Publications by authors named "Michael J Thrippleton"

Background: White matter hyperintensities (WMHs) are established structural imaging markers of cerebral small vessel disease. The pathophysiologic condition of brain tissue varies over the core, the vicinity, and the subtypes of WMH and cannot be interpreted from conventional magnetic resonance imaging. We aim to improve our pathophysiologic understanding of WMHs and the adjacently injured normal-appearing white matter in terms of microstructural and microvascular alterations using quantitative magnetic resonance imaging in patients with sporadic and genetic cerebral small vessel disease.

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Preterm birth correlates with brain dysmaturation and neurocognitive impairment. The gut microbiome associates with behavioral outcomes in typical development, but its relationship with neurodevelopment in preterm infants is unknown. We characterize fecal microbiome in a cohort of 147 neonates enriched for very preterm birth using 16S-based and shotgun metagenomic sequencing.

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Article Synopsis
  • The study aimed to evaluate relationships between three key cerebrovascular functions (blood-brain barrier permeability, vascular pulsatility, and cerebrovascular reactivity) in patients with cerebral small vessel diseases (SVD), including both sporadic cases and a genetic condition known as CADASIL.
  • Researchers used advanced brain imaging techniques to analyze these functions in a group of 77 patients, assessing how they relate to SVD severity, subtype, and specific brain changes.
  • Findings revealed that worse white matter hyperintensity (WMH) was linked to lower cerebrovascular reactivity and blood plasma volume fraction, with the type of SVD having little impact on these vascular functions after accounting for WMH severity.
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Background And Objectives: In patients with cerebral small vessel disease (SVD), impaired cerebrovascular reactivity (CVR) is related to worse concurrent SVD burden, but less is known about cerebrovascular reactivity and long-term SVD lesion progression and clinical outcomes. We investigated associations between cerebrovascular reactivity and 1-year progression of SVD features and clinical outcomes.

Methods: Between 2018 and 2021, we recruited patients from the Edinburgh/Lothian stroke services presenting with minor ischemic stroke and SVD features as part of the Mild Stroke Study 3, a prospective observational cohort study (ISRCTN 12113543).

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Optical coherence tomography angiography (OCT-A) retinal imaging enables visualization of the retinal microvasculature that is developmentally related to the brain and can offer insight on cerebrovascular health. We investigated retinal phenotypes and neuroimaging markers of small vessel disease (SVD) in individuals with obstructive sleep apnoea (OSA). We enrolled 44 participants (mean age 50.

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  • Multiple sclerosis (MS) is a disease that affects the brain and spinal cord, often causing fatigue as a disabling symptom, with unclear mechanisms behind this fatigue.
  • A study involving 440 recently diagnosed individuals with relapsing-remitting MS examined the relationship between fatigue and MRI findings related to neuroinflammation and neurodegeneration.
  • Results showed participants with fatigue had higher disability and depression scores, and while both fatigued and non-fatigued groups exhibited changes in brain and spinal cord structures over time, no significant differences were found between the two groups' MRI measures.
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Background: White matter hyperintensity (WMH) progression is well documented; WMH regression is more contentious, which might reflect differences in defining WMH change. We compared four existing WMH change definitions in one population to determine the effect of definition on WMH regression.

Methods: We recruited patients with minor non-disabling ischaemic stroke who underwent MRI 1-3 months after stroke and 1 year later.

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Article Synopsis
  • - The study focuses on understanding the connection between preterm birth (PTB) and encephalopathy of prematurity (EoP), particularly how neuroendocrine stress and immune responses might influence brain development issues in preterm infants.
  • - Researchers at the University of Edinburgh will recruit 300 mother-infant pairs, including both preterm and term births, over a five-year period to gather a variety of biological and demographic data, including MRI scans to assess brain development.
  • - Ethical approval for the study has been granted, ensuring that the research will be conducted responsibly and that findings will be shared for broader educational and clinical use.
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Background And Objectives: The survival rate and patterns of brain injury after very preterm birth are evolving with changes in clinical practices. Additionally, incidental findings can present legal, ethical and practical considerations. Here, we report MRI features and incidental findings from a large, contemporary research cohort of very preterm infants and term controls.

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White matter hyperintensities (WMH), a common feature of cerebral small vessel disease, are related to worse clinical outcomes after stroke. We assessed the impact of white matter hyperintensity changes over 1 year after minor stroke on change in mobility and dexterity, including differences between the dominant and non-dominant hands and objective in-person assessment versus patient-reported experience. We recruited participants with lacunar or minor cortical ischaemic stroke, performed medical and cognitive assessments and brain MRI at presentation and at 1 year.

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Infant attachment is an antecedent of later socioemotional abilities, which can be adversely affected by preterm birth. The structural integrity of amygdalae and hippocampi may subserve attachment in infancy. We aimed to investigate associations between neonatal amygdalae and hippocampi structure and their whole-brain connections and attachment behaviours at nine months of age in a sample of infants enriched for preterm birth.

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The early life environment programmes cortical architecture and cognition across the life course. A measure of cortical organisation that integrates information from multimodal MRI and is unbound by arbitrary parcellations has proven elusive, which hampers efforts to uncover the perinatal origins of cortical health. Here, we use the Vogt-Bailey index to provide a fine-grained description of regional homogeneities and sharp variations in cortical microstructure based on feature gradients, and we investigate the impact of being born preterm on cortical development at term-equivalent age.

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Background: White matter hyperintensities (WMHs) might regress and progress contemporaneously, but we know little about underlying mechanisms. We examined WMH change and underlying quantitative magnetic resonance imaging tissue measures over 1 year in patients with minor ischemic stroke with sporadic cerebral small vessel disease.

Methods And Results: We defined areas of stable normal-appearing white matter, stable WMHs, progressing and regressing WMHs based on baseline and 1-year brain magnetic resonance imaging.

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Metallic foreign bodies (FBs) are a safety risk during MRI. Here, we describe a boy in early childhood with an unexpected ferromagnetic FB discovered during a research brain MRI. Safety precautions included written and oral safety screening checklists and visual check during a structured safety pause.

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  • There’s growing interest in using perivascular spaces (PVS) as a biomarker for brain dysfunction due to their link to cerebrovascular diseases, prompting the development of new neuroimaging techniques.
  • A study evaluates improvements to a common PVS segmentation method using vesselness filters on MRI scans from patients with small vessel disease, emphasizing the need for tailored threshold selections based on different brain regions.
  • Findings suggest T2-weighted MRI images are preferable for assessing PVS, as the Frangi filter outperforms others in accurately segmenting PVS, particularly against noise and threshold variability.
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Objectives: To quantify brain microstructural changes in recently diagnosed relapsing-remitting multiple sclerosis (RRMS) using longitudinal T measures, and determine their associations with clinical disability.

Methods: Seventy-nine people with recently diagnosed (< 6 months) RRMS were recruited from a single-centre cohort sub-study, and underwent baseline and 1-year brain MRI, including variable flip angle T mapping. Median T was measured in white matter lesions (WML), normal-appearing white matter (NAWM), cortical/deep grey matter (GM), thalami, basal ganglia and medial temporal regions.

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Background: Hypertension is the leading risk factor for cerebral small vessel disease. We aimed to determine whether antihypertensive drug classes differentially affect microvascular function in people with small vessel disease.

Methods: We did a multicentre, open-label, randomised crossover trial with blinded endpoint assessment at five specialist centres in Europe.

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This manuscript describes the ISMRM OSIPI (Open Science Initiative for Perfusion Imaging) lexicon for dynamic contrast-enhanced and dynamic susceptibility-contrast MRI. The lexicon was developed by Taskforce 4.2 of OSIPI to provide standardized definitions of commonly used quantities, models, and analysis processes with the aim of reducing reporting variability.

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Background: Cerebrovascular reactivity (CVR) is inversely related to white matter hyperintensity severity, a marker of cerebral small vessel disease (SVD). Less is known about the relationship between CVR and other SVD imaging features or cognition. We aimed to investigate these cross-sectional relationships.

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Background: Recent evidence from case reports suggests that a ketogenic diet may be effective for bipolar disorder. However, no clinical trials have been conducted to date.

Aims: To assess the recruitment and feasibility of a ketogenic diet intervention in bipolar disorder.

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Purpose: Software has a substantial impact on quantitative perfusion MRI values. The lack of generally accepted implementations, code sharing and transparent testing reduces reproducibility, hindering the use of perfusion MRI in clinical trials. To address these issues, the ISMRM Open Science Initiative for Perfusion Imaging (OSIPI) aimed to establish a community-led, centralized repository for sharing open-source code for processing contrast-based perfusion imaging, incorporating an open-source testing framework.

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Recurrent neuroinflammation in relapsing-remitting MS (RRMS) is thought to lead to neurodegeneration, resulting in progressive disability. Repeated magnetic resonance imaging (MRI) of the brain provides non-invasive measures of atrophy over time, a key marker of neurodegeneration. This study investigates regional neurodegeneration of the brain in recently-diagnosed RRMS using volumetry and voxel-based morphometry (VBM).

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Introduction: While 2D phase-contrast MRI is often used to examine intracranial vessels in neurovascular disease contexts, the ability of 4D flow to assess many vessels at once makes it an attractive alternative. We aimed to assess the repeatability, reliability, and conformity of 2D and 4D flow across intracranial vessels.

Methods: Using correlation analyses and paired -tests, test-retest repeatability, intra-rater reliability, and inter-method conformity for measurements of pulsatility index (PI) and mean flow were assessed in the arteries and veins of 11 healthy volunteers.

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Article Synopsis
  • - The study reviews existing controversies about brain fluid dynamics and tests if conventional MRI can visualize brain fluid outflow pathways and their connection to small vessel disease (SVD).
  • - Researchers conducted a pilot study on 19 subjects and found significant increases in signal intensity along various fluid outflow routes after administering Gadolinium contrast, indicating that interstitial fluid drainage can be assessed using MRI.
  • - The results showed a link between fluid drainage and increased perivascular spaces in the brain, suggesting further research is needed to explore this relationship in humans.
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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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