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Background: Late gadolinium enhancement (LGE) by cardiac magnetic resonance (CMR) may reveal myocardial fibrosis which is associated with adverse clinical outcomes in patients undergoing implantable cardioverter-defibrillator (ICD) placement. At the same time, transmural LGE in the posterolateral wall is related to nonresponse to conventional cardiac resynchronization therapy (CRT). Herein, the aim was to assess the presence and determinants of LGE in CMR in heart failure (HF) with reduced ejection fraction. Methods: Sixty-seven patients were included (17.9% female, aged 45 [29–60] years), who underwent LGE-CMR and had left ventricular ejection fraction (LVEF) as determined by echocardiography. Results: In HF patients with LVEF ≤ 35% (n = 29), ischemic and non-ischemic patterns of LGE were observed in 51.7% and 34.5% of patients, respectively. In controls (n = 38), these patterns were noted in 23.7% and 42.1% of patients, respectively. HF patients with LVEF ≤ 35% and transmural LGE in the posterolateral wall (31.0%) were characterized by older age, coronary artery disease (CAD) and previous myocardial infarction (MI) (61 ± 6 vs. 49 ± 16 years, p = 0.008, 100% vs. 40%, p = 0.003 and 78% vs. 25%, p = 0.014, respectively). In patients with LVEF ≤ 35%, LGE of any type, diagnosed in 86.2% of patients, was associated with CAD (68% vs. 0%, p = 0.02), while only trends were observed for its association with older age and previous MI (p = 0.08 and p = 0.12, respectively). Conclusions: Among HF patients with LVEF ≤ 35%, clinical factors including older age, CAD, and previous MI are associated with transmural LGE in the posterolateral wall, while CAD is associated with LGE. This data may have potential implications for planning ICD and CRT placement procedures.

Background: Olfactory dysfunction evaluated with time-consuming tests was more common in patients with multiple sclerosis (MS) than in controls and correlated with neurological deficit. The aim of the present study was to compare olfactory function between patients with relapsing-remitting MS (RRMS) and controls with short and simple screening tool—the Sniffin’ Sticks Identification Test (SSIT)—and search for its association with clinical and radiological features of the disease. Methods: The study included 30 controls and 30 patients with RRMS treated with disease-modifying therapies—injectables (interferon β or glatiramer acetate, N = 18) and oral drugs (dimethyl fumarate or fingolimod, N = 12). Hyposmia was defined as a score of 6 points or fewer in the SSIT olfactory test. The data concerning number of previous relapses, disability in Expanded Disability Status Scale (EDSS), and recent brain magnetic resonance imaging (MRI) scan were collected. Moreover, thalamic volume and third ventricle width were recorded in every patient. Additionally, cognition and fatigue in patients were evaluated 24 months after olfactory assessment with the Symbol Digit Modalities Test (SDMT) and Fatigue Scale for Motor and Cognitive Functions (FSMC), respectively. Results: Patients with RRMS had a higher risk of hyposmia than controls (66.7% vs 36.7%, OR = 1.82, 95% CI, 1.10-3.67, P = .02). Neither inflammatory (number of previous relapses or new brain MRI lesions) nor neurodegenerative (EDSS, SDMT, and FSMC scores; thalamic volume; third ventricle width) MS features did not correlate with SSIT score ( P > .05). In patients treated with oral drugs, olfactory dysfunction correlated with FSMC cognitive subscale ( r = −0.90, P = .006). Conclusions: Olfactory dysfunction is nearly twice as common in RRMS as in controls and correlates with fatigue level in patients treated with dimethyl fumarate or fingolimod.

Background: Discrepancies between increased left ventricular mass (LVM) and electrocardiographic (ECG) criteria for the diagnosis of left ventricular hypertrophy (LVH) are described in the literature. Aims: This study aimed to evaluate the usefulness of ECG criteria in the diagnosis of LVH, as determined by cardiac magnetic resonance (CMR) imaging, using various LVM indexing methods. Methods: We included 53 patients who underwent CMR imaging and had electrocardiograms of appropriate quality available in their medical records. The majority of the study patients had cardiovascular diseases. We defined CMR‑LVH as increased LVM, also assessed after LVM indexing to body surface area (LVM/BSA), height1.7, height2.7, or as the percentage of predicted LVM (%pLVM). To determine ECG‑LVH, 10 different ECG-LVH criteria were used. Results: The prevalence of CMR‑LVH ranged from 11% (for %pLVM) to 72% (for LVM/BSA). At the same time, for a single criterion, the prevalence of ECG‑LVH ranged between 1.9% (for R wave amplitude in lead V5 / V6 greater than 2.6 mV, Sokolow–Lyon product, and Gubner–Ungerleider criterion) and 45.3% (for Peguero–Lo Presti criterion), showing high sensitivity, from 55.3% (95% CI, 38.3–71.4) to 100% (95% CI, 54.1–100). The sensitivity of ECG‑LVH criteria when all criteria were applied together ranged from 57.9% (95% CI, 40.8–73.7) to 100% (95% CI, 63.1–100). The best performance regarding the endpoint of CMR‑LVH diagnosis after LVM indexing was achieved by the Peguero–Lo Presti and Cornell criteria (area under the curve, 0.621–0.876; P, 0.001–0.17). Conclusions: Thediagnosis of LVH strongly depends on ECG- and CMR‑based definitions. ThePeguero–Lo Presti criterion and the Cornell criteria, which are sex‑specific, may provide the highest level of diagnostic accuracy and should be considered when screening patients with cardiovascular diseases for LVH.

Cel pracyZespoły kardiometaboliczne są najczęstszą przyczyną powikłań skracających oczekiwaną długość życia u pacjentów leczonych z powodu zaburzeń psychicznych, w tym schizofrenii. Jednak to, jak bardzo ryzyko kardiometaboliczne jest związane ze stylem życia, skutkami ubocznymi leczenia lub psychozą, nie jest jasne. Celem tego badania była prospektywna ocena zmian metabolicznych u młodych pacjentów, u których zdiagnozowano pierwszy ostry epizod psychozy bez wcześniejszej farmakoterapii.MetodaAnalizy zostały przeprowadzone w trakcie przyjęcia do szpitala oraz po 3 i 12 tygodniach i obejmowały morfologię krwi, profil lipidowy, glukozę, markery stanu zapalnego, ciśnienie krwi oraz wskaźnik masy ciała. Nasilenie objawów klinicznych oceniono za pomocą skali pozytywnych i negatywnych objawów (z ang. Positive and Negative Syndrome Scale, PANSS), a zdolności poznawcze oceniono za pomocą skali Montreal Cognitive Assessment (MoCA). Zmierzono również czas trwania nieleczonej psychozy (z ang. duration of untreated psychosis, DUP).WynikiStwierdzono znaczny wzrost wskaźnika masy ciała, nasilenie dyslipidemii, stanu zapalnego i skurczowego ciśnienia krwi po 12 tygodniach od rozpoczęcia leczenia, podczas gdy poziom kortyzolu spadł. Zaobserwowano ujemną korelację między pomiarami PANSS-P (skala dodatnia PANSS) a całkowitym poziomem cholesterolu, skalą całkowitą PANSS i lipoproteiną o niskiej gęstości (LDL), a także DUP i MoCA. Poziom lipoprotein o wysokiej gęstości (HDL) korelował dodatnio z DUP, kortyzolem, monocytami i leukocytami w pierwszym tygodniu.WnioskiWyniki wskazują na związek pomiędzy rozwojem i leczeniem pierwszego epizodu psychozy z wynikami badań laboratoryjnych, przyczyniając się do rozwoju stresu metabolicznego u pacjentów.

The goal of this paper is to investigate the baseline brain activity in euthymic bipolar disorder (BD) patients by comparing it to healthy controls (HC) with the use of a variety of resting state functional magnetic resonance imaging (rs-fMRI) analyses, such as amplitude of low frequency fluctuations (ALFF), fractional ALFF (f/ALFF), ALFF-based functional connectivity (FC), and r egional homogeneity (ReHo). We hypothesize that above-mentioned techniques will differentiate BD from HC indicating dissimilarities between the groups within different brain structures. Forty-two participants divided into two groups of euthymic BD patients (n = 21) and HC (n = 21) underwent rs-fMRI evaluation. Typical band ALFF, slow-4, slow-5, f/ALFF, as well as ReHo indexes were analyzed. Regions with altered ALFF were chosen as ROI for seed-to-voxel analysis of FC. As opposed to HC, BD patients revealed: increased ALFF in left insula, increased slow-5 in left middle temporal pole, increased f/ALFF in left superior frontal gyrus, left superior temporal gyrus, left middle occipital gyrus, right putamen, and bilateral thalamus. There were no significant differences between BD and HC groups in slow-4 band. Compared to HC, the BD group presented higher ReHo values in the left superior medial frontal gyrus and lower ReHo values in the right supplementary motor area. FC analysis revealed significant hyper-connectivity within the BD group between left insula and bilateral middle frontal gyrus, right superior parietal gyrus, right supramarginal gyrus, left inferior parietal gyrus, left cerebellum, and left supplementary motor area. To our best knowledge, this is the first rs-fMRI study combining ReHo, ALFF, f/ALFF, and subdivided frequency bands (slow-4 and slow-5) in euthymic BD patients. ALFF, f/ALFF, slow-5, as well as REHO analysis revealed significant differences between two studied groups. Although results obtained with the above methods enable to identify group-specific brain structures, no overlap between the brain regions was detected. This indicates that combination of foregoing rs-fMRI methods may complement each other, revealing the bigger picture of the complex resting state abnormalities in BD.

Despite extensive research, there is no convincing evidence of a reliable diagnostic biomarker for schizophrenia beyond clinical observation. Disorders of glutamatergic neurotransmission associated with N-methyl-D-aspartate (NMDA) receptor insufficiency, neuroinflammation, and redox dysregulation are the principal common mechanism linking changes in the periphery with the brain, ultimately contributing to the emergence of negative symptoms of schizophrenia that underlie differential diagnosis. The aim of the study was to evaluate the influence of these systems via peripheral and cerebral biochemical indices in relation to the patient’s clinical condition. Using neuroimaging diagnostics, we were able to define endophenotypes of schizophrenia based on objective laboratory data that form the basis of a personalized approach to diagnosis and treatment. The two distinguished endophenotypes differed in terms of the quality of life, specific schizophrenia symptoms, and glutamatergic neurotransmission metabolites in the anterior cingulate gyrus. Our results, as well as further studies of the excitatory or inhibitory balance of microcircuits, relating the redox systems on the periphery with the distant regions of the brain might allow for predicting potential biomarkers of neuropsychiatric diseases, including schizophrenia. To the best of our knowledge, our study is the first to identify an objective molecular biomarker of schizophrenia outcome.

Objective The occurrence of death by suicide in patients diagnosed with bipolar disorder is as much as 60 times greater than in the general population. Even during the state of euthymia patients are characterized by suicide risk. The aim of the study is to investigate the baseline brain activity in euthymic bipolar disorder patients in regard to suicide risk. We hypothesized that patients compared to healthy control group will demonstrate altered functional connectivity among resting state networks which will be directly related to current suicide risk. Method 41 subjects were enrolled in the study consisting control group (n = 21) and euthymic bipolar disorder patients group (n = 20). Functional magnetic resonance imaging was used to evaluate resting state brain activity and ROI-ROI functional connectivity analysis was performed. Suicidal risk was estimated using The Suicide Behaviors Questionnaire-Revised. Results A two sample t-test revealed decreased functional connectivity between regions involved in the salience network in patients compared to the control group. This decrease was negatively correlated with current suicide risk. Conclusion Obtained results suggest the association between risk of suicide and activity of regions responsible for functions such as learning from mistakes, prospective thinking, and sensory integration.

Schizophrenia is a complex mental disorder whose course varies with periods of deterioration and symptomatic improvement without diagnosis and treatment specific for the disease. So far, it has not been possible to clearly define what kinds of functional and structural changes are responsible for the onset or recurrence of acute psychotic decompensation in the course of schizophrenia, and to what extent personality disorders may precede the appearance of the appropriate symptoms. The work combines magnetic resonance spectroscopy imaging with clinical evaluation and laboratory tests to determine the likely pathway of schizophrenia development by identifying peripheral cerebral biomarkers compared to personality disorders. The relationship between the level of metabolites in the brain, the clinical status of patients according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision ICD-10, duration of untreated psychosis (DUP), and biochemical indices related to redox balance (malondialdehyde), the efficiency of antioxidant systems (FRAP), and bioenergetic metabolism of mitochondria, were investigated. There was a reduction in the level of brain N-acetyl-aspartate and glutamate in the anterior cingulate gyrus of patients with schisophrenia compared to the other groups that seems more to reflect a biological etiopathological factor of psychosis. Decreased activity of brain metabolites correlated with increased peripheral oxidative stress (increased malondialdehyde MDA) associated with decreased efficiency of antioxidant systems (FRAP) and the breakdown of clinical symptoms in patients with schizophrenia in the course of psychotic decompensation compared to other groups. The period of untreated psychosis correlated negatively with glucose value in the brain of people with schizophrenia, and positively with choline level. The demonstrated differences between two psychiatric units, such as schizophrenia and personality disorders in relation to healthy people, may be used to improve the diagnosis and prognosis of schizophrenia compared to other heterogenous psychopathology in the future. The collapse of clinical symptoms of patients with schizophrenia in the course of psychotic decompensation may be associated with the occurrence of specific schizotypes, the determination of which is possible by determining common relationships between changes in metabolic activity of particular brain structures and peripheral parameters, which may be an important biological etiopathological factor of psychosis. Markers of peripheral redox imbalance associated with disturbed bioenergy metabolism in the brain may provide specific biological factors of psychosis however, they need to be confirmed in further studies.

The aim of the study was to verify the hypothesis about differences in sweet taste perception in the group of preschool children with and without caries, and to determine its relationship with cariogenic microbiota and the frequency of sweets consumption in children. The study group included of 63 children aged 2&ndash, 6 years: 32 with caries and 31 without caries. The study consisted of collecting questionnaire data and assessment of dental status using the decayed, missing, filled in primary teeth index (dmft) and the International Caries Detection and Assessment System (ICDAS II). The evaluation of sweet taste perception was carried out using a specific method that simultaneously assessed the level of taste preferences and the sensitivity threshold for a given taste. The microbiological analysis consisted of the assessment of the quantitative and qualitative compositions of the oral microbiota of the examined children. The sweet taste perception of children with caries was characterized by a lower susceptibility to sucrose (the preferred sucrose solution concentration was &gt, 4 g/L) compared to children without caries (in the range &le, 4 g/L, p = 0.0015, chi-square test). A similar relationship was also observed for frequent snacking between meals (p = 0.0038, chi-square test). The analysis of studied variables showed the existence of a strong positive correlation between the perception of sweet taste and the occurrence and intensity of the cariogenic process (p = 0.007 for dmft, and p = 0.012 for ICDAS II), as well as the frequency of consuming sweets (p &le, 0.001 for frequent and repeated consumption of sweets during the day, Spearman test) in children with caries. Additionally, children with an elevated sucrose taste threshold were more than 10-times more likely to develop S. mutans presence (OR = 10.21, 95% CI 3.11&ndash, 33.44). The results of this study suggest the future use of taste preferences in children as a diagnostic tool for the early detection of increased susceptibility to caries through microbial dysbiosis towards specific species of microorganisms.

Schizophrenia is a neurodevelopmental disorder featuring chronic, complex neuropsychiatric features. The etiology and pathogenesis of schizophrenia are not fully understood. Oxidative-antioxidant imbalance is a potential determinant of schizophrenia. Oxidative, nitrosative, or sulfuric damage to enzymes of glycolysis and tricarboxylic acid cycle, as well as calcium transport and ATP biosynthesis might cause impaired bioenergetics function in the brain. This could explain the initial symptoms, such as the first psychotic episode and mild cognitive impairment. Another concept of the etiopathogenesis of schizophrenia is associated with impaired glucose metabolism and insulin resistance with the activation of the mTOR mitochondrial pathway, which may contribute to impaired neuronal development. Consequently, cognitive processes requiring ATP are compromised and dysfunctions in synaptic transmission lead to neuronal death, preceding changes in key brain areas. This review summarizes the role and mutual interactions of oxidative damage and impaired glucose metabolism as key factors affecting metabolic complications in schizophrenia. These observations may be a premise for novel potential therapeutic targets that will delay not only the onset of first symptoms but also the progression of schizophrenia and its complications.

The aim of our study was to compare the degree of brain atrophy in centenarians and in seniors 70&ndash, 99 years old. The study group consisted of 23 patients aged 100&ndash, 106 years. The control group consisted of 90 patients, 30 in each age subgroup 90&ndash, 99, 80&ndash, 89, 70&ndash, 79. In all the patients, the brain atrophy linear parameters were measured on computed tomography scans, in relation to both &ldquo, subcortical atrophy&rdquo, evaluated as progressive widening of the ventricular system, and &ldquo, cortical atrophy&rdquo, defined as widening of subarachnoid space. Secondary indices based on the parameters were calculated. Correlations between the above parameters/indices and age were tested. Significantly different values between the centenarians and the control group were found in the brain atrophy parameters: A, B, C, E, FI, ICR, ICL, SW, CFW, F/A &lsquo, frontal horn index&rsquo, A/G &lsquo, Evans index&rsquo, D/A &lsquo, ventricular index&rsquo, H/E &lsquo, cella media Schiersmann index&rsquo, A+B &lsquo, Huckman number&rsquo, Correlations between parameter/index and age were found for: A, B, C, FI, ICR, ICL, SW, F/A &lsquo, Brain atrophy associated with aging is a continuously advancing process, affecting centenarians even more than people before the &ldquo, magic&rdquo, threshold of 100 years.

Dental materials are common sources of artifacts during brain MRI studies. The aim of the present study was to estimate the degree of image disturbance caused by dental materials during an MRI examination, and the risk of ferromagnetic materials being dislocated in the magnetic field. MR sequences where dental materials containing metals produced the smallest artifacts was also calculated. Thirty-five dental material samples containing metals were examined using the 1.5 T MR system. They consisted of the most commonly used dental restorations and root-canal instruments left in the oral cavity for iatrogenic reasons. Additionally, cubes (10×5×5 mm) and balls (10 mm diameter) were cast from commonly used dental alloys. No dislocation of the examined samples in the gelatin medium was observed. All the materials were found to produce artifacts characterised by similar images. The study showed that the presence of distant artifacts, besides those located in the area immediately surrounding the object, depends on the shape of the given material. The size of artifacts generated by the most commonly used fixed restorations was graded. The sequences in which artifacts were least pronounced were selected. No dislocation of samples in the 1.5 T field was observed during the examination. However they produced artifacts; the typical image of an artifact — a signal void zone surrounded by a hyperintensive rim. Alloys consisting of Ag-Pd, dental gold and amalgam distorted the MR image to the least degree. In the case of a routine spin echo (SE) sequence examination the smallest artifacts were generated in the FSE T2 and PD sequences.

Congenital malformations comprise all cases of abnormal fetal develop. ment. Among the most serious ano malies - those of the central nervous system (CNS) - the most common are disrafic disorders, i.e. malformations of neural tube closure. This study is an approach to the problem of congenital malformation diagnostics, in the context of modern prenatal treatment and prognosis.

The of aim of the present study was the estimation of the influence of proficiency level of the second language on activation patterns of language areas. 30 volunteers participated in the experiment (15 females and 15 males) from 18 to 40 years of age. Mean age was 28 years. All participants were divided by linguist into two groups according to their proficiency level of the foreign language: high proficiency group (HP) and low proficiency group (LP). Block design method was used in the performed experiment. The experimental task was speech production in the form of sentences, the control tusk was silence. The experiment was performed using 1,5 T MR system. Functional data analysis was performed using SPM2 software (Wellcome Department of Cognitive Neurology, Great Britain). In low proficiency group (LP) stronger activation was found in right inferior frontal gyrus (pars tiangulris) incuding insula and in the left hemisphere on the border of supramarginal and superior temporal gyrus. In high proficiency group (HP) more activated in second language (L2) was the left inferior frontal gyrus (pars tiangulris), and a small part of left middle frontal gyrus. Proficiency level of the second language influences the pattern of activation of language areas.

The aim of the study is to present usefulness of Cardiac Magnetic Resonance (CMR) to assess left ventricular hypertrophy in hypertensive patients. 48 patients were examined (24 females and 24 males) from 37 to 75 years of age (mean age was 56 years) with diagnosed cardiac hypertrophy in the course of 2nd and 3rd degree primary hypertension. All patients from this group underwent Cardio MR examination using MR 1.5 T Signa Excite (GE) system. Dedicated software was used for post-processing (MASS, Medis). We assessed left ventricular functional parameters such as: Ejection Fraction (EF), End-Diastolic Volume(EDV) and End-Systolic Volume (ESV). We also assessed left ventricular diameters as well as left ventricular posterior wall (PWD) and interventricular septum (IVSD) thickness. We also calculated left ventricular mass (LVM) and left ventricular mass index (LVMI). In most cases (66.7%) patients had significant increase of LVM. On the base of LVMI hypertrophy of the left ventricle was found in 6.2% patients. We affirmed statistically significant changes of left ventricular's morphological and functional parameters. The significant correlation was found between posterior wall diameter (PWD) and LVM, as well as between interventricular septum (IVSD) and LVM. The significant correlation was found between posterior wall diameter (PWD) and left ventricular Ejection Fraction (EF) and End-Systolic Volume (ESV). Cardio MR is an effective method to detect left ventricular hypertrophy (LVH) in hypertensive patients.

Fibrous dysplasia (dysplasia fibrosa -DF) is a local disorder of spongy bone structure caused by local pathological metabolism. Transformation of trabecular bony structure into connective tissue takes place. Inside the transformed bone scattered connective tissue elements, cartilaginous elements and pathological density are found. The disease proliferates either in the medullary bone or in subperiosteal region, and the development of fibrous tissue causes bone expansion with thinning of overlying cortex. The radiological appearance depends on the stage of the disease. The margins of the lesions are usually obscured and gradually turn into pathological tissue of trabeculated appearance.The aim of the study is to demonstrate fibrous dysplasia that is accidentally found during radiological diagnostics of facial skeleton and stomatological disease, and to describe radiological appearance of the pathological lesions.The material included 23 patients (9 males, 14 females), of 24 to 64 years of age, that were directed for the diagnostics of facial skeleton and stomatological disease with the use of multislice computer tomography, because of clinically diagnosed pathologies in the nasal sinuses, temporomandibular joints, pathologies of the mandible and maxillary, and before treatment with prosthetic implants. All the presented fibrous dysplasia cases were diagnosed during the performance of the above examinations. The examinations were performed by the use of spiral CT (Siemens Somatom Sensation 10) with standard parameters. The range of the examination included the nasal sinuses, facial skeleton or the whole scull-configuration of the detectors 10 x 0.75 mm, slice thickness 1 mm, reconstruction gap 0.7 mm, kernel H60s for osseous structure evaluation, and slice thickness 1, 4 do 4 mm, reconstruction gap 4 mm, kernel H31s for soft tissue evaluation. The obtained results were presented sented in the form of figures.In the analyzed material 23 cases of scull fibrous dysplasia were found. The disease involved 9 males (39.14%) and 14 females (60.86%) from 24 to 64 years of age. Mean age for the whole group was 46.6 years, for males was 50,5 years and for females was 44.4 years. Females with fibrous dysplasia were more numerous (60.86%) than males (39.14%). Monoostotic dysplasia was found in 18 cases (78,89%), polyostotic dysplasia was found in 4 cases (13.05%), the skull-face dysplasia was found in 9 cases (14.07%). The radiological appearance is characterized by lesions that unclearly and gradually turn into pathological tissue with different densities, trabeculated appearance, and sclerotic, lytic or mixed structure. Early lesions usually have lower density than the normal surrounding bone, giving the appearance of translucency.Fibrous dysplasia of the facial skeleton is most commonly incidentally found on CT examinations of the head, mandible and nasal sinuses. Diagnosis of fibrous dysplasia is important because of unfavorable influence of the disease on stomatognathic system, laryngological disease, ophthalmic and neurological disease.

Persistent notochordal canal is a rare developmental anomaly, typically restricted to 1 or 2 vertebral levels, and only in exceptional cases extending over a longer segment. It is usually asymptomatic and discovered incidentally.A 30-year-old woman reported to our department for control lumbar spine plain films. About 2 years before, after minor trauma, she had been misdiagnosed on radiograms in another hospital as having a compression L5 vertebra fracture. The assessment of current plain films and analysis of previous radiograms delivered indicated the need for taking a developmental anomaly into consideration. Based on CT and MR of lumbar spine performed, a final diagnosis of a persistent notochordal canal was established.In spite of its rare occurrence, the characteristic features of a persistent notochordal canal should be known by radiologists, particularly to avoid misinterpretation in post-traumatic patients.