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BackgroundMRI is a sensitive method for the assessment of brain abnormalities in Wilson disease, that is, T2 hyperintensities, T2 hypointensities, and atrophy, but a validated scoring system for the classification of radiological severity is lacking. The objective of this study was to develop and validate a brain MRI visual rating scale for Wilson disease.MethodsThe proposed Wilson disease brain MRI severity scale consists of acute toxicity and chronic damage subscores from predefined structures. The former, calculated by summing scores of T2 hyperintensities (excluding cavitation), is likely to be partially reversible with treatment. The latter, representing the sum of scores of T2 hypointensities and brain atrophy, reflects pathology that is not readily reversible. Validation was performed on MRI scans acquired using 1.5T system from 39 Wilson disease patients examined at baseline and after 24 months on anticopper treatment. Intraclass correlation coefficients of 5 ratings from 3 raters were calculated. Temporal evolution of the MRI severity score and its association with clinical severity, assessed using the Unified Wilson Disease Rating Scale part III, was calculated.ResultsIntrarater and interrater agreement were good (r > 0.93; P < 0.001; and r > 0.74; P < 0.001, respectively). In neurologic Wilson disease patients, the total MRI severity score improved over 2 years (P = 0.032), mainly because of reduced acute toxicity (P = 0.0015), whereas the chronic damage score deteriorated (P = 0.035). Unified Wilson Disease Rating Scale part III score was positively associated with chronic damage and total score at baseline (P = 0.005 and P = 0.003, respectively) and in month 24 (P < 0.001 and P = 0.001, respectively).ConclusionsThe Wilson disease brain MRI severity scale is a simple, reliable, and valid instrument that allows semiquantitative assessment of radiological Wilson disease severity. © 2020 International Parkinson and Movement Disorder Society

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The main function of cuticular lipids in insects is the restriction of water transpiration through the surface. Lipids are involved in various types of chemical communication between species and reduce the penetration of insecticides, chemicals, and toxins and they also provide protection from attack by microorganisms, parasitic insects, and predators. Hydrocarbons, which include straight-chain saturated, unsaturated, and methyl-branched hydrocarbons, predominate in the cuticular lipids of most insect species; fatty acids, alcohols, esters, ketones, aldehydes, as well as trace amounts of epoxides, ethers, oxoaldehydes, diols, and triacylglycerols have also been identified. Analyses of cuticular lipids are chemically relatively straightforward, and methods for their extraction should be simple. Classically, extraction has relied mainly on application of apolar solvents to the entire insect body. Recently, several alternative methods have been employed to overcome some of the shortcomings of solvent extraction. These include the use of solid-phase microextraction (SPME) fibers to extract hydrocarbons from the headspace of heated samples, SPME to sample live individuals, and a less expensive method (utilized for social wasps), which consists of the collection of cuticular lipids by means of small pieces of cotton rubbed on the body of the insect. Both classical and recently developed extraction methods are reviewed in this work. The separation and analysis of the insect cuticular lipids were performed by column chromatography, thin-layer chromatography (TLC), high performance liquid chromatography with a laser light scattering detector (HPLC-LLSD), gas chromatography (GC), and GC-mass spectrometry (MS). The strategy of lipid analysis with the use of chromatographic techniques was as follows: extraction of analytes from biological material, lipid class separation by TLC, column chromatography, HPLC-LLSD, derivatization, and final determination by GC, GC-MS, matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) MS, and liquid chromatography-mass spectrometry (LC-MS).