scholarly journals Cortical Atrophy, White Matter Lesions, and Bulb Configuration in Patients with Idiopathic Olfactory Loss and Other Causes of Olfactory Loss

ORL ◽  
2021 ◽  
pp. 1-9
Author(s):  
Alexander Wieck Fjaeldstad ◽  
Therese Ovesen ◽  
Rikke Beese Dalby
Keyword(s):  
White Matter ◽  
Medial Temporal Lobe ◽  
Structural Changes ◽  
Structural Integrity ◽  
White Matter Lesions ◽  
Structural Mri ◽  
Cortical Atrophy ◽  
Mri Findings ◽  
Olfactory Loss ◽  
Post Traumatic

<b><i>Introduction:</i></b> While magnetic resonance imaging (MRI) is not included in the current guidelines for diagnosing olfactory disorders in the most recent position paper on olfactory dysfunction, both 1.5T and 3T MRI are commonly used in the diagnostic workup of many patients with olfactory loss. Often, MRI is used to rule out intracranial tumours, but other useful information may be obtained from MRI scans in these patients. The potential of MRI in olfactory loss depends on sufficient knowledge of structural changes in different aetiologies of olfactory loss. We present common clinical MRI findings in olfactory loss and evaluate the usefulness of structural integrity scores in differentiating between aetiologies. <b><i>Methods:</i></b> In this study, we investigated if white matter hyperintensities (WMHs, measured by Fazekas score), global cortical atrophy (GCA), and medial temporal lobe atrophy (MTA) are more common in patients with idiopathic olfactory loss than in patients with acquired olfactory loss due to other aetiologies. Furthermore, we compared olfactory bulb (OB) configurations in different olfactory loss aetiologies. <b><i>Results:</i></b> In 88 patients with olfactory loss, WMHs, GCA, and MTA were not more significant findings on MRI in idiopathic olfactory loss (<i>n</i> = 51) compared with other causes of acquired olfactory loss (Fazekas score <i>p</i> = 0.2977; GCA score <i>p</i> = 0.6748; MTA score <i>p</i> = 0.7851). Bulb configurations differed in patients suffering from post-traumatic olfactory loss and may aid in identifying the underlying aetiology in patients where trauma is among the suspected causes of olfactory loss. <b><i>Conclusion:</i></b> We recommend that structural MRI with an OB sequence is included in the diagnostic evaluation of olfactory loss with suspected congenital and post-traumatic aetiology and should be considered in idiopathic olfactory loss with suspected central aetiology (e.g., tumour).

scholarly journals Characteristics of Cortical Atrophy and White Matter Lesions Between Dementia With Lewy Bodies and Alzheimer's Disease: A Case-Control Study

2022 ◽  
Vol 12 ◽  
Author(s):  
Han Zhu ◽  
Hao Lu ◽  
Fei Wang ◽  
Shuai Liu ◽  
Zhihong Shi ◽  
...  
Keyword(s):  
White Matter ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Dementia With Lewy Bodies ◽  
Rating Scales ◽  
Lewy Bodies ◽  
White Matter Lesions ◽  
Cortical Atrophy ◽  
Visual Rating ◽  
Normal Controls

Introduction: Currently, there is still clinical overlap between dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) patients, which may affect the accuracy of the early diagnosis of DLB. For better diagnosis and prognosis, further exploration of local cortical atrophy patterns and white matter lesions is needed.Methods: We reviewed the outpatient medical records of 97 DLB patients and 173 AD patients from January 2018 to September 2020 along with 30 matched outpatient clinic normal elderly people. MRI visual rating scales, including medial temporal lobe atrophy (MTA), global cortical atrophy-frontal subscale (GCA-F), posterior atrophy (PA), Fazekas scale, Evans Index and cerebral microbleeds were evaluated and analyzed in DLB and AD patients with different severities and normal controls.Results: Overall, patients with DLB had higher scores on all visual rating scales than the normal controls. Meanwhile, compared with AD, DLB had lower MTA scores in the mild to moderate groups (both p ≤ 0.001), but the GCA-F and PA scores were similar (all p &gt; 0.05). The Fazekas scores in the moderate to severe DLB group were lower than those in the AD group (p = 0.024 and p = 0.027, respectively). In addition, the diagnostic performance and sensitivity of multiple imaging indicators for DLB were better than that of MTA alone (the combination of MTA, GCA-F, PA, Fazekas visual rating scales, AUC = 0.756, 95%CI: 0.700–0.813, sensitivity = 0.647, specificity = 0.804 and MTA visual rating scale, AUC = 0.726, 95%CI: 0.667–0.785, sensitivity = 0.497, specificity = 0.876, respectively).Conclusion: The medial temporal lobe of DLB patients was relatively preserved, the frontal and parietal lobes were similarly atrophied to AD patients, and the white matter hyperintensity was lighter than that in AD patients. Combined multiple visual rating scales may provide a novel idea for the diagnosis of early DLB.

scholarly journals A novel CT-based automated analysis method provides comparable results with MRI in measuring brain atrophy and white matter lesions

2021 ◽  
Author(s):  
Aku L Kaipainen ◽  
Johanna Pitkänen ◽  
Fanni Haapalinna ◽  
Olli Jääskeläinen ◽  
Hanna Jokinen ◽  
...  
Keyword(s):  
White Matter ◽  
Ct Scan ◽  
Medial Temporal Lobe ◽  
White Matter Lesions ◽  
Automated Analysis ◽  
University Hospital ◽  
Cortical Atrophy ◽  
Analysis Method ◽  
Automated Method ◽  
Ct And Mri

Abstract Purpose Automated analysis of neuroimaging data is commonly based on magnetic resonance imaging (MRI), but sometimes the availability is limited or a patient might have contradictions to MRI. Therefore, automated analyses of computed tomography (CT) images would be beneficial. Methods We developed an automated method to evaluate medial temporal lobe atrophy (MTA), global cortical atrophy (GCA), and the severity of white matter lesions (WMLs) from a CT scan and compared the results to those obtained from MRI in a cohort of 214 subjects gathered from Kuopio and Helsinki University Hospital registers from 2005 - 2016. Results The correlation coefficients of computational measures between CT and MRI were 0.9 (MTA), 0.82 (GCA), and 0.86 (Fazekas). CT-based measures were identical to MRI-based measures in 60% (MTA), 62% (GCA) and 60% (Fazekas) of cases when the measures were rounded to the nearest full grade variable. However, the difference in measures was 1 or less in 97–98% of cases. Similar results were obtained for cortical atrophy ratings, especially in the frontal and temporal lobes, when assessing the brain lobes separately. Bland–Altman plots and weighted kappa values demonstrated high agreement regarding measures based on CT and MRI. Conclusions MTA, GCA, and Fazekas grades can also be assessed reliably from a CT scan with our method. Even though the measures obtained with the different imaging modalities were not identical in a relatively extensive cohort, the differences were minor. This expands the possibility of using this automated analysis method when MRI is inaccessible or contraindicated.

Individual differences in white and grey matter structure associated with verbal habits of thought

2019 ◽  
Author(s):  
Justin C. Hayes ◽  
Katherine L Alfred ◽  
Rachel Pizzie ◽  
Joshua S. Cetron ◽  
David J. M. Kraemer
Keyword(s):  
Individual Differences ◽  
White Matter ◽  
Cognitive Processing ◽  
Grey Matter ◽  
Structural Changes ◽  
Structural Integrity ◽  
Diffusion Tensor ◽  
Self Report ◽  
White Matter Tracts

Modality specific encoding habits account for a significant portion of individual differences reflected in functional activation during cognitive processing. Yet, little is known about how these habits of thought influence long-term structural changes in the brain. Traditionally, habits of thought have been assessed using self-report questionnaires such as the visualizer-verbalizer questionnaire. Here, rather than relying on subjective reports, we measured habits of thought using a novel behavioral task assessing attentional biases toward picture and word stimuli. Hypothesizing that verbal habits of thought are reflected in the structural integrity of white matter tracts and cortical regions of interest, we used diffusion tensor imaging and volumetric analyses to assess this prediction. Using a whole-brain approach, we show that word bias is associated with increased volume in several bilateral language regions, in both white and grey matter parcels. Additionally, connectivity within white matter tracts within an a priori speech production network increased as a function of word bias. These results demonstrate long-term structural and morphological differences associated with verbal habits of thought.

Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe

Neurology ◽  
2005 ◽  
Vol 64 (2) ◽  
pp. 263-267 ◽  
Author(s):  
T. den Heijer ◽  
L. J. Launer ◽  
N. D. Prins ◽  
E. J. van Dijk ◽  
S. E. Vermeer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
White Matter Lesions

Neurosyphilis: mighty imitator forays with benign presentation and unique neuroimaging findings

Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 358 ◽  
Author(s):  
Harmanpreet Tiwana ◽  
Aiesha Ahmed
Keyword(s):  
White Matter ◽  
Temporal Lobe ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Treponema Pallidum ◽  
White Matter Lesions ◽  
Vascular Pathology ◽  
Cortical Atrophy ◽  
Neck Stiffness ◽  
Fluid Attenuated Inversion Recovery

Background Common causes of temporal lobe hyper intensities are central nervous system infections like herpes simplex encephalitis, Lyme disease, limbic encephalitis and vascular pathology like Cerebral Autosomal Dominant Arteriopathy with Subcortical infarcts and Leukoencephalopathy. Methods: Personal assessment, laboratory data analysis and neuroimaging for the patient who was admitted to a central Pennsylvania tertiary care referral centre were conducted. Results: A 52-year-old male presented with a 1-year history of diffuse dysesthesia in upper and lower extremities with associated intermittent headaches and neck stiffness. Evaluation with lumbar puncture revealed increased nucleated cells (50 ul) with lymphocytic predominance (96%) and an elevated protein level of 109 mg/dl. Magnetic resonance imaging (MRI) of the brain showed T2/FLAIR hyper intensity in bilateral subcortical temporal white matter, left-greater-than-right and associated volume loss in cerebral parenchyma. Additional abnormal work up included reactive serum reactive plasma regain and Treponema pallidum antibody particle agglutination. Diagnosis of neurosyphilis was made and the patient was treated with intramuscular (IM) penicillin for 3 weeks. At the time of discharge, his headache and neck stiffness resolved and dysesthesias were decreased in intensity. Conclusions: The diagnosis of neurosyphilis is intricate, and no reference standard exists. Neuroimaging findings of neurosyphilis commonly are cerebral infarctions, leptomeningeal enhancement or non-specific white matter lesions. Less common features on fluid-attenuated inversion recovery (FLAIR) sequences are cortical atrophy and mesial temporal parenchymal signal changes. It is prudent to keep neurosyphilis in differential of mesial temporal lobe white matter changes, as early diagnosis and treatment results in better prognosis.

Cognitive impairment in relation to MRI metrics in patients with clinically isolated syndrome

2010 ◽  
Vol 17 (2) ◽  
pp. 173-180 ◽  
Author(s):  
M Khalil ◽  
C Enzinger ◽  
C Langkammer ◽  
K Petrovic ◽  
M Loitfelder ◽  
...  
Keyword(s):  
Cognitive Dysfunction ◽  
Cognitive Deficits ◽  
Processing Speed ◽  
Structural Changes ◽  
Magnetization Transfer ◽  
Clinically Isolated Syndrome ◽  
Cortical Atrophy ◽  
Mri Findings ◽  
Lesion Load ◽  
In Cis

Background: Cognitive deficits are frequent in multiple sclerosis (MS) and have been associated with morphologic brain changes. Less information exists on their extent and relation to MRI findings in clinically isolated syndrome (CIS). It is also unclear if structural changes as detected by magnetization transfer (MT) imaging may provide an additional explanation for cognitive dysfunction. Objective: To analyse the extent of cognitive deficits and their relation to MRI metrics including MT imaging in CIS compared to relapsing-remitting MS (RRMS). Methods: Forty-four CIS and 80 RRMS patients underwent the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) and a 3 T MRI scan. Results: BRB-N subtests revealed similar results in CIS and RRMS. Impaired mental processing speed was most prevalent in both groups (CIS 13.6%; RRMS 16.3%) and thus served for correlation with MRI metrics. Using stepwise linear regression analyses, the strongest predictor for decreased mental processing speed was normalized cortex volume ( p < 0.001) followed by T2-lesion load ( p < 0.05) in RRMS, whereas cortical MT ratio was the only MRI parameter associated with decreased mental processing speed in CIS ( p < 0.005). Conclusion: Cognitive dysfunction occurs in CIS in a pattern similar to RRMS, with impaired mental processing speed being most prevalent. Cortical MT-ratio changes may be an early sign for tissue changes related to impaired mental processing speed in CIS while this association shifts to increased signs of cortical atrophy and lesion load in RRMS.

scholarly journals Full Recovery From Cocaine-Induced Toxic Leukoencephalopathy: Emphasizing the Role of Neuroinflammation and Brain Edema

2019 ◽  
Vol 7 ◽  
pp. 232470961986826 ◽  
Author(s):  
Edward C. Mader ◽  
Alexander B. Ramos ◽  
Roberto A. Cruz ◽  
Lionel A. Branch
Keyword(s):  
White Matter ◽  
Time Course ◽  
Brain Mri ◽  
White Matter Lesions ◽  
Psychomotor Retardation ◽  
Full Recovery ◽  
White Matter Disease ◽  
Mri Findings ◽  
Prognostic Information ◽  
Toxic Leukoencephalopathy

Toxic leukoencephalopathy (TL) is characterized by white matter disease on magnetic resonance imaging (MRI) and evidence of exposure to a neurotoxic agent. We describe a case of cocaine-induced TL in which extensive white matter disease did not preclude full recovery. A 57-year-old man with substance abuse disorder presented with a 5-day history of strange behavior. On admission, he was alert but had difficulty concentrating, psychomotor retardation, and diffuse hyperreflexia. Brain MRI revealed confluent subcortical white matter hyperintensities with restricted diffusion in some but not in other areas. Electroencephalography (EEG) showed mild diffuse slowing. Blood tests were normal except for mild hyperammonemia. Urine screen was positive for cocaine and benzodiazepine but quantitative analysis was significant only for cocaine. Prednisone 60-mg qd was initiated on day 4, tapered over a 5-day period, and discontinued on day 9. He was discharged after 3 weeks. Cognitive function returned to normal 2 weeks after discharge. Five months later, neurologic exam and EEG were normal and MRI showed near-100% resolution of white matter lesions. TL has been attributed to white matter ischemia/hypoxia resulting in demyelination/axonal injury. The clinical, EEG, and MRI findings and time course of recovery of our patient suggest that cocaine-induced inflammation/edema resulted in TL but not in ischemic/hypoxic injury. While inflammation/edema may have regressed when cocaine was discontinued, we cannot exclude a role for prednisone in protecting the patient from the ischemic/hypoxic sequelae of inflammation/edema. MRI is indispensable for diagnosing TL but EEG may provide additional useful diagnostic and prognostic information.

scholarly journals Relationship Between Type 2 Diabetes and White Matter Hyperintensity: A Systematic Review

2020 ◽  
Vol 11 ◽  
Author(s):  
Dan-Qiong Wang ◽  
Lei Wang ◽  
Miao-Miao Wei ◽  
Xiao-Shuang Xia ◽  
Xiao-Lin Tian ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
White Matter ◽  
Structural Changes ◽  
White Matter Lesions ◽  
Poor Performance ◽  
White Matter Hyperintensity ◽  
Diabetic Microangiopathy ◽  
The Relationship ◽  
The Brain

White matter (WM) disease is recognized as an important cause of cognitive decline and dementia. White matter lesions (WMLs) appear as white matter hyperintensities (WMH) on T2-weighted magnetic resonance imaging (MRI) scans of the brain. Previous studies have shown that type 2 diabetes (T2DM) is associated with WMH. In this review, we reviewed the literature on the relationship between T2DM and WMH in PubMed and Cochrane over the past five years and explored the possible links among the presence of T2DM, the course or complications of diabetes, and WMH. We found that: (1) Both from a macro- and micro-scopic point of view, most studies support the relationship of a larger WMH and a decrease in the integrity of WMH in T2DM; (2) From the relationship between brain structural changes and cognition in T2DM, the poor performance in memory, attention, and executive function tests associated with abnormal brain structure is consistent; (3) Diabetic microangiopathy or peripheral neuropathy may be associated with WMH, suggesting that the brain may be a target organ for T2DM microangiopathy; (4) Laboratory markers such as insulin resistance and fasting insulin levels were significantly associated with WMH. High HbA1c and high glucose variability were associated with WMH but not glycemic control.

Ischemic White Matter Lesions Associated With Medullary Arteries: Classification of MRI Findings Based on the Anatomic Arterial Distributions

2017 ◽  
Vol 209 (3) ◽  
pp. W160-W168 ◽  
Author(s):  
Toshiaki Akashi ◽  
Shoki Takahashi ◽  
Shunji Mugikura ◽  
Shiho Sato ◽  
Takaki Murata ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Lesions ◽  
Mri Findings

Age Dependent White Matter Lesions and Brain Volume Changes in Healthy Volunteers

1994 ◽  
Vol 35 (2) ◽  
pp. 117-122 ◽  
Author(s):  
P. Christiansen ◽  
H. B. W. Larsson ◽  
C. Thomsen ◽  
S. B. Wieslander ◽  
O. Henriksen
Keyword(s):  
White Matter ◽  
Healthy Volunteers ◽  
White Matter Lesions ◽  
Linear Increase ◽  
Cerebral Hemispheres ◽  
Cortical Atrophy ◽  
White Matter Hyperintensity ◽  
Lateral Ventricles ◽  
Males And Females ◽  
Hyperintensity Lesions

The brain of 142 healthy volunteers aged 21 to 80 years were investigated using MR imaging. The number and size of the white matter hyperintensity lesions (WMHL) in the cerebral hemispheres were determined. Furthermore, the volume of the cerebral hemispheres and of the lateral ventricles was measured. An almost linear increase in the number of volunteers with WMHL was seen with aging for males and females. With aging a significant decrease in the volume of the cerebral hemispheres was found for males, and a significant increase in the volume of the lateral ventricles was seen for both males and females. Our results suggest that with aging central atrophy increases more (relatively) than cortical atrophy. No correlation was found between the decreasing volume of the cerebral hemispheres and the increasing number and size of WMHL, nor between the increasing volume of the lateral ventricles and the increasing number and size of WMHL.

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