Differential Brain Perfusion Changes Following Two Mind–Body Interventions for Fibromyalgia Patients: an Arterial Spin Labelling fMRI Study

Objectives Further mechanistic insight on mind–body techniques for fibromyalgia (FMS) is needed. Arterial spin labelling (ASL) imaging can capture changes in regional cerebral blood flow (rCBF) that relate to spontaneous pain. Methods We recruited FMS patients undergoing either mindfulness-based stress reduction training (MBSR, n = 14) or a psychoeducational programme (FibroQoL, n = 18), and a control FMS group with no add-on treatment (n = 14). We acquired whole-brain rCBF maps and self-report measures at baseline and following treatment and explored interaction effects in brain perfusion between the treatment group and session with a focus on the amygdala, the insula and the anterior cingulate cortex (ACC). Results We identified a significant interaction effect in the amygdala, which corresponded with rCBF decreases following FibroQoL specifically. At baseline, rCBF in the amygdala for the FibroQoL group correlated with pain catastrophizing and anxiety scores, but not after treatment, suggesting a decoupling between activity in the amygdala and negative emotional symptoms of FMS as a consequence of treatment. Baseline rCBF correlated positively with pain symptoms in the ACC and the anterior insula across all patients; moreover, the correlation between rCBF changes post intervention in the insula and pain improvement was negative for both treatments and significantly different from the control group. We suggest that there is disruption of the typical relationship between clinical pain and activity as a product of these two nonpharmacological therapies. Conclusions We have demonstrated that different mind-to-body treatments correspond to differential changes in clinical symptoms and brain activity patterns, which encourages future research investigating predictors of treatment response. Trial Registration NCT02561416.

Effects of red blood cells with reduced deformability on cerebral blood flow and vascular water transport: measurements in rats using time-resolved pulsed arterial spin labelling at 9.4 T

Background Our aim was to introduce damaged red blood cells (RBCs) as a tool for haemodynamic provocation in rats, hypothesised to cause decreased cerebral blood flow (CBF) and prolonged water capillary transfer time (CTT), and to investigate whether expected changes in CBF could be observed and if haemodynamic alterations were reflected by the CTT metric. Methods Damaged RBCs exhibiting a mildly reduced deformability were injected to cause aggregation of RBCs. Arterial spin labelling (ASL) magnetic resonance imaging experiments were performed at 9.4 T. Six datasets (baseline plus five datasets after injection) were acquired for each animal in a study group and a control group (13 and 10 female adult Wistar rats, respectively). For each dataset, ASL images at ten different inversion times were acquired. The CTT model was adapted to the use of a measured arterial input function, implying the use of a realistic labelling profile. Repeated measures ANOVA was used (alpha error = 0.05). Results After injection, significant differences between the study group and control group were observed for relative CBF in white matter (up to 20 percentage points) and putamen (up to 18–20 percentage points) and for relative CTT in putamen (up to 35–40 percentage points). Conclusions Haemodynamic changes caused by injection of damaged RBCs were observed by ASL-based CBF and CTT measurements. Damaged RBCs can be used as a tool for test and validation of perfusion imaging modalities. CTT model fitting was challenging to stabilise at experimental signal-to-noise ratio levels, and the number of free parameters was minimised.

Improving the Algorithm for the Management of Patients with Viral Hepatitis Using Contrast-Free Hepatic Arterial Spin Labelling Magnetic Resonance Perfusion

Objective: improving the algorithm for the management of patients with viral hepatitis using contrast-free arterial spin labelling (ASL) magnetic resonance (MR) perfusion.Material and methods. A total of 116 patients with viral hepatitis (VH) B, C and B + C were examined on the basis of Clinical hospital No. 1 (Smolensk): 75 (64.7%) men and 41 (35.3%) women, mean age 49.7 ± 2.3 years. The patients underwent instrumental diagnostic methods: ultrasound, clinical elastography, contrast-free hepatic ASL MR perfusion. Liver biopsy (n = 57) was used as the reference method.Results. The results of ASL MR perfusion had a high correlation with the data of clinical elastography in the diagnosis of fibrotic process; the diagnostic and prognostic significance of ASL liver perfusion in the diagnosis of fibrotic process was: AUROC 0.943 (95% CI, 0.884–0.953). There was a high correlation between ASL MR perfusion with Doppler ultrasound of hepatic blood vessels in the diagnosis of arterial blood flow disorders, but in VH В + C and cirrhosis – diagnostic and prognostic significance of the method: AUROC 0.951 (95% CI 0.932–0.972).Conclusion. ASL MR perfusion in VH patients allows to predict fibrotic changes in the hepatic parenchyma (AUROC 0.934 (95% CI 0.845–0.957)), provides information about changes in blood flow in the parenchymal structure (p < 0.005). The algorithm for the examination of VH patients should include contrast-free ASL MR perfusion at admission (AUROC 0.865 (95% CI 0.843–0.928)) and in dynamic follow-up (AUROC 0.915 (95% CI 0.881–0.946)).