Neuroimage-Clinical最新文献

{"title":"Functional and microstructural neurosubstrates between apathy and depressive symptoms in dementia","authors":"Sheng-Min Huang ,&nbsp;Yen-Hsuan Hsu ,&nbsp;Jir-Jei Yang ,&nbsp;Chien-Yuan Lin ,&nbsp;Min-Chien Tu ,&nbsp;Li-Wei Kuo","doi":"10.1016/j.nicl.2025.103781","DOIUrl":"10.1016/j.nicl.2025.103781","url":null,"abstract":"<div><div>The overlapping features of depressive symptoms and apathy hinder their differentiation in clinical practice, and hence a greater understanding of their neurosubstrates in dementia and its subtypes is necessary. Ninety-two dementia patients (Alzheimer’s disease [AD, n = 52]; subcortical ischemic vascular disease [SIVD, n = 40]), and 30 cognitively normal subjects were evaluated using the Apathy Evaluation Scale (AES), Beck’s Depression Inventory (BDI), and brain magnetic resonance imaging (MRI). Grouped by AES/BDI scores, and hubs of depression/apathy were identified by comparing MRI metrics including fractional amplitude of low-frequency fluctuation (fALFF) of resting-state functional MRI, and mean kurtosis (MK) of diffusion kurtosis imaging. Associations between the hubs with depressive and apathy symptoms were analyzed. Comparing low-AES and high-AES groups, fALFF indicated pervasive changes mainly within the default mode network (DMN) and frontoparietal network (FPN). Comparing low-BDI and high-BDI groups, fALFF reflected changes within the DMN, FPN, and salience network (SAN). Contrarily, MK showed focal changes within DMN and SAN regions from the same group-wise comparisons. While fALFF was more correlated with DMN/FPN for AES than BDI and more significantly correlated with SIVD than AD, MK was more correlated with the left anterior cingulate cortex and right insula for AES than BDI, but more significantly correlated with AD than SIVD (all <em>P</em> &lt; 0.01). Topologically, the fALFF hubs for AES and BDI centered at the posterior and anterior poles, respectively. These findings suggest that dual-modal MRI could reflect the distinct neuropathological basis for apathy and depressive symptoms in AD and SIVD.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103781"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-atlas multi-modality morphometry analysis of the South Texas Alzheimer’s Disease Research Center postmortem repository","authors":"Nicolas Honnorat ,&nbsp;Mariam Mojtabai ,&nbsp;Karl Li ,&nbsp;Jinqi Li ,&nbsp;David Michael Martinez ,&nbsp;Tanweer Rashid ,&nbsp;Morgan Smith ,&nbsp;Margaret E Flanagan ,&nbsp;Elyas Fadaee ,&nbsp;Morgan Fox Torres ,&nbsp;Mallory Keating ,&nbsp;Kevin Bieniek ,&nbsp;Sudha Seshadri ,&nbsp;Mohamad Habes","doi":"10.1016/j.nicl.2025.103752","DOIUrl":"10.1016/j.nicl.2025.103752","url":null,"abstract":"<div><div>Histopathology provides critical insights into the neurological processes inducing neurodegenerative diseases and their impact on the brain, but brain banks combining histology and neuroimaging data are difficult to create. As part of an ongoing global effort to establish new brain banks providing both high-quality neuroimaging scans and detailed histopathology examinations, the South Texas Alzheimer’s Disease Re- search Center postmortem repository was recently created with the specific purpose of studying comorbid dementias. As the repository is reaching a milestone of two hundred brain donations and a hundred curated MRI sessions are ready for processing, robust statistical analyses can now be conducted. In this work, we report the very first morphometry analysis conducted with this new data set. We describe the processing pipelines that were specifically developed to exploit the available MRI sequences, and we explain how we addressed several postmortem neuroimaging challenges, such as the separation of brain tissues from fixative fluids, the need for updated brain atlases, and the tissue contrast changes induced by brain fixation. In general, our results establish that a combination of structural MRI sequences can provide enough informa- tion for state-of-the-art Deep Learning algorithms to almost perfectly separate brain tissues from a formalin buffered solution. Regional brain volumes are challenging to measure in postmortem scans, but robust estimates sensitive to sex differences and age trends, reflecting clinical diagnosis, neuropathology findings, and the shrinkage induced by tissue fixation can be obtained. We hope that the new processing methods developed in this work, such as the lightweight Deep Networks we used to identify the formalin signal in multimodal MRI scans and the MRI synthesis tools we used to fix our anisotropic resolution brain scans, will inspire other research teams working with postmortem MRI scans.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"45 ","pages":"Article 103752"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning based tractography with TractSeg in patients with hemispherotomy: Evaluation and refinement","authors":"Johannes Gruen ,&nbsp;Tobias Bauer ,&nbsp;Theodor Rüber ,&nbsp;Thomas Schultz","doi":"10.1016/j.nicl.2025.103738","DOIUrl":"10.1016/j.nicl.2025.103738","url":null,"abstract":"<div><div>Deep learning-based tractography implicitly learns anatomical prior knowledge that is required to resolve ambiguities inherent in traditional streamline tractography. TractSeg is a particularly widely used example of such an approach. Even though it has exclusively been trained on healthy subjects, a certain level of generalization to different pathologies has been demonstrated, and TractSeg is now increasingly used for clinical cases. We explore the limits of TractSeg by evaluating it on a unique dataset of 25 patients with epilepsy who underwent hemispherotomy, a type of surgery in which the two hemispheres are surgically separated. We compare results to those on 25 healthy controls who have been imaged with the same setup.</div><div>We find that TractSeg generalizes remarkably well, given the severity of the abnormalities. However, to our knowledge, we are the first to document cases in which TractSeg erroneously reconstructs (“hallucinates”) tracts that are known to have been surgically disconnected, and we found cases in which it implausibly continues tracts through obvious lesions. At the same time, TractSeg failed to reconstruct or undersegmented some tracts that are known to be preserved.</div><div>We subsequently propose a refinement of TractSeg which aims to improve its applicability to data with pathologies, by using its Tract Orientation Maps as an anatomical prior in low-rank tensor approximation based tractography such that tracking is guaranteed to continue only where presence of the tract is directly supported by the data (“data fidelity”). We demonstrate that our extension not only eliminates hallucinated tracts and reconstructions within lesions, but that it also increases the ability to reconstruct the preserved tracts, and leads to more complete reconstructions even in healthy controls. Despite these advances, we recommend caution and manual quality control when applying deep learning based tractography to patient data.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"45 ","pages":"Article 103738"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion network mapping of REM Sleep Behaviour Disorder","authors":"H. Odd ,&nbsp;C. Dore ,&nbsp;S.H. Eriksson ,&nbsp;L. Heydrich ,&nbsp;P. Bargiotas ,&nbsp;J. Ashburner ,&nbsp;C. Lambert","doi":"10.1016/j.nicl.2025.103751","DOIUrl":"10.1016/j.nicl.2025.103751","url":null,"abstract":"<div><div>REM Sleep Behaviour Disorder (RBD) is a parasomnia characterised by dream enactment behaviour due to loss of sleep atonia during REM sleep. It is of considerable interest as idiopathic RBD is strongly associated with a high risk of future α-synuclein disorders. Whilst candidate brainstem structures for sleep atonia have been identified in animal studies, the precise mechanisms underpinning RBD in humans remain unclear. Here, we set out to empirically define a candidate anatomical RBD network using lesion network mapping. Our objective was to test the hypothesis that RBD is either due to damage to <em>canonical RBD nodes</em> previously identified in the animal literature, or disruption to the white matter connections between these nodes, or as a consequence of damage to some other brains regions.</div><div>All published cases of secondary RBD arising due to discrete brain lesions were reviewed and those providing sufficient detail to estimate the original lesion selected. This resulted in lesion masks for 25 unique RBD cases. These were combined to create a lesion probability map, demonstrating the area of maximal overlap. We also obtained MRI lesion masks for 15 pontine strokes that had undergone sleep polysomnography investigations confirming the absence of RBD. We subsequently used these as an exclusion mask and removed any intersecting voxels from the aforementioned region of maximal overlap, creating a single candidate region-of-interest (ROIs) within the pons. This remaining region overlapped directly with the locus coeruleus. As sleep atonia is unlikely to be lateralized, a contralateral ROI was created via a left–right flip, and both were warped to the 100 healthy adult Human Connectome dataset. Probabilistic tractography was run from each ROI to map and characterize the white-matter tracts and connectivity properties.</div><div>All reported lesions were within the brainstem but there was significant variability in location. Only half of these intersected with at least one of the six a priori RBD anatomical nodes assessed, however 72 % directly intersected with the white matter tracts created from the region of maximum overlap pontine ROIs, and the remainder were within 3.05 mm (±1.51 mm) of these tracts. 92 % of lesions were either at the level of region of maximum overlap or caudal to it.</div><div>These results suggest that RBD is a brainstem disconnection syndrome, where damage anywhere along the tract connecting the rostral locus coeruleus and medulla may result in failure of sleep atonia, in line with the animal literature. This implies idiopathic disease may emerge through different patterns of damage across this brainstem circuit. This observation may account for the both the paucity of brainstem neuroimaging results reported to date and the observed phenotypic variability seen in idiopathic RBD.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"45 ","pages":"Article 103751"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encoding-related hippocampus connectivity for scenes, faces, and words: Healthy people compared to people with temporal and frontal lobe epilepsy","authors":"Anna Doll ,&nbsp;Daniel A. Schlueter ,&nbsp;Martin Wegrzyn ,&nbsp;Friedrich G. Woermann ,&nbsp;Kirsten Labudda ,&nbsp;Christian G. Bien ,&nbsp;Johanna Kissler","doi":"10.1016/j.nicl.2025.103784","DOIUrl":"10.1016/j.nicl.2025.103784","url":null,"abstract":"<div><div>Interactions of the hippocampus with other brain structures are supposed to support memory formation but knowledge is limited regarding hippocampal task-based functional connectivity (FC) during encoding in both healthy people and people with epilepsy, who frequently have impaired memory. We compared absolute [FC(encoding)] and relative FC (isolating task-specific FC [FC(encoding)-FC(baseline)]) of the anterior hippocampus in 30 controls, 56 mesial temporal (mTLE, 26 right) and 24 frontal lobe epilepsy (FLE) patients using a memory fMRI-task of encoding scenes, faces and words. <strong>In controls</strong>, absolute hippocampus FC comprised regions typically active in memory fMRI-tasks and the default mode network (DMN): For faces and scenes, FC was pronounced to temporo-occipital areas, whereas for words it extended to lateral-temporal regions. Relative FC was more circumscribed and encompassed temporo-occipital and frontal stimulus-selective regions for scenes and faces. Also, relative FC revealed weaker hippocampus – DMN connectivity during encoding. <strong>mTLE</strong> patients had decreased FC from the epileptogenic hippocampus and slight disruptions from the contralateral hippocampus. Decreased absolute FC was found to the contralateral mTL, the precuneus and the posterior cingulate gyrus. Further, mTLE patients’ weaker FC to frontal and temporo-occipital regions reflected material-specific changes. Conversely, mTLE patients had higher absolute FC to regions to which the hippocampus is normally anticorrelated and increased relative FC to DMN regions. During word encoding only, <strong>FLE</strong> patients had increased left hippocampal relative FC to right-sided regions. Together, these findings further delineate the network architecture of memory in healthy people and its dysfunction in focal epilepsies, which prospectively could inform surgical interventions.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103784"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-scale functional network connectivity mediate the associations of white matter lesions with executive functions and information processing speed in asymptomatic cerebral small vessels diseases","authors":"Jing Chen ,&nbsp;Weiwei lu ,&nbsp;Zhangyang Wang ,&nbsp;Mingfang Shi ,&nbsp;Zhang Shi ,&nbsp;Weibin Shi","doi":"10.1016/j.nicl.2025.103773","DOIUrl":"10.1016/j.nicl.2025.103773","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the role of the large-scale functional network connectivity between white matter lesions (WMLs) and cognitive behaviors in patients of asymptomatic cerebral small vascular diseases (CSVD).</div></div><div><h3>Methods</h3><div>The study sample consisted of 211 asymptomatic CSVD patients with WMLs. Large-scale internetwork and intranetwork functional connectivity (FC) were calculated using a combination of resting-state functional MRI data and independent component analysis. Neuropsychological tests involve cognitive functions were also measured. Then, potential correlations between WMLs, functional network connectivity and cognitive behaviors were tested. Mediation analysis was used to explore the role of functional network connectivity between WMLs and cognitive behaviors.</div></div><div><h3>Results</h3><div>We successfully identified fourteen meaningful resting-state functional networks. Internetwork FC between dorsal sensorimotor network (dSMN) and right frontoparietal network (rFPN), dSMN and left frontoparietal network (lFPN), auditory network (AN) and posterior default network (pDMN), AN and executive control network (ECN), ECN and salience network (SN), dorsal attention network (DAN) and ECN were significant correlated with volumes of WMLs. Executive function were associated with internetwork FC between AN and pDMN, ECN and SN. Moreover, internetwork FC between AN and pDMN, ECN and SN mediated the relations of WMLs with executive function (for AN and pDMN, indirect effect: −0.0371, 95% CI: −0.0829 to −0.0073; for ECN and SN, indirect effect: −0.03191, 95% CI: −0.0807 to −0.0047). Moreover, left inferior parietal lobule in rFPN, right precentral gyrus in anterior default network (aDMN), right paracentral lobue in pDMN and left precunues in ECN were related to volumes of WMLs. There is a significant association of WMLs with intranetwork FC in left precunues, which could mediate the link between WMLs and information processing speed (indirect effect: −0.0437, 95% CI: −0.1055 to −0.0081).</div></div><div><h3>Conclusion</h3><div>WMLs in asymptomatic CSVD patients may induce large-scale connectivity changes including the internetwork FC and intranetwork FC, which might further influence executive function and information processing speed.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103773"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced microstructural white matter integrity is associated with the severity of physical symptoms in functional neurological disorder","authors":"Nicolas Gninenko ,&nbsp;Eliane Müller ,&nbsp;Selma Aybek","doi":"10.1016/j.nicl.2025.103791","DOIUrl":"10.1016/j.nicl.2025.103791","url":null,"abstract":"<div><h3>Background</h3><div>Functional neurological disorder (FND) is linked to functional changes in brain networks without an underlying brain lesion. However, the dichotomy between functional and structural changes has been challenged by research suggesting that not only functional but also anatomical alterations in the gray and white matter may underlie a subset of symptoms. This study aimed to characterize white matter microstructural integrity and its association with patient-reported and clinician-rated physical symptoms’ severity in a large sample of FND patients.</div></div><div><h3>Methods</h3><div>Diffusion-weighted imaging data were collected from 85 FND patients with mixed symptoms and 75 healthy controls (HCs), together with illness duration, clinician-rated (S-FMDRS &amp; CGI), and patient-reported (SF-36) symptom severity. Microstructural integrity was computed based on probabilistic tractography using the Desikan-Killiany parcellation.</div></div><div><h3>Results</h3><div>Compared to HCs, patients with FND presented widespread reduced microstructural integrity stemming from regions such as the right lateral orbitofrontal cortex, insula, putamen, and superior temporal regions. After adjusting for depression and anxiety, these differences were no longer significant. Within-group analysis revealed that reduced microstructural integrity, particularly in the left precuneus and left superior parietal cortex, was strongly correlated with both patient-reported and clinician-evaluated severity of physical symptoms in FND patients.</div></div><div><h3>Conclusion</h3><div>Patients with FND present widespread reduced microstructural integrity in the brain, predominantly originating from temporoparietal, paralimbic and associated regions involved in emotion regulation and body awareness. These changes seem to be partly explained by comorbid mood disorders and the severity of physical symptoms, suggesting a plasticity phenomenon rather than trait biomarkers, which warrants further investigation in longitudinal study designs.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103791"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion tensor imaging at 3T for diagnosing root avulsion in adults with acute traumatic brachial plexus injuries","authors":"Ryckie G. Wade ,&nbsp;Irvin Teh ,&nbsp;David Shelley ,&nbsp;Robert D. Bains ,&nbsp;James D. Bedford ,&nbsp;Lucy E. Homer Newton ,&nbsp;Chye Yew Ng ,&nbsp;Grainne Bourke","doi":"10.1016/j.nicl.2025.103806","DOIUrl":"10.1016/j.nicl.2025.103806","url":null,"abstract":"<div><h3>Background</h3><div>Root avulsion in patients with traumatic brachial plexus injury (tBPI) are common and MRI is used to help identify patients who need urgent reconstruction. Diffusion tensor MRI (DTI) generates proxy measures of nerve ‘health’ which are sensitive to myelination, axon diameter, fibre density and organisation. This prospective multicentre pilot study assessed the utility of DTI for detecting root avulsion in adults with acute traumatic brachial plexus injury.</div></div><div><h3>Methods</h3><div>Patients underwent DTI at 3 Tesla. Fractional anisotropy (FA) and radial diffusivity (RD) were extracted from spinal nerve roots. The reference standard was surgical exploration or surveillance if spontaneous recovery occurred preoperatively. Comparisons were made between spinal nerve root avulsions, in-continuity roots and the contralateral uninjured roots, using linear methods and 95% confidence intervals (CI) were computed.</div></div><div><h3>Results</h3><div>14 males with tBPI (mean age 44 years, SD 14) were scanned at a mean 18 days post-injury (CI 15–21). Diffusion was more isotropic in avulsed roots; root avulsions had 12 % lower FA than injured in-continuity roots (CI 5–19) and 14 % lower FA (CI 7–21) than the contralateral uninjured side. Similarly, avulsed roots had higher radial diffusivity than injured in-continuity roots (mean difference 0·30 x10⁻³ mm²/s [CI 0·01–0·60]) and contralateral uninjured roots (mean difference 0·36 x10⁻³ mm²/s [CI 0·7–0·64]).</div></div><div><h3>Conclusions</h3><div>Diffusion tensor imaging appears to be sensitive to early microstructural changes in the distal stumps of avulsed roots in adults with tBPI. DTI may supplement morphological MRI to better identify patients who need early reconstruction.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"47 ","pages":"Article 103806"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional and longitudinal quantification of total white matter perivascular space volume fraction in Dutch-type Cerebral Amyloid Angiopathy","authors":"Manon R. Schipper ,&nbsp;Thijs W. van Harten ,&nbsp;Arie-Tjerk Razoux-Schultz ,&nbsp;Kanishk Kaushik ,&nbsp;Lydiane Hirschler ,&nbsp;Sabine Voigt ,&nbsp;Ingeborg Rasing ,&nbsp;Emma A. Koemans ,&nbsp;Rosemarie van Dort ,&nbsp;Reinier G.J. van der Zwet ,&nbsp;Sanne E. Schriemer ,&nbsp;Erik W. van Zwet ,&nbsp;Jeroen van der Grond ,&nbsp;Mark A. van Buchem ,&nbsp;Steven M. Greenberg ,&nbsp;Marieke J.H. Wermer ,&nbsp;Matthias J.P. van Osch ,&nbsp;Marianne A.A. van Walderveen ,&nbsp;Sanneke van Rooden","doi":"10.1016/j.nicl.2025.103778","DOIUrl":"10.1016/j.nicl.2025.103778","url":null,"abstract":"<div><div>Enlarged perivascular spaces (PVS) in the centrum semiovale are an important marker of Cerebral Amyloid Angiopathy (CAA) and are thought to reflect brain clearance dysfunction. However, the current golden standard for assessing PVS is limited to a unilateral, single slice, qualitative analysis, which has the disadvantage of a strong ceiling effect. We aim to introduce a whole-brain PVS volume fraction (PVS_vf) measurement to assess cross-sectional and longitudinal PVS_vf differences between pre-symptomatic and symptomatic Dutch-type CAA (D-CAA) mutation carriers and similar-age controls. PVS_vf was assessed with a Frangi-vesselness filter-based, segmentation tool developed in-house and was compared cross-sectionally in 70 participants (28 symptomatic D-CAA, 17 pre-symptomatic D-CAA, 10 controls &gt; 50 years, 17 controls ≤ 50 years) and longitudinally in 40 participants (16 symptomatic D-CAA, 13 pre-symptomatic D-CAA, 11 controls combined from both age groups). We found a higher baseline PVS_vf in symptomatic D-CAA compared to controls ≤ 50 years (<em>p</em> &lt; 0.0001, 95% CI [−0.051, −0.025]) and controls &gt; 50 years (<em>p</em> &lt; 0.0001, 95% CI [-0.042, −0.016]), in pre-symptomatic D-CAA compared to controls ≤ 50 years (<em>p</em> = 0.023, 95% CI [−0.035, −0.002]), and in controls &gt; 50 years compared to controls ≤ 50 years (<em>p</em> &lt; 0.001, 95% CI [0.004, 0.014]). We found no group differences in PVS_vf change over time. The introduction of this quantitative measure of PVS volume in D-CAA showed cross-sectional differences already in pre-symptomatic D-CAA, indicating increased PVS_vf in the early stages of D-CAA. We did not observe longitudinal differences over a four-year follow-up when analyzed at group level.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103778"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143800416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized lesion-symptom mapping using explainable artificial intelligence for the cognitive impact of white matter hyperintensities","authors":"Ryanne Offenberg ,&nbsp;Alberto De Luca ,&nbsp;Geert Jan Biessels ,&nbsp;Frederik Barkhof ,&nbsp;Wiesje M. van der Flier ,&nbsp;Argonde C. van Harten ,&nbsp;Ewoud van der Lelij ,&nbsp;Josien Pluim ,&nbsp;Hugo Kuijf","doi":"10.1016/j.nicl.2025.103790","DOIUrl":"10.1016/j.nicl.2025.103790","url":null,"abstract":"<div><div>Lesion-symptom mapping methods assess the relationship between lesions caused by cerebral small vessel disease and cognition, but current technology like support vector regression (SVR)) primarily provide group-level results. We propose a novel lesion-symptom mapping approach that can indicate how lesion patterns contribute to cognitive impairment on an individual level. A convolutional neural network (CNN) predicts cognitive scores and is combined with explainable artificial intelligence (XAI) to map the relation between cognition and vascular lesions.</div><div>This method was evaluated primarily using real white matter hyperintensity maps of 821 memory clinic patients and simulated cognitive data, with weighted lesions and noise levels. Simulated data provided ground truth locations to assess predictive performance of the CNN and accuracy of strategic lesion identification by XAI, using an established lesion-symptom mapping method, SVR, and a simple fully connected neural network (FNN) as benchmarks. Real cognitive scores were used in a final proof-of-principle analysis.</div><div>Predictive performance in simulation experiments was high for the CNN (R² = 0.964), SVR (R² = 0.875), and FNN (R² = 0.863). CNN with XAI provided patient-specific attribution maps that highlighted the ground truth locations. All methods showed similar sensitivity to noise. Using real cognitive scores, SVR (R² = 0.291) obtained a somewhat higher predictive performance than the CNN (R² = 0.216), although both methods substantially exceeded the predictive performance of total WMH volume alone (R² = 0.013). The FNN performed worse on real data (R² = 0.020).</div><div>To conclude, results show that CNNs combined with XAI can perform lesion-symptom mapping and generate individual attribution maps, which could be a valuable feature with further method development.</div></div>","PeriodicalId":54359,"journal":{"name":"Neuroimage-Clinical","volume":"46 ","pages":"Article 103790"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}