Background: This study aimed to explore possible differences of the whole-brain functional connectivity of the anterior cingulate cortex (ACC) and anterior insula (AI), in a sample of depressed patients with major depressive disorder (MDD), bipolar disorder (BD) and healthy controls (HC). Methods: A hundred and three subjects (nMDD = 35, nBD = 25, and nHC = 43) between the ages of eighteen and sixty-five years old underwent functional magnetic resonance imaging. The CONN Toolbox was used to process and analyze the functional connectivity of the ACC and AI. Results: The comparison between the patients (MDD/BD) and HC yielded increased resting-state functional connectivity (rsFC) between the ACC and the motor and somatosensory cortices (SSC), superior parietal lobule (SPL), precuneus, and lateral occipital cortex, which was driven by the BD group. In addition, hyperconnectivity between the right AI and the motor and SSC was found in BD, as compared to HC. In MDD, as compared to HC, hyperconnectivity between ACC and SPL and the lateral occipital cortex was found, with no statistical rsFC differences for the AI seed. Compared to BD, the MDD group showed ACC–cerebellum hyperconnectivity and a trend for increased rsFC between the right AI and the bilateral superior frontal cortex. Conclusions: Considering the observed hyperconnectivity between the ACC/somatosensory cortex in the patient group, we suggest depression may be related to an impairment of the sensory-discriminative function of the SSC, which results in the phenomenological signature of mental pain in both MDD and BD. These findings suggest that future research should investigate this particular network with respect to motor functions and executive control, as a potential differential diagnostic biomarker for MDD and BD.

Carotid atherosclerosis is a main risk factor for ischemic stroke. Plaque instability is determined by the morphological characteristics of the plaque and can be characterized by immunological biomarkers. The study aimed to examine the connection between serum levels of hs-CRP, fibrinogen, ICAM-1, VCAM-1 and carotid atherosclerosis and the different types of atherosclerotic plaques imaged by ultrasound and magnetic resonance. The study involved 120 patients with carotid atherosclerosis and 33 patients without carotid atherosclerosis. Blood samples were collected to analyze the serum level of hs-CRP, fibrinogen, ICAM-1 and VCAM-1. The ultrasound analysis included detection of atherosclerotic plaques in the internal carotid arteries, measurement of artery stenosis in percentage and determination of plaque types by the classification of Gray-Weales/Gerolacus. A small subset of 30 patients with carotid atherosclerosis performed 3T magnetic resonance imaging. Atherosclerotic plaques were classified into 8 types based on the modified MR classification of the American Heart Association. Significantly higher serum levels of hs-CRP (p <0.001) and fibrinogen (p = 0.018) were observed in patients with carotid atherosclerosis compared to patients without atherosclerosis. Criterion values for hs-CRP > 4.13mg/l and for fibrinogen > 3.6 g/l were associated with the presence of carotid plaques with accuracy of 70%. No relation was observed between the investigated biomarkers, the artery stenosis and the types of atherosclerotic plaques determined by ultrasound and magnetic resonance diagnostic methods. Hs-CRP and fibrinogen are reliable serum markers whose increased serum concentrations are connected with the presence of carotid atherosclerosis.

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder that mainly attacks the joints and leads to early disability. Despite aggressive anti-inflammatory therapy, the risk of systemic complications remains high. Moreover, the rate of premature cardiovascular disease mortality in patients with active RA, as well as the risk for development of non-fatal cardiovascular and cerebrovascular complications is also high. Central nervous system (CNS) involvement is one of the main components of extra-articular manifestations of RA. Brain changes might be caused by systemic inflammatory response or by the drugs used for treatment. Assessment of brain involvement and its relationship to the characteristics of the disease in patients with RA are particularly useful. Early detection of changes without cerebral symptoms and rapid response in acute events are of particular importance. With the increasing use of more imaging modalities magnetic resonance imaging (MRI) has become highly specific, safe and non-invasive diagnostic tool for early detection and monitoring of different pathological processes involving the brain in patients with RA. Understanding MRI imaging findings in brain involvement is important for selecting appropriate treatment and control of disease progression. The aim of this review is to summarize literature data of brain changes in RA and their relationship with systemic inflammation as well as to demonstrate the role of MRI in their assessment.  

IntroductionDespite the significant scientific progress in the study of the mechanisms underlying mental disorders, stable biomarkers facilitating their diagnosis and differential diagnosis are lacking. Therefore, we attempted to explore possible functional connectivity (FC) differences across some of the more prevalent mental disorders, namely mood disorders.ObjectivesThe current study aimed at investigating the alterations of the functional connectivity of major seeds of the Salience Network (SN) (the Anterior Cingulate Cortex (ACC), and Anterior Insula (AI) in patients with unipolar (Major Depressive Disorder-MDD) or bipolar (Bipolar Disorder-BD) depression as compared to healthy controls (HC).MethodsFor this study 103 adult subjects underwent resting-state Magnetic Resonance Imaging of whom 60 were patients with a depressive episode (MDD: n=35; BD: n=25), and 43 were healthy controls (HC). The individuals in both groups were matched for age and gender. Each participant has provided written informed consent (Ethics Committee: P186/22.01.2021). Seed-to-voxel analysis was performed via the CONN toolbox running on MATLAB. Random Field Theory parametric statistics was used with a cluster-level FWE correction p<0.05.ResultsBoth the ACC and the right AI demonstrated a statistically significant increase in the FC to the somatosensory cortex and the motor cortex in patients as opposed to HC. In addition, there was hyperconnectivity between ACC and the right Superior Frontal Gyrus, Precuneus, and the Superior Parietal Lobule bilaterally in patients as well. A reduced FC between the ACC and the hippocampus and parahippocampus was observed in depression in comparison to HC. The analysis of the left AI seed yielded no statistically significant between-group differences.ConclusionsOur results demonstrate aberrant connectivity between nodes of the SN, the Default Mode Network, and the Limbic Network which might provide clarification on the mechanisms of impaired balance between internally and externally oriented attention, affective and cognitive control in depression. In addition, the alterations of the FC between SN and the somatosensory and motor cortices may be suggested as a possible explanation of the disturbances in the psychomotor activity in mood disorders.Disclosure of InterestA. Todeva-Radneva Grant / Research support from: This work has been funded by the Bulgarian National Program “European Scientific Networks” - Project DIP Neuroscience, R. Paunova Grant / Research support from: This work has been funded by the Bulgarian National Program “European Scientific Networks” - Project DIP Neuroscience, D. Stoyanov Grant / Research support from: This work has been funded by the Bulgarian National Program “European Scientific Networks” - Project DIP Neuroscience, T. Zdravkova Grant / Research support from: This work has been funded by the Bulgarian National Program “European Scientific Networks” - Project DIP Neuroscience, S. Kandilarova Grant / Research support from: This work has been funded by the Bulgarian National Program “European Scientific Networks” - Project DIP Neuroscience