The clinical, MRI and anatomic features of tibial intraneural ganglion cysts are the posterior counterpart of the peroneal intraneural ganglion cysts arising from the anterior portion of the superior tibiofibular joint. These predictable features can be exploited and have implications for the pathogenesis of these intraneural cysts and treatment outcomes. These ganglion cysts are joint-related and provide further evidence to support the unifying articular theory. In each case the joint connection needs to be identified preoperatively, and the articular branches and the superior tibiofibular joint should be addressed operatively to prevent cyst recurrence.
A noninvasive
and cost-effective means to detect preclinical Alzheimer’s
disease (AD) and monitor disease progression would be invaluable.
The retina is a developmental extension of the brain and has been
viewed as a window to evaluate AD-related pathology. Cross-sectional
studies have shown structural changes in the retina of AD patients
that include thinning of the retinal nerve-fiber layer and changes
in retinal vasculature. However, such changes do not manifest in early
stages of the disease nor are they specific biomarkers for AD. Described
herein is the utilization of our retinal hyperspectral imaging (rHSI)
technique as a biomarker for identification of AD-related early pathological changes in
the retina. Specifically, this account concerns the translation of
our rHSI technique from animal models to human AD subjects. The underlying
principle is Rayleigh light scattering, which is expected from low-order
Aβ aggregates present in early pathology. Recruitment was restricted
to AD subjects (N = 19) and age-matched
controls, with no family history of AD (N = 16).
To limit the influence of skin pigmentation, subjects were restricted
to those with skin pigmentation values of 2–3 on the Fitzpatrick
scale. The largest spectral deviation from control subjects, rHSI
signature, was obtained at the MCI stage with MMSE scores ⩾22,
suggesting higher sensitivity of this technique in early disease stages.
The rHSI signature observed is unaffected by eye pathologies such
as glaucoma and cataract. Age of the subjects minimally influenced
the spectral signatures. The rHSI technique shows promise for detection
of preclinical AD; it is conducted in a truly noninvasive manner,
without application of an exogenous label, and is thus potentially
suitable for population screening.
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