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Background Electroconvulsive therapy (ECT) has been shown to induce broadly distributed cortical and subcortical volume increases, more prominently in the amygdala and the hippocampus. Structural changes after one ECT session and in the long-term have been understudied. Objective The aim of this study was to describe short-term and long-term volume changes induced in cortical and subcortical regions by ECT. Methods Structural brain data were acquired from depressed patients before and 2 h after their first ECT session, 7–14 days after the end of the ECT series and at 6 months follow up (N = 34). Healthy, age and gender matched volunteers were scanned according to the same schedule (N = 18) and patients affected by atrial fibrillation were scanned 1–2 h before and after undergoing electrical cardioversion (N = 16). Images were parcelled using FreeSurfer and estimates of cortical gray matter volume and subcortical volume changes were obtained using Quarc. Results Volume increase was observable in most of gray matter regions after 2 h from the first ECT session, with significant results in brain stem, bilateral hippocampi, right putamen and left thalamus, temporal and occipital regions in the right hemisphere. At the end of treatment series, widespread significant volume changes were observed. After six months, the right amygdala volume was still significantly increased. No significant changes were observed in the comparison groups. Conclusions Volume increases in gray matter areas can be detected 2 h after a single ECT session. Further studies are warranted to explore the underlying molecular mechanisms.

A 42-year-old man presented with a headache and right hemiparesis and was found to have a cystic mass with a calcified mural nodule in the left thalamus. Because the thalamus is surrounded by vital neurovascular structures, the surgical approach to thalamic lesions can be challenging. We decided to remove the mass for decompression and pathological diagnosis. The mass was removed through a contralateral interhemispheric transcallosal transchoroidal approach with less retraction and parenchymal injury than other approaches to avoid brain retraction and cortical injury. The pathological diagnosis was cavernous malformation. Temporary worsening of the preoperative hemiparesis was recovered over two months following surgery. Tolerable thalamic pain syndrome remained. Here, we report a rare case of thalamic cavernous malformation with a favorable outcome through a contralateral surgical approach.

Background Transient periictal MRI abnormalities (TPMA) are caused by seizures, and may completely or partially reverse within a few days following seizure. Although TPMA are usually observed in patients with status epilepticus (SE), they have also been rarely reported after isolated/recurrent seizures not fulfilling the criteria for SE. Herein, we present a case of a 1-year-old girl with TPMA. Case A 1-year-old girl with Apert syndrome and epilepsy showed MRI abnormalities in the cortico-subcortical areas of the left temporal, occipital and parietal lobes, as well as the left thalamus. These abnormalities showed as a hyperintense signal on diffusion-weighted imaging and a hypointense signal on apparent-diffusion coefficient maps. On follow-up MRI after 3 days, the abnormal signals were completely reversed. We confirmed TPMA after eliminating other possibilities. When treatment was withdrawn, the patient regained consciousness immediately and did not show any abnormality on subsequent MRI. Conclusion TPMA may occur in young children; recognizing this possibility is important for making the diagnosis and conducting appropriate treatment. As a previous study revealed, the distribution of signal changes in cortico-subcortical areas and the ipsilateral thalamus may be a characteristic feature of TPMA.

Goal-directed behavior crucially relies on our capacity to suppress impulses and predominant behavioral responses. This ability, called inhibitory control, emerges in early childhood with marked improvements between 3 and 4 years. Here, we ask which brain structures are related to the emergence of this critical ability. Using a multimodal approach, we relate the pronounced behavioral improvements in different facets of 3-and 4-year-olds’ (N = 37, 20 female) inhibitory control to structural indices of maturation in the developing brain assessed with MRI. Our results show that cortical and subcortical structure of core regions in the adult cognitive control network, including the PFC, thalamus, and the inferior parietal cortices, are associated with early inhibitory functioning in preschool children. Probabilistic tractography revealed an association of frontoparietal (i.e., the superior longitudinal fascicle) and thalamocortical connections with early inhibitory control. Notably, these associations to brain structure were distinct for different facets of early inhibitory control, often referred to as motivational (‘hot’) and cognitive (‘cold’) inhibitory control. Our findings thus reveal the structural brain networks and connectivity related to the emergence of this core faculty of human cognition.Significance StatementThe capacity to suppress impulses and behavioral responses is crucial for goal-directed behavior. This ability, called inhibitory control, develops between the ages of 3 and 4 years. The factors behind this developmental milestone have been debated intensely for decades, however, the brain structure that underlies the emergence of inhibitory control in early childhood is largely unknown. Here, we relate the pronounced behavioral improvements in inhibitory control between 3 and 4 years with structural brain markers of grey matter and white matter maturation. Using a multimodal approach that combines analyses of cortical surface structure, subcortical structures, and white matter connectivity, our results reveal the structural brain networks and connectivity related to this core faculty of human cognition.

A 71-year-old, right-handed woman was admitted to our hospital due to a sudden difficulty with conversation. On admission, she was alert, but had a euphoric mood, disorientation, and a disturbance of recent memory. Her speech was fluent. Her repetition and auditory word cognition were excellent, but she had a slight difficulty with naming visual objects. She frequently showed word-finding difficulty and irrelevant paraphasia during free conversation and a word fluency task. Her irrelevant paraphasia was observed more frequently when she was asked to explain her outbreak of anger at the hospital, i.e., it was situation-dependent. She also had anosognosia. MRI showed an infarct in the territory of the left tuberothalamic artery. Single-photon emission computed tomography revealed low-uptake lesions in the left thalamus and orbital frontal, medial frontal, and medial temporal lobes. The patient was diagnosed with non-aphasic misnaming. The clinical characteristics of patients with non-aphasic misnaming in the literature were reviewed. All of the patients with non-aphasic misnaming had word-finding difficulty and irrelevant paraphasia. Additionally, they had either emotional disturbance or anosognosia.

Macroscopic structural abnormalities in the thalamus and thalamic circuits have been shown to contribute to the neuropathology of major depressive disorder (MDD). However, cytoarchitectonic properties underlying these macroscopic abnormalities remain unknown. The purpose of this study was to identify systematic deficits of brain architecture in depression, from structural brain network organization to microstructural properties. A multi-modal neuroimaging approach including diffusion, anatomical and quantitative magnetic resonance imaging (MRI) was used to examine structural-related alternations in 56 MDD patients compared with 35 age- and sex-matched controls. Structural networks were constructed and analyzed using seed-based probabilistic tractography. Morphometric measurements, including cortical thickness and voxel-based morphometry (VBM), were evaluated across the whole brain. A conjunction analysis was then conducted to identify key regions showing common structural alternations across modalities. The microstructural properties, macromolecular tissue volume (MTV) and T1 relaxation times of identified key regions were then calculated. Results showed multiple alterations of structural connectivity within a set of subcortical areas and their connections to cortical regions in MDD patients. These subcortical regions included the putamen, thalamus and caudate, which are predominately involved in the limbic-cortical-striatal-pallidal-thalamic network (LCSPT). Structural connectivity was disrupted within and between large-scale networks, mainly including subcortical networks, default mode networks and salience/ventral attention networks. Consistently, these regions also exhibited widespread volume reductions in MDD patients, specifically the bilateral thalamus, left putamen and right caudate. Importantly, the microstructural properties, T1 relaxation time of left thalamus were increased and negatively correlated with its gray matter volume in MDD patients. The present work to date sheds light on the neuropathological disruptions of LCSPT circuit in MDD, providing the first multi-modal neuroimaging evidence for the macro-micro structural abnormalities of the thalamus in patients with MDD. These findings have implications in understanding the abnormal changes of brain structures across development of MDD.

Background In people with multiple sclerosis (pwMS), lesions with a hyperintense rim (rim+) on Quantitative Susceptibility Mapping (QSM) have been shown to have greater myelin damage compared to rim‐ lesions, but their association with disability has not yet been investigated. Furthermore, how QSM rim+ and rim‐ lesions differentially impact disability through their disruptions to structural connectivity has not been explored. We test the hypothesis that structural disconnectivity due to rim+ lesions is more predictive of disability compared to structural disconnectivity due to rim‐ lesions. Methods Ninety‐six pwMS were included in our study. Individuals with Expanded Disability Status Scale (EDSS), The hyperintense rim lesions on Quantitative Susceptibility Mapping (QSM) (QSM rim+ lesions) have been shown to be particularly detrimental to tissue concentration causing greater myelin damage compared to chronic silent lesions (QSM rim‐ lesions) in multiple sclerosis (MS). However, there is no large study to date that has demonstrated the relationship of disability with rim+ lesions that are identified with QSM in MS. Our results showed that structural disconnectivity associated with rim+ lesions on QSM was more related to disability than structural disconnectivity associated with rim‐ lesions. Damages to the structural connections of the left cerebellum and thalamus from either lesion type were especially impactful on disability. This analysis provides a deeper understanding of how different lesion types can disrupt the structural connectome and contribute to MS‐related disability. A deeper understanding of the role of the connectome in MS is needed if we are to gain a comprehensive view of the disease to ultimately improve clinical outcomes in people with MS.

Background and Objectives. Juvenile myoclonic epilepsy (JME) is an idiopathic generalized epileptic syndrome, with a genetic basis clinically identified by myoclonic jerks of the upper limbs upon awaking, generalized tonic-clonic seizures and less frequent absences. Although the brain magnetic resonance imaging (MRI) is by definition normal, computer-based Voxel-Based morphometry studies have shown a number of volumetric changes in patients with juvenile myoclonic epilepsy. Thus, the aim of the present Voxel-Wise Meta-Analysis was to determine the most consistent regional differences of gray matter volume between JME patients and healthy controls. Materials and Methods. The initial search returned 31 studies. After excluding reviews and studies without control groups or without detailed peak coordinates, 12 studies were finally included in the present meta-analysis. The total number of JME patients was 325, and that of healthy controls was 357. Results. Our study showed a statistically significant increase of the gray matter in the left median cingulate/paracingulate gyri, the right superior frontal gyrus, the left precentral gyrus, the right supplementary motor area and left supplementary motor area. It also showed a decrease in the gray matter volume in the left thalamus, and in the left insula. Conclusions. Our findings could be related to the functional deficits and changes described by previous studies in juvenile myoclonic epilepsy. In this way, the volumetric changes found in the present study could be related to the impaired frontal lobe functions, the emotional dysfunction and impaired pain empathy, and to the disrupted functional connectivity of supplementary motor areas described in JME. It additionally shows changes in the volume of the left thalamus, supporting the theory of thalamocortical pathways being involved in the pathogenesis of juvenile myoclonic epilepsy.

Mild behavioral impairment (MBI), characterized by the late-life onset of sustained and meaningful neuropsychiatric symptoms, is increasingly recognized as a prodromal stage of dementia. However, the underlying neural mechanisms of MBI remain unclear. Here, we examined alterations in the topological organization of the structural covariance networks of patients with MBI (N = 32) compared with normal controls (N = 38). We found that the gray matter structural covariance networks of both the patients with MBI and controls exhibited a small-world topology evidenced by sigma value larger than one. The patients with MBI had significantly decreased clustering coefficients at several network densities and local efficiency at densities ranging from 0.05 to 0.26, indicating decreased local segregation. No significant differences in the characteristic path length, gamma value, sigma value, or global efficiency were detected. Locally, the patients with MBI showed significantly decreased nodal betweenness centrality in the left middle frontal gyrus, right inferior frontal gyrus (opercular part), and left Heschl gyrus and increased betweenness centrality in the left gyrus rectus, right insula, bilateral precuneus, and left thalamus. Moreover, the difference in the bilateral precuneus survived after correcting for multiple comparisons. In addition, a different number and distribution of hubs was identified in patients with MBI, showing more paralimbic hubs than observed in the normal controls. In conclusion, we revealed abnormal topological patterns of the structural covariance networks in patients with MBI and offer new insights into the network dysfunctional mechanisms of MBI.

Background: Schistosomiasis is a helminthic infestation of public health importance. Central nervous system involvement is a severe but under reported complication. Case report: This was a case of neuroschistosomiasis in an eight year old male who lived in a rural community in Enugu, South East Nigeria. Patient had presented with terminal haematuria, headache and neurological complications. Urine microscopy showed many ova of schistosoma haematobium while ultrasound showed urinary bladder base changes that appeared irregular with hyper echoic mucosa and focal mucosal thickening on the right side. Computed tomography of the brain revealed a hyper dense oval area surrounded by an irregular hypo dense area in the left parietal region overlying the left thalamus and lentiform nucleus. Patient showed good clinical response to praziquantel and corticosteroid. Conclusion: Neuroschistosomiasis is a rare complication of schistosomiasis. A high index of suspicion should be entertained in endemic areas as early treatment with praziquantel and steroids has good outcome.

Functional connectivity pattern altered of default mode network (DMN) is gaining more attention as a potential noninvasive biomarker to diagnose incipient Alzheimer's disease. However, the changed functional connectivity except for DMN, the longitudinal changes in executive control network (ECN) and frontoparietal network (FPN) also has attracted wide interest. Moreover, AD-related functional connectivity abnormalities within the DMN are well replicated research, but the (increased/decreased and reduced) functional connectivity in ECN and FPN weren't receive adequate attention. To address the above issues, in this paper, we adopt sparse inverse covariance estimation (SICE) approach to investigate the changed functional connectivity of ECN and FPN on the ADNI2 dataset. Our experimental results indicate the left superior frontal gyrus (SFGmed.L) and left thalamus (THA.L) regions of ECN has shown increased functional connectivity, the left anterior cingulate (ACG.L) region of ECN has shown decreased functional connectivity. The Superior Parietal Gyrus (SPG) regions and left paracentral lobule (PCL.L) of FPN has shown increased functional connectivity, the left supramarginal gyrus (SMG.L) regions has shown decreased functional connectivity in AD patients. On the other hand, the ACG.L regions in ECN, SMG.L and left inferior parietal (IPL.L) in FPN have shown significantly reduced functional connectivity. These results demonstrate that increased/decreased functional connectivity and reduced functional connectivity not only within DMN, but also associated with ECN and FPN. It also suggest that AD is associated with the characteristics of large-scale functional networks, and these changed functional connectivity possibly as a potential noninvasive biomarker to diagnose incipient Alzheimer's disease.

Moving from the central role of the thalamus in the integration of inner and external stimuli and in the implementation of a stress-related response, the objective of the present study was to investigate the presence of any MRI structural and volumetric changes of the thalamic structures in earthquake witnesses. Forty-one subjects were included, namely 18 university students belonging to the experimental earthquake-exposed group (8 males and 10 females, mean age 24.5 ± 1.8 years) and a control group of 23 students not living in any earthquake-affected areas at the time of the earthquake (14 males and 9 females, mean age 23.7 ± 2.0 years). Instrumental MRI evaluation was performed using a 3-Tesla scanner, by acquiring a three-dimensional fast spoiled gradient-echo (FSPGR) sequence for volumetric analysis and an EPI (echoplanar imaging) sequence to extract fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values. As compared to the control one, the experimental group showed significantly lower gray matter volume in the mediodorsal nucleus of the left thalamus (p < 0.001). The dominant hemisphere thalamus in the experimental group showed higher mean ADC values and lower mean FA values as compared to the control group.

Purpose. The purpose of the current study is to detect changes of topological organization of whole-brain functional networks and their relationship with the clinical treatment effects of antiepileptic drugs (AEDs) for patients with childhood absence epilepsy (CAE) using resting-state functional MRI (RS-fMRI). Patients and Methods. RS-fMRI data from 30 CAE patients were collected and compared with findings from 30 age- and gender-matched healthy controls (HCs). The patients were treated with first-line AEDs for 46.03 months before undergoing a second RS-fMRI scan. Results. CAE children at baseline showed a reduced clustering coefficient (Cp) and local efficiency (El) than the HC group, implying the reduction of functional segregation. CAE children at baseline also showed smaller characteristic path length (Lp) and higher global efficiency (Eg) compared with the HC group, implying the impairment of functional segregation. However, those metrics showed no significant differences between CAE children at follow-up and the HC group which indicated a clear renormalization of topological organization after AED treatments. CAE at follow-up also showed significantly decreased connectivity between several network regions, with which the thalamus is mainly involved. Furthermore, the reduced connectivity change between the left superior parietal gyrus and the left thalamus is positively correlated with the symptom improvements after AED treatment. Conclusion. We highlighted the convergence and divergence of brain functional network dysfunctions in CAE patients and provided crucial insights into pathophysiological mechanisms and the AED effects.

Chordoid glioma is a rare intracranial tumour, which usually occurs in middle-aged female patients, mainly in the third ventricle, hypothalamus and suprasellar region. It can reportedly occur in the temporal–parietal lobe, occipital horn of the lateral ventricle and left thalamus. Here, we report a case of chordoid glioma in the thalamic region of a female child, which is different from the previously reported chordoid glioma in the left thalamus. Given its atypical location and imaging findings, it is often misdiagnosed as low-grade glioma before operation. Through the study of this case, we recognized the atypical imaging manifestations of chordoid glioma in a rare location.

Background/Objective: Prenatal opioid exposure (POE) is a growing public health issue that can result in premature birth, Neonatal Abstinence Syndrome (NAS), and adverse neurodevelopmental outcomes. However, the neural basis for these findings remains relatively unknown. In this study, we aimed to investigate the neural correlates of POE based on neonatal thalamocortical functional connectivity using resting state functional magnetic resonance imaging (rs-fMRI). Methods: In this prospective, IRB-approved study, nineteen neonates with POE and twenty opioid naive (ON) controls underwent non-invasive MRI during natural sleep at mean post-menstrual age (PMA) of 44.7 ± 2.6 and 44.6 ± 2.6 weeks respectively. MR imaging included anatomic T2-weighted images and rs-fMRI. General Linear Model (GLM) seed-based whole brain functional connectivity analysis was performed for each subject, with the right and left thalamus as distinct seed regions. Unpaired mixed-effects group analyses between POE and ON groups were conducted for each seed region corrected for PMA and sex. Results: Thalamic connectivity to cortical and subcortical structures differed in the POE group compared to the ON control group. The POE group exhibited higher functional connectivity to deep gray structures, frontal, medial prefrontal, parietal, occipital, and anterior temporal cortices compared to controls. The POE group exhibited lower connectivity to the nuclei accumbentes, bilateral caudate nuclei, posterior cingulate gyri, superior frontal gyri, insular, and dorsolateral prefrontal cortices. Conclusion and Potential Impact: Overall, these novel results suggest the presence of opioid exposure-related alterations in thalamic functional connectivity. Given that the thalamus plays a crucial role in early brain development, the described alterations in thalamocortical and thalamic-subcortical connectivity may have implications in stratifying risk and informing treatment for the adverse neurodevelopmental outcomes associated with POE. Future studies should explore the relationship between POE-associated disruptions in thalamic connectivity and developmental outcomes.

Background A framework for understanding rapid diffusion changes from 0 to 6 years of age is important in the detection of neurodevelopmental disorders. Purpose To quantify patterns of normal apparent diffusion coefficient (ADC) development from 0 to 6 years of age. Materials and Methods Previously constructed age-specific ADC atlases from 201 healthy full-term children (108 male; age range, 0-6 years) with MRI scans acquired from 2006 to 2013 at one large academic hospital were analyzed to quantify four patterns: ADC trajectory, rate of ADC change, age of ADC maturation, and hemispheric asymmetries of maturation ages. Patterns were quantified in whole-brain, segmented regional, and voxelwise levels by fitting a two-term exponential model. Hemispheric asymmetries in ADC maturation ages were assessed using t tests with Bonferroni correction. Results The posterior limb of the internal capsule (mean ADC: left hemisphere, 1.18 ×103μm2/sec; right hemisphere, 1.17 ×103μm2/sec), anterior limb of the internal capsule (left, 1.11 ×103μm2/sec; right, 1.09 ×103μm2/sec), vermis (1.26 ×103μm2/sec), thalami (left, 1.17 ×103μm2/sec; right, 1.15 ×103μm2/sec), and basal ganglia (left, 1.26 ×103μm2/sec; right, 1.23 ×103μm2/sec) demonstrate low initial ADC values, indicating an earlier prenatal time course of development. ADC maturation was completed between 1.3 and 2.4 years of age, depending on the region. The vermis and left thalamus matured earliest (1.3 years). The frontolateral gray matter matured latest (right, 2.3 years; left, 2.4 years). ADC maturation occurred earlier in the left hemisphere (P < .001) in several regions, including the frontal (mean ± standard deviation) (left, 2.16 years ± 0.29; right, 2.19 years ± 0.31), temporal (left, 1.93 years ± 0.22; right, 1.99 years ± 0.22), and parietal (left, 1.92 years ± 0.30; right, 2.03 years ± 0.28) white matter. Maturation occurred earlier in the right hemisphere (P < .001) in several regions, including the thalami (left, 1.63 years ± 0.32; right, 1.45 years ± 0.33), basal ganglia (left, 1.79 years ± 0.31; right, 1.70 years ± 0.37), and hippocampi (left, 1.93 years ± 0.34; right, 1.78 years ± 0.33). Conclusion Normative apparent diffusion coefficient developmental patterns on diffusion-weighted MRI scans were quantified in children aged 0 to 6 years. This work provides knowledge about early brain development and may guide the detection of abnormal patterns of maturation. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Rollins in this issue.

Altered resting-state functional connectivity (FC) of the amygdala (AMY) has been demonstrated to be implicated in schizophrenia (SZ) and attenuated psychosis syndrome (APS). Specifically, no prior work has investigated FC in individuals with APS using subregions of the AMY as seed regions of interest. The present study examined AMY subregion-based FC in individuals with APS and first-episode schizophrenia (FES) and healthy controls (HCs). The resting state FC maps of the three AMY subregions were computed and compared across the three groups. Correlation analysis was also performed to examine the relationship between the Z-values of regions showing significant group differences and symptom rating scores. Individuals with APS showed hyperconnectivity between the right centromedial AMY (CMA) and left frontal pole cortex (FPC) and between the laterobasal AMY and brain stem and right inferior lateral occipital cortex compared to HCs. Patients with FES showed hyperconnectivity between the right superficial AMY and left occipital pole cortex and between the left CMA and left thalamus compared to the APS and HCs respectively. A negative relationship was observed between the connectivity strength of the CMA with the FPC and negative-others score of the Brief Core Schema Scales in the APS group. We observed different altered FC with subregions of the AMY in individuals with APS and FES compared to HCs. These results shed light on the pathogenetic mechanisms underpinning the development of APS and SZ.

Meditation has shown to benefit a wide range of conditions and symptoms, but the neural mechanisms underlying the practice remain unclear. Magnetic resonance imaging (MRI) studies have investigated the structural brain changes due to the practice by examining volume, density, or cortical thickness changes. However, these studies have focused on adults; meditation’s structural effects on the adolescent brain remain understudied. In this study, we investigated how meditation training affects the structure of the adolescent brain by scanning a group of 38 adolescents (16.48 ± 1.29 years) before and after participating in a 12-week meditation training. Subjects underwent Training for Awareness, Resilience, and Action (TARA), a program that mainly incorporates elements from mindfulness meditation and yoga-based practices. A subset of the adolescents also received an additional control scan 12 weeks before TARA. We conducted voxel-based morphometry (VBM) to assess gray matter volume changes pre- to post-training and during the control period. Subjects showed significant gray matter (GM) volume decreases in the left posterior insula and to a lesser extent in the left thalamus and left putamen after meditation training. There were no significant changes during the control period. Our results support previous findings that meditation affects regions associated with physical and emotional awareness. However, our results are different from previous morphometric studies in which meditation was associated with structural increases. We posit that this discrepancy may be due to the differences between the adolescent brain and the adult brain.

Objectives The aim of this longitudinal study was to clarify whether significant alterations in structural connectivity occur over time in patients with newly diagnosed focal epilepsy of unknown origin. Methods A total of 40 patients with newly diagnosed focal epilepsy of unknown origin and with normal brain magnetic resonance imaging (MRI) on visual inspection were enrolled. All subjects underwent MRI twice involving three-dimensional volumetric T1-weighted imaging, which were suitable for structural volume analysis. Gray matter volumes were obtained using the FreeSurfer image analysis suite, and structural connectivity analyses were performed using Matlab-based BRain Analysis using graPH theory software. Results The median interval between the two MRI scans was 18.5 months in patients with epilepsy. There was a general tendency toward decreased gray matter volumes on the second scan compared with the initial scan. However, the volumes of the right and left thalamus and brainstem on the second MRI scan had an increased tendency compared with those on the initial MRI scan. In measures of connectivity, there were significant differences between the two MRI scans. The mean clustering coefficient, global efficiency, local efficiency, and the small-worldness index were significantly increased, whereas the characteristic path length was decreased on the second MRI scan compared with the initial MRI scan. Conclusions The structural connectivity in patients with newly diagnosed focal epilepsy of unknown origin increases over time in the initial stage. These alterations and increases in structural connectivity may be related to underlying epileptogenicity in the initial stages of epilepsy.

While the proximal dentatothalamocortical tracts are considered pivotal in the occurrence of cerebellar mutism syndrome (CMS) after medulloblastoma resection, how the cerebellum participates in motor-speech networks through direct structural connectivity is still unclear. Via tractography, we provide evidence of cerebellar streamlines projecting into the left inferior frontal gyrus majorly connecting Broca's complex and the bilateral Crus lobes. The streamlines, named Crus-Broca tracts, originated from the bilateral Crus lobes, synapsed onto the dentate nucleus, ascended into the superior cerebellar peduncle (where these streamlines were closely superior to the superior border of the supratonsillar cleft and the superolateral roof of the fourth ventricle), surprisingly bypassed the left red nucleus and the left thalamus, and ended at the subregions of Broca's complex. The streamlines, named Broca-Crus tracts, originated from the subregions of Broca's complex and ended predominantly at the right Crus lobes. If verified, the existence of these connections would support the notion of the bilateral cerebellums' participation in motor-speech planning, and the anatomical relationship of Broca-Crus tracts with the supratonsillar cleft would merit consideration for further studies aimed at further elucidating CMS mechanisms.

For most fractionated stereotactic radiosurgery treatment plans, daily imaging is not routinely performed, because there is little expectation that lesions will change significantly in the short term. However, here, we present the case of an abrupt increase and decrease in tumor volume during fractionated gamma knife radiosurgery (GKRS) for metastatic brain cancer. A 65-year-old man with a history of nephrectomy due to renal cell carcinoma was admitted to our hospital because of mild cognitive disorder and gait disturbance. An initial MRI of the brain demonstrated a 5 × 3 × 4.5 cm-sized, heterogeneously well-enhanced tumor with a large cystic component compressing the left thalamus and corpus callosum near the lateral ventricle. Owing to its large size and proximity to critical structures, we decided to perform 3 fractionated GKRSs over 3 consecutive days. After the first fraction of 9 Gy with 50% isodose, follow-up MRI the next day revealed an unexpected increase in tumor volume up to 30%. Therefore, the radiosurgical plan was adjusted, and GKRS was performed again using the same dose for the second fraction. The image taken on the third day showed rapid shrinkage of the tumor volume. This case shows that a tumor may change its shape and volume unexpectedly even during the short period of a fractionated GKRS session. Hence, for optimal fractionated GKRS treatment of tumors with the likelihood of an abrupt change in the short term, interval imaging should be considered.

Studies on action observation mostly described the activation of a network of cortical areas, while less investigation focused specifically on the activation and role of subcortical nodes. In the present fMRI study, we investigated the recruitment of cerebellum and basal ganglia during the execution and observation of object manipulation performed with the right hand. The observation conditions consisted in: (a) observation of manipulative actions; (b) observation of sequences of random finger movements. In the execution conditions, participants had to perform the same actions or movements as in (a) and (b), respectively. The results of conjunction analysis showed significant shared activations during both observation and execution of manipulation in several subcortical structures, including: (1) cerebellar lobules V, VI, crus I, VIIIa and VIIIb (bilaterally); (2) globus pallidus, bilaterally, and left subthalamic nucleus; (3) red nucleus (bilaterally) and left thalamus. These findings support the hypothesis that the action observation/execution network also involves subcortical structures, such as cerebellum and basal ganglia, forming an integrated network. This suggests possible mechanisms, involving these subcortical structures, underlying learning of new motor skills, through action observation and imitation.

Objective: The study aimed to investigate exchangeable proton signals of Aβ proteins of the brains of Alzheimer’s disease (AD) model mice by using a chemical exchange-sensitive spin-lock (CESL) MR imaging technique. Method: Eight non-transgenic (Tg) mice (5 young and 3 old) and twelve Tg-APPswe/PSdE9 mice (5 young and 7 old) were used in this study. CESL Z-spectra were obtained by using two saturation powers, which were ω1 = 25 Hz with TSL = 3.0 s and ω1 = 500 Hz with TSL = 150 ms, at 71 offsets with uneven intervals between the offset frequencies at Ω = ±7.0 ppm at a 9.4-T animal MRI system. For Zspectrum analyses, regions of interest (ROIs) were drawn in the cortex, hippocampus, and thalamus of both hemispheres. Magnetization transfer ratio asymmetry (MTRasym) curves were obtained from the Zspectra. The Mann-Whitney test was used to compare the MTRasym values between the Tg and non-Tg mice for each offset frequency and for each ROI. Results: The water saturation width of the full Z-spectrum was narrow with the 25-Hz saturation power, but relatively broad with the 500-Hz saturation power. With the 25-Hz CESL saturation power, most of the MTRasym values were negative for 3.5-, 3.0-, 2.0-, and 0.9-ppm offset frequencies and the MTRasym values were significantly different between the control and Tg groups only in the left thalamus region at 3.5 ppm offset (p=0.0487). The MTRasym values were -6% to -7% for both 3.5 and 3.0 ppm, but less than -2% for both 2.0 and 0.9 ppm. With 500-Hz CESL saturation power, all the MTRasym values were positive for the 3.5-, 3.0-, 2.0-, and 0.9-ppm offset frequencies and the MTRasym values were not significantly different between the control and Tg groups at all ROIs and at all offset frequencies. However, a trend towards a significant difference was observed between the control and Tg groups in the right cortex at 3.5 ppm (p=0.0578). The MTRasym values were 6% to 9% for 3.5, 3.0, and 2.0 ppm, but less than 2% for 0.9 ppm. Conclusion: In an in-vivo AD model experiment, MTRasym values increased with the high saturation power than with the low saturation power. The MTRasym values were not significantly different, except in the left thalamus region at 3.5 ppm offset. The CESL technique should be further developed to enable its application in the brain of patients with neurodegenerative diseases.

Background Previous studies have reported functional and structural abnormalities in the thalamus and the pars triangularis of the inferior frontal gyrus in patients with insomnia disorder. However, no studies have been conducted on the white-matter tracts between these 2 brain regions. We aimed to compare the white-matter integrity and structure of the left thalamus–pars triangularis tracts between patients with insomnia and controls, and to characterize the relationship between white-matter integrity and clinical features in patients with insomnia. Methods In total, 22 participants with insomnia disorder and 27 controls underwent overnight polysomnography and brain magnetic resonance imaging, and then completed self-report clinical questionnaires and neurocognitive tests for spatial planning. Structural and diffusion measures such as fractional anisotropy, axial diffusivity, radial diffusivity and trace were analyzed in group comparison and correlation analyses. Results The insomnia group showed significantly lower fractional anisotropy (F = 8.647, p = 0.02) and axial diffusivity (F = 5.895, p = 0.038) in the left thalamus–pars triangularis tracts than controls. In patients with insomnia, fractional anisotropy in the tracts was correlated with the results of the Stockings of Cambridge test (r = 0.451, p = 0.034), and radial diffusivity was correlated with Epworth Sleepiness Scale score (r = 0.437, p = 0.042). Limitations Limitations included analyses of limited brain regions and the cross-sectional design. Conclusion The insomnia group showed decreased integrity in the left thalamus–pars triangularis tracts, and integrity was correlated with cognition and daytime sleepiness. These results may imply that insomnia is characterized by disintegration of the white-matter tract between the left thalamus and inferior frontal gyrus.

Surgical treatment of lesions in the posterior thalamus, especially those extending laterally, is technically challenging because of a deep surgical field, narrow operative corridor, and the surrounding critical neurovascular structures. The authors describe an occipital transtentorial/falcine approach (OTFA) that was successfully used in the treatment of a cavernous malformation (CM) extending laterally from thalamus to midbrain. A 40-year-old man complained of progressive right hemiparesis and numbness. Radiological evaluation revealed a large CM in the left thalamus, surfacing on the pulvinar thalami, and extending 4 cm laterally from the midline. In addition to the usual procedures of a right-sided occipital transtentorial approach, the authors incised the falx cerebri to expand the operative corridor to the left thalamus. They achieved generous exposure of the left thalamus through a “cross-court” oblique trajectory while avoiding excessive retraction on the occipital lobe. The CM was completely removed, and no newly developed or worsening deficits were detected postoperatively. To better understand the OTFA and its application, the authors performed a cadaveric dissection. The OTFA provides increased exposure of the posterior thalamus without cortical incision and facilitates lateral access to this area through the “cross-court” operative corridor. This approach adds to the armamentarium for neurosurgeons treating thalamic lesions.

Despite intact decoding ability, deficits in reading comprehension are relatively common in children with autism spectrum disorders (ASD). However, few neuroimaging studies have tested the neural bases of this specific profile of reading deficit in ASD. This fMRI study examined activation and synchronization of the brain's reading network in children with ASD with specific reading comprehension deficits during a word similarities task. Thirteen typically developing children and 18 children with ASD performed the task in the MRI scanner. No statistically significant group differences in functional activation were observed; however, children with ASD showed decreased functional connectivity between the left inferior frontal gyrus (LIFG) and the left inferior occipital gyrus (LIOG). In addition, reading comprehension ability significantly positively predicted functional connectivity between the LIFG and left thalamus (LTHAL) among all subjects. The results of this study provide evidence for altered recruitment of reading-related neural resources in ASD children and suggest specific weaknesses in top-down modulation of semantic processing.

The purpose.The purpous of the present study is to compare the data of brain PET wih 2-18F-2-desoxi-D-glucose (18-FDG) of patients with dystonia with the results of patients with essential tremor (ET) by analyzing the data with the help of the new calculation method of Z-score of PET results.Materials and methods. In 2010 in journal “Medical Visualization” we published results of PET study with 18-FDG of brain of 11 patients, which have been divided in two groups: the group with dystonia – 7 patients and the group with essential tremor – 4 patients. Glucose metabolism was studied by means of Siemens Exacthigh resolution tomograph. The results were presented in semi quantitative form of percentage of change of glucose metabolism, without comparison with the healthy control. The calculation has been done by means of software package SPM2, installated to the personal computer (OS Windows 2000). Later the Advantage Workstation of the same tomograph, used for the study, was equipped by software package Cortex ID that allows automatic structural and functional analyzes of PET visualization of the brain in comparison with the scans of control group of the same age. The results of such comparison are calculated by this program in the equation of Z-score, that is calculated automatically by special program for each brain zone. In present study we applied Z-score for analyzing again the comparison of the PET results of these two disorders. The group of essential tremor remained the same and included 4 patients studied before. As to the second group of dystonia, we added to it 3 new patients, studied since aforementioned study of 2010, the whole group of D rising up to ten patients. In order to level the conditions of our research, we also compared the former group of dystonia of 7 patients with the group of essential tremor by means of Z-score method.Results. We have detected reliable difference between the group of dystonia and the group of essential tremor, presented in the form of different changes of glucose metabolism in 4 brain zones – left thalamus, right nucleus lentiformis, girus cingularis and the pons. Such result has not changed when we also compared the former staff of dystonia group of 7 patients with essential tremor group.Conclusion.The study has confirmed efficacy PET in differential diagnosis of extrapyramidal disorders and of Z-score method in PET investigations by means of establishing of the correspondence of cinical heterogeneity to PET heterogeneity.

Alcohol expectancy and impulsivity are implicated in alcohol misuse. However, how these two risk factors interact to determine problem drinking and whether men and women differ in these risk processes remain unclear. In 158 social drinkers (86 women) assessed for Alcohol Use Disorder Identification Test (AUDIT), positive alcohol expectancy, and Barratt impulsivity, we examined sex differences in these risk processes. Further, with structural brain imaging, we examined the neural bases underlying the relationship between these risk factors and problem drinking. The results of general linear modeling showed that alcohol expectancy best predicted problem drinking in women, whereas in men as well as in the combined group alcohol expectancy and impulsivity interacted to best predict problem drinking. Alcohol expectancy was associated with decreased gray matter volume (GMV) of the right posterior insula in women and the interaction of alcohol expectancy and impulsivity was associated with decreased GMV of the left thalamus in women and men combined and in men alone, albeit less significantly. These risk factors mediated the correlation between GMV and problem drinking. Conversely, models where GMV resulted from problem drinking were not supported. These new findings reveal distinct psychological factors that dispose men and women to problem drinking. Although mediation analyses did not determine a causal link, GMV reduction in the insula and thalamus may represent neural phenotype of these risk processes rather than the consequence of alcohol consumption in non-dependent social drinkers. The results add to the alcohol imaging literature which has largely focused on dependent individuals and help elucidate alterations in brain structures that may contribute to the transition from social to habitual drinking., Highlights • Alcohol expectancy (AE) and impulsivity are risk factors for problem drinking. • AE mediates the correlation between right insula GMV and problem drinking in women. • AE and impulsivity interacts to mediate left thalamus GMV and problem drinking in all. • Models where changes in GMV as a result of problem drinking are not supported.

Highlights • Higher flexibility in schizophrenia at the resting state network and node level. • Higher flexibility in the thalamus due to default-mode sensory/motor transitions. • Altered between sub-network dynamic modular configuration in schizophrenia. • Flexibility scores affected by methodological choices such as window size., Novel methods for measuring large-scale dynamic brain organisation are needed to provide new biomarkers of schizophrenia. Using a method for modelling dynamic modular organisation (Mucha et al., 2010), evidence suggests higher ‘flexibility’ (switching between multilayer network communities) to be a feature of schizophrenia (Braun et al., 2016). The current study compared flexibility between 55 patients with schizophrenia and 72 controls (the COBRE Dataset). In addition, novel methods of ‘between resting state network synchronisation’ (BRSNS) and the probability of transition from one community to another were used to further describe group differences in dynamic community structure. There was significantly higher schizophrenia group flexibility scores in cerebellar (F (1124) = 9.33, p (FDR) = 0.017), subcortical (F (1124) = 13.14, p (FDR) = 0.005), and fronto-parietal task control (F (1124) = 7.19, p (FDR) = 0.033) resting state networks (RSNs), as well as in the left thalamus (MNI XYZ: -2, -13, 12; F(1, 124) = 17.1, p (FDR) < 0.001) and the right crus I (MNI XYZ: 35, -67, -34; F (1, 124) = 19.65, p (FDR) < 0.001). Flexibility in the left thalamus reflected transitions between communities covering default mode and sensory-somatomotor RSNs. BRSNS scores suggested altered dynamic inter-RSN modular configuration in schizophrenia. This study suggests less stable community structure in a schizophrenia group at an RSN and node level and provides novel methods of exploring dynamic community structure. Mediation of group differences by mean time window correlation did however suggest flexibility to be no better as a schizophrenia biomarker than simpler measures and a range of methodological choices affected results.

Bimanual mirror-symmetrical movement (MSM) is relatively easy to control movement. Different MSM tasks may have different activations and interhemispheric interactions. The purpose of this study is to compare anatomo-physiological features such as hemispheric activations and dominance of two different MSMs, namely melody-playing and rhythm. We examined functional MRI (fMRI) recordings in a group of fifteen right-handed pianists performing two separate tasks: bimanual rhythm and bimanual melody-playing on two different keyboards with standard key order for right hand and reversed for left hand, which allows homolog fingers' movements. Activations and laterality indices on fMRI were examined. The results show that significant cerebellar activations (especially in anterior cerebellum) in both groups. Significant primary sensorimotor cortical activations are observed in the melody-playing group. While there are also bilaterally symmetric activations, and laterality indices suggest overall lateralization towards the left hemisphere in both groups. Activations in the left fronto-parietal cortex, left putamen and left thalamus in conjunction with right cerebellar activations suggest that the left cortico-thalamo-cerebellar loop may be a dominant loop. Dynamic causal modeling (DCM) indicates the presence of causal influences from the left to the right cerebral cortex. In conclusion, melody-playing with bimanual MSM is a complex in-phase task and may help activate the bilateral cortical areas, and left hemisphere is dominant according to laterality indices and DCM results. On the other hand, bimanual rhythm is a simpler in-phase task and may help activate subcortical areas, which might be independent of the voluntary cortical task.

RATIONALE. Previous studies have suggested that chronic cannabis use has been associated with increased blood oxygen level dependent (BOLD) response during a response inhibition task; however, these studies primarily included males. OBJECTIVES. We investigated whether gender moderated the effects of cannabis use on BOLD response and behavioral performance during a Go-NoGo task in adolescents and young adults following two weeks of monitored abstinence. METHODS. Participants included 77 16–26 year olds (MJ=36, Controls=41). An emotion based Go-NoGo task required participants to inhibit their response during a calm face. A whole-brain analysis looked at differences between cannabis group, gender, and their interaction. RESULTS. Significant greater BOLD responses were observed in cannabis users compared to controls in the left frontal cortex, left cingulate cortex, and the left thalamus during correct response inhibitions; gender did not moderate these effects. CONCLUSION. Supporting previous research, cannabis users showed greater BOLD responses in core areas associated with response inhibition during a Go-NoGo task, even after a minimum of two weeks of abstinence.

Background We describe for the first time the clinical features and mechanisms of a bilateral dorsomedial pons and left thalamus infarction with seesaw nystagmus and internuclear ophthalmoplegia. Case presentation A 62-year-old Chinese man was hospitalized for sudden-onset dizziness, diplopia, and gait disturbance. A neurological examination revealed seesaw nystagmus and internuclear ophthalmoplegia. Magnetic resonance imaging disclosed an acute infarction confined to the bilateral dorsomedial pons and left thalamus. Subsequently, 2 weeks of antithrombotic therapy led to an improvement in his symptoms. Conclusions This case illustrates that the acute onset of seesaw nystagmus and internuclear ophthalmoplegia accompanied by risk factors for cerebrovascular diseases are highly suggestive of brainstem infarction.

In this paper, an automatic method to process and quantify the metabolites of a magnetic resonance spectroscopy signal is presented. Signals obtained from a region of the left thalamus were analyzed. The obtained results were compared with the ones obtained using a Phillips’ commercial magnetic resonance software. Three features of the signal corresponding to five different metabolites (NAA, Cr, Cho, Glx, Cr2) were obtained: width, height and area of the curve corresponding to each peak. The obtained results showed a maximum relative error of over 20%, indicating the potential that the proposal has. Further refinements are required to reduce the error.

Primary monosymptomatic nocturnal enuresis (PMNE) is a heterogeneous disorder, which remains a difficult condition to manage due to lack of knowledge on the underlying pathophysiological mechanisms. Here we investigated the underlying neuropathological mechanisms of PMNE with functional MRI (fMRI), combining the amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo), and seed-based functional connectivity (seed-based FC) analyses. Compared to the control group, PMNE group showed decreased ALFF value in the left medial orbital superior frontal gyrus (Frontal_Med_Orb_L), and increased ReHo value in the left superior occipital gyrus (Occipital_Sup_L). With left thalamus as the seed, PMNE group showed significantly decreased functional connectivity to the left medial superior frontal gyrus (Frontal_Sup_Medial_L). We conclude that these abnormal brain activities are probably important neuropathological mechanisms of PMNE in children. Furthermore, this study facilitated the understanding of underlying pathogenesis of PMNE and may provide an objective basis for the effective treatment.

Background: Avoidant personality disorder (AvPD) is a condition typified by social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. AvPD has a high comorbidity rate with other personality disorders and other psychological diagnostic categories. There is very little research investigating subcortical volumetry in AvPD. We studied subcortical brain morphometry in AvPD as compared to both healthy controls and comorbidity-matched psychiatric controls (patients in the same clinic matched for age, sex and all psychiatric diagnoses except for AvPD). Methods: We compared volumetric measures of 9 bilateral subcortical brain regions between AvPD patients, healthy controls, and psychiatric controls (n = 100 each group). The Bonferroni correction was used to control for multiple comparisons across regions (p Results: Compared to healthy controls, AvPD patients had lower volume of the left accumbens and left thalamus. However, no significant results were found when comparing AvPD patients and psychiatric controls. An exploratory study of cortical regions showed similar results: statistically significant differences between HC and AvPD (left lateral occipital, left and right pericalcarine smaller in AvPD) but no differences between AvPD and PC. Limitations: MRI and neuroimaging provides correlational information, and no causal claims can be made. Conclusions: These results suggest there may be no overt subcortical volumetric differences specific to AvPD, and provide strong cautionary advice when comparing patients to healthy controls, a common practice in psychiatry biomarker research.

Anesthesia is thought to be mediated by inhibiting the integration of information between different areas of the brain. Long-range thalamo-cortical interaction plays a critical role in inducing anesthesia-related unconsciousness. However, it remains unclear how this interaction change according to anesthetic depth. In this study, we aimed to investigate how different levels of anesthesia affect thalamo-frontal interactions. Prior to the experiment, electrodes were implanted to record local field potentials (LFPs). Isoflurane (ISO) was administered and LFPs were measured in rats from four different brain areas (left frontal, right frontal, left thalamus and right thalamus) at four different anesthesia levels: awake, deep (ISO 2.5 vol%), light (ISO 1 vol%) and recovery. Spectral granger causality (Spectral-GC) were calculated at the measured areas in accordance with anesthetic levels. Anesthesia led to a decrease in connectivity in the thalamo-frontal direction and an increase in connectivity in the frontal-thalamic direction. The changes in thalamo-frontal functional connectivity were prominent during deep anesthesia at high frequency bands. The connection strengths between the thalamus and the frontal area changed depending on the depth of anesthesia. The relationships between anesthetic levels and thalamo-frontal activity may shed light on the neural mechanism by which different levels of anesthesia act.

This study aimed to investigate distinct neurometabolites in the anterior cingulate cortex (ACC), right and left thalamus, and insula of patients with fibromyalgia (FM) compared with healthy controls using proton magnetic resonance spectroscopy (MRS). Levels of N-acetylaspartate (NAA), N-acetylaspartylglutamate (NAAG), total NAA (tNAA = NAA + NAAG), myo-inositol (ml), glutamine (Gln), glutamate (Glu), Glx (Glu + Gln), glycerophosphocholine (GPC), total choline (tCho = GPC + phosphocholine) and glutathione (GSH) levels relative to total creatine (tCr) levels including creatine (Cr) and phosphocreatine (PCr) and relative to Cr levels were determined in the ACC, right and left thalamus, and insula in 12 patients with FM and 13 healthy controls using MRS. In the ACC, NAA/tCr (P = 0.028) and tCho/tCr (P = 0.047) were higher in patients with FM. In the right and left insula, tNAA/tCr (P = 0.019, P = 0.007, respectively) was lower in patients with FM. Patients with FM showed lower levels of ml/Cr (P = 0.037) in the right insula than healthy controls. These findings are paramount to understand decisive pathophysiological mechanisms related to abnormal features in the brain and parasympathetic nervous systems in FM. We suggest that the results presented herein may be essential to understand hidden pathological mechanisms and also life system potential as protective and recovering metabolic strategies in patients with FM.

Background and purpose Assessment of the effects of microgravity on astronauts' brains using microstructural measures by utilizing quantitative MRI, before and after spaceflight would help understand the structural changes. Methods Quantitative MRI data sets in 19 astronauts were acquired before and after space missions. Both diffusion tensor metrics and volumetric measures were analyzed in the brain regions involved in the visual function. Results The fractional anisotropy was reduced in the right posterior thalamic radiations (P = .0009) and remained significant after a false discovery rate (FDR) correction (P = .03). A trend of increase in the mean diffusivities of different subregions of the occipital cortex on the right side, including calcarine, middle occipital, inferior occipital, and fusiform gyri, was noted and became insignificant after FDR correction. Similarly, there was a trend of cortical thinning involving the right occipital lobe and bilateral fusiform gyri, volume reduction of the left thalamus, and increase in lateral ventricular volume in the postflight scans. Conclusion Gray and white matter alterations are detected by quantitative MRI before and after space flight. Our findings may be used to understand the neuroanatomical mechanisms of possible brain dysfunction or neuroplasticity in microgravity condition in the future studies.

Structural brain abnormalities in schizophrenia have been well characterized with the application of univariate methods to magnetic resonance imaging (MRI) data. However, these traditional techniques lack sensitivity and predictive value at the individual level. Machine-learning approaches have emerged as potential diagnostic and prognostic tools. We used an anatomically and spatially regularized support vector machine (SVM) framework to categorize schizophrenia and healthy individuals based on whole-brain gray matter densities estimated using voxel-based morphometry from structural MRI scans. The regularized SVM model yielded recognition accuracy of 86.6% in the training set of 127 individuals and validation accuracy of 83.5% in an independent set of 85 individuals. A sequential region-of-interest (ROI) selection step was adopted for feature selection, improving recognition accuracy to 92.0% in the training set and 89.4% in the validation set. The combined model achieved 96.6% sensitivity and 74.1% specificity. Seven ROIs were identified as the optimal discriminatory subset: the occipital fusiform gyrus, middle frontal gyrus, pars opercularis of the inferior frontal gyrus, anterior superior temporal gyrus, superior frontal gyrus, left thalamus and left lateral ventricle. These findings demonstrate the utility of spatial and anatomical priors in SVM for neuroimaging analyses in conjunction with sequential ROI selection in the recognition of schizophrenia.

Objective: Investigation of brain structure in disease has been enhanced by developments in shape analysis methods that can identify subtle regional surface distortions. High-resolution magnetic resonance (MR) imaging was used to compare volumetric and shape analysis in schizophrenia (SCZ) patients and healthy controls (CON). Methods: T1-weighted, 1-mm thick MR images were acquired for 15 patients with SCZ and 15 age-matched healthy controls using subcortical volume and shape analysis, which we believe to be complimentary to volumetric measures. Results: SCZ patients showed significant shape differences compared to healthy controls in the right hippocampus (P < 0.005), left and right putamen (P < 0.044 and P < 0.031), left caudate (P < 0.029), right pallidum (P < 0.019), and left thalamus (P < 0.033). Conclusion: Our results provide evidence for subcortical neuroanatomical changes in patients with SCZ. Hence, shape analysis may aid in the identification of structural biomarkers for identifying individuals of SCZ.

A 17-month-old boy came to our attention for a left hemiparesis, without any other neurologic disorder. Brain MRI revealed a remarkable hypertrophy of the left thalamus. There were no differences with the right thalamus before and after using contrast, either a hypersignal in fluid-attenuated inversion recovery or restriction at diffusion-weighted imaging. In the same way, the spectroscopy showed normal metabolite peaks (choline and N -acetylaspartate)1 (figure, A and B). This hemithalamus leaves a mark on the left anterior ventricle with a dilation of the opposite one that could explain the clinical sign.

Ojjective The aim of this study was to find peripheral biomarkers and central metabolites affecting neuroinflammation in complex regional pain syndrome (CRPS) patients using [11C]-(R)-PK11195 positron emission tomography (PET) and magnetic resonance spectroscopy (MRS). Methods Using MRS and PET, we measured associations between neurometabolites and neuroinflammation in 12 CRPS patients and 11 healthy controls. Also, we investigated various peripheral parameters that may affect neuroinflammation in CRPS. Results We found positive correlations of Lipid (Lip)13a/total creatine (tCr) and Lip09/tCr with neuroinflammation, the distribution volume ratio (DVR) of [11C]-(R)-PK11195 in the right and left insula in CRPS patients. However, these correlations were not found in controls. High hemoglobin levels correlated with decreased neuroinflammation (the DVR of [11C]-(R)-PK11195) in the right thalamus and left insula in healthy controls. We found that high levels of glucose and pH correlated with increased neuroinflammation, but high levels of CO2, basophil, and creatinine were associated with decreased neuroinflammation in the left thalamus and the right and left insula in CRPS patients. Conclusions This is the first report indicating that elevated neuroinflammation levels are associated primarily with lipids in the brain and pH, glucose, CO2, basophil, and creatinine in the peripheral parameters in CRPS patients. Our results suggest that characterizing the peripheral biomarkers and central metabolites affecting neuroinflammation is essential to understanding the pathophysiology of CRPS.