Editorial: Neuroimaging innovations for encephalitis, neuroinfectious diseases, and neuroinflammation, 2025, Hsiuying Wang et al

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Senior Member (Voting Rights)
Several contributions focus on advanced MRI applications and related quantitative imaging modalities. Gkotsoulias et al. demonstrated that deep learning-assisted reconstruction substantially improves QSM image quality in multiple sclerosis (MS), enabling clearer visualization of MS-related biomarkers. Using diffusion tensor imaging along the perivascular space (DTI-ALPS) to examine glymphatic function in patients recovering from COVID-19, He et al. identified dynamic changes associated with cognitive symptoms and fatigue. In addition, Churchill et al. reported persistent white matter microstructural abnormalities linked to emotional health measures in individuals with post-acute COVID-19 syndrome, which may help distinguish post-acute COVID-19 syndrome from symptomatic non-COVID infection. Finally, Essel et al. compared synthetic fluid-attenuated inversion recovery (FLAIR) with conventional FLAIR imaging in MS and found strong agreement in lesion quantification, suggesting that synthetic sequences may serve as a practical alternative for the assessment of MS patients with a low lesion burden. Collectively, these studies highlight the ability of advanced MRI techniques to detect subtle tissue changes that may not be evident on standard imaging.

Other studies highlight the utility of electrophysiological techniques in identifying functional disturbances in the CNS. Liu et al. synthesized quantitative EEG findings associated with psychiatric symptoms after ischemic stroke and identified stage-specific abnormalities in power spectra. In evaluating EEG patterns in antibody-mediated autoimmune encephalitis, Sun et al. reported that EEG abnormalities are common, often more sensitive than MRI, and strongly correlate with disease severity and prognosis. Wu et al. investigated resting-state EEG in convalescent patients with anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis and revealed persistent disruptions in rhythmic activity and network connectivity, indicating residual brain dysfunction, despite clinical recovery. Together, these investigations underscore the value of EEG as a non-invasive and sensitive modality for monitoring functional disturbances across a variety of neurological disorders.

Several studies address challenges in diagnosing CNS infections. Tang et al. compared CSF obtained via lumbar puncture vs. external ventricular drainage for the diagnosis of post-operative CNS infections and demonstrated that lumbar puncture provides significantly greater diagnostic sensitivity. Their findings highlight the risk of false-negative results when relying solely on ventricular samples. Ci et al. examined varicella zoster virus (VZV) infection in immunocompetent adults and showed that VZV can involve the CNS in otherwise healthy individuals, typically presenting with mild symptoms and favorable outcomes following antiviral therapy. These findings reinforce the importance of appropriate sampling strategies and thorough clinical evaluation when CNS infection is suspected.

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