Background Knee osteoarthritis (OA) is one of the most common degenerative diseases causing disability in elderly people. Although X-ray radiography is widely used as a diagnostic tool, several limitations have been identified [1]. MRI is a non-invasive imaging method widely used in order to assess articular and periarticular structures of the knee joint [2]. However, the image resolution provided by conventional MRI is not high enough to assess subchondral bone so that ultra-high field MRI (7 Tesla) has been proposed as an alternative of interest to compute bone microarchitectural parameters [3]. Objectives We used ultra-high field MRI (UHF 7 Tesla MRI) to assess cartilage and subchondral bone microarchitecture in patients with mild and severe OA. For each patient, compartments classified as osteoarthritic were compared with non-osteoarthritic compartments. Methods Twenty-four patients were divided into 3 groups according to the Kellgren Lawrence staging and 12 volunteers were recruited as controls. UHF MRI was used to calculate cartilage thickness (Tc), volume (Vc), and T2*. MRI sequences used were T1 3D gradient recalled echo sequence (T1 3D GRE) and sagittal T2* mapping. Bone microarchitecture was assessed on the basis of trabecular thickness (TbTh), trabecular number (TbN), trabecular space (TbSp), and bone volume fraction (BVF). Results For the medial tibial plateau, while Tc was unchanged between the two OA groups, Vc was decreased in patients with severe OA (Δ= -49%, p < 0.05). For the patella, Vc was decreased in patients with mild OA (Δ = -36%, p<0.05), while Tc was unchanged. Similar results were found for the lateral femoral condyle. The study of T2* cartilage relaxation (T2* mapping) revealed no statistically significant changes in all knee joint compartments. Computed TbSp in the lateral tibial plateau and patella was significantly higher in the mild OA group (Δlateral tibial plateau = +25%; Δpatella = +31.5, p<0.05), whereas most subchondral bone parameters were unchanged. Medial femoral condyle cartilage volume was significantly correlated with patellar cartilage thickness r=0.46 (p = 0.01). Medial tibial plateau cartilage thickness and patellar cartilage thickness were linearly related r = 0.587 (p < 0.05). Medial tibial plateau cartilage volume was significantly correlated with patella TbTh, r = 0.41 (p = 0.02) Conclusion Cartilage volume seems to be more sensitive than thickness for the assessment of cartilage changes in OA. TbSp would be a sensitive marker of subchondral bone degradation. Cartilage degradation in a given OA compartment would be accompanied by changes in subchondral bone and cartilage in the opposite healthy compartments. UHF MRI can provide interesting information for the analysis of cartilage and subchondral bone and could be considered as a tool of interest for the subtle evaluation of changes associated to therapeutic strategies.#8232;#8232; References [1]Lee LS, Chan PK, Fung WC, Chan VWK, Yan CH, Chiu KY. Imaging of knee osteoarthritis: A review of current evidence and clinical guidelines. Musculoskeletal Care. 2021;19(3):363-374. doi:10.1002/msc.1536 [2]Andreani L, Giuntoli M, Addevico F, Aringhieri G, Cosottini M, Marchetti S. The effect of viscosupplementation on early-stage knee osteoarthritis: Clinical evaluation and assessment of cartilage in vivo with 7 T MRI. J Clin Orthop Trauma. 2021;19:53-61. Published 2021 May 8. doi:10.1016/j.jcot.2021.04.024 [3]Krug R, Carballido-Gamio J, Banerjee S, Burghardt AJ, Link TM, Majumdar S. In vivo ultra-high-field magnetic resonance imaging of trabecular bone microarchitecture at 7 T. J Magn Reson Imaging. 2008;27(4):854-859. doi:10.1002/jmri.21325 Acknowledgements: NIL. Disclosure of Interests None Declared.

Purpose Although enthesitis is a hallmark of several rheumatologic conditions, current imaging methods are still unable to characterize entheses changes because of the corresponding short transverse relaxation times ( T 2). A growing number of MR studies have used Ultra-High Field (UHF) MRI in order to assess low- T 2 tissues e.g., tendon but never in humans. The purpose of the present study was to assess in vivo the enthesis of the quadriceps tendon in healthy subjects using UHF MRI. Methods Eleven healthy subjects volunteered in an osteoarthritis imaging study. The inclusion criteria were: no knee trauma, Lequesne index = 0, less than 3 h of sport activities per week, and Kellgren and Lawrence grade = 0. 3D MR images were acquired at 7 T using GRE sequences and a T 2* mapping. Regions of interest i.e., trabecular bone, subchondral bone, enthesis, and tendon body were identified, and T 2* values were quantified and compared. Results Quadriceps tendon enthesis was visible as a hyper-intense signal. The largest and the lowest T 2* values were quantified in the subchondral bone region and the tendon body respectively. T 2* value within subchondral bone was significantly higher than T 2* value within the enthesis. T 2* in subchondral bone region was significantly higher than the whole tendon body T 2*. Conclusion A T 2* gradient was observed along the axis from the enthesis toward the tendon body. It illustrates different water biophysical properties. These results provide normative values which could be used in the field of inflammatory rheumatologic diseases and mechanical disorders affecting the tendon.

Objective Psoriatic arthritis (PsA) is an inflammatory rheumatic disease, mediated in part by TNFα and associated with bone loss. Anti-TNFα treatment should inhibit this phenomenon and reduce the systemic bone loss. Ultra-high field MRI (UHF MRI) may be used to quantify bone microarchitecture (BM) in-vivo. In this study, we quantified BM using UHF MRI in a PsA patient and followed up the changes related to anti-TNFα treatment. Subjects and methods A non-treated PsA patient with knee arthritis and 7 gender-matched controls were scanned using a gradient re-echo sequence at UHF MRI. After a year of Adalimumab treatment, the patient underwent a second UHF MRI. A PET-FNa imaging was performed before and after treatment to identify and localize the abnormal metabolic areas. BM was characterized using typical morphological parameters quantified in 32 regions of interest (ROIs) located in the patella, proximal tibia, and distal femur. Results Before treatment, the BM parameters were statistically different from controls in 24/32 ROIs with differences reaching up to 38%. After treatment, BM parameters were normalized for 15 out of 24 ROIs. The hypermetabolic areas disclosed by PET-FNa before the treatment partly resumed after the treatment. Conclusion Thanks to UHF MRI, we quantified in vivo BM anomalies in a PsA patient and we illustrated a major reversion after one year of treatment. Moreover, BM results highlighted that the abnormalities were not only localized in hypermetabolic regions identified by PET-FNa, suggesting that the bone loss was global and not related to inflammation.

Background:In psoriatic arthritis (PA), a systemic inflammatory phenomenon, mainly mediated by TNFα, is characterized by a bone loss due to osteoclastic stimulation. Anti-TNFα treatment should inhibit this phenomenon having a role on systemic bone loss. Ultra-high field MRI (UHF MRI) may be a tool of choice for the quantification of bone microarchitecture (BM) in vivo.Objectives:The purpose of the present study was to quantify BM using UHF MRI in a PA patient and to follow up changes related to anti-TNFα treatment.Methods:An 18 years-old untreated PA patient with knee arthritis and 7 gender-matched healthy controls [21.6±0.8 years] were scanned using a gradient echo sequence at UHF MRI (TR/TE = 15/4.36ms). After a year of Adalimumab treatment, the patient underwent a second UHF MRI. BM analysis was performed on sagittal planes in regions corresponding to tendon insertion: proximal and distal patellar, and posterior tibial. A PET-FNa imaging was also performed before and after treatment. BM was characterized using the bone volume fraction (BVF), the trabecular thickness (TbTh) and the spacing (TbSp) and number of trabeculae (TbN). Student T-test was used for the statistical analysis and a p-value < 0.01 was considered as significative.Results:PET-FNa recorded before the treatment illustrated hypermetabolic areas which resumed after the treatment while the patient was in remission. The BM parameters are shown in figure 1. The BM parameters quantified before the treatment were very different as compared to controls. BVF was significatively lower (-33±23%), TbSp and TbN were significatively distinct (-27±3% and +27±9%) for all ROIs but proximal patellar, while TbTh was in the normal range (-2±2%). After 1 year of treatment, BM parameters were significantly improved. BVF was no longer different than controls (-8±6%). Similarly, TbSp and TbN were in the normal range (+13±12% and -15±10%) for all ROIs but posterior tibial. TbTh (-5±3%) was only significantly decreased for the distal patella.Table 1. Data are presented as mean ± SD. “P.” refers as patient. BVF: Bone volume fraction, TbTh: Trabecular Thickness, TbSp: Trabecular Space, TbN: Trabecular number. * indicates a statistically significant difference (p < 0.01) with the Healthy reference values.Conclusion:Our results illustrated knee microstructure alterations in a PA patient and a normalization after a year of treatment. The abnormalities initially observed were not only localized in the hypermetabolic regions identified by PET-FNa, suggesting that the bone loss was global and not related to inflammatory sites.Using UHF MRI, we highlighted and quantified in vivo BM anomalies in a patient with an inflammatory rheumatism together with the reversibility after one year of treatment.Acknowledgements:All the authors declare no conflict of interest.ES has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skodowska-Curie grant agreement No713750. Also, it has been carried out with the financial support of the Regional Council of Provence- Alpes-Côte d’Azur and with the financial support of the A*MIDEX (n° ANR- 11-IDEX-0001-02), funded by the “Investissements d’Avenir” project funded by the French Government, managed by the French National Research Agency (ANR). edgements to declare.Disclosure of Interests:None declared

Il existe dans le rhumatisme psoriasique (RP) un phénomène inflammatoire systémique principalement médié par le TNFα induisant notamment une perte osseuse par stimulation ostéoclastique. Les traitements anti-TNFα devraient inhiber cette voie et donc avoir une action sur la perte osseuse systémique. L’IRM ultra haut champ (IRM UHC) offre la possibilité d’explorer la micro-architecture osseuse in vivo. Le but de notre étude était d’analyser sur le plan quantitatif la micro-architecture osseuse du genou par IRM UHC chez un patient atteint de RP et de suivre l’évolution avant et après un an de traitement par anti-TNFα. Un patient de 18 ans et 7 hommes volontaires sains [21,6 ans ± 0,8] ont été inclus. Le patient, naïf de tout traitement, présentait une arthrite des genoux. Une IRM UHC du genou a été réalisée pour tous les sujets et une seconde exploration été faite chez le patient traité par adalimumab après 1 an. La séquence d’acquisition était une séquence écho de gradient à temps d’écho court (4,36 ms). L’analyse osseuse était faite sur coupes sagittales des zones d’intérêt : proximales et distales patellaires, postérieure tibiale, zones d’insertion d’enthèses. Une imagerie par TEP-FNa était également réalisée avant et après traitement. Les paramètres osseux mesurés étaient la fraction volumique osseuse (FVO), l’épaisseur trabéculaire (EpTb), l’espace inter trabéculaire (EsTb) et le nombre de travées osseuses (NTb). L’analyse statistique était réalisée par test t de Student avec un seuil de significativité de p < 0,01. Avant traitement, l’imagerie par TEP-FNa mettait en évidence des zones enthésitiques hypermétaboliques. Après un an de traitement, le patient était en rémission de son RP et le TEP-FNa ne montrait plus de zones hypermétaboliques au niveau du genou exploré. Les paramètres de microstructure osseuse (MO) avant traitement étaient très différents de ceux du groupe témoin. La FVO était significativement inférieure pour les régions d’intérêt (−33 ± 23 % vs témoins). L’EsTb et le NTb étaient significativement inférieurs, (−27 ± 3 % et −27 ± 9 %) sauf pour l’extrémité supérieure de la rotule, pour l’EpTb (-2 ± 2 % non significative). Ces anomalies étaient indépendantes des zones spécifiquement hypermétaboliques en PET-FNa. Après traitement, tous les paramètres de MO présentaient une amélioration significative avec normalisation par rapport aux témoins. La FVO montrait une différence moyenne non significative avec les témoins de 8 ± 6 %, l’EsTb et le NTb n’étaient pas significativement différents des témoins (13 ± 12 % et 15 ± 10 % respectivement) sauf en région postérieur tibiale. L’EpTb (−5 ± 3 %) est devenue significativement différente dans la région distale de la rotule. Nos résultats ont mis en évidence des altérations de la MO du genou chez un patient RP et une normalisation après une année de traitement. Les anomalies initialement constatées n’étaient pas uniquement localisées au niveau des régions hypermétaboliques identifiées par TEP-FNa suggérant que la perte osseuse est globale et non dépendante des sites inflammatoires. Nous avons pu mettre en évidence et quantifier par IRM UHC in vivo des anomalies de la MO chez un patient atteint de rhumatisme inflammatoire vs témoins ainsi que leur réversibilité après un an de traitement.

The study objective was to investigate the performance of a dedicated convolutional neural network (CNN) optimized for wrist cartilage segmentation from 2D MR images. CNN utilized a planar architecture and patch-based (PB) training approach that ensured optimal performance in the presence of a limited amount of training data. The CNN was trained and validated in twenty multi-slice MRI datasets acquired with two different coils in eleven subjects (healthy volunteers and patients). The validation included a comparison with the alternative state-of-the-art CNN methods for the segmentation of joints from MR images and the ground-truth manual segmentation. When trained on the limited training data, the CNN outperformed significantly image-based and patch-based U-Net networks. Our PB-CNN also demonstrated a good agreement with manual segmentation (Sorensen-Dice similarity coefficient (DSC) = 0.81) in the representative (central coronal) slices with large amount of cartilage tissue. Reduced performance of the network for slices with a very limited amount of cartilage tissue suggests the need for fully 3D convolutional networks to provide uniform performance across the joint. The study also assessed inter- and intra-observer variability of the manual wrist cartilage segmentation (DSC=0.78-0.88 and 0.9, respectively). The proposed deep-learning-based segmentation of the wrist cartilage from MRI could facilitate research of novel imaging markers of wrist osteoarthritis to characterize its progression and response to therapy.

Abstract Objective: Psoriatic arthritis (PA) is an inflammatory rheumatism, mediated in part by TNFα and associated with bone loss. Anti-TNFα treatment should inhibit this phenomenon and reduce the systemic bone loss. Ultra-high field MRI (UHF MRI) may be used to quantify bone microarchitecture (BM) in-vivo. In this study, we quantified BM using UHF MRI in a PA patient and followed up the changes related to anti-TNFα treatment.Patients and methods: A non-treated PA patient with knee arthritis and 7 gender-matched controls were scanned using a gradient re-echo sequence at UHF MRI. After a year of Adalimumab treatment, the patient underwent a second UHF MRI. A PET-FNa imaging was performed before and after treatment to identify and localize the abnormal metabolic areas. BM was characterized using typical morphological parameters quantified in 32 regions of interest (ROIs) located in the patella, proximal tibia, and distal femur. Statistical analysis was assessed performing Student T-tests.Results: Before treatment, the BM parameters were statistically different from controls in 24/32 ROIs with differences reaching up to 38%. After treatment, BM parameters were normalized for 15 out of 24 ROIs. The hypermetabolic areas disclosed by PET-FNa before the treatment partly resumed after the treatment.Conclusion: Thanks to UHF MRI, we quantified in-vivo BM anomalies in a PA patient and we illustrated a major reversion after one year of treatment. Moreover, BM results highlighted that the abnormalities were not only localized in hypermetabolic regions identified by PET-FNa, suggesting that the bone loss was global and not related to inflammation.

L’exploration fine des enthèses, éléments clefs dans plusieurs pathologies rhumatologiques est un challenge. L’IRM de routine (1,5 T) peut détecter pour la plupart des tissus mous des modifications précoces. Pour l’enthèse leur faible valeur de T2 rend difficile leur exploration. Il y a de nombreuses études récentes utilisant l’IRM à très haut champ (> 3Teslas) plus fine, mais aucune d’elles n’a encore évalué les enthèses chez l’humain in vivo. Nous avons étudié in vivo l’enthèse du tendon quadricipital chez des sujets sains en IRM à 7 Teslas (7 T). Onze hommes sains volontaires, d’âge moyen de 22 ans [19–25] ont été sélectionnés. Les critères d’inclusion étaient : pas d’antécédent traumatique du genou, indice de Lequesne à 0, moins de 3 heures d’activités sportives par semaine, stade de Kellgren et Lawrence à 0. Les images IRM ont été acquises à 7 T en 3D, suivant des séquences GRE et de cartographie T2*. Les régions d’intérêt (RI) du genou soit l’os trabéculaire, l’os sous-chondral, l’enthèse et le corps tendineux ont été délimitées manuellement sur 5 coupes sagittales sur les scans GRE, et les RI ont été délimitées sur les autres coupes sagittales en utilisant une interpolation linéaire. Puis les masques correspondants ont été transférés sur les cartographies T2*. La normalité de distribution des valeurs de T2* a été évaluée par le test de Shapiro–Wilk. La comparaison des valeurs moyennes de T2* entre chaque zone constitutive a été réalisée grâce au test non paramétrique de Friedman, et les comparaisons par paires ont été réalisées selon le test de Nemenyi. L’enthèse quadricipitale, en hypersignal, était bien visible avec cette technique. Les données chiffrées de T2* ont pu être obtenues. La plus grande valeur de T2* (16,99 ms) a été retrouvée dans l’os sous-chondral alors que la plus faible valeur (6,94 ms) a été identifiée dans le corps tendineux. La valeur de T2* dans l’os sous-chondral était significativement plus haute que dans l’enthèse (p = 0,02). De même, le T2* de l’os sous-chondral était significativement plus haut que dans le corps tendineux entier (p = 0,001). Nous avons observé de façon nette des changements de T2* le long de l’axe de l’enthèse vers le corps tendineux chez ces hommes sains âgés de 19 à 25 ans. Les variations de T2* pourraient être liées à des changements dans la composition moléculaire ou cellulaire dans chaque région anatomique allant de la zone de l’os sous-chondral au corps de l’enthèse. Ces résultats offrent les premières valeurs normatives de l’ensemble du tendon. Ces données pourront être un élément de comparaison lors de l’exploration des tendons dans des maladies rhumatologiques inflammatoires et mécaniques. Cette étude devra être poursuivie notamment chez la femme et dans d’autres groupes d’âge. Dans notre étude, nous rapportons des résultats montrant qu’une évaluation fine de l’enthèse quadricipitale est possible en IRM 7 T avec l’acquisition de valeurs normatives. Dans de futures études, ces valeurs pourront être utilisées comme références quantitatives dans les pathologies impliquant l’enthèse.

Background: Fibrocartilaginous enthesis is composed of different histological zones which are commonly referred to the tendon distal extremity (a lamellar tissue with a low cell density, collagen and connective tissue), the fibrocartilaginous zone (with chondrocytes), a progressively mineralized zone and the bone. The MRI visualization of the water content of entheses is challenging given the very short relation time so that entheses has been very poorly assessed using MRI (1). Objectives: The main objective of the study was to assess the structural elements of the knee enthesis based on the quantitative T2* measurements using Ultra High Field (UHF) MRI. Methods: Twelve healthy subjects without any osteoarticular pathology were included in the study after they provided their informed consent. 3D gradient echo sequence with a 4.3 ms echo time and T2* mapping were performed. The lateral internal, external and crossed ligaments, patellar and quadricipital tendons were assessed. T2* measurements were performed specifically on the quadricipital tendon. Results: The quadricipital tendon and the bone trabeculation could be visualized on the UHF MR image. The T2* mapping analysis illustrated a large value (16.4 ± 4 ms) for the subchondral bone and much lower values for the trabecular bone (11 ± 4.5 ms) and the different zones of the keen entheses (7.7 ± 1.9 ms). Conclusion: Based on T2* measurements performed using UHF MRI, the different structural elements of the knee entheses were distinguished. This quantitative stratification could be used to assess changes in pathological conditions such as SpA and trauma. References: [1]Benjamin M, Bydder GM. Magnetic resonance imaging of entheses using ultrashort TE (UTE) pulse sequences. Journal of magnetic resonance imaging: JMRI. 2007;25(2):381-9. Disclosure of Interests: None declared

Purpose: The purpose of this study was to investigate bone microarchitecture of cadaveric proximal femurs using ultra-high field (UHF) 7-Testa magnetic resonance imaging (MRI) and to compare the corresponding metrics with failure load assessed during mechanical compression test and areal bone mineral density (ABMD) measured using dual-energy X-ray absorptiometry. Materials and methods: ABMD of ten proximal femurs from five cadavers (5 women; mean age =86.2 +/- 3.8 (SD) years; range: 82.5-90 years) were investigated using dual-energy X-ray absorptiometry and the bone volume fraction, trabecular thickness, trabecutar spacing, fractal dimension, Euler characteristics, connectivity density and degree of anisotropy of each femur was quantified using UHF MRI. The whole set of specimens underwent mechanical compression tests to failure. The inter-rater reliability of microarchitecture characterization was assessed with the intraclass correlation coefficient (ICC). Associations were searched using correlation tests and multiple regression analysis. Results: The inter-rater reliability for bone microarchitecture parameters measurement was good with ICC ranging from 0.80 and 0.91. ABMD and the whole set of microarchitecture metrics but connectivity density significantly correlated with failure load. Microarchitecture metrics correlated to each other but did not correlate with ABMD. Multiple regression analysis disclosed that the combination of microarchitecture metrics and ABMD improved the association with failure load. Conclusion: Femur bone microarchitecture metrics quantified using UHF MRI significantly correlated with biomechanical parameters. The multimodal assessment of ABMD and trabecular bone microarchitecture using UHF MRI provides more information about fracture risk of femoral bone and might be of interest for future investigations of patients with undetected osteoporosis. (C) 2019 Societe francaise de radiologie. Published by Elsevier Masson SAS. All rights reserved.

niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Background The purpose of this study was to assess cadaveric proximal femurs from the points of view of bone microarchitecture using ultra-high field (UHF) 7 Tesla magnetic resonance imaging (MRI), bone strength using biomechanical tests and bone mineral density (BMD) using Dual-energy X-ray absorptiometry (DXA). Objectives We aimed at determining whether bone microarchitecture parameters were related to bone strength and BMD and whether UHF MRI can provide additional information regarding bone strength. Methods BMD of ten proximal femurs from five cadavers were investigated using DXA and the bone volume fraction (BVF), trabecular thickness (Tb.Th), and trabecular spacing (Tb.Sp), fractal dimension (FD), Euler characteristics (Euler Ch.), Connectivity density (Conn. D) and Degree of anisotropy (DA) of each femur was quantified using UHF MRI. The whole set of specimens underwent mechanical compression tests to failure. Results BMD and all the microarchitecture parameters except ConnD were significantly correlated with failure load (p < 0.05). The microarchitecture parameters were correlated to each other but not correlated with BMD. Multiple regression analysis demonstrated that the combination of the microarchitecture parameters and BMD improved the prediction of the failure load with for example an improved fracture risk prediction from R2 = 0.418 to 0.688 when combining BMD and Euler Ch. Overall, femur bone microarchitecture assessed with UHF MRI was significantly correlated with biomechanical parameters. The multimodal assessment of BMD and trabecular bone microarchitecture using UHF MRI improved the fracture risk prediction of femoral bone and might be of interest for the future investigation of selected osteoporotic patients. Conclusion We demonstrated that femur bone microarchitecture assessed with UHF MRI was significantly correlated with biomechanical parameters. The multimodal assessment of bone mineral density and trabecular bone microarchitecture using UHF MRI improved the fracture risk prediction of femoral bone and might be of interest for the future investigation of selected osteoporotic patients. Disclosure of Interests None declared

Mujer de 81 años en tratamiento con una combinación fija de timolol y brimonidina en colirio que fue diagnosticada en urgencias de uveítis anterior aguda hipertensiva granulomatosa. La paciente respondió favorablemente a la retirada del colirio sin mostrar recaída posterior.La uveítis por brimonidina es un efecto adverso raro, pero que debe ser conocido. Una vez se llega al diagnóstico de sospecha, el tratamiento efectivo es la retirada del colirio de brimonidina, con adición o no de corticoides tópicos para controlar la inflamación según la gravedad del cuadro. Se trata de un proceso con un pronóstico excelente.The case concerns an 81-year-old woman on treatment with a topical fixed combination of timolol and brimonidine who was diagnosed in the Emergency Department with acute anterior granulomatous hypertensive uveitis. The patient responded favourably to the withdrawal of the eye drops without showing any subsequent relapse.Uveitis due to brimonidine is a rare adverse effect, but it must be known. Once the diagnosis is suspected, the effective treatment is the withdrawal of brimonidine, with or without the addition of topical corticosteroids to control inflammation depending on the severity of the condition. It is a process with an excellent prognosis.

The influence of neuromuscular electrical stimulation (NMES) parameters on brain activation has been scarcely investigated. We aimed at comparing two frequently used NMES protocols - designed to vary in the extent of sensory input. Whole-brain functional magnetic resonance imaging was performed in sixteen healthy subjects during wide-pulse high-frequency (WPHF, 100 Hz–1 ms) and conventional (CONV, 25 Hz–0.05 ms) NMES applied over the triceps surae . Each protocol included 20 isometric contractions performed at 10% of maximal force. Voluntary plantar flexions (VOL) were performed as control trial. Mean force was not different among the three protocols, however, total current charge was higher for WPHF than for CONV. All protocols elicited significant activations of the sensorimotor network, cerebellum and thalamus. WPHF resulted in lower deactivation in the secondary somatosensory cortex and precuneus. Bilateral thalami and caudate nuclei were hyperactivated for CONV. The modulation of the NMES parameters resulted in differently activated/deactivated regions related to total current charge of the stimulation but not to mean force. By targeting different cerebral brain regions, the two NMES protocols might allow for individually-designed rehabilitation training in patients who can no longer execute voluntary movements.