Publications by authors named "Alberto De Luca"

Cerebral small vessel diseases (cSVDs) contribute significantly to stroke and dementia. Advanced 7 T MRI techniques have revealed small vessel dysfunction in cSVD patients, linked to global white matter damage cross-sectionally. However, it remains unclear whether these vascular deficits predict progressive tissue damage.

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Background: Survivors of aneurysmal subarachnoid hemorrhage (aSAH) often have cognitive impairment, which may be caused by long-term inflammation. We aimed to determine whether long-term neuroinflammation or microstructural brain damage is associated with cognitive impairment after aSAH.

Methods: In this prospective cohort study, we included patients >3 years after aSAH between 2020 and 2022.

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Tractography involves many steps, and as such can be heavily affected by data quality, operator decisions such as algorithm and parameter selection and/or biological variables - in addition to random effects such as noise and motion. Due to the interplay between sources of variability, even seemingly minor decisions or overlooked assumptions can lead to major variations in output that can potentially confound tractography results. This article summarizes the main sources of variability in tractography to remind both new and experienced users of the importance of making informed decisions at all stages of the tractography pipeline.

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Background: The apparent diffusion coefficient (ADC) derived from diffusion-weighted imaging (DWI) is a potential biomarker for treatment response in pediatric rhabdomyosarcoma. Due to its rarity, investigations into this marker require multicenter approaches, which can result in variability in acquisition parameters.

Objective: To evaluate the impact of different acquisition parameters on ADC estimates in a multicenter dataset of rhabdomyosarcoma patients.

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Tractography provides a powerful framework to reconstruct white matter pathways from diffusion magnetic resonance imaging (dMRI) but remains challenged by its inherent ambiguity and lack of direct biological specificity. This short communication summarizes the key points of a debate held at the 2024 Tract-Anat Retreat on the utility of MRI and non-MRI quantifiable neuroanatomical and functional parameters for improving tractography. During the discussion, concerns were raised about the availability of histological properties only on post-mortem tissues, the disparity in scale between MRI and other modalities and the additional costs (both in time and money) of such additional parameters.

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The idea that self-control (or executive) functions depend on limited "mental resources" that can be depleted (aka ego-depletion) has generated a lot of interest, but both the empirical status of the phenomenon and its theoretical explanation remain controversial. Here, we tested a widely neglected but straightforward prediction of ego-depletion theory: The longer people work on a control-demanding task, the more should their ego deplete. If so, ego-depletion effects should become more pronounced as time on (control) task increases.

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Purpose: Diffusion MRI (dMRI) data typically suffer of significant cross-site variability, which prevents naively performing pooled analyses. To attenuate cross-site variability, harmonization methods such as the rotational invariant spherical harmonics (RISH) have been introduced to harmonize the dMRI data at the signal level. A common requirement of the RISH method is the availability of healthy individuals who are matched at the group level, which may not always be readily available, particularly retrospectively.

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Lesion-symptom mapping methods assess the relationship between lesions caused by cerebral small vessel disease and cognition, but current technology like support vector regression (SVR)) primarily provide group-level results. We propose a novel lesion-symptom mapping approach that can indicate how lesion patterns contribute to cognitive impairment on an individual level. A convolutional neural network (CNN) predicts cognitive scores and is combined with explainable artificial intelligence (XAI) to map the relation between cognition and vascular lesions.

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In cerebral small vessel disease (cSVD), vascular dysfunction has been associated with cSVD-lesions across the brain. Here we further explore the relation between vascular dysfunction and cSVD-related brain injury. We tested two hypotheses: (1) that complementary measures of abnormal small vessel function relate to decreased white matter integrity, and (2) that local variance in vascular dysfunction relates to local variance in white matter integrity within individual patients.

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White matter (WM) free water (FW) is a potential imaging marker for cerebral small vessel disease (CSVD). This study aimed to characterize longitudinal changes in WM FW and investigate factors contributing to its elevation in CSVD. We included 80 CSVD patients and 40 normal controls (NCs) with multi-modality MRI data.

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Objective: Previous retrospective studies have reported vigabatrin-associated brain abnormalities on magnetic resonance imaging (VABAM), although clinical impact is unknown. We evaluated the association between vigabatrin and predefined brain magnetic resonance imaging (MRI) changes in a large homogenous tuberous sclerosis complex (TSC) cohort and assessed to what extent VABAM-related symptoms were reported in TSC infants.

Methods: The Dutch TSC Registry and the EPISTOP cohort provided retrospective and prospective data from 80 TSC patients treated with vigabatrin (VGB) before the age of 2 years and 23 TSC patients without VGB.

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Article Synopsis
  • White matter hyperintensities (WMH) are linked to cognitive impairment but solely measuring their volume doesn't fully explain the cognitive deficits.
  • Lesion network mapping (LNM) offers a new way to assess how WMH connects with brain networks, potentially improving our understanding of their impact on cognition.
  • In a study of 3,485 patients, LNM scores outperformed WMH volumes in predicting cognitive performance, especially in attention, processing speed, and verbal memory, but not for language functions.
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Peak width of skeletonized mean diffusivity (PSMD) is an emerging diffusion-MRI based marker to study subtle early alterations to white matter microstructure. We assessed PSMD over the clinical continuum in Dutch-type hereditary CAA (D-CAA) and its association with other CAA-related MRI-markers and cognitive symptoms. We included (pre)symptomatic D-CAA mutation-carriers and calculated PSMD from diffusion-MRI data.

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Introduction: White matter hyperintensities of presumed vascular origin (WMH) are associated with cognitive impairment and are a key imaging marker in evaluating cognitive health. However, WMH volume alone does not fully account for the extent of cognitive deficits and the mechanisms linking WMH to these deficits remain unclear. We propose that lesion network mapping (LNM), enables to infer if brain networks are connected to lesions, and could be a promising technique for enhancing our understanding of the role of WMH in cognitive disorders.

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Article Synopsis
  • The study focuses on optimizing diffusion-weighted imaging (DWI) acquisition protocols to analyze tissue microstructure effectively in a clinical setting.
  • Eleven healthy subjects participated in an extensive protocol that tested various DWI models, including DTI and NODDI, assessing data collection time and parameter estimation.
  • The findings indicate that the optimized acquisition scheme reduces the time needed from 35 minutes to 14 minutes without compromising the quality of the data, allowing for effective analysis of multiple models within a shorter timeframe.
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Background: Pediatric brain tumor patients are at risk of developing neurocognitive impairments and associated white matter alterations. In other populations, post-traumatic stress symptoms (PTSS) impact cognition and white matter. This study aims to investigate the effect of PTSS on neurocognitive functioning and limbic white matter in pediatric brain tumor patients.

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Article Synopsis
  • During long spaceflights, astronauts experience fluid shifts and changes in brain spaces, creating challenges for understanding their effects due to the difficulty of studying them directly.
  • This study analyzed the effects of head-down tilt bed rest (HDBR) and elevated carbon dioxide on the brain's perivascular spaces, which simulate conditions in space.
  • Results showed that while overall changes in these spaces were minimal, individuals with symptoms of Spaceflight Associated Neuro-ocular Syndrome (SANS) had different responses, suggesting the need for countermeasures to protect astronauts' health during space missions.
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Advanced intraoperative MR images (ioMRI) acquired during the resection of pediatric brain tumors could offer additional physiological information to preserve healthy tissue. With this work, we aimed to develop a protocol for ioMRI with increased sensitivity for arterial spin labeling (ASL) and diffusion MRI (dMRI), optimized for patient positioning regularly used in the pediatric neurosurgery setting. For ethical reasons, ASL images were acquired in healthy adult subjects that were imaged in the prone and supine position.

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Background: Magnetic Resonance Imaging (MRI) visible perivascular spaces (PVS) have been associated with age, decline in cognitive abilities, interrupted sleep, and markers of small vessel disease. But the limits of validity of their quantification have not been established.

New Method: We use a purpose-built digital reference object to construct an in-silico phantom for addressing this need, and validate it using a physical phantom.

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Cerebral Amyloid Angiopathy (CAA) is characterized by cerebrovascular amyloid-β accumulation leading to hallmark cortical MRI markers, such as vascular reactivity, but white matter is also affected. By studying the relationship in different disease stages of Dutch-type CAA (D-CAA), we tested the relation between vascular reactivity and microstructural white matter integrity loss. In a cross-sectional study in D-CAA, 3 T MRI was performed with Blood-Oxygen-Level-Dependent (BOLD) fMRI upon visual activation to assess vascular reactivity and diffusion tensor imaging to assess microstructural white matter integrity through Peak Width of Skeletonized Mean Diffusivity (PSMD).

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Objective: To investigate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) as a predictive imaging marker after neoadjuvant chemotherapy in patients with rhabdomyosarcoma.

Material And Methods: We performed a multicenter retrospective study including pediatric, adolescent and young adult patients with rhabdomyosarcoma, Intergroup Rhabdomyosarcoma Study group III/IV, treated according to the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 or MTS2008 studies. DW-MRI was performed according to institutional protocols.

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Cerebral small vessel disease (SVD) is common during ageing and can present as stroke, cognitive decline, neurobehavioural symptoms, or functional impairment. SVD frequently coexists with neurodegenerative disease, and can exacerbate cognitive and other symptoms and affect activities of daily living. Standards for Reporting Vascular Changes on Neuroimaging 1 (STRIVE-1) categorised and standardised the diverse features of SVD that are visible on structural MRI.

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In the pediatric brain tumor surgery setting, intraoperative MRI (ioMRI) provides "real-time" imaging, allowing for evaluation of the extent of resection and detection of complications. The use of advanced MRI sequences could potentially provide additional physiological information that may aid in the preservation of healthy brain regions. This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging.

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