Journal Of Neuroimaging[JOURNAL]
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200 papers
Disrupted Sensorimotor Network Integration in Women With Fibromyalgia Revealed by Resting-State Functional MRI.
de Oliveira GR, Gama TM, Ramos LR … +1 more , DosSantos MF
J Neuroimaging · 2026 · PMID 41518021 · Full text
BACKGROUND AND PURPOSE: Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, hypersensitivity, and cognitive impairments. Alterations in brain functional connectivity have been sugges...
BACKGROUND AND PURPOSE: Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, hypersensitivity, and cognitive impairments. Alterations in brain functional connectivity have been suggested as possible mechanisms underlying pain amplification in these patients. This study aimed to investigate patterns of brain functional connectivity in patients with FM using resting-state functional magnetic resonance imaging. METHODS: Data were obtained from the public OpenNeuro repository and acquired on a 3 Tesla scanner. The sample consisted of 33 women with a clinical diagnosis of FM (x̅ = 41.73 ± 6.09 years) and 33 age-matched healthy controls (x̅ = 41.52 ± 6.03 years), with no significant differences in age (p = 0.89) or education level (p = 0.81). Images were processed and analyzed using independent component analysis. Between-group comparisons were corrected for multiple comparisons using false discovery rate (FDR) correction (p < 0.05). RESULTS: Patients with FM showed a significant reduction in functional connectivity within the right sensorimotor network (SMN) compared to controls (p-FDR < 0.05). Moreover, a negative correlation was observed between connectivity in this network and the sensory dimension of pain assessed by the McGill Pain Questionnaire (r = -0.35; p = 0.05). CONCLUSION: The reduced functional connectivity within the SMN may represent a neurobiological marker of FM, reflecting dysfunctions in sensorimotor integration and central modulation of pain. These findings support the hypothesis that FM involves functional brain alterations related to pain perception and amplification.
Diffusion Kurtosis Shows a Smaller Ischemic Core Versus Diffusion-Weighted MR in Early or Subacute Post-Thrombectomy Stroke.
Steward C, Venkatraman V, Kataike VM … +4 more , Mitchell PJ, Campbell BCV, Desmond PM, Ng F
J Neuroimaging · 2025 · PMID 41416612 · Publisher ↗
BACKGROUND AND PURPOSE: Diffusion-weighted imaging (DWI) is the gold standard for assessing ischemic core in acute stroke but may overestimate irreversible injury due to its assumption of Gaussian diffusion. Diffusion ku...
BACKGROUND AND PURPOSE: Diffusion-weighted imaging (DWI) is the gold standard for assessing ischemic core in acute stroke but may overestimate irreversible injury due to its assumption of Gaussian diffusion. Diffusion kurtosis imaging (DKI), which accounts for non-Gaussian water diffusion, may provide more accurate tissue characterization. Most prior studies examined DWI and DKI within 24 h or up to 1 month after stroke, but very few have captured both an ultra-early (e.g., 3-h) postreperfusion and a subacute (24-72 h) imaging window in the same population. This study compared DWI and DKI for measuring ischemic core evolution after reperfusion. METHODS: Fifty-two patients with anterior circulation large vessel occlusion stroke underwent endovascular thrombectomy and were imaged with both DWI and DKI at <3 h and again at 24-72 h postreperfusion in a prospective multicenter longitudinal cohort study. Lesion volumes for DWI and DKI were manually segmented to derive a mismatch between DWI and DKI, and reversal between the two time points. Diffusion metrics (apparent diffusion coefficient [ADC] and mean kurtosis [MK]) within regions of interest were also analyzed. RESULTS: DKI lesion volumes were significantly smaller than DWI at both time points (DWI 11.1 mL vs. DKI 8.5 mL, p = 0.007 at 3 h, and DWI 27.9 mL vs. DKI 19.3 mL, p = 0.002 at 24-72 h), with both increasing significantly over time. DKI(+ve)-DWI(-ve) mismatch regions showed higher ADC and lower MK, indicating less severe injury. The percentage amount of lesion that reversed in relation to the entire infarct was similar for both modalities (DWI: 15.9%, DKI: 12.4%, p > 0.05). CONCLUSION: DKI offers additional information to DWI for identifying irreversibly injured tissue in acute stroke, with smaller lesion volumes and further information on tissue microstructure that reversed. These findings suggest DKI may enhance ischemic core assessment and help guide treatment decisions after reperfusion therapy.
Subregional Amygdala Functional Connectivity at 3T: Comparison of High-Resolution 2D and 3D fMRI Acquisitions.
Foster SL, Landin-Romero R, Lewis S … +1 more , Korgaonkar MS
J Neuroimaging · 2025 · PMID 41405479 · Full text
BACKGROUND AND PURPOSE: Amygdala dysfunction is implicated in major depressive disorder. Despite wide acknowledgement of its heterogeneity, the amygdala is predominantly considered as a single entity and functional conne...
BACKGROUND AND PURPOSE: Amygdala dysfunction is implicated in major depressive disorder. Despite wide acknowledgement of its heterogeneity, the amygdala is predominantly considered as a single entity and functional connectivity investigations have reported findings using standard or low spatial resolution functional MRI data. This study compared the capabilities of two high spatial resolution acquisition strategies, the gold standard 2D and a novel 3D, in identifying amygdala functional connectivity to other brain regions at a subregional level. METHODS: Resting state fMRI data were acquired at 3T in 10 healthy controls using both versions of a Gradient-Echo Echo Planar Imaging (GRE-EPI) sequence. Whole brain voxel-wise functional connectivity measures were calculated using the whole amygdala and six subregional seed regions-of-interest; left and right basolateral, centromedial and superficial. RESULTS: The 3D data identified multiple stronger bilateral connections between both centromedial subregions, most notably to subcortical structures including brainstem and hippocampus, as well as intra-amygdala subregional connections. The 2D data displayed stronger connections to several cortical regions. Whole amygdala and subregional FC results differed. CONCLUSIONS: This study identified underutilized capability in current fMRI acquisition techniques at 3T. 2D GRE-EPI sequences optimized for high spatial resolution with voxel volumes of 15.6 mm capably demonstrate functional connectivity patterns of the amygdala at a subregional level, allowing interrogation of heterogeneous amygdala function at a more granular level. The novel 3D acquisition with voxel volumes of 8 mm showed promise in outperforming its 2D counterpart in identifying amygdala subregional connections to other subcortical structures that are traditionally difficult to image well.
Neurodegeneration With Brain Iron Accumulation and Ferroptosis Disorders in Children and Adults: An Imaging Review.
Mertiri L, Lequin M, Rossi A … +2 more , Hoffmann C, Huisman TAGM
J Neuroimaging · 2025 · PMID 41320772 · Publisher ↗
Neurodegeneration with brain iron accumulation (NBIA) refers to a group of rare genetic disorders characterized by abnormal iron deposition in the basal ganglia and brainstem due to impaired iron homeostasis. Disease sev...
Neurodegeneration with brain iron accumulation (NBIA) refers to a group of rare genetic disorders characterized by abnormal iron deposition in the basal ganglia and brainstem due to impaired iron homeostasis. Disease severity and manifestations vary according to the underlying genetic mutation and age of presentation; however, most subtypes share progressive neurological features such as dystonia, Parkinsonism, spasticity, cognitive decline, and intellectual disability. In this review, we first outline the physiological role of iron in the central nervous system, emphasizing its importance for neurotransmitter synthesis, myelination, and mitochondrial metabolism, and discuss how disruption of homeostatic mechanisms may lead to ferroptosis and neuronal injury. We then explore the role of neuroimaging in the diagnosis of NBIA, with a focus on MRI as the modality of choice. Finally, we provide an overview of the clinical and imaging features of the major NBIA subtypes, highlighting both shared characteristics and distinctive patterns. Covered NBIA include primary disorders of iron metabolism, such as neuroferritinopathy and aceruloplasminemia, and secondary disorders with disrupted iron regulation, including Pantothenate Kinase-Associated Neurodegeneration, Phospholipase A2 Group VI-Associated Neurodegeneration, Mitochondrial Membrane Protein-Associated Neurodegeneration, Beta-Propeller Protein-Associated Neurodegeneration, Fatty Acid Hydroxylase-Associated Neurodegeneration, Coenzyme A Synthetase Protein-Associated Neurodegeneration, Woodhouse-Sakati syndrome, and Kufor-Rakeb Disease. By integrating genetics, pathophysiology, and imaging, this review aims to improve recognition of NBIA and support comprehensive clinical management.
Beyond Parkinson's Disease: A Narrative Review of Neuromelanin MRI in Neurodegenerative Diseases.
Burade A, Lakhani DA, Dagher R … +3 more , Anosh J, Sair HI, Luna LP
J Neuroimaging · 2025 · PMID 41320758 · Publisher ↗
BACKGROUND AND PURPOSE: Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) is an emerging noninvasive biomarker of catecholaminergic neurons. It assesses neuromelanin-rich regions such as the substantia nigra par...
BACKGROUND AND PURPOSE: Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) is an emerging noninvasive biomarker of catecholaminergic neurons. It assesses neuromelanin-rich regions such as the substantia nigra pars compacta (SNc) and locus coeruleus (LC). Although initially developed for Parkinson's disease (PD), evidence supports broader utility. This narrative review highlights the diagnostic and prognostic applications of NM-MRI in PD, atypical parkinsonian syndromes, spinocerebellar ataxias (SCA), and Alzheimer's disease (AD), while evaluating methodological heterogeneity, diagnostic performance across diseases, and directions for clinical implementation. RESULTS: In PD, reduced SNc volume and contrast-to-noise ratio (CNR) correlate with motor symptom severity. Early-stage PD shows lateral SNc signal attenuation progressing ventromedially with disease advancement. NM-MRI sensitivity and specificity range from 70%-92% to 65%-89%, respectively, with higher accuracy at 7T. In progressive supranuclear palsy (PSP), SNc degeneration is more pronounced medially; LC contrast ratio (CR) is elevated compared to PD. In multiple system atrophy (MSA), LC signal attenuation is particularly marked in the parkinsonian subtype (MSA-P). NM-MRI findings in SCA (notably SCA2 and SCA7) vary by genotype; AD is characterized by reduction in the middle and caudal segments of LC, reflecting early tau pathology. NM-MRI LC signal reduction variably correlates with cognitive scores and Braak staging, suggesting potential as a preclinical biomarker. CONCLUSION: NM-MRI holds promise for early diagnosis and monitoring of neurodegenerative diseases. While its role in PD is well established, emerging data in PSP, MSA, SCA, and AD suggest wider applicability. Standardization, multimodal imaging integration, and machine learning are critical for clinical translation.
Imaging Biomarkers in Idiopathic Normal Pressure Hydrocephalus: Associations With Symptoms and 1-Year Treatment Outcomes.
Galvin CP, Phan B, Zekelman L … +5 more , Vangel M, Anketell MB, Torio E, Golby AJ, Racicot F
J Neuroimaging · 2025 · PMID 41316686 · Publisher ↗
BACKGROUND AND PURPOSE: Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder that primarily affects older adults and is typically characterized clinically by a triad of symptoms: gait disturbance, u...
BACKGROUND AND PURPOSE: Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder that primarily affects older adults and is typically characterized clinically by a triad of symptoms: gait disturbance, urinary urgency or incontinence, and cognitive decline. The relationship between clinical presentation and iNPH imaging biomarkers remains unclear, as does the ability of these markers to predict outcomes following cerebrospinal fluid diversion. Additionally, the association between fecal incontinence (FI) and iNPH, as well as the relationship between FI and iNPH imaging biomarkers, is poorly understood. METHODS: A retrospective review was conducted on 125 consecutive iNPH patients treated by a single surgeon at Brigham and Women's Hospital between 2015 and 2023. Patients were treated with the placement of a ventriculoperitoneal (VP) shunt. Patient demographics, symptoms, and clinical improvement were recorded at 3 and 12 months post-shunt placement. Imaging biomarkers, including Evans Index (EI), callosal angle (CA), anteroposterior diameter of the lateral ventricle index (ALVI), and disproportionately enlarged subarachnoid space hydrocephalus score, were measured using preoperative imaging. RESULTS: Of 125 patients (mean age 74.8 years, 71 males), 124 presented with gait disturbance, 113 with urinary dysfunction, and 111 with cognitive decline. FI was present in 24 patients. Patients with preoperative FI had higher EI and ALVI. Patients with improved FI at 3-month follow-up had larger CA. Patients with improved gait at 12-month follow-up had smaller EI and ALVI scores. Patients with preoperative urinary symptoms had a higher EI. CONCLUSIONS: Imaging biomarkers can have both diagnostic utility and predictive potential for outcomes related to specific symptoms following CSF diversion with VP shunts.
New Stent Retriever Technology Versus Standard Devices for Anterior Large Vessel Thrombectomy: A Multicenter Study.
Puig J, Dolz G, Werner M … +29 more , Daunis-I-Estadella P, Comas-Cufí M, Tomasello A, González E, Manso Del Caño X, Vega P, Murias E, Bravo I, Jiménez E, Aparici-Robles F, Sanchís JM, Remollo S, Castaño C, Moreu M, López-Frías A, Terceño M, Silva Y, Chirife Ó, López-Rueda A, Martínez-Fernández J, Méndez JC, Sagredo A, Díaz-Pérez J, Cuba V, Llibre JC, Aguilar Y, SanRoman L, Blasco J, ROSSETTI Group
J Neuroimaging · 2025 · PMID 41311321 · Full text
BACKGROUND AND PURPOSE: Guidelines recommend stent retrievers (SRs) for treating large vessel occlusion (LVO) stroke. We assessed noninferiority of the iNtercept (iVascular) SR with a self-expanding basket on a pusher wi...
BACKGROUND AND PURPOSE: Guidelines recommend stent retrievers (SRs) for treating large vessel occlusion (LVO) stroke. We assessed noninferiority of the iNtercept (iVascular) SR with a self-expanding basket on a pusher wire versus contemporary SRs (CSRs) using propensity score (PS) matching analysis. METHODS: We analyzed data from the ROSSETTI multicenter registry of patients with anterior circulation LVO to compare procedural (recanalization rates according to the modified Thrombolysis In Cerebral Infarction (mTICI) score and procedural complications), clinical (modified Rankin Scale at 90 days), and safety (symptomatic intracranial hemorrhage, mortality at 90 days) outcomes of patients treated with iNtercept or CSRs (Solitaire, Trevo, and EmboTrap) as a first-line strategy, with or without balloon-guide catheter (BGC + SR, BCG - SR) after PS matching. Non-inferiority of iNtercept was established if the prespecified lower bound of the 95% confidence interval was over -10%. RESULTS: A total of 164 and 132 patients treated first-line by iNtercept were matched to 656 and 132 patients treated first-line by CSR + BGC and CSR - BGC, respectively. After matching, successful reperfusion (mTICI2b/3) after first-line strategy was achieved in 53.7% and 54.8% in the iNtercept versus CSR + BGC groups, respectively (absolute difference, -0.1%), and 53.8% and 51.3% in the iNtercept versus CSR - BGC, respectively (2.6%). Final reperfusion rates and favorable 90-day outcomes were similar. iNtercept had fewer sICH, procedural complications, and emboli in a new territory than CSR + BGC, and fewer procedural complications than CSR - BGC. CONCLUSIONS: This multicenter registry with PS matching demonstrated the non-inferiority of iNtercept to approved CSRs for successful reperfusion in LVO acute ischemic stroke.
The Effect of Gadolinium on Synthetic Magnetic Resonance Quantitative Imaging.
Novakova L, Rosenstein I, Axelsson M … +1 more , Ouellette R
J Neuroimaging · 2025 · PMID 41250281 · Full text
BACKGROUND AND PURPOSE: Synthetic (Sy) MRI is a clinically approved technique providing quantitative MRI measures based on T-weighted, T-weighted, and proton density relaxometry. MRI sequences are often acquired after co...
BACKGROUND AND PURPOSE: Synthetic (Sy) MRI is a clinically approved technique providing quantitative MRI measures based on T-weighted, T-weighted, and proton density relaxometry. MRI sequences are often acquired after contrast injection with gadolinium (Gd) to assess active lesions in persons with multiple sclerosis (PwMS), affecting relaxation time. We aimed to assess the influence of Gd on the SyMRI-based volumetrics in PwMS. METHODS: We enrolled 106 PwMS and 15 controls who performed pre-/post-contrast brain SyMRI on a 3T scanner. We evaluated mean change in brain parenchymal fraction (BPF), white matter (WM), grey matter (GM), myelin (Myl), non-aqueous component (NAC), excess parenchymal water (EPW), and T enhancement (TE) using paired sample t-test for pre-/post-Gd volumes and independent sample t-test for comparison between groups. RESULTS: The mean age was 40.9 and 39.9 years with 69% and 87% females in MS and controls, respectively. Compared to native volumetrics, Gd caused a significant observed volume increase (p < 0.001) in BPF 1.05 ± 0.3%, WM 2.8 ± 0.99%, Myl 1.42 ± 0.39%, NAC 1.04 ± 0.23%, and EPW 0.6 ± 0.4% and decrease in GM -3.05 ± 1.34% in MS. Similar change was seen in controls: BPF 0.99 ± 0.21%, WM 2.94 ± 0.93%, Myl 1.35 ± 0.37%, NAC 0.99 ± 0.22%, EPW 0.47 ± 0.29%, and GM -2.89 ± 1.18%. The change in TE was 0.05 ± 0.12% in MS (p < 0.001) and 0.02 ± 0.25% (p = 0.76) in controls. The number of contrast-enhancing lesions correlated with TE (r = 0.348, p < 0.003). CONCLUSION: There was a consistent pattern of volume changes in PwMS and controls, except for TE, where the contrast could have affected the results in PwMS. Therefore, combining pre- and post-contrast metrics in longitudinal studies should be interpreted with caution.
Cerebral Perfusion and Blood-Brain Barrier Changes After Cranioplasty: A Diffusion-Prepared Arterial Spin Labeling Study.
Ojogho B, Abedi A, Lee DJ … +5 more , Shao X, Russin J, Jann K, Liu CY, Wang DJJ
J Neuroimaging · 2025 · PMID 41239816 · Full text
BACKGROUND AND PURPOSE: Cranioplasty reconstruction after hemicraniectomy restores skull integrity and has been associated with neurological improvement, but the physiological mechanisms underlying recovery remain incomp...
BACKGROUND AND PURPOSE: Cranioplasty reconstruction after hemicraniectomy restores skull integrity and has been associated with neurological improvement, but the physiological mechanisms underlying recovery remain incompletely understood. This study investigated cerebral blood flow (CBF), arterial transit time (ATT), and blood-brain barrier (BBB) water exchange rate (Kw) as imaging metrics of hemodynamic recovery following cranioplasty. METHODS: Fourteen patients (mean age: 33.4 ± 8.53 years; 2 females, 12 males) who previously underwent hemicraniectomy for traumatic brain injury, ruptured aneurysm, or hemorrhagic stroke were included. All participants underwent diffusion-prepared pseudo-continuous arterial spin labeling (DP-pCASL) Magnetic Resonance Imaging (MRI) at 3 Tesla before and after cranioplasty. Hemodynamic parameters were quantified globally and regionally, with particular focus on the middle cerebral artery perforator (MCA Perf) territory. RESULTS: Post-surgical imaging revealed significant increases in CBF within the ipsilateral MCA Perf territory compared to pre-surgical values. BBB Kw asymmetry between MCA Perf territories also improved, indicating enhanced perfusion and BBB function in the impacted hemisphere. ATT changes were region-specific, with significant increases in asymmetry observed in the leptomeningeal anterior cerebral artery and posterior cerebral artery territories, but not in the MCA Perf region. CONCLUSIONS: These findings underscore the mechanobiological role of cranioplasty reconstruction in neurological recovery. Advanced hemodynamic imaging with DP-pCASL MRI provides quantitative insight into cerebral perfusion, BBB function, and regional perfusion timing. This approach may guide future research on post-cranioplasty recovery and inform personalized rehabilitation strategies.
Perfusion Territory Shifts in Cerebrovascular Diseases Measured by Super-Selective Arterial Spin Labeling.
Hoffmann G, Reichert M, Göttler J … +10 more , Helle M, Schmitzer L, Petzsche MH, Zimmer C, Preibisch C, Kallmayer M, Kreiser K, Sollmann N, Liebl H, Kaczmarz S
J Neuroimaging · 2025 · PMID 41229085 · Full text
BACKGROUND AND PURPOSE: Individualized diagnostic approaches are crucial in cerebrovascular diseases, such as internal carotid artery stenosis (ICAS). To evaluate individual collateral blood supply, vessel-selective imag...
BACKGROUND AND PURPOSE: Individualized diagnostic approaches are crucial in cerebrovascular diseases, such as internal carotid artery stenosis (ICAS). To evaluate individual collateral blood supply, vessel-selective imaging has gained high relevance. However, clinically established digital subtraction angiography (DSA) exposes patients to intervention risks and radiation. Two noninvasive MRI-based alternatives are super-selective pseudo-continuous arterial spin labeling (ss-pCASL, a technique for selective labeling of arterial blood-water) for perfusion territory mapping and four-dimensional vessel-selective angiography (4D-sPACK). We hypothesized that asymptomatic atherosclerosis-induced ICAS and Moyamoya disease result in chronic malperfusion. Therefore, we aimed towards quantitative assessment of collateral blood flow by ss-pCASL. METHODS: In this prospective monocentric study, we acquired data in three subgroups (n = 23): patients with asymptomatic unilateral atherosclerosis-induced ICAS, Moyamoya disease, and age-matched healthy controls (HCs). On the basis of vascular territories from ss-pCASL, we introduced four parameters: volume, territorial shift, overlap with an atlas, and cerebral blood flow (CBF). For patients with atherosclerosis-induced ICAS, ipsi- and contralateral hemispheres were compared (paired t-test), and hemispheric lateralization Δ was calculated subjectwise and compared between patients and HCs (unpaired t-test) (p < 0.05). RESULTS: We included data from 20 subjects (8 ICAS, 3 Moyamoya, 9 HC). Group-level results showed ICAS-induced shifts with significant lateralization compared to HCs (Δ = 18% ± 10%, p < 0.001; Δ = 4.9% ± 5.8%, p = 0.027; Δ = 0.2 ± 0.3, p = 0.033, Δ = 3 ± 3 mL/100 g/min, p = 0.045). Furthermore, collateral blood supply in Moyamoya disease was assessed by 4D-sPACK and showed comparable diagnostic value as DSA. CONCLUSION: Perfusion territory mapping by ss-pCASL revealed chronic malperfusion in asymptomatic ICAS that can be objectively quantified, and 4D-sPACK added diagnostic value similar to DSA.
Differentiating Brain Metastasis and High-Grade Glioma Using Multi-b Value Diffusion MRI and Tumor Volumetry.
Kopřivová T, Dostál M, Jůza T … +4 more , Vybíhal V, Ovesná P, Kozubek M, Keřkovský M
J Neuroimaging · 2025 · PMID 41229073 · Full text
BACKGROUND AND PURPOSE: To evaluate feasibility of multi-b value diffusion magnetic resonance imaging (MRI) and volumetry in differentiating between brain metastases and high-grade gliomas (HGGs) while producing a differ...
BACKGROUND AND PURPOSE: To evaluate feasibility of multi-b value diffusion magnetic resonance imaging (MRI) and volumetry in differentiating between brain metastases and high-grade gliomas (HGGs) while producing a differentiation tool. METHODS: Preoperative brain MRI consisting of both morphological and multi-b value diffusion sequences of patients with HGGs and brain metastases was prospectively performed. Three-dimensional masks of enhancing and non-enhancing tumor and surrounding edema were semiautomatically segmented. Multiple diffusion parameters were subsequently derived together with volumes of the particular tissues. Histogram analysis of the diffusion parameters was performed, and the parameters' diagnostic power to differentiate between the subgroups was evaluated by receiver operating characteristic analysis and least absolute shrinkage and selection operator (LASSO) regression method. RESULTS: A training dataset included 97 consecutive patients (67 HGGs, 30 metastases), whereas 17 patients (9 HGGs and 8 metastases) comprised a validation group. Overall, 66 histogram diffusion parameters and tissue volumes were found to differ significantly between metastasis and HGG subgroups. LASSO regression identified 17 of these as best predictors. A decision tree using four parameters achieved sensitivity of 90% and 87.5% and specificity of 97% and 77.8% for the training and validation subgroups, respectively. CONCLUSION: Multi-b diffusion MRI and tumor volumetry may be valuable diagnostic tools for differentiating HGG from brain metastasis.
Diffusion Tensor Imaging Reveals Altered Centrality of Pain-Related Regions in SCN9A-Associated Small Fiber Neuropathy.
Drenthen GS, Kool D, Far A … +9 more , Upadhyay J, Linden DEJ, van Gool R, Goijen CP, Merkies ISJ, Backes WH, Faber CG, Jansen JFA, Hoeijmakers JGJ
J Neuroimaging · 2025 · PMID 41216932 · Full text
BACKGROUND AND PURPOSE: Small fiber neuropathy (SFN) is a neuropathic disorder that is associated with chronic pain. While most SFN cases are idiopathic, SFN can also have hereditary causes. For example, rare SCN9A gene...
BACKGROUND AND PURPOSE: Small fiber neuropathy (SFN) is a neuropathic disorder that is associated with chronic pain. While most SFN cases are idiopathic, SFN can also have hereditary causes. For example, rare SCN9A gene mutations can impair the Na1.7 sodium channel, which leads to dorsal root ganglion neuron hyperexcitability, causing SFN. Although chronic pain may induce cerebral changes, the specific structural brain alterations in SCN9A-associated SFN (SFN-SCN9A) remain insufficiently characterized. Therefore, potential alterations in the structural brain network of idiopathic SFN and SFN-SCN9A were explored. METHODS: Ten SFN-SCN9A patients, 20 idiopathic SFN patients, and 20 controls were included. All participants underwent 3-Tesla diffusion MRI (66 gradient directions, b-value = 1200 s/mm), and the brain network was quantified using nodal importance, which describes the influence of a group of regions on the whole network. RESULTS: The nodal importance of pain-associated regions (postcentral gyrus, insular cortex, anterior cingulate cortex, and thalamus) was increased in SFN-SCN9A patients compared to controls (β = 0.43, p = 0.02) and idiopathic SFN patients (β = 0.43, p = 0.02). Moreover, higher self-reported pain was associated with higher nodal importance of pain-associated regions in the SFN-SCN9A group (r = 0.67, p = 0.03), while this effect was not observed in the idiopathic SFN patients (r = -0.22, p = 0.34). As self-reported pain did not differ between the SFN groups, it is likely specific to the SCN9A-mutation and not to differences in pain intensity. CONCLUSION: Combined, these results suggest the potential involvement of a distinct structural pathway related to pain processing in SFN-SCN9A.
Distinguishing Myo-Inositol From Glycine in Brain MRS at 3T: A Pitfall Using Intermediate Echo Times.
Alcicek S, Oeltzschner G, Lin DDM … +1 more , Barker PB
J Neuroimaging · 2025 · PMID 41216898 · Full text
BACKGROUND AND PURPOSE: In in vivo magnetic resonance spectroscopy (MRS) of the brain, glycine (Gly) is traditionally separated from the overlapping signal of myo-inositol (mI) through the use of intermediate (e.g., 130-...
BACKGROUND AND PURPOSE: In in vivo magnetic resonance spectroscopy (MRS) of the brain, glycine (Gly) is traditionally separated from the overlapping signal of myo-inositol (mI) through the use of intermediate (e.g., 130-140 ms) or long (270-280 ms) echo times (TE). However, no quantitative comparisons have been performed to date comparing the performance of clinically available MRS sequences to differentiate mI and Gly as a function of TE. METHODS: In vivo spectra recorded with two clinically available MRS pulse sequences (single voxel PRESS and semi-LASER 2D-MRSI) with short (35 ms), intermediate (135 ms), and long (280 ms) echo times in a neonate with clinically suspected nonketotic hyperglycinemia were compared to those recorded from phantoms, and spectral simulations. RESULTS: In vivo spectra recorded at short and intermediate TE spectra showed signals at 3.5 ppm that could arise from either mI or Gly; however, long TE spectra showed an absence of signal in this spectral region, which was consistent with the final clinical diagnosis of hypoxic-ischemic encephalopathy. Phantom data and spectral simulations demonstrated that at intermediate TE, mI has a "pseudo-singlet" appearance that is very similar to that of Gly. CONCLUSIONS: Long echo times are used to best discriminate Gly from mI if specialized sequences and analysis methods are not available. Quantitative spectral analysis methods may also assist in correctly assigning Gly and mI.
Assessing a Stimulator Modification for Simultaneous Noninvasive Auricular Vagus Nerve Stimulation and MRI.
Teckentrup V, Ludwig M, Seibt J … +15 more , Hartig R, Preissl H, Schuppert M, Avdievich NI, Scheffler K, Priovoulos N, Ehses M, Poser BA, Wiggins CJ, Trautner P, Honerbach W, Jacobs HIL, Speck O, Hämmerer D, Kroemer NB
J Neuroimaging · 2025 · PMID 41199481 · Full text
BACKGROUND AND PURPOSE: The vagus nerve can be stimulated noninvasively at the ear using transcutaneous auricular vagus nerve stimulation (taVNS). Concurrent functional MRI (fMRI) permits study of taVNS-induced changes i...
BACKGROUND AND PURPOSE: The vagus nerve can be stimulated noninvasively at the ear using transcutaneous auricular vagus nerve stimulation (taVNS). Concurrent functional MRI (fMRI) permits study of taVNS-induced changes in brain dynamics, a key requisite for precision neurostimulation. However, there is no standardized protocol for how to safely apply taVNS during MRI. One major risk is temperature increase exceeding innocuous thresholds due to coupling of the emitted radio frequency (RF) pulse during imaging. Thus, we developed and tested a stimulator cable configuration with floating ground cable traps and filter plate connectors. METHODS: We measured temperature, resonance of the stimulation electrodes, and current interference using unmodified and modified stimulation cables. Measurements were conducted across three sites using different 3T MRI scanner models, stimulators, and stimulation strengths with phantoms and human participants. RESULTS: The modified compared to the unmodified cable considerably reduced RF heating as the relative temperature increase stayed well below the 2 K threshold specified by the ASTM F2182 standard. Additionally, in accordance with ASTM 2119, we can rule out potential distortion and signal loss around the electrodes due to current flow from the stimulator and demonstrate that impaired image quality in brainstem and midbrain regions is recovered using the modified cable. CONCLUSIONS: We show that adding floating ground cable traps to the stimulator cable allows the safe use of taVNS with fMRI and may improve image quality in functional imaging. To enable other researchers to modify their hardware in the same way, we provide details of the modifications.
Diagnostic Accuracy of Neuromuscular Ultrasound for Carpal Tunnel Syndrome: A Real-World Study.
Roy U, Cartwright MS, Srivastava AK … +8 more , Dixit A, Panwar A, Vanchi M, Ramamurthy G, Shivaraman MMA, Ayan S, Verma S, Lal PK
J Neuroimaging · 2025 · PMID 41185453 · Publisher ↗
BACKGROUND AND PURPOSE: To determine the diagnostic accuracy of median nerve ultrasound in suspected cases of carpal tunnel syndrome (CTS) in a prospective, real-world study. METHODS: This prospective study was carried o...
BACKGROUND AND PURPOSE: To determine the diagnostic accuracy of median nerve ultrasound in suspected cases of carpal tunnel syndrome (CTS) in a prospective, real-world study. METHODS: This prospective study was carried out over one year at Roy Neuro Care Centre, Ranchi, Jharkhand, India. The clinical, electrophysiologic, and ultrasonographic findings in suspected cases of CTS were collected. A history and physical examination consistent with CTS were considered the gold standard for diagnosis. RESULTS: A total of 134 patients with symptoms suggestive of CTS were enrolled, and both wrists were examined. The diagnostic accuracy of various ultrasound parameters including maximum cross-sectional area (CSA) of the median nerve in the tunnel, difference between CSA at the level of the pronator quadratus compared to the carpal tunnel, and wrist-to-forearm ratio were evaluated by individual, parallel, and serial testing strategies using optimal cut-off values determined by the Youden Index. Parallel testing provided the highest sensitivity, making it suitable for screening, whereas serial testing produced the highest overall accuracy. CONCLUSION: Median nerve ultrasound is an accurate diagnostic tool for CTS in a real-world setting.
Edge-Guided Deep Learning Model to Predict Fetal Brain Age Using MRI.
Gan H, Gao Q, Yang Z … +4 more , Zhou Y, Zhou R, Guo Y, Xia W
J Neuroimaging · 2025 · PMID 41185452 · Publisher ↗
BACKGROUND AND PURPOSE: Deep learning enables fast fetal brain age prediction from MRI. However, most models emphasize global features while ignoring local edge details. To improve accuracy, we propose a novel model inco...
BACKGROUND AND PURPOSE: Deep learning enables fast fetal brain age prediction from MRI. However, most models emphasize global features while ignoring local edge details. To improve accuracy, we propose a novel model incorporating global edge information, achieving performance comparable to that of experienced clinicians. METHODS: A retrospective collection of 1630 fetal brain coronal T2-weighted MR images from 207 singleton pregnancies with brain ages ranging from 22 to 38 weeks from June 2019 to July 2023 was performed. The fetal MRI dataset was divided into two independent subsets: a training dataset for optimizing model parameters and a test dataset for evaluating the model's performance relative to a reference standard. Four-fifths of the dataset were allocated as training data and one-fifth as test data. We trained a neural network that incorporates global edge information and continuously optimized it using performance indicators such as mean absolute error (MAE) and r-square (R) to achieve the desired results. RESULTS: In a retrospective study involving 1630 fetal brain MR images from 207 subjects, the edge-guided deep learning model achieved higher accuracy in predicting fetal age compared to existing methods, with an MAE of 0.79 weeks and an R value of 0.94, and can promote regression models to produce more stable and reliable predictions. CONCLUSIONS: Compared to existing methods for predicting fetal brain age, our method demonstrates superior performance and is helpful for accurately assessing the fetal brain development in clinical practice.
The Ghost Penumbra Pattern in Acute Ischemic Stroke: Characterization and Prognostic Significance.
Alfonso ML, Sierra-Gómez A, Calleja AI … +10 more , Cortijo E, Valle G, Gómez-Vicente B, Martínez-Galdámez M, Galván J, Schüller M, Pérez L, Millán A, Eiros I, Arenillas JF
J Neuroimaging · 2025 · PMID 41185442 · Publisher ↗
BACKGROUND AND PURPOSE: We studied the so-called ghost penumbra pattern (GPP), characterized by an underestimation of ischemic core volume on computed tomography perfusion (CTP) as compared with noncontrast CT (NCCT). We...
BACKGROUND AND PURPOSE: We studied the so-called ghost penumbra pattern (GPP), characterized by an underestimation of ischemic core volume on computed tomography perfusion (CTP) as compared with noncontrast CT (NCCT). We aimed to describe its frequency, to characterize the baseline factors associated with its presence, and to investigate its impact on clinical and radiological outcomes in acute ischemic stroke (AIS) patients treated with endovascular therapy (EVT). METHODS: A consecutive series of AIS patients with proximal anterior circulation large vessel occlusion (LVO) treated with EVT and achieving successful reperfusion were included. All underwent NCCT, multiphase CT angiography (CTA), and CTP, which were analyzed with RAPID software. Ischemic core volumes were compared between CT and CTP. GPP was defined by a CT core/CTP core ratio >1.5. Collateral status and thrombus migration were assessed. Parenchymal hematoma (PH) and hypodensity volume were measured at 24 h. Functional outcome was evaluated at 90 days using the modified Rankin Scale. RESULTS: From June 2020 to December 2021, a total of 173 AIS patients were included in the study (mean age was 73; 52% women; median National Institutes of Health Stroke Scale [NIHSS] 16). GPP was detected in 100 (58%) patients. Good collateral circulation (OR 2.8 [1.5-5.4]; p = 0.001) and lower NIHSS (OR 0.9 [0.8-0.9]; p = 0.02) were independently associated with GPP. The GPP predicted a lower risk of PH (OR 0.43 [0.19-0.97]; p = 0.04). CONCLUSION: GPP was observed in about half of the included AIS patients and was associated with better collateral circulation and thrombus migration. Endovascular reperfusion in this group was safe.
Middle Meningeal Artery Lidocaine Infusion for Refractory Migraine: Angiographic Dose Response and 3-Month Outcomes.
Fakih R, Ranjini NJ, Gillani SA … +6 more , Pfeiffer K, Gomez CR, Sirakov A, Suri MFK, Bhogal P, Qureshi AI
J Neuroimaging · 2025 · PMID 41185441 · Publisher ↗
BACKGROUND AND PURPOSE: Several studies have demonstrated the amelioration of refractory migraines with middle meningeal artery (MMA) intra-arterial lidocaine infusion, but the durability beyond 1 month is not well studi...
BACKGROUND AND PURPOSE: Several studies have demonstrated the amelioration of refractory migraines with middle meningeal artery (MMA) intra-arterial lidocaine infusion, but the durability beyond 1 month is not well studied, and the angiographic dose response of lidocaine infusion was not previously evaluated. We aimed to assess the efficacy of middle meningeal artery lidocaine infusion in the treatment of refractory migraines at a 3-month follow-up. METHODS: We quantified the response to intra-arterial lidocaine infusion (maximum dose of 150 mg) in patients with refractory migraine using the Migraine Disability Assessment (MIDAS) evaluated pre- and posttreatment. At 3 months, We determined the MIDAS score changes, the proportion of responders (≥50% MIDAS reduction), the proportion of patients with "no disability" (MIDAS Grade 1), and the cessation of opioid medication for headache management measured at the last known follow-up. An angiographic dose response was quantified. RESULTS: Eight patients were included in our analysis (mean age of 49.1 ± 13.2 years; 87.5% were women). The cohort comprised equal numbers of unilateral and bilateral MMA lidocaine infusions (4 each), with doses titrated from 50 to 150 mg per procedure. At 3 months posttreatment, the mean MIDAS score improved from 86.3 ± 40.1 to 23.5 ± 26.8 (p = 0.001, paired t-test), and 62.5% of the patients showed 50% MIDAS score reduction. The disability pre-treatment was classified as "severe disability" in all patients, and 50% achieved "no disability" (MIDAS Grade 1) at 3 months posttreatment. No adverse events were reported in any of the procedures. At last known follow-up of a median period of 9.8 months [range 4-21 months], three out of the four patients who were on opioid medication pre-treatment discontinued their opioid medications following MMA lidocaine infusion. CONCLUSION: Intra-arterial lidocaine infusion was associated with sustained improvement at 3 months posttreatment in 50% of patients with refractory migraines.
Dynamic Nature of Arachnoid Granulations During Acute Changes in Intracranial Pressure: A Pilot Study.
Ko AWK, Thakor D, Aboudahab N … +2 more , Sheikhy A, Taheri MR
J Neuroimaging · 2025 · PMID 41139921 · Publisher ↗
BACKGROUND AND PURPOSE: Arachnoid granulations (AGs) are cerebrospinal fluid drainage structures whose number and size may vary with intracranial pressure (ICP). Although changes in AG size following lumbar puncture have...
BACKGROUND AND PURPOSE: Arachnoid granulations (AGs) are cerebrospinal fluid drainage structures whose number and size may vary with intracranial pressure (ICP). Although changes in AG size following lumbar puncture have been reported, longitudinal changes in patients with and without acute ICP alterations have not been studied. This study evaluated AG number and volume over time in patients with and without acute ICP changes. METHODS: We retrospectively reviewed head and neck computed tomography angiography scans over a 10-year period. Subjects had two consecutive scans with visible AGs. Controls had no acute intracranial pathology, whereas cases had acute hydrocephalus with decompression and ICP monitoring via extraventricular drains. AG volume was measured in both groups; AG number was assessed in controls only. Wilcoxon signed rank tests and paired t-tests were used to assess within-group differences. Welch's t-test and Type III analysis of variance were used for between-group differences and interaction effects. RESULTS: In 88 controls, AG volumes had a statistically significant change over time (p = 0.010). In four hydrocephalus cases, AG volume decreased by 29.9 mm (p = 0.030) after ICP reduction. Between-group analysis showed a significant point estimate difference (p = 0.020) and interaction (p < 0.0001), indicating differing AG responses to acute ICP changes. CONCLUSION: AGs are dynamic structures exhibiting measurable changes in number and volume over time. AG volume appears responsive to acute ICP alterations, supporting their function in ICP regulation and suggesting a potential role as an imaging biomarker for ICP dynamics in acute hydrocephalus.
Bridging Neuroimaging and Neuropathology: A Comprehensive Workflow for Targeted Sampling of White Matter Lesions.
Farhat N, Li J, Berardinelli J … +14 more , Stauffer M, Sajewski A, Alkhateeb S, Schweitzer N, Jin H, Wood S, Ikonomovic MD, Liou JJ, Aizenstein HJ, Mettenburg JM, Santini T, Wu M, Kofler JK, Ibrahim TS
J Neuroimaging · 2025 · PMID 41126483 · Full text
BACKGROUND AND PURPOSE: White matter lesions are common imaging biomarkers associated with aging and neurodegenerative diseases, yet their underlying pathology remains unclear due to limitations in imaging-based characte...
BACKGROUND AND PURPOSE: White matter lesions are common imaging biomarkers associated with aging and neurodegenerative diseases, yet their underlying pathology remains unclear due to limitations in imaging-based characterization. We aim to develop and validate a comprehensive workflow enabling precise MRI-guided histological sampling of white matter lesions to bridge neuroimaging and neuropathology. METHODS: We established a workflow integrating agar-sucrose brain embedding, ultrahigh field 7 Tesla (7T) MRI acquisition, reusable three-dimensional (3D) printed cutting guides, and semiautomated MRI-blockface alignment. Left hemispheric postmortem brains were stabilized in the embedding medium and scanned using optimized MRI protocols. Coronal sectioning was guided by standardized 3D-printed cutting guides, and knife traces were digitally matched to MRI planes. White matter lesions were segmented on MRI and aligned for histopathological sampling. RESULTS: The workflow enabled reproducible brain sectioning, minimized imaging artifacts, and achieved precise spatial alignment between MRI and histology. For demonstration, detailed results from two representative brains were presented in this article. Consistent, high-resolution MRI data facilitated accurate lesion detection and sampling. The use of standardized cutting guides and alignment protocols reduced variability and improved efficiency. CONCLUSIONS: Our cost-effective, scalable workflow reliably linked neuroimaging findings with histological analysis, enhancing the understanding of white matter lesion pathology. This framework held significant potential for advancing translational research in aging and neurodegenerative diseases.
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