In Parkinson's disease (PD), iron elevation in specific brain regions as well as selective loss of dopaminergic neurons is a major pathologic feature. A reliable quantitative measure of iron deposition is a potential biomarker for PD and may contribute to the investigation of iron-mediated PD. The primary purpose of this study is to assess iron variations in multiple deep grey matter nuclei in early PD with a novel MRI technique, quantitative susceptibility mapping (QSM). The inter-group differences of susceptibility and R2* value in deep grey matter nuclei, namely head of caudate nucleus (CN), putamen (PUT), global pallidus (GP), substantia nigra (SN), and red nucleus (RN), and the correlations between regional iron deposition and the clinical features were explored in forty-four early PD patients and 35 gender and age-matched healthy controls. Susceptibility values were found to be elevated within bilateral SN and RN contralateral to the most affected limb in early PD compared with healthy controls (HCs). The finding of increased susceptibility in bilateral SN is consistent with work on a subgroup of patients at the earliest clinical detectable state (Hoehn and Yahr [1967]: Neurology 17:427-442; Stage I). However, increased R2* values were only seen within SN contralateral to the most affected limb in the PD group when compared with controls. Furthermore, bilateral SN magnetic susceptibility positively correlated with disease duration and UPDRS-III scores in early PD. This finding supports the potential value of QSM as a non-invasive quantitative biomarker of early PD.

Diffusion-weighted MR imaging is feasible in the assessment of renal function, especially in the detection of early stage renal failure of CKD.

Purpose: To investigate the brain iron deposits in patients with Alzheimer's disease (AD) and healthy age-matched controls using phase imaging. Materials and Methods:Twenty-six AD patients and 24 healthy controls were recruited. A three-dimensional highresolution, gradient-echo sequence was used to acquire phase data in the coronal plane. A high-pass filter was used to remove the phase variation caused by field inhomogeneity. The regions evaluated included the bilateral putamen, globus pallidus, and the head and body of the hippocampus.Results: Significantly lower phase values in both the basal ganglion and hippocampus were revealed in the AD group compared to the normal controls (P Ͻ 0.05). The phase value in the right side of the head of the hippocampus had a moderate positive correlation with the MMSE score (rϭ 0.603, P ϭ 0.000) and a negative correlation with the duration of the disease (r ϭ Ϫ0.677, P ϭ 0.013). Using Ϫ0.0972 radians as an optimal cutoff value, the sensitivity and specificity for differentiation between AD and normal controls reached 95.8 and 80.8%, respectively. Conclusion:Phase imaging proved to be a useful method for the differentiation between normal controls and AD patients. An investigation of the excessive accumulation of iron in the hippocampus may help us better understand the pathologic process and neuropsychological dysfunction of AD disease.

PurposeA three-dimensional (3D) continuous pulse arterial spin labeling (ASL) technique was used to investigate cerebral blood flow (CBF) changes in patients with Alzheimer’s disease (AD), amnestic mild cognitive impairment (aMCI), and age- and sex-matched healthy controls.Materials and methodsThree groups were recruited for comparison, 24 AD patients, 17 MCI patients, and 21 age- and sex-matched control subjects. Three-dimensional ASL scans covering the entire brain were acquired with a 3.0 T magnetic resonance scanner. Spatial processing was performed with statistical parametric mapping 8. A second-level one-way analysis of variance analysis (threshold at P<0.05) was performed on the preprocessed ASL data. An average whole-brain CBF for each subject was also included as group-level covariates for the perfusion data, to control for individual CBF variations.ResultsSignificantly increased CBF was detected in bilateral frontal lobes and right temporal subgyral regions in aMCI compared with controls. When comparing AD with aMCI, the major hyperperfusion regions were the right limbic lobe and basal ganglia regions, including the putamen, caudate, lentiform nucleus, and thalamus, and hypoperfusion was found in the left medial frontal lobe, parietal cortex, the right middle temporo-occipital lobe, and particularly, the left anterior cingulate gyrus. We also found decreased CBF in the bilateral temporo-parieto-occipital cortices and left limbic lobe in AD patients, relative to the control group. aMCI subjects showed decreased blood flow in the left occipital lobe, bilateral inferior temporal cortex, and right middle temporal cortex.ConclusionOur results indicated that ASL provided useful perfusion information in AD disease and may be used as an appealing alternative for further pathologic and neuropsychological studies, especially of compensatory mechanisms for cerebral hypoperfusion.

BackgroundComputerized multi-model training has been widely studied for its effect on delaying cognitive decline. In this study, we designed the first Chinese-version computer-based multi-model cognitive training for mild cognitive impairment (MCI) patients. Neuropsychological effects and neural activity changes assessed by functional MRI were both evaluated.MethodMCI patients in the training group were asked to take training 3–4 times per week for 6 months. Neuropsychological and resting-state fMRI assessment were performed at baseline and at 6 months. Patients in both groups were continuously followed up for another 12 months and assessed by neuropsychological tests again.Results78 patients in the training group and 63 patients in the control group accomplished 6-month follow-up. Training group improved 0.23 standard deviation (SD) of mini-mental state examination, while control group had 0.5 SD decline. Addenbrooke's cognitive examination-revised scores in attention (p = 0.002) and memory (p = 0.006), as well as stroop color-word test interference index (p = 0.038) and complex figure test-copy score (p = 0.035) were also in favor of the training effect. Difference between the changes of two groups after training was not statistically significant. The fMRI showed increased regional activity at bilateral temporal poles, insular cortices and hippocampus. However, difference between the changes of two groups after another 12 months was not statistically significant.ConclusionsMulti-model cognitive training help MCI patients to gained cognition benefit, especially in memory, attention and executive function. Functional neuroimaging provided consistent neural activation evidence. Nevertheless, after one-year follow up after last training, training effects were not significant. The study provided new evidence of beneficial effect of multi-model cognitive training.

Parkinson disease (PD) is a heterogeneous neurodegenerative disorder with variable clinicopathologic phenotypes and underlying neuropathologic mechanisms. Each clinical phenotype has a unique set of motor symptoms. Tremor is the most frequent initial motor symptom of PD and is the most difficult symptom to treat. The dentate nucleus (DN) is a deep iron rich nucleus in the cerebellum and may be involved in PD tremor. In this study, we test the hypothesis that DN iron may be elevated in tremor dominant PD patients using quantitative susceptibility mapping. Forty-three patients with PD [19 tremor dominant (TD)/24 akinetic-rigid dominant (AR)] and 48 healthy gender- and age-matched controls were recruited. Multi-echo gradient echo data were collected for each subject on a 3.0 T MR system. Inter-group susceptibility differences in bilateral DN were investigated and correlations of clinical features with susceptibility were also examined. In contrast to the AR group, the TD group was found to have increased susceptibility in the bilateral DN, when compared to healthy controls. In addition, susceptibility was positively correlated with tremor score in drug naive PD patients. These findings indicate that iron load within DN may make an important contribution to motor phenotypes in PD. Moreover, our results suggest that TD and AR phenotypes of PD can be differentiated on the basis of the susceptibility of the DN at least on the group level.

Parkinson’s disease (PD) is a neurodegenerative disease characterized by dysfunction in distributed functional brain networks. Previous studies have reported abnormal changes in static functional connectivity using resting-state functional magnetic resonance imaging (fMRI). However, the dynamic characteristics of brain networks in PD is still poorly understood. This study aimed to quantify the characteristics of dynamic functional connectivity in PD patients at nodal, intra- and inter-subnetwork levels. Resting-state fMRI data of a total of 42 PD patients and 40 normal controls (NCs) were investigated from the perspective of the temporal variability on the connectivity profiles across sliding windows. The results revealed that PD patients had greater nodal variability in precentral and postcentral area (in sensorimotor network, SMN), middle occipital gyrus (in visual network), putamen (in subcortical network) and cerebellum, compared with NCs. Furthermore, at the subnetwork level, PD patients had greater intra-network variability for the subcortical network, salience network and visual network, and distributed changes of inter-network variability across several subnetwork pairs. Specifically, the temporal variability within and between subcortical network and other cortical subnetworks involving SMN, visual, ventral and dorsal attention networks as well as cerebellum was positively associated with the severity of clinical symptoms in PD patients. Additionally, the increased inter-network variability of cerebellum-auditory pair was also correlated with clinical severity of symptoms in PD patients. These observations indicate that temporal variability can detect the distributed abnormalities of dynamic functional network of PD patients at nodal, intra- and inter-subnetwork scales, and may provide new insights into understanding PD.

ObjectiveTo investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases.Materials and MethodsA perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti- CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5.ResultsThe mean perfusion values and MVD for tumors were as follows: BF (48.14±16.46 ml/100 g/min), BV (6.70±2.95 ml/100 g), MTT (11.75±4.02 s), PS (14.17±5.23 ml/100 g/min) and MVD (41.7±11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05).ConclusionThe perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.