Uric acid(UA)is a naturally antioxidant that is strongly associated with the development and progression of Parkinson's disease(PD).The purine diet is an important exogenous pathway that modulates blood UA levels....Uric acid(UA)is a naturally antioxidant that is strongly associated with the development and progression of Parkinson's disease(PD).The purine diet is an important exogenous pathway that modulates blood UA levels.Deep brain stimulation(DBS)is an important tool for PD treatment.This study aimed to explore the effects of preoperative purine diet on the prognosis of patients with PD after DBS.Sixty-four patients with PD who underwent DBS were included in this study,and their clinical data,blood UA levels,and daily purine intake.Patients were followed up for improvement 1 year after surgery.We found that patient higher purine intake was strongly associated with the rate of improvement after DBS and was a protective factor for patient prognosis.Daily purine intake from meat and seafood was significantly higher in the responsive patients than in the lessresponsive patients.Mediation analysis showed that UA mediated 78%of the effect of purine intake on motor symptom improvement after DBS.In summary,we observed that purine intake is strongly associated with the rate of improvement in motor symptoms after subthalamic nucleus-DBS in patients with PD.This study provides a reference for preoperative diet planning in patients with PD undergoing DBS.展开更多
Brain tumor classification is crucial for personalized treatment planning.Although deep learning-based Artificial Intelligence(AI)models can automatically analyze tumor images,fine details of small tumor regions may b...Brain tumor classification is crucial for personalized treatment planning.Although deep learning-based Artificial Intelligence(AI)models can automatically analyze tumor images,fine details of small tumor regions may be overlooked during global feature extraction.Therefore,we propose a brain tumor Magnetic Resonance Imaging(MRI)classification model based on a global-local parallel dual-branch structure.The global branch employs ResNet50 with a Multi-Head Self-Attention(MHSA)to capture global contextual information from whole brain images,while the local branch utilizes VGG16 to extract fine-grained features from segmented brain tumor regions.The features from both branches are processed through designed attention-enhanced feature fusion module to filter and integrate important features.Additionally,to address sample imbalance in the dataset,we introduce a category attention block to improve the recognition of minority classes.Experimental results indicate that our method achieved a classification accuracy of 98.04%and a micro-average Area Under the Curve(AUC)of 0.989 in the classification of three types of brain tumors,surpassing several existing pre-trained Convolutional Neural Network(CNN)models.Additionally,feature interpretability analysis validated the effectiveness of the proposed model.This suggests that the method holds significant potential for brain tumor image classification.展开更多
The categorization of brain tumors is a significant issue for healthcare applications.Perfect and timely identification of brain tumors is important for employing an effective treatment of this disease.Brain tumors po...The categorization of brain tumors is a significant issue for healthcare applications.Perfect and timely identification of brain tumors is important for employing an effective treatment of this disease.Brain tumors possess high changes in terms of size,shape,and amount,and hence the classification process acts as a more difficult research problem.This paper suggests a deep learning model using the magnetic resonance imaging technique that overcomes the limitations associated with the existing classification methods.The effectiveness of the suggested method depends on the coyote optimization algorithm,also known as the LOBO algorithm,which optimizes the weights of the deep-convolutional neural network classifier.The accuracy,sensitivity,and specificity indices,which are obtained to be 92.40%,94.15%,and 91.92%,respectively,are used to validate the effectiveness of the suggested method.The result suggests that the suggested strategy is superior for effectively classifying brain tumors.展开更多
Alzheimer's disease is the most common type of cognitive disorder,and there is an urgent need to develop more effective,targeted and safer therapies for patients with this condition.Deep brain stimulation is an in...Alzheimer's disease is the most common type of cognitive disorder,and there is an urgent need to develop more effective,targeted and safer therapies for patients with this condition.Deep brain stimulation is an invasive surgical treatment that modulates abnormal neural activity by implanting electrodes into specific brain areas followed by electrical stimulation.As an emerging therapeutic approach,deep brain stimulation shows significant promise as a potential new therapy for Alzheimer's disease.Here,we review the potential mechanisms and therapeutic effects of deep brain stimulation in the treatment of Alzheimer's disease based on existing clinical and basic research.In clinical studies,the most commonly targeted sites include the fornix,the nucleus basalis of Meynert,and the ventral capsule/ventral striatum.Basic research has found that the most frequently targeted areas include the fornix,nucleus basalis of Meynert,hippocampus,entorhinal cortex,and rostral intralaminar thalamic nucleus.All of these individual targets exhibit therapeutic potential for patients with Alzheimer's disease and associated mechanisms of action have been investigated.Deep brain stimulation may exert therapeutic effects on Alzheimer's disease through various mechanisms,including reducing the deposition of amyloid-β,activation of the cholinergic system,increasing the levels of neurotrophic factors,enhancing synaptic activity and plasticity,promoting neurogenesis,and improving glucose metabolism.Currently,clinical trials investigating deep brain stimulation for Alzheimer's disease remain insufficient.In the future,it is essential to focus on translating preclinical mechanisms into clinical trials.Furthermore,consecutive follow-up studies are needed to evaluate the long-term safety and efficacy of deep brain stimulation for Alzheimer's disease,including cognitive function,neuropsychiatric symptoms,quality of life and changes in Alzheimer's disease biomarkers.Researchers must also prioritize the initiation of multi-center clinical trials of deep brain stimulation with large sample sizes and target earlier therapeutic windows,such as the prodromal and even the preclinical stages of Alzheimer's disease.Adopting these approaches will permit the efficient exploration of more effective and safer deep brain stimulation therapies for patients with Alzheimer's disease.展开更多
Among the existing research on the treatment of disorders of consciousness(DOC),deep brain stimulation(DBS)offers a highly promising therapeutic approach.This comprehensive review documents the historical development ...Among the existing research on the treatment of disorders of consciousness(DOC),deep brain stimulation(DBS)offers a highly promising therapeutic approach.This comprehensive review documents the historical development of DBS and its role in the treatment of DOC,tracing its progression from an experimental therapy to a detailed modulation approach based on the mesocircuit model hypothesis.The mesocircuit model hypothesis suggests that DOC arises from disruptions in a critical network of brain regions,providing a framework for refining DBS targets.We also discuss the multimodal approaches for assessing patients with DOC,encompassing clinical behavioral scales,electrophysiological assessment,and neuroimaging techniques methods.During the evolution of DOC therapy,the segmentation of central nuclei,the recording of single-neurons,and the analysis of local field potentials have emerged as favorable technical factors that enhance the efficacy of DBS treatment.Advances in computational models have also facilitated a deeper exploration of the neural dynamics associated with DOC,linking neuron-level dynamics with macroscopic behavioral changes.Despite showing promising outcomes,challenges remain in patient selection,precise target localization,and the determination of optimal stimulation parameters.Future research should focus on conducting large-scale controlled studies to delve into the pathophysiological mechanisms of DOC.It is imperative to further elucidate the precise modulatory effects of DBS on thalamo-cortical and cortico-cortical functional connectivity networks.Ultimately,by optimizing neuromodulation strategies,we aim to substantially enhance therapeutic outcomes and greatly expedite the process of consciousness recovery in patients.展开更多
Detecting brain tumours is complex due to the natural variation in their location, shape, and intensity in images. While having accurate detection and segmentation of brain tumours would be beneficial, current methods...Detecting brain tumours is complex due to the natural variation in their location, shape, and intensity in images. While having accurate detection and segmentation of brain tumours would be beneficial, current methods still need to solve this problem despite the numerous available approaches. Precise analysis of Magnetic Resonance Imaging (MRI) is crucial for detecting, segmenting, and classifying brain tumours in medical diagnostics. Magnetic Resonance Imaging is a vital component in medical diagnosis, and it requires precise, efficient, careful, efficient, and reliable image analysis techniques. The authors developed a Deep Learning (DL) fusion model to classify brain tumours reliably. Deep Learning models require large amounts of training data to achieve good results, so the researchers utilised data augmentation techniques to increase the dataset size for training models. VGG16, ResNet50, and convolutional deep belief networks networks extracted deep features from MRI images. Softmax was used as the classifier, and the training set was supplemented with intentionally created MRI images of brain tumours in addition to the genuine ones. The features of two DL models were combined in the proposed model to generate a fusion model, which significantly increased classification accuracy. An openly accessible dataset from the internet was used to test the model's performance, and the experimental results showed that the proposed fusion model achieved a classification accuracy of 98.98%. Finally, the results were compared with existing methods, and the proposed model outperformed them significantly.展开更多
Deep brain stimulation(DBS),including optical stimulation and electrical stimulation,has been demonstrated considerable value in exploring pathological brain activity and developing treatments for neural disorders.Adv...Deep brain stimulation(DBS),including optical stimulation and electrical stimulation,has been demonstrated considerable value in exploring pathological brain activity and developing treatments for neural disorders.Advances in DBS microsystems based on implantable microelectrode array(MEA)probes have opened up new opportunities for closed-loop DBS(CL-DBS)in situ.This technology can be used to detect damaged brain circuits and test the therapeutic potential for modulating the output of these circuits in a variety of diseases simultaneously.Despite the success and rapid utilization of MEA probe-based CL-DBS microsystems,key challenges,including excessive wired communication,need to be urgently resolved.In this review,we considered recent advances in MEA probe-based wireless CL-DBS microsystems and outlined the major issues and promising prospects in this field.This technology has the potential to offer novel therapeutic options for psychiatric disorders in the future.展开更多
Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical imp...Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.展开更多
At present,the prediction of brain tumors is performed using Machine Learning(ML)and Deep Learning(DL)algorithms.Although various ML and DL algorithms are adapted to predict brain tumors to some range,some concerns st...At present,the prediction of brain tumors is performed using Machine Learning(ML)and Deep Learning(DL)algorithms.Although various ML and DL algorithms are adapted to predict brain tumors to some range,some concerns still need enhancement,particularly accuracy,sensitivity,false positive and false negative,to improve the brain tumor prediction system symmetrically.Therefore,this work proposed an Extended Deep Learning Algorithm(EDLA)to measure performance parameters such as accuracy,sensitivity,and false positive and false negative rates.In addition,these iterated measures were analyzed by comparing the EDLA method with the Convolutional Neural Network(CNN)way further using the SPSS tool,and respective graphical illustrations were shown.The results were that the mean performance measures for the proposed EDLA algorithm were calculated,and those measured were accuracy(97.665%),sensitivity(97.939%),false positive(3.012%),and false negative(3.182%)for ten iterations.Whereas in the case of the CNN,the algorithm means accuracy gained was 94.287%,mean sensitivity 95.612%,mean false positive 5.328%,and mean false negative 4.756%.These results show that the proposed EDLA method has outperformed existing algorithms,including CNN,and ensures symmetrically improved parameters.Thus EDLA algorithm introduces novelty concerning its performance and particular activation function.This proposed method will be utilized effectively in brain tumor detection in a precise and accurate manner.This algorithm would apply to brain tumor diagnosis and be involved in various medical diagnoses aftermodification.If the quantity of dataset records is enormous,then themethod’s computation power has to be updated.展开更多
Brain tumors present significant challenges in medical diagnosis and treatment,where early detection is crucial for reducing morbidity and mortality rates.This research introduces a novel deep learning model,the Progr...Brain tumors present significant challenges in medical diagnosis and treatment,where early detection is crucial for reducing morbidity and mortality rates.This research introduces a novel deep learning model,the Progressive Layered U-Net(PLU-Net),designed to improve brain tumor segmentation accuracy from Magnetic Resonance Imaging(MRI)scans.The PLU-Net extends the standard U-Net architecture by incorporating progressive layering,attention mechanisms,and multi-scale data augmentation.The progressive layering involves a cascaded structure that refines segmentation masks across multiple stages,allowing the model to capture features at different scales and resolutions.Attention gates within the convolutional layers selectively focus on relevant features while suppressing irrelevant ones,enhancing the model's ability to delineate tumor boundaries.Additionally,multi-scale data augmentation techniques increase the diversity of training data and boost the model's generalization capabilities.Evaluated on the BraTS 2021 dataset,the PLU-Net achieved state-of-the-art performance with a dice coefficient of 0.91,specificity of 0.92,sensitivity of 0.89,Hausdorff95 of 2.5,outperforming other modified U-Net architectures in segmentation accuracy.These results underscore the effectiveness of the PLU-Net in improving brain tumor segmentation from MRI scans,supporting clinicians in early diagnosis,treatment planning,and the development of new therapies.展开更多
Accurate brain tumour segmentation is critical for diagnosis and treatment planning, yet challenging due to tumour complexity. Manual segmentation is time-consuming and variable, necessitating automated methods. Deep ...Accurate brain tumour segmentation is critical for diagnosis and treatment planning, yet challenging due to tumour complexity. Manual segmentation is time-consuming and variable, necessitating automated methods. Deep learning, particularly 3D U-Net architectures, has revolutionised medical image analysis by leveraging volumetric data to capture spatial context, enhancing segmentation accuracy. This paper reviews brain tumour segmentation methods, emphasising 3D U-Net advancements. We analyse contributions from the Brain Tumour Segmentation (BraTS) challenges (2014-2023), highlighting key improvements and persistent challenges, including tumour heterogeneity, limited annotated data, varied imaging protocols, computational constraints, and model generalisation. Unlike previous reviews, we synthesise these challenges, proposing targeted research directions: enhancing model robustness through domain adaptation and multi-institutional data sharing, developing lightweight architectures for clinical deployment, integrating multi-modal and clinical data, and incorporating explainability techniques to build clinician trust. By addressing these challenges, we aim to guide future research toward developing more robust, generalisable, and clinically applicable segmentation models, ultimately improving patient outcomes in neuro-oncology.展开更多
A healthy brain is vital to every person since the brain controls every movement and emotion.Sometimes,some brain cells grow unexpectedly to be uncontrollable and cancerous.These cancerous cells are called brain tumor...A healthy brain is vital to every person since the brain controls every movement and emotion.Sometimes,some brain cells grow unexpectedly to be uncontrollable and cancerous.These cancerous cells are called brain tumors.For diagnosed patients,their lives depend mainly on the early diagnosis of these tumors to provide suitable treatment plans.Nowadays,Physicians and radiologists rely on Magnetic Resonance Imaging(MRI)pictures for their clinical evaluations of brain tumors.These evaluations are time-consuming,expensive,and require expertise with high skills to provide an accurate diagnosis.Scholars and industrials have recently partnered to implement automatic solutions to diagnose the disease with high accuracy.Due to their accuracy,some of these solutions depend on deep-learning(DL)methodologies.These techniques have become important due to their roles in the diagnosis process,which includes identification and classification.Therefore,there is a need for a solid and robust approach based on a deep-learning method to diagnose brain tumors.The purpose of this study is to develop an intelligent automatic framework for brain tumor diagnosis.The proposed solution is based on a novel dense dynamic residual self-attention transfer adaptive learning fusion approach(NDDRSATALFA),carried over two implemented deep-learning networks:VGG19 and UNET to identify and classify brain tumors.In addition,this solution applies a transfer learning approach to exchange extracted features and data within the two neural networks.The presented framework is trained,validated,and tested on six public datasets of MRIs to detect brain tumors and categorize these tumors into three suitable classes,which are glioma,meningioma,and pituitary.The proposed framework yielded remarkable findings on variously evaluated performance indicators:99.32%accuracy,98.74%sensitivity,98.89%specificity,99.01%Dice,98.93%Area Under the Curve(AUC),and 99.81%F1-score.In addition,a comparative analysis with recent state-of-the-art methods was performed and according to the comparative analysis,NDDRSATALFA shows an admirable level of reliability in simplifying the timely identification of diverse brain tumors.Moreover,this framework can be applied by healthcare providers to assist radiologists,pathologists,and physicians in their evaluations.The attained outcomes open doors for advanced automatic solutions that improve clinical evaluations and provide reasonable treatment plans.展开更多
Background Brain tumors are challenging to diagnose and treat,and require accurate and early therapeutic intervention.Magnetic Resonance Imaging(MRI)scans can visualize the internal structure of the brain.Often,deep l...Background Brain tumors are challenging to diagnose and treat,and require accurate and early therapeutic intervention.Magnetic Resonance Imaging(MRI)scans can visualize the internal structure of the brain.Often,deep learning is applied to images for the early and accurate detection of tumor cells.However,these models lack accuracy and efficacy in practical applications.Hybrid or modified models can facilitate better classification and provide insights into early-stage cancer detection.Methods This study demonstrates a parallel architecture that uses MRI images and integrates transformer-based frameworks with Convolutional Neural Networks(CNNs)to better classify distinct types of brain tumors.The proposed architecture,SwinResDual(SwRD),combines a Residual Network(ResNet)and a Swin Transformer in parallel to extract key features from input images.Using augmented MRI scans,31,464 scans for multiclass classification,and 30,000 scans for binary classification,the architecture simultaneously processed images through the ResNet50 and Swin Transformer branches,leveraging their strengths in hierarchical feature extraction and global context modeling to efficiently capture local and global image features.The final classifications are obtained by merging these features and passing them through a linear classifier.This approach identifies strong and varied characteristics and provides a precise brain tumor diagnosis.Results In the extensive evaluation,the model performed with an accuracy of 99.79% and a cross-validation accuracy of 100%for multiclass classification,along with 99.97% accuracy in binary classification.Conclusions In conclusion,the findings demonstrate great promise for brain tumor detection and advanced medical imaging diagnostics.展开更多
Brain tumors are neoplastic diseases caused by the proliferation of abnormal cells in brain tissues,and their appearance may lead to a series of complex symptoms.However,current methods struggle to capture deeper brai...Brain tumors are neoplastic diseases caused by the proliferation of abnormal cells in brain tissues,and their appearance may lead to a series of complex symptoms.However,current methods struggle to capture deeper brain tumor image feature information due to the variations in brain tumor morphology,size,and complex background,resulting in low detection accuracy,high rate of misdiagnosis and underdiagnosis,and challenges in meeting clinical needs.Therefore,this paper proposes the CMS-YOLO network model for multi-category brain tumor detection,which is based on the You Only Look Once version 10(YOLOv10s)algorithm.This model innovatively integrates the Convolutional Medical UNet extended block(CMUNeXt Block)to design a brand-new CSP Bottleneck with 2 convolutions(C2f)structure,which significantly enhances the ability to extract features of the lesion area.Meanwhile,to address the challenge of complex backgrounds in brain tumor detection,a Multi-Scale Attention Aggregation(MSAA)module is introduced.The module integrates features of lesions at different scales,enabling the model to effectively capture multi-scale contextual information and enhance detection accuracy in complex scenarios.Finally,during the model training process,the Shape-IoU loss function is employed to replace the Complete-IoU(CIoU)loss function for optimizing bounding box regression.This ensures that the predicted bounding boxes generated by the model closely match the actual tumor contours,thereby further enhancing the detection precision.The experimental results show that the improved method achieves 94.80%precision,93.60%recall,96.20%score,and 79.60%on the MRI for Brain Tumor with Bounding Boxes dataset.Compared to the YOLOv10s model,this represents improvements of 1.0%,1.1%,1.0%,and 1.1%,respectively.The method can achieve automatic detection and localization of three distinct categories of brain tumors—glioma,meningioma,and pituitary tumor,which can accurately detect and identify brain tumors,assist doctors in early diagnosis,and promote the development of early treatment.展开更多
Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis trea...Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis treated with stereotactic radio-surgery(SRS)and quantifies their radiomic quality score(RQS).A systematic search on Scopus,Web of Science,and PubMed was conducted to identify original studies on radiomics for predicting treatment response,adhering to predefined patient,intervention,comparator,and outcome(PICO)criteria.No restrictions were placed on language or publication date.Two in-dependent reviewers assessed eligible studies,and the RQS was calculated based on Lambin’s guidelines.The Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guidelines were followed.Seventeen studies involving 2744 patients met the inclusion criteria out of 200 identified.All studies were retrospective and utilizing various MRI scanners models with different field strength.The average RQS across studies was low(39.2%),with a maximum score of 19 points(52.7%).Radiomic-based models demonstrated superior predictive accuracy compared to clinical or visual assessment,with AUC values ranging from 0.74 to 0.92.Integration of clinical features such as Karnofsky performance status,dose,and isodose line further improved model performance.Deep learning models achieved the highest predictive accuracy,with AUC of 0.92.Radiomics demonstrate significant potential in predicting treatment outcomes with high accuracy,offering opportunities to advance personalized management for BM.To facilitate clinical adoption,future studies must prioritize adherence to standardized guidelines and robust model validation to ensure reproducibility.展开更多
In recent decades,brain tumors have emerged as a serious neurological disorder that often leads to death.Hence,Brain Tumor Segmentation(BTS)is significant to enable the visualization,classification,and delineation of ...In recent decades,brain tumors have emerged as a serious neurological disorder that often leads to death.Hence,Brain Tumor Segmentation(BTS)is significant to enable the visualization,classification,and delineation of tumor regions in Magnetic Resonance Imaging(MRI).However,BTS remains a challenging task because of noise,non-uniform object texture,diverse image content and clustered objects.To address these challenges,a novel model is implemented in this research.The key objective of this research is to improve segmentation accuracy and generalization in BTS by incorporating Switchable Normalization into Faster R-CNN,which effectively captures the fine-grained tumor features to enhance segmentation precision.MRI images are initially acquired from three online datasets:Dataset 1—Brain Tumor Segmentation(BraTS)2018,Dataset 2—BraTS 2019,and Dataset 3—BraTS 2020.Subsequently,the Switchable Normalization-based Faster Regions with Convolutional Neural Networks(SNFRC)model is proposed for improved BTS in MRI images.In the proposed model,Switchable Normalization is integrated into the conventional architecture,enhancing generalization capability and reducing overfitting to unseen image data,which is essential due to the typically limited size of available datasets.The network depth is increased to obtain discriminative semantic features that improve segmentation performance.Specifically,Switchable Normalization captures the diverse feature representations from the brain images.The Faster R-CNN model develops end-to-end training and effective regional proposal generation,with an enhanced training stability using Switchable Normalization,to perform an effective segmentation in MRI images.From the experimental results,the proposed model attains segmentation accuracies of 99.41%,98.12%,and 96.71%on Datasets 1,2,and 3,respectively,outperforming conventional deep learning models used for BTS.展开更多
Accurate and efficient brain tumor segmentation is essential for early diagnosis,treatment planning,and clinical decision-making.However,the complex structure of brain anatomy and the heterogeneous nature of tumors pr...Accurate and efficient brain tumor segmentation is essential for early diagnosis,treatment planning,and clinical decision-making.However,the complex structure of brain anatomy and the heterogeneous nature of tumors present significant challenges for precise anomaly detection.While U-Net-based architectures have demonstrated strong performance in medical image segmentation,there remains room for improvement in feature extraction and localization accuracy.In this study,we propose a novel hybrid model designed to enhance 3D brain tumor segmentation.The architecture incorporates a 3D ResNet encoder known for mitigating the vanishing gradient problem and a 3D U-Net decoder.Additionally,to enhance the model’s generalization ability,Squeeze and Excitation attention mechanism is integrated.We introduce Gabor filter banks into the encoder to further strengthen the model’s ability to extract robust and transformation-invariant features from the complex and irregular shapes typical in medical imaging.This approach,which is not well explored in current U-Net-based segmentation frameworks,provides a unique advantage by enhancing texture-aware feature representation.Specifically,Gabor filters help extract distinctive low-level texture features,reducing the effects of texture interference and facilitating faster convergence during the early stages of training.Our model achieved Dice scores of 0.881,0.846,and 0.819 for Whole Tumor(WT),Tumor Core(TC),and Enhancing Tumor(ET),respectively,on the BraTS 2020 dataset.Cross-validation on the BraTS 2021 dataset further confirmed the model’s robustness,yielding Dice score values of 0.887 for WT,0.856 for TC,and 0.824 for ET.The proposed model outperforms several state-of-the-art existing models,particularly in accurately identifying small and complex tumor regions.Extensive evaluations suggest integrating advanced preprocessing with an attention-augmented hybrid architecture offers significant potential for reliable and clinically valuable brain tumor segmentation.展开更多
Deep brain stimulation （DBS） is an effective technique for treating Parkinson＇s disease （PD） in the middle and advanced stages. The subthalamic nucleus （STN） is the most common target for clinical treatment usi...Deep brain stimulation （DBS） is an effective technique for treating Parkinson＇s disease （PD） in the middle and advanced stages. The subthalamic nucleus （STN） is the most common target for clinical treatment using DBS. While STN-DBS can significantly improve motor symptoms in PD patients, adverse cognitive effects have also been reported. The specific effects of STN-DBS on cognitive function and the related mechanisms remain unclear. Thus, it is imperative to identify the influence of STN-DBS on cognition and investigate the potential mechanisms to provide a clearer view of the various cognitive sequelae in PD patients. For this review, a literature search was performed using the following inclusion criteria： （1） at least 10 patients followed for a mean of at least 6 months after surgery since the year 2006; （2） pre- and postoperative cognitive data using at least one standardized neuropsychological scale; and （3） adequate reporting of study results using means and standard deviations. Of -170 clinical studies identified, 25 cohort studies （including 15 self-controlled studies, nine intergroup controlled studies, and one multi-center, randomized control experiment） and one meta- analysis were eligible for inclusion. The results suggest that the precise mechanism of the changes in cognitive function after STN-DBS remains obscure, but STN-DBS certainly has effects on cognition. In particular, a progressive decrease in verbal fluency after STN-DBS is consistently reported and although executive function is unchanged in the intermediate stage postoperatively, it tends to decline in the early and later stages. However, these changes do not affect the improvements in quality of life. STN-DBS seems to be safe with respect to cognitive effects in carefully-selected patients during a follow-up period from 6 months to 9 years.展开更多
Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by...Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov（NCT03115814） on April 14, 2017.展开更多
Intractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symp...Intractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symptoms such as chronic pain may share similar mechanisms. Brain ablation and stimulation are used to treat chronic pain with success. Recent studies showed that ablation and stimulation in non-auditory areas resulted in tinnitus improvement. Deep brain stimulation (DBS) may be an alternative treatment for intractable tinnitus and deserves further study.展开更多
文摘Uric acid(UA)is a naturally antioxidant that is strongly associated with the development and progression of Parkinson's disease(PD).The purine diet is an important exogenous pathway that modulates blood UA levels.Deep brain stimulation(DBS)is an important tool for PD treatment.This study aimed to explore the effects of preoperative purine diet on the prognosis of patients with PD after DBS.Sixty-four patients with PD who underwent DBS were included in this study,and their clinical data,blood UA levels,and daily purine intake.Patients were followed up for improvement 1 year after surgery.We found that patient higher purine intake was strongly associated with the rate of improvement after DBS and was a protective factor for patient prognosis.Daily purine intake from meat and seafood was significantly higher in the responsive patients than in the lessresponsive patients.Mediation analysis showed that UA mediated 78%of the effect of purine intake on motor symptom improvement after DBS.In summary,we observed that purine intake is strongly associated with the rate of improvement in motor symptoms after subthalamic nucleus-DBS in patients with PD.This study provides a reference for preoperative diet planning in patients with PD undergoing DBS.
文摘Brain tumor classification is crucial for personalized treatment planning.Although deep learning-based Artificial Intelligence(AI)models can automatically analyze tumor images,fine details of small tumor regions may be overlooked during global feature extraction.Therefore,we propose a brain tumor Magnetic Resonance Imaging(MRI)classification model based on a global-local parallel dual-branch structure.The global branch employs ResNet50 with a Multi-Head Self-Attention(MHSA)to capture global contextual information from whole brain images,while the local branch utilizes VGG16 to extract fine-grained features from segmented brain tumor regions.The features from both branches are processed through designed attention-enhanced feature fusion module to filter and integrate important features.Additionally,to address sample imbalance in the dataset,we introduce a category attention block to improve the recognition of minority classes.Experimental results indicate that our method achieved a classification accuracy of 98.04%and a micro-average Area Under the Curve(AUC)of 0.989 in the classification of three types of brain tumors,surpassing several existing pre-trained Convolutional Neural Network(CNN)models.Additionally,feature interpretability analysis validated the effectiveness of the proposed model.This suggests that the method holds significant potential for brain tumor image classification.
文摘The categorization of brain tumors is a significant issue for healthcare applications.Perfect and timely identification of brain tumors is important for employing an effective treatment of this disease.Brain tumors possess high changes in terms of size,shape,and amount,and hence the classification process acts as a more difficult research problem.This paper suggests a deep learning model using the magnetic resonance imaging technique that overcomes the limitations associated with the existing classification methods.The effectiveness of the suggested method depends on the coyote optimization algorithm,also known as the LOBO algorithm,which optimizes the weights of the deep-convolutional neural network classifier.The accuracy,sensitivity,and specificity indices,which are obtained to be 92.40%,94.15%,and 91.92%,respectively,are used to validate the effectiveness of the suggested method.The result suggests that the suggested strategy is superior for effectively classifying brain tumors.
基金supported by the Capital Fund for Health Improvement and Research,No.2022-2-2048(to WZ)the National Natural Science Foundation of China,No.81970992(to WZ)+3 种基金Capital Clinical Characteristic Application Research,No.Z121107001012161(to WZ)the Natural Science Foundation of Beijing,No.7082032(to WZ)the Key Technology R&D Program of Beijing Municipal Education Commission,No.KZ201610025030(to WZ)Project of Scientific and Technological Development of Traditional Chinese Medicine in Beijing,No.JJ2018-48(to WZ)。
文摘Alzheimer's disease is the most common type of cognitive disorder,and there is an urgent need to develop more effective,targeted and safer therapies for patients with this condition.Deep brain stimulation is an invasive surgical treatment that modulates abnormal neural activity by implanting electrodes into specific brain areas followed by electrical stimulation.As an emerging therapeutic approach,deep brain stimulation shows significant promise as a potential new therapy for Alzheimer's disease.Here,we review the potential mechanisms and therapeutic effects of deep brain stimulation in the treatment of Alzheimer's disease based on existing clinical and basic research.In clinical studies,the most commonly targeted sites include the fornix,the nucleus basalis of Meynert,and the ventral capsule/ventral striatum.Basic research has found that the most frequently targeted areas include the fornix,nucleus basalis of Meynert,hippocampus,entorhinal cortex,and rostral intralaminar thalamic nucleus.All of these individual targets exhibit therapeutic potential for patients with Alzheimer's disease and associated mechanisms of action have been investigated.Deep brain stimulation may exert therapeutic effects on Alzheimer's disease through various mechanisms,including reducing the deposition of amyloid-β,activation of the cholinergic system,increasing the levels of neurotrophic factors,enhancing synaptic activity and plasticity,promoting neurogenesis,and improving glucose metabolism.Currently,clinical trials investigating deep brain stimulation for Alzheimer's disease remain insufficient.In the future,it is essential to focus on translating preclinical mechanisms into clinical trials.Furthermore,consecutive follow-up studies are needed to evaluate the long-term safety and efficacy of deep brain stimulation for Alzheimer's disease,including cognitive function,neuropsychiatric symptoms,quality of life and changes in Alzheimer's disease biomarkers.Researchers must also prioritize the initiation of multi-center clinical trials of deep brain stimulation with large sample sizes and target earlier therapeutic windows,such as the prodromal and even the preclinical stages of Alzheimer's disease.Adopting these approaches will permit the efficient exploration of more effective and safer deep brain stimulation therapies for patients with Alzheimer's disease.
基金supported by the Science and Technology Innovation 2030(2022ZD0205300)the International(Hong Kong,Macao,and Taiwan)Science and Technology Cooperation Project(Z221100002722014)+5 种基金the 2022 Open Project of Key Laboratory and Engineering Technology Research of the Ministry of Civil Affairs(2022GKZS0003)the Chinese Institute for Brain Research Youth Scholar Program(2022-NKX-XM-02)the Natural Science Foundation of Beijing municipality(7232049)the General Program of National Natural Science Foundation of China(82371197)the FundRef Organization name of Guarantors of Brain(HMR04170)the Royal Society(IES\R3\213123).
文摘Among the existing research on the treatment of disorders of consciousness(DOC),deep brain stimulation(DBS)offers a highly promising therapeutic approach.This comprehensive review documents the historical development of DBS and its role in the treatment of DOC,tracing its progression from an experimental therapy to a detailed modulation approach based on the mesocircuit model hypothesis.The mesocircuit model hypothesis suggests that DOC arises from disruptions in a critical network of brain regions,providing a framework for refining DBS targets.We also discuss the multimodal approaches for assessing patients with DOC,encompassing clinical behavioral scales,electrophysiological assessment,and neuroimaging techniques methods.During the evolution of DOC therapy,the segmentation of central nuclei,the recording of single-neurons,and the analysis of local field potentials have emerged as favorable technical factors that enhance the efficacy of DBS treatment.Advances in computational models have also facilitated a deeper exploration of the neural dynamics associated with DOC,linking neuron-level dynamics with macroscopic behavioral changes.Despite showing promising outcomes,challenges remain in patient selection,precise target localization,and the determination of optimal stimulation parameters.Future research should focus on conducting large-scale controlled studies to delve into the pathophysiological mechanisms of DOC.It is imperative to further elucidate the precise modulatory effects of DBS on thalamo-cortical and cortico-cortical functional connectivity networks.Ultimately,by optimizing neuromodulation strategies,we aim to substantially enhance therapeutic outcomes and greatly expedite the process of consciousness recovery in patients.
基金Ministry of Education,Youth and Sports of the Chezk Republic,Grant/Award Numbers:SP2023/039,SP2023/042the European Union under the REFRESH,Grant/Award Number:CZ.10.03.01/00/22_003/0000048。
文摘Detecting brain tumours is complex due to the natural variation in their location, shape, and intensity in images. While having accurate detection and segmentation of brain tumours would be beneficial, current methods still need to solve this problem despite the numerous available approaches. Precise analysis of Magnetic Resonance Imaging (MRI) is crucial for detecting, segmenting, and classifying brain tumours in medical diagnostics. Magnetic Resonance Imaging is a vital component in medical diagnosis, and it requires precise, efficient, careful, efficient, and reliable image analysis techniques. The authors developed a Deep Learning (DL) fusion model to classify brain tumours reliably. Deep Learning models require large amounts of training data to achieve good results, so the researchers utilised data augmentation techniques to increase the dataset size for training models. VGG16, ResNet50, and convolutional deep belief networks networks extracted deep features from MRI images. Softmax was used as the classifier, and the training set was supplemented with intentionally created MRI images of brain tumours in addition to the genuine ones. The features of two DL models were combined in the proposed model to generate a fusion model, which significantly increased classification accuracy. An openly accessible dataset from the internet was used to test the model's performance, and the experimental results showed that the proposed fusion model achieved a classification accuracy of 98.98%. Finally, the results were compared with existing methods, and the proposed model outperformed them significantly.
基金supported by the National Natural Science Foundation of China(Nos.T2293730,T2293731,62121003,61960206012,61973292,62171434,61975206,and 61971400)the National Key Research and Development Program of China(Nos.2022YFC2402501 and 2022YFB3205602)+1 种基金the Major Program of Scientific and Technical Innovation 2030(No.2021ZD02016030)the Scientific Instrument Developing Project of the Chinese Academy of Sciences(No.GJJSTD20210004).
文摘Deep brain stimulation(DBS),including optical stimulation and electrical stimulation,has been demonstrated considerable value in exploring pathological brain activity and developing treatments for neural disorders.Advances in DBS microsystems based on implantable microelectrode array(MEA)probes have opened up new opportunities for closed-loop DBS(CL-DBS)in situ.This technology can be used to detect damaged brain circuits and test the therapeutic potential for modulating the output of these circuits in a variety of diseases simultaneously.Despite the success and rapid utilization of MEA probe-based CL-DBS microsystems,key challenges,including excessive wired communication,need to be urgently resolved.In this review,we considered recent advances in MEA probe-based wireless CL-DBS microsystems and outlined the major issues and promising prospects in this field.This technology has the potential to offer novel therapeutic options for psychiatric disorders in the future.
文摘Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.
基金supported by Project No.R-2023-23 of the Deanship of Scientific Research at Majmaah University.
文摘At present,the prediction of brain tumors is performed using Machine Learning(ML)and Deep Learning(DL)algorithms.Although various ML and DL algorithms are adapted to predict brain tumors to some range,some concerns still need enhancement,particularly accuracy,sensitivity,false positive and false negative,to improve the brain tumor prediction system symmetrically.Therefore,this work proposed an Extended Deep Learning Algorithm(EDLA)to measure performance parameters such as accuracy,sensitivity,and false positive and false negative rates.In addition,these iterated measures were analyzed by comparing the EDLA method with the Convolutional Neural Network(CNN)way further using the SPSS tool,and respective graphical illustrations were shown.The results were that the mean performance measures for the proposed EDLA algorithm were calculated,and those measured were accuracy(97.665%),sensitivity(97.939%),false positive(3.012%),and false negative(3.182%)for ten iterations.Whereas in the case of the CNN,the algorithm means accuracy gained was 94.287%,mean sensitivity 95.612%,mean false positive 5.328%,and mean false negative 4.756%.These results show that the proposed EDLA method has outperformed existing algorithms,including CNN,and ensures symmetrically improved parameters.Thus EDLA algorithm introduces novelty concerning its performance and particular activation function.This proposed method will be utilized effectively in brain tumor detection in a precise and accurate manner.This algorithm would apply to brain tumor diagnosis and be involved in various medical diagnoses aftermodification.If the quantity of dataset records is enormous,then themethod’s computation power has to be updated.
文摘Brain tumors present significant challenges in medical diagnosis and treatment,where early detection is crucial for reducing morbidity and mortality rates.This research introduces a novel deep learning model,the Progressive Layered U-Net(PLU-Net),designed to improve brain tumor segmentation accuracy from Magnetic Resonance Imaging(MRI)scans.The PLU-Net extends the standard U-Net architecture by incorporating progressive layering,attention mechanisms,and multi-scale data augmentation.The progressive layering involves a cascaded structure that refines segmentation masks across multiple stages,allowing the model to capture features at different scales and resolutions.Attention gates within the convolutional layers selectively focus on relevant features while suppressing irrelevant ones,enhancing the model's ability to delineate tumor boundaries.Additionally,multi-scale data augmentation techniques increase the diversity of training data and boost the model's generalization capabilities.Evaluated on the BraTS 2021 dataset,the PLU-Net achieved state-of-the-art performance with a dice coefficient of 0.91,specificity of 0.92,sensitivity of 0.89,Hausdorff95 of 2.5,outperforming other modified U-Net architectures in segmentation accuracy.These results underscore the effectiveness of the PLU-Net in improving brain tumor segmentation from MRI scans,supporting clinicians in early diagnosis,treatment planning,and the development of new therapies.
文摘Accurate brain tumour segmentation is critical for diagnosis and treatment planning, yet challenging due to tumour complexity. Manual segmentation is time-consuming and variable, necessitating automated methods. Deep learning, particularly 3D U-Net architectures, has revolutionised medical image analysis by leveraging volumetric data to capture spatial context, enhancing segmentation accuracy. This paper reviews brain tumour segmentation methods, emphasising 3D U-Net advancements. We analyse contributions from the Brain Tumour Segmentation (BraTS) challenges (2014-2023), highlighting key improvements and persistent challenges, including tumour heterogeneity, limited annotated data, varied imaging protocols, computational constraints, and model generalisation. Unlike previous reviews, we synthesise these challenges, proposing targeted research directions: enhancing model robustness through domain adaptation and multi-institutional data sharing, developing lightweight architectures for clinical deployment, integrating multi-modal and clinical data, and incorporating explainability techniques to build clinician trust. By addressing these challenges, we aim to guide future research toward developing more robust, generalisable, and clinically applicable segmentation models, ultimately improving patient outcomes in neuro-oncology.
基金funded by the Deanship of Scientific Research(DSR)at King Abdulaziz University,Jeddah,Saudi Arabia under Grant No.(GPIP:1055-829-2024).
文摘A healthy brain is vital to every person since the brain controls every movement and emotion.Sometimes,some brain cells grow unexpectedly to be uncontrollable and cancerous.These cancerous cells are called brain tumors.For diagnosed patients,their lives depend mainly on the early diagnosis of these tumors to provide suitable treatment plans.Nowadays,Physicians and radiologists rely on Magnetic Resonance Imaging(MRI)pictures for their clinical evaluations of brain tumors.These evaluations are time-consuming,expensive,and require expertise with high skills to provide an accurate diagnosis.Scholars and industrials have recently partnered to implement automatic solutions to diagnose the disease with high accuracy.Due to their accuracy,some of these solutions depend on deep-learning(DL)methodologies.These techniques have become important due to their roles in the diagnosis process,which includes identification and classification.Therefore,there is a need for a solid and robust approach based on a deep-learning method to diagnose brain tumors.The purpose of this study is to develop an intelligent automatic framework for brain tumor diagnosis.The proposed solution is based on a novel dense dynamic residual self-attention transfer adaptive learning fusion approach(NDDRSATALFA),carried over two implemented deep-learning networks:VGG19 and UNET to identify and classify brain tumors.In addition,this solution applies a transfer learning approach to exchange extracted features and data within the two neural networks.The presented framework is trained,validated,and tested on six public datasets of MRIs to detect brain tumors and categorize these tumors into three suitable classes,which are glioma,meningioma,and pituitary.The proposed framework yielded remarkable findings on variously evaluated performance indicators:99.32%accuracy,98.74%sensitivity,98.89%specificity,99.01%Dice,98.93%Area Under the Curve(AUC),and 99.81%F1-score.In addition,a comparative analysis with recent state-of-the-art methods was performed and according to the comparative analysis,NDDRSATALFA shows an admirable level of reliability in simplifying the timely identification of diverse brain tumors.Moreover,this framework can be applied by healthcare providers to assist radiologists,pathologists,and physicians in their evaluations.The attained outcomes open doors for advanced automatic solutions that improve clinical evaluations and provide reasonable treatment plans.
文摘Background Brain tumors are challenging to diagnose and treat,and require accurate and early therapeutic intervention.Magnetic Resonance Imaging(MRI)scans can visualize the internal structure of the brain.Often,deep learning is applied to images for the early and accurate detection of tumor cells.However,these models lack accuracy and efficacy in practical applications.Hybrid or modified models can facilitate better classification and provide insights into early-stage cancer detection.Methods This study demonstrates a parallel architecture that uses MRI images and integrates transformer-based frameworks with Convolutional Neural Networks(CNNs)to better classify distinct types of brain tumors.The proposed architecture,SwinResDual(SwRD),combines a Residual Network(ResNet)and a Swin Transformer in parallel to extract key features from input images.Using augmented MRI scans,31,464 scans for multiclass classification,and 30,000 scans for binary classification,the architecture simultaneously processed images through the ResNet50 and Swin Transformer branches,leveraging their strengths in hierarchical feature extraction and global context modeling to efficiently capture local and global image features.The final classifications are obtained by merging these features and passing them through a linear classifier.This approach identifies strong and varied characteristics and provides a precise brain tumor diagnosis.Results In the extensive evaluation,the model performed with an accuracy of 99.79% and a cross-validation accuracy of 100%for multiclass classification,along with 99.97% accuracy in binary classification.Conclusions In conclusion,the findings demonstrate great promise for brain tumor detection and advanced medical imaging diagnostics.
基金supported in part by the National Natural Science Foundation of China under Grants 61861007in part by the Guizhou Province Science and Technology Planning Project ZK[2021]303in part by the Guizhou Province Science Technology Support Plan under Grants[2022]264,[2023]096,[2023]412 and[2023]409.
文摘Brain tumors are neoplastic diseases caused by the proliferation of abnormal cells in brain tissues,and their appearance may lead to a series of complex symptoms.However,current methods struggle to capture deeper brain tumor image feature information due to the variations in brain tumor morphology,size,and complex background,resulting in low detection accuracy,high rate of misdiagnosis and underdiagnosis,and challenges in meeting clinical needs.Therefore,this paper proposes the CMS-YOLO network model for multi-category brain tumor detection,which is based on the You Only Look Once version 10(YOLOv10s)algorithm.This model innovatively integrates the Convolutional Medical UNet extended block(CMUNeXt Block)to design a brand-new CSP Bottleneck with 2 convolutions(C2f)structure,which significantly enhances the ability to extract features of the lesion area.Meanwhile,to address the challenge of complex backgrounds in brain tumor detection,a Multi-Scale Attention Aggregation(MSAA)module is introduced.The module integrates features of lesions at different scales,enabling the model to effectively capture multi-scale contextual information and enhance detection accuracy in complex scenarios.Finally,during the model training process,the Shape-IoU loss function is employed to replace the Complete-IoU(CIoU)loss function for optimizing bounding box regression.This ensures that the predicted bounding boxes generated by the model closely match the actual tumor contours,thereby further enhancing the detection precision.The experimental results show that the improved method achieves 94.80%precision,93.60%recall,96.20%score,and 79.60%on the MRI for Brain Tumor with Bounding Boxes dataset.Compared to the YOLOv10s model,this represents improvements of 1.0%,1.1%,1.0%,and 1.1%,respectively.The method can achieve automatic detection and localization of three distinct categories of brain tumors—glioma,meningioma,and pituitary tumor,which can accurately detect and identify brain tumors,assist doctors in early diagnosis,and promote the development of early treatment.
文摘Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis treated with stereotactic radio-surgery(SRS)and quantifies their radiomic quality score(RQS).A systematic search on Scopus,Web of Science,and PubMed was conducted to identify original studies on radiomics for predicting treatment response,adhering to predefined patient,intervention,comparator,and outcome(PICO)criteria.No restrictions were placed on language or publication date.Two in-dependent reviewers assessed eligible studies,and the RQS was calculated based on Lambin’s guidelines.The Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guidelines were followed.Seventeen studies involving 2744 patients met the inclusion criteria out of 200 identified.All studies were retrospective and utilizing various MRI scanners models with different field strength.The average RQS across studies was low(39.2%),with a maximum score of 19 points(52.7%).Radiomic-based models demonstrated superior predictive accuracy compared to clinical or visual assessment,with AUC values ranging from 0.74 to 0.92.Integration of clinical features such as Karnofsky performance status,dose,and isodose line further improved model performance.Deep learning models achieved the highest predictive accuracy,with AUC of 0.92.Radiomics demonstrate significant potential in predicting treatment outcomes with high accuracy,offering opportunities to advance personalized management for BM.To facilitate clinical adoption,future studies must prioritize adherence to standardized guidelines and robust model validation to ensure reproducibility.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Science and ICT(NRF-2022R1A2C2012243).
文摘In recent decades,brain tumors have emerged as a serious neurological disorder that often leads to death.Hence,Brain Tumor Segmentation(BTS)is significant to enable the visualization,classification,and delineation of tumor regions in Magnetic Resonance Imaging(MRI).However,BTS remains a challenging task because of noise,non-uniform object texture,diverse image content and clustered objects.To address these challenges,a novel model is implemented in this research.The key objective of this research is to improve segmentation accuracy and generalization in BTS by incorporating Switchable Normalization into Faster R-CNN,which effectively captures the fine-grained tumor features to enhance segmentation precision.MRI images are initially acquired from three online datasets:Dataset 1—Brain Tumor Segmentation(BraTS)2018,Dataset 2—BraTS 2019,and Dataset 3—BraTS 2020.Subsequently,the Switchable Normalization-based Faster Regions with Convolutional Neural Networks(SNFRC)model is proposed for improved BTS in MRI images.In the proposed model,Switchable Normalization is integrated into the conventional architecture,enhancing generalization capability and reducing overfitting to unseen image data,which is essential due to the typically limited size of available datasets.The network depth is increased to obtain discriminative semantic features that improve segmentation performance.Specifically,Switchable Normalization captures the diverse feature representations from the brain images.The Faster R-CNN model develops end-to-end training and effective regional proposal generation,with an enhanced training stability using Switchable Normalization,to perform an effective segmentation in MRI images.From the experimental results,the proposed model attains segmentation accuracies of 99.41%,98.12%,and 96.71%on Datasets 1,2,and 3,respectively,outperforming conventional deep learning models used for BTS.
基金the National Science and Technology Council(NSTC)of the Republic of China,Taiwan,for financially supporting this research under Contract No.NSTC 112-2637-M-131-001.
文摘Accurate and efficient brain tumor segmentation is essential for early diagnosis,treatment planning,and clinical decision-making.However,the complex structure of brain anatomy and the heterogeneous nature of tumors present significant challenges for precise anomaly detection.While U-Net-based architectures have demonstrated strong performance in medical image segmentation,there remains room for improvement in feature extraction and localization accuracy.In this study,we propose a novel hybrid model designed to enhance 3D brain tumor segmentation.The architecture incorporates a 3D ResNet encoder known for mitigating the vanishing gradient problem and a 3D U-Net decoder.Additionally,to enhance the model’s generalization ability,Squeeze and Excitation attention mechanism is integrated.We introduce Gabor filter banks into the encoder to further strengthen the model’s ability to extract robust and transformation-invariant features from the complex and irregular shapes typical in medical imaging.This approach,which is not well explored in current U-Net-based segmentation frameworks,provides a unique advantage by enhancing texture-aware feature representation.Specifically,Gabor filters help extract distinctive low-level texture features,reducing the effects of texture interference and facilitating faster convergence during the early stages of training.Our model achieved Dice scores of 0.881,0.846,and 0.819 for Whole Tumor(WT),Tumor Core(TC),and Enhancing Tumor(ET),respectively,on the BraTS 2020 dataset.Cross-validation on the BraTS 2021 dataset further confirmed the model’s robustness,yielding Dice score values of 0.887 for WT,0.856 for TC,and 0.824 for ET.The proposed model outperforms several state-of-the-art existing models,particularly in accurately identifying small and complex tumor regions.Extensive evaluations suggest integrating advanced preprocessing with an attention-augmented hybrid architecture offers significant potential for reliable and clinically valuable brain tumor segmentation.
基金supported by National Natural Science Foundation of China(81071065)
文摘Deep brain stimulation （DBS） is an effective technique for treating Parkinson＇s disease （PD） in the middle and advanced stages. The subthalamic nucleus （STN） is the most common target for clinical treatment using DBS. While STN-DBS can significantly improve motor symptoms in PD patients, adverse cognitive effects have also been reported. The specific effects of STN-DBS on cognitive function and the related mechanisms remain unclear. Thus, it is imperative to identify the influence of STN-DBS on cognition and investigate the potential mechanisms to provide a clearer view of the various cognitive sequelae in PD patients. For this review, a literature search was performed using the following inclusion criteria： （1） at least 10 patients followed for a mean of at least 6 months after surgery since the year 2006; （2） pre- and postoperative cognitive data using at least one standardized neuropsychological scale; and （3） adequate reporting of study results using means and standard deviations. Of -170 clinical studies identified, 25 cohort studies （including 15 self-controlled studies, nine intergroup controlled studies, and one multi-center, randomized control experiment） and one meta- analysis were eligible for inclusion. The results suggest that the precise mechanism of the changes in cognitive function after STN-DBS remains obscure, but STN-DBS certainly has effects on cognition. In particular, a progressive decrease in verbal fluency after STN-DBS is consistently reported and although executive function is unchanged in the intermediate stage postoperatively, it tends to decline in the early and later stages. However, these changes do not affect the improvements in quality of life. STN-DBS seems to be safe with respect to cognitive effects in carefully-selected patients during a follow-up period from 6 months to 9 years.
基金supported by the National Natural Science Foundation of China,No.8187052509(to XGY)the National Key Research and Development Plan of China,No.2017YFC0114005(to ZPL)
文摘Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov（NCT03115814） on April 14, 2017.
文摘Intractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symptoms such as chronic pain may share similar mechanisms. Brain ablation and stimulation are used to treat chronic pain with success. Recent studies showed that ablation and stimulation in non-auditory areas resulted in tinnitus improvement. Deep brain stimulation (DBS) may be an alternative treatment for intractable tinnitus and deserves further study.
