Background: Amide proton transfer (APT) MR imaging has shown great potential in the evaluation of stroke severity because of its sensitivity to acid environments. However, this promising MRI technique has not been used to assess treatment efficacy with regard to stroke recovery. Purpose: To assess the therapeutic effect of supportive treatment in ischemic stroke patients using the pH-sensitive APT MRI technique. Material and Methods: Forty-three ischemic stroke patients at an early stage were recruited and scanned with conventional and APT MRI sequences at 3T before treatment. After treatment, 26 patients underwent a follow-up MRI scan (one to three times on different days). The magnetization-transfer-ratio asymmetry at 3.5 ppm, usually called the APT-weighted (APTW) signal, was measured. The APTW signal changes following treatment were analyzed. Results: Baseline APTW signal intensities in the infarcted lesions inversely correlated with baseline stroke severity. Lesion APTW values gradually increased with time in 24 cases (92.3%) with a follow-up MRI scan, showing clinical symptom improvements. Two cases (7.7%) showed further decreased APTW signal in the follow-up scan, accompanied by clinical symptom aggravation. Compared to the baseline, significant APTW signal increases were found for all post-treatment patients (efficacious), whether based on post-treatment or on stroke onset times. The increase in APTW signal in the ischemic stroke lesion after treatment was associated with an improvement in clinical symptoms. Conclusion: The APTW signal would be a useful imaging biomarker by which to assess the therapeutic efficacy of ischemic stroke treatment.
Brain activity is time varying and dynamic, even in the resting state. However, little attention has been paid to the dynamic alterations in regional brain activity in Parkinson’s disease (PD). We aimed to test for differences in dynamic regional homogeneity (dReHo) between PD patients and healthy controls (HCs) and to further investigate the pathophysiological meaning of this altered dReHo in PD. We included 57 PD patients and 31 HCs with rs-fMRI scans and neuropsychological examinations. Then, ReHo and dReHo were calculated for all subjects. We compared ReHo and dReHo between PD patients and HCs and then analyzed the associations between altered dReHo variability and clinical/neuropsychological measurements. Support vector machines (SVMs) were also used to assist in differentiating PD patients from HCs using the classification values of dReHo. The results showed that PD patients had increased ReHo in the bilateral medial temporal lobe and decreased ReHo in the right posterior cerebellar lobe, right precentral gyrus, and supplementary motor area, compared with controls. The coefficient of variation (CV) of dReHo was considerably higher in the precuneus in PD patients compared with HCs, and the CV of dReHo in the precuneus was found to be highly associated with HAMD, HAMA, and NMSQ scores. Multiple linear regression analysis controlling for demographic, clinical, and neuropsychiatric variables confirmed the association between altered dReHo and HAMD. Using the leave-one-out cross validation procedure, 98% (p < 0.001) of individuals were properly identified using the SVM classifier. These results provide new evidence for the aberrant resting-state brain activity in the precuneus of PD patients and its role in neuropsychiatric symptoms in PD.
1 January 2022 in Annals of Translational Medicine
Immune abnormalities and differential gene expression in the hippocampus and peripheral blood of patients with Alzheimer’s disease Xiaonan Wang, Di Wang, Fei Su, Chunmei Li, Min Chen