Research Presentation Session: Neuro

RPS 811 - Foetal and neonatal neuroimaging: epilepsy and the senses

February 29, 09:30 - 11:00 CET

7 min
One-minute full brain multi-contrast MRI vs brain CT in paediatric patients in the elective setting: a prospective feasibility study
Francesca De Luca, Solna / Sweden
Author Block: F. De Luca, A. Kits, D. Martin Muñoz, A. Aspelin, O. Kvist, Y. Osterman, S. Diaz Ruiz, S. Skare, A. Falk Delgado; Stockholm/SE
Purpose: The radiological examination of paediatric patients with suspected cerebral pathology is performed at first instance with brain CT when MRI resources and general anaesthesia are unavailable. The study aimed to evaluate the tolerance to a complete diagnostic fast brain MRI (EPIMix) by paediatric patients without general anaesthesia and to compare the diagnostic accuracy of EPIMix and brain CT.
Methods or Background: Paediatric patients with a referral for elective brain CT between March 2019 and March 2020 were prospectively included and underwent EPIMix and brain CT without anaesthesia. Three readers evaluated EPIMix and CT image datasets separately, blinded from any clinical information. The study outcomes were to assess the tolerance to a complete diagnostic EPIMix sequence without general anaesthesia and the diagnostic performance in classifying scans as non-pathological or pathological. The two image modalities were compared using descriptive statistics and Fisher’s exact test. Furthermore, a side-by-side evaluation of EPIMIx and CT image datasets was performed by two additional unblinded readers and one previously blinded reader.
Results or Findings: All included paediatric patients (n=15) tolerated EPIMix well. The EPIMIx and CT scans were reported as non-pathological in 13 and 12 cases, respectively, by the three readers, while two cases of EPIMix and three cases of CT were classified as pathological by one reader (Fisher’s exact test, reader 1–3 p=1.00). Side-by-side evaluation reported all scans as non-pathological on both EPIMix and CT image datasets.
Conclusion: Paediatric patients tolerated the diagnostic fast brain MRI EPIMix without the need for general anaesthesia. Further, EPIMix showed a comparable diagnostic performance to brain CT.

An article from this study has been published in BMC Medical imaging. The Version of Record of this article is published in BMC Medical Imaging and is available online at https://doi.org/10.1186/s12880-024-01196-6
Limitations: The three blinded readers evaluating the images had varied experiences. However, there were no significant differences in scan classification between EPIMix and CT, which enhances the applicability of our findings.
Funding for this study: Funding for the authors of this study was received from Stockholms Läns Landsting. Funding was also received from the Svenska Sällskapet för Medicinsk Forskning and Karolinska Institutet.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Swedish Ethical Review Authority.
7 min
Diffusion tensor magnetic resonance neuroimaging metrics of neonates with intraventricular haemorrhages predict neurodevelopmental outcome
Selina Seeliger, Vienna / Austria
Author Block: S. Seeliger, P. Kienast, V. Schmidbauer, K. Goeral, J. Elis, D. Prayer, G. Kasprian; Vienna/AT
Purpose: Intraventricular haemorrhages (IVH) are a major cause of neurodevelopmental impairment in premature neonates. Approximately 15-20% of neonates delivered prior to reaching 32 weeks of gestation (GW) suffer from IVH. This study aims to identify new noninvasive markers based on diffusion tensor magnetic resonance imaging (DTI) to accurately predict neurodevelopmental outcomes in preterm infants with IVH.
Methods or Background: Neuroimaging was performed on 41 (n=15, 37% female) preterm neonates (mean GW 26,34 ± 2.6 weeks SD at the time of birth) with IVH using DTI. Regions of interest (ROIs) were placed in early myelinating structures. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in the set ROIs. Neonatal outcome scores were calculated using the Bayley Scales of Infant and Toddler Development conducted at 12 months and 24 months corrected age. Statistical analyses, including Pearson's correlations and ANOVA, were performed to establish correlations between DTI metrics and neurodevelopmental outcomes.
Results or Findings: FA of the medulla oblongata showed a highly significant correlation with the one-year outcome (r=-0.559, p=0.004). FA of the right internal capsule showed a significant correlation between one-year outcome (r=-0.404, p=0.045) and two-year language outcome (r=-0.658, p=0.020). FA of the left internal capsule showed highly significant correlations between cognitive (r=-0.525, p=0.007), motor (r=-0.637, p<0.001), and motor outcome (r=-0.527, p=0.007) after 12 months corrected age.
Conclusion: DTI-based MRI provides valuable prognostic information on future neurodevelopmental outcomes after IVH. DTI enhances the sensitivity of neonatal MR neuroimaging and could support clinical decision-making for these vulnerable patients.
Limitations: No limitations were identified.
Funding for this study: Funding for the authors of this study, Patric Kienast and Julia Elis, was provided by the Vienna Science and Technology Fund (WWTF; LS20-030, PIMIENTO).
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: The study was approved with the approval code: EK 2455/2020.
7 min
Quantitative synthetic MRI- vs MR-fingerprinting-based relaxometry of foetal brainstem myelination: a post-mortem imaging study
Jakob Malik, Vienna / Austria
Author Block: V. Schmidbauer, J. Malik, I-V. A. Malla Houech, J. Binder, E. Gelpi, D. Prayer, G. Kasprian; Vienna/AT
Purpose: Novel quantitative magnetic resonance imaging (MRI) modalities provide relaxometric properties that are linked to myelinogenesis. The aim of this work was to investigate ongoing myelin development in foetuses based on a quantitative post-mortem imaging approach using Synthetic MRI- and MR-Fingerprinting (MRF). Furthermore, the results of both modalities were compared.
Methods or Background: In 26 cases, quantitative post-mortem foetal MR data were available. Relaxometric measurements (T1-/T2-relexation times (T1R/T2R)) were determined in the medulla oblongata and the midbrain using Synthetic MRI-/MRF-specific post-processing procedures. Pearson’s correlations were applied to detect relationships between T1R/T2R metrics and gestational age (GA) at MRI. Intra-class correlation coefficients were calculated to proof the consistency of the results provided by both modalities.
Results or Findings: Both modalities provided quantitative data that revealed negative correlations with GA at MRI: Synthetic MRI-derived T1R (medulla oblongata (r=-0.459; p=0.021); midbrain (r=-0.413; p=0.040)) and T2R (medulla oblongata (r=-0.625; p<0.001); midbrain (r=-0.571; p=0.003)) versus MRF-derived T1R (medulla oblongata (r=-0.433; p=0.035); midbrain (r=-0.386; p=0.062)) and T2R (medulla oblongata (r=-0.883; p<0.001); midbrain (r=-0.890; p<0.001)). Results consistency between both MR approaches ranged between 0.661; confidence interval (CI: 0.351 – 0.841) (T2R: medulla oblongata) and 0.920 (CI: 0.821 – 0.965) (T1R: midbrain).
Conclusion: Synthetic MRI and MRF provide consistent results. Both modalities hold high sensitivity to quantify ongoing myelinogenesis prenatally. Therefore, quantitative MRI holds promising potential for the assessment of biochemical aspects of brain maturation in the second half of pregnancy.
Limitations: The study was limited by its small sample size.
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study received ethical approval with the code: 1585/2023.
7 min
The visibility of the indusium griseum on foetal MRI postmortem and in vivo
Ivana Pogledic, Vienna / Austria
Author Block: I. Pogledic1, M. Bobić-Rasonja2, C. Mitter1, A. Štajduhar2, E. Schwartz1, G. Kasprian1, M. Judaš2, D. Prayer1, N. Jovanov-Milošević2; 1Vienna/AT, 2Zagreb/HR
Purpose: The study aimed to assess the visibility of the indusium griseum (IG) on MR scans of the foetal human brain and to evaluate its reliability as an imaging biomarker of the regularity of brain midline development.
Methods or Background: The retrospective observational study encompassed T2-w 3T MR images postmortem from ninety foetal brains and immunohistochemical sections from 41 foetal brains with regular brain development. Three raters independently evaluated the visibility of IG, and weighted kappa statistics and regression analysis were used for visibility evaluation.
Results or Findings: The visibility of the IG was the highest between the 25 and 30 GW period (inter-rater kappa 0.623-0.709) and excellent intra-rater variability (kappa 0.81 – 0.93). The immunochemical analysis of the IG discloses the expression of highly hydrated extracellular molecules in IG as the substrate of higher signal intensity and the best visibility of IG during the mid-foetal period. The IG anatomic position above the callosal trunk could influence the measurements of CC thickness when imaging methods are used at its developmental peak. Super-resolution imaging modalities may improve the visibility of the IG in in vivo MRI in the near future, strengthening the value of IG as a biomarker.
Conclusion: The knowledge of developmental brain histology and foetal age allows us to predict the IG-visibility in MRI and use it as a biomarker to evaluate the morphogenesis of the brain midline. IG is particularly interesting as a biomarker in postmortem pathological examination by MRI.
Limitations: The number of encompassed cases due to the unavailability of MRI scans without brain pathologies is the main limitation of this study; therefore multicentric foetal MR studies, with more cases included, could elucidate the role of IG in health and disease and its prognostic value.
Funding for this study: Funding was received from the Croatian Science funds: IP-2019-04-3182, DOK-01-3771, DOK-02-5988); University of Zagreb School of Medicine Funds: (10106-22-3116; 10106-23-2487), and by the European Regional Development Fund: “Experimental and clinical research of hypoxic-ischemic damage in perinatal and adult brain” (GA KK01.1.1.01.0007).
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: Approval for the histological part of the study was given by the Ethics Committee of the University of Zagreb, School of Medicine, following the Declaration of Helsinki (No.: 380-59-10106-19-111/210 class:641-01/19-02/01). The MRI part of the study was approved by the Ethics Committee of the Medical School of the University of Vienna (EK 1211/2019).
7 min
Regional cortical thinning and aberrant cortical folding in sleep-related hypermotor epilepsy
Huaxia Pu, Chengdu / China
Author Block: H. Pu, X. Su, S. Zhang, Q. Yue, Q. Gong; Chengdu/CN
Purpose: Sleep-related hypermotor epilepsy (SHE) is a focal epilepsy whose neurobiological factors such as cortical surface structure alterations remain poorly understood. The objective of this study was to investigate the neuromorphometric abnormalities and their relationship with clinical characteristics in SHE patients using structural magnetic resonance imaging (MRI).
Methods or Background: 69 patients with SHE and 69 healthy controls (HCs) were prospectively recruited and underwent high-resolution T1-weighted MRI scanning. The surface-based morphometry (SBM) analysis based on Computational Anatomy Toolbox (CAT12) was used to evaluate structural parameters such as cortical thickness, fractal dimension, gyrification, and sulcal depth. The two groups were compared with two-sample t-tests (p<0.05, family-wise error (FWE) corrected at cluster level). The association between the cortical morphological changes in local brain regions and the epilepsy duration or the seizure frequency was explored with correlation analysis.
Results or Findings: SHE patients exhibited significantly decreased cortical thickness in the left inferior-parietal, right superior-parietal, bilateral lateral-occipital cortices, left fusiform, and lingual gyri (p=0.00001 - 0.00004), and decreased sulcal depth in the right precentral and postcentral gyri (p≤0.00001) compared to HCs . However, there were no statistically significant differences in the fractal dimension or gyrification between SHE and HCs (all P>0.05). Correlation analysis showed a negative correlation between the left inferior-parietal cortical thickness alteration and the duration of SHE (r=-0.325, p=0.006).
Conclusion: Our study revealed that cortical thinning and aberrant folding of local cerebral cortices existed in SHE and may be associated with clinical hypermotor semiology. These findings might provide a foundation for understanding the epilepsy network disturbances and the underlying neuropathologic mechanism of SHE.
Limitations: This study used a cross-sectional design with a relatively small sample size. Some patients received anti-epileptic drugs, which may impact the results.
Funding for this study: Funding was received from the National Natural Science Foundation of China (Grant No. 82271961).
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the local Ethical Committee of West China Hospital, Sichuan University.
7 min
Task-negative brain activity as an indicator of task engagement in preoperative temporal lobe epilepsy patients: a functional MRI study
Radheshyam Stepponat, Vienna / Austria
Author Block: R. Stepponat, M. S. Yildirim, J. Leinkauf, F. Fischmeister, S. Bonelli, G. Kasprian; Vienna/AT
Purpose: This study aimed to analyse the relationship between task-negative and task-positive brain activity, focusing on the stability of the default mode network during verb-generation and sentence-comprehension and its relationship to language lateralisation and task-engagement.
Methods or Background: In clinical practice, fMRI is mainly used for preoperative language lateralisation assessment, commonly employing verb-generation (VG) and sentence-comprehension (SC) tasks. Language lateralisation is determined by calculating the lateralisation index (LI) for task-positive brain activity, but variability in task performance can lead to uncertain results. Twenty-three patients (12 male, 11 female), averaging 28.6 years, with lesional (n=13) and MR-negative (n=10) temporal lobe epilepsy underwent preoperative fMRI. Standard preprocessing was conducted. The LI toolbox was used to assess temporal lobe lateralisation for the task-active contrast. Region of interest (ROI) analysis of the posterior cingulate cortex (PCC, Brodmann-area 23 and 31) at a threshold of p≤0.01 was conducted for the task-negative contrast.
Results or Findings: Sixteen patients displayed consistent temporal lobe lateralisation: 13 left and 3 bilateral lateralization, while seven patients exhibited varying lateralisation between tasks.
In VG task-negative ROI analysis, four patients lacked PCC activation, while others showed left (n=3), right (n=3), or bilateral (n=13) activation. In SC all but one patient displayed bilateral PCC activation. Divergent lateralisation between tasks was significantly associated with PCC inactivity in VG task-negative ROI analysis using X2 (1, N=23)= 4.5, p=0.033.
Conclusion: The absence of PCC activation during VG may be indicative of incompliance, epilepsy-associated DMN changes, and cognitive impairment due to epilepsy, all of which may limit the clinical usability of the data. Further functional connectome subgroup analysis is underway.
Limitations: ROI analysis conducted in the study was limited to PCC. The study's sample size is a further limitation; a larger sample size may yield more significant correlations. Task-compliance was also only partially documented.
Funding for this study: No funding was received for this study, which was conducted as part of a PhD-thesis.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Medical University of Vienna, EK: 1141/2023.
7 min
Altered neurovascular coupling in thyroid-associated ophthalmopathy: a combined resting-state fMRI and arterial spin labelling study
Wen Chen, Suzhou / China
Author Block: W. Chen1, H. Hu2, X-Q. Xu2, F-Y. Wu2; 1Suzhou/CN, 2Nanjing/CN
Purpose: Besides the well-documented ophthalmic manifestations, thyroid-associated ophthalmopathy (TAO) is believed to be related to emotional and psychological abnormalities. Given the previous neuroimaging evidence, we hypothesised that TAO patients would have altered neurovascular coupling associated with clinical-psychiatric disturbances. The purpose of this study was to investigate neurovascular coupling changes in TAO by combining resting-state functional magnetic resonance imaging (rs-fMRI) and arterial spin labelling (ASL) techniques.
Methods or Background: Amplitude of low-frequency fluctuation (ALFF) was calculated from rs-fMRI (evaluating neuronal activity), and cerebral blood flow (CBF) was computed from ASL (evaluating vascular response) in 37 TAO patients and 21 healthy controls (HCs). Global neurovascular coupling was assessed by across-voxel CBF-ALFF correlation, and regional neurovascular coupling was evaluated by CBF/ALFF ratio. Auxiliary analyses were performed by using fractional amplitude of low-frequency fluctuation (fALFF) and regional homogeneity (ReHo) as rs-fMRI measures.
Results or Findings: TAO patients showed significantly reduced global CBF-ALFF coupling compared with HCs. Moreover, TAO patients exhibited decreased CBF/ALFF ratio in the left lingual gyrus (LG)/fusiform gyrus (FFG), and increased CBF/ALFF ratio in the bilateral precuneus (PCu). In TAOs, CBF/ALFF ratio in the left LG/FFG was positively correlated with visual acuity, whilst CBF/ALFF ratio in the bilateral PCu was negatively correlated with MoCA score. The auxiliary analyses showed trends of reduced global neurovascular coupling (i.e. CBF-fALFF correlation and CBF-ReHo correlation), as well as significant altered regional neurovascular coupling (i.e. CBF/fALFF ratio and CBF/ReHo ratio) in several brain regions.
Conclusion: TAO patients had altered neurovascular coupling in the visual and higher order cognitive cortices. The neurovascular decoupling might be a possible neuropathological mechanism of TAO.
Limitations: The sample size was relatively small, and the cross-sectional design may limit the evaluations of brain changes along with the development of the disease.
Funding for this study: Funding was received from the National Natural Science Foundation of China (NSFC) (81801659 to Hao Hu) and Clinical Capability Promotion Project of Jiangsu Province Hospital (to Xiao-Quan Xu).
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University (ref: 2021-SRFA-024).
7 min
Structural and functional brain changes after glucocorticoid therapy in thyroid-associated ophthalmopathy
Qian Wu, Nanjing / China
Author Block: Q. Wu, J. Zhou, W-H. Jiang, X-Y. Pu, X-Q. Xu, H. Hu, F-Y. Wu; Nanjing/CN
Purpose: The purpose of this study was to investigate the brain structural and functional alterations in patients with thyroid-associated ophthalmopathy (TAO) before and after glucocorticoid therapy, using voxel-based morphometry (VBM) as well as resting-state functional magnetic resonance imaging (MRI) with amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo).
Methods or Background: Between 2019 and 2022, 32 patients with TAO and 23 healthy controls were recruited to undergo pre-therapy MRI scans. Intravenous glucocorticoid therapy was administered to all patients. Twenty-six of the patients were available for rescanned MRI three months after the end of therapy. The VBM, ALFF and ReHo methods were used to evaluate the brain structural and functional differences.
Results or Findings: Before therapy, TAO patients showed significantly decreased grey matter volume in the left orbital part of superior frontal gyrus (ORBsup) and the medial superior frontal gyrus (SFGmed) than healthy controls. Patients had higher ALFF values in bilateral gyrus rectus and olfactory cortex as well as lower values in bilateral cuneus. The patients also showed decreased ReHo values in bilateral lingual gyrus. After therapy, increased grey matter volume in left anterior cingulate gyrus and SFGmed, increased ALFF values in bilateral cuneus and superior occipital gyrus, as well as increased ReHo values in bilateral SFGmed were found in TAO patients compared to the pre-therapy cohort. Compared to controls, decreased grey matter volume in the left ORBsup was observed in post-therapy TAO patients.
Conclusion: Our results indicated that TAO might cause functional and structural deficits in the visual and emotional regions of the brain, with recovery in the former and partial restoration in the latter after effective glucocorticoid therapy. These findings may lead to a deeper understanding of the pathophysiological mechanism behind TAO.
Limitations: The sample size was relatively small.
Funding for this study: Funding was received from the National and Natural Science Foundation of China (NSFC) (81801659 to Hao Hu), Jiangsu Province Capability Improvement Project through Science, Technology and Education (JSDW202243 to Fei-Yun Wu), and Jiangsu Province Hospital (the First Affiliated Hospital, Nanjing Medical University) Clinical Capability Enhancement Project (JSPH-MC-2021-8 to Xiao-Quan Xu).
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Review Board of the First Affiliated Hospital, Nanjing Medical University.
7 min
The neural correlates of hearing loss-related distress: an fMRI study
Faten Aldhafeeri, Hafar al-Batin / Saudi Arabia
Author Block: F. Aldhafeeri; Hafar Albatin/SA
Purpose: Hearing loss (HL) is associated with a decline in the ability to hear high-frequency sounds, resulting in impaired speech comprehension, particularly under adverse listening conditions. The presence of hearing loss in older adults has been found to have a substantial influence on their overall quality of life and general well-being. Additionally, there is evidence suggesting a potential correlation between HL and the development of depressive symptoms as well as feelings of social isolation. The purpose of this study was to examine how hearing impairment affects the brain's emotional processing network.
Methods or Background: A total of 16 subjects with hearing loss and 15 age and gender-matched healthy controls were recruited in this study. All participants underwent functional magnetic resonance imaging (fMRI) during which they were asked to listen to emotionally evocative sound clips. These were rated as pleasant unpleasant or neutral. The sounds were obtained from the International Affective Digitised Sounds (IADS). To examine the impact of hearing loss severity on neuronal activity, a correlation analysis between the mean fMRI blood oxygen level-dependent (BOLD) signal and the hearing thresholds in both groups were performed.
Results or Findings: Compared to the healthy control group, HL subjects demonstrated exaggerated brain activation in auditory, limbic and frontal regions. HL group exhibited a positive correlation between the mean fMRI BOLD signal and hearing threshold in the right superior temporal gyrus and anterior cingulate.
Conclusion: Current findings indicate that hearing loss leads to neuronal reorganisation, particularly in brain networks that are involved in the processing of emotions.
Limitations: This study is limited by a relatively small number of subjects. The contribution of the scanner's noise with the auditory stimuli is a further limitation.
Funding for this study: No funding was received for this study.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the University's Local Research Ethics Committee.
7 min
Causal associations of genetically determined tinnitus with neuroimaging traits: evidence from a Mendelian randomisation study
Jing Sun, Beijing / China
Author Block: J. Sun, H. Lv, Z. Wang; Beijing/CN
Purpose: Potential reverse causality and unmeasured confounding factors are common biases in most neuroimaging studies on tinnitus and central correlates. The causal association of tinnitus with neuroimaging features also remains unclear. This study aimed to investigate the causal relationship of tinnitus with neuroplastic alterations using Mendelian randomisation (MR).
Methods or Background: Summary-level data from a genome-wide association study (GWAS) of tinnitus were derived from UK Biobank (n=117,882). The GWAS summary statistics for four global-brain tissues and 14 sub-brain gray matter volumetric traits were also obtained (n=up to 33,224). A bidirectional MR analysis was conducted to explore the causal relationship between tinnitus and neuroanatomical features at global-brain and sub-brain levels.
Results or Findings: Genetic susceptibility to tinnitus was causally associated with increased white matter volume (OR=2.361, 95% CI 1.033–5.393) and total brain volume (OR=2.391, 95% CI 1.047–5.463) but inversely associated with cerebrospinal fluid volume (OR=0.362, 95% CI 0.158–0.826). A smaller grey matter volume in the left Heschl’s gyrus and right insular cortex and larger grey matter volume in the posterior division of the left parahippocampal gyrus may lead to an increased risk for tinnitus (OR=0.978, 95% CI 0.961–0.996; OR=0.987, 95% CI 0.976–0.998; and OR=1.015, 95% CI 1.001–1.028, respectively).
Conclusion: Genetic susceptibility to tinnitus was causally associated with increased white matter volume and total brain volume. Volume alteration in several cortical regions may indicate a higher tinnitus risk, and further research is recommended for causality inference at the level of sub-brain regions. Our findings provide genetic evidence for elucidating the underlying pathophysiological mechanisms of tinnitus-related neuroanatomical abnormalities.
Limitations: The difference in the genetic background between different ancestries limits the broader application of our findings.
Funding for this study: Funding was received as part of Grant 62171297 (H.L.) from the National Natural Science Foundation of China, No. ZYLX202101 from Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support, No. 2021-135 from Beijing Municipal Health Commission-Beijing Key Clinical Discipline Funding.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was based on publicly available summary data, and ethical approval of each GWAS study was obtained from the relevant institutional review board.
7 min
Multimodal quantitative magnetic resonance imaging of the thalamus supports distinct outcomes in tinnitus patients treated with sound therapy
Qian Chen, Beijing / China
Author Block: Q. Chen; Beijing/CN
Purpose: The objective of this study was to systematically investigate structural and functional alterations in the thalamus and its subregions using multimodal magnetic resonance (MR) imaging and examine its clinical relevance in tinnitus patients with different outcomes after sound therapy (narrowband noise).
Methods or Background: In total, 60 patients with persistent tinnitus and 57 healthy controls (HCs) were recruited. Based on treatment efficacy, 28 patients were categorised into the effective group and 32 into the ineffective group. Five MR imaging measurements of the thalamus and its seven subregions, including gray matter volume, fractional anisotropy, fractional amplitude of low-frequency fluctuation, and functional connectivity (FC), were obtained for each participant and compared between the groups.
Results or Findings: Patients in both groups exhibited widespread functional and diffusion abnormalities in the whole thalamus and several subregions, with more obvious changes observed in the effective group. All tinnitus patients had abnormal FC compared with the HCs; FC differences between the two patient groups were only observed in the striatal network, auditory-related cortex, and the core area of the limbic system. We combined the multimodal quantitative thalamic alterations and used it as an imaging indicator to evaluate prognosis before sound therapy and achieved a sensitivity of 71.9% and specificity of 85.7%.
Conclusion: Similar patterns of thalamic alterations were identified in tinnitus patients with different outcomes, with more obvious changes observed in the effective group. Our findings support the tinnitus generation hypothesis of frontostriatal gating system dysfunction. A combination of multimodal quantitative thalamic properties may be used as indicators to predict tinnitus prognosis before sound therapy.
Limitations: This is not a longitude study.
Funding for this study: Funding was received as part of Grant No. 82302284 from the National Natural Science Foundation of China.
Has your study been approved by an ethics committee? Yes
Ethics committee - additional information: This study was approved by the Ethics Committee of Beijing Friendship Hospital, Capital Medical University (No. 2017-P2-134-01).

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