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Background and purposeHypoperfusion of the posterior cingulate cortex (PCC) and precuneus has consistently been reported in patients with Alzheimer's disease (AD). Repetitive transcranial magnetic stimulation (rTMS) combined with cognitive training (COG) is effective in alleviating the symptoms of patients with mild AD. This study investigated the effects of rTMS-COG therapy on cerebral blood flow (CBF), with a special interest in the PCC/precuneus, and whether observed CBF changes are associated with changes in neuropsychological assessments in AD.Materials and methodsTwenty-one patients with mild or moderate AD were randomly divided into real rTMS (n = 11) and sham treatment (n = 10) groups, both combined with COG. Neuro-navigated 10 Hz rTMS was used to stimulate the left dorsolateral prefrontal cortex (DLPFC) and then the left lateral temporal lobe (LTL) for 20 min each day for 4 weeks in the real rTMS group. All patients with AD underwent neuropsychological assessment, pseudo-continuous arterial spin labeling, and structural 3D T1-weighted MRI before treatment (T0), immediately after treatment (T1), and 4 weeks after treatment (T2). CBF in the precuneus, PCC, and stimulation targets at the region-of-interest (ROI) level, as well as whole-brain CBF changes at the voxel level, were compared between the two groups at three timepoints.ResultsrTMS-COG therapy revealed significant group × time interactions for the Mini-Mental State Examination (F = 5.339, p = 0.023, η2 = 0.433) and activities of daily living (F = 5.409, p = 0.039, η2 = 0.436) scores. The regional CBF in the precuneus showed a significant group × time interaction (F = 5.833, p = 0.027, η2 = 0.593). For voxel-level analysis, a significant group main effect was found in the left limbic lobe cluster, with the maximal peak in the left parahippocampus (p < 0.001, uncorrected, peak at [−16 −8 −24]). Simple effects analysis indicated that rTMS-COG therapy induced a decrease in CBF in the precuneus at T1 (p = 0.007) and an increase in the left parahippocampus at T2 (p=0.008). CBF decrease in the precuneus was correlated with better cognitive function immediately after treatment (T1) (r =−0.732, p=0.025).ConclusionNeuropsychological assessments showed immediate and long-term effects on cognitive function and activities of daily living after rTMS-COG therapy. CBF changes induced by high-frequency rTMS-COG therapy are region-dependent, showing immediate effects in the precuneus and long-term effects in the left parahippocampus. These results provide imaging evidence to understand the underlying neurobiological mechanism for the application of rTMS-COG in AD.

Urbanicity, the impact of living in urban areas, is among the greatest environmental challenges for mental health. While urbanicity might be distinct in different sociocultural conditions and geographic locations, there are likely to exist common features shared in different areas of the globe. Understanding these common and specific relations of urbanicity with human brain and behavior will enable to assess the impact of urbanicity on mental disorders, especially in childhood and adolescence, where prevention and early interventions are likely to be most effective.We constructed from satellite-based remote sensing data a factor for urbanicity that was highly correlated with population density ground data. This factor, ‘UrbanSat’ was utilized in the Chinese CHIMGEN sample (N=831) and the longitudinal European IMAGEN cohort (N=810) to investigate if exposure to urbanicity during childhood and adolescence is associated with differences in brain structure and function in young adults, and if these changes are linked to behavior.Urbanicity was found negatively correlated with medial prefrontal cortex volume and positively correlated with cerebellar vermis volume in young adults from both China and Europe. We found an increased correlation of urbanicity with functional network connectivity within- and between- brain networks in Chinese compared to European participants. Urbanicity was highly correlated with a measure of perceiving a situation from the perspective of others, as well as symptoms of depression in both datasets. These correlations were mediated by the structural and functional brain changes observed. Susceptibility to urbanicity was greatest in two developmental windows during mid-childhood and adolescence.Using innovative technology, we were able to probe the relationship between urban upbringing with brain change and behavior in different sociocultural conditions and geographic locations. Our findings help to identify shared and distinct determinants of adolescent brain development and mental health in different regions of the world, thus contributing to targeted prevention and early-intervention programs for young people in their unique environment. Our approach may be relevant for public health, policy and urban planning globally.

Objective This study aims to investigate the clinical performance of three-dimensional (3D) fast-recovery fast spin-echo (FRFSE) magnetic resonance dacryocystography (MRD) with topical administration of sterile saline solution for the assessment of the lacrimal drainage system (LDS). Methods A total of 13 healthy volunteers underwent both 3D-FRFSE MRD and two-dimensional (2D)-impulse recovery (IR)-single-shot fast spin-echo (SSFSE) MRD after topical administration of sterile saline solution, and 31 patients affected by primary LDS outflow impairment or postsurgical recurrent epiphora underwent 3D-FRFSE MRD and conventional T1- and T2-weighted sequences. All patients underwent lacrimal endoscopy or surgery, which served as a standard of reference for confirming the MRD findings. Results 3D-FRFSE MRD detected more visualized superior and inferior canaliculi and nasolacrimal duct than 2D-IR-SSFSE MRD. Compared with 2D-IR-SSFSE MRD, 3D-FRFSE MRD showed more visualized segments per LDS, although the difference was not statistically significant. Significant improvements in the inferior canaliculus and nasolacrimal duct visibility grades were achieved using 3D-FRFSE MRD. 3D-FRFSE MRD had 100% sensitivity and 63.6% specificity for detecting LDS obstruction. In 51 out of the 62 LDSs that were assessed, a 90% agreement was noted between the findings of 3D-FRFSE MRD and lacrimal endoscopy in detecting the obstruction level. Conclusion 3D-FRFSE MRD combined with topical administration of sterile saline solution is a simple and noninvasive method of obtaining detailed morphological and functional information on the LDS. Overall, 3D-FRFSE MRD could be used as a reliable diagnostic method in many patients with epiphora prior to surgery.

The value of combined application of both ECG-gated cine MRA and 3D-CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty-four patients with 26 large intracranial aneurysms underwent MRI and DSA. All these aneurysms, diameter from 15 to 39 mm, were located at internal cerebral artery (n=12), vertebral artery (n=3), basilar artery (n=4), anterior cerebral artery (n=2), middle cerebral artery (n=2), anterior communicate artery (n=2) and posterior communicate artery (n=1). Thirteen cases of hematoma or cavernoma were studied as control group. All patients were examined on GE 1.5T MR system. ECG-gated cine MRA was performed with 2D multi-phase fast gradient-recalled echo sequence in a single section. All the images were analyzed with signal intensity VS time curve for differentiating intraaneurysmal blood flow from static tissue. The results were analyzed by statistic "t" test. 3D-CEMRA was performed with spoiled gradient-recalled echo and one dose of Gd-DTPA. All data was processed with multi-plannar reformat (MPR) and tomography for the demonstration of aneurysms in detail. All 26 aneurysms were demonstrated successfully by combined application of both cine MRA and 3D-CEMRA. Compared to DSA and conventional 3D-MOTSA, its sensitivity and specificity figures were both 100%. Cine MRA could differentiate the blood flow from the static tissue. The intensity VS time curves of intraaneurysmal blood flow offered fluctuating form and average signal change between systole and diastole period was about 89.8 +/- 37.4; However, under the control group, intraaneurysmal thrombus or cerebral hemorrhage or cavernomas had no significant signal change and the curves offered steady form with the average signal change being about 8.2 +/- 6.3. There was statistically significant difference between the intraaneurysmal blood flow and static tissue (P=0.025,0.05). 3D-CEMRA was very useful in demonstrating the aneurysmal size, intraaneurysmal thrombus formation, neck and the detailed relationship of the aneurysm to the surrounding structures. It was concluded that the combined application of both cine MRA and 3D-CEMRA might be a valuable clinical tool for the detection of large intracranial aneurysms.

The utility of three-dimensional spoiled gradient recalled acquisition in steady state (3D-SPGR) imaging in the cerebral diseases was evaluated and 3D-SPGR after enhancement in depicting contrast enhancement of all lesions and 2D-SE T1WI comparatively analyzed. 117 patients were subjected to MRI by a GE 1.5T MR system. After performance of axial T1WI and T2WI in all patients, MRA (3D-MOTSA) images were acquired in 6 cases (8 lesions) of aneurysms. After enhancement, 3D-SPGR images were obtained in all the remaining patients. Quality parameters (SNR, C and CNR) were calculated on enhanced 2D-SE T1WI and 3D-SPGR images. And a four-point scale was used to measure the signal intensity of the main lesions on both sequences, then statistical analysis of the average score was performed with "t" test. Except for aneurysms, 2D-SE T1WI detected 134 lesions and 3D-SPGR disclosed 147 lesions. It was found that there was no statistically significant difference between the two average scores as determined by the "t" test (t = 1,894, P0.05). The enhancement degree of the main lesion was equivalent on 3D-SPGR and 2D-SE T1WI. Quality parameters (SNR, C and CNR) on 2D-SE T1WI were much larger than that of 3D-SPGR, increasing by an average of 57%, 20% and 97% respectively. 3D-SPGR imaging with MPR could clearly depict vascularity related to neoplasms in 20 cases and demonstrate shifted, deformed and blocked vessels involved by tumors. Six cases of large aneurysms (8 lesions) were visualized more clearly on 3D-SPGR than MRA (3D-MOTSA): 3D-SPGR could display aneurysm necks and differentiate thrombosed portion from the patent lumen, and disclose relationship of aneurysm to surrounding structures. It was concluded that enhanced 3D-SPGR played an important role in the depiction of the cerebral lesions and was superior to 2D-SE T1WI in many aspects.

The irradiation damages in the electron beam lithography (EBL) to Al-gate MOS capacitors in the ranges of 10–30 keV and 10−6–10−3C·cm−2 and the effects of annealing on damages at low temperature (