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Harloff A, Berg S, Barker AJ, Schöllhorn J, Schumacher M, Weiller C, Markl M. Wall shear stress distribution at the carotid bifurcation: influence of eversion carotid endarterectomy. Eur Radiol 2013; 23:3361-9. [PMID: 23812310 DOI: 10.1007/s00330-013-2953-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 05/31/2013] [Accepted: 06/07/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To test the feasibility of four-dimensional (4D) flow MRI to quantify the systolic wall shear stress (WSSsystole) and oscillatory shear index (OSI) in high-grade internal carotid artery (ICA) stenosis before and after endarterectomy (CEA). METHODS Twenty patients with ≥60 % ICA stenosis were prospectively and consequently included. Four-dimensional flow MRI was used to measure individual time-resolved 3D blood flow velocities. Segmental WSSsystole and OSI were derived at eight wall segments in analysis planes positioned along the ICA, common (CCA) and external carotid artery (ECA). RESULTS Regional WSSsystole of all patients decreased after CEA (P < 0.05). Changes were most prominent at the ICA bulb but remained unchanged in the CCA and ECA. OSI was significantly lower after CEA in the lateral vessel walls (P < 0.05). For analysis planes at the stenosis in- and outlet, a reduction of mean WSSsystole by 32 % and 52 % (P < 0.001) and OSI distal to the stenosis (40 %, P = 0.01) was found after CEA. CONCLUSIONS Our findings show the potential of in vivo 4D flow MRI to quantify haemodynamic changes in wall shear stress even in patients with complex flow conditions.
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Hellwig S, Kreft A, Amtage F, Tüscher O, Winz OH, Weiller C, Weber WA, Vach W, Meyer PT. Die IBZM-SPECT ist kein erkrankungsunabhängiger Prädiktor des dopaminergen Ansprechens beim neurodegenerativen Parkinson-Syndrom. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kümmerer D, Foit N, Kellmeyer P, Schulze-Bonhage A, Wagner K, Weiller C, Saur D. Reorganisation im Sprachsystem bei Patienten mit Temporallappenepilepsie. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hellwig S, Frings L, Bormann T, Kreft A, Amtage F, Weiller C, Weber WA, Tüscher O, Meyer PT. Neuronale Korrelate der kognitiven Dysfunktion bei Tauopathien und Erkrankungen des Lewykörperspektrums: Kombiniertes Assessment mittels [18F]FDG-PET und CERAD-Testbatterie. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kümmerer D, Bormann T, Glauche V, Mader I, Rijntjes M, Saur D, Schelter B, Weiller C. Schädigungen der Assoziationsfasersysteme bei Patienten mit akuter Aphasie. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dersch R, Stich O, Goller K, Meckel S, Dechent F, Doostkam S, Weiller C, Bardutzky J. Atypical posterior reversible encephalopathy syndrome associated with chemotherapy with Bevacizumab, Gemcitabine and Cisplatin. J Neurol 2013; 260:1406-7. [DOI: 10.1007/s00415-013-6866-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 01/30/2013] [Accepted: 02/02/2013] [Indexed: 10/27/2022]
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Harloff A, Zech T, Wegent F, Strecker C, Weiller C, Markl M. Comparison of blood flow velocity quantification by 4D flow MR imaging with ultrasound at the carotid bifurcation. AJNR Am J Neuroradiol 2013; 34:1407-13. [PMID: 23413247 DOI: 10.3174/ajnr.a3419] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 4D flow MR imaging is an emerging technique that allows visualization and quantification of 3D blood flow in vivo. However, representative studies evaluating its accuracy are lacking. Therefore, we compared blood flow quantification by using 4D flow MR imaging with US within the carotid bifurcation. MATERIALS AND METHODS Thirty-two healthy volunteers (age 25.3 ± 3.4 years) and 20 patients with ≥50% ICA stenosis (age 67.7 ± 7.4 years) were examined preoperatively and postoperatively by use of 4D flow MR imaging, with complete coverage of the left and right carotid bifurcation. Blood flow velocities were assessed with standardized 2D analysis planes distributed along the CCA and the ICA and were compared with US at baseline and postoperatively in patients. In addition, we tested reproducibility and interobserver agreement of 4D MR imaging in 10 volunteers. RESULTS Overall, 101 CCAs and 79 ICAs were available for comparison. MR imaging underestimated (P < .05) systolic CCA and ICA blood flow velocity by 26% (0.79 ± 0.29 m/s vs 1.06 ± 0.31 m/s) and 19% (0.72 ± 0.21 m/s vs 0.89 ± 0.27 m/s) compared with US. Diastolic blood flow velocities were similar for MR imaging and US (differences, 9% and 3%, respectively; not significant). Reproducibility and interobserver agreement of 4D flow MR imaging was excellent. CONCLUSIONS 4D flow MR imaging allowed for an accurate measurement of blood flow velocities in the carotid bifurcation of both volunteers and patients with only moderate underestimation compared with US. Thus, 4D flow MR imaging seems promising for a future combination with MRA to comprehensively assess ICA stenosis and related hemodynamic changes.
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Stich O, Nagy S, Reinhard M, Hetzel A, Winkler C, Taschner C, Leschka S, Weiller C, Rijntjes M. Hypoglossal nerve palsy after extensive vomiting. J Clin Neurosci 2012; 19:744, 776-7. [DOI: 10.1016/j.jocn.2011.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Amtage F, Hellwig S, Kreft A, Rijntjes M, Winkler C, Weiller C, Weber WA, Tüscher O, Meyer PT. Funktionelle Korrelate der vertikalen Blickparese und anderer okulomotorischer Störungen der PSP: eine FDG-PET Studie. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hellwig S, Amtage F, Kreft A, Buchert R, Winz OH, Spehl T, Weiller C, Winkler C, Tüscher O, Meyer PT. Prospektiver Vergleich von FDG-PET und IBZM-SPECT zur Differentialdiagnostik des Parkinson-Syndroms. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Reinhard M, Schork J, Allignol A, Weiller C, Kaube H. Gestörte Autoregulation als Ursache für cerebelläre Grenzzoneninfarkte bei Migräne? KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Franz A, Granert O, Rijntjes M, Siebner HR, Weiller C, van Eimeren T. Separable cortico-basal ganglia networks support self-imposed transient response inhibition. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Reinhard M, Rutsch S, Lambeck J, Wihler C, Czosnyka M, Weiller C, Hetzel A. Dynamic cerebral autoregulation associates with infarct size and outcome after ischemic stroke. Acta Neurol Scand 2012; 125:156-62. [PMID: 21470192 DOI: 10.1111/j.1600-0404.2011.01515.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Cerebral autoregulation is particularly challenged in acute ischemic stroke. We investigated (1) clinical and radiological factors related to dynamic cerebral autoregulation (DCA) in acute stroke and (2) the relationship between DCA and clinical outcome of stroke. METHODS A total of 45 patients with middle cerebral artery (MCA) stroke were analyzed pooling two previous studies. DCA was measured by transcranial Doppler in both MCAs early (within 48 h from onset) and late (day 5-7) using low-frequency phase and correlation analysis (index Mx). Outcome was assessed by modified Rankin scale after a mean period of 4 months. RESULTS Mx increased (i.e. autoregulation worsened) between the early and late measurement, more so on affected (P = 0.005) than on unaffected sides (P = 0.014). Poorer autoregulation as indicated by lower ipsilateral phase (early and late) and higher Mx (late measurement) were significantly related to larger infarction. More severe stroke was significantly related to poorer ipsilateral Mx and phase. Ipsilateral phase in the early (P = 0.019) and Mx in the late measurement (P =0..016) were related to poor clinical outcome according to univariate analysis. CONCLUSIONS Impairment of DCA ipsilateral to acute ischemic stroke is associated with larger infarction. Dysautoregulation tends to worsen and spread to the contralateral side over the first days post-stroke and is associated with poor clinical outcome.
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Amtage F, Hellwig S, Kreft A, Glauche V, Winkler C, Rijntjes M, Weiller C, Weber WA, Tüscher O, Meyer PT. Funktionelle Korrelate der asymmetrischen progressiven supranukleären Blickparese: eine FDG-PET-Studie. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dressel K, Weiller C, Huber W, Abel S. Gestörter Wortabruf im kognitiven Modell und im Gehirn - eine Therapiestudie mit 3 Einzelfällen. SPRACHE-STIMME-GEHOR 2011. [DOI: 10.1055/s-0031-1273694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fischer J, Fritsch B, Weiller C, Reis J. Schlaf-unabhängige Verbesserung der Konsolidierung motorischer Fähigkeiten unter dem Einfluss von transkranieller Gleichstromstimulation. KLIN NEUROPHYSIOL 2011. [DOI: 10.1055/s-0031-1272749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Weiller C, Brandt T. [Functional imaging in neurology]. DER NERVENARZT 2010; 81:1427-1428. [PMID: 21109993 DOI: 10.1007/s00115-010-3102-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Weiller C, Meyer PT, Hennig J. [Neuroimaging in medicine]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2010; 53:801-9. [PMID: 20700779 DOI: 10.1007/s00103-010-1096-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neuroimaging has in recent years greatly contributed to our understanding of a wide range of aspects of central neurological diseases. These include the classification and localization of disease (e.g., in headache), the understanding of pathology (e.g., in Parkinson's disease), mechanisms of reorganization (e.g., in stroke), and the subclinical progress of disease (e.g., in degenerative diseases). Apart form presurgical mapping, clinical applications of fMRI are limited. However, functional imaging enables the formulation of neurobiological hypotheses that can be tested clinically and is suited to test classical clinical hypotheses about how the brain works. Understanding the mechanisms and the site of pathology, e.g., in cluster headaches, will lead and has led to new therapeutic strategies. New methodological developments for neuroscientific applications are aimed at the integration of functional and morphological connectivity through a combination of magnetic resonance techniques (fMRI, DTI) and electrophysiological (EEG, MEG) recordings. In addition to stimulus-dependent activations, resting state activity has found increasing interest, for example, in sleep research and various psychiatric diseases (e.g., schizophrenia, borderline).
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Saur D, Weiller C. Bildgebung der Reorganisation im Sprachsystem nach Schlaganfall. KLIN NEUROPHYSIOL 2009. [DOI: 10.1055/s-0029-1242731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Harloff A, Markl M, Frydrychowicz A, Hennig J, Weiller C. [Diagnosing stroke aetiologies. Morphologic and functional analysis of the aorta and carotid arteries by MRI]. DER NERVENARZT 2009; 80:929-40. [PMID: 19319500 DOI: 10.1007/s00115-009-2679-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Magnetic resonance imaging allows detailed visualization of the thoracic aorta and is not limited by air artefacts or insonation angles like transoesophageal echocardiography (TEE). Thus the aortic arch can be investigated with higher accuracy, and additional embolic high-risk sources such as complex plaques can be additionally detected by MRI in patients with cryptogenic stroke. Furthermore, MRI provides exact 3D plaque localisation and can be combined with multidirectional 3D MRI velocity mapping. In this way, previously not demonstrable retrograde flow paths originating at complex descending aortic plaques reaching the supra-aortic great arteries can be identified as the probable stroke mechanism in certain patients. The same technique can also be applied to the carotid arteries. This allows analysing the complex 3D helical flow within the internal carotid artery as well as measuring absolute flow velocities and wall shear stress in combination with data on vessel anatomy derived from conventional MR angiography. It is the purpose of this work to describe the state of the art of these modern MR imaging techniques and their potential to identify potential stroke mechanisms, and to analyse the particular role of individual haemodynamic factors on the development of local atherosclerosis.
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Umarova R, Saur D, Kaller C, Vry MS, Glauche V, Mader I, Weiller C. Mapping of visuospatial attention in acute stroke patients with and without neglect. AKTUELLE NEUROLOGIE 2009. [DOI: 10.1055/s-0029-1238425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Heimbach B, Fischer A, Hüll M, Weiller C. Auswirkungen einer Ambulanten Gerontoneurologischen Rehabilitation (AGNR) auf Stand- und Gangsicherheit sowie alltagsrelevante Funktionen. AKTUELLE NEUROLOGIE 2009. [DOI: 10.1055/s-0029-1238639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hören M, Vry MS, Saur D, Glauche V, Mader I, Weiller C, Hamzei F. Mirror neurons, Lokalisation und funktionelle Bedeutung. AKTUELLE NEUROLOGIE 2009. [DOI: 10.1055/s-0029-1238485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Harloff A, Brendecke S, Assefa D, Simon J, Wallis W, Helbing T, Frydrychowicz A, Weber J, Weiller C, Hennig J, Markl M. 3D Plaquedetektion in der Aorta von Schlaganfallpatienten mittels 3 Tesla MRT. AKTUELLE NEUROLOGIE 2009. [DOI: 10.1055/s-0029-1238697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kellmeyer P, Saur D, Peschke C, Kappes J, Ziegler W, Weiller C, Baumgärtner A. Ventral and dorsal fronto-parietal fiber pathways for phonological transformation processes. AKTUELLE NEUROLOGIE 2009. [DOI: 10.1055/s-0029-1238429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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