Search Results (13)

Background and Objectives: Olfactory dysfunction is an early non-cognitive feature of Alzheimer’s disease (AD). The volumetric behavior of olfactory and related frontal structures and their link to eating disturbances remains unclear; we therefore compared olfactory bulb (OB) and gyrus rectus (GR) volumes between patients with AD and controls and examined their relationship with eating disturbances and their diagnostic value. Materials and Methods: In this single-center, retrospective, case–control study, 135 patients with AD and 49 age-matched controls underwent 3-Tesla MRI. Right, left, and total OB and GR volumes were measured. Groups were compared using the Mann–Whitney U test; age- and sex-adjusted logistic regression and receiver operating characteristic (ROC) analyses were performed; and OB and GR volumes were compared according to eating disturbance status in patients with AD, with adjustment for age and sex. p-Values were corrected for multiple comparisons using the Benjamini–Hochberg false discovery rate procedure. Results: All OB and GR volumes were significantly lower in patients with AD compared to controls (all p < 0.001), with the total OB volume nearly half that of the controls. Among patients with AD, all OB volumes were significantly lower in those with eating disturbances (all p < 0.001) and remained independently associated after adjustment for age and sex, whereas none of the GR volumes was significantly associated with eating disturbance status after adjustment. In adjusted models, every volumetric measure was independently associated with AD (all p < 0.001). The total OB volume showed the best diagnostic performance (AUC 0.940; sensitivity 0.82; specificity 0.98), while GR volumes performed less well (AUC 0.78–0.84). Conclusions: AD is associated with marked OB and GR atrophy. OB volume was associated with eating disturbances and discriminated AD from controls with high accuracy, supporting OB volumetry as an accessible candidate imaging marker that warrants prospective validation. Full article

Background/Objectives: The anterior communicating artery (AcomA) is one of the most common sites of intracranial aneurysms. We aimed to investigate the effect of routine extradural anterior clinoidectomy (EAC) and extradural lamina terminalis fenestration (ELTF) on the incidence of shunt-dependent hydrocephalus (SDH) and gyrus rectus injury in patients undergoing microsurgical clip reconstruction. Methods: This matched case–control study included 15 patients treated with routine EAC/ELTF between July 2023 and June 2025, matched 1:2 to 30 historical controls (2000–2019) by aneurysm size, location, dome-to-neck ratio, and rupture status. The primary outcome was the incidence of SDH. The secondary outcomes included the incidence of gyrus rectus hypodensity/injury and clinical outcomes, as assessed by the modified Rankin Scale (mRS) at discharge and follow-up. Results: Among 15 cases, 6 had ruptured aneurysms, 4 had unruptured aneurysms, and 5 were recanalized post-endovascular treatment. EAC was performed in all cases; ELTF was performed in 83% of ruptured cases. SDH occurred in 33% of ruptured cases versus 90% in controls (p = 0.02). Gyrus rectus hypodensity occurred in 13% of cases vs. 50% of controls (p = 0.01). EAC/ELTF was associated with reduced odds of SDH (OR: 0.06; 95% CI: 0.004–0.80; p = 0.03) and gyrus rectus hypodensity (OR: 0.15; 95% CI: 0.03–0.80; p = 0.03). A poor outcome (mRS >2) was seen in 27% at discharge, improving to 14% at follow-up (with a median of 11 months). Delayed cerebral ischemia occurred in 33% of ruptured cases. Conclusions: Routine EAC/ELTF may reduce SDH and gyrus rectus injury after AComA aneurysm clip reconstruction, particularly in ruptured cases. Prospective multi-center studies are needed to validate these preliminary findings. Full article

Background: The gyrus rectus is a key brain region with neural connections to the entorhinal cortex and hippocampus, both of which are among the earliest areas affected in Alzheimer’s disease (AD). Investigating volumetric differences and asymmetry in this region may provide insights into disease progression. This study aimed to assess gyrus rectus volume and asymmetry in AD patients using an MRI-based parcellation method. Methods: This cross-sectional volumetric study included 25 cognitively healthy adults and 25 AD patients recruited from the Neurology Clinic of Balıkesir University Hospital. Brain MRI scans were obtained using a 1.5 Tesla MRI scanner. Volumetric measurements were computed using MRIStudio, an atlas-based image analysis program. Group differences in brain volume and asymmetry index were examined, and their correlations with Mini-Mental State Examination (MMSE) scores were evaluated. Results: AD patients exhibited significantly greater rightward volumetric asymmetry of the gyrus rectus volume than healthy controls (p < 0.05). Additionally, a positive correlation was observed between gyrus rectus volume and MMSE scores (p < 0.05). Conclusions: These results suggest that rightward volumetric asymmetry of the gyrus rectus may represent a promising biomarker for tracking the progression of Alzheimer’s disease. Detecting asymmetry in brain structures could improve understanding of AD pathology and aid clinical evaluation. Full article

Introduction: Advanced magnetic resonance imaging (MRI) techniques in neuroplasticity evaluations provide important information on stroke disease and the underlying mechanisms of neuronal recovery. It has been observed that gray matter density or volume in brain regions closely related to motor function can be a valuable indicator of the response to treatment. Objective: To compare structural MRI-evaluated gray matter volume changes in patients with post-stroke upper limb spasticity for >1 year between those undergoing surgery and those treated with botulinum toxin A (BoNT-A) and to relate these findings to upper limb function and quality of life outcomes. Materials and Methods: Design. A two-arm controlled and randomized clinical trial in patients with post-stroke upper limb spasticity. Participants. Thirty post-stroke patients with spastic upper limbs. Intervention. Participants were randomly assigned (1:1 allocation ratio) for surgery (experimental group) or treatment with BoNT-A (control group). Main outcome measures. The functional parameters were analyzed with Fugl-Meyer, Zancolli, Keenan, House, Ashworth, pain visual analogue, and hospital anxiety and depression scales. Quality of life was evaluated using SF-36 and Newcastle stroke-specific quality of life scales. The carer burden questionnaire was also applied. Clinical examinations and MRI scans were performed at baseline and at six months post-intervention. Correlations between brain volume/thickness and predictors of interest were examined across evaluations and groups. Results: Five patients were excluded due to the presence of intracranial implants. Eleven patients were excluded from analyses since they were late dropouts. Changes were observed in the experimental group but not in the control group. Between baseline and six months, gray matter volume was augmented at the hippocampus and gyrus rectus and cortical thickness was increased at the frontal pole, occipital gyrus, and insular cortex, indicating anatomical changes in key areas related to motor and behavioral adaptation These changes were significantly related to subjective pain, Ashworth spasticity scale, and Newcastle quality of life scores, and marginally related to the carer burden score. Conclusions: The structural analysis of gray matter by MRI revealed differences in patients with post-stroke sequelae undergoing different therapies. Gray matter volume and cortical thickness measurements showed significant improvements in the surgery group but not in the BoNT-A group. Volume was increased in areas associated with motor and sensory functions, suggesting a neuroprotective or regenerative effect of upper limb surgery. Full article

Background: Prolonged confinement in enclosed environments has raised concerns about its effects on both physical and mental health. Although increased rates of depression or anxiety during COVID-19 lockdowns have been reported, the effects of short-term restrictions on social activities and physical on brain function and structure remain poorly known. Methods: This study explored longitudinal changes in brain gray matter volume (GMV) and functional connectivity (FC) immediately after and four months following a short-term lockdown in comparison to pre-lockdown conditions. MRI data were collected from 20 participants before the lockdown, from 29 participants (14 original, 15 new) two months post-lockdown, and from 27 out of the 29 participants four months post-lifting of the lockdown. Results: Results showed significant GMV reductions in the right gyrus rectus and cuneus post-lockdown, with further reductions observed four months after lifting the restrictions, affecting additional brain regions. Longitudinal FC trajectories revealed decreased connectivity between the default mode network (DMN) and sensorimotor/attention networks post-lockdown, and recovery after four months post-lifting of the lockdown. Conclusions: The observed plasticity in brain FC indicates substantial recovery potential with the potential long-term effect of structural changes. Our findings offer insights into the effects of isolation on the human brain, potentially informing rehabilitation mechanisms and interventions for individuals in similar conditions. Full article

(1) Background: The transglabellar approach, a type of transfacial technique, typically involves glabellar resection and opening the frontal sinus via a bicoronal incision, providing access to the anterior cranial vault. To prevent complications, the frontal sinus is typically obliterated. However, the success of transnasal endoscopic techniques has prompted a re-evaluation of these traditional methods. (2) Methods: This paper provides a brief literature review and discusses the removal of an elongated glioma of the left gyrus rectus (4.4 × 1.9 × 2.2 cm) in a 63-year-old male using a transglabellar subfrontal approach via a butterfly incision, with frontal sinus preservation. (3) Results: An uneventful gross-total resection of a WHO grade II oligodendroglioma was achieved. There is a paucity of literature describing a transglabellar subfrontal approach via a butterfly incision with frontal sinus preservation. (4) Conclusions: The described approach could be utilized in selected cases such as small intra-axial lesions oriented longitudinally along the inferomedial frontal lobe from the posterior wall of the frontal sinus to the anterior communicating artery complex in patients with pre-existing glabellar rhytids. Since this is merely a case presentation, we cannot conclude that this represents established clinical practice. The outcomes of this approach should be investigated in the future. Full article

Serotonergic neurotransmission has been associated with aggression in several psychiatric disorders. Human aggression is a continuum of traits, ranging from normal to pathological phenomena. However, the individual differences in serotonergic neurotransmission and their relationships with aggression traits in healthy individuals remain unclear. In this study, we explored the relationship between 5-HT2A receptor availability in vivo and aggression traits in healthy participants. Thirty-three healthy participants underwent 3-Tesla magnetic resonance imaging and positron emission tomography (PET) with [¹¹C]MDL100907, a selective radioligand for 5-HT2A receptors. To quantify 5-HT2A receptor availability, the binding potential (BP_ND) was derived using the basis function implementation of the simplified reference tissue model, with the cerebellum as the reference region. The participants’ aggression levels were assessed using the Buss–Perry Aggression Questionnaire. The voxel-based correlation analysis with age and sex as covariates revealed that the total aggression score was significantly positively correlated with [¹¹C]MDL100907 BP_ND in the right middle temporal gyrus (MTG) pole, left fusiform gyrus (FUSI), right parahippocampal gyrus, and right hippocampus. The physical aggression subscale score had significant positive correlations with [¹¹C]MDL100907 BP_ND in the left olfactory cortex, left orbital superior frontal gyrus (SFG), right anterior cingulate and paracingulate gyri, left orbitomedial SFG, left gyrus rectus, left MTG, left inferior temporal gyrus, and left angular gyrus. The verbal aggression subscale score showed significant positive correlations with [¹¹C]MDL100907 BP_ND in the bilateral SFG, right medial SFG, left FUSI, and right MTG pole. Overall, our findings suggest the possibility of positive correlations between aggression traits and in vivo 5-HT2A receptor availability in healthy individuals. Future research should incorporate multimodal neuroimaging to investigate the downstream effects of 5-HT2A receptor-mediated signaling and integrate molecular and systems-level information in relation to aggression traits. Full article

Treatment-resistant depression (TRD) is a severe disorder characterized by high relapse rates and decreased quality of life. An effective strategy in the management of TRD is deep brain stimulation (DBS), a technique consisting of the implantation of electrodes that receive a stimulation via a pacemaker-like stimulator into specific brain areas, detected through neuroimaging investigations, which include the subgenual cingulate cortex (sgCC), basal ganglia, and forebrain bundles. In this context, to improve our understanding of the mechanism underlying the antidepressant effects of DBS in TRD, we collected the results of diffusion tensor imaging (DTI) studies exploring how WM microstructure is associated with the therapeutic effects of DBS in TRD. A search on PubMed, Web of Science, and Scopus identified 11 investigations assessing WM microstructure in responders and non-responders to DBS. Altered WM microstructure, particularly in the sgCC, medial forebrain bundle, cingulum bundle, forceps minor, and uncinate fasciculus, was associated with the antidepressant effect of DBS in TRD. Overall, the results show that DBS targeting selective brain regions, including the sgCC, forebrain bundle, cingulum bundle, rectus gyrus, anterior limb of the internal capsule, forceps minor, and uncinate fasciculus, seem to be effective for the treatment of TRD. Full article

Chronic pain is common after burn injuries, and post-burn neuropathic pain is the most important complication that is difficult to treat. Scrambler therapy (ST) is a non-invasive modality that uses patient-specific electrocutaneous nerve stimulation and is an effective treatment for many chronic pain disorders. This study used magnetic resonance imaging (MRI) to evaluate the pain network-related mechanisms that underlie the clinical effect of ST in patients with chronic burn-related pain. This prospective, double-blinded, randomized controlled trial (ClinicalTrials.gov: NCT03865693) enrolled 43 patients who were experiencing chronic neuropathic pain after unilateral burn injuries. The patients had moderate or greater chronic pain (a visual analogue scale (VAS) score of ≥5), despite treatment using gabapentin and other physical modalities, and were randomized 1:1 to receive real or sham ST sessions. The ST was performed using the MC5-A Calmare device for ten 45 min sessions (Monday to Friday for 2 weeks). Baseline and post-treatment parameters were evaluated subjectively using the VAS score for pain and the Hamilton Depression Rating Scale; MRI was performed to identify objective central nervous system changes by measuring the cerebral blood volume (CBV). After 10 ST sessions (two weeks), the treatment group exhibited a significant reduction in pain relative to the sham group. Furthermore, relative to the pre-ST findings, the post-ST MRI evaluations revealed significantly decreased CBV in the orbito-frontal gyrus, middle frontal gyrus, superior frontal gyrus, and gyrus rectus. In addition, the CBV was increased in the precentral gyrus and postcentral gyrus of the hemisphere associated with the burned limb in the ST group, as compared with the CBV of the sham group. Thus, a clinical effect from ST on burn pain was observed after 2 weeks, and a potential mechanism for the treatment effect was identified. These findings suggest that ST may be an alternative strategy for managing chronic pain in burn patients. Full article

To explore the role of the interictal and ictal SPECT to identity functional neuroimaging biomarkers for SUDEP risk stratification in patients with drug-resistant focal epilepsy (DRFE). Twenty-nine interictal-ictal Single photon emission computed tomography (SPECT) scans were obtained from nine DRFE patients. A methodology for the relative quantification of cerebral blood flow of 74 cortical and sub-cortical structures was employed. The optimal number of clusters (K) was estimated using a modified v-fold cross-validation for the use of K means algorithm. The two regions of interest (ROIs) that represent the hypoperfused and hyperperfused areas were identified. To select the structures related to the SUDEP-7 inventory score, a data mining method that computes an automatic feature selection was used. During the interictal and ictal state, the hyperperfused ROIs in the largest part of patients were the bilateral rectus gyrus, putamen as well as globus pallidus ipsilateral to the seizure onset zone. The hypoperfused ROIs included the red nucleus, substantia nigra, medulla, and entorhinal area. The findings indicated that the nearly invariability in the perfusion pattern during the interictal to ictal transition observed in the ipsi-lateral putamen F = 12.60, p = 0.03, entorhinal area F = 25.80, p = 0.01, and temporal middle gyrus F = 12.60, p = 0.03 is a potential biomarker of SUDEP risk. The results presented in this paper allowed identifying hypo- and hyperperfused brain regions during the ictal and interictal state potentially related to SUDEP risk stratification. Full article

Purpose: Violent subjects were demonstrated to exhibit abnormal brain structures; however, the brain changes may be different between criminals committing affective (VA), predatory violence (VP), and non-violence (NV). Therefore, the purpose of this study was to compare the differences in brain structures and psychological characteristics between VA, VP, and NV offenders. Methods: Twenty male criminal subjects (7 VP; 6 VA; and 7 NV) offenders; and twenty age-matched male healthy non-criminals were enrolled in this study. All subjects received psychological assessments as well as magnetic resonance imaging scans of the brain. Analysis of variance (ANOVA) was performed to understand the differences among four groups with Bonferroni correction. The voxel-based morphometry and voxel-wise diffusion tensor imaging analyses were performed to compare the gray matter (GM) volume and white matter (WM) integrity between the groups. In significant regions, a Spearman correlation analysis was performed to understand the relationship between the brain changes and psychological scores. Results: The ANOVA analysis showed that AUDIT scores were significantly different among four groups, but no significant group difference was noted after Bonferroni correction. The imaging comparisons further demonstrated that the VP and NV offenders exhibited significant alterations of WM and GM tissues in the rectus and superior temporal gyrus, respectively. In addition, the VP offenders exhibited greater GM volumes than VA offenders in the right middle frontal gyrus, and NV offenders had greater GM volumes than VP offenders in the bilateral thalamus. Conclusion: We concluded that the VA, VP, and NV groups exhibited different degrees of alterations in GM and WM tissues in regions involved in emotion and cognition. Full article

Ictal semiology and brain single-photon emission computed tomography have been performed in approaching the epileptogenic zone in drug-resistant focal epilepsies. The authors aim to describe the brain structures involved in the ictal and interictal epileptogenic network from sequential semiology and brain perfusion quantitative patterns analysis. A sequential representation of seizures was performed (n = 15). A two-level analysis (individual and global) was carried out for the analysis of brain perfusion quantification and estimating network structures from the perfusion indexes. Most of the subjects started with focal seizures without impaired consciousness, followed by staring, automatisms, language impairments and evolution to a bilateral tonic-clonic seizure (temporal lobe and posterior quadrant epilepsy). Frontal lobe epilepsy seizures continued with upper limb clonus and evolution to bilateral tonic-clonic. The perfusion index of the epileptogenic zone ranged between 0.439–1.362 (mesial and lateral structures), 0.826–1.266 in dorsolateral frontal structures and 0.678–1.507 in the occipital gyrus. The interictal epileptogenic network proposed involved the brainstem and other subcortical structures. For the ictal state, it included the rectus gyrus, putamen and cuneus. The proposed methodology provides information about the brain structures in the neural networks in patients with drug-resistant focal epilepsies. Full article

Previous studies have demonstrated that functional connectivity (FC) of different brain regions in resting state function MRI were abnormal in patients suffering from mild cognitive impairment (MCI) and Alzheimer’s disease (AD) when comparing to healthy controls (HC) using seed based, independent component analysis (ICA) or small world network techniques. A new technique called voxel-mirrored homotopic connectivity (VMHC) was used in the current study to evaluate the value of interhemispheric functional connectivity (IFC) as a diagnostic tool to differentiate vascular dementia (VD) from other Alzheimer’s related neurodegenerative diseases. Eighty-three participants were recruited from the university hospital memory clinic. A multidisciplinary panel formed by a neuroradiologist and two geriatricians classified the participants into VD (13), AD (16), MCI (29), and HC (25) based on clinical history, Montreal Cognitive Assessment Hong Kong version (HK‑MoCA) neuropsychological score, structural MRI, MR perfusion, and 18-F Flutametamol (amyloid) PET-CT findings of individual subjects. We adopted the calculation method used by Kelly et al. (2011) and Zuo et al. (2010) in obtaining VMHC maps. Specific patterns of VMHC maps were obtained for VD, AD, and MCI to HC comparison. VD showed significant reduction in VMHC in frontal orbital gyrus and gyrus rectus. Increased VMHC was observed in default mode network (DMN), executive control network (ECN), and the remaining salient network (SN) regions. AD showed a reduction of IFC in all DMN, ECN, and SN regions; whereas MCI showed VMHC reduction in vSN, and increased VMHC in DMN and ECN. When combining VMHC values of relevant brain regions, the accuracy was improved to 87%, 92%, and 83% for VD, AD, and MCI from HC, respectively, in receiver operating characteristic (ROC) analysis. Through studying the VMHC maps and using VMHC values in relevant brain regions, VMHC can be considered as a reliable diagnostic tool for VD, AD, and MCI from HC. Full article