development-an-individualized-ct-based-radiomics-nomogram-for

Development of an Individualized CT-based Radiomics Nomogram for Preoperative Differentiation Between Gastric Stromal Tumors and Gastric Leiomyomas

This protocol describes the development and validation of a computed tomography (CT)-based radiomics nomogram for the noninvasive preoperative ...

Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine

 Spinal manipulative therapy (SMT) helps to reduce chronic low back pain (cLBP). However, the underlying mechanism of pain relief and the neurological response to SMT remains unclear. We utilized brain functional magnetic resonance imaging (fMRI) upon the application of a real-time spot pressure mechanical stimulus to assess the effects of SMT on patients with cLBP.  Patients with cLBP (Group 1,  = 14) and age-matched healthy controls without cLBP (Group 2,  = 20) were prospectively enrolled. Brain fMRI was performed for Group 1 at three time points: before SMT (TP1), after the first SMT session (TP2), and after the sixth SMT session (TP3). The healthy controls (Group 2) did not receive SMT and underwent only one fMRI scan. During fMRI scanning, a real-time spot pressure mechanical stimulus was applied to the low back area of all participants. Participants in Group 1 completed clinical questionnaires assessing pain and quality of life using a visual analog scale (VAS) and the Chinese Short Form Oswestry Disability Index (C-SFODI), respectively.  Before SMT (TP1), there were no significant differences in brain activity between Group 1 and Group 2. After the first SMT session (TP2), Group 1 showed significantly greater brain activity in the right parahippocampal gyrus, right dorsolateral prefrontal cortex, and left precuneus compared to Group 2 ( < 0.05). After the sixth SMT session (TP3), Group 1 showed significantly greater brain activity in the posterior cingulate gyrus and right inferior frontal gyrus compared to Group 2 ( < 0.05). After both the first and sixth SMT sessions (TP2 and TP3), Group 1 had significantly lower VAS pain scores and C-SFODI scores than at TP1 ( < 0.001).  We observed alterations in brain activity in regions of the default mode network in patients with cLBP after SMT. These findings suggest the potential utility of the default mode network as a neuroimaging biomarker for pain management in patients with cLBP.  Chinese Clinical Trial Registry, identifier ChiCTR1800015620.

Spinal Manipulative Therapy Alters Brain Activity in Patients With Chronic Low Back Pain: A Longitudinal Brain fMRI Study.

To investigate the effect of electroacupuncture (EA) on cognitive dysfunction in rats with hepatic encephalopathy and its underlying mechanism.

Electroacupuncture Synergistically Inhibits Proinflammatory Cytokine Production and Improves Cognitive Function in Rats with Cognitive Impairment due to Hepatic Encephalopathy through p38MAPK/STAT3 and TLR4/NF-B Signaling Pathways.

We explored the dynamic alterations of intrinsic brain activity and effective connectivity after acupuncture treatment to investigate the underlying neurological mechanism of acupuncture treatment in patients with migraine without aura (MwoA). The Functional Magnetic Resonance Imaging (fMRI) scans were separately obtained at baseline, after the first and 12th acupuncture sessions in 40 patients with MwoA. Compared with the healthy controls (HCs), patients with MwoA mostly showed a decreased dynamic amplitude of low-frequency fluctuation (dALFF) variability in the rostral ventromedial medulla (RVM), superior lobe of left cerebellum (Cerebellum_Crus1_L), right precuneus (PCUN.R), and so on. The decreased dALFF variability of RVM, Cerebellum_Crus1_L, and PCUN.R progressively recovered after the first and 12th acupuncture treatment sessions as compared to the baseline. There was gradually increased dynamic effective connectivity (DEC) variability in RVM outflow to the right middle frontal gyrus, left insula, right precentral gyrus, and right supramarginal gyrus, and gradually enhanced DEC variability from the right fusiform gyrus inflow to RVM. Furthermore, the gradually increased DEC variability was found from Cerebellum_Crus1_L outflow to the left middle occipital gyrus and the left precentral gyrus, from PCUN.R outflow to the right thalamus. These dALFF variabilities were positively correlated with the frequency of migraine attacks and negatively correlated with disease duration at baseline. The dynamic Granger causality analysis (GCA) coefficients of this DEC variability were positively correlated with Migraine-Specific Quality of Life Questionnaire scores and negatively correlated with the frequency of migraine attacks and visual analog scale (VAS) scores after 12th acupuncture sessions. Our results were analyzed by a longitudinal fMRI in the absence of a sham acupuncture control group and provided insight into the dynamic alterations of brain activity and effective connectivity in patients with MwoA after acupuncture intervention. Acupuncture might relieve MwoA by increasing the effective connectivity of RVM, Cerebellum_Crus1_L, and PCUN.R to make up for the decreased dALFF variability in these brain areas.

The cumulative therapeutic effect of acupuncture in patients with migraine without aura: Evidence from dynamic alterations of intrinsic brain activity and effective connectivity.

The aim of this study was to explore simultaneous brain network responses to electroacupuncture stimulation (EAS) at scalp acupoints by accounting for placebo effects.

A true response of the brain network during electroacupuncture stimulation at scalp acupoints: An fMRI with simultaneous EAS study.

To explore the central processing mechanism of pain perception in chronic low back pain (cLBP) using multi-voxel pattern analysis (MVPA) based on the static and dynamic fractional amplitude of low-frequency fluctuations (fALFF) analysis, and spectral dynamic causal modeling (spDCM). Thirty-two patients with cLBP and 29 matched healthy controls (HCs) for the first cohort and 24 patients with cLBP and 22 HCs for the validation cohort underwent resting-state fMRI scan. The alterations in static and dynamic fALFF were as classification features to distinguish patients with cLBP from HCs. The brain regions gotten from the MVPA results were used for further spDCM analysis. We found that the most discriminative brain regions that contributed to the classification were the right supplementary motor area (SMA.R), left paracentral lobule (PCL.L), and bilateral cerebellar Crus II. The spDCM results displayed decreased excitatory influence from the bilateral cerebellar Crus II to PCL.L in patients with cLBP compared with HCs. Moreover, the conversion of effective connectivity from the bilateral cerebellar Crus II to SMA.R from excitatory influence to inhibitive influence, and the effective connectivity strength exhibited partially mediated effects on Chinese Short Form Oswestry Disability Index Questionnaire (C-SFODI) scores. Our findings suggest that the cerebellum and its weakened or inhibited connections to the motor cortex may be one of the underlying feedback pathways for pain perception in cLBP, and partially mediate the degree of dysfunction.

Altered effective connectivity from cerebellum to motor cortex in chronic low back pain: A multivariate pattern analysis and spectral dynamic causal modeling study.

Alterations in the static and dynamic characteristics of spontaneous brain activity have been extensively studied to investigate functional brain changes in migraine without aura (MwoA). However, alterations in concordance among the dynamics of spontaneous brain activity in MwoA remain largely unknown. This study aimed to determine the possibilities of diagnosis based on the concordance indices.

Aberrant concordance among dynamics of spontaneous brain activity in patients with migraine without aura: A multivariate pattern analysis study.

: This study is aimed at assessing glymphatic function by diffusion tensor image analysis along the perivascular space (DTI-ALPS) and its associations with cortical morphological changes and severity of accommodative asthenopia (AA). : We prospectively enrolled 50 patients with AA and 47 healthy controls (HCs). All participants underwent diffusion tensor imaging (DTI) and T1-weighted imaging and completed the asthenopia survey scale (ASS). Differences in brain morphometry and the analysis along the perivascular space (ALPS) index between the two groups were compared. The correlation and mediation analyses were conducted to explore the relationships between them. : Compared to HCs, patients with AA exhibited significantly increased sulcal depth in the left superior occipital gyrus (SOG.L) and increased cortical thickness in the left superior temporal gyrus (STG.L), left middle occipital gyrus (MOG.L), left postcentral gyrus (PoCG.L), and left precuneus (PCUN.L). Additionally, patients with AA had a significantly lower ALPS index than HCs. The sulcal depth of the SOG.L was significantly positively correlated with the ASS score in patients with AA, and a positive correlation was found between the cortical thickness of the MOG.L and ASS score. The ALPS index was negatively associated with the sulcal depth of the SOG.L and cortical thickness of the MOG.L. Mediation analysis revealed that the sulcal depth of SOG.L and cortical thickness of MOG.L partially mediated the impact of the DTI-ALPS index on the ASS score. : Our findings suggested that patients with AA exhibit impaired glymphatic function, which may contribute to the severity of asthenopia through its influence on cortical morphological changes. The ALPS index is anticipated to become a potential imaging biomarker for patients with AA.  Chinese Registry of Clinical Trials: ChiCTR1900028306.

Cortical Morphology Alterations Mediate the Relationship Between Glymphatic System Function and the Severity of Asthenopia.

Electroacupuncture at Zusanli (ST36) exerted an effect on brain function by regulating spontaneous brain activity. This study aims to investigate the influence of different post-processing methods of amplitude of low-frequency fluctuation (ALFF) and different frequency band to measure brain low-frequency oscillations (LFOs) after electroacupuncture at ST36.

The influence of post-processing methods and frequency bands on rs-fMRI: An example of electroacupuncture at Zusanli (ST36).

Cerebral small vessel disease (CSVD) is a major contributor to vascular cognitive impairment, with respective changes in neurovascular coupling (NVC) and glymphatic function, but the association between them has not been illustrated. This study aimed to investigate the relationship between NVC and glymphatic function in patients with CSVD coexisting cognitive impairment.

Article	Year
Spinal Manipulative Therapy Alters Brain Activity in Patients With Chronic Low Back Pain: A Longitudinal Brain fMRI Study. Frontiers in integrative neuroscience\| PubMed ID: 33328915	2020
Electroacupuncture Synergistically Inhibits Proinflammatory Cytokine Production and Improves Cognitive Function in Rats with Cognitive Impairment due to Hepatic Encephalopathy through p38MAP... Evidence-based complementary and alternative medicine : eCAM\| PubMed ID: 34630618	2021
The cumulative therapeutic effect of acupuncture in patients with migraine without aura: Evidence from dynamic alterations of intrinsic brain activity and effective connectivity. Frontiers in neuroscience\| PubMed ID: 35928016	2022
A true response of the brain network during electroacupuncture stimulation at scalp acupoints: An fMRI with simultaneous EAS study. Brain and behavior\| PubMed ID: 36427258	2023
Altered effective connectivity from cerebellum to motor cortex in chronic low back pain: A multivariate pattern analysis and spectral dynamic causal modeling study. Brain research bulletin\| PubMed ID: 37871687	2023
Aberrant concordance among dynamics of spontaneous brain activity in patients with migraine without aura: A multivariate pattern analysis study. Heliyon\| PubMed ID: 38737279	2024
Cortical Morphology Alterations Mediate the Relationship Between Glymphatic System Function and the Severity of Asthenopia. International journal of biomedical imaging\| PubMed ID: 40041480	2025
The influence of post-processing methods and frequency bands on rs-fMRI: An example of electroacupuncture at Zusanli (ST36). Neuroimage. Reports\| PubMed ID: 40567885	2025
Glymphatic-mediated Pathway Pinking Neurovascular Dysfunction to Cognitive-sleep Impairment in Cerebral Small Vessel Disease. Academic radiology\| PubMed ID: 40780986	2025

Yingjie Kang

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