Objective: (1) To assess cognitive function and cerebral magnetic resonance imaging (MRI) involvement in relapsing-remitting multiple sclerosis; (2) to monitor disease evolution, cognitive dysfunction, and cerebral lesion burden over time (mean 8.5 year follow up period); (3) to study the relation between clinical, neuropsychological, and MRI data. On follow up assessment, visual and auditory oddball event related potentials (ERPs) were recorded as psychophysiological evaluation of cognitive status. Correlations between neuropsychological, MRI, and ERP data were also analysed. Methods: Neuropsychological study assessed verbal and non-verbal IQ, deterioration index (DI) from WAIS subtests, conceptual reasoning, attention, verbal and visuospatial short-term and long term memory. MRI assessment detected presence of demyelinating lesions by using a semiquantitative method as well as cortical and subcortical atrophy over time.Results: Attention, short-term and long term visuospatial memory were mildly impaired at baseline and remained unaltered longitudinally. At retesting a significant worsening of verbal long term memory (p=0.023), DI presence (p=0.041) and the increase of supratentorial and subtentorial MRI lesions load (p=0.001) emerged. Expanded disability status scale score correlated significantly with total lesion burden at both evaluations (p=0.043 and p=0.024 respectively). Temporal, occipital, and frontal horn lesions as well as cortical atrophy correlated significantly with attention and memory tests at baseline. Follow up assessment revealed significant correlation between cortical atrophy and attention as well as visuospatial short-term memory; spatial long term memory correlated significantly with lesions in body of lateral ventricle and frontal lobe. ERP study showed P300 latency abnormalities in 75% of patients, involving specifically more visual P300 (58.4 % of cases) than auditory wave (41.6 %). Visual P300 latency and amplitude correlated significantly with DI and auditory P300 latency with frontal horn and brain stem lesions. Conclusions: These findings revealed mild cognitive impairment in MS patients particularly consistent with slowing information processing over time. Increased MRI lesions do not correlate with the clinical course of the disease and cognitive deficit evolution. Thus, cognitive dysfunction could be related to disease peculiarity and not to the time course. Correlations between P300, neuropsychological, and MRI findings provide further information about ERP application to examine cognitive impairment in MS and probably to investigate their neural origin. C ognitive dysfunction in multiple sclerosis (MS) occurs in 30%-70% of cases 1 2 especially referred to attention, recent memory, information processing speed, executive functions, verbal intellectual ability, and visuospatial perception.3-5 Conflicting literature data report that cognitive impairment could be considered an early feature of the disease or a consequence of its duration, course, and severity. [6][7][8] It is well...
Introduction Over the last decade, the field of medical imaging experienced an exponential growth, leading to the development of radiomics, with which innumerable quantitative features are obtained from digital medical images, providing a comprehensive characterization of the tumor. This review aims to assess the role of this emerging diagnostic tool in breast cancer, focusing on the ability of radiomics to predict malignancy, response to neoadjuvant chemotherapy, prognostic factors, molecular subtypes, and risk of recurrence. Evidence Acquisition A literature search on PubMed and on Cochrane database websites to retrieve English-written systematic reviews, review articles, meta-analyses, and randomized clinical trials published from August 2013 up to July 2018 was carried out. Results Twenty papers (19 retrospective and 1 prospective studies) conducted with different conventional imaging modalities were included. Discussion The integration of quantitative information with clinical, histological, and genomic data could enable clinicians to provide personalized treatments for breast cancer patients. Current limitations of a routinely application of radiomics are represented by the limited knowledge of its basics concepts among radiologists and by the lack of efficient and standardized systems of feature extraction and data sharing.
Spinal epidural lipomatosis can be a cause of back pain but rarely radicular impingement. Magnetic resonance imaging is the procedure of choice. The treatment must be performed early by wide surgical decompression.
The purpose of this study is to evaluate chest CT imaging features, clinical characteristics, laboratory values of COVID-19 patients who underwent CTA for suspected pulmonary embolism. We also examined whether clinical, laboratory or radiological characteristics could be associated with a higher rate of PE. Materials and methods: This retrospective study included 84 consecutive patients with laboratory-confirmed SARS-CoV-2 who underwent CTA for suspected PE. The presence and localization of PE as well as the type and extent of pulmonary opacities on chest CT exams were examined and correlated with the information on comorbidities and laboratory values for all patients. Results: Of the 84 patients, pulmonary embolism was discovered in 24 patients. We observed that 87% of PE was found to be in lung parenchyma affected by COVID-19 pneumonia. Compared with no-PE patients, PE patients showed an overall greater lung involvement by consolidation (p = 0.02) and GGO (p < 0.01) and a higher level of D-Dimer (p < 0,01). Moreover, the PE group showed a lower level of saturation (p = 0,01) and required more hospitalization (p < 0,01). Conclusion: Our study showed a high incidence of PE in COVID-19 pneumonia. In 87% of patients, PE was found in lung parenchyma affected by COVID-19 pneumonia with a worse CT severity score and a greater number of lung lobar involvement compared with non-PE patients. CT severity, lower level of saturation, and a rise in Ddimer levels could be an indication for a CTPA. Advances in knowledge: Certain findings of non-contrast chest CT could be an indication for a CTPA.
BackgroundThe human gleno-humeral joint is normally represented as a spherical hinge and its center of rotation is used to construct humerus anatomical axes and as reduction point for the computation of the internal joint moments. The position of the gleno-humeral joint center (GHJC) can be estimated by recording ad hoc shoulder joint movement following a functional approach. In the last years, extensive research has been conducted to improve GHJC estimate as obtained from positioning systems such as stereo-photogrammetry or electromagnetic tracking. Conversely, despite the growing interest for wearable technologies in the field of human movement analysis, no studies investigated the problem of GHJC estimation using miniaturized magneto-inertial measurement units (MIMUs). The aim of this study was to evaluate both accuracy and precision of the GHJC estimation as obtained using a MIMU-based methodology and a functional approach.MethodsFive different functional methods were implemented and comparatively assessed under different experimental conditions (two types of shoulder motions: cross and star type motion; two joint velocities: ωmax = 90°/s, 180°/s; two ranges of motion: Ɵ = 45°, 90°). Validation was conducted on five healthy subjects and true GHJC locations were obtained using magnetic resonance imaging.ResultsThe best performing methods (NAP and SAC) showed an accuracy in the estimate of the GHJC between 20.6 and 21.9 mm and repeatability values between 9.4 and 10.4 mm. Methods performance did not show significant differences for the type of arm motion analyzed or a reduction of the arm angular velocity (180°/s and 90°/s). In addition, a reduction of the joint range of motion (90° and 45°) did not seem to influence significantly the GHJC position estimate except in a few subject-method combinations.ConclusionsMIMU-based functional methods can be used to estimate the GHJC position in vivo with errors of the same order of magnitude than those obtained using traditionally stereo-photogrammetric techniques. The methodology proposed seemed to be robust under different experimental conditions. The present paper was awarded as “SIAMOC Best Methodological Paper 2016”.
Cerebellar pathology commonly shows important motor signs and less evident cognitive dysfunction. The 'cerebellar cognitive affective syndrome' is characterised by impairment on executive function, spatial cognition, language and behaviour. We report the case of a man with acute onset of transitory motor features and severe mental disorders. Cranial CT and brain MRI revealed extended cerebellar lesions. Neuropsychological assessment disclosed deficits of attention, executive function and memory. Auditory event-related potentials showed abnormal P300. These data suggest a pure "cerebellar cognitive affective syndrome"and strengthen the hypothesis of cerebellar cognitive function modulation.
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