Neurodegenerative process in amyotrophic lateral sclerosis (ALS) has been proven to involve sever... more Neurodegenerative process in amyotrophic lateral sclerosis (ALS) has been proven to involve several cortical and subcortical brain regions within and beyond motor areas. However, how ALS pathology spreads progressively during disease evolution is still unknown. In this cross-sectional study we investigated 54 ALS patients, divided into 3 subsets according to the clinical stage, and 18 age and sex-matched healthy controls, by using tract-based spatial statistics (TBSS) diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) analyses. We aimed to identify white (WM) and gray matter (GM) patterns of disease distinctive of each clinical stage, corresponding to specific clinical milestones. ALS cases in stage 2A (i.e., at diagnosis) were characterized by GM and WM impairment of left motor and premotor cortices and brainstem at ponto-mesenchephalic junction. ALS patients in clinical stage 2B (with impairment of two functional regions) exhibited decreased fractional anisotropy (FA...
A 65-year-old woman underwent MRI for a mild cognitive impairment (MCI) at Mini-Mental State Exam... more A 65-year-old woman underwent MRI for a mild cognitive impairment (MCI) at Mini-Mental State Examination (MMSE). MRI showed hippocampal sulcus remnants bilaterally, although they were larger on the right, and left hippocampal atrophy with increased left fimbriosubicular distance (right side: 1.2 mm; left side: 2.0 mm). The meaning of these findings in relation to clinical aspects is discussed and reviewed according to data from the literature.
Freezing of gait is a common cause of disability and falls in patients with Parkinson&amp... more Freezing of gait is a common cause of disability and falls in patients with Parkinson's disease. We studied brain functional connectivity, by means of resting-state functional magnetic resonance imaging, in patients with Parkinson's disease and freezing of gait. Resting-state functional magnetic resonance imaging at 3 T was collected in 29 patients with Parkinson's disease, of whom 16 presented with freezing of gait as determined by a validated freezing of gait questionnaire, and 15 matched healthy controls. Single-subject and group-level independent component analysis was used to identify the main resting-state networks differing between Parkinson's disease patients with and without freezing of gait. Statistical analysis was performed using BrainVoyager QX. Between-group differences in resting-state networks revealed that patients with freezing of gait exhibit significantly reduced functional connectivity within both "executive-attention" (in the right middle frontal gyrus and in the angular gyrus) and visual networks (in the right occipito-temporal gyrus) [p < 0.05 corrected for multiple comparisons]. Freezing of gait clinical severity was significantly correlated with decreased connectivity within the two networks. Consistent with their…
The aim of this study was to assess differences in the presence, size, number and site of dilated... more The aim of this study was to assess differences in the presence, size, number and site of dilated cerebral Virchow-Robin spaces (VRSd) between patients with multiple sclerosis (MS) in the inactive phase and healthy controls, and between MS patients with disabling (MSd) or nondisabling (MSnd) disease. The study was performed by retrospectively analysing the 3 T magnetic resonance studies of 40 MS patients and 30 healthy subjects (matched for age, education and gender). The data were analysed with MIPAV (Medical Image Processing, Analysis and Visualisation) software to assess for VRSd and with FSL SIENA-X to measure global cerebral atrophy (GCA) expressed as brain parenchyma fraction. The MS patients had significantly higher VRSd number (p < 0.011), area (p < 0.0073) and volume (p < 0.0071) than controls, with a marked increase for atypical sites (p < 0.0069) without significant intragroup differences between the disease forms (MSd vs MSnd). The number and size of VRSd did not correlate with GCA. Our results confirm previous reports regarding the increase in VRSd in nonactive phases of MS and support the immunological role of the VRS within the central nervous system. The lack of correlation between VRSd and the degree of GCA and their prevailing localisation in atypical sites in MS patients make VRSd a potential marker of inflammatory-demyelinating disease.
The use of high magnetic field strength fMRI units has the potential for improving considerably t... more The use of high magnetic field strength fMRI units has the potential for improving considerably the sensitivity and specificity of functional studies. As a result of the high-field studies, fundamental neural dynamics taking place at a very small dimensional scale in specific laminar, columnar and multicolumnar domains have become directly visible. The advantages in terms of spatial resolution, temporal resolution,
Dementia is a common and growing problem, with 20% of those over 80 years of age suffering from t... more Dementia is a common and growing problem, with 20% of those over 80 years of age suffering from this disorder. The prospect of more effective treatments has caused an increasing demand for a more accurate and earlier diagnosis of different dementia syndromes. Neuroimaging techniques may have an important role in the clinical evaluation of dementia for early diagnosis, differential diagnosis and may help in the prediction of conversion to dementia in individuals at a higher risk of developing the disorder. Moreover, new MRI techniques might not only further broaden our understanding of the pathophysiology but also accelerate treatment discovery. This review will focus on the use of conventional and non-conventional MRI techniques to investigate dementias.
To compare three-dimensional (3D) time-of-flight (TOF)-magnetic resonance angiography (MRA) at 3 ... more To compare three-dimensional (3D) time-of-flight (TOF)-magnetic resonance angiography (MRA) at 3 T with 3D TOF-MRA and ultrafast contrast-enhanced (CE)-MRA at 1.5 T and to determine the optimum MRA sequence for follow-up of cerebral aneurysms treated with Guglielmi detachable coils (GDCs). Twenty-eight patients treated with GDCs for 29 cerebral aneurysms underwent MRA at 3 T and 1.5 T within 24 hours (during the same session for outpatients). All imaging was performed using a sensitivity-encoding head coil (SENSE factor = 2). Unenhanced axial 3D TOF-MRA at 3 T was performed with repetition time (TR)/echo time (TE) = 16/2.9. At 1.5 T, axial 3D TOF-MRA (TR/TE = 23/4) was performed first, followed by axial 3D ultrafast gradient echo MRA (TR/TE = 6/2) enhanced with 0.1 mmol/kg gadobenate dimeglumine (MultiHance). Source images and maximum intensity projection and shaded surface display reconstructions for each acquisition sequence were evaluated for quality of visualization of residual aneurysm patency and scored for visualization preference. Residual aneurysm was detected in 15/29 cases on CE-MRA at 1.5 T and TOF-MRA at 3 T but in only 11/29 cases on TOF-MRA at 1.5 T. CE-MRA at 1.5 T was preferred to TOF-MRA at 1.5 T in 13 cases (P = 0.004) and to TOF-MRA at 3 T in 3 cases. TOF-MRA at 3 T was preferred to TOF-MRA at 1.5 T in 11 cases (P = 0.04) but was not preferred to CE-MRA at 1.5 T in any case. The parent artery was identifiable in all 29 cases after TOF-MRA at 3 T and CE-MRA at 1.5 T but in only 27 cases after 3D TOF-MRA at 1.5 T. TOF-MRA follow-up of coiled aneurysms is better at 3 T than at 1.5 T; nevertheless, greater definition of residual patency is achieved with ultrafast CE-MRA at 1.5 T.
Neurodegenerative process in amyotrophic lateral sclerosis (ALS) has been proven to involve sever... more Neurodegenerative process in amyotrophic lateral sclerosis (ALS) has been proven to involve several cortical and subcortical brain regions within and beyond motor areas. However, how ALS pathology spreads progressively during disease evolution is still unknown. In this cross-sectional study we investigated 54 ALS patients, divided into 3 subsets according to the clinical stage, and 18 age and sex-matched healthy controls, by using tract-based spatial statistics (TBSS) diffusion tensor imaging (DTI) and voxel-based morphometry (VBM) analyses. We aimed to identify white (WM) and gray matter (GM) patterns of disease distinctive of each clinical stage, corresponding to specific clinical milestones. ALS cases in stage 2A (i.e., at diagnosis) were characterized by GM and WM impairment of left motor and premotor cortices and brainstem at ponto-mesenchephalic junction. ALS patients in clinical stage 2B (with impairment of two functional regions) exhibited decreased fractional anisotropy (FA...
A 65-year-old woman underwent MRI for a mild cognitive impairment (MCI) at Mini-Mental State Exam... more A 65-year-old woman underwent MRI for a mild cognitive impairment (MCI) at Mini-Mental State Examination (MMSE). MRI showed hippocampal sulcus remnants bilaterally, although they were larger on the right, and left hippocampal atrophy with increased left fimbriosubicular distance (right side: 1.2 mm; left side: 2.0 mm). The meaning of these findings in relation to clinical aspects is discussed and reviewed according to data from the literature.
Freezing of gait is a common cause of disability and falls in patients with Parkinson&amp... more Freezing of gait is a common cause of disability and falls in patients with Parkinson's disease. We studied brain functional connectivity, by means of resting-state functional magnetic resonance imaging, in patients with Parkinson's disease and freezing of gait. Resting-state functional magnetic resonance imaging at 3 T was collected in 29 patients with Parkinson's disease, of whom 16 presented with freezing of gait as determined by a validated freezing of gait questionnaire, and 15 matched healthy controls. Single-subject and group-level independent component analysis was used to identify the main resting-state networks differing between Parkinson's disease patients with and without freezing of gait. Statistical analysis was performed using BrainVoyager QX. Between-group differences in resting-state networks revealed that patients with freezing of gait exhibit significantly reduced functional connectivity within both "executive-attention" (in the right middle frontal gyrus and in the angular gyrus) and visual networks (in the right occipito-temporal gyrus) [p < 0.05 corrected for multiple comparisons]. Freezing of gait clinical severity was significantly correlated with decreased connectivity within the two networks. Consistent with their…
The aim of this study was to assess differences in the presence, size, number and site of dilated... more The aim of this study was to assess differences in the presence, size, number and site of dilated cerebral Virchow-Robin spaces (VRSd) between patients with multiple sclerosis (MS) in the inactive phase and healthy controls, and between MS patients with disabling (MSd) or nondisabling (MSnd) disease. The study was performed by retrospectively analysing the 3 T magnetic resonance studies of 40 MS patients and 30 healthy subjects (matched for age, education and gender). The data were analysed with MIPAV (Medical Image Processing, Analysis and Visualisation) software to assess for VRSd and with FSL SIENA-X to measure global cerebral atrophy (GCA) expressed as brain parenchyma fraction. The MS patients had significantly higher VRSd number (p < 0.011), area (p < 0.0073) and volume (p < 0.0071) than controls, with a marked increase for atypical sites (p < 0.0069) without significant intragroup differences between the disease forms (MSd vs MSnd). The number and size of VRSd did not correlate with GCA. Our results confirm previous reports regarding the increase in VRSd in nonactive phases of MS and support the immunological role of the VRS within the central nervous system. The lack of correlation between VRSd and the degree of GCA and their prevailing localisation in atypical sites in MS patients make VRSd a potential marker of inflammatory-demyelinating disease.
The use of high magnetic field strength fMRI units has the potential for improving considerably t... more The use of high magnetic field strength fMRI units has the potential for improving considerably the sensitivity and specificity of functional studies. As a result of the high-field studies, fundamental neural dynamics taking place at a very small dimensional scale in specific laminar, columnar and multicolumnar domains have become directly visible. The advantages in terms of spatial resolution, temporal resolution,
Dementia is a common and growing problem, with 20% of those over 80 years of age suffering from t... more Dementia is a common and growing problem, with 20% of those over 80 years of age suffering from this disorder. The prospect of more effective treatments has caused an increasing demand for a more accurate and earlier diagnosis of different dementia syndromes. Neuroimaging techniques may have an important role in the clinical evaluation of dementia for early diagnosis, differential diagnosis and may help in the prediction of conversion to dementia in individuals at a higher risk of developing the disorder. Moreover, new MRI techniques might not only further broaden our understanding of the pathophysiology but also accelerate treatment discovery. This review will focus on the use of conventional and non-conventional MRI techniques to investigate dementias.
To compare three-dimensional (3D) time-of-flight (TOF)-magnetic resonance angiography (MRA) at 3 ... more To compare three-dimensional (3D) time-of-flight (TOF)-magnetic resonance angiography (MRA) at 3 T with 3D TOF-MRA and ultrafast contrast-enhanced (CE)-MRA at 1.5 T and to determine the optimum MRA sequence for follow-up of cerebral aneurysms treated with Guglielmi detachable coils (GDCs). Twenty-eight patients treated with GDCs for 29 cerebral aneurysms underwent MRA at 3 T and 1.5 T within 24 hours (during the same session for outpatients). All imaging was performed using a sensitivity-encoding head coil (SENSE factor = 2). Unenhanced axial 3D TOF-MRA at 3 T was performed with repetition time (TR)/echo time (TE) = 16/2.9. At 1.5 T, axial 3D TOF-MRA (TR/TE = 23/4) was performed first, followed by axial 3D ultrafast gradient echo MRA (TR/TE = 6/2) enhanced with 0.1 mmol/kg gadobenate dimeglumine (MultiHance). Source images and maximum intensity projection and shaded surface display reconstructions for each acquisition sequence were evaluated for quality of visualization of residual aneurysm patency and scored for visualization preference. Residual aneurysm was detected in 15/29 cases on CE-MRA at 1.5 T and TOF-MRA at 3 T but in only 11/29 cases on TOF-MRA at 1.5 T. CE-MRA at 1.5 T was preferred to TOF-MRA at 1.5 T in 13 cases (P = 0.004) and to TOF-MRA at 3 T in 3 cases. TOF-MRA at 3 T was preferred to TOF-MRA at 1.5 T in 11 cases (P = 0.04) but was not preferred to CE-MRA at 1.5 T in any case. The parent artery was identifiable in all 29 cases after TOF-MRA at 3 T and CE-MRA at 1.5 T but in only 27 cases after 3D TOF-MRA at 1.5 T. TOF-MRA follow-up of coiled aneurysms is better at 3 T than at 1.5 T; nevertheless, greater definition of residual patency is achieved with ultrafast CE-MRA at 1.5 T.
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