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Background: Growing evidence suggests that marrow adipocytes play an active role in the regulation of bone metabolism and hematopoiesis. However, research on the relationship between bone and fat in the context of hematological diseases, particularly β‐thalassemia, remains limited. Purpose: To investigate the relationship between marrow fat and cortical bone thickness in β‐thalassemia and to identify key determinants influencing these variables. Study Type: Prospective. Subjects: Thirty‐five subjects in four subject groups of increasing disease severity: 6 healthy control (25.0 ± 5.3 years, 2 male), 4 β‐thalassemia minor, 13 intermedia, and 12 major (29.1 ± 6.4 years, 15 male). Field Strength/Sequence: 3.0 T, 3D fast low angle shot sequence and T1‐weighted turbo spin echo. Assessment: Analyses on proton density fat fraction (PDFF) and R2* values in femur subregions (femoral head, greater trochanter, intertrochanteric, diaphysis, distal) and cortical thickness (CBI) of the subjects' left femur. Clinical data such as age, sex, body mass index (BMI), and disease severity were also included. Statistical Tests: One‐way analysis of variance (ANOVA), mixed ANOVA, Pearson correlation and multiple regression. P‐values <0.05 were considered significant. Results: Bone marrow PDFF significantly varied between the femur subregions, F(2.89,89.63) = 44.185 and disease severity, F(1,3) = 12.357. A significant interaction between subject groups and femur subregions on bone marrow PDFF was observed, F(8.67,89.63) = 3.723. Notably, a moderate positive correlation was observed between PDFF and CBI (r = 0.33–0.45). Multiple regression models for both PDFF (R2 = 0.476, F(13,151) = 10.547) and CBI (R2 = 0.477, F(13,151) = 10.580) were significant. Significant predictors for PDFF were disease severity (βTMi = 0.36, βTMa = 0.17), CBI (β = 0.24), R2* (β = −0.32), and height (β = −0.29) while for CBI, the significant determinants were sex (β = −0.27), BMI (β = 0.55), disease severity (βTMi = 2.15), and PDFF (β = 0.25). Data Conclusion: This study revealed a positive correlation between bone marrow fat fraction and cortical bone thickness in β‐thalassemia with varying disease severity, potentially indicating a complex interplay between bone health and marrow composition. Evidence Level: 2 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

The growing interest in complementary interventions for stroke recovery necessitates the need for neural insights to aid in making evidence-based clinical decisions. This systematic review examined the brain activation effects of complementary therapies, including acupuncture (n = 5), motor imagery therapy (MIT) (n = 5), music (n = 3), and virtual reality (VR) interventions (n = 3), on clinical outcomes and neural activity in stroke patients. All therapies engaged motor and sensory networks, frontal regions, parietal regions, and temporal regions, suggesting their potential to improve motor control, attention, memory, and cognitive function. Acupuncture activated motor areas in both hemispheres, while MIT stimulated frontoparietal regions in both sides of the brain, supporting whole-body integration in recovery. In contrast, VR therapy exhibited ipsilesional lateralization, while music therapy showed left-lateralization. The review also found that increased interhemispheric connectivity between motor regions, along with intrahemispheric ipsilesional connectivity between motor, cognitive, and sensory areas, is key to achieving better clinical outcomes. Systematic Review Registration: http://www.crd.york.ac.uk/PROSPERO , identifier (ID: CRD42023455192). [ABSTRACT FROM AUTHOR]

Background: β‐thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition. Purpose: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proximal femur using 1H‐MRS. Study Type: Prospective. Subjects: Twenty‐three subjects were included in this study, seven control and 16 β‐thalassemia subjects. Field Strength/Sequence: 3.0T; stimulated echo acquisition Mode (STEAM); magnetic resonance spectroscopy (MRS) sequence. Assessment: Multiecho MRS scans were performed in four regions of the proximal left femur of each subject, that is, diaphysis, femoral neck, femoral head, and greater trochanter. The examined regions were grouped into red (diaphysis and femoral neck) and yellow marrow regions (femoral head and greater trochanter). Statistical Tests: The Jonckheere–Terpstra test was used to evaluate the impact of increasing disease severity on bone marrow fat fraction (BMFF), marrow conversion index, and fat unsaturation index (UI). Pairwise comparison analysis was performed when a significant trend (P < 0.05) was found. K‐means clustering analysis was used to examine the clusters observed when BMFF in the red and yellow regions were studied (diaphysis against greater trochanter). Results: BMFF showed a significant decreasing trend with increasing disease severity in both red (TJT = 109.00, z = –4.414, P < 0.05) and yellow marrow regions (TJT = 108.00, z = –4.438, P < 0.05). The opposite trend was observed in UI in both bone marrow regions (red marrow: TJT = 180.5, z = 3.515, P < 0.05; yellow marrow: TJT = 155.0, z = 2.282, P = 0.05). Three distinct forms of marrow adipogenesis were found when plotting BMFF diaphysis against BMFF greater trochanter: 1) normal (centroid: 80.4%, 66.6%), 2) partial disruption (centroid: 51.1%, 16.6%), and 3) total disruption (centroid: 2.6%, 1.6%). Data Conclusion: β‐thalassemia is associated with decreased marrow fat, and increased marrow fat unsaturation level. Level of Evidence: 2 Technical Efficacy Stage: 3 [ABSTRACT FROM AUTHOR]

Background: β-thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition., Purpose: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proximal femur using 1 H-MRS., Study Type: Prospective., Subjects: Twenty-three subjects were included in this study, seven control and 16 β-thalassemia subjects., Field Strength/sequence: 3.0T; stimulated echo acquisition Mode (STEAM); magnetic resonance spectroscopy (MRS) sequence., Assessment: Multiecho MRS scans were performed in four regions of the proximal left femur of each subject, that is, diaphysis, femoral neck, femoral head, and greater trochanter. The examined regions were grouped into red (diaphysis and femoral neck) and yellow marrow regions (femoral head and greater trochanter)., Statistical Tests: The Jonckheere-Terpstra test was used to evaluate the impact of increasing disease severity on bone marrow fat fraction (BMFF), marrow conversion index, and fat unsaturation index (UI). Pairwise comparison analysis was performed when a significant trend (P < 0.05) was found. K-means clustering analysis was used to examine the clusters observed when BMFF in the red and yellow regions were studied (diaphysis against greater trochanter)., Results: BMFF showed a significant decreasing trend with increasing disease severity in both red (T JT = 109.00, z = -4.414, P < 0.05) and yellow marrow regions (T JT = 108.00, z = -4.438, P < 0.05). The opposite trend was observed in UI in both bone marrow regions (red marrow: T JT = 180.5, z = 3.515, P < 0.05; yellow marrow: T JT = 155.0, z = 2.282, P = 0.05). Three distinct forms of marrow adipogenesis were found when plotting BMFF diaphysis against BMFF greater trochanter: 1) normal (centroid: 80.4%, 66.6%), 2) partial disruption (centroid: 51.1%, 16.6%), and 3) total disruption (centroid: 2.6%, 1.6%)., Data Conclusion: β-thalassemia is associated with decreased marrow fat, and increased marrow fat unsaturation level., Level of Evidence: 2 TECHNICAL EFFICACY STAGE: 3., (© 2020 International Society for Magnetic Resonance in Medicine.)