Faculty Profiles - NAGANAWA, Shinji

Papers - NAGANAWA, Shinji

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もやもや病にGlymphatic system機能不全は存在するか？―DTI-ALPS indexによる評価― Reviewed

原祥子、菊田潤子、高林海斗、鎌形康司、林志保里、稲次基希、田中洋次、堀正明、石井賢二、成相直、田岡俊昭、長縄慎二、青木茂樹、前原健寿

日本磁気共鳴医学会雑誌 Vol. 43 ( 2 ) page： 56 - 59 2023.5

ALPS-indexを用いた糖尿病と糖尿病前期の病態におけるGlymphatic systemの評価 Reviewed International coauthorship

Rukeye Tuerxun、鎌形康司、Christina Andica、内田　航、斎藤勇哉、高林海斗、加賀英義、染谷由希、明石敏昭、和田昭彦、田端宏樹、内藤仁嗣、田村好史、田岡俊昭、長縄慎二、河盛隆造、綿田裕孝、青木茂樹

日本磁気共鳴医学会雑誌 Vol. 43 ( 2 ) page： 60 - 62 2023.5

Labyrinthine calcification in ears with otitis media and antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV): A report of two cases. Reviewed International journal

Tadao Yoshida, Masumi Kobayashi, Satofumi Sugimoto, Shinji Naganawa, Michihiko Sone

Auris, nasus, larynx Vol. 50 ( 2 ) page： 299 - 304 2023.4

Language：English Publishing type：Research paper (scientific journal)

Otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV) has been proposed as a new type of otitis media. The hearing loss caused by OMAAV can be expected to improve with early detection and intervention, but if it continues to worsen and leads to deafness, it is challenging to recover the patient's hearing. When bilateral deafness occurs, cochlear implant (CI) surgery is the only way to improve hearing. Here, Case 1 showed unilateral cochlear calcification, and Case 2 showed bilateral cochlear calcification. In Case 1, CI surgery was performed on the ear lacking calcification, and in Case 2 it was performed on the ear with milder calcification. In Case 2, granulation was present from the tympanic space to the mastoid, the round window was closed, and the basal turn of the cochlea was narrowed. Such calcification of the cochlea caused by OMAAV has not been reported so far. It is essential to detect these changes by computed tomography scans at an early stage and to perform CI surgery at an appropriate time, because hearing improvements are not expected in patients who become deaf because of OMAAV.

DOI： 10.1016/j.anl.2022.01.004

PubMed

Postendovascular Aneurysmal Repair Increase in Local Energy Loss for Fusiform Abdominal Aortic Aneurysm: Assessments With 4D flow MRI. Reviewed International journal

Ryota Horiguchi, Yasuo Takehara, Masataka Sugiyama, Ryota Hyodo, Tomohiro Komada, Masaya Matsushima, Shinji Naganawa, Takashi Mizuno, Yasuo Sakurai, Masayuki Sugimoto, Hiroshi Banno, Kimihiro Komori, Keiichi Itatani

Journal of magnetic resonance imaging : JMRI Vol. 57 ( 4 ) page： 1199 - 1211 2023.4

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Although endovascular aneurysmal repair (EVAR) is a preferred treatment for abdominal aortic aneurysm (AAA) owing to its low invasiveness, its impact on the local hemodynamics has not been fully assessed. PURPOSE: To elucidate how EVAR affects the local hemodynamics in terms of energy loss (EL). STUDY TYPE: Prospective single-arm study. FIELD STRENGTH/SEQUENCE: A 3.0 T/4D flow MRI using a phase-contrast three-dimensional cine-gradient-echo sequence. POPULATION: A total of 13 consecutive patients (median [interquartile range] age: 77.0 [73.0, 78.8] years, 11 male) scheduled for EVAR as an initial treatment for fusiform AAA. ASSESSMENT: 4D flow MRI covering the abdominal aorta and bilateral common iliac arteries and the corresponding stent-graft (SG) lumen was performed before and after EVAR. Plasma brain natriuretic peptide (BNP) was measured within 1 week before and 1 month after EVAR. The hemodynamic data, including mean velocity and the local EL, were compared pre-/post-EVAR. EL was correlated with AAA neck angle and with BNP. Patients were subdivided into deformed (N = 5) and undeformed SG subgroups (N = 8) and pre-/post-EVAR BNP compared in each. STATISTICS: Parametric or nonparametric methods. Spearman's rank correlation coefficients (r). The interobserver/intraobserver variabilities with Bland-Altman plots. A P value < 0.05 is considered significant. RESULTS: The mean velocity (cm/sec) at the AAA was five times greater after EVAR: 4.79 ± 0.32 vs. 0.91 ± 0.02. The total EL (mW) increased by 1.7 times after EVAR: 0.487 (0.420, 0.706) vs. 0.292 (0.192, 0.420). The total EL was proportional to the AAA neck angle pre-EVAR (r = 0.691) and post-EVAR (r = 0.718). BNP (pg/mL) was proportional to the total EL post-EVAR (r = 0.773). In the deformed SG group, EL (0.349 [0.261, 0.416]) increased 2.4-fold to 0.848 (0.597, 1.13), and the BNP 90.3 (53.6, 105) to 100 (67.2, 123) post-EVAR. CONCLUSION: The local EL showed a 1.7-fold increase after EVAR. The larger increase in the EL in the deformed SG group might be a potential concern for frail patients. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 2.

DOI： 10.1002/jmri.28359

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PubMed

門松健治先生のすごさ；高いVision、現実解実現のための行動力 Invited Reviewed

長縄慎二

門松健治教授退任記念誌 page： 75 - 76 2023.4

門松健治先生のすごさ；高いVision、現実解実現のための行動力 Invited Reviewed

長縄慎二

門松健治教授退任記念誌 page： 75 - 76 2023.4

Glymphatic system impairment in nonathlete older male adults who played contact sports in their youth associated with cognitive decline: A diffusion tensor image analysis along the perivascular space study Reviewed International journal

Yuichi Morita, Koji Kamagata, Christina Andica, Kaito Takabayashi, Junko Kikuta, Shohei Fujita, Thomas Samoyeau, Wataru Uchida, Yuya Saito, Hiroki Tabata, Hitoshi Naito, Yuki Someya, Hideyoshi Kaga, Yoshifumi Tamura, Mari Miyata, Toshiaki Akashi, Akihiko Wada, Toshiaki Taoka, Shinji Naganawa, Hirotaka Watada, Ryuzo Kawamori, Osamu Abe, Shigeki Aoki

Frontiers in Neurology Vol. 14 page： 1100736 - 1100736 2023.2

Language：English Publishing type：Research paper (scientific journal) Publisher：Frontiers Media SA

Background and purpose

Exposure to contact sports in youth causes brain health problems later in life. For instance, the repetitive head impacts in contact sports might contribute to glymphatic clearance impairment and cognitive decline. This study aimed to assess the effect of contact sports participation in youth on glymphatic function in old age and the relationship between glymphatic function and cognitive status using the analysis along the perivascular space (ALPS) index.

Materials and methods

A total of 52 Japanese older male subjects were included in the study, including 12 who played heavy-contact sports (mean age, 71.2 years), 15 who played semicontact sports (mean age, 73.1 years), and 25 who played noncontact sports (mean age, 71.3 years) in their youth. All brain diffusion-weighted images (DWIs) of the subjects were acquired using a 3T MRI scanner. The ALPS indices were calculated using a validated semiautomated pipeline. The ALPS indices from the left and right hemispheres were compared between groups using a general linear model, including age and years of education. Furthermore, partial Spearman's rank correlation tests were performed to assess the correlation between the ALPS indices and cognitive scores (Mini-Mental State Examination and the Japanese version of the Montreal Cognitive Assessment [MoCA-J]) after adjusting for age years of education and HbA1c.

Results

The left ALPS index was significantly lower in the heavy-contact and semicontact groups than that in the noncontact group. Although no significant differences were observed in the left ALPS index between the heavy-contact and semicontact groups and in the right ALPS index among groups, a trend toward lower was found in the right ALPS index in individuals with semicontact and heavy-contact compared to the noncontact group. Both sides' ALPS indices were significantly positively correlated with the MoCA-J scores.

Conclusion

The findings indicated the potential adverse effect of contact sports experience in youth on the glymphatic system function in old age associated with cognitive decline.

DOI： 10.3389/fneur.2023.1100736

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Neuroimaging findings related to glymphatic system alterations in older adults with metabolic syndrome. Reviewed International journal

Christina Andica, Koji Kamagata, Kaito Takabayashi, Junko Kikuta, Hideyoshi Kaga, Yuki Someya, Yoshifumi Tamura, Ryuzo Kawamori, Hirotaka Watada, Toshiaki Taoka, Shinji Naganawa, Shigeki Aoki

Neurobiology of disease Vol. 177 page： 105990 - 105990 2023.2

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: The glymphatic system is a glial-based perivascular network that promotes brain metabolic waste clearance. Reduced glymphatic flow has been observed in rat models of type 2 diabetes and hypertension, indicating the role of vascular risk factors in the glymphatic system. However, little is known about how vascular risk factors affect the human glymphatic system. The present study aims to assess the relationships between metabolic syndrome (MetS), a cluster of vascular risk factors, and the glymphatic system function using diffusion magnetic resonance imaging (MRI)-based measures of water diffusivity in the glymphatic compartments, including the brain interstitial space and perivascular spaces around the deep medullary vein. We hypothesized that vascular risk factors are associated with glymphatic dysfunction, leading to cognitive impairment in older adults. METHODS: This cross-sectional study assessed 61 older adults (age range, 65-82 years) who had participated in the Bunkyo Health Study, including 15 healthy controls (mean age, 70.87 ± 4.90 years) and 46 individuals with MetS (mean age, 71.76 ± 4.61 years). Fractional volume of extracellular-free water (FW) and an index of diffusion tensor imaging along the perivascular space (DTI-ALPS) were used as indirect indicators of water diffusivity in the interstitial extracellular and perivenous spaces of white matter, respectively. RESULTS: After adjusting for age, sex, years of education, total Fazekas scale, Pittsburgh sleep quality index (PSQI) score, and intracranial volume (ICV), a significantly (P = 0.030; Cohen's d = 1.01) higher FW was observed in individuals with MetS than in the healthy controls. Furthermore, individuals with MetS had a significantly (P = 0.031; Cohen's d = 0.86) lower ALPS index than the healthy controls, with age, sex, years of education, total Fazekas scale, PSQI score, ICV, fractional anisotropy, and mean diffusivity included as confounding factors. Higher FW was significantly associated with lower ALPS index (r = -0.37; P = 0.004). Multiple linear regression (MLR) with backward elimination analyses showed that higher diastolic blood pressure (BP; standardized β = 0.33, P = 0.005) was independently associated with higher FW, whereas higher fasting plasma glucose levels (standardized β = -0.63, P = 0.002) or higher Brinkman index of cigarette consumption cumulative amount (standardized β = -0.27, P = 0.022) were associated with lower ALPS index. The lower ALPS index (standardized β, 0.28; P = 0.040) was associated with poorer global cognitive performance, which was determined using the Japanese version of the Montreal Cognitive Assessment (MOCA-J) scores. Finally, partial correlation analyses showed a significant correlation between higher FW and lower MOCA-J scores (r = -0.35; P = 0.025) and between higher FW and higher diastolic BP (r = 0.32, P = 0.044). CONCLUSION: The present study shows the changes in diffusion MRI-based measures reflected by the higher FW and lower ALPS index in older adults with MetS, possibly due to the adverse effect of vascular risk factors on the glymphatic system. Our findings also indicate the associations between the diffusion MRI-based measures and elevated diastolic BP, hyperglycemia, smoking habit, and poorer cognitive performance. However, owing to the limitations of this study, the results should be cautiously interpreted.

DOI： 10.1016/j.nbd.2023.105990

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自己免疫性膵炎の画像診断：コンピュータ断層撮影と磁気共鳴画像法 Reviewed

小川　浩、竹原康雄、長縄慎二

Jpn. J Med Ultrasonics. Vol. 50 ( 1 ) page： 39 - 45 2023.1

A plea for systematic literature analysis and conclusive study design, comment on: "Systematic review of magnetic resonance imaging for diagnosis of Meniere disease". Reviewed International journal

Robert Gürkov, Krisztina Barath, Bert de Foer, Munehisa Fukushima, Michael Gluth, Jermy Hornibrook, Nicolas Perez-Fernandez, Ilmari Pyykkö, Michihiko Sone, Shin-Ichi Usami, Wuqing Wang, Jing Zou, Shinji Naganawa

Journal of vestibular research : equilibrium & orientation Vol. 33 ( 2 ) page： 151 - 157 2023

"Speckled Enhancement" on Gd-EOB-DTPA Enhanced MR Imaging of Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma. Reviewed

Ryota Hyodo, Yasuo Takehara, Ayumi Nishida, Masaya Matsushima, Shinji Naganawa

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine Vol. 22 ( 3 ) page： 273 - 281 2023

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To elucidate MRI features of primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma, particularly, the "speckled enhancement" on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI. METHODS: The institutional review board approved this retrospective observational study and waived informed consent. Using our picture archiving and communication systems and electronic medical records, five patients histopathologically diagnosed as hepatic MALT lymphoma and clinically confirmed as primary lesions who had undergone dynamic contrast-enhanced (DCE)-CT and DCE-MRI with Gd-EOB-DTPA were identified from September 2009 to December 2020. Two radiologists assessed their CT and MRI data in consensus with a pathologist's advice. RESULTS: Overall, five lesions in five patients were included in this study. Precontrast CT showed hypoattenuation in all lesions. In the arterial phase of DCE-CT, four lesions (80%) showed hyperattenuation, whereas all lesions showed iso- to hypoattenuation in the delayed phase. A vessel penetration sign was also observed in all lesions. On MRI, all lesions showed hypointensity on T1-weighted images, hyperintensity on T2-weighted images, and restricted diffusion on diffusion-weighted images. Both DCE-CT and DCE-MRI with Gd-EOB-DTPA showed similar enhancement patterns, except for the hepatocyte phase. Notably, however, four out of five lesions showed characteristic "speckled enhancement" that refers to punctate positive enhancements within the low signal lesions on the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI pathologically confirmed to be hepatocyte clusters that remained in the tumor. CONCLUSION: Primary hepatic MALT lymphomas were characterized by arterial phase enhancement, restricted diffusion, vessel penetration sign, and more specifically "speckled enhancement" in the hepatobiliary phase of DCE-MRI with Gd-EOB-DTPA.

DOI： 10.2463/mrms.mp.2021-0069

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Peripheral Retinal Leakage after Intravenous Administration of a Gadolinium-based Contrast Agent: Age Dependence, Temporal and Inferior Predominance and Potential Implications for Eye Homeostasis. Reviewed

Shinji Naganawa, Rintaro Ito, Mariko Kawamura, Toshiaki Taoka, Tadao Yoshida, Michihiko Sone

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine Vol. 22 ( 1 ) page： 45 - 55 2023

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Peripheral retinal leakage (PRL) of contrast medium from the ora serrata (i.e., the peripheral part of the retina) was recently reported in normal eyes using ultra-widefield fluorescein angiography. We occasionally see PRL of gadolinium-based contrast agents (GBCAs) in the vitreous from the temporal and inferior sides of the ora serrata on MR images of subjects without ophthalmic disease. In this study, we retrospectively evaluated these MR images to determine if PRL was associated with aging. We also evaluated whether the initial leakage appeared in the temporal and inferior sides, and whether there was uniform distribution within the vitreous after 24 hours. METHODS: In 127 subjects (9 volunteers, 85 patients with sudden deafness, and 33 patients with a suspicion of endolymphatic hydrops), pre- and post-contrast-enhanced heavily T2-weighted 3D-fluid attenuated inversion recovery (FLAIR) images were obtained. The presence or absence of PRL was subjectively evaluated. For patients with a suspicion of endolymphatic hydrops, 3D-real inversion recovery (IR) images were also obtained at pre-, 10 mins, 4 hours, and 24 hours after intravenous administration (IV) of GBCA. Four circular ROIs were placed in the vitreous humor and the signal intensity was measured. RESULTS: In the cases with PRL (n = 88) and without PRL (n = 47), the median age was 59 and 47 years, respectively (P = 0.001). At 4 hours after IV-GBCA, the mean signal increase in the inferior temporal ROI was greater than all the other ROIs. At 24 hours after IV-GBCA, no significant difference in signal intensity was observed for the four ROIs. CONCLUSION: PRL of GBCA is age-dependent and occurs mainly from the inferior temporal side of the ora serrata. The contrast effect was uniformly distributed at 24 hours after IV-GBCA. Future observations in a variety of diseases will determine the clinical significance of these findings.

DOI： 10.2463/mrms.mp.2021-0100

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Pitfalls of Using T2-contrast Enhancement Techniques in 3D-FLAIR to Detect Endolymphatic Hydrops. Reviewed

Yutaka Kato, Shinji Naganawa, Toshiaki Taoka, Tadao Yoshida, Michihiko Sone

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine Vol. 22 ( 3 ) page： 335 - 344 2023

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To determine whether T2-contrast enhancement techniques can be used to diagnose endolymphatic hydrops, we compared fluid signal artifacts with and without T2-contrast enhancement techniques in 3D fluid-attenuated inversion recovery (3D-FLAIR). METHODS: We prepared a custom-made phantom consisting of eight tubes half-filled with saline. Images were obtained using four 3D-FLAIR: without T2-contrast enhancement (Normal), with non-selective T2-inversion recovery (T2-IR), and two with non-selective T2 preparation IR (T2-prep). Scans were performed with and without rice covering the phantom to simulate minimal and severe B0-inhomogeneity conditions. The average signal intensity (SI) values of eight saline tubes were compared between the four sequences and between each other. Comparisons were performed for all measurement slices and the central 10 slices. The images using T2-contrast enhancement technique were obtained from a volunteer and a patient suspected of Meniere's disease. RESULTS: The Normal sequence SI for all slices was significantly lower than that for the other sequences, with smaller standard deviation (SD) and no outliers. Several outliers were detected in the other sequences. The SDs and outliers were larger without rice than with rice. When the central 10 slices with rice, the T2-IR had a significantly higher SI with more outliers compared with the Normal sequence. The T2-prep had no outliers and SIs that were comparable to those of the Normal sequence. However, without rice, the T2-IR and T2-prep sequences had significantly higher SIs with outliers and larger SDs compared to the Normal sequence. In the corresponding images, the Normal sequence achieved excellent fluid suppression, whereas the T2-IR and T2-prep sequences showed high-signal artifacts. Imperfect fluid suppressions were observed in the volunteer image and the endolymphatic hydrops on the post-gadolinium image differed in size and shape in the non-injected T2-IR in the patient image. CONCLUSION: T2-contrast enhancement techniques should be used with caution in 3D-FLAIR for diagnosing endolymphatic hydrops.

DOI： 10.2463/mrms.mp.2022-0017

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Assessing the Complicated Venous Hemodynamics and Therapeutic Outcomes of Budd-Chiari Syndrome with Respiratory-gated 4D Flow MR Imaging During the Expiratory and Inspiratory Phases. Reviewed

Ryota Hyodo, Yasuo Takehara, Takashi Mizuno, Kazushige Ichikawa, Shinya Yokoyama, Yoji Ishizu, Shinji Naganawa

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine Vol. 22 ( 1 ) page： 1 - 6 2023

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

A man in his 50s with Budd-Chiari syndrome diagnosed with the suprahepatic inferior vena cava (IVC) obstruction on CT was assessed using 4D Flow MRI before and after balloon angioplasty. 4D Flow MRI acquired in two respiratory phases, depicted complex hemodynamic and respiratory variability, and a jet stream at the narrowed channel of the membranous IVC. Post-interventional 4D Flow MRI showed that the IVC blood flow increased with corrected flow directions in the infrarenal IVC.

DOI： 10.2463/mrms.ici.2021-0110

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Parasagittal Cystic Lesions May Arise from the Pial Sheath around the Cortical Venous Wall. Reviewed

Shinji Naganawa, Rintaro Ito, Toshiaki Taoka, Tadao Yoshida, Michihiko Sone

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine Vol. 22 ( 1 ) page： 143 - 146 2023

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

It has been reported that perivenous cystic structures near the parasagittal dura are associated with the leakage of gadolinium-based contrast agents at 4 hours after intravenous administration. The origin of such cystic structures remains unknown. While reading many cases of MR cisternography, we noticed that some of the cystic structures appeared to connect to the perivenous subpial space. This new imaging finding might facilitate future research of the waste clearance system for the central nervous system.

DOI： 10.2463/mrms.bc.2021-0141

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Current State of Artificial Intelligence in Clinical Applications for Head and Neck MR Imaging Reviewed

Noriyuki Fujima, Koji Kamagata, Daiju Ueda, Shohei Fujita, Yasutaka Fushimi, Masahiro Yanagawa, Rintaro Ito, Takahiro Tsuboyama, Mariko Kawamura, Takeshi Nakaura, Akira Yamada, Taiki Nozaki, Tomoyuki Fujioka, Yusuke Matsui, Kenji Hirata, Fuminari Tatsugami, Shinji Naganawa

Magnetic Resonance in Medical Sciences Vol. 22 ( 4 ) page： 401 - 414 2023

Stereotactic radiotherapy for ventricular tachycardia: A study protocol. Reviewed International journal

Mariko Kawamura, Masafumi Shimojo, Yasuya Inden, Takeshi Kamomae, Kuniyasu Okudaira, Tomohiro Komada, Sumire Aoki, Yurika Shindo, Ryotaro Yasui, Yusuke Yanagi, Masayuki Okumura, Takehiro Yamada, Yuka Kozai, Yumi Oie, Yutaka Kato, Shunichi Ishihara, Toyoaki Murohara, Shinji Naganawa

F1000Research Vol. 12 page： 798 - 798 2023

Authorship：Last author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Currently, the standard curative treatment for ventricular tachycardia (VT) and ventricular fibrillation (VF) is radiofrequency catheter ablation. However, when the VT circuit is deep in the myocardium, the catheter may not be delivered, and a new, minimally invasive treatment using different energies is desired. METHODS: This is a protocol paper for a feasibility study designed to provide stereotactic radiotherapy for refractory VT not cured by catheter ablation after at least one catheter ablation. The primary end point is to evaluate the short-term safety of this treatment and the secondary endpoint is to evaluate its efficacy as assessed by the reduction in VT episode. Cyberknife M6 radiosurgery system will be used for treatment, and the prescribed dose to the target will be 25Gy in one fraction. The study will be conducted on three patients. CONCLUSION: Since catheter ablation is the only treatment option for VT that is covered by insurance in Japan, there is currently no other treatment for VT/VF that cannot be cured by catheter ablation. We hope that this feasibility study will provide hope for patients who are currently under the stress of ICD activation. TRIAL REGISTRATION: The study has been registered in the Japan Registry of Clinical Trials (jRCTs042230030).

DOI： 10.12688/f1000research.138758.2

PubMed

Association of MRI Indices of Glymphatic System With Amyloid Deposition and Cognition in Mild Cognitive Impairment and Alzheimer Disease. Reviewed International journal

Koji Kamagata, Christina Andica, Kaito Takabayashi, Yuya Saito, Toshiaki Taoka, Hayato Nozaki, Junko Kikuta, Shohei Fujita, Akifumi Hagiwara, Kouhei Kamiya, Akihiko Wada, Toshiaki Akashi, Katsuhiro Sano, Mitsuo Nishizawa, Masaaki Hori, Shinji Naganawa, Shigeki Aoki

Neurology Vol. 99 ( 24 ) page： E2648 - E2660 2022.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND AND OBJECTIVES: The glymphatic system is a whole-brain perivascular network, which promotes CSF/interstitial fluid exchange. Alterations to this system may play a pivotal role in amyloid β (Aβ) accumulation. However, its involvement in Alzheimer's disease (AD) pathogenesis is not fully understood. Here, we investigated the changes in noninvasive MRI measurements related to the perivascular network in patients with mild cognitive impairment (MCI) and AD. Additionally, we explored the associations of MRI measures with neuropsychological score, PET standardized uptake value ratio (SUVR), and Aβ deposition. METHODS: MRI measures, including perivascular space (PVS) volume fraction (PVSVF), fractional volume of free water in white matter (FW-WM), and index of diffusivity along the perivascular space (ALPS index) of patients with MCI, those with AD, and healthy controls from the Alzheimer's Disease Neuroimaging Initiative database were compared. MRI measures were also correlated with the levels of CSF biomarkers, PET SUVR, and cognitive score in the combined subcohort of patients with MCI and AD. Statistical analyses were performed with age, sex, years of education, and APOE status as confounding factors. RESULTS: In total, 36 patients with AD, 44 patients with MCI, and 31 healthy controls were analyzed. Patients with AD had significantly higher total, WM, and basal ganglia PVSVF (Cohen's d = 1.15-1.48; p < 0.001), and FW-WM (Cohen's d = 0.73; p < 0.05) and a lower ALPS index (Cohen's d = 0.63; p < 0.05) than healthy controls. Meanwhile, the MCI group only showed significantly higher total (Cohen's d = 0.99; p < 0.05) and WM (Cohen's d = 0.91; p < 0.05) PVSVF. Low ALPS index was associated with lower CSF Aβ42 (r s = 0.41, p fdr = 0.026), FDG-PET uptake (r s = 0.54, p fdr < 0.001), and worse multiple cognitive domain deficits. High FW-WM was also associated with lower CSF Aβ42 (r s = -0.47, p fdr = 0.021) and worse cognitive performances. CONCLUSION: Our study indicates that changes in PVS-related MRI parameters occur in MCI and AD, possibly due to impairment of the glymphatic system. We also report the associations between MRI parameters and Aβ deposition, neuronal change, and cognitive impairment in AD.

DOI： 10.1212/WNL.0000000000201300

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Reproducibility of functional connectivity metrics estimated from resting-state functional MRI with differences in days, coils, and global signal regression Reviewed

Sanae Kato, Epifanio Bagarinao, Haruo Isoda, Shuji Koyama, Hirohisa Watanabe, Satoshi Maesawa, Kazuhiro Hara, Masahisa Katsuno, Shinji Naganawa, Norio Ozaki, Gen Sobue

Radiological Physics and Technology Vol. 15 ( 4 ) page： 298 - 310 2022.12

Interstitial Fluidopathy of the Central Nervous System: An Umbrella Term for Disorders with Impaired Neurofluid Dynamics.

Toshiaki Taoka, Rintaro Ito, Rei Nakamichi, Toshiki Nakane, Hisashi Kawai, Shinji Naganawa

Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine Vol. 23 ( 1 ) page： 1 - 13 2022.11

Language：English Publishing type：Research paper (scientific journal)

Interest in interstitial fluid dynamics has increased since the proposal of the glymphatic system hypothesis. Abnormal dynamics of the interstitial fluid have been pointed out to be an important factor in various pathological statuses. In this article, we propose the concept of central nervous system interstitial fluidopathy as a disease or condition in which abnormal interstitial fluid dynamics is one of the important factors for the development of a pathological condition. We discuss the aspects of interstitial fluidopathy in various diseases, including Alzheimer's disease, Parkinson's disease, normal pressure hydrocephalus, and cerebral small vessel disease. We also discuss a method called "diffusion tensor image analysis along the perivascular space" using MR diffusion images, which is used to evaluate the degree of interstitial fluidopathy or the activity of the glymphatic system.

DOI： 10.2463/mrms.rev.2022-0012

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Papers - NAGANAWA, Shinji