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The human brain is organized as a complex, hierarchical network. However, the structural covariance patterns among brain regions and the underlying biological substrates of such covariance networks remain to be clarified. The present study proposed a novel individualized structural covariance network termed voxel-based texture similarity networks (vTSNs) based on 76 refined voxel-based textural features derived from structural magnetic resonance images. Validated in three independent longitudinal healthy cohorts (40, 23, and 60 healthy participants, respectively) with two common brain atlases, we found that the vTSN could robustly resolve inter-subject variability with high test-retest reliability. In contrast to the regional-based texture similarity networks (rTSNs) that calculate radiomic features based on region-of-interest information, vTSNs had higher inter- and intra-subject variability ratios and test-retest reliability in connectivity strength and network topological properties. Moreover, the Spearman correlation indicated a stronger association of the gene expression similarity network (GESN) with vTSNs than with rTSNs (vTSN: r = 0.600, rTSN: r = 0.433, z = 39.784, P < 0.001). Hierarchical clustering identified 3 vTSN subnets with differential association patterns with 13 coexpression modules, 16 neurotransmitters, 7 electrophysiology, 4 metabolism, and 2 large-scale structural and 4 functional organization maps. Moreover, these subnets had unique biological hierarchical organization from the subcortex-limbic system to the ventral neocortex and then to the dorsal neocortex. Based on 424 unrelated, qualified healthy subjects from the Human Connectome Project, we found that vTSNs could sensitively represent sex differences, especially for connections in the subcortex-limbic system and between the subcortex-limbic system and the ventral neocortex. Moreover, a multivariate variance component model revealed that vTSNs could explain a significant proportion of inter-subject behavioral variance in cognition (80.0 %) and motor functions (63.4 %). Finally, using 494 healthy adults (aged 19-80 years old) from the Southwest University Adult Lifespan Dataset, the Spearman correlation identified a significant association between aging and vTSN strength, especially within the subcortex-limbic system and between the subcortex-limbic system and the dorsal neocortex. In summary, our proposed vTSN is robust in uncovering individual variability and neurobiological brain processes, which can serve as biologically plausible measures for linking biological processes and human behavior., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Structural covariance network disruption has been considered an important pathophysiological indicator for schizophrenia. Here, we introduced a novel individualized structural covariance network measure, referred to as a texture similarity network (TSN), and hypothesized that the TSN could reliably reveal unique intersubject heterogeneity and complex dysconnectivity patterns in schizophrenia., Methods: The TSN was constructed by measuring the covariance of 180 three-dimensional voxelwise gray-level co-occurrence matrix feature maps between brain areas in each participant. We first tested the validity and reproducibility of the TSN in characterizing the intersubject variability in 2 longitudinal test-retest healthy cohorts. The TSN was further applied to elucidate intersubject variability and dysconnectivity patterns in 10 schizophrenia case-control datasets (609 schizophrenia cases vs. 579 controls) as well as in a first-episode depression dataset (69 patients with depression vs. 69 control participants)., Results: The test-retest analysis demonstrated higher TSN intersubject than intrasubject variability. Moreover, the TSN reliably revealed higher intersubject variability in both chronic and first-episode schizophrenia, but not in depression. The TSN also reproducibly detected coexistent increased and decreased TSN strength in widespread brain areas, increased global small-worldness, and the coexistence of both structural hyposynchronization in the central networks and hypersynchronization in peripheral networks in patients with schizophrenia but not in patients with depression. Finally, aberrant intersubject variability and covariance strength patterns revealed by the TSN showed a missing or weak correlation with other individualized structural covariance network measures, functional connectivity, and regional volume changes., Conclusions: These findings support the reliability of a TSN in revealing unique structural heterogeneity and complex dysconnectivity in patients with schizophrenia., (Copyright © 2024 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.)

Background: Injury to the spinal cord of children may cause potential brain reorganizations, affecting their rehabilitation. However, the specific functional alterations of children after complete spinal cord injury (CSCI) remain unclear., Purpose: To explore the specific functional changes in local brain and the relationship with clinical characteristics in pediatric CSCI patients, clarifying the impact of CSCI on brain function in developing children., Study Type: Prospective., Subjects: Thirty pediatric CSCI patients (7.83 ± 1.206 years) and 30 age-, gender-matched healthy children as controls (HCs) (8.77 ± 2.079 years)., Field Strength/sequence: 3.0 T/Resting-state functional MRI (rs-fMRI) using echo-planar-imaging (EPI) sequence., Assessment: Amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) were used to characterize regional neural function., Statistical Tests: Two-sample t-tests were used to compare the ALFF, fALFF, ReHo values of the brain between pediatric CSCI and HCs (voxel-level FWE correction, P < 0.05). Spearman correlation analyses were performed to analyze the associations between the ALFF, fALFF, ReHo values in altered regions and the injury duration, sensory motor scores of pediatric CSCI patients (P < 0.05). Then receiver operating characteristic (ROC) analysis was conducted to identify possible sensitive imaging indicators for clinical therapy., Results: Compared with HCs, pediatric CSCI showed significantly decreased ALFF in the right postcentral gyrus (S1), orbitofrontal cortex, and left superior temporal gyrus (STG), increased ALFF in bilateral caudate nucleus, thalamus, middle cingulate gyrus, and cerebellar lobules IV-VI, and increased ReHo in left cerebellum Crus II and Brodmann area 21. The ALFF value in the right S1 negatively correlated with the pinprick and light touch sensory scores of pediatric CSCI. When the left STG was used as an imaging biomarker for pediatric CSCI, it achieved the highest area under the curve of 0.989., Conclusions: These findings may provide potential neural mechanisms for sensory motor and cognitive-emotional deficits in children after CSCI., Evidence Level: 2 TECHNICAL EFFICACY: Stage 5., (© 2023 International Society for Magnetic Resonance in Medicine.)

The hippocampus is critical for memory and cognition and neuropsychiatric disorders, and its subfields differ in architecture and function. Genome-wide association studies on hippocampal and subfield volumes are mainly conducted in European populations; however, other ancestral populations are under-represented. Here we conduct cross-ancestry genome-wide association meta-analyses in 65,791 individuals for hippocampal volume and 38,977 for subfield volumes, including 7,009 individuals of East Asian ancestry. We identify 339 variant-trait associations at P < 1.13 × 10 -9 for 44 hippocampal traits, including 23 new associations. Common genetic variants have similar effects on hippocampal traits across ancestries, although ancestry-specific associations exist. Cross-ancestry analysis improves the fine-mapping precision and the prediction performance of polygenic scores in under-represented populations. These genetic variants are enriched for Wnt signaling and neuron differentiation and affect cognition, emotion and neuropsychiatric disorders. These findings may provide insight into the genetic architectures of hippocampal and subfield volumes., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Subcortical stroke may cause widespread structural changes to the cerebral cortex in multiple domains; however, the details of this process remain unclear. In this prospective observational study, we acquired two datasets to investigate the effect of lesion location on cortical structure. One was cross-sectional, comprising 269 patients with chronic stroke, either capsular stroke (CS) or pontine stroke (PS), and the other was longitudinal, comprising 119 patients with CS or PS. In the chronic-stage data, both CS and PS exhibited reduced cortical thickness in the precentral gyrus and increased cortical thickness and area in the frontal, temporal, occipital and insular cortices. Cortical thicknesses were correlated with motor outcomes in the precentral and lingual gyri, and early impairment of the corticospinal tract was associated with cortical thickness in the middle frontal gyrus. In the longitudinal dataset, CS showed gradually decreasing cortical thickness in the precentral gyrus, and both CS and PS showed gradually increasing cortical thickness and area in regions with significant structural reorganization. Subcortical stroke can therefore cause complex cortical structural changes in multi-domain regions involved in motor, primary and higher cognitive areas and have different evolution patterns depending on the subcortical level of the lesion affecting the motor pathways.

Nociceptive and tactile information is processed in the somatosensory system via reciprocal (i.e., feedforward and feedback) projections between the thalamus, the primary (S1) and secondary (S2) somatosensory cortices. The exact hierarchy of nociceptive and tactile information processing within this 'thalamus-S1-S2' network and whether the processing hierarchy differs between the two somatosensory submodalities remains unclear. In particular, two questions related to the ascending and descending pathways have not been addressed. For the ascending pathways, whether tactile or nociceptive information is processed in parallel (i.e., 'thalamus-S1' and 'thalamus-S2') or in serial (i.e., 'thalamus-S1-S2') remains controversial. For the descending pathways, how corticothalamic feedback regulates nociceptive and tactile processing also remains elusive. Here, we aimed to investigate the hierarchical organization for the processing of nociceptive and tactile information in the 'thalamus-S1-S2' network using dynamic causal modeling (DCM) combined with high-temporal-resolution fMRI. We found that, for both nociceptive and tactile information processing, both S1 and S2 received inputs from thalamus, indicating a parallel structure of ascending pathways for nociceptive and tactile information processing. Furthermore, we observed distinct corticothalamic feedback regulations from S1 and S2, showing that S1 generally exerts inhibitory feedback regulation independent of external stimulation whereas S2 provides additional inhibition to the thalamic activity during nociceptive and tactile information processing in humans. These findings revealed that nociceptive and tactile information processing have similar hierarchical organization within the somatosensory system in the human brain., Competing Interests: Declaration of Competing Interest The authors declare no competing financial interests., (Copyright © 2021. Published by Elsevier Inc.)

Canonical correlation analysis (CCA), a multivariate approach to identifying correlations between two sets of variables, is becoming increasingly popular in neuroimaging studies on brain-behavior relationships. However, the CCA stability in neuroimaging applications has not been systematically investigated. Although it is known that the number of subjects should be greater than the number of variables due to the curse of dimensionality, it is unclear at what subject-to-variable ratios (SVR) and at what correlation strengths the CCA stability can be maintained. Here, we systematically assessed the CCA stability, in the context of investigating the relationship between the brain structural/functional imaging measures and the behavioral measures, by measuring the similarity of the first-mode canonical variables across randomly sampled subgroups of subjects from a large set of 936 healthy subjects. Specifically, we tested how the CCA stability changes with SVR under two different brain-behavior correlation strengths. The same tests were repeated using an independent data set (n = 700) for validation. The results confirmed that both SVR and correlation strength affect greatly the CCA stability-the CCA stability cannot be guaranteed if the SVR is not sufficiently high or the brain-behavior relationship is not sufficiently strong. Based on our quantitative characterization of CCA stability, we provided a practical guideline to help correct interpretation of CCA results and proper applications of CCA in neuroimaging studies on brain-behavior relationships., (© 2021 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.)

The way spatial memory retrieval is represented in the brain remains unclear to date. Previous studies have displayed a hippocampus-centered navigation network using functional magnetic resonance imaging (fMRI) analysis. There have been some studies on the representation of navigation behavior by signal distribution patterns, but only in the hippocampus and adjacent structures. In this study, we aimed to determine (1) the brain regions that represent information in both intensity and distribution patterns during spatial memory retrieval and (2) whether the patterns of neural responses represent spatial memory retrieval behavior performance. Both univariate analysis [general linear model (GLM)] and multivariate pattern analysis (MVPA) were employed to reveal the spatial distributions of brain responses elicited by spatial memory retrieval. Correlation analyses were performed to detect the correspondences between brain responses and behavior performance. We found that spatial memory retrieval occurred in widespread brain regions, including the bilateral hippocampi, bilateral superior frontal gyrus, bilateral superior parietal lobules, bilateral occipital lobes, and cerebellum. The amplitude of activation in the left hippocampus showed a significant negative correlation ( r = -0.46, p = 0.039) with the number of task completions. Additionally, within-subject classification accuracies based on the blood oxygenation level-dependent (BOLD) signal patterns of the right middle temporal gyrus (rMTG) rostral areas in the Brainnetome Atlas showed a significant positive correlation ( r = 0.78, p < 0.0001) with retrieval accuracy. In summary, our findings have implications for understanding the separation between navigational and non-navigational states and emphasizing the utility of MVPA in the whole brain., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Guo, Zhang, Zhang, Zhao, Liang, Lin, Yu, Qin and Yang.)

Studies have indicated that the dorsal attention network (DAN) and the ventral attention network (VAN) functionally interact via several fronto-parietal connector hubs. However, the anatomical connectivity profiles of these connector hubs, and the coupling between the anatomical and functional connectivities of them, are still unknown. In the present study, we found that functional connector hubs anatomically bridged the DAN and VAN based on multimodal magnetic resonance imaging data from the Human Connectome Project (HCP) Consortium and an independent Chinese cohort. The three hubs had unique anatomical connectivity patterns with the attention sub-networks. For each connector hub, the pattern of anatomical connectivity resembled the functional one. Finally, the strength of the anatomical connectivity of these connector hubs was positively associated with the functional connectivity at the group- and individual-levels. Our findings help to better understand the anatomical mechanisms underlying the functional interactions between the DAN and the VAN., (Copyright © 2021. Published by Elsevier Inc.)

Background: The background parenchymal enhancement at breast magnetic resonance imaging use to predict breast cancer attracts many searchers to draw a possible relationship. However, the results of their relationships were conflicting. This meta-analysis was performed to assess breast cancer frequency associations with background parenchymal enhancement., Methods: A systematic literature search up to January 2020 was performed to detect studies recording associations between breast cancer frequency and background parenchymal enhancement. We found thirteen studies including 13,788 women at the start with 4046 breast cancer. We calculated the odds ratio (OR) and the 95% confidence intervals (CIs) between breast cancer frequency and background parenchymal enhancement by the dichotomous technique with a random or fixed-effect model., Results: Women with minimal or mild background parenchymal enhancement at breast magnetic resonance imaging did not have any risk of breast cancer compared to control women (OR, 1.20; 95% CI 0.54-2.67). However, high background parenchymal enhancement at breast magnetic resonance imaging (OR, 2.66; 95% CI 1.36-5.19) and moderate (OR, 2.51; 95% CI 1.49-4.21) was associated with a significantly higher rate of breast cancer frequency compared to control women., Conclusions: Our meta-analysis showed that the women with high and moderate background parenchymal enhancement at breast magnetic resonance imaging have higher risks, up to 2.66 fold, of breast cancer. We suggest that women with high or moderate background parenchymal enhancement at breast magnetic resonance imaging to be scheduled for more frequent follow-up and screening for breast cancer to avoid any complications.

Objective: To evaluate urologist satisfaction on structured prostate MRI reports, including report with tumor-node-metastasis (TNM) staging (report B) and with Prostate Imaging Reporting and Data System (PI-RADS) score with/without TNM staging (report C, report with PI-RADS score only [report C-a] and report with PI-RADS score and TNM staging [C-b]) compared with conventional free-text report (report A)., Materials and Methods: This was a prospective comparative study. Altogether, 3015 prostate MRI reports including reports A, B, C-a, and C-b were rated by 13 urologists using a 5-point Likert Scale. A questionnaire was used to assess urologist satisfaction based on the following parameters: correctness, practicality, and urologist subjectivity. Kruskal-Wallis H-test followed by Nemenyi test was used to compare urologists' satisfaction parameters for each report type. The rate of urologist-radiologist recalls for each report type was calculated., Results: Reports B and C including its subtypes had higher ratings of satisfaction than report A for overall satisfaction degree, and parameters of correctness, practicality, and subjectivity ( p < 0.05). There was a significant difference between report B and C ( p < 0.05) in practicality score, but no statistical difference was found in overall satisfaction degree, and correctness and subjectivity scores ( p > 0.05). Compared with report C-b ( p > 0.05), report B and C-a ( p < 0.05) showed a significant difference in overall satisfaction degree and parameters of practicality and subjectivity. In terms of correctness score, neither report C-a nor C-b had a significant difference with report B ( p > 0.05). No statistical difference was found between report C-a and C-b in overall satisfaction degree and all three parameters ( p > 0.05). The rate of urologist-radiologist recalls for reports A, B, C-a and C-b were 29.1%, 10.8%, 18.1% and 11.2%, respectively., Conclusion: Structured reports, either using TNM or PI-RADS are highly preferred over conventional free-text reports and lead to fewer report-related post-hoc inquiries from urologists., Competing Interests: The authors have no potential conflicts of interest to disclose., (Copyright © 2020 The Korean Society of Radiology.)

BACKGROUND Chronic obstructive pulmonary disease (COPD) and cerebral small vessel disease (CSVD) reportedly share similar risk factors and pathogenesis. However, the relationship between these 2 diseases is not clear. This study aimed to investigate the association between COPD and CSVD. MATERIAL AND METHODS Patients with stable COPD and matched healthy control participants were recruited for this study. Clinical characteristics were collected based on medical history, serological tests, brain magnetic resonance imaging, and pulmonary function tests. Individual CSVD imaging markers (white matter hyperintensities [WMH], enlarged perivascular space [EPVS], and brain atrophy) were assessed to determine their severity. Logistic analysis was used to test the relationship between CSVD markers and COPD. RESULTS Significant differences in WMH, basal ganglia EPVS (BG-EPVS), and centrum semiovale EPVS (CSO-EPVS) were found between COPD and control groups (P0.05). CONCLUSIONS A significant correlation exists between COPD and imaging markers of CSVD, including WMH, BG-EPVS, and CSO-EPVS. In addition, the severity of WMH and BG-EPVS is positively related to the duration of COPD, suggesting that COPD may be a risk factor for CSVD.

Background: It is clinically essential to distinguish aquaporin-4 antibody (AQP4-Ab) negative neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) because of different therapeutic strategies. Since clinical and lesion features may not allow the distinction, we aimed to identify advanced imaging features that could improve the distinction between two disorders., Methods: Multimodal imaging measures included fractional anisotropy, mean, axial, radial diffusivity (MD, AD, RD) and kurtosis (MK, AK, RK) from diffusion kurtosis imaging; functional connectivity strength (FCS) and density, regional homogeneity, amplitude of low frequency fluctuations from resting-state functional MRI; gray matter volume from structural MRI; and cerebral blood flow from arterial spin labeling imaging. Voxel-wise comparisons were performed to identify inter-group differences in imaging measures, and the performance of differentiating these two disorders was estimated by receiver operating characteristic curves., Results: Compared to MS, patients with AQP4-Ab negative NMOSD showed decreased MD and AD but increased MK and AK in white matter regions; and reduced FCS in the occipital cortex (P < 0.05, FWE corrected). The joint-use of these five imaging measures distinguished the two disorders with an accuracy of 94% (P < 0.001, 95%CI = 0.84-0.98). Other imaging measures showed no significant differences between the two patient groups., Conclusions: The study showed less white matter damage and a more severe functional disconnection of the occipital cortex in patients with AQP4-Ab negative NMOSD compared to MS. The combined use of diffusion and functional connectivity could facilitate a better distinction between NMO and MS with seronegative AQP4-Ab in clinical management., Competing Interests: Declaration of Competing Interest The Authors declare that there is no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Professional Pingju actors have been shown to exhibit practice-induced plastic changes in spontaneous regional brain activity; however, whether these changes are present in resting-state regional cerebral blood flow (CBF) remains largely unclear. Here, twenty professional Pingju opera actors and 20 age-, sex-, and handedness-matched untrained subjects were recruited, and resting-state CBF maps were obtained by using a three-dimensional pseudocontinuous arterial spin labelling sequence. Voxel-based comparisons of the CBF maps between the two groups were performed with two-sample t-tests, and correlation analyses between the CBF changes and years of training in the actor group were conducted. In addition, the CBF connectivity between regions with CBF alterations and the whole brain was computed and compared between the two groups. Compared with untrained subjects, the actors showed significantly higher CBF in the right inferior temporal gyrus, right middle temporal gyrus, left temporal pole, and left inferior frontal gyrus, whereas significantly lower CBF was not found in the actor group (voxel-level uncorrected p < 0.001, cluster-level family-wise error corrected p < 0.05). Furthermore, there was no correlation between the mean CBF values from significantly different clusters and the years of training, and no significant alterations in CBF connectivity were found in the actor group. Overall, these results provided preliminary evidence that neural plastic changes in CBF are present in professional Pingju opera actors, which may correspond to specific experiences associated with Pingju opera training., (Copyright © 2020 IBRO. Published by Elsevier Ltd. All rights reserved.)

Background: Numerous neuroimaging studies have revealed that schizophrenia was characterized by wide-spread dysconnection among brain regions during rest measured by functional connectivity (FC). In contrast with FC, effective connectivity (EC) provides information about directionality of brain connections and is thus valuable in mechanistic investigation of schizophrenic brain. However, a systematic characterization of whole-brain resting-state EC (rsEC) and how it captures different information compared with resting-state FC (rsFC) in schizophrenia are still lacking., Aims: To systematically characterize the abnormalities of rsEC, compared with rsFC, in schizophrenia, and to test its discriminative power as a neuroimaging marker for schizophrenia diagnosis., Method: Whole-brain rsEC and rsFC networks were constructed using resting-state fMRI data and compared between 103 patients with schizophrenia and 110 healthy participants. Pattern classifications between patients and controls based on whole-brain rsEC and rsFC were further performed using multivariate pattern analysis., Results: We identified 17 rsEC significantly disrupted (mostly decreased) in patients, among which all were associated with the thalamus and 15 were from limbic areas (including hippocampus, parahippocampus and cingulate cortex) to the thalamus. In contrast, abnormal rsFC were widely distributed in the whole brain. The classification accuracies for distinguishing patients and controls using whole-brain rsEC and rsFC patterns were 78.6% and 82.7%, respectively, and was further improved to 84.5% when combining rsEC and rsFC., Conclusions: Schizophrenia is featured by disrupted 'limbic areas-to-thalamus' rsEC, in contrast with diffusively altered rsFC. Moreover, both rsEC and rsFC contain valuable and complementary information which may be used as diagnostic markers for schizophrenia., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflicts of interest., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives: To establish and validate a radiomics nomogram for prediction of induction chemotherapy (IC) response and survival in nasopharyngeal carcinoma (NPC) patients., Methods: One hundred twenty-three NPC patients (100 in training and 23 in validation cohort) with multi-MR images were enrolled. A radiomics nomogram was established by integrating the clinical data and radiomics signature generated by support vector machine., Results: The radiomics signature consisting of 19 selected features from the joint T1-weighted (T1-WI), T2-weighted (T2-WI), and contrast-enhanced T1-weighted MRI images (T1-C) showed good prognostic performance in terms of evaluating IC response in two cohorts. The radiomics nomogram established by integrating the radiomics signature with clinical data outperformed clinical nomogram alone (C-index in validation cohort, 0.863 vs 0.549; p < 0.01). Decision curve analysis demonstrated the clinical utility of the radiomics nomogram. Survival analysis showed that IC responders had significant better PFS (progression-free survival) than non-responders (3-year PFS 84.81% vs 39.75%, p < 0.001). Low-risk groups defined by radiomics signature had significant better PFS than high-risk groups (3-year PFS 76.24% vs 48.04%, p < 0.05)., Conclusions: Multiparametric MRI-based radiomics could be helpful for personalized risk stratification and treatment in NPC patients receiving IC., Key Points: • MRI Radiomics can predict IC response and survival in non-endemic NPC. • Radiomics signature in combination with clinical data showed excellent predictive performance. • Radiomics signature could separate patients into two groups with different prognosis.

Purpose: Segmentation of magnetic resonance images (MRI) of the left ventricle (LV) plays a key role in quantifying the volumetric functions of the heart, such as the area, volume, and ejection fraction. Traditionally, LV segmentation is performed manually by experienced experts, which is both time-consuming and prone to subjective bias. This study aims to develop a novel capsule-based automated segmentation method to automatically segment the LV from images obtained by cardiac MRI., Method: The technique applied for segmentation uses Fourier analysis and the circular Hough transform (CHT) to indicate the approximate location of the LV and a network capsule to precisely segment the LV. The neurons of the capsule network output a vector and preserve much of the information about the input by replacing the largest pooling layer with convolutional strides and dynamic routing. Finally, the segmentation result is postprocessed by threshold segmentation and morphological processing to increase the accuracy of LV segmentation., Results: We fully exploit the capsule network to achieve the segmentation goal and combine LV detection and capsule concepts to complete LV segmentation. In the experiments, the tested methods achieved LV Dice scores of 0.922±0.05 end-diastolic (ED) and 0.898±0.11 end-systolic (ES) on the ACDC 2017 data set. The experimental results confirm that the algorithm can effectively perform LV segmentation from a cardiac magnetic resonance image. To verify the performance of the proposed method, visual and quantitative comparisons are also performed, which show that the proposed method exhibits improved segmentation accuracy compared with the traditional method., Conclusions: The evaluation metrics of medical image segmentation indicate that the proposed method in combination with postprocessing and feature detection effectively improves segmentation accuracy for cardiac MRI. To the best of our knowledge, this study is the first to use a deep learning model based on capsule networks to systematically evaluate end-to-end LV segmentation.

Previous studies have revealed that sleep deprivation (SD) alters hippocampal functional connectivity (FC). However, the effects of SD on the FC of hippocampal subregions are still unknown. In this study, we used a masked independent component analysis (mICA) to partition the hippocampus into several small regions and investigated the changes in the FC of each small region within the whole brain after 24 h of SD in 40 normal young subjects. First, we determined the optimal number of hippocampal subregions in a data-driven manner using a reproducibility analysis and chose 17 as the optimal number of hippocampal subregions. Second, we compared the FC of each subregion between rested wakefulness and SD states using mCIA. Reduced FC was found between the left junction of anterior and anterolateral hippocampal region and the default mode network and bilateral thalamus after SD (p < 0.05/17, Threshold-Free Cluster Enhancement correction, Bonferroni's corrected for the number of subregions). The FC between the left posterior of the anterolateral and the left lateral posterior of the anterior hippocampal regions and somatomotor network changed more negative after SD. However, increased FC was identified between the left middle hippocampal region and vision-related regions after SD. Our results reflect differential effects of SD on the FC in specific hippocampal regions and provide new insights into the impact of SD on the resting-state functional organization in the human brain., (Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.)

Purpose: Prostate cancer classification has a significant impact on the prognosis and treatment planning of patients. Currently, this classification is based on the Gleason score analysis of biopsied tissues, which is neither accurate nor risk free. This study aims to learn discriminative features in prostate images and assist physicians in classifying prostate cancer automatically., Methods: We develop a novel multiparametric magnetic resonance transfer learning (MPTL) method to automatically stage prostate cancer. We first establish a deep convolutional neural network with three branch architectures, which transfer pretrained model to compute features from multiparametric MRI images (mp-MRI): T2w transaxial, T2w sagittal, and apparent diffusion coefficient (ADC). The learned features are concatenated to represent information of mp-MRI sequences. A new image similarity constraint is then proposed to enable the distribution of the features within the same category in a narrow angle region. With the joint constraints of softmax loss and image similarity loss in the fine-tuning process, the MPTL can provide descriptive features with intraclass compactness and interclass separability., Results: Two cohorts: 132 cases from our institutional review board-approved patient database and 112 cases from the PROSTATEx-2 Challenge are utilized to evaluate the robustness and effectiveness of the proposed MPTL model. Our model achieved high accuracy of prostate cancer classification (accuracy of 86.92%). Moreover, the comparison results demonstrate that our method outperforms both hand-crafted feature-based methods and existing deep learning models in prostate cancer classification with higher accuracy., Conclusion: The experiment results showed that the proposed method can learn discriminative features in prostate images and classify the cancer accurately. Our MPTL model could be further applied in the clinical practice to provide valuable information for cancer treatment and precision medicine., (© 2018 American Association of Physicists in Medicine.)

Visual-related cortex plays an important role in the process of movement. It is of great importance to clarify whether traumatic spinal cord injury (SCI), which is a typical disease that results in sensorimotor dysfunction, leads to the alteration of visual-related brain structure and function area. To address this issue, multimodality MRI was applied on eleven patients with acute incomplete cervical cord injury (ICCI) and eleven healthy controls (HCs) to explore possible structural and functional changes of the brain. Voxel-based morphometry (VBM) analysis was performed to investigate the changes in brain structure of ICCI patients. The fractional amplitude of low-frequency fluctuations (fALFF) was used to characterize changes in regional neural activities, and independent component analysis (ICA) was carried out to explore alterations in the resting-state networks (RSNs) after ICCI. We also investigated correlations among brain imaging metrics and between the metrics and clinical variables. Compared with HCs, ICCI patients exhibited significant gray matter atrophy in the left hippocampus and parahippocampal gyrus, right superior frontal gyrus (SFG), and middle frontal gyrus (MFG) and also a decrease in fALFF in the left orbitofrontal cortex (OFC). Moreover, ICCI patients exhibited decreased intra-network functional connectivity (FC) in the medial vision network (mVN). The mean fALFF value was correlated with clinical motor scores of the left extremities and the total motor scores. Our findings proved that ICCI can not only cause structural changes in visual-related brain regions, but also result in visual-related brain functional alterations, revealing the possible mechanism of the effects of visual feedback training in motor function rehabilitation of SCI patients., (Copyright © 2018 IBRO. Published by Elsevier Ltd. All rights reserved.)

Specific biomarker reflecting neurobiological substrates of schizophrenia (SZ) is required for its diagnosis and treatment selection of SZ. Evidence from neuroimaging has implicated disrupted functional connectivity in the pathophysiology. We aimed to develop and validate a method of disease definition for SZ by resting-state functional connectivity using radiomics strategy. This study included 2 data sets collected with different scanners. A total of 108 first-episode SZ patients and 121 healthy controls (HCs) participated in the current study, among which 80% patients and HCs (n = 183) and 20% (n = 46) were selected for training and testing in intra-data set validation and 1 of the 2 data sets was selected for training and the other for testing in inter-data set validation, respectively. Functional connectivity was calculated for both groups, features were selected by Least Absolute Shrinkage and Selection Operator (LASSO) method, and the clinical utility of its features and the generalizability of effects across samples were assessed using machine learning by training and validating multivariate classifiers in the independent samples. We found that the accuracy of intra-data set training was 87.09% for diagnosing SZ patients by applying functional connectivity features, with a validation in the independent replication data set (accuracy = 82.61%). The inter-data set validation further confirmed the disease definition by functional connectivity features (accuracy = 83.15% for training and 80.07% for testing). Our findings demonstrate a valid radiomics approach by functional connectivity to diagnose SZ, which is helpful to facilitate objective SZ individualized diagnosis using quantitative and specific functional connectivity biomarker.

Background: Premenstrual syndrome (PMS) is characterized by a series of emotional, physical and behavioral symptoms. Although PMS is related to dysfunctions of the central nervous system, the neuropathological mechanism of PMS still has not been clearly established. The aim of this study is to evaluate potential differences in both cortical thickness and subcortical volumes in PMS patients compared to healthy controls (HCs)., Methods: Twenty PMS patients and twenty HCs underwent a structural magnetic resonance imaging scan and clinical assessment. Cortical thickness and subcortical volumes were computed using the FreeSurfer image analysis suite. Relationships between cortical thickness/subcortical volumes and the daily rating of severity of problems (DRSP) score were then measured in patients., Results: Compared to HCs, PMS patients exhibited reduced cortical thickness in the medial prefrontal cortex (MPFC), orbitofrontal cortex (OFC) and insula, and increased subcortical volumes of the amygdala, thalamus and pallidum. Furthermore, negative correlations were detected between the DRSP and cortical thickness in the anterior cingulate cortex and precuneus., Limitations: The study is limited by a small sample size and narrow age range of participants., Conclusions: Our findings indicate that the abnormal morphological changes are mainly implicated in emotional regulation and visceral perception in PMS patients. We hope that our study may contribute to a better understanding of PMS., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: To demonstrate that certain qualitative amide proton transfer-weighted (APTw) characteristics can provide practical imaging clues for predicting O6-methylguanine-DNA methyltransferase (MGMT) protein expression in primary low- and high-grade gliomas, preoperatively and noninvasively., Methods: Pathologically confirmed low- and high-grade gliomas with APT data and immunohistochemical (IHC) reports were recruited in this study. The MGMT protein expression status was classified by postsurgery specimen immunostaining. Subjects were divided into two groups, MGMT-positive and MGMT-negative group, according to the immunoreactivity of MGMT protein expression documented in IHC reports. APTw images scanned at 3T magnetic resonance preoperatively were retrospectively analyzed. Two neuroradiologists were trained to evaluate presence of certain APTw features. Kappa value was calculated to show the consistency between the 2 observers. The Mann-Whitney U test was used to evaluate relationships between the 2 groups on APTw features. Negative predictive value and positive predictive value was used to evaluate the ability of APTw characteristics in predicting MGMT protein expression. Receiver operating characteristic curve was used to evaluate the diagnostic performance of APTw characters. Two-tailed P < 0.05 was considered as statistically significant., Results: Forty-two subjects were recruited in this study. Among them 38 specimens presented positive MGMT immunostaining (MGMT-positive group), 4 specimens were negative MGMT immunostaing (MGMT-negative group). There were, respectively, 37 and 5 APTw images appeared positive and negative APTw features. Differences between tumors of positive and negative MGMT expression on qualitative APTw features were significant (P = 0.020). The consistency coefficient of the 2 observers was 0.876 (kappa = 0.876). Three of five llgliomas with negative APTw features showed MGMT-negative immunostaining, leading to a negative predictive value of 60%, and 36 of 37 cases presenting positive APTw characteristics were tumors of MGMT-positive expression, generating a positive predictive value of 97.3%. The area under curve was 0.849., Conclusions: APTw characteristics could be promising imaging markers by which to predict IHC MGMT expression in primary low- and high-grade gliomas preoperatively and noninvasively., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Respiratory control is essential for treatment effect of radiotherapy due to the high dose, especially for thoracic-abdomen tumor, such as lung and liver tumors. As a noninvasive and comfortable way of respiratory control, hypnosis has been proven effective as a psychological technology in clinical therapy. In this study, the neural control mechanism of hypnosis for respiration was investigated by using functional magnetic resonance imaging (fMRI). Altered spontaneous brain activity as well as neural correlation of respiratory motion was detected for eight healthy subjects in normal state (NS) and hypnosis state (HS) guided by a hypnotist. Reduced respiratory amplitude was observed in HS (mean ± SD: 14.23 ± 3.40 mm in NS, 12.79 ± 2.49 mm in HS, p =0.0350), with mean amplitude deduction of 9.2%. Interstate difference of neural activity showed activations in the visual cortex and cerebellum, while deactivations in the prefrontal cortex and precuneus/posterior cingulate cortex (PCu/PCC) in HS. Within these regions, negative correlations of neural activity and respiratory motion were observed in visual cortex in HS. Moreover, in HS, voxel-wise neural correlations of respiratory amplitude demonstrated positive correlations in cerebellum anterior lobe and insula, while negative correlations were shown in the prefrontal cortex and sensorimotor area. These findings reveal the involvement of cognitive, executive control, and sensorimotor processing in the control mechanisms of hypnosis for respiration, and shed new light on hypnosis performance in interaction of psychology, physiology, and cognitive neuroscience.

Primary dysmenorrhea (PDM), a common gynecological disorder, is associated with structural and functional alterations in several subregions of the anterior cingulate cortex (ACC). However, systematic functional connectivity of the ACC subregions in PDM has not been clarified. In this study, we used resting-state functional magnetic resonance imaging (fMRI) data from forty-eight PDM patients and thirty-eight matched female healthy controls to investigate the functional connectivity of ACC subregions in PDM. Compared to healthy controls, PDM patients exhibited increased connectivity between the caudal ACC (cACC) and primary somatosensory cortex (SI), between the perigenual ACC (pACC) and caudate, and between the subgenual ACC (sACC) and medial prefrontal cortex (mPFC). PDM patients also showed decreased connectivity between the pACC and precuneus. In PDM group, the connectivity of the right pACC-right caudate positively correlated with disease duration, and the connectivity of the left pACC-left precuneus negatively correlated with disease severity. These present findings reveal that abnormal ACC connectivity may be implicated in the PDM-related disturbances in pain sensory, modulation, and affection. We hope that our study could enhance the understanding of the pathophysiology underlying PDM.

The effects of acupuncture can be characterized by clear individual differences. Several revealing studies suggest an underlying role of inherited genetic factor in interindividual variability in response to acupuncture treatment. It remains unclear, however, if the modulation of acupuncture on resting brain function is influenced by genetic factors. Catechol-o-methyltransferase (COMT) Val158Met polymorphism has been shown to regulate the resting brain network, especially in the default mode network (DMN), which is a target area that responds to acupuncture stimulation. Therefore, the present study investigated the effect of COMT Val158Met polymorphism on the modulation of acupuncture in DMN connectivity in healthy Chinese young adults. Using mixed-design ANOVA analysis, we found a significant interactive effect between acupuncture and the COMT gene. For subjects carrying the Val/Met genotype, acupuncture induced decreased DMN connectivity with the left middle frontal gyrus during the post-acupuncture stage compared with the pre-acupuncture stage, which was not observed in Val/Val homozygous subjects. These results demonstrated that during sustained periods after acupuncture stimulation, the brain network is likely under genetic control, and COMT might be a candidate gene that regulates the resting DMN response to acupuncture stimulation.

Background: In glioblastoma (GBM), promoter methylation of the DNA repair gene O-methylguanine-DNA methyltransferase (MGMT) is associated with beneficial chemotherapy., Purpose/hypothesis: To analyze radiomics features for utilizing the full potential of medical imaging as biomarkers of MGMT promoter methylation., Study Type: Retrospective., Population/subjects: In all, 98 GBM patients with known MGMT (48 methylated and 50 unmethylated tumors)., Field Strength/sequence: 3.0T magnetic resonance (MR) images, containing T 1 -weighted image (T 1 WI), T 2 -weighted image (T 2 WI), and enhanced T 1 WI., Assessment: A region of interest (ROI) of the tumor was delineated. A total of 1665 radiomics features were extracted and quantized, and were reduced using least absolute shrinkage and selection operator (LASSO) regularization., Statistical Testing: After the support vector machine construction, accuracy, sensitivity, and specificity were computed for different sequences. An independent validation cohort containing 20 GBM patients was utilized to further evaluate the radiomics model performance., Results: Radiomics features of T 1 WI reached an accuracy of 67.54%. Enhanced T 1 WI features reached an accuracy of 82.01%, while T 2 WI reached an accuracy of 69.25%. The best classification system for predicting MGMT promoter methylation status originated from the combination of 36 T 1 WI, T 2 WI, and enhanced T 1 WI images features, with an accuracy of 86.59%. Further validation on the independent cohort of 20 patients produced similar results, with an accuracy of 80%., Data Conclusion: Our results provide further evidence that radiomics MR features could predict MGMT methylation status in preoperative GBM. Multiple imaging modalities together can yield putative noninvasive biomarkers for the identification of MGMT., Level of Evidence: 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1380-1387., (© 2017 International Society for Magnetic Resonance in Medicine.)

Recent studies suggest dysfunctional brain-gut interactions are involved in the pathophysiology of functional dyspepsia (FD). However, limited studies have investigated brain structural abnormalities in FD patients. This study aimed to identify potential differences in both cortical thickness and subcortical volume in FD patients compared to healthy controls (HCs) and to explore relationships of structural abnormalities with clinical symptoms. Sixty-nine patients and forty-nine HCs underwent 3T structural magnetic resonance imaging scans. Cortical thickness and subcortical volume were compared between the groups across the cortical and subcortical regions, respectively. Regression analysis was then performed to examine relationships between the structure alternations and clinical symptoms in FD patients. Our results showed that FD patients had decreased cortical thickness compared to HCs in the distributed brain regions including the dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC), medial prefrontal cortex (mPFC), anterior/posterior cingulate cortex (ACC/PCC), insula, superior parietal cortex (SPC), supramarginal gyrus and lingual gyrus. Significantly negative correlations were observed between the Nepean Dyspepsia Index (NDI) and cortical thickness in the mPFC, second somatosensory cortex (SII), ACC and parahippocampus (paraHIPP). And significantly negative correlations were found between disease duration and the cortical thickness in the vlPFC, first somatosensory cortex (SI) and insula in FD patients. These findings suggest that FD patients have structural abnormalities in brain regions involved in sensory perception, sensorimotor integration, pain modulation, affective and cognitive controls. The relationships between the brain structural changes and clinical symptoms indicate that the alternations may be a consequence of living with FD.

Purpose: Premature ejaculation (PE) is one of the most common sexual dysfunctions in men. However, there has been little research evaluating alterations in brain structure related to PE. We aimed to investigate the characteristics of nonmedicated PE patients in terms of brain morphometry., Materials and Methods: The sample consisted with 32 medication-naïve adult men with clinical diagnosed PE and matched 31 healthy controls. All participants received diagnostic interviews and 3.0 Tesla MRI scans. Automatic segmentation processing of MRI structure images was performed using FreeSurfer software and cerebral cortical thickness between groups was compared., Results: The PE group had thicker cortex in widespread regions, including the frontal, parietal and occipital lobe, and limbic system, compared with the healthy control group (P < 0.05). Moreover, the duration is negatively correlated with the mean cortical thickness of the right medial orbitofrontal cortex, right precentral gyrus and left superior frontal cortex (R 2 = 0.29, P < 0.003; R 2 = 0.163, P < 0.04; R 2 = 0.2, P < 0.02), while the Premature Ejaculation Diagnostic Tool score is negatively correlated with the mean cortical thickness of the left caudal middle frontal cortex (R 2 = 0.33, P < 0.005)., Conclusion: The result highlights the structural features of PE and suggests the relationship with the severity of impairment is related to the severity of anatomic abnormality with the relevant brain region. These results support the value of imaging measures as markers for understanding the physiopathology of PE., Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:656-662., (© 2017 International Society for Magnetic Resonance in Medicine.)

Primary dysmenorrhea (PDM), characterized by cramping pain in the lower abdomen, is a common gynecological disorder in women of child-bearing age. An increasing number of neuroimaging studies have emphasized that PDM is associated with functional and structural abnormalities in the regions related to the default mode network (DMN). Based on resting-state functional magnetic resonance imaging (fMRI), the aim of this study was to use amplitude of low-frequency fluctuation (ALFF) and functional connectivity (FC) to investigate changes of the intrinsic brain activity in the DMN in PDM. Pearson correlation analysis was conducted to assess relationships between the neuroimaging findings and clinical symptoms. Forty-eight PDM patients and thirty-eight matched healthy controls participated in this study. Compared to healthy controls, PDM patients had increased ALFF in the precuneus, dorsomedial prefrontal cortex (dmPFC) and anterior cingulate cortex (ACC) and decreased ALFF in the thalamus. PDM patients also had decreased connectivity between the precuneus and left dmPFC and right ACC, while increased connectivity between the precuneus and left thalamus. In addition, the ALFF in the left dmPFC in PDM patients positively correlated with disease duration. Our findings provide further evidence of the DMN-related abnormalities in PDM patients which might contribute to a better understanding of the pathophysiology of this disease.

Objectives: According to aquaporin-4 antibody (AQP4-Ab), neuromyelitis optica (NMO) can be divided into seropositive and seronegative subgroups. The purpose of this study was to a) compare the distribution of spinal cord and brain magnetic resonance imaging (MRI) lesions between seropositive and seronegative NMO patients; b) explore occult brain damage in seropositive and seronegative NMO patients; and c) explore the contribution of visible lesions to occult grey and white matter damage in seropositive and seronegative NMO patients., Materials and Methods: Twenty-two AQP4-Ab seropositive and 14 seronegative NMO patients and 30 healthy controls were included in the study. Two neuroradiologists independently measured the brain lesion volume (BLV) and the length of spinal cord lesion (LSCL) and recorded the region of brain lesions. The normal-appearing grey matter volume (NAGM-GMV) and white matter fractional anisotropy (NAWM-FA) were calculated for each subject to evaluate occult brain damage., Results: The seropositive patients displayed more extensive damage in the spinal cord than the seronegative patients, and the seronegative group had a higher proportion of patients with brainstem lesions (28.57%) than the seropositive group (4.55%, P=0.064). Both NMO subgroups exhibited reduced NAGM-GMV and NAWM-FA compared with the healthy controls. NAGM-GMV was negatively correlated with LSCL in the seropositive group (r s =-0.444, P=0.044) and with BLV in the seronegative group (r s =-0.768, P=0.002). NAWM-FA was also negatively correlated with BLV in the seropositive group (r s =-0.682, P<0.001)., Conclusion: Our findings suggest that the occult brain damage in these two NMO subgroups may be due to different mechanisms, which need to be further clarified., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Purpose To investigate auditory verbal hallucination (AVH)-specific patterns of brain activity within the resting-state networks (RSNs) that have been proposed to underpin the neural mechanisms of schizophrenia (SZ). Materials and Methods This cross-sectional study was approved by the local ethics committee, and written informed consent was obtained from all participants prospectively recruited. Independent component analysis was used to investigate RSNs in 17 patients with first-episode untreated SZ with AVHs, 15 patients with SZ without AVHs, and 19 healthy control subjects who underwent resting-state functional magnetic resonance imaging. Dual regression was implemented to perform between-group analysis. Regional brain function was then explored within RSNs by using the amplitude of low-frequency fluctuation. Two-sample t tests were used to compare regional brain function between the two patient groups, and Pearson correlation analysis was used to characterize the relationship between imaging findings and severity of AVHs. Receiver operating characteristic analysis was used to evaluate the diagnostic performance of these brain function measures. Results Independent component analysis demonstrated symptom-specific abnormal disrupted coactivation within the auditory, default mode, executive, motor, and frontoparietal networks and was pronounced in the auditory cortex, supramarginal gyrus, insula, putamen, dorsolateral prefrontal cortex, angular gyrus, precuneus, and thalamus (P < .05 with false discovery rate correction). Amplitude of low-frequency fluctuation analysis demonstrated similar patterns within these RSNs (P < .05 with false discovery rate correction). Furthermore, a positive correlation between the degree of coactivation within the motor network and the severity of AVHs was observed in patients with SZ with AVHs (r = 0.67, P = .003). The area under the receiver operating characteristic curve was 0.76-0.90 for all RSNs. Conclusion These findings indicate that dysfunctional brain regions are involved in auditory processing, language production and monitoring, and sensory information filtering in patients with SZ with AVHs, which may be helpful in furthering the understanding of pathophysiological correlates of AVHs in SZ. Online supplemental material is available for this article.

Background: Although previous studies found that aberrations in gray matter volume (GMV) and global functional connectivity density (gFCD) are important characteristics of schizophrenia, to the best of our knowledge no study to date has investigated the associations between the spatial distribution patterns of GMV and gFCD alterations. We investigated pattern changes in gFCD and GMV among patients with schizophrenia and their associated spatial distributions., Methods: Ninety-five patients with schizophrenia and 93 matched healthy controls underwent structural and resting-state functional MRI scanning to assess gFCD and GMV., Results: We found that gFCD increased in the subcortical regions (caudate, pallidum, putamen, and thalami) and limbic system (left hippocampus and parahippocampus), and decreased in the posterior parieto-occipito-temporal cortices (postcentral gyri, occipital cortex, temporo-occipital conjunction, and inferior parietal lobule), in patients with schizophrenia. By contrast, we found decreased GMV in brain regions including the frontal, parietal, temporal, occipital, cingulate cortices, and the insular, striatum, thalamus in these patients. Increased gFCD primarily occurred in subcortical regions including the basal ganglia and some regions of the limbic system. Decreased gFCD appeared primarily in the cortical regions. There were no statistically significant correlations between changes in gFCD and GMV, and their spatial distribution patterns, in different regions., Conclusions: Our findings indicate that gFCD and GMV are both perturbed in multiple brain regions in schizophrenia. gFCD and GMV consistently decreased in the cortical regions, with the exception of the Supplementary Motor Area (SMA). However, in the sub-cortical regions, the alterations of gFCD and GMV showed the opposite pattern, with increased gFCD and decreased GMV simultaneously observed in these regions. Overall, our findings suggest that structural and functional alterations appear to contribute independently to the neurobiology of schizophrenia.

Abnormal pain processing in the central nervous system may be related to abdominal pain in patients with Crohn's disease (CD). The purpose of this study was to investigate changes in resting-state brain activity in patients with CD in remission and its relationship with the presence of abdominal pain. Twenty-five patients with CD and with abdominal pain, 25 patients with CD and without abdominal pain, and 32 healthy subjects were scanned using a 3.0-T functional magnetic resonance imaging scanner. Regional homogeneity (ReHo) was used to assess resting-state brain activity. Daily pain scores were collected 1 week before functional magnetic resonance imaging. We found that patients with abdominal pain exhibited lower ReHo values in the insula, middle cingulate cortex (MCC), and supplementary motor area and higher ReHo values in the temporal pole. In contrast, patients without abdominal pain exhibited lower ReHo values in the hippocampal/parahippocampal cortex and higher ReHo values in the dorsomedial prefrontal cortex (all P < 0.05, corrected). The ReHo values of the insula and MCC were significantly negatively correlated with daily pain scores for patients with abdominal pain (r = -0.53, P = 0.008 and r = -0.61, P = 0.002, respectively). These findings suggest that resting-state brain activities are different between remissive patients with CD with and without abdominal pain and that abnormal activities in insula and MCC are closely related to the severity of abdominal pain.

Clinical and brain structural differences have been reported between patients with familial and sporadic schizophrenia; however, little is known about the brain functional differences between the two subtypes of schizophrenia. Twenty-six patients with familial schizophrenia (PFS), 26 patients with sporadic schizophrenia (PSS) and 26 healthy controls (HC) underwent a resting-state functional magnetic resonance imaging. The whole-brain functional network was constructed and analyzed using graph theoretical approaches. Topological properties (including global, nodal and edge measures) were compared among the three groups. We found that PFS, PSS and HC exhibited common small-world architecture of the functional brain networks. However, at a global level, only PFS showed significantly lower normalized clustering coefficient, small-worldness, and local efficiency, indicating a randomization shift of their brain networks. At a regional level, PFS and PSS disrupted different neural circuits, consisting of abnormal nodes (increased or decreased nodal centrality) and edges (decreased functional connectivity strength), which were widely distributed throughout the entire brain. Furthermore, some of these altered network measures were significantly correlated with severity of psychotic symptoms. These results suggest that familial and sporadic schizophrenia had segregated disruptions in the topological organization of the intrinsic functional brain network, which may be due to different etiological contributions.

Sex-related differences in emotion regulation (ER) in the frequency power distribution within the human amygdala, a brain region involved in emotion processing, have been reported. However, how sex differences in ER are manifested in the brain networks which are seeded on the amygdala subregions is unclear. The goal of this study was to investigate this issue from a brain network perspective. Utilizing resting-state functional connectivity (RSFC) analysis, we found that the sex-specific functional connectivity patterns associated with ER trait level were only seeded in the centromedial amygdala (CM). Women with a higher trait-level ER had a stronger negative RSFC between the right CM and the medial superior frontal gyrus (mSFG), and stronger positive RSFC between the right CM and the anterior insula (AI) and the superior temporal gyrus (STG). But men with a higher trait-level ER was associated with weaker negative RSFC of the right CM-mSFG and positive RSFCs of the right CM-left AI, right CM-right AI/STG, and right CM-left STG. These results provide evidence for the sex-related effects in ER based on CM and indicate that men and women may differ in the neural circuits associated with emotion representation and integration.

Background and Purpose: Whether gray matter impairment occurs in neuromyelitis optica is a matter of ongoing debate, and the association of gray matter impairment with cognitive deficits remains largely unknown. The purpose of this study was to investigate gray matter volume reductions and their association with cognitive decline in patients with neuromyelitis optica., Materials and Methods: This study included 50 patients with neuromyelitis optica and 50 sex-, age-, handedness-, and education-matched healthy subjects who underwent high-resolution structural MR imaging examinations and a battery of cognitive assessments. Gray matter volume and cognitive differences were compared between the 2 groups. The correlations of the regional gray matter volume with cognitive scores and clinical variables were explored in the patients with neuromyelitis optica., Results: Compared with healthy controls (635.9 ± 51.18 mL), patients with neuromyelitis optica (602.8 ± 51.03 mL) had a 5.21% decrease in the mean gray matter volume of the whole brain (P < .001). The significant gray matter volume reduction in neuromyelitis optica affected the frontal and temporal cortices and the right thalamus (false discovery rate correction, P < .05). The regional gray matter volumes in the frontal and temporal cortices were negatively correlated with disease severity in patients with neuromyelitis optica (Alphasim correction, P < .05). Patients with neuromyelitis optica had impairments in memory, information processing speed, and verbal fluency (P < .05), which were correlated with gray matter volume reductions in the medial prefrontal cortex and thalamus (Alphasim correction, P < .05)., Conclusions: Gray matter volume reduction is present in patients with neuromyelitis optica and is associated with cognitive impairment and disease severity in this group., (© 2015 by American Journal of Neuroradiology.)

Background and Purpose: Motor recovery after stroke has been shown to be correlated with both the fractional anisotropy (FA) of the affected corticospinal tract (CST) and the interhemispheric resting-state functional connectivity (rsFC) of the primary motor cortex (M1). However, the role of the restoration or enhancement of the M1-M1 rsFC in motor recovery remains largely unknown. We aimed to clarify this issue by investigating the correlations between the M1-M1 rsFC and the integrity of the M1-M1 anatomic connection and the affected CST in chronic subcortical stroke patients with good motor outcomes., Methods: Twenty patients and 16 healthy controls underwent multimodal magnetic resonance imaging examinations. Diffusion tensor imaging was used to reconstruct the M1-M1 anatomic connection and bilateral CSTs. White matter integrity of these tracts was assessed using FA. Resting-state functional magnetic resonance imaging was used to calculate M1-M1 rsFC. Group differences in these measures were compared. Correlations between M1-M1 rsFC and FA of the M1-M1 anatomic connection and the affected CST were analyzed in patients with stroke., Results: Compared with healthy controls, patients with stroke exhibited significantly reduced FA in the affected CST and the M1-M1 anatomic connection and a significantly increased M1-M1 rsFC. The FA values of the affected CST were positively correlated with the M1-M1 anatomic connection, and these FA values were negatively correlated with the M1-M1 rsFC in these patients., Conclusions: Our findings suggest that the M1-M1 anatomic connection impairment is secondary to CST damage, and the M1-M1 rsFC enhancement may reflect compensatory or reactive neural plasticity in stroke patients with CST impairment., (© 2015 American Heart Association, Inc.)

Objective: Although extensive resting-state functional connectivity (rsFC) changes have been reported in schizophrenia, rsFC changes of the frontal pole (FP) remain unclear. The FP contains several subregions with different connection patterns; however, it is unknown whether the FP subregions are differentially affected in schizophrenia. To explore this possibility, we compared rsFC differences of the FP subregions between schizophrenia patients and healthy controls., Method: One hundred healthy controls and 91 patients with schizophrenia underwent resting-state functional MRI with a sensitivity-encoded spiral-in (SENSE-SPIRAL) imaging sequence to reduced susceptibility-induced signal loss and distortion. The FP was subdivided into the orbital (FPo), medial (FPm), and lateral (FPl) subregions. Mean fMRI time series were extracted for each FP subregion and entered into a seed-based rsFC analysis., Results: The FP subregions exhibited differential rsFC patterns in both healthy controls and schizophrenia patients. Direct comparison between groups revealed reduced rsFCs between the bilateral FPl and several cognitive-related regions, including the dorsolateral prefrontal cortex, medial prefrontal cortex, anterior cingulate cortex, posterior cingulate cortex/precuneus, temporal cortex and inferior parietal lobule in schizophrenia. Although the FPl exhibited obvious atrophy, rsFC changes were unrelated to volumetric atrophy in the FPl, to duration of illness, and to antipsychotic medication dosage. No significant differences were observed in the rsFCs of other FP subregions., Conclusion: These findings suggest a selective (the lateral subregion) functional disconnection of the FP subregions in schizophrenia.

Background and Purpose: The resting-state functional connectivity (rsFC) has been reported to be impaired in the default-mode network (DMN) in stroke patients. However, it remains unclear whether the regional homogeneity (ReHo) of spontaneous activity and gray matter volume (GMV) are also altered in the DMN in these patients. Here we investigated ReHo, rsFC and GMV changes in the DMN and their functional correlations in stroke patients., Methods: Eighteen patients with chronic subcortical stroke and 20 healthy controls underwent multi-modality MRI examinations to extract the DMN and to calculate the ReHo, rsFC and GMV. The ReHo difference in the DMN was compared between groups and brain regions with significant group differences in ReHo were extracted to calculate rsFC and GMV of these regions. Correlations of the cognitive or depressive scores with the imaging indices of the DMN that exhibit group differences were also investigated in stroke patients., Results: Compared with healthy controls, patients with stroke exhibited decreased ReHo in the posterior cingulate cortex (PCC) and decreased rsFC between the PCC and anterior cingulate cortex (ACC). There were no significant volumetric differences in the PCC or the whole DMN between the two groups. The ReHo (not the rsFC) of the PCC was correlated with cognitive decline even after controlling for depressive scores. Neither ReHo nor rsFC of the PCC was correlated with depressive severity in these patients., Conclusions: These findings suggest that both regional spontaneous activity and their interactions are impaired in stroke patients and that the reduced ReHo of the PCC may underlie post-stroke cognitive decline., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: To investigate whether the neural representations underlying alternating two acupoint combinations (ACs) are the same or not., Methods: In this functional magnetic resonance imaging study, two sets of analgesia ACs were utilized, including Waiguan (TE5) and Qiuxu (GB40) for Group A, and Neiguan (PC6) and Taichong (LR3) for Group B, which are the most commonly adopted in clinical treatment. Each group had 20 healthy subjects. An experimental design was proposed, which consisted of a pre-needling resting phase, a needling phase and a post-needling resting phase. This paradigm optimally mimics the clinical protocol as well as focuses on both the stimulation and the resting periods. The results were subjected to general linear model analysis, conjunction analysis and the functional connectivity analysis., Results: The rostral anterior cingulated cortex was engaged in the initiative period of the acupuncture effect in both groups, and it was chosen as the seed region for the functional connectivity analysis for the following resting period. The results showed that several shared brain regions were involved in both groups, in particular the insula, amygdala and hypothalamus. Moreover, significant differences were located at the posterior cingulated cortex as revealed by a two sample -test (P<0.05, corrected). Other regions showed no significant differences. This finding was further supported by the spatial correlation analysis that the two groups were significantly correlated (r =0.51, P<0.01)., Conclusion: This preliminary research helps us understand the neurophysiological mechanisms of acupuncture when following clinical guidelines on ACs, as well as provides an important opportunity to develop better treatment strategies for reducing, or even preventing pain.

Background: Little research has been done on the connection between functional status and acupuncture efficacy; however, functional status is a key factor in the study of acupuncture efficacy. Therefore, we have tried to compare functional dyspepsia (FD) patients with healthy subjects (HS) to determine the different cerebral responses elicited by acupuncture stimulation at Zusanli (ST36)., Patients and Methods: IN this study, 24 FD patients and 24 HS were given acupuncture stimulation at ST36 while being monitored by an fMRI scan., Results: Compared with HS, FD patients showed an fMRI signal decrease in the right anterior cingulate cortex, right medial prefrontal cortex, right orbitofrontal cortex, left superior occipital gyrus, and right cuneus; but on the other hand, there was an fMRI signal increase in the right insula, right postcentral gyrus, and right supramarginal gyrus., Conclusion: Acupuncture stimulation at ST36 evoked pronounced changes, especially in the homeostatic afferent processing network of FD patients, compared to HS. We hypothesize that the cerebral responses elicited by acupuncture stimulation in certain diseases, such as FD are correlated to specific regions. The action of stimulating acupoints might be dynamic; the functional status is therefore an essential impact factor for cerebral responses to acupuncture stimulation., (© 2014 S. Karger GmbH, Freiburg.)

Background: Abdominal organs segmentation of magnetic resonance (MR) images is an important but challenging task in medical image processing. Especially for abdominal tissues or organs, such as liver and kidney, MR imaging is a very difficult task due to the fact that MR images are affected by intensity inhomogeneity, weak boundary, noise and the presence of similar objects close to each other., Method: In this study, a novel method for tissue or organ segmentation in abdomen MR imaging is proposed; this method combines kernel graph cuts (KGC) with shape priors. First, the region growing algorithm and morphology operations are used to obtain the initial contour. Second, shape priors are obtained by training the shape templates, which were collected from different human subjects with kernel principle component analysis (KPCA) after the registration between all the shape templates and the initial contour. Finally, a new model is constructed by integrating the shape priors into the kernel graph cuts energy function. The entire process aims to obtain an accurate image segmentation., Results: The proposed segmentation method has been applied to abdominal organs MR images. The results showed that a satisfying segmentation without boundary leakage and segmentation incorrect can be obtained also in presence of similar tissues. Quantitative experiments were conducted for comparing the proposed segmentation with other three methods: DRLSE, initial erosion contour and KGC without shape priors. The comparison is based on two quantitative performance measurements: the probabilistic rand index (PRI) and the variation of information (VoI). The proposed method has the highest PRI value (0.9912, 0.9983 and 0.9980 for liver, right kidney and left kidney respectively) and the lowest VoI values (1.6193, 0.3205 and 0.3217 for liver, right kidney and left kidney respectively)., Conclusion: The proposed method can overcome boundary leakage. Moreover it can segment liver and kidneys in abdominal MR images without segmentation errors due to the presence of similar tissues. The shape priors based on KPCA was integrated into fully automatic graph cuts algorithm (KGC) to make the segmentation algorithm become more robust and accurate. Furthermore, if a shelter is placed onto the target boundary, the proposed method can still obtain satisfying segmentation results.

The majority of previous neuroimaging studies have demonstrated both structural and task-related functional abnormalities in adolescents with online gaming addiction (OGA). However, few functional magnetic resonance imaging (fMRI) studies focused on the regional intensity of spontaneous fluctuations in blood oxygen level-dependent (BOLD) during the resting state and fewer studies investigated the relationship between the abnormal resting-state properties and the impaired cognitive control ability. In the present study, we employed the amplitude of low frequency fluctuation (ALFF) method to explore the local features of spontaneous brain activity in adolescents with OGA and healthy controls during resting-state. Eighteen adolescents with OGA and 18 age-, education- and gender-matched healthy volunteers participated in this study. Compared with healthy controls, adolescents with OGA showed a significant increase in ALFF values in the left medial orbitofrontal cortex (OFC), the left precuneus, the left supplementary motor area (SMA), the right parahippocampal gyrus (PHG) and the bilateral middle cingulate cortex (MCC). The abnormalities of these regions were also detected in previous addiction studies. More importantly, we found that ALFF values of the left medial OFC and left precuneus were positively correlated with the duration of OGA in adolescents with OGA. The ALFF values of the left medial OFC were also correlated with the color-word Stroop test performance. Our results suggested that the abnormal spontaneous neuronal activity of these regions may be implicated in the underlying pathophysiology of OGA.

Background: Previous imaging studies on functional dyspepsia (FD) have focused on abnormal brain functions during special tasks, while few studies concentrated on the resting-state abnormalities of FD patients, which might be potentially valuable to provide us with direct information about the neural basis of FD. The main purpose of the current study was thereby to characterize the distinct patterns of resting-state function between FD patients and healthy controls (HCs)., Methodology/principal Findings: Thirty FD patients and thirty HCs were enrolled and experienced 5-mintue resting-state scanning. Based on the support vector machine (SVM), we applied multivariate pattern analysis (MVPA) to investigate the differences of resting-state function mapped by regional homogeneity (ReHo). A classifier was designed by using the principal component analysis and the linear SVM. Permutation test was then employed to identify the significant contribution to the final discrimination. The results displayed that the mean classifier accuracy was 86.67%, and highly discriminative brain regions mainly included the prefrontal cortex (PFC), orbitofrontal cortex (OFC), supplementary motor area (SMA), temporal pole (TP), insula, anterior/middle cingulate cortex (ACC/MCC), thalamus, hippocampus (HIPP)/parahippocamus (ParaHIPP) and cerebellum. Correlation analysis revealed significant correlations between ReHo values in certain regions of interest (ROI) and the FD symptom severity and/or duration, including the positive correlations between the dmPFC, pACC and the symptom severity; whereas, the positive correlations between the MCC, OFC, insula, TP and FD duration., Conclusions: These findings indicated that significantly distinct patterns existed between FD patients and HCs during the resting-state, which could expand our understanding of the neural basis of FD. Meanwhile, our results possibly showed potential feasibility of functional magnetic resonance imaging diagnostic assay for FD.

Background and Aims: Brain dysfunction in functional dyspepsia (FD) has been identified by multiple neuroimaging studies. This study aims to investigate the regional gray matter density (GMD) changes in meal-related FD patients and their correlations with clinical variables, and to explore the possible influence of the emotional state on FD patients's brain structures., Methods: Fifty meal-related FD patients and forty healthy subjects (HS) were included and underwent a structural magnetic resonance imaging scan. Voxel-based morphometry analysis was employed to identify the cerebral structure alterations in meal-related FD patients. Regional GMD changes' correlations with the symptoms and their durations, respectively, have been analyzed., Results: Compared to the HS, the meal-related FD patients showed a decreased GMD in the bilateral precentral gyrus, medial prefrontal cortex (MPFC), anterior cingulate cortex (ACC) and midcingulate cortex (MCC), left orbitofrontal cortex (OFC) and right insula (p<0.05, FWE Corrected, Cluster size>50). After controlling for anxiety and depression, the meal-related FD patients showed a decreased GMD in the bilateral middle frontal gyrus, left MCC, right precentral gyrus and insula (p<0.05, FWE Corrected, Cluster size>50). Before controlling psychological factors, the GMD decreases in the ACC were negatively associated with the symptom scores of the Nepean Dyspepsia Index (NDI) (r = -0.354, p = 0.048, Bonferroni correction) and the duration of FD (r = -0.398, p = 0.02, Bonferroni correction) respectively., Conclusions: The regional GMD of meal-related FD patients, especially in the regions of the homeostatic afferent processing network significantly differed from that of the HS, and the psychological factors might be one of the essential factors significantly affecting the regional brain structure of meal-related FD patients.

Recently, there is an increasing interest in the study of the role of brain dysfunction in the pathogenesis of symptoms of functional dyspepsia (FD). More specifically, abnormal brain activities in patients with FD during the resting state have been proven by several positron emission tomography (PET) studies. Resting-state functional magnetic resonance imaging (fMRI) is also a valuable tool in investigating spontaneous brain activity abnormalities in pathological conditions. In the present study, we examined the amplitude of low-frequency fluctuations (ALFF) and fractional (f)ALFF changes in patients with FD by using fMRI. Twenty-nine patients with FD and sixteen healthy controls participated in this study. Between-group differences in ALFF/fALFF were examined using a permutation-based nonparametric test after accounting for the gender and age effects. The results revealed a significant between-group difference in fALFF but not in ALFF in multiple brain regions including the right insula, brainstem and cerebellum. Seed-based resting-state functional connectivity analysis revealed that FD patients have increased correlations between the right cerebellum and multiple brain regions including the bilateral brainstem, bilateral cerebellum, bilateral thalamus, left para-/hippocampus, left pallidum and left putamen. Furthermore, fLAFF values in the right insula were positively correlated with the severity of the disease. These findings have provided further evidence of spontaneous brain activity abnormalities in FD patients which might contribute to our understanding of the pathophysiology of the disease., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Susceptibility weighted imaging (SWI) is a new MRI technique which has been proved very useful in the diagnosis of brain diseases, but few study was performed on its value in prostatic diseases. The aim of the present study was to investigate the value of SWI in distinguishing prostate cancer from benign prostatic hyperplasia and detecting prostatic calcification., Methodology/principal Findings: 23 patients with prostate cancer and 53 patients with benign prostatic hyperplasia proved by prostate biopsy were scanned on a 3.0T MR and a 16-row CT scanner. High-resolution SWI, conventional MRI and CT were performed on all patients. The MRI and CT findings, especially SWI, were analyzed and compared. The analyses revealed that 19 out of 23 patients with prostate cancer presented hemorrhage within tumor area on SWI. However, in 53 patients with benign prostatic hyperplasia, hemorrhage was detected only in 1 patient in prostate by SWI. When comparing SWI, conventional MRI and CT in detecting prostate cancer hemorrhage, out of the 19 patients with prostate cancer who had prostatic hemorrhage detected by SWI, the prostatic hemorrhage was detected in only 7 patients by using conventional MRI, and none was detected by CT. In addition, CT demonstrated calcifications in 22 patients which were all detected by SWI whereas only 3 were detected by conventional MRI. Compared to CT, SWI showed 100% in the diagnostic sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) in detecting calcifications in prostate but conventional MRI demonstrated 13.6% in sensitivity, 100% in specificity, 75% in accuracy, 100% in PPV and 74% in NPV., Conclusions: More apparent prostate hemorrhages were detected on SWI than on conventional MRI or CT. SWI may provide valuable information for the differential diagnosis between prostate cancer and prostatic hyperplasia. Filtered phase images can identify prostatic calcifications as well as CT.

Migraine is a primary headache disorder characterized by recurrent attacks of throbbing pain associated with neurological, gastrointestinal and autonomic symptoms. Previous studies have detected structural deficits and functional impairments in migraine patients. However, researchers have failed to investigate the functional connectivity alterations of regions with structural deficits during the resting state. Twenty-one migraine patients without aura and 21 age- and gender-matched healthy controls participated in our study. Voxel-based morphometric (VBM) analysis and functional connectivity were employed to investigate the abnormal structural and resting-state properties, respectively, in migraine patients without aura. Relative to healthy comparison subjects, migraine patients showed significantly decreased gray matter volume in five brain regions: the left medial prefrontal cortex (MPFC), dorsal anterior cingulate cortex (dACC), right occipital lobe, cerebellum and brainstem. The gray matter volume of the dACC was correlated with the duration of disease in migraine patients, and thus we chose this region as the seeding area for resting-state analysis. We found that migraine patients showed increased functional connectivity between several regions and the left dACC, i.e. the bilateral middle temporal lobe, orbitofrontal cortex (OFC) and left dorsolateral prefrontal cortex (DLPFC). Furthermore, the functional connectivity between the dACC and two regions (i.e. DLPFC and OFC) was correlated with the duration of disease in migraine patients. We suggest that frequent nociceptive input has modified the structural and functional patterns of the frontal cortex, and these changes may explain the functional impairments in migraine patients., (Copyright © 2012 John Wiley & Sons, Ltd.)