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Byun JI, Oh S, Sunwoo JS, Shin JW, Kim TJ, Jun JS, Kim HJ, Shin WC, Seong JK, Jung KY. White matter tract-specific microstructural disruption is associated with depressive symptoms in isolated RBD. Neuroimage Clin 2022; 36:103186. [PMID: 36116164 PMCID: PMC9483791 DOI: 10.1016/j.nicl.2022.103186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/23/2022] [Accepted: 09/02/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE White matter (WM) tract-specific changes may precede gray matter loss in isolated rapid eye movement sleep behavior disorder (iRBD). We aimed to evaluate tract-specific WM changes using tract-specific statistical analysis (TSSA) and their correlation with clinical variables in iRBD patients. METHODS This was a cross-sectional single-center study of 50 polysomnography-confirmed iRBD patients and 20 age- and sex-matched controls. We used TSSA to identify tract-specific fractional anisotropy (FA) and mean diffusivity (MD) in fourteen major fiber tracts and analyzed between-group differences in these values. Correlations between FA or MD values and clinical variables, including RBD symptom severity, depression and cognition, were evaluated. RESULTS Patients with iRBD showed lower FA in the right anterior thalamic radiation (ATR) and higher MD in the bilateral ATR and right inferior fronto-occipital fasciculus (IF-OF) than controls after adjusting for age, sex, and years of education. MD values in the IF-OF positively correlated with scores on the Korean version of the Rapid Eye Movement Sleep Behavior Disorder Questionnaire-Hong Kong (RBDQ-KR, p = 0.042) and the Korean version of the geriatric depression scale (GDS-K, p = 0.002) in iRBD patients. Only GDS-K scores independently correlated with IF-OF MD values after adjusting for RBDQ-KR scores (adjusted p = 0.026). CONCLUSION This study suggests WM microstructural disruption in the bilateral ATR and right IF-OF in patients with iRBD and that alterations in the IF-OF may contribute to depressive symptoms.
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Affiliation(s)
- Jung-Ick Byun
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seunghwan Oh
- Department of Artificial Intelligence, Korea University, Seoul, South Korea
| | - Jun-Sang Sunwoo
- Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea
| | - Jung-Won Shin
- Department of Neurology, CHA University, CHA Bundang Medical Center, Seongnam, South Korea
| | - Tae-Joon Kim
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of South Korea
| | - Jin-Sun Jun
- Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Han-Joon Kim
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Won Chul Shin
- Department of Neurology, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Joon-Kyung Seong
- Department of Artificial Intelligence, Korea University, Seoul, South Korea,Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea,School of Biomedical Engineering, Korea University, Seoul, South Korea,Corresponding authors at: School of Biomedical Engineering, Korea University, 145, Anam-ro, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, South Korea (Joon-Kyung Seong), Department of Neurology, Seoul National University Hospital, Neuroscience Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, South Korea (Ki-Young Jung)
| | - Ki-Young Jung
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea,Corresponding authors at: School of Biomedical Engineering, Korea University, 145, Anam-ro, Anam-dong 5-ga, Seongbuk-gu, Seoul 02841, South Korea (Joon-Kyung Seong), Department of Neurology, Seoul National University Hospital, Neuroscience Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, South Korea (Ki-Young Jung)
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White matter tract-specific alterations in patients with primary restless legs syndrome. Sci Rep 2021; 11:16116. [PMID: 34373482 PMCID: PMC8352949 DOI: 10.1038/s41598-021-95238-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/22/2021] [Indexed: 01/18/2023] Open
Abstract
Prior diffusion tensor imaging (DTI) studies have investigated white matter (WM) changes in patients with primary restless legs syndrome (RLS), but the results were inconsistent. Here, we proposed using tract-specific statistical analysis (TSSA) to find alterations in specific WM tracts to clarify the pathophysiological mechanisms of RLS. We enrolled 30 patients with RLS and 31 age- and sex- matched controls who underwent brain magnetic resonance imaging, neuropsychological tests, and polysomnography. Fractional anisotropy (FA) maps obtained from whole-brain diffusion tensor imaging and TSSA were used to localize WM changes in patients with RLS. Subsequently, a comparison of FA values for each tract between patients and controls was performed. The associations between FA values and clinical, polysomnographic, and neuropsychological parameters in RLS patients were assessed. RLS patients demonstrated decreased FA values in the left corticospinal tract (CST) and cingulum, and in the right anterior thalamic radiation (ATR) and inferior fronto-occipital fasciculus (IFO). Patients’ attention/executive function and visual memory scores positively correlated with FA values in the right ATR, and anxiety levels negatively correlated with FA values in the right IFO. Additionally, the number of periodic leg movements and movement arousal index were negatively correlated with FA values in the left CST. The TSSA method identified previously unknown tract-specific alterations in patients with RLS and significant associations with distinct clinical manifestations of RLS.
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Park HR, Kim HR, Seong JK, Joo EY. Localizing deficits in white matter tracts of patients with narcolepsy with cataplexy: tract-specific statistical analysis. Brain Imaging Behav 2021; 14:1674-1681. [PMID: 31115860 DOI: 10.1007/s11682-019-00100-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
White matter alterations related to hypocretin pathway have been less evaluated in patients who have narcolepsy with cataplexy (NC), as compared to the identified exploration of gray matter and have varied among structural brain magnetic resonance imaging studies. The aim of this study was to investigate the disruption of specific white matter tracts in drug-naïve patients with NC, by using a tract-specific statistical analysis (TSSA). Forty drug-naïve NC patients with cataplexy and 42 heathy controls were enrolled in the study. All participants completed diffusion weighted imaging, polysomnography, and neuropsychological testing. At that time, we automatically identified fourteen major fiber tracts using diffusion tensor imaging techniques and analyzed the group comparison of fractional anisotropy (FA) values for each tract between the NC and controls, controlling for the participant's age and gender. The mean age of the NC patients was 26.9 years and the onset age of daytime sleepiness and cataplexy was 16.7 years and 19.9 years, respectively. Relative to the controls, the NC patients showed that there were identified decreased FA values in the bilateral inferior fronto-occipital fasciculus (IFO). The Epworth sleepiness scale was positively correlated with FA values for the left IFO and right cingulate. The REM sleep latency was positively correlated with FA values for the left IFO, cingulate, and uncinate fasciculus in patients. This TSSA study revealed disintegration of the IFO in the NC patients and suggested that disintegration of WM tracts connected to the frontal cortex contributes to clinical manifestations of narcolepsy.
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Affiliation(s)
- Hea Ree Park
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
| | - Hye Ryun Kim
- School of Biomedical Engineering, Korea University, 145, Anam-ro, Anam-dong 5-ga, Seongbuk-gu, Seoul, 02841, Republic of Korea.,Global Health Technology Research Center, College of Health Science, Korea University, Seoul, South Korea
| | - Joon-Kyung Seong
- Global Health Technology Research Center, College of Health Science, Korea University, Seoul, South Korea.
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea. .,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea.
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Koo DL, Kim HR, Kim H, Seong JK, Joo EY. White matter tract-specific alterations in male patients with untreated obstructive sleep apnea are associated with worse cognitive function. Sleep 2021; 43:5680176. [PMID: 31848608 DOI: 10.1093/sleep/zsz247] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/21/2019] [Indexed: 01/13/2023] Open
Abstract
STUDY OBJECTIVES Neurocognitive impairment is one of the daytime symptoms of obstructive sleep apnea (OSA). We proposed to use tract-specific statistical analysis (TSSA) to investigate whether there are fiber tract abnormalities in OSA, which may be undiscovered using voxel-based approaches, and whether such tract-specific disruptions in brain connectivity are associated with neuropsychological deficits in patients with untreated OSA. METHODS We enrolled 38 patients with OSA diagnosed by overnight polysomnography, and 41 healthy sleepers. Fractional anisotropy (FA) and mean diffusivity (MD) maps were obtained from whole-brain diffusion tensor imaging, and TSSA were used to assess regional deficits of white matter tracts. All participants underwent a battery of neuropsychological tests. To evaluate the association between FA values and clinical, polysomnographic, and neuropsychological parameters in the OSA group, permutation-based tests for correlation were performed preceding cluster-based statistics. RESULTS Compared to healthy controls, patients with OSA showed decreased values of FA in the left and right anterior thalamic radiations, and right uncinate fasciculus (UNC) (p < 0.001, p = 0.005, and p = 0.008, respectively). A lower score of digit span backward was associated with lower FA values of right UNC in the OSA group (p = 0.023). The Rey Complex Figure Test copy score revealed a positive correlation with FA values in the right UNC (p = 0.010). CONCLUSIONS The TSSA method indeed identified previously unrevealed tract-specific disruptions in OSA. Furthermore, reduced FA values in the frontal lobe portion of the right UNC which has been known to be involved in working memory function were significantly associated with lower cognitive performance in patients with untreated OSA.
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Affiliation(s)
- Dae Lim Koo
- Department of Neurology, Boramae Medical Center, Seoul National University College of Medicine, Seoul, South Korea
| | - Hye Ryun Kim
- Global Health Technology Research Center, College of Health Science, Korea University, Seoul, South Korea
| | - Hosung Kim
- Department of Neurology, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Joon-Kyung Seong
- Global Health Technology Research Center, College of Health Science, Korea University, Seoul, South Korea.,School of Biomedical Engineering, Korea University, Seoul, South Korea
| | - Eun Yeon Joo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Samsung Biomedical Research Institute, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, South Korea
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Xu Z, Wang J, Lyu H, Wang R, Hu Y, Guo Z, Xu J, Hu Q. Alterations of White Matter Microstructure in Subcortical Vascular Mild Cognitive Impairment with and without Depressive Symptoms. J Alzheimers Dis 2020; 73:1565-1573. [PMID: 31958086 DOI: 10.3233/jad-190890] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ziyun Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jianjun Wang
- Department of Neurology and Psychiatry, Shenzhen Traditional Chinese Medicine Hospital / the Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, P. R. China
| | - Hanqing Lyu
- Department of Radiology, Shenzhen Traditional Chinese Medicine Hospital / the Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, P. R. China
| | - Runshi Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuanming Hu
- Department of Radiology, Shenzhen Traditional Chinese Medicine Hospital / the Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, P. R. China
| | - Zhouke Guo
- Department of Neurology and Psychiatry, Shenzhen Traditional Chinese Medicine Hospital / the Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, P. R. China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- University of Chinese Academy of Sciences, Beijing, China
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Kim KW, Kwon H, Kim YE, Yoon CW, Kim YJ, Kim YB, Lee JM, Yoon WT, Kim HJ, Lee JS, Jang YK, Kim Y, Jang H, Ki CS, Youn YC, Shin BS, Bang OY, Kim GM, Chung CS, Kim SJ, Na DL, Duering M, Cho H, Seo SW. Multimodal imaging analyses in patients with genetic and sporadic forms of small vessel disease. Sci Rep 2019; 9:787. [PMID: 30692550 PMCID: PMC6349863 DOI: 10.1038/s41598-018-36580-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 11/24/2018] [Indexed: 11/09/2022] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is thought to be a pure genetic form of subcortical vascular cognitive impairment (SVCI). The aim of this study was to compare white matter integrity and cortical thickness between typical CADASIL, a genetic form, and two sporadic forms of SVCI (with NOTCH3 and without NOTCH3 variants). We enrolled typical CADASIL patients (N = 11) and SVCI patients [with NOTCH3 variants (N = 15), without NOTCH3 variants (N = 101)]. To adjust the age difference, which reflects the known difference in clinical and radiologic courses between typical CADASIL patients and SVCI patients, we constructed a W-score of measurement for diffusion tensor image and cortical thickness. Typical CADASIL patients showed more frequent white matter hyperintensities in the bilateral posterior temporal region compared to SVCI patients (p < 0.001, uncorrected). We found that SVCI patients, regardless of the presence of NOTCH3 variants, showed significantly greater microstructural alterations (W-score, p < 0.05, FWE-corrected) and cortical thinning (W-score, p < 0.05, FDR-corrected) than typical CADASIL patients. In this study, typical CADASIL and SVCI showed distinct anatomic vulnerabilities in the cortical and subcortical structures. However, there was no difference between SVCI with NOTCH3 variants and SVCI without NOTCH3 variants.
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Affiliation(s)
- Ko Woon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Department of Neurology, Chonbuk National University Medical School & Hospital, Jeonju, Korea
| | - Hunki Kwon
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea.,Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Young-Eun Kim
- Genome Research Center, Green Cross Genome, Yong-in, Korea
| | - Cindy W Yoon
- Department of Neurology, Inha University School of Medicine, Incheon, Korea
| | - Yeo Jin Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Yong Bum Kim
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Won Tae Yoon
- Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin San Lee
- Department of Neurology, Kyung Hee University Hospital, Seoul, Korea
| | - Young Kyoung Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeshin Kim
- Department of Neurology, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea
| | - Hyemin Jang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang-Seok Ki
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Byoung-Soo Shin
- Department of Neurology, Chonbuk National University Medical School & Hospital, Jeonju, Korea
| | - Oh Young Bang
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gyeong-Moon Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chin-Sang Chung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Joo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU, Munich, Germany
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, and Departments of, Clinical Research Design and Evaluation, Seoul, Korea.
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. .,Neuroscience Center, Samsung Medical Center, Seoul, Korea. .,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.
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Lee WJ, Han CE, Aganj I, Seo SW, Seong JK. Distinct Patterns of Rich Club Organization in Alzheimer’s Disease and Subcortical Vascular Dementia: A White Matter Network Study. J Alzheimers Dis 2018; 63:977-987. [DOI: 10.3233/jad-180027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Wha Jin Lee
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea
| | - Cheol E. Han
- Department of Electronics and Information Engineering, Korea University, Sejong, Republic of Korea
| | - Iman Aganj
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea
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Ye Q, Bai F. Contribution of diffusion, perfusion and functional MRI to the disconnection hypothesis in subcortical vascular cognitive impairment. Stroke Vasc Neurol 2018; 3:131-139. [PMID: 30294468 PMCID: PMC6169607 DOI: 10.1136/svn-2017-000080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 01/26/2018] [Accepted: 02/14/2018] [Indexed: 11/29/2022] Open
Abstract
Vascular cognitive impairment (VCI) describes all forms of cognitive impairment caused by any type of cerebrovascular disease. Early identification of VCI is quite difficult due to the lack of both sensitive and specific biomarkers. Extensive damage to the white matter tracts, which connect the cortical and subcortical regions, has been shown in subcortical VCI (SVCI), the most common subtype of VCI that is caused by small vessel disease. Two specific MRI sequences, including diffusion tensor imaging (DTI) and functional MRI (fMRI), have emerged as useful tools for identifying subtle white matter changes and the intrinsic connectivity between distinct cortical regions. This review describes the advantages of these two modalities in SVCI research and the current DTI and fMRI findings on SVCI. Using DTI technique, a variety of studies found that white matter microstructural damages in the anterior and superior areas are more specific to SVCI. Similarly, functional brain abnormalities detected by fMRI have also been mainly shown in anterior brain areas in SVCI. The characteristic distribution of brain abnormalities in SVCI interrupts the prefrontal-subcortical loop that results in cognitive impairments in particular domains, which further confirms the ‘disconnection syndrome’ hypothesis. In addition, another MRI technique, arterial spin labelling (ASL), has been used to describe the disconnection patterns in a variety of conditions by measuring cerebral blood flow. The role of the ASL technique in SVCI research is also assessed. Finally, the review proposes the application of multimodality fusion in the investigation of SVCI pathogenesis.
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Affiliation(s)
- Qing Ye
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
| | - Feng Bai
- Department of Neurology, Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, China
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