Language：English  

DOI： 10.1016/j.jns.2022.120441

PubMed

Language：English  

DOI： 10.1016/j.neuroimage.2022.119263

PubMed

Language：English   Publisher：European Journal of Neurology  

Background and purpose: To clarify the relationship between fiber-specific white matter changes in amyotrophic lateral sclerosis (ALS) and clinical signs of upper motor neuron (UMN) involvement, we performed a fixel-based analysis (FBA), a novel framework for diffusion-weighted imaging analysis. Methods: We enrolled 96 participants, including 48 nonfamilial ALS patients and 48 age- and sex-matched healthy controls (HCs), in this study and conducted whole-brain FBA and voxel-based morphometry analysis. We compared the fiber density (FD), fiber morphology (fiber cross-section [FC]), and a combined index of FD and FC (FDC) between the ALS and HC groups. We performed a tract-of-interest analysis to extract FD values across the significant regions in the whole-brain analysis. Then, we evaluated the associations between FD values and clinical variables. Results: The bilateral corticospinal tracts (CSTs) and the corpus callosum (CC) showed reduced FD and FDC in ALS patients compared with HCs (p < 0.05, familywise error-corrected), and the comparison of FCs revealed no region that was significantly different from another. Voxel-based morphometry showed cortical volume reduction in the regions, including the primary motor area. Clinical scores showed correlations with FD values in the CSTs (UMN score: rho = −0.530, p < 0.001; central motor conduction time [CMCT] in the upper limb: rho = −0.474, p = 0.008; disease duration: rho = −0.383, p = 0.007; ALS Functional Rating Scale-Revised: rho = 0.340, p = 0.018). In addition, patients whose CMCT was not calculated due to unevoked waves also showed FD reduction in the CSTs. Conclusions: Our findings suggest that FD values in the CST estimated via FBA can be potentially used in evaluating UMN impairments.

DOI： 10.1111/ene.15136

Web of Science

Scopus

PubMed

Language：English  

DOI： 10.1523/ENEURO.0455-21.2022

PubMed

Language：English  

DOI： 10.1093/braincomms/fcac214

PubMed

Language：Japanese  

DOI： 10.1016/j.isci.2021.103106

Web of Science

PubMed

Language：Japanese   Publisher：Parkinsonism and Related Disorders  

Introduction: This study aimed to evaluate whether novel individual voxel-based morphometry adjusting covariates (iVAC), such as age, sex, and total intracranial volume, could increase the accuracy of a diagnosis of multiple system atrophy (MSA) and enable the differentiation of MSA from Parkinson's disease (PD). Methods: We included 53 MSA patients (MSA-C: 33, MSA-P: 20), 53 PD patients, and 189 healthy controls in this study. All participants underwent high-resolution T1-weighted imaging (WI) and T2-WI with a 3.0-T MRI scanner. We evaluated the occurrence of significant atrophic findings in the pons/middle cerebellar peduncle (MCP) and putamen on iVAC and compared these findings with characteristic changes on T2-WI. Results: On iVAC, abnormal findings were observed in the pons/MCP of 96.2% of MSA patients and in the putamen of 80% of MSA patients; however, on T2-WI, they were both observed at a frequency of 60.4% in MSA patients. On iVAC, all but one MSA-P patient (98.1%) showed significant atrophic changes in the pons/MCP or putamen. By contrast, 69.8% of patients with MSA showed abnormal signal changes in the pons/MCP or putamen on T2-WI. iVAC yielded 95.0% sensitivity and 96.2% specificity for differentiating MSA-P from PD. Conclusion: iVAC enabled us to recognize the morphological characteristics of MSA visually and with high accuracy compared to T2-WI, indicating that iVAC is a potential diagnostic screening tool for MSA.

DOI： 10.1016/j.parkreldis.2021.07.025

Web of Science

Scopus

PubMed

Language：Japanese   Publisher：Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration  

Objective: Amyotrophic lateral sclerosis (ALS) is an adult-onset neurodegenerative disorder characterized by motor neuron involvement. Although olfactory dysfunction has been described in ALS, clinicoradiological features associated with the olfactory dysfunction remain poorly understood. Methods: We enrolled 30 patients with ALS and age- and sex-matched 53 healthy controls (HCs). All participants underwent the odor stick identification test for Japanese (OSIT-J) and clinical assessments, including disease duration, ALSFRS-R, site of onset, forced vital capacity, and cognitive examinations that reflected the general, executive, memory and language function. We investigated the associations between OSIT-J score and clinical features and examined atrophic changes by voxel-based morphometry (VBM) analysis to MRI. Results: The OSIT-J score was significantly lower in ALS patients than HCs (6.9 ± 3.2 vs. 9.8 ± 1.9, p < 0.001). In ALS, there were significant relationships between OSIT-J score and age at examination, frontal assessment battery, word fluencies, digit span forward, and ADAS-Jcog recognition, but not education, disease type, duration, ALSFRS-R and, %VC. Multiple regression analysis with stepwise method showed the only ADAS-Jcog recognition substantially predicted OSIT-J score. VBM analysis with age, sex, total intracranial volume, and ADAS-Jcog recognition as covariates showed OSIT-J scores were substantially correlated with atrophic changes of left orbital cortex consisting of gyrus rectus and medial orbital gyrus and right hippocampus in ALS. Conclusion: ALS patients could show substantial olfactory dysfunction in association with orbital cortex and hippocampus involvements. The olfactory examination could be a useful marker for screening of frontotemporal alteration in ALS.

DOI： 10.1080/21678421.2020.1859544

Web of Science

Scopus

PubMed

Language：English   Publisher：Frontiers in Human Neuroscience  

Purpose: Maintenance of cognitive performance is important for healthy aging. This study aims to elucidate the relationship between brain networks and cognitive function in subjects maintaining relatively good cognitive performance. Methods: A total of 120 subjects, with equal number of participants from each age group between 20 and 70 years, were included in this study. Only participants with Addenbrooke’s Cognitive Examination – Revised (ACE-R) total score greater than 83 were included. Anatomical T1-weighted MR images and resting-state functional MR images (rsfMRIs) were taken from all participants using a 3-tesla MRI scanner. After preprocessing, several factors associated with age including the ACE-R total score, scores of five domains, sub-scores of ACE-R, and brain volumes were tested. Morphometric changes associated with age were analyzed using voxel based morphometry (VBM) and changes in resting state networks (RSNs) were examined using dual regression analysis. Results: Significant negative correlations with age were seen in the total gray matter volume (GMV, r = −0.58), and in the memory, attention, and visuospatial domains. Among the different sub-scores, the score of the delayed recall (DR) showed the highest negative correlation with age (r = −0.55, p < 0.001). In VBM analysis, widespread regions demonstrated negative correlation with age, but none with any of the cognitive scores. Quadratic approximations of cognitive scores as functions of age showed relatively delayed decline compared to total GMV loss. In dual regression analysis, some cognitive networks, including the dorsal default mode network, the lateral dorsal attention network, the right / left executive control network, the posterior salience network, and the language network, did not demonstrate negative correlation with age. Some regions in the sensorimotor networks showed positive correlation with the DR, memory, and fluency scores. Conclusion: Some domains of the cognitive test did not correlate with age, and even the highly correlated sub-scores such as the DR score, showed delayed decline compared to the loss of total GMV. Some RSNs, especially involving cognitive control regions, were relatively maintained with age. Furthermore, the scores of memory, fluency, and the DR were correlated with the within-network functional connectivity values of the sensorimotor network, which supported the importance of exercise for maintenance of cognition.

DOI： 10.3389/fnhum.2021.753836

Web of Science

Scopus

PubMed

Language：English  

DOI： 10.3389/fnagi.2021.747359

PubMed

Language：English  

DOI： 10.1016/j.neuroimage.2020.117241

PubMed

Language：English  

DOI： 10.1016/j.parkreldis.2020.09.005

PubMed

Language：English  

DOI： 10.1002/acn3.51185

PubMed

Language：English  

DOI： 10.1007/s00702-020-02248-1

PubMed

Language：English  

DOI： 10.1002/hbm.25008

PubMed

Language：English  

DOI： 10.3389/fnagi.2020.592469

PubMed

Language：English  

DOI： 10.1016/j.prdoa.2020.100036

PubMed

Language：Japanese   Publisher：The Japan Stroke Society  

<p>The patient is a 65-year-old man was admitted due to the visual disturbance. Neurologic images including cranial CT and MRI showed a cerebral infarction in the right occipital lobe. This infarction was diagnosed as the embolic infarct, but embolic cause including the paroxysmal atrial fibrillation was not detected in further examinations during the hospital stay. He was diagnosed as embolic stroke of undetermined source, however, he was strongly suspected to have undetected paroxysmal atrial fibrillation. He participated in a disease management program for the ischemic stroke recurrence prevention and received self-management educations lead by the disease management nurse. He was educated to measure and record the pulse and blood pressure for himself every day to detect the arrhythmia, especially paroxysmal atrial fibrillation. On the 86th day after the onset, the patient himself noticed the abnormality of blood pressure and irregular pulse in daily check at home and called the disease management nurse. The disease management nurse suspected paroxysmal atrial fibrillation, and suggested him to have a medical examination immediately. As a result, atrial fibrillation was confirmed with an electrocardiogram, and an anticoagulant therapy was started soon after. For the detection of paroxysmal atrial fibrillation in embolic stroke of undetermined source, the self-management education to the patients was proved to be effective.</p>

DOI： 10.3995/jstroke.10741

CiNii Research

Language：English  

DOI： 10.1016/j.ebiom.2019.08.022

PubMed

Language：English  

DOI： 10.1038/s41598-019-47922-x

PubMed

Language：English  

DOI： 10.1007/s12311-019-01031-7

PubMed

Language：English  

DOI： 10.1080/21678421.2018.1510009

PubMed

Language：English  

DOI： 10.1007/s00415-018-8923-7

PubMed

Language：English  

DOI： 10.1016/j.neuroimage.2017.12.014

PubMed

Language：English  

DOI： 10.1007/s00415-018-8755-5

PubMed

Language：English  

DOI： 10.3389/fnagi.2018.00304

PubMed

Language：Japanese   Publisher：The Japan Stroke Society  

Recently four NOACs have become available, which requires us to determine the most appropriate one among the options. Since each NOAC has a specific indication and two different dosages according to various patient criteria including age, weight, renal function, and so on, it is often confusing and troublesome to compare them and select the best one. We developed an electrical medical record template for automatically evaluating and selecting the most suitable candidate among four NOAC candidates. In selecting an adequate NOAC, this system is easy and useful for objective comparison and apparent assessment, avoiding contraindication and off-label use.

DOI： 10.3995/jstroke.10385

CiNii Research