Cerebral white matter status and resting state functional MRI.

White Matter (WM) is a pivotal component of the Central Nervous System (CNS), and its main role is the transmission of the neural impulses within the CNS and between CNS and Peripheral Nervous System (PNS). It is note from literature that changes in the WM affects the function of the CNS with effects on the higher neurological function, included cognition. Further, it has been theorized in the last decades that ageing-associated decline in higher neurological functions, in particular in the neurocognitive sphere, could be at least partly explained by the “disconnection” of the cortical areas of the brain due to the WM degeneration. Although standard “in-vivo” imaging biomarkers of WM integrity have not been validated yet for clinical purposes, several researches have demonstrated the correlation between different potential imaging biomarkers and WM integrity. The aim of the PhD project is to explore and better understanding the effects of WM status on the brain structure, networking and cognition. In particular, we designed three distinct explorative and cross-sectional studies; more specifically, we analyzed the effects of two Magnetic Resonance Imaging (MRI) markers of WM degeneration (the global Fractional Anisotropy (gFA) and the white matter hyperintensities burden (WMHb), respectively) on the brain activity measured with the Resting-State Functional Magnetic Resonance Imaging (rs-fMRI) technique. The project was conducted by analyzing a human population of healthy subjects extracted from the public available dataset “Leipzig Study for Mind-Body-Emotion Interactions” (LEMON). The results of these studies have been published during the PhD course on three distinct international scientific papers

Volumetric analysis of carotid plaque components and cerebral microbleeds: a correlative study

PURPOSE: The purpose of this work was to explore the association between carotid plaque volume (total and the subcomponents) and cerebral microbleeds (CMBs). MATERIALS AND METHODS: Seventy-two consecutive (male 53; median age 64) patients were retrospectively analyzed. Carotid arteries were studied by using a 16-detector-row computed tomography scanner whereas brain was explored with a 1.5 Tesla system. CMBs were studied using a T2*-weighted gradient-recalled echo sequence. CMBs were classified as from absent (grade 1) to severe (grade 4). Component types of the carotid plaque were defined according to the following Hounsfield unit (HU) ranges: lipid less than 60 HU; fibrous tissue from 60 to 130 HU; calcification greater than 130 HU, and plaque volumes of each component were calculated. Each carotid artery was analyzed by 2 observers. RESULTS: The prevalence of CMBs was 35.3%. A statistically significant difference was observed between symptomatic (40%) and asymptomatic (11%) patients (P value = .001; OR = 6.07). Linear regression analysis demonstrated an association between the number of CMBs and the symptoms (P = .0018). Receiver operating characteristics curve analysis found an association between the carotid plaque subcomponents and CMBs (Az = .608, .621, and .615 for calcified, lipid, and mixed components, respectively), and Mann-Whitney test confirmed this association in particular for the lipid components (P value = .0267). CONCLUSIONS: Results of this study confirm the association between CMBs and symptoms and that there is an increased number of CMBs in symptomatic patients. Moreover, we found that an increased volume of the fatty component is associated with the presence and number of CMBs

Association between carotid artery and abdominal aortic aneurysm plaque

The correlation between AAA and carotid artery plaque is unknown and a common etiology and pathophysiology is suspected by some authors. The purpose of this work was to explore the association between the features of a) carotid artery plaque and b) abdominal aortic aneurysm (AAA) plaques using multi-detector-CT Angiography (MDCTA). Forty-eight (32 males; median age 72 years) patients studied using a 16-detectors CT scanner were retrospectively analyzed. A region of interest (ROI) ≥ 2 mm2 was used to quantify the HU value of the plaque by two readers independently. Inter-observer reproducibility was calculated and Pearson correlation analysis was performed. The Bland-Altman plots showed the inter-observer reproducibility to be good. The Pearson correlation was 0.224 (95 % CI = 0.071 to 0.48), without statistically significant association between HU measured in the carotid artery plaque and in the AAA plaques (p = 0.138); after exclusion of the calcified plaques from the analysis, the rho values resulted 0.494 (95 % CI = 0.187 to 0.713) with a statistically significant association (p = 0.003). In this study, we found an association between the features of the non calcific carotid plaque and the features of AAA plaque

A new system of authorship best assessment

Purpose:The standard bibliometric indexes ("m-quotient "H-," "H2-," "g-," "a-," "m-," and "r-" index) do not considered the research' position in the author list of the paper. We proposed a new methodology, System of Authorship Best Assessment (SABA), to characterize the scientific output based on authors' position. Material and Methods:Four classes S1A, S1B, S2A, and S2B include only papers where the researcher is in first, first/last, first/second/last, and first/second/second-last/last position respectively were used for the calculation of H-index and number of citations The system was tested with Noble prize winners controlled with researchers matched for H-index. The different in percentage between standard bibliometric index and S2B was calculated and compared. Results:The percentage differences in Noble prize winners between S2B-H-index versus Global H-index and number of citations is very lower comparing with control group (median 4.15% [adjusted 95% CI, 2.54-5.30] vs 9.00 [adjusted 95% CI, 7.16-11.84], p < 0.001; average difference 8.7% vs 20.3%). All different in percentage between standard bibliometric index and S2B except two (H2- and m-index) were significantly lower among Noble prize compared with control group. Conclusion:The SABA methodology better weight the research impact by showing that for excellent profiles the S2B is similar to global values whereas for other researchers there is a significant difference

Impact of corpus callosum integrity on functional interhemispheric connectivity and cognition in healthy subjects

To examine the corpus callosum's (CC) integrity in terms of fractional anisotropy (FA) and how it affects resting-state hemispheric connectivity (rs-IHC) and cognitive function in healthy individuals. Sixty-eight healthy individuals were recruited for the study. The global FA (gFA) and FA values of each CC tract (forceps minor, body, tapetum, and forceps major) were evaluated using diffusion-weighted imaging (DWI) sequences. The homotopic functional connectivity technique was used to quantify the effects of FA in the CC tracts on bilateral functional connectivity, including the confounding effect of gFA. Brain regions with higher or lower rs-IHC were identified using the threshold-free cluster enhancement family-wise error-corrected p-value of 0.05. The null hypothesis was rejected if the p-value was <= 0.05 for the nonparametric partial correlation technique. Several clusters of increased rs-IHC were identified in relation to the FA of individual CC tracts, each with a unique topographic distribution and extension. Only forceps minor FA values correlated with cognitive scores. The integrity of CC influences rs-IHC differently in healthy subjects. Specifically, forceps minor anisotropy impacts rs-IHC and cognition more than other CC tracts do

Clinical neuroimaging markers of response to treatment in mood disorders.

Mood disorders (MD) are important and frequent psychiatric illness. The management of patients affected by these conditions represents an important factor of disability as well as a significant social and economic burden. The "in-vivo" studies can help researchers to understand the first developmental events of the pathology and to identify the molecular and non-molecular targets of therapies. However, they have strong limitations due to the fact that human brain circuitry can not be reproduced in animal models. In addition, these neural pathways are difficult to be selectively studied with the modern imaging (such as Magnetic Resonance and Positron Emitted Tomography/Computed Tomography) and non-imaging (such as electroencephalography, magnetoencephalography, transcranial magnetic stimulation and evoked potentials) methods. In comparison with other methods, the "in-vivo" imaging investigations have higher temporal and spatial resolution compared to the "in-vivo" non-imaging techniques. All these factors make difficult to fully understand the aetiology and pathophysiology of these disorders, and consequently hinder the analysis of the effects of pharmacological and non-pharmacological therapies, which have been demonstrated effective in clinical settings. In this review, we will focus our attention on the current state of the art of imaging in the assessment of treatment efficacy in MD. We will analyse briefly the actual classification of MD; then we will focus on the "in vivo" imaging methods used in research and clinical activity, the current knowledge about the neural models at the base of MD. Finally the last part of the review will focus on the analysis of the main markers of response to treatment

Left atrial strain in patients with β-thalassemia major: a cross-sectional CMR study

Objectives The aim of this cross-sectional study was to investigate the association of left atrial (LA) strain parameters with demographics, clinical data, cardiovascular magnetic resonance (CMR) fndings, and cardiac complications (heart failure and arrhythmias) in a cohort of patients with β-thalassemia major (β-TM). Materials and methods We considered 264 β-TM patients (133 females, 36.79 ± 11.95 years) consecutively enrolled in the Extension-Myocardial Iron Overload in Thalassemia (E-MIOT) project. Moreover, we included 35 sex- and agematched healthy controls (14 females, mean age 37.36 ± 17.52 years). Reservoir, conduit, and booster LA functions were analysed by CMR feature tracking using dedicated software. Results Compared to the healthy control group, β-TM patients demonstrated lower LA reservoir strain and booster strains, as well as LA reservoir and booster strain rates. However, no diferences were found in LA conduit deformation parameters. In β-TM patients, ageing, sex, and left ventricle (LV) volume indexes were independent determinants of LA strain parameters. The number of segments with late gadolinium enhancement (LGE) signifcantly correlated with all LA strain parameters, with the exception of the LA conduit rate. Patients with cardiac complications exhibited signifcantly impaired strain parameters compared to patients without cardiac complications. Conclusion In patients with β-TM, LA strain parameters were impaired compared to control subjects, and they exhibited a signifcant correlation with the number of LV segments with LGE. Furthermore, patients with cardiac complications had impaired left atrial strain parameters. Clinical relevance statement In patients with β-thalassemia major, left atrial strain parameters were impaired compared to control subjects and emerged as a sensitive marker of cardiac complications, stronger than cardiac iron levels

Safety and Efficacy of Vedolizumab in Kidney Transplant Recipients With Crohn’s Disease

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Review of imaging biomarkers for the vulnerable carotid plaque

Identification of carotid artery atherosclerosis is conventionally based on measurements of luminal stenosis. However, histopathologic studies demonstrate considerable differences between plaques with identical degrees of stenosis and indicate that certain plaque features are associated with increased risk for ischemic events. As a result of the rapid technological evolution in medical imaging, several important steps have been taken in the field of carotid plaque imaging allowing us to visualize the carotid atherosclerotic plaque and its composition in great detail. For computed tomography, magnetic resonance imaging, positron emission tomography, and ultrasound scan, evidence has accumulated on novel imaging-based markers that confer information on carotid plaque vulnerability, such as intraplaque hemorrhage and lipid-rich necrotic cores. In terms of the imaging-based identification of individuals at high risk of stroke, routine assessments of such imaging markers are the way forward for improving current clinical practice. The current review highlights the main characteristics of the vulnerable plaque indicating their role in the etiology of ischemic stroke as identified by intensive plaque imaging