (p < 0.01) on the test set for distinguishing active and inactive GO. Compared with the CT-only model, the GO-Net model showed superior diagnostic performance. Moreover, Grad-CAM demonstrated that the GO-Net model placed focus on the GO-active regions. For EOM segmentation, our segmentation model achieved a mean intersection over union (IOU) of 0.82. CONCLUSION: The proposed Go-Net model accurately detected GO activity and has great potential in the diagnosis of GO.

A Deep Learning-based Method to Extract Lumen and Media-Adventitia in Intravascular Ultrasound Images.

Intravascular ultrasound (IVUS) imaging allows direct visualization of the coronary vessel wall and is suitable for assessing atherosclerosis and the degree of stenosis. Accurate segmentation and lumen and median-adventitia (MA) measurements from IVUS are essential for such a successful clinical evaluation. However, current automated segmentation by commercial software relies on manual corrections, which is time-consuming and user-dependent. We aim to develop a deep learning-based method using an encoder-decoder deep architecture to automatically and accurately extract both lumen and MA border. Inspired by the dual-path design of the state-of-the-art model IVUS-Net, our method named IVUS-U-Net++ achieved an extension of the U-Net++ model. More specifically, a feature pyramid network was added to the U-Net++ model, enabling the utilization of feature maps at different scales. Following the segmentation, the Pearson correlation and Bland-Altman analyses were performed to evaluate the correlations of 12 clinical parameters measured from our segmentation results and the ground truth. A dataset with 1746 IVUS images from 18 patients was used for training and testing. Our segmentation model at the patient level achieved a Jaccard measure (JM) of 0.9080 ± 0.0321 and a Hausdorff distance (HD) of 0.1484 ± 0.1584 mm for the lumen border; it achieved a JM of 0.9199 ± 0.0370 and an HD of 0.1781 ± 0.1906 mm for the MA border. The 12 clinical parameters measured from our segmentation results agreed well with those from the ground truth (all p-values are smaller than .01). Our proposed method shows great promise for its clinical use in IVUS segmentation.

[Dynamic characteristics of brain networks in patients with irritable bowel syndrome based on functional magnetic resonance imaging].

The disorder of brain-gut interaction is an important cause of irritable bowel syndrome (IBS), but the dynamic characteristics of the brain remain unclear. Since there are many shortcomings for evaluating brain dynamic nature in the previous studies, we proposed a new method based on slope calculation by point-by-point analysis of the data from functional magnetic resonance imaging, and detected the abnormalities of brain dynamic changes in IBS patients. The results showed that compared with healthy subjects, there were dynamic changes in the brain for the IBS patients. After correction by false discovery rate (FDR), significant abnormalities were only found in two functional connections of the right posterior cingulate gyrus linked to left middle frontal gyrus, and the right posterior cingulate gyrus linked to left pallidus. The above results of the brain dynamic analysis were totally different from those of the brain static analysis of IBS patients. Our findings provide novel complementary information for illustrating the central nervous mechanism of IBS and may offer a new direction to explore central target for patients with IBS.

White Matter Fiber Tracking Method with Adaptive Correction of Tracking Direction.

Background: The deterministic fiber tracking method has the advantage of high computational efficiency and good repeatability, making it suitable for the noninvasive estimation of brain structural connectivity in clinical fields. To address the issue of the current classical deterministic method tending to deviate in the tracking direction in the region of crossing fiber region, in this paper, we propose an adaptive correction-based deterministic white matter fiber tracking method, named FTACTD. Methods: The proposed FTACTD method can accurately track white matter fibers by adaptively adjusting the deflection direction strategy based on the tensor matrix and the input fiber direction of adjacent voxels. The degree of correction direction changes adaptively according to the shape of the diffusion tensor, mimicking the actual tracking deflection angle and direction. Furthermore, both forward and reverse tracking techniques are employed to track the entire fiber. The effectiveness of the proposed method is validated and quantified using both simulated and real brain datasets. Various indicators such as invalid bundles (IB), valid bundles (VB), invalid connections (IC), no connections (NC), and valid connections (VC) are utilized to assess the performance of the proposed method on simulated data and real diffusion-weighted imaging (DWI) data. Results: The experimental results of the simulated data show that the FTACTD method tracks outperform existing methods, achieving the highest number of VB with a total of 13 bundles. Additionally, it identifies the least number of incorrect fiber bundles, with only 32 bundles identified as wrong. Compared to the FACT method, the FTACTD method reduces the number of NC by 36.38%. In terms of VC, the FTACTD method surpasses even the best performing SD_Stream method among deterministic methods by 1.64%. Extensive in vivo experiments demonstrate the superiority of the proposed method in terms of tracking more accurate and complete fiber paths, resulting in improved continuity. Conclusion: The FTACTD method proposed in this study indicates superior tracking results and provides a methodological basis for the investigating, diagnosis, and treatment of brain disorders associated with white matter fiber deficits and abnormalities.

An automated two-stage approach to kidney and tumor segmentation in CT imaging.

BACKGROUND: The incidence of kidney tumors is progressively increasing each year. The precision of segmentation for kidney tumors is crucial for diagnosis and treatment. OBJECTIVE: To enhance accuracy and reduce manual involvement, propose a deep learning-based method for the automatic segmentation of kidneys and kidney tumors in CT images. METHODS: The proposed method comprises two parts: object detection and segmentation. We first use a model to detect the position of the kidney, then narrow the segmentation range, and finally use an attentional recurrent residual convolutional network for segmentation. RESULTS: Our model achieved a kidney dice score of 0.951 and a tumor dice score of 0.895 on the KiTS19 dataset. Experimental results show that our model significantly improves the accuracy of kidney and kidney tumor segmentation and outperforms other advanced methods. CONCLUSION: The proposed method provides an efficient and automatic solution for accurately segmenting kidneys and renal tumors on CT images. Additionally, this study can assist radiologists in assessing patients' conditions and making informed treatment decisions.

Brain identification of IBS patients based on GBDT and multiple imaging techniques.

The brain biomarker of irritable bowel syndrome (IBS) patients is still lacking. The study aims to explore a new technology studying the brain alterations of IBS patients based on multi-source brain data. In the study, a decision-level fusion method based on gradient boosting decision tree (GBDT) was proposed. Next, 100 healthy subjects were used to validate the effectiveness of the method. Finally, the identification of brain alterations and the pain evaluation in IBS patients were carried out by the fusion method based on the resting-state fMRI and DWI for 46 patients and 46 controls selected randomly from 100 healthy subjects. The results showed that the method can achieve good classification between IBS patients and controls (accuracy = 95%) and pain evaluation of IBS patients (mean absolute error = 0.1977). Moreover, both the gain-based and the permutation-based evaluation instead of statistical analysis showed that left cingulum bundle contributed most significantly to the classification, and right precuneus contributed most significantly to the evaluation of abdominal pain intensity in the IBS patients. The differences seem to suggest a probable but unexplored separation about the central regions between the identification and progression of IBS. This finding may provide one new thought and technology for brain alteration related to IBS.

Functional division of the dorsal striatum based on a graph neural network.

The dorsal striatum, an essential nucleus in subcortical areas, has a crucial role in controlling a variety of complex cognitive behaviors; however, few studies have been conducted in recent years to explore the functional subregions of the dorsal striatum that are significantly activated when performing multiple tasks. To explore the differences and connections between the functional subregions of the dorsal striatum that are significantly activated when performing different tasks, we propose a framework for functional division of the dorsal striatum based on a graph neural network model. First, time series information for each voxel in the dorsal striatum is extracted from acquired functional magnetic resonance imaging data and used to calculate the connection strength between voxels. Then, a graph is constructed using the voxels as nodes and the connection strengths between voxels as edges. Finally, the graph data are analyzed using the graph neural network model to functionally divide the dorsal striatum. The framework was used to divide functional subregions related to the four tasks including olfactory reward, "0-back" working memory, emotional picture stimulation, and capital investment decision-making. The results were further subjected to conjunction analysis to obtain 15 functional subregions in the dorsal striatum. The 15 different functional subregions divided based on the graph neural network model indicate that there is functional differentiation in the dorsal striatum when the brain performs different cognitive tasks. The spatial localization of the functional subregions contributes to a clear understanding of the differences and connections between functional subregions.

Functional differentiation of the dorsal striatum: a coordinate-based neuroimaging meta-analysis.

Background: The dorsal striatum, a nucleus in the basal ganglia, plays a key role in the execution of cognitive functions in the human brain. Recent studies have focused on how the dorsal striatum participates in a single cognitive function, whereas the specific roles of the caudate and putamen in performing multiple cognitive functions remain unclear. In this paper we conducted a meta-analysis of the relevant neuroimaging literature to understand the roles of subregions of the dorsal striatum in performing different functions. Methods: PubMed, Web of Science, and BrainMap Functional Database were searched to find original functional magnetic resonance imaging (fMRI) studies conducted on healthy adults under reward, memory, emotion, and decision-making tasks, and relevant screening criteria were formulated. Single task activation, contrast activation, and conjunction activation analyses were performed using the activation likelihood estimation (ALE) method for the coordinate-based meta-analysis to evaluate the differences and linkages. Results: In all, 112 studies were included in this meta-analysis. Analysis revealed that, of the 4 single activation tasks, reward, memory, and emotion tasks all activated the putamen more, whereas decision-making tasks activated the caudate body. Contrast analysis showed that the caudate body played an important role in the 2 cooperative activation tasks, but conjunction activation results found that more peaks appeared in the caudate head. Discussion: Different subregions of the caudate and putamen assume different roles in processing complex cognitive behaviors. Functional division of the dorsal striatum identified specific roles of 15 different subregions, reflecting differences and connections between the different subregions in performing different cognitive behaviors.

A new method incorporating deep learning with shape priors for left ventricular segmentation in myocardial perfusion SPECT images.

Accurate segmentation of the left ventricle (LV) is crucial for evaluating myocardial perfusion SPECT (MPS) and assessing LV functions. In this study, a novel method combining deep learning with shape priors was developed and validated to extract the LV myocardium and automatically measure LV functional parameters. The method integrates a three-dimensional (3D) V-Net with a shape deformation module that incorporates shape priors generated by a dynamic programming (DP) algorithm to guide its output during training. A retrospective analysis was performed on an MPS dataset comprising 31 subjects without or with mild ischemia, 32 subjects with moderate ischemia, and 12 subjects with severe ischemia. Myocardial contours were manually annotated as the ground truth. A 5-fold stratified cross-validation was used to train and validate the models. The clinical performance was evaluated by measuring LV end-systolic volume (ESV), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF), and scar burden from the extracted myocardial contours. There were excellent agreements between segmentation results by our proposed model and those from the ground truth, with a Dice similarity coefficient (DSC) of 0.9573 ± 0.0244, 0.9821 ± 0.0137, and 0.9903 ± 0.0041, as well as Hausdorff distances (HD) of 6.7529 ± 2.7334 mm, 7.2507 ± 3.1952 mm, and 7.6121 ± 3.0134 mm in extracting the LV endocardium, myocardium, and epicardium, respectively. Furthermore, the correlation coefficients between LVEF, ESV, EDV, stress scar burden, and rest scar burden measured from our model results and the ground truth were 0.92, 0.958, 0.952, 0.972, and 0.958, respectively. The proposed method achieved a high accuracy in extracting LV myocardial contours and assessing LV functions.

A New Method on Construction of Brain Effective Connectivity Based on Functional Magnetic Resonance Imaging.

Most of the existing methods about the causal relationship based on functional magnetic resonance imaging (fMRI) data are either the hypothesis-driven methods or based on a linear model, which can result in the deviation for detecting the original brain activity. Therefore, it is necessary to develop a new method for detecting the effective connectivity (EC) of the brain activity by the nonlinear calculation. In this study, we firstly proposed a new technology evaluating effective connectivity of the human brain based on back-propagation neural network with nonlinear model, named EC-BP. Next, we simulated four time series for assessing the feasibility and accuracy of EC-BP compared to Granger causality analysis (GCA). Finally, the proposed EC-BP was applied to the brain fMRI from 60 healthy subjects. The results from the four simulated time series showed that the proposed EC-BP can detect the originally causal relationship, consistent with the actual causality. However, the GCA can not find nonlinear causality. Based on the analysis of the fMRI data from the healthy participants, EC-BP and GCA showed the huge differences in the top 50 connections in descending order of EC. EC-BP showed all ECs related to hippocampus and parahippocampus, whereas GCA showed most ECs related to the paracentral lobule, caudate, putamen, and pallidum, which represents the brain regions with most frequent information passing measured by different methods. The proposed EC-BP method can provide supplementary information to GCA, which will promote more comprehensive detection and evaluation of brain EC.

Fast reconstruction of multiphase microstructures based on statistical descriptors.

In this paper, we propose a hierarchical simulated annealing of erosion method (HSAE) to improve the computational efficiency of multiphase microstructure reconstruction, whose computational efficiency can be improved by an order of magnitude. Reconstruction of the two-dimensional (2D) and three-dimensional (3D) multiphase microstructures (pore, grain, and clay) based on simulated annealing (SA) and HSAE are performed. In the reconstruction of multiphase microstructure with HSAE and SA, three independent two-point correlation functions are chosen as the morphological information descriptors. The two-point cluster function which contains significant high-order statistical information is used to verify the reconstruction results. From the analysis of 2D reconstruction, it can find that the proposed HSAE technique not only improves the quality of reconstruction, but also improves the computational efficiency. The reconstructions of our proposed method are still imperfect. This is because the used two-point correlation functions contain insufficient information. For the 3D reconstruction, the two-point correlation functions of the 3D generation are in excellent agreement with those of the original 2D image, which illustrates that our proposed method is effective for the reconstruction of 3D microstructure. The comparison of the energy vs computational time between the SA and HSAE methods shows that our presented method is an order of magnitude faster than the SA method. That is because only some of the pixels in the overall hierarchy need to be considered for sampling.

[Application of HHT to driving fatigue in EEG analysis].

Based on the fact that the signals of electroencephalogram (EEG) possess non-linear and non-stationary properties, Hilbert-Huang Transform (HHT) was proposed for the EEG analysis of driving fatigue. Firstly, C4-lead EEG was selected, and the data of normal driving state and fatigue driving state was analyzed by HHT to explore the differences. Then O2-lead EEG was chosen for contrastive analysis of differences between the different leads. It was found through the analysis that the EEG signals had different Hilbert marginal spectrums for different states, and there were also some differences at the same state for the two leads. It can be certain that HHT can well distinguish different states of drivers as a novel approach for driving fatigue detection, and the selected lead may affect detectable results to some extent.

A Medical Image Registration Method Based on Progressive Images.

BACKGROUND: Medical image registration is an essential task for medical image analysis in various applications. In this work, we develop a coarse-to-fine medical image registration method based on progressive images and SURF algorithm (PI-SURF) for higher registration accuracy. METHODS: As a first step, the reference image and the floating image are fused to generate multiple progressive images. Thereafter, the floating image and progressive image are registered to get the coarse registration result based on the SURF algorithm. For further improvement, the coarse registration result and the reference image are registered to perform fine image registration. The appropriate progressive image has been investigated by experiments. The mutual information (MI), normal mutual information (NMI), normalized correlation coefficient (NCC), and mean square difference (MSD) similarity metrics are used to demonstrate the potential of the PI-SURF method. RESULTS: For the unimodal and multimodal registration, the PI-SURF method achieves the best results compared with the mutual information method, Demons method, Demons+B-spline method, and SURF method. The MI, NMI, and NCC of PI-SURF are improved by 15.5%, 1.31%, and 7.3%, respectively, while MSD decreased by 13.2% for the multimodal registration compared with the optimal result of the state-of-the-art methods. CONCLUSIONS: The extensive experiments show that the proposed PI-SURF method achieves higher quality of registration.

Changes of the postcentral cortex in irritable bowel syndrome patients.

The postcentral cortex (poCC) is commonly found to respond to visceral stimulation, but researchers usually pay less attention to this role of the poCC in the patients with functional gastrointestinal disorders, because it is a primary receptor for general bodily feeling of touch, such as temperature and pain. The current study focuses on the changes around the poCC in irritable bowel syndrome (IBS) patients based on the resting-state functional magnetic resonance imaging, aiming to investigate whether the poCC-centric brain metrics may be directly related to visceral perception. In the study, we calculated the regional homogeneity, seed-based correlation (SBC) and nodal centralities of the poCC to explore the changes in the regional activity and information flow around the poCC in IBS patients. Moreover, we examined the performance of the poCC-centric features in classifying the IBS group and healthy group in comparison to those features unrelated to the poCC. The results found that central alterations around the poCC in IBS patients were associated with the level of visceral pain, and exhibited a better discriminative power than those around the whole brain and the insula when classifying the IBS group and healthy group. In conclusion, the preliminary investigation provided fundamental advances in understanding the roles of the poCC in the pathphysiology of the IBS.

[Comparison between approximate entropy and regional homogeneity for identification of irritable bowel syndrome based on functional magnetic resonance imaging].

OBJECTIVE: To compare the effectiveness and sensitivity of entropy and regional homogeneity (ReHo) for identifying irritable bowel syndrome (IBS) based on functional magnetic resonance imaging (fMRI). METHODS: Voxel-based approximate entropy (ApEn) was calculated based on findings of resting fMRI of 54 patients with IBS and 54 healthy control subjects. Feature selection was performed using independent sample t-test, and support vector machine was then used to classify and identify different groups. The classification performance obtained from ApEn was compared with that from ReHo. RESULTS: Significant differences between the two groups were found in the left triangle part of inferior prefrontal gyrus, right angular gyrus of the inferior parietal lobule, left inferior temporal gyrus, left middle temporal gyrus, left lingual gyrus, bilateral middle occipital gyrus and bilateral superior occipital gyrus for ReHo (P < 0.05), and in the bilateral postcentral gyrus, right precentral gyrus, right inferior temporal gyrus, bilateral middle temporal gyrus and left superior occipital gyrus for ApEn (P < 0.05). ApEn consistently showed better performance than ReHo regardless of the variations in the number of features. The classification accuracy, specificity and sensitivity of ApEn were 93.5185%, 90.7407% and 96.2963%, respectively, as compared with 86.1111%, 85.1852% and 87.037% of ReHo. CONCLUSIONS: Entropy analysis based on fMRI can be more sensitive and effective than ReHo for identification of IBS.

Coil combination using linear deconvolution in k-space for phase imaging.

BACKGROUND: The combination of multi-channel data is a critical step for the imaging of phase and susceptibility contrast in magnetic resonance imaging (MRI). Magnitude-weighted phase combination methods often produce noise and aliasing artifacts in the magnitude images at accelerated imaging sceneries. To address this issue, an optimal coil combination method through deconvolution in k-space is proposed in this paper. METHODS: The proposed method firstly employs the sum-of-squares and phase aligning method to yield a complex reference coil image which is then used to calculate the coil sensitivity and its Fourier transform. Then, the coil k-space combining weights is computed, taking into account the truncated frequency data of coil sensitivity and the acquired k-space data. Finally, combining the coil k-space data with the acquired weights generates the k-space data of proton distribution, with which both phase and magnitude information can be obtained straightforwardly. Both phantom and in vivo imaging experiments were conducted to evaluate the performance of the proposed method. RESULTS: Compared with magnitude-weighted method and MCPC-C, the proposed method can alleviate the phase cancellation in coil combination, resulting in a less wrapped phase. CONCLUSIONS: The proposed method provides an effective and efficient approach to combine multiple coil image in parallel MRI reconstruction, and has potential to benefit routine clinical practice in the future.

White Matter Microstructural Similarity and Diversity of Functional Constipation and Constipation-predominant Irritable Bowel Syndrome.

BACKGROUND/AIMS: The Rome III criteria separated chronic constipation into functional constipation (FC) and constipation-predominant irritable bowel syndrome (IBS-C), but some researchers questioned the partitioning and treated both as distinct parts of a continuum. The study aims to explore the similarity and diversity of brain white matter between FC and IBS-C. METHODS: The voxel-wise analysis of the diffusion parameters was used to quantify the white matter changes of female brains in 18 FC patients and 20 IBS-C patients compared with a comparison group with 19 healthy controls by tract-based spatial statistics. The correlations between diffusive parameters and clinical symptoms were evaluated using a Pearson's correlation. RESULTS: In comparison to healthy controls, FC patients showed a decrease of fractional anisotropy (FA) and an increase of radial diffusivity (RD) in multiple major fibers encompassing the corpus callosum (CC, P = 0.001 at peak), external capsule (P = 0.002 at peak), corona radiata (CR, P = 0.001 at peak), and superior longitudinal fasciculus (SLF, P = 0.002 at peak). In contrast, IBS-C patients showed FA and RD aberrations in the CC (P = 0.048 at peak). Moreover, the direct comparison between FC and IBS-C showed only RD differences in the CR and SLF. In addition, FA and RD in the CC were significantly associated with abdominal pain for all patients, whereas FA in CR (P = 0.016) and SLF (P = 0.040) were significantly associated with the length of time per attempt and incomplete evacuation separately for FC patients. CONCLUSION: These results may improve our understanding of the pathophysiological mechanisms underlying different types of constipation.

A Structure Design Method for Reduction of MRI Acoustic Noise.

The acoustic problem of the split gradient coil is one challenge in a Magnetic Resonance Imaging and Linear Accelerator (MRI-LINAC) system. In this paper, we aimed to develop a scheme to reduce the acoustic noise of the split gradient coil. First, a split gradient assembly with an asymmetric configuration was designed to avoid vibration in same resonant modes for the two assembly cylinders. Next, the outer ends of the split main magnet were constructed using horn structures, which can distribute the acoustic field away from patient region. Finally, a finite element method (FEM) was used to quantitatively evaluate the effectiveness of the above acoustic noise reduction scheme. Simulation results found that the noise could be maximally reduced by 6.9 dB and 5.6 dB inside and outside the central gap of the split MRI system, respectively, by increasing the length of one gradient assembly cylinder by 20 cm. The optimized horn length was observed to be 55 cm, which could reduce noise by up to 7.4 dB and 5.4 dB inside and outside the central gap, respectively. The proposed design could effectively reduce the acoustic noise without any influence on the application of other noise reduction methods.

Topological Alterations of the Intrinsic Brain Network in Patients with Functional Dyspepsia.

BACKGROUND/AIMS: Previous studies reported that integrated information in the brain ultimately determines the subjective experience of patients with chronic pain, but how the information is integrated in the brain connectome of functional dyspepsia (FD) patients remains largely unclear. The study aimed to quantify the topological changes of the brain network in FD patients. METHODS: Small-world properties, network efficiency and nodal centrality were utilized to measure the changes in topological architecture in 25 FD patients and 25 healthy controls based on functional magnetic resonance imaging. Pearson's correlation assessed the relationship of each topological property with clinical symptoms. RESULTS: FD patients showed an increase of clustering coefficients and local efficiency relative to controls from the perspective of a whole network as well as elevated nodal centrality in the right orbital part of the inferior frontal gyrus, left anterior cingulate gyrus and left hippocampus, and decreased nodal centrality in the right posterior cingulate gyrus, left cuneus, right putamen, left middle occipital gyrus and right inferior occipital gyrus. Moreover, the centrality in the anterior cingulate gyrus was significantly associated with symptom severity and duration in FD patients. Nevertheless, the inclusion of anxiety and depression scores as covariates erased the group differences in nodal centralities in the orbital part of the inferior frontal gyrus and hippocampus. CONCLUSIONS: The results suggest topological disruption of the functional brain networks in FD patients, presumably in response to disturbances of sensory information integrated with emotion, memory, pain modulation, and selective attention in patients.

Brain-based Correlations Between Psychological Factors and Functional Dyspepsia.

BACKGROUND/AIMS: Increasing evidence shows involvement of psychological disorders in functional dyspepsia (FD), but how psychological factors exert their influences upon FD remains largely unclear. The purpose of the present study was to explore the brain-based correlations of psychological factors and FD. METHODS: Based on Fluorine-18-deoxyglucose positron emission tomography-computed tomography, the altered cerebral glycometabolism was investigated in 40 FD patients compared with 20 healthy controls during resting state using statistical parametric mapping software. RESULTS: FD patients exhibited increased glucose metabolism in multiple regions relative to controls (P< 0.001, family-wise error corrected). After controlling for the dyspeptic symptoms, increased aberrations persisted within the insula, anterior cingulate cortex (ACC), middle cingulate cortex (MCC) and middle frontal cortex (midFC), which was related to anxiety and depression score. Interestingly, FD patients without anxiety/depression symptoms also showed increased glycometabolism within the insula, ACC, MCC and midFC. Moreover, FD patients with anxiety/depression symptoms exhibited more significant hypermetabolism within the above 4 sites compared with patients without anxiety/depression symptoms. CONCLUSIONS: Our results suggested that the altered cerebral glycometabolism may be in a vicious cycle of psychological vulnerabilities and increased gastrointestinal symptoms.