Brain communications最新文献

{"title":"Voices of patients' relatives to support weaning from mechanical ventilation: a randomized trial.","authors":"Maximilian I Sprügel, Marie-Louise Isenberg, Jochen A Sembill, Tamara M Welte, Rüdiger Hopfengärtner, Stefanie Balk, Kosmas Macha, Anne Mrochen, Lena Rühl, Franziska Panier, Luise Biburger, Tobias Heckelsmüller, Lisa Dietmar, Markus Prinz, Stefan Schwab, Hagen B Huttner, Joji B Kuramatsu","doi":"10.1093/braincomms/fcaf197","DOIUrl":"10.1093/braincomms/fcaf197","url":null,"abstract":"<p><p>Weaning from mechanical ventilation is complicated in patients with severe brain injury, but recurrent stimulation by familiar voices and commands to breathe in and out during critical weaning periods may improve patient outcomes. This study aimed to assess the feasibility, safety and efficacy of audio recordings of patients' relatives to support weaning from mechanical ventilation. VOICE-WEANING II (Voices of patients' relatives to support weaning from mechanical ventilation) was a randomized (1:1), sham-controlled clinical trial. Patients aged 18 years and older with controlled mechanical ventilation ≥ 48 h due to neurological disease were included. Patients received either audio recordings or sham control with muted audio recordings for 10 min, three times per day from initiation of assisted mechanical ventilation. The primary outcome was rate of weaning failure. Secondary outcomes included duration of controlled ventilation, rate of tracheostomy, delirium and all-cause mortality at 90 days. Brain activity was assessed using spectral density analysis of continuous electroencephalogram monitoring. Fourty-five participants were randomized (25 males/20 females, median age 60 years). Of those, 22 patients received audio recordings (48.9%) and 23 (51.1%) sham control. Rate of weaning failure was 52.4% in the intervention group and 63.6% in the control group (adjusted difference -9.5; 95% confidence interval, -38.8 to 19.9; <i>P</i> = 0.50). Duration of controlled mechanical ventilation was significantly reduced in the treatment group (adjusted difference -19.4 h; 95% confidence interval, -37.4 to -1.5 h; <i>P</i> = 0.03). The intervention was feasible and safe. Brain activity was increased in response to treatment and pronounced in right fronto-central brain regions. Although audio recordings of patients' relatives did not significantly reduce weaning failure, the duration of controlled mechanical ventilation was significantly reduced and brain activity increased suggesting an immediate treatment response. These trial results seem to indicate a therapeutic effect of audio recordings of patients' relatives for weaning from mechanical ventilation.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf197"},"PeriodicalIF":4.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain [¹⁸F]FDG uptake patterns in type 2 diabetes: new phenotypes relating to biomarkers of cognitive impairment.","authors":"Queralt Martín-Saladich, Deborah Pareto, Rafael Simó, Andreea Ciudin, Carolina Aparicio, Khadija Hammawa, Elena de la Calle Vargas, Santiago Aguadé-Bruix, Marina Giralt, Clara Ramirez-Serra, Miguel A González Ballester, José Raul Herance","doi":"10.1093/braincomms/fcaf213","DOIUrl":"10.1093/braincomms/fcaf213","url":null,"abstract":"<p><p>Previous studies in patients without Type 2 diabetes suggest that brain hypo- and hypermetabolic regions may indicate risk for cognitive disorders. We aimed to study these brain glucose uptake patterns in Type 2 diabetes to assess cognitive disorder risk and improve personalized management. Six hyper- and three hypometabolic regions were obtained through statistical parametric mapping, with cerebellar vermis and right superior temporal gyrus being the most relevant areas, respectively. Such allowed identification of two phenotypes via <i>k</i>-means clustering: brain hypometabolic dominant (bU[-]) and hypermetabolic dominant (bU[+]). bU[-] displayed elevated markers of both Type 2 diabetes and cognitive disorders, specifically of secreted frizzled-related protein 1, a protein related to different neuronal pathologies. A classifier was developed (area under the curve = 0.84, true positive rate = 0.81 and true negative rate = 0.78) using a combination of biochemical features. Type 2 diabetes patients exhibit hypo- and hypermetabolic brain regions that phenotype into bU[-] and bU[+] by using the relationship between right superior temporal gyrus and cerebellar vermis, which defines the transition from one phenotype to the other. We suggest bU[-] patients are exposed to a higher risk of developing cognitive disorders based on the alteration of secreted frizzled-related protein 1 due to progressed type 2 diabetes, which can be identified using the proposed biomarker-based classification model.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf213"},"PeriodicalIF":4.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Encephalography cross-frequency coupling and brain alteration in amyotrophic lateral sclerosis.","authors":"Cristina Benetton, Arnaud Preuilh, Mohammed Khamaysa, Maximilien Chaumon, Alexandra Lackmy-Vallée, Alper Er, Mélanie Pélégrini-Issac, Giorgia Querin, Caroline Rouaux, Pierre-François Pradat, Véronique Marchand-Pauvert","doi":"10.1093/braincomms/fcaf192","DOIUrl":"10.1093/braincomms/fcaf192","url":null,"abstract":"<p><p>The diagnosis of amyotrophic lateral sclerosis requires identifying degeneration in both brain and bulbospinal motor neurons. However, detecting cortical dysfunction remains challenging, as peripheral symptoms often overshadow upper motor neuron signs. Although transcranial magnetic stimulation and MRI are valuable tools, transcranial magnetic stimulation is challenged as disease progresses but also at early stage in some patients, and brain MRI shows in most cohorts no significant change at the time of diagnosis. This emphasizes the need for neuromarkers facilitating detection of cortical dysfunction and longitudinal monitoring. EEG offers promising avenues. Accordingly, we recently identified altered theta-gamma phase-amplitude coupling in amyotrophic lateral sclerosis. The present study aimed to further explore phase-amplitude coupling in patients, focusing not only on theta and gamma bands but also on alpha and beta bands, and the link with handedness and brain structure. Resting-state EEG was recorded in 26 patients with amyotrophic lateral sclerosis and 26 age- and sex-matched controls, alongside anatomical and diffusion MRI. PAC was calculated between slow and gamma oscillations at five sensorimotor electrodes bilaterally. Grey and white matter integrity was evaluated through cortical thickness measurements and diffusion metrics along the corticospinal tract. Results revealed significantly decreased theta-gamma PAC in the dominant hemisphere of patients, without changes in band powers or other frequency couplings. MRI confirmed well-known handedness-related brain structural asymmetry in both groups, although it was less pronounced in patients. Specifically, diffusion metrics were altered in the most caudal segment (brainstem level) of the pyramidal tract within the dominant hemisphere in patients. These findings align with lateralized theta-gamma PAC alterations and the greater vulnerability of the dominant hemisphere to amyotrophic lateral sclerosis. No correlation was found between electrophysiological and diffusion metrics, likely because they are related to different mechanisms: PAC alteration being presumably linked to excitation/inhibition imbalance preceding upper motor neuron degeneration. Moreover, theta-gamma PAC was found to be particularly altered in patients with altered cognitive scores, consistent with previous findings in patients with mild cognitive impairment. Lastly, receiver operating characteristic analyses demonstrated that PAC outperformed diffusion MRI in diagnostic accuracy, underscoring its potential as a very sensitive marker of cortical dysfunction in amyotrophic lateral sclerosis. Although these results need validation in a larger cohort at different stages of the disease and across different forms (sporadic and familial), they confirm that PAC can detect cortical dysfunctions in amyotrophic lateral sclerosis.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf192"},"PeriodicalIF":4.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-sensor approach to improve interpretability of the 6-min walk test as an outcome in muscular dystrophies: an observational study.","authors":"Aisha Sheikh, Mireia Claramunt-Molet, Karen Rudolf, Carolina Migliorelli, Sebastian Idelsohn-Zielonka, Felip Miralles, John Vissing","doi":"10.1093/braincomms/fcaf205","DOIUrl":"10.1093/braincomms/fcaf205","url":null,"abstract":"<p><p>The 6-min walk test (6MWT) is commonly used to assess physical function and endurance. The purpose of this observational study was to test a newly developed biomechanical system, Ephion Mobility system, and establish whether these biomechanical measures can improve the objectivity and interpretability of the 6MWT as an outcome measure. Fifty-eight participants took part in this study: 20 participants with myotonic muscular dystrophy (DM1), 18 with Becker muscular dystrophy (BMD) and 20 healthy controls for comparison. Every DM1 participant was classified using Muscular Impairment Rating Scale, and every BMD participant was classified using the Vignos scale. Each participant performed the 6MWT while wearing the Ephion Mobility system sensors, which recorded walking distance, surface electromyography (sEMG), heart rate (HR), ground reaction force (GRF), trunk vertical acceleration and joint kinematics. Both patient groups exhibited significantly shorter walking distance, lower cadence and shorter step length. Lower HR was found in both patient groups; this increased as disease severity increased. Limited range of motion was observed during the entire walk test in both patient groups. The DM1 group showed gait alterations during toe-off with reduction in hip and knee extension and a delayed and reduced plantar flexion. As disease severity increased, visual interpretation of sEMG in the DM1 group exhibited lower amplitude in the proximal muscles. The BMD group exhibited gait alterations during contact, stance and toe-off phases. Flat foot landing was observed in the BMD group along with reduced hip flexion and ankle dorsiflexion. During stance, they were unable to extend the hip and flex the knee and muscle activity increased, and reduced plantarflexion was observed during toe-off. The GRF was lower during heel strike and higher during mid-stance, and trunk vertical acceleration was close to zero during the contact phase in both patient groups. A visual interpretation of the gait patterns showed differences among disease severity levels. Our findings show that the Ephion Mobility system can determine biomechanics during walking and is coupled with distinct patterns of walking in BMD and DM1. Ephion Mobility system is useful in obtaining observational differences among disease severities and may be responsive to progression or treatment-induced improvement. The system adds value to improving interpretability of the 6MWT and additionally be used in assessing other functional capabilities, such as sit-to-stand and stair climbing.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf205"},"PeriodicalIF":4.1,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic and genotypic characterization of familial adult myoclonus epilepsy in a Chinese case series.","authors":"Sheng Zeng, Yao Zhou, Yuwen Zhao, Mingqiang Li, Chaojun Zhou, Xuejing Wang, Hui Quan, Tiandong Che, Jinchen Li, Qiying Sun, Beisha Tang","doi":"10.1093/braincomms/fcaf214","DOIUrl":"10.1093/braincomms/fcaf214","url":null,"abstract":"<p><p>Familial adult myoclonus epilepsy is a type of repeat expansion disorders caused by insertion of the causative pentanucleotide TTTCA repeat into an intronic polymorphic TTTTA repeat in different genes. We aimed to characterize the clinical features and elucidate the exact genetic basis of TTTTA/TTTCA repeat expansion in familial adult myoclonus epilepsy from mainland China. Eighty-five individuals including 36 patients and 49 normal phenotype relatives from seven pedigrees with familial adult myoclonus epilepsy, were recruited in a case series from mainland China. Repeat-primed PCR was used for initial screening. Long-range PCR-based enrichment, followed by targeted deep HiFi long-read sequencing, was performed to precisely clarify the detailed information of causative pentanucleotide TTTTA/TTTCA repeat expansion. The results indicated there exists obvious clinical heterogeneity both within and between families in our patient group. All patients were genetically diagnosed with familial adult myoclonus epilepsy type 1. The number of pentanucleotide repeats was extremely unstable, with median TTTCA repeat sizes ranging from 10 to 647 in the affected members of our case series under a mean sequence depth of coverage above 50 000. The [(TTTTA)exp (TTTCA)exp] motif was the only configuration of expanded <i>SAMD12</i> repeats in our case series. An inverse correlation was found between the age of onset and the number of TTTCA repeats and the total number of TTTTA/TTTCA repeats. Clinical anticipation was observed for tremor and seizure symptoms. However, we did not demonstrate a link between parent-offspring differences in repeat sizes and their changes in age of onset. In summary, we determined the nature of the expanded repeats and a reliable phenotype-genotypic correlation in our case series of familial adult myoclonus epilepsy through targeted deep HiFi long-read sequencing technologies.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf214"},"PeriodicalIF":4.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of disproportionately enlarged subarachnoid-space hydrocephalus in progressive supranuclear palsy.","authors":"Mu-Hui Fu, Jeffrey L Gunter, Ryota Satoh, Rodolfo G Gatto, Farwa Ali, Heather M Clark, Julie A Stierwalt, Mary M Machulda, Yehkyoung C Stephens, Hossam Youssef, Nha Trang Thu Pham, Clifford R Jack, Val J Lowe, Keith A Josephs, Jennifer L Whitwell","doi":"10.1093/braincomms/fcaf206","DOIUrl":"10.1093/braincomms/fcaf206","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Normal pressure hydrocephalus is typically defined by the triad of gait disturbance, cognitive impairment, and urinary incontinence, and is characterized on MRI by disproportionately enlarged subarachnoid-space. Gait disturbance is also a commonly reported symptom in Parkinsonian disorders, especially progressive supranuclear palsy, although the frequency, clinical significance and mechanisms of hydrocephalus in these disorders are unclear. We aimed to assess the prevalence of hydrocephalic MRI parameters in a large cohort of Parkinsonian disorders and evaluate associations with clinical features and abnormalities on MRI and PET. Two hundred and thirty-eight participants with a Parkinsonian disorder, including 181 progressive supranuclear palsy, 36 corticobasal syndrome and 21 Parkinson's disease, were enrolled from Mayo Clinic by the Neurodegenerative Research Group between September 2009 to October 2023. Automated detection of disproportionately enlarged subarachnoid-space hydrocephalus (D) was applied and using Evans' index (E) cut-off point &gt;0.3, participants were classified based on both measures as imaging-suggestive of hydrocephalus (D+E+), enlarged subarachnoid-space only (D+E-), large Evans' index only (D-E+) and no imaging evidence of hydrocephalus (D-E-). Demographic, clinical and imaging features, including magnetic resonance parkinsonism index, cortical and subcortical volumes, white matter hyperintensities, diffusion tractography metrics, and metabolism on PET, were compared across groups. Among the 238 participants, 24 had borderline subarachnoid space scores and were excluded. The remaining 214 participants were classified as: D+E+ (&lt;i&gt;n&lt;/i&gt; = 20, 9%); D+E- (&lt;i&gt;n&lt;/i&gt; = 8, 4%); D-E+ (&lt;i&gt;n&lt;/i&gt; = 71, 33%) and D-E- (&lt;i&gt;n&lt;/i&gt; = 115, 54%). Among the progressive supranuclear palsy participants, 11% were D+E+, 4% D+E-, 34% D-E+ and 51% D-E-. Most cases (&lt;i&gt;n&lt;/i&gt; = 18) in the imaging-suggestive of hydrocephalus D+E+ group had progressive supranuclear palsy. The D+E+ participants were older, had more disorientation, more downgaze palsy, greater midbrain and cortical atrophy, lower striatal metabolism, greater degeneration of long-range white matter tracts, larger cistern areas and more periventricular and deep white matter hyperintensities compared to the D-E- participants without imaging evidence of hydrocephalus. The D+E- participants had the highest metabolism in the paracentral lobule and superior parietal gyrus. The D-E+ participants showed worse disease severity and greater midbrain and cortical atrophy compared to the D-E- participants. These findings demonstrate that disproportionately enlarged subarachnoid-space hydrocephalus occurs in ∼15% of progressive supranuclear palsy participants, and is associated with worse clinical and imaging outcomes, as well as white matter hyperintensities. We hypothesize that disproportionately enlarged subarachnoid-space may be a mechanistic byproduct of degeneration and subsequent cerebrospin","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf206"},"PeriodicalIF":4.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain MRI signatures across sex and CSF Alzheimer's disease biomarkers.","authors":"You Cheng, Yingnan He, Karthik Gopinath, Benjamin Billot, Juan Eugenio Iglesias, Chao-Yi Wu, Hiroko Dodge, Anne-Marie Wills, Becky Carlyle, Pia Kivisäkk, Bradley T Hyman, Steven E Arnold, Sudeshna Das","doi":"10.1093/braincomms/fcaf210","DOIUrl":"10.1093/braincomms/fcaf210","url":null,"abstract":"<p><p>The relationship between cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease and neurodegenerative effects is not fully understood. This study investigates neurodegeneration patterns across CSF Alzheimer's disease biomarker groups, the association of brain volumes with CSF amyloid and tau status and sex differences in these relationships in a clinical neurology sample. MRI and CSF Alzheimer's disease biomarkers data were analysed in 306 patients of the Mass General Brigham healthcare system aged 50+ (mean age = 68.4 ± 8.8 years; 43.1% female), who had lumbar punctures within 1 year of clinical MRI scans. We first analysed neurodegeneration patterns across four biomarker groups: 60 controls (A-T-&CU; amyloid negative, tau negative, cognitively unimpaired), 25 A+T- (amyloid positive, tau negative), 121 A+T+ (amyloid positive, tau positive) and 100 other dementia (A-T-&CI; amyloid negative, tau negative, cognitively impaired). Second, we examined volumetric associations with amyloid (amyloid positive, tau negative versus control) and tau in the presence of amyloid (amyloid positive, tau positive versus amyloid positive, tau negative) across 52 brain areas. Third, we examined sex differences in these relationships. Finally, we validated core analyses across three independent datasets-NACC (National Alzheimer's Coordinating Center), ADNI (Alzheimer's Disease Neuroimaging Initiative) and EPAD (European Prevention of Alzheimer's Dementia)-totalling 3137 participants, and performed meta-analyses to obtain more robust estimates. We observed distinct neurodegeneration patterns across biomarker groups, with disrupted connectivity (brain volume covariance networks) in amyloid positive and other dementia groups, while amyloid and tau negative, cognitively unimpaired controls exhibited the most connected network. Amyloid was associated with subcortical, cerebellar and brainstem atrophy, with consistent association observations in the thalamus and amygdala across all four datasets. Tau in the presence of amyloid demonstrated general brain shrinkage through enlargement of extracerebral CSF, alongside unexpected ventricle shrinkages. Sex-based analyses revealed that A+T+ (amyloid positive, tau positive) had lower sex differences in connectivity patterns compared with other groups. Sex differences were also noted in amyloid-related ventricular volume changes. This study reveals how amyloid and tau affect brain connectivity and volume across sex and CSF biomarker groups, emphasizing global brain changes and sex differences. By leveraging automated pipelines and advanced MRI and biomarker analyses, we extracted meaningful and replicable findings from heterogeneous clinical samples from real-world data. The meta-analyses across four datasets enhance the generalizability of our results.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf210"},"PeriodicalIF":4.1,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paramagnetic rim lesions are highly specific for multiple sclerosis in real-world data.","authors":"Christopher C Hemond, Sathish K Dundamadappa, Mugdha Deshpande, Jonggyu Baek, Robert H Brown, Carolina Ionete, Daniel S Reich","doi":"10.1093/braincomms/fcaf211","DOIUrl":"10.1093/braincomms/fcaf211","url":null,"abstract":"<p><p>Paramagnetic rim lesions (PRLs) are an emerging biomarker for multiple sclerosis representing chronic, low-grade intraparenchymal brain inflammation. In addition to associating with greater disease severity, PRLs may be diagnostically supportive. Our aim in this study was to determine PRL specificity and sensitivity for discriminating multiple sclerosis from its diagnostic mimics using real-world clinical diagnostic and imaging data. This is a retrospective, cross-sectional analysis of a longitudinal cohort of patients with prospectively collected observational data. Patients were included if they underwent clinical evaluation in our academic neuroimmunology centre and had an available MRI scan from the same clinical 3-T magnet that included a T2*-weighted sequence with susceptibility post-processing (Susceptibility Weighted ANgiography protocol, General Electric). Susceptibility imaging-derived filtered phase maps and corresponding T2-fluid attenuated inversion recovery images were manually reviewed to determine PRLs. PRLs were categorized as 'definite', 'probable' or 'possible' based on modified, recent consensus criteria. We hypothesized that PRLs would convey a high specificity to discriminate multiple sclerosis from its MRI mimics. Five hundred seventy-four patients were evaluated in total: 473 with multiple sclerosis, 53 with non-inflammatory neurological disease and 48 with other inflammatory neurological disease. Identification of 'definite' or 'probable' PRL provided a specificity of 98% to discriminate multiple sclerosis from non-inflammatory neurological disease and other inflammatory neurological disease; sensitivity was 36%. Interrater agreement was almost perfect for definite/probable identification at a subject level. PRLs convey high specificity for multiple sclerosis and can aid in the diagnostic evaluation. Modest sensitivity limits their use as single diagnostic indicators. Including lesions with lower confidence ('possible') rapidly erodes specificity and should be interpreted with caution given the potential harms associated with misdiagnosis.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf211"},"PeriodicalIF":4.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating brain dysfunction in neuropathic pain with MRI.","authors":"Roland Peyron, Siloé Corvin, Camille Fauchon, Isabelle Faillenot","doi":"10.1093/braincomms/fcaf196","DOIUrl":"10.1093/braincomms/fcaf196","url":null,"abstract":"<p><p>Neuropathic pain is a severe chronic disease following nervous system lesions. Allodynia is a main symptom of neuropathic pain, and it can be easily triggered by normally innocuous stimuli inside a functional MRI magnet. In this new series of 35 patients (age ranges: 33-82 years old, 14 females, 21 males, peripheral neuropathic pain: 4, central neuropathic pain: 31), we investigated mechanical dynamic and thermal cold allodynia. Patients were enrolled for the study if allodynia was intense on one part of the body and very slight-or absent-on another part of the body. Allodynia was associated mainly with bilateral increases of activity in anterior insular cortices, anterior mid-cingulate cortex, prefrontal cortex and secondary somatosensory cortices. Most of these activities were correlated with the subjective perception of allodynia, and thus, they dealt with abnormal pain perception. Since these patients also had sensory loss in or around the areas of allodynia, we examined the hypothesis of structural abnormalities in brain structures receiving sensory inputs. Secondary somatosensory cortex ipsilateral to pain showed grey matter loss, and there was a correlation between sensory loss and grey matter density in the lateral thalamus contralateral to pain. The allodynic brain activations were found to be influenced by individual variables describing the patients: the inclination of the patients to experience provoked pain-as defined by quantitative sensory testing/laser-evoked potentials-exacerbated secondary somatosensory cortices activations during allodynia, with the possible consequence that excito-toxicity or similar mechanisms could (secondarily) lead to structural abnormalities. Conversely, we found a negative weighting of ongoing pain level on the allodynic responses in contralateral anterior insula, frontal operculum and parts of secondary somatosensory cortices, suggesting that these regions previously engaged in spontaneous pain had limited possibilities to further increase their response in case of allodynia. In this new series of patients, we confirmed that brain areas that are normally not involved during innocuous stimulations became overactive in case of mechanical allodynia. These results suggest that the above-reported areas could be new targets for neuromodulation techniques with the aim to induce pain relief.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf196"},"PeriodicalIF":4.1,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal neuromelanin changes in prodromal and early Parkinson's disease in humans and rat model.","authors":"Jean-Baptiste Pérot, Anthony Ruze, Rahul Gaurav, Sana Rebbah, Capucine Cadin, Arnaud Le Troter, Lucas Soustelle, Laura Mouton, Romain Valabrègue, Annabelle Parent, Graziella Mangone, François-Xavier Lejeune, Isabelle Arnulf, Jean-Christophe Corvol, Marie Vidailhet, Mathieu D Santin, Miquel Vila, Stéphane Lehéricy","doi":"10.1093/braincomms/fcaf204","DOIUrl":"10.1093/braincomms/fcaf204","url":null,"abstract":"<p><p>Neuromelanin-sensitive MRI has been proposed as a biomarker of Parkinson's disease pathology. However, the biological and physical origins of this contrast are debated. A recent rodent model of controlled neuromelanin accumulation in the substantia nigra has been developed and recapitulates several features of Parkinson's disease. In this work, we first combined neuromelanin-sensitive-MRI and histology to study neuromelanin accumulation and neurodegeneration in a humanized rat model of Parkinson's disease. Neuromelanin-sensitive-MRI signal changes were biphasic with an initial increase due to the accumulation of neuromelanin in dopaminergic neurons, followed signal decrease due to neurodegeneration. In healthy subjects and patients with isolated rapid eye movement sleep behaviour disorder, neuromelanin-sensitive-MRI signal increased initially and then decreased similarly as in rodents after reaching a similar maximum signal intensity in both groups. In early Parkinson's disease and converted isolated rapid eye movement sleep behaviour disorder patients, neuromelanin-sensitive-MRI signal drop was greater than in healthy individuals. Results in animals and humans show that neuromelanin-sensitive-MRI is a marker of the intracellular neuromelanin accumulation and then of neuronal degeneration and originates mainly from T₁ reduction effect of neuromelanin.</p>","PeriodicalId":93915,"journal":{"name":"Brain communications","volume":"7 3","pages":"fcaf204"},"PeriodicalIF":4.1,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}