Background:Preclinical studies have indicated that Angong Niuhuang Pills(ANP)reduce cerebral infarct and edema volumes.This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in p...Background:Preclinical studies have indicated that Angong Niuhuang Pills(ANP)reduce cerebral infarct and edema volumes.This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in patients with moderate to severe acute ischemic stroke.Methods:This randomized,double-blind,placebo-controlled pilot trial included patients with acute ischemic stroke with National Institutes of Health Stroke Scale(NIHSS)scores ranging from 10 to 20 in 17 centers in China between April 2021 and July 2022.Patients were allocated within 36 h after onset via block randomization to receive ANP or placebo(3 g/day for 5 days).The primary outcomes were changes in cerebral infarct and edema volumes after 14 days of treatment.The primary safety outcome was severe adverse events(SAEs)for 90 days.Results:There were 57 and 60 patients finally included in the ANP and placebo groups,respectively for modified intention-to-treat analysis.The median age was 66.0 years,and the median NIHSS score at baseline was 12.0.The changes in cerebral infarct volume at day 14 were 0.3 mL and 0.4 mL in the ANP and placebo groups,respectively(median difference:-7.1 mL;interquartile range[IQR]:-18.3 to 2.3 mL,P=0.30).The changes in cerebral edema volume of the ANP and placebo groups on day 14 were 11.4 mL and 4.0 mL,respectively(median difference:3.0 mL,IQR:-1.3 to 9.9 mL,P=0.15).The rates of SAE within 90 days were similar in the ANP(3/57,5%)and placebo(7/60,12%)groups(P=0.36).Changes in serum mercury and arsenic concentrations were comparable.In patients with large artery atherosclerosis,ANP reduced the cerebral infarct volume at 14 days(median difference:-12.3 mL;IQR:-27.7 to-0.3 mL,P=0.03).Conclusions:ANP showed a similar safety profile to placebo and non-significant tendency to reduce cerebral infarct volume in patients with moderate-to-severe stroke.Further studies are warranted to assess the efficacy of ANP in reducing cerebral infarcts and improving clinical prognosis.Trail Registration:Clinicaltrials.gov,No.NCT04475328.展开更多
The common cerebral small vessel disease(CSVD)neuroimaging features visible on conventional structural magnetic resonance imaging include recent small subcortical infarcts,lacunes,white matter hyperintensities,perivas...The common cerebral small vessel disease(CSVD)neuroimaging features visible on conventional structural magnetic resonance imaging include recent small subcortical infarcts,lacunes,white matter hyperintensities,perivascular spaces,microbleeds,and brain atrophy.The CSVD neuroimaging features have shared and distinct clinical consequences,and the automatic quantification methods for these features are increasingly used in research and clinical settings.This review article explores the recent progress in CSVD neuroimaging feature quantification and provides an overview of the clinical consequences of these CSVD features as well as the possibilities of using these features as endpoints in clinical trials.The added value of CSVD neuroimaging quantification is also discussed for researches focused on the mechanism of CSVD and the prognosis in subjects with CSVD.展开更多
The use of neuroimaging examinations is crucial in Alzheimer’s disease(AD),in both research and clinical settings.Over the years,magnetic resonance imaging(MRI)–based computer-aided diagnosis has been shown to be he...The use of neuroimaging examinations is crucial in Alzheimer’s disease(AD),in both research and clinical settings.Over the years,magnetic resonance imaging(MRI)–based computer-aided diagnosis has been shown to be helpful for early screening and predicting cognitive decline.Meanwhile,an increasing number of studies have adopted machine learning for the classification of AD,with promising results.In this review article,we focus on computerized MRI-based biomarkers of AD by reviewing representative studies that used computerized techniques to identify AD patients and predict cognitive progression.We categorized these studies based on the following applications:(1)identifying AD from normal control;(2)identifying AD from other dementia types,including vascular dementia,dementia with Lewy bodies,and frontotemporal dementia;and(3)predicting conversion from NC to mild cognitive impairment(MCI)and from MCI to AD.This systematic review could act as a state-of-the-art overview of this emerging field as well as a basis for designing future studies.展开更多
Objective:Understanding how brain changes over lifetime provides the basis for new insights into neurophysiology and neuropathology.In this study,we carried out a pseudo-longitudinal study based on age-related Chinese...Objective:Understanding how brain changes over lifetime provides the basis for new insights into neurophysiology and neuropathology.In this study,we carried out a pseudo-longitudinal study based on age-related Chinese brain atlases(i.e.,Chinese2020)constructed from large-scale volumetric brain MRI data collected in normal Han Chinese adults at varying ages.Methods:In order to quantify the deformation and displacement of brains for each voxel as age increases,optical flow algorithm was employed to compute motion vectors between every two consecutive brain templates of the age-related brain atlas,i.e.,Chinese2020.Results:Dynamic age-related neuroanatomical changes in a standardized brain space were shown.Overall,our results demonstrate that brain inward deformation(mainly due to atrophy)can appear in adulthood and this trend generally accelerates as age increases,affecting multiple regions including frontal cortex,temporal cortex,parietal cortex,and cerebellum,whereas occipital cortex is least affected by aging,and even showed some degree of outward deformation in the midlife.Conclusion:Our findings indicated more complicated age-related changes instead of a simple trend of brain volume decrease,which may be in line with the recently increasing interests in the age-related cortical complexity with other morphometry measures.展开更多
基金supported by the Projected Subjects of National Health Commission Stroke Prevention Project Expert Committee(No.GN-2020B0001)Tongrentang Pharmaceutical Factory,Beijing Tongrentang Co.
文摘Background:Preclinical studies have indicated that Angong Niuhuang Pills(ANP)reduce cerebral infarct and edema volumes.This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in patients with moderate to severe acute ischemic stroke.Methods:This randomized,double-blind,placebo-controlled pilot trial included patients with acute ischemic stroke with National Institutes of Health Stroke Scale(NIHSS)scores ranging from 10 to 20 in 17 centers in China between April 2021 and July 2022.Patients were allocated within 36 h after onset via block randomization to receive ANP or placebo(3 g/day for 5 days).The primary outcomes were changes in cerebral infarct and edema volumes after 14 days of treatment.The primary safety outcome was severe adverse events(SAEs)for 90 days.Results:There were 57 and 60 patients finally included in the ANP and placebo groups,respectively for modified intention-to-treat analysis.The median age was 66.0 years,and the median NIHSS score at baseline was 12.0.The changes in cerebral infarct volume at day 14 were 0.3 mL and 0.4 mL in the ANP and placebo groups,respectively(median difference:-7.1 mL;interquartile range[IQR]:-18.3 to 2.3 mL,P=0.30).The changes in cerebral edema volume of the ANP and placebo groups on day 14 were 11.4 mL and 4.0 mL,respectively(median difference:3.0 mL,IQR:-1.3 to 9.9 mL,P=0.15).The rates of SAE within 90 days were similar in the ANP(3/57,5%)and placebo(7/60,12%)groups(P=0.36).Changes in serum mercury and arsenic concentrations were comparable.In patients with large artery atherosclerosis,ANP reduced the cerebral infarct volume at 14 days(median difference:-12.3 mL;IQR:-27.7 to-0.3 mL,P=0.03).Conclusions:ANP showed a similar safety profile to placebo and non-significant tendency to reduce cerebral infarct volume in patients with moderate-to-severe stroke.Further studies are warranted to assess the efficacy of ANP in reducing cerebral infarcts and improving clinical prognosis.Trail Registration:Clinicaltrials.gov,No.NCT04475328.
基金supported partially by grants from the National Key Research and Development Program of China(No.2016YFC1300600)Research Grants Council of the Hong Kong Special Administrative Region,China(No.CUHK 14204117)。
文摘The common cerebral small vessel disease(CSVD)neuroimaging features visible on conventional structural magnetic resonance imaging include recent small subcortical infarcts,lacunes,white matter hyperintensities,perivascular spaces,microbleeds,and brain atrophy.The CSVD neuroimaging features have shared and distinct clinical consequences,and the automatic quantification methods for these features are increasingly used in research and clinical settings.This review article explores the recent progress in CSVD neuroimaging feature quantification and provides an overview of the clinical consequences of these CSVD features as well as the possibilities of using these features as endpoints in clinical trials.The added value of CSVD neuroimaging quantification is also discussed for researches focused on the mechanism of CSVD and the prognosis in subjects with CSVD.
文摘The use of neuroimaging examinations is crucial in Alzheimer’s disease(AD),in both research and clinical settings.Over the years,magnetic resonance imaging(MRI)–based computer-aided diagnosis has been shown to be helpful for early screening and predicting cognitive decline.Meanwhile,an increasing number of studies have adopted machine learning for the classification of AD,with promising results.In this review article,we focus on computerized MRI-based biomarkers of AD by reviewing representative studies that used computerized techniques to identify AD patients and predict cognitive progression.We categorized these studies based on the following applications:(1)identifying AD from normal control;(2)identifying AD from other dementia types,including vascular dementia,dementia with Lewy bodies,and frontotemporal dementia;and(3)predicting conversion from NC to mild cognitive impairment(MCI)and from MCI to AD.This systematic review could act as a state-of-the-art overview of this emerging field as well as a basis for designing future studies.
基金supported by grants from the Innovation and Technology Commission(Project Nos.GHP-025-17SZ and GHP/028/14SZ)of the Hong Kong Special Administrative RegionShenzhen Science and Technology Innovation Committee(Project NoCYZZ20160421160735632)+2 种基金Beijing Nova Program(No.2016000021223TD07)Capacity Building for Sci-Tech Innovation￡-Fundamental Scientific Research Funds(No.19530050157,No.19530050184)the Beijing Brain Initiative of Beijing Municipal Science&Technology Commission.
文摘Objective:Understanding how brain changes over lifetime provides the basis for new insights into neurophysiology and neuropathology.In this study,we carried out a pseudo-longitudinal study based on age-related Chinese brain atlases(i.e.,Chinese2020)constructed from large-scale volumetric brain MRI data collected in normal Han Chinese adults at varying ages.Methods:In order to quantify the deformation and displacement of brains for each voxel as age increases,optical flow algorithm was employed to compute motion vectors between every two consecutive brain templates of the age-related brain atlas,i.e.,Chinese2020.Results:Dynamic age-related neuroanatomical changes in a standardized brain space were shown.Overall,our results demonstrate that brain inward deformation(mainly due to atrophy)can appear in adulthood and this trend generally accelerates as age increases,affecting multiple regions including frontal cortex,temporal cortex,parietal cortex,and cerebellum,whereas occipital cortex is least affected by aging,and even showed some degree of outward deformation in the midlife.Conclusion:Our findings indicated more complicated age-related changes instead of a simple trend of brain volume decrease,which may be in line with the recently increasing interests in the age-related cortical complexity with other morphometry measures.
