Objective:To investigate the structural changes in the spinal cord in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and their relationship with clinical disability.Methods:This study was cross-sectional. A retrospective analysis of clinical and imaging data from 124 patients with MS (MS group), 101 patients with aquaporin-4 antibody-positive NMOSD (NMOSD group), and 110 healthy controls (HC group) from seven medical centers were conducted from January 2018 to October 2021. All subjects underwent 3D T 1WI, and the upper cervical spinal cord cross-sectional area (MUCCA) was segmented and measured. All patients completed the expanded disability status scale (EDSS) assessments at baseline and during follow-up, as well as the baseline 25-foot walk test (T25FW) and the nine-hole peg test (NHPT). Patients were classified into EDSS progression and non-progression groups based on follow-up EDSS scores. Comparisons of MUCCA among the three groups were conducted using analysis of covariance, controlling for age and sex as covariates. Pairwise comparisons between groups were performed using the HSD test. Univariate linear regression and logistic models were employed to identify candidate predictors of baseline clinical disability status or EDSS progression in the MS and NMOSD groups. L1 regularized multivariable linear regression analysis was used to determine independent predictors of baseline clinical disability status or EDSS progression. Independent predictors were then combined to establish a logistic regression model, and the model′s performance in predicting EDSS progression was evaluated using receiver operating characteristic analysis and the area under the curve (AUC). Results:A total of 144 patients completed follow-up EDSS assessments, with a follow-up duration of 3.30 (1.10, 6.42) years, including 82 patients in the MS group and 62 patients in the NMOSD group. Controlling for sex and age as covariates, the overall difference in MUCCA among the MS, NMOSD, and HC groups was statistically significant ( P=0.001). The MUCCA in the MS group was lower than that in the HC group, with a significant difference ( t=-2.54, P=0.007); the MUCCA in the NMOSD group was also lower than that in the HC group, with a significant difference ( t=-2.80, P=0.002). However, the difference in MUCCA between the MS and NMOSD groups was not statistically significant ( t=-0.40, P=0.882). In the MS group, MUCCA was an independent predictor of baseline EDSS score (β=-0.03), baseline T25FW score (β=-0.09), and baseline NHPT score (β=-0.30). In the NMOSD group, MUCCA (β=-0.08), age (β=0.06), and baseline EDSS score (β=-0.43) were independent predictors of EDSS progression, and the logistic regression model incorporating these three factors predicted EDSS progression with an AUC of 0.82. Conclusions:Significant spinal cord atrophy occurs in patients with both MS and NMOSD. Atrophy of the upper cervical spinal cord can predict the degree of disability in MS patients and the progression of clinical disability in NMOSD patients.

Objective:To investigate the structural changes in the spinal cord in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and their relationship with clinical disability.Methods:This study was cross-sectional. A retrospective analysis of clinical and imaging data from 124 patients with MS (MS group), 101 patients with aquaporin-4 antibody-positive NMOSD (NMOSD group), and 110 healthy controls (HC group) from seven medical centers were conducted from January 2018 to October 2021. All subjects underwent 3D T 1WI, and the upper cervical spinal cord cross-sectional area (MUCCA) was segmented and measured. All patients completed the expanded disability status scale (EDSS) assessments at baseline and during follow-up, as well as the baseline 25-foot walk test (T25FW) and the nine-hole peg test (NHPT). Patients were classified into EDSS progression and non-progression groups based on follow-up EDSS scores. Comparisons of MUCCA among the three groups were conducted using analysis of covariance, controlling for age and sex as covariates. Pairwise comparisons between groups were performed using the HSD test. Univariate linear regression and logistic models were employed to identify candidate predictors of baseline clinical disability status or EDSS progression in the MS and NMOSD groups. L1 regularized multivariable linear regression analysis was used to determine independent predictors of baseline clinical disability status or EDSS progression. Independent predictors were then combined to establish a logistic regression model, and the model′s performance in predicting EDSS progression was evaluated using receiver operating characteristic analysis and the area under the curve (AUC). Results:A total of 144 patients completed follow-up EDSS assessments, with a follow-up duration of 3.30 (1.10, 6.42) years, including 82 patients in the MS group and 62 patients in the NMOSD group. Controlling for sex and age as covariates, the overall difference in MUCCA among the MS, NMOSD, and HC groups was statistically significant ( P=0.001). The MUCCA in the MS group was lower than that in the HC group, with a significant difference ( t=-2.54, P=0.007); the MUCCA in the NMOSD group was also lower than that in the HC group, with a significant difference ( t=-2.80, P=0.002). However, the difference in MUCCA between the MS and NMOSD groups was not statistically significant ( t=-0.40, P=0.882). In the MS group, MUCCA was an independent predictor of baseline EDSS score (β=-0.03), baseline T25FW score (β=-0.09), and baseline NHPT score (β=-0.30). In the NMOSD group, MUCCA (β=-0.08), age (β=0.06), and baseline EDSS score (β=-0.43) were independent predictors of EDSS progression, and the logistic regression model incorporating these three factors predicted EDSS progression with an AUC of 0.82. Conclusions:Significant spinal cord atrophy occurs in patients with both MS and NMOSD. Atrophy of the upper cervical spinal cord can predict the degree of disability in MS patients and the progression of clinical disability in NMOSD patients.

Objective To establish normal reference values for left ventricular trabecular and papillary muscle mass(TPMM)in Chinese adults using MRI and to explore its impact factors.Methods A total of 168 healthy Chinese adults were retrospectively included,and compacted and total left ventricular myocardial mass(LVM)were measured using traditional and dedicated methods,respectively.TPMM was calculated from the difference between total and compacted LVM.Independent sample t-tests and analysis of variance were used to explore the differences in TPMM among genders and age groups,while multiple linear regression was used to explore the independent correlation between TPMM and age,gender,heart rate,systolic blood pressure(SBP),fasting blood glucose(FBG),and body mass index(BMI).Results TPMM for men was significantly larger than that for female(P<0.001).TPMM in the elderly group was significantly larger in female(P<0.05),but not in men.Multiple linear regression showed that BMI and SBP were both independently positively correlated with TPMM,and female and heart rate were independently negatively correlated with TPMM(P<0.05).Conclusion This study provides age-and gender-specific normal reference values for TPMM in Chinese adults.Gender,heart rate,BMI,and SBP are all independently associated with TPMM.

L-dopa (l-3,4-dihydroxyphenylalanine)-induced dyskinesia (LID) is a debilitating complication of dopamine replacement therapy for Parkinson's disease. The potential contribution of striatal D₂ receptor (D₂R)-positive neurons and downstream circuits in the pathophysiology of LID remains unclear. In this study, we investigated the role of striatal D₂R⁺ neurons and downstream globus pallidus externa (GPe) neurons in a rat model of LID. Intrastriatal administration of raclopride, a D₂R antagonist, significantly inhibited dyskinetic behavior, while intrastriatal administration of pramipexole, a D₂-like receptor agonist, yielded aggravation of dyskinesia in LID rats. Fiber photometry revealed the overinhibition of striatal D₂R⁺ neurons and hyperactivity of downstream GPe neurons during the dyskinetic phase of LID rats. In contrast, the striatal D₂R⁺ neurons showed intermittent synchronized overactivity in the decay phase of dyskinesia. Consistent with the above findings, optogenetic activation of striatal D₂R⁺ neurons or their projections in the GPe was adequate to suppress most of the dyskinetic behaviors of LID rats. Our data demonstrate that the aberrant activity of striatal D₂R⁺ neurons and downstream GPe neurons is a decisive mechanism mediating dyskinetic symptoms in LID rats.
Rats ; Animals ; Levodopa/toxicity* ; Dopamine ; Parkinsonian Disorders/drug therapy* ; Oxidopamine ; Dyskinesia, Drug-Induced ; Corpus Striatum/metabolism* ; Neurons/metabolism* ; Receptors, Dopamine D2/metabolism* ; Antiparkinson Agents/toxicity*

With the attention to CT radiation and contrast-induced nephropathy,the technology of "double low" CTA has been gradually applied in clinical practice and become a research hotspot in recent years.The "double low" CTA technology aims to reduce X-ray dose and iodine intake of subject in ensuring image quality to meet the diagnostic requirements.The concept of "double low",basic principles,scanning standard protocols and current status of clinical application of "double low" were reviewed in this paper.

Alzheimer disease (AD) is the most common cause of dementia in the aging people.The early diagnosis is very important to slow down the progression and improve the prognosis of AD.At present,most researches focus on the subjective cognitive decline (SCD),which is considered as the preclinical stage of AD.The use of biological markers to predict whether the progress of SCD to AD is necessary.The progresses of imaging studies on SCD were reviewed in this article.

Objective To examine the nonhuman primate(NHP)model of acute cerebral infarction thrombus-thrombolysis using multi-parameter high-field magnetic resonance imaging(MRI). Methods Altogether, 8 adult male rhesus monkeys aged 8.2(± 1.2)years old and weighing 9.4(± 1.0)kg were randomized into an infarction group(n=4)and thrombolysis group(n =4). Middle cerebral artery occlusion(MCAO)was induced with a clot in the M1 segment. Monkeys in the thrombolysis group were treated with the recombinant tissue plasminogen activator, rt-PA, while those in the infarction group were treated with 0.9% NaCl only. T2 weighted imaging(T2WI), T2-weighted-fluid-attenuated inversion recovery(T2-FLAIR), time-of-flight magnetic resonance angiography(TOF-MRA), and diffusion-weighted imaging(DWI)were used to examine all monkeys at 4 and 24 h after onset of ischemia. Results The rhesus monkey thrombus-thrombolysis model was successfully established. MRA showed that the middle cerebral artery(MCA) was not recanalized in the infarction group, but was recanalized in the thrombolysis group. T2WI sequence showed an increase in infarction volume(12 027 ± 5507 mm3)in the infarction group compared with the thrombolysis group(4910 ± 2764 mm3). DWI sequence showed an increase in infarction volume(9498 ± 5226 mm3)in the infarction group and thrombolysis group(4854 ± 1792 mm3). Both T2WI and DWI sequences showed no significant difference in infarction volume at 4 h between the two groups, while infarction volume in the thrombolysis group at 24 h was significantly lower compared with the infarction group. The increase in infarction volume was significantly lower in the thrombolysis group compared with the infarction group. Conclusions MRI sequences can be used to successfully evaluate recanalization and infarct changes in the thrombus-thrombolysis model in rhesus monkeys.

Neuromyelitis optica (NMO) is an inflammatory-demyelinating disease of central nervous system that is characterized by severe attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM).Conventional MRI is the most sensitive method in detection of NMO lesions in brain,spinal cord and optic nerve,which can objectively show the site,number,size and distribution of lesions.The MRI features of NMO lesion in brain,spinal cord and optic nerve lesions were reviewed in this article.

Objective To evaluate the value of procalcitonin(PCT) and endotoxin(ET) in early diagnosis and prognosis in critically illness patients with sepsis.Methods A total of 104 cases with suspected sepsis were prospectively collected in this study from February 2015 to October 2016 in ICU.There were 31 cases of systemic inflammatory response syndrome (SIRS group),30 cases of sepsis 24 cases of severe sepsis and 19 cases of septic shock.Prognosis was observed in patients with sepsis discharged,57 cases were survival (survival group) while 16 cases were dead (death group).The level of PCT and ET and the clinical characteristics were recorded,The the ROC curve was applied to evaluate the discriminative power of variables.Results The levels of PCT,APACHE-Ⅱ score,ET of cases with sepsis,severe sepsis and septic shock were significantly higher than those in SIRS group(P<0.05).The PCT and APACHE-Ⅱ scores were elevated by the severities of disease (P<0.05).ROC curve analysis showed that,the sensitivity of PCT value was 82.2% and specificity was 87.5%.PCT and APACHE-Ⅱ scores were higher in the death group (P<0.05),whereas there was no significant difference on ET between the two groups (P>0.05).ROC curve showed that AUC of PCT was 0.867,which was significantly higher than that for APACHE-Ⅱ score (AUC=0.762) (P>0.05).Conclusion Compared with APACHE-Ⅱ score and ET,PCT can help clinicians to early diagnose and treat cases with sepsis.

The hybrid PET/MR has a unique advantage of simultaneous scanning of both PET and MRI images,which has been gradually applied in clinical practice.In the clinical studies of severe brain diseases (such as cerebrovascular disease,brain tumor and epilepsy),accurate quantification of cerebral blood flow (CBF) can help to understand the etiology,pathogenesis,and to make early diagnosis as well as therapeutic solutions.The hybrid PET/MR can implement a noninvasive,convenient and accurate method of arterial input function for quantification of CBF.The application of the hybrid PET/MR in quantification of cerebral blood flow were reviewed in this article.