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Pan JW, Duckrow RB, Spencer DD, Avdievich NI, Hetherington HP. Selective homonuclear polarization transfer for spectroscopic imaging of GABA at 7T. Magn Reson Med 2012; 69:310-6. [PMID: 22505305 DOI: 10.1002/mrm.24283] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 03/13/2012] [Indexed: 12/29/2022]
Abstract
We develop and implement a selective homonuclear polarization transfer method for the detection of 3.0 ppm C-4 GABA resonance by spectroscopic imaging in the human brain at 7T. This single shot method is demonstrated with simulations and phantoms, which achieves comparable efficiency of detection to that of J-difference editing. The macromolecule resonance that commonly co-edits with GABA is suppressed at 7T through use of a narrow band preacquisition suppression pulse. This technique is implemented in humans with an eight channel transceiver array and high degree B(0) shimming to measure supplementary motor area and thalamic GABA in controls (n = 8) and epilepsy patients (n = 8 total). We find that the GABA/N-acetyl aspartate ratio in the thalamus of control volunteers, well controlled and poorly controlled epilepsy patients are 0.053 ± 0.012 (n = 8), 0.090 ± 0.012 (n = 2), and 0.038 ± 0.009 (n = 6), respectively.
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Pan JW, Lo KM, Hetherington HP. Role of very high order and degree B0 shimming for spectroscopic imaging of the human brain at 7 tesla. Magn Reson Med 2011; 68:1007-17. [PMID: 22213108 DOI: 10.1002/mrm.24122] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 11/21/2011] [Accepted: 11/23/2011] [Indexed: 01/19/2023]
Abstract
With the advent of ultrahigh field systems (7 T), significant improvements in spectroscopic imaging (SI) studies of the human brain have been anticipated. These gains are dependent upon the achievable B0 homogeneity, both globally (σB0Global, over the entire regions of interest or slice) and locally (σB0Global, influencing the linewidth of individual SI voxels within the regions of interest). Typically the B0 homogeneity is adjusted using shim coils with spatial distributions modeled on spherical harmonics which can be characterized by a degree (radial dependence) and order (azimuthal symmetry). However, the role of very high order and degree shimming (e.g., 3rd and 4th degree) in MRSI studies has been controversial. Measurements of σB0Global and σB0Local were determined from B0 field maps of 64×64 resolution. In a 10 mm thick slice taken through the region of the subcortical nuclei, we find that in comparison to 1st-2nd degree shims, use of 1st-3rd and 1st-4th degree shims reduces σB0Global by 29% and 55%, respectively. Using a SI voxel size of ∼1cc with an estimate of σB0Local from 3×3×3 B0 map pixels in this subcortical region, the number of pixels with σB0Local of less than 5 Hz increased from 24 to 59% with 1st-3rd and 1st-4th over 1st-2nd degree shims, respectively.
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Pan JW, Avdievich N, Hetherington HP. J-refocused coherence transfer spectroscopic imaging at 7 T in human brain. Magn Reson Med 2011; 64:1237-46. [PMID: 20648684 DOI: 10.1002/mrm.22534] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Short echo spectroscopy is commonly used to minimize signal modulation due to J-evolution of the cerebral amino acids. However, short echo acquisitions suffer from high sensitivity to macromolecules which make accurate baseline determination difficult. In this report, we describe implementation at 7 T of a double echo J-refocused coherence transfer sequence at echo time (TE) of 34 msec to minimize J-modulation of amino acids while also decreasing interfering macromolecule signals. Simulation of the pulse sequence at 7 T shows excellent resolution of glutamate, glutamine, and N-acetyl aspartate. B(1) sufficiency at 7 T for the double echo acquisition is achieved using a transceiver array with radiofrequency (RF) shimming. Using an alternate RF distribution to minimize receiver phase cancellation in the transceiver, accurate phase determination for the coherence transfer is achieved with rapid single scan calibration. This method is demonstrated in spectroscopic imaging mode with n = 5 healthy volunteers resulting in metabolite values consistent with literature and in a patient with epilepsy.
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Avdievich NI, Oh S, Hetherington HP, Collins CM. Improved homogeneity of the transmit field by simultaneous transmission with phased array and volume coil. J Magn Reson Imaging 2010; 32:476-81. [PMID: 20677280 PMCID: PMC2925674 DOI: 10.1002/jmri.22257] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To improve the homogeneity of transmit volume coils at high magnetic fields (> or =4 T). Due to radiofrequency (RF) field/tissue interactions at high fields, 4 T to 8 T, the transmit profile from head-sized volume coils shows a distinctive pattern with relatively strong RF magnetic field B(1) in the center of the brain. MATERIALS AND METHODS In contrast to conventional volume coils at high field strengths, surface coil phased arrays can provide increased RF field strength peripherally. In theory, simultaneous transmission from these two devices could produce a more homogeneous transmission field. To minimize interactions between the phased array and the volume coil, counter rotating current (CRC) surface coils consisting of two parallel rings carrying opposite currents were used for the phased array. RESULTS Numerical simulations and experimental data demonstrate that substantial improvements in transmit field homogeneity can be obtained. CONCLUSION We have demonstrated the feasibility of using simultaneous transmission with human head-sized volume coils and CRC phased arrays to improve homogeneity of the transmit RF B(1) field for high-field MRI systems.
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Hetherington HP, Avdievich NI, Kuznetsov AM, Pan JW. RF shimming for spectroscopic localization in the human brain at 7 T. Magn Reson Med 2010; 63:9-19. [PMID: 19918903 DOI: 10.1002/mrm.22182] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Spectroscopic imaging of the human head at short echo times (<or=15 ms) typically requires suppression of signals from extracerebral tissues. However, at 7 T, decreasing efficiency in B1+ generation (hertz/watt) and increasing spectral bandwidth result in dramatic increases in power deposition and increased chemical shift registration artifacts for conventional gradient-based in-plane localization. In this work, we describe a novel method using radiofrequency shimming and an eight-element transceiver array to generate a B1+ field distribution that excites a ring about the periphery of the head and leaves central brain regions largely unaffected. We have used this novel B1+ distribution to provide in-plane outer volume suppression (>98% suppression of extracerebral lipids) without the use of gradients. This novel B1+ distribution is used in conjunction with a double inversion recovery method to provide suppression of extracerebral resonances with T1s greater than 400 ms, while having negligible effect on metabolite ratios of cerebral resonances with T1s>1000 ms. Despite the use of two adiabatic pulses, the high efficiency of the ring distribution allows radiofrequency power deposition to be limited to 3-4 W for a pulse repetition time of 1.5 sec. The short echo time enabled the acquisition of images of the human brain, displaying glutamate, glutamine, macromolecules, and other major cerebral metabolites.
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Zimmerman ME, Pan JW, Hetherington HP, Lipton ML, Baigi K, Lipton RB. Hippocampal correlates of pain in healthy elderly adults: a pilot study. Neurology 2009; 73:1567-70. [PMID: 19901248 DOI: 10.1212/wnl.0b013e3181c0d454] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Few neuroimaging investigations of pain in elderly adults have focused on the hippocampus, a brain structure involved in nociceptive processing that is also subject to involution associated with dementing disorders. The goal of this pilot study was to examine MRI- and magnetic resonance spectroscopy (MRS)-derived hippocampal correlates of pain in older adults. METHODS A subset of 20 nondemented older adults was drawn from the Einstein Aging Study, a community-based sample from the Bronx, NY. Pain was measured on 3 time scales: 1) acute pain right now (pain severity); 2) pain over the past 4 weeks (Short Form-36 Bodily Pain); 3) chronic pain over the past 3 months (Total Pain Index). Hippocampal data included volume data normalized to midsagittal area and N-acetylaspartate to creatine ratios (NAA/Cr). RESULTS Smaller hippocampal volume was associated with higher ratings on the Short Form-36 Bodily Pain (r(s) = 0.52, p = 0.02) and a nonsignificant trend was noted for higher ratings of acute pain severity (r(s) = -0.44, p = 0.06). Lower levels of hippocampal NAA/Cr were associated with higher acute pain severity (r(s) = -0.45, p = 0.05). Individuals with chronic pain had a nonsignificant trend for smaller hippocampal volumes (t = 2.00, p = 0.06) and lower levels of hippocampal NAA/Cr (t = 1.71, p = 0.10). CONCLUSIONS Older adults who report more severe acute or chronic pain have smaller hippocampal volumes and lower levels of hippocampal N-acetylaspartate/creatine, a marker of neuronal integrity. Future studies should consider the role of the hippocampus and other brain structures in the development and experience of pain in healthy elderly and individuals with Alzheimer disease.
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Avdievich NI, Hetherington HP. High-field head radiofrequency volume coils using transverse electromagnetic (TEM) and phased array technologies. NMR IN BIOMEDICINE 2009; 22:960-974. [PMID: 18574792 DOI: 10.1002/nbm.1262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This article describes technological advances in quadrature transverse electromagnetic (TEM) volume coils and phased arrays reported recently from our laboratory developed for MRI and MRS imaging of the human brain. The first part of this work presents a new method for tuning TEM volume coils based on measurements of the radiofrequency current distribution in the coil elements. This technique facilitates bench adjustment of the coils' homogeneity and is particularly important for tuning double-tuned TEM volume coils. We have also used this method to optimize other TEM configurations such as a quadrature TEM half-volume coil and a split TEM coil. TEM half-volume coils provide greater sensitivity over localized regions than conventional full-volume coils, and the split TEM coil provides greater patient access and ease of use. The second part of this work describes the development of single-tuned and double-tuned transmit TEM volume coils in combination with phased arrays. A variety of different techniques for active detuning of single-tuned and double-tuned TEM volume coils are presented along with the development of phased arrays and transmission line preamplifier decoupling. The final section describes the use of counter rotating current (CRC) surface coils in phased arrays. Because of the intrinsic isolation of CRC coils from transmit volume coils, CRC arrays can be used simultaneously with volume coils for both reception and transmission. Near the center of the human head where both the phased array and the volume coil produce similar sensitivities, simultaneous reception enhances the signal-to-noise ratio. Conversely, simultaneous transmission can be used to boost the transmit field in peripheral brain regions from the volume coil to provide a more homogeneous transmit field.
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Avdievich NI, Pan JW, Baehring JM, Spencer DD, Hetherington HP. Short echo spectroscopic imaging of the human brain at 7T using transceiver arrays. Magn Reson Med 2009; 62:17-25. [PMID: 19365851 DOI: 10.1002/mrm.21970] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent advances in magnet technology have enabled the construction of ultrahigh-field magnets (7T and higher) that can accommodate the human head and body. Despite the intrinsic advantages of performing spectroscopic imaging at 7T, increased signal-to-noise ratio (SNR), and spectral resolution, few studies have been reported to date. This limitation is largely due to increased power deposition and B(1) inhomogeneity. To overcome these limitations, we used an 8-channel transceiver array with a short TE (15 ms) spectroscopic imaging sequence. Utilizing phase and amplitude mapping and optimization schemes, the 8-element transceiver array provided both improved efficiency (17% less power for equivalent peak B(1)) and homogeneity (SD(B(1)) = +/-10% versus +/-22%) in comparison to a transverse electromagnetic (TEM) volume coil. To minimize the echo time to measure J-modulating compounds such as glutamate, we developed a short TE sequence utilizing a single-slice selective excitation pulse followed by a broadband semiselective refocusing pulse. Extracerebral lipid resonances were suppressed with an inversion recovery pulse and delay. The short TE sequence enabled visualization of a variety of resonances, including glutamate, in both a control subject and a patient with a Grade II oligodendroglioma.
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Zimmerman ME, Lipton RB, Pan JW, Hetherington HP, Verghese J. MRI- and MRS-derived hippocampal correlates of quantitative locomotor function in older adults. Brain Res 2009; 1291:73-81. [PMID: 19631621 DOI: 10.1016/j.brainres.2009.07.043] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 07/08/2009] [Accepted: 07/15/2009] [Indexed: 11/28/2022]
Abstract
Gait measures have been shown to predict cognitive decline and dementia in older adults. Investigation of the neurobiology associated with locomotor function is needed to elucidate this relationship with cognitive abilities. This study aimed to examine magnetic resonance imaging (MRI; hippocampal volume)- and proton magnetic resonance spectroscopy (MRS; N-acetylaspartate to creatine (NAA/Cr) ratios)-derived hippocampal correlates of quantitative gait function (swing time (seconds), stride length (cm), and stride length variability (standard deviation)) in a subset of 48 nondemented older adults (24 males; mean age=81 years) drawn from the Einstein Aging Study, a community-based sample of individuals over the age of 70 residing in Bronx, New York. Linear regression analyses controlling for age were used to examine hippocampal volume and neurochemistry as predictors of gait function. We found that stride length was associated with hippocampal volume (beta=0.36, p=0.03; overall model R(2)=0.33, p=0.01), but not hippocampal neurochemistry (beta=0.09, p=0.48). Stride length variability was more strongly associated with hippocampal NAA/Cr (beta=-0.38, p=0.01; overall model R(2)=0.14, p=0.04) than hippocampal volume (beta=-0.33, p=0.08). Gait swing time was not significantly related to any neuroimaging measure. These relationships remained significant after accounting for memory and clinical gait impairments. These findings suggest that nondemented older adults exhibit increased stride length variability that is associated with lower levels of hippocampal neuronal metabolism, but not hippocampal volume. Conversely, decreased stride length is associated with smaller hippocampal volumes, but not hippocampal neurochemistry. Distinct neurobiological hippocampal substrates may support decreased stride length and increased stride length variability in older adults.
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Zimmerman ME, Pan JW, Hetherington HP, Lipton ML, Baigi KH, Lipton RB. IC‐P‐143: Hippocampal correlates of pain in healthy elderly adults: A pilot study. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.05.115] [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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Zimmerman ME, Pan JW, Hetherington HP, Lipton ML, Baigi KH, Lipton RB. P1‐143: Hippocampal correlates of pain in healthy elderly adults: a pilot study. Alzheimers Dement 2009. [DOI: 10.1016/j.jalz.2009.04.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Avdievich NI, Hetherington HP, Kuznetsov AM, Pan JW. 7T head volume coils: improvements for rostral brain imaging. J Magn Reson Imaging 2009; 29:461-5. [PMID: 19161203 DOI: 10.1002/jmri.21660] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To improve the performance of 7T head coils over the rostral head regions. Due to radiofrequency (RF) field/tissue interactions, the RF magnetic field profile produced by 7T volume head coils is very inhomogeneous, with enhanced sensitivity near the center of the human brain and substantially reduced in the periphery. MATERIALS AND METHODS Two head-sized quadrature volume coils of similar diameters but substantially different lengths (17 and 10 cm) were constructed and tested using a 7T Varian Inova system. RESULTS Experimental data demonstrated that by using a shorter volume head-sized coil or simply by partially moving a head out of the coil, coil efficiency near the top of a head can be improved by 20%. The homogeneity also improved, largely resulting from an increase in peripheral B(1) values. This resulted in 10%-20% variation in axial slices located near the top of a head. CONCLUSION We have demonstrated a less deeply positioned head or substantially shorter volume coil can significantly improve coil performance and homogeneity for the rostral head at ultrahigh magnetic fields (7T and above). For studies that target superior brain regions, this coil arrangement can be highly effective.
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Pan JW, Cavus I, Kim J, Hetherington HP, Spencer DD. Hippocampal extracellular GABA correlates with metabolism in human epilepsy. Metab Brain Dis 2008; 23:457-68. [PMID: 18807158 PMCID: PMC3578212 DOI: 10.1007/s11011-008-9106-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Accepted: 08/07/2008] [Indexed: 11/26/2022]
Abstract
As the major inhibitory neurotransmitter in human brain, GABA is an important modulator of hyperexcitability in epilepsy patients. Given the high energetic cost of neurotransmission and synaptic activity, GABA concentrations may be hypothesized to correlate with metabolic function. We studied human epilepsy patients undergoing intracranial EEG monitoring for seizure localization to examine microdialysis measures of extracellular GABA (ecGABA), pre-operative MR spectroscopic measures of neuronal mitochondrial function (NAA/Cr), and wherever possible, neuropathology and hippocampal volumetry. Two groups undergoing intracranial monitoring for seizure localization were studied: surgically treated hippocampal epilepsy (MTLE) and neocortical (non-hippocampal seizure onset) epilepsy. All data are hippocampal and thus these groups allow comparisons between the epileptogenic and non-epileptogenic regions. ecGABA was measured using in vivo microdialysis performed during intracranial monitoring. Pre-operative in vivo MR spectroscopic imaging was performed to measure the ratio of N-acetyl aspartate (NAA) to creatine. Standard methods for neuropathology and hippocampal volumetry were used. In the neocortical group, increased ecGABA correlated with greater NAA/Cr (R = +0.70, p < 0.015, n = 12) while in the MTLE group, increased ecGABA linked with decreased NAA/Cr (R = -0.94, p < 0.001, n = 8). In MTLE, ecGABA (increased) and NAA/Cr (decreased) correlated with increased glial cell numbers (R = +0.71, p < 0.01, n = 12, R = -0.76 p < 0.03 respectively). No relationship was seen between ecGABA and hippocampal volumes in either group. In epilepsy, ecGABA increases occur across a range of metabolic function. Outside the seizure focus, ecGABA and NAA/Cr increase together; in contrast, within the seizure focus, ecGABA increases with declining mitochondrial function.
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Zimmerman ME, Lipton RB, Pan JW, Hetherington HP, Verghese J. P2‐103: MRI‐ and MRS‐derived hippocampal correlates of quantitative gait dysfunction in older adults. Alzheimers Dement 2008. [DOI: 10.1016/j.jalz.2008.05.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pan JW, Williamson A, Cavus I, Hetherington HP, Zaveri H, Petroff OAC, Spencer DD. Neurometabolism in human epilepsy. Epilepsia 2008; 49 Suppl 3:31-41. [PMID: 18304254 DOI: 10.1111/j.1528-1167.2008.01508.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Because of the large and continuous energetic requirements of brain function, neurometabolic dysfunction is a key pathophysiologic aspect of the epileptic brain. Additionally, neurometabolic dysfunction has many self-propagating features that are typical of epileptogenic processes, that is, where each occurrence makes the likelihood of further mitochondrial and energetic injury more probable. Thus abnormal neurometabolism may be not only a chronic accompaniment of the epileptic brain, but also a direct contributor to epileptogenesis. METHODS We examine the evidence for neurometabolic dysfunction in epilepsy, integrating human studies of metabolic imaging, electrophysiology, microdialysis, as well as intracranial EEG and neuropathology. RESULTS As an approach of noninvasive functional imaging, quantitative magnetic resonance spectroscopic imaging (MRSI) measured abnormalities of mitochondrial and energetic dysfunction (via 1H or 31P spectroscopy) are related to several pathophysiologic indices of epileptic dysfunction. With patients undergoing hippocampal resection, intraoperative 13C-glucose turnover studies show a profound decrease in neurotransmitter (glutamate-glutamine) cycling relative to oxidation in the sclerotic hippocampus. Increased extracellular glutamate (which has long been associated with increased seizure likelihood) is significantly linked with declining energetics as measured by 31P MR, as well as with increased EEG measures of Teager energy, further arguing for a direct role of glutamate with hyperexcitability. DISCUSSION Given the important contribution that metabolic performance makes toward excitability in brain, it is not surprising that numerous aspects of mitochondrial and energetic state link significantly with electrophysiologic and microdialysis measures in human epilepsy. This may be of particular relevance with the self-propagating nature of mitochondrial injury, but may also help define the conditions for which interventions may be developed.
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Cavus I, Pan JW, Hetherington HP, Abi-Saab W, Zaveri HP, Vives KP, Krystal JH, Spencer SS, Spencer DD. Decreased hippocampal volume on MRI is associated with increased extracellular glutamate in epilepsy patients. Epilepsia 2008; 49:1358-66. [PMID: 18410365 DOI: 10.1111/j.1528-1167.2008.01603.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Temporal lobe epilepsy (TLE) is associated with smaller hippocampal volume and with elevated extracellular (EC) glutamate levels. We investigated the relationship between the hippocampal volume and glutamate in refractory TLE patients. METHODS We used quantitative MRI volumetrics to measure the hippocampal volume and zero-flow microdialysis to measure the interictal glutamate, glutamine, and GABA levels in the epileptogenic hippocampus of 17 patients with medication-resistant epilepsy undergoing intracranial EEG evaluation. The relationships between hippocampal volume, neurochemical levels, and relevant clinical factors were examined. RESULTS Increased EC glutamate in the epileptogenic hippocampus was significantly related to smaller ipsilateral (R(2)= 0.75, p < 0.0001), but not contralateral hippocampal volume when controlled for glutamine and GABA levels, and for clinical factors known to influence hippocampal volume. Glutamate in the atrophic hippocampus was significantly higher (p = 0.008, n = 9), with the threshold for hippocampal atrophy estimated as 5 microM. GABA and glutamine levels in the atrophic and nonatrophic hippocampus were comparable. Decreased hippocampal volume was related to higher seizure frequency (p = 0.008), but not to disease duration or febrile seizure history. None of these clinical factors were related to the neurochemical levels. CONCLUSIONS We provide evidence for a significant association between increased EC glutamate and decreased ipsilateral epileptogenic hippocampal volume in TLE. Future work will be needed to determine whether the increase in glutamate has a causal relationship with hippocampal atrophy, or whether another, yet unknown factor results in both. This work has implications for the understanding and treatment of epilepsy as well as other neurodegenerative disorders associated with hippocampal atrophy.
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Zimmerman ME, Pan JW, Hetherington HP, Katz MJ, Verghese J, Buschke H, Derby CA, Lipton RB. Hippocampal neurochemistry, neuromorphometry, and verbal memory in nondemented older adults. Neurology 2008; 70:1594-600. [PMID: 18367703 DOI: 10.1212/01.wnl.0000306314.77311.be] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Characterization of the behavioral correlates of neuromorphometry and neurochemistry in older adults has important implications for an improved understanding of the aging process. The objective of this study was to test the hypothesis that a measure of hippocampal neuronal metabolism was associated with verbal memory in nondemented older adults after controlling for hippocampal volume. METHODS 4-T MRI, proton magnetic resonance spectroscopy ((1)H MRS), and neuropsychological assessment were conducted in 48 older adults (23 women; mean age 81 years). Average hippocampal N-acetyl aspartate/creatine ratios (NAA/Cr) and hippocampal volumes were obtained. Neuropsychological evaluation included tests of verbal memory (Buschke and Grober Free and Cued Selective Reminding Test-Immediate Recall [FCSRT-IR], Wechsler Memory Scale-Revised Logical Memory subtest) and attention and executive function (Trail Making Test Parts A and B). RESULTS Linear regression analysis indicated that after adjusting for age, hippocampal NAA/Cr was a significant predictor of FCSRT-IR performance (beta = 0.38, p = 0.01, R (2) = 0.21). Hippocampal volume was also a significant predictor of FCSRT-IR performance after adjusting for age and midsagittal area (beta = 0.47, p = 0.01, R (2) = 0.24). In a combined model, hippocampal NAA/Cr (beta = 0.33, p = 0.03) and volume (beta = 0.35, p = 0.03) were independent predictors of FCSRT-IR performance, accounting for 30% of the variance in memory. CONCLUSIONS These findings indicate that nondemented older adults with smaller hippocampal volumes and lower levels of hippocampal N-acetyl aspartate/creatine ratio metabolites perform more poorly on a test of verbal memory. The integrity of both the structure and metabolism of the hippocampus may underlie verbal memory function in nondemented elderly.
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Hetherington HP, Kuzniecky RI, Vives K, Devinsky O, Pacia S, Luciano D, Vasquez B, Haut S, Spencer DD, Pan JW. A subcortical network of dysfunction in TLE measured by magnetic resonance spectroscopy. Neurology 2008; 69:2256-65. [PMID: 18071146 DOI: 10.1212/01.wnl.0000286945.21270.6d] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The goal of this work was to evaluate the relationship between neuronal injury/loss in the hippocampus, thalamus, and putamen in temporal lobe epilepsy (TLE) patients using (1)H magnetic resonance spectroscopic imaging. METHODS (1)H spectroscopic images from the hippocampus and thalamus of controls and patients with TLE were acquired at 4 T. The spectroscopic imaging data were reconstructed using an automated voxel-shifting method based on anatomic landmarks providing four, six, and three loci for the hippocampus, thalamus, and putamen, respectively. For correlation analysis, the hippocampal and striatal loci were averaged to provide single estimates of the entire structure, whereas the thalamus was divided into two regions, an anterior and posterior measure, using the average of three loci each. RESULTS The ratio of N-acetyl aspartate to creatine (NAA/Cr), a measure of neuronal injury/loss, was significantly reduced in both the ipsilateral and contralateral hippocampi and thalami. NAA/Cr in the ipsilateral hippocampus was significantly correlated with the ipsilateral and contralateral anterior and posterior thalami, putamen, and contralateral hippocampus. In control subjects, the hippocampi were only correlated with each other. CONCLUSIONS The data demonstrate that there is significant neuronal injury/loss in both the ipsilateral and contralateral thalami in temporal lobe epilepsy patients, with greater impairment in the anterior portions of the ipsilateral thalamus. The degree of injury/loss in the ipsilateral and contralateral thalamus and putamen is directly correlated with that of the ipsilateral hippocampus. This is consistent with the hypothesis that the impairment and damage associated with recurrent seizures as measured by N-acetyl aspartate originating in the hippocampus results in injury and impairment in other subcortical structures.
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Gomes WA, Lado FA, de Lanerolle NC, Takahashi K, Pan C, Hetherington HP. Spectroscopic imaging of the pilocarpine model of human epilepsy suggests that early NAA reduction predicts epilepsy. Magn Reson Med 2007; 58:230-5. [PMID: 17654595 DOI: 10.1002/mrm.21310] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Reduced hippocampal N-acetyl aspartate (NAA) is commonly observed in patients with advanced, chronic temporal lobe epilepsy (TLE). It is unclear, however, whether an NAA deficit is also present during the clinically quiescent latent period that characterizes early TLE. This question has important implications for the use of MR spectroscopic imaging (MRSI) in the early identification of patients at risk for TLE. To determine whether NAA is diminished during the latent period, we obtained high-resolution (1)H spectroscopic imaging during the latent period of the rat pilocarpine model of human TLE. We used actively detuneable surface reception and volume transmission coils to enhance sensitivity and a semiautomated voxel shifting method to accurately position voxels within the hippocampi. During the latent period, 2 and 7 d following pilocarpine treatment, hippocampal NAA was significantly reduced by 27.5 +/- 6.9% (P < 0.001) and 17.3 +/- 6.9% (P < 0.001) at 2 and 7 d, respectively. Quantitative estimates of neuronal loss at 7 d (2.3 +/- 7.7% reduction; P = 0.58, not significant) demonstrate that the NAA deficit is not due to neuron loss and therefore likely represents metabolic impairment of hippocampal neurons during the latent phase. Therefore, spectroscopic imaging provides an early marker for metabolic dysfunction in this model of TLE.
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Avdievich NI, Bradshaw K, Lee JH, Kuznetsov AM, Hetherington HP. 4T split TEM volume head and knee coils for improved sensitivity and patient accessibility. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2007; 187:234-41. [PMID: 17533142 PMCID: PMC2749647 DOI: 10.1016/j.jmr.2007.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2006] [Revised: 05/03/2007] [Accepted: 05/08/2007] [Indexed: 05/15/2023]
Abstract
Split RF coils offer improved patient access by eliminating the need for the coil to be slid over the region of interest. For unshielded birdcage coils, the presence of end ring currents necessitates a direct electrical connection between two halves of the coil. For high-field (>3T) shielded birdcage coils, both the shield and the coil must be split and reliably connected electrically. This problem can be circumvented by the use of split TEM volume coils. Since the elements of a TEM coil are coupled inductively, no direct electrical connection between the halves is necessary. In this work we demonstrate that the effects of splitting the shield for head and knee TEMs can be compensated for, and performance retained. For the knee, the improved access allowed the coil diameter to be reduced, enhancing the sensitivity by 15-20%.
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Avdievich NI, Hetherington HP. 4 T Actively detuneable double-tuned 1H/31P head volume coil and four-channel 31P phased array for human brain spectroscopy. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2007; 186:341-6. [PMID: 17379554 PMCID: PMC2677064 DOI: 10.1016/j.jmr.2007.03.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2006] [Revised: 02/09/2007] [Accepted: 03/01/2007] [Indexed: 05/14/2023]
Abstract
Typically 31P in vivo magnetic resonance spectroscopic studies are limited by SNR considerations. Although phased arrays can improve the SNR; to date 31P phased arrays for high-field systems have not been combined with 31P volume transmit coils. Additionally, to provide anatomical reference for the 31P studies, without removal of the coil or patient from the magnet, double-tuning (31P/1H) of the volume coil is required. In this work we describe a series of methods for active detuning and decoupling enabling use of phased arrays with double-tuned volume coils. To demonstrate these principles we have built and characterized an actively detuneable 31P/1H TEM volume transmit/four-channel 31P phased array for 4 T magnetic resonance spectroscopic imaging (MRSI) of the human brain. The coil can be used either in volume-transmit/array-receive mode or in TEM transmit/receive mode with the array detuned. Threefold SNR improvement was obtained at the periphery of the brain using the phased array as compared to the volume coil.
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Miyasaka N, Takahashi K, Hetherington HP. 1H NMR spectroscopic imaging of the mouse brain at 9.4 T. J Magn Reson Imaging 2007; 24:908-13. [PMID: 16958063 DOI: 10.1002/jmri.20709] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To assess the feasibility of 1H spectroscopic imaging (SI) in the mouse brain at 9.4 T, and investigate regional variations in brain metabolites. MATERIALS AND METHODS A total of 21 SI studies were performed in CD-1 mice to evaluate the basal ganglia (N=5), hippocampus and thalamus (N=11), and cerebellum (N=5). We adjusted the B0 homogeneity for each slice using a fully automated shim calculation method based on the B0 map, which we measured using a multislice gradient-echo sequence with multiple phase evolution delays. The SI employed a modified localization by adiabatic selective refocusing (LASER) sequence with TE/TR of 50/2000 msec, 24x24 encodes over a field of view (FOV) of 24 mmx24 mm, 1 microL voxel resolution, and two averages, for a total acquisition time of 38 minutes. RESULTS Sufficient shimming was achieved and high-quality spectra were consistently obtained in each slice. N-acetyl aspartate (NAA)/creatine (Cr) ratios in the basal ganglia and thalamus (0.86+/-0.07, and 0.87+/-0.07, respectively) were significantly higher than those in the hippocampus and cerebellum (0.76+/-0.03 and 0.67+/-0.07), which were also significantly different from each other. CONCLUSION 1H SI of the mouse brain is highly reproducible and allows differences in regional metabolite ratios to be easily visualized.
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Avdievich NI, Bradshaw K, Kuznetsov AM, Hetherington HP. High-field actively detuneable transverse electromagnetic (TEM) coil with low-bias voltage for high-power RF transmission. Magn Reson Med 2007; 57:1190-5. [PMID: 17534919 DOI: 10.1002/mrm.21242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The design and construction of a 4T (170 MHz) transverse electromagnetic (TEM) actively detuneable quadrature head coil is described. Conventional schemes for active detuning require high negative bias voltages (>300 V) to prevent leakage of RF pulses with amplitudes of 1-2 kW. To extend the power handling capacity and avoid the use of high DC bias voltages, we developed an alternate method of detuning the volume coil. In this method the PIN diodes in the detuning circuits are shorted when the RF volume coil is tuned, and negatively biased with -12 V when the coil is detuned. To preserve the high Q(U)/Q(L) ratio of the TEM coil, we modified the method of Nabetani and Watkins (Proceedings of the 13th Annual Meeting of ISMRM, Kyoto, Japan, 2004, abstract 1574) by utilizing a high-impedance (approximately 200 Omega), lumped-element, quarter-wavelength transformer. A Q(U) of 500 was achieved for the detuneable TEM, such that incorporation of the detuning network had minimal effect (<1 dB) on the performance of the coil in vivo.
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Hetherington HP, Chu WJ, Gonen O, Pan JW. Robust fully automated shimming of the human brain for high-field 1H spectroscopic imaging. Magn Reson Med 2006; 56:26-33. [PMID: 16767750 DOI: 10.1002/mrm.20941] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Although a variety of methods have been proposed to provide automated adjustment of shim homogeneity, these methods typically fail or require large numbers of iterations in vivo when applied to regions with poor homogeneity, such as the temporal lobe. These limitations are largely due to 1) the limited accuracy of single evolution time measurements when full B0 mapping studies are used, and 2) inaccuracies arising from projection-based methods when the projections pass through regions where the inhomogeneity exceeds the order of the fitted parameters. To overcome these limitations we developed a novel B0 mapping method using multiple evolution times with a novel unwrapping scheme in combination with a user-defined ROI selection tool. We used these methods at 4T on 10 control subjects to obtain high-resolution spectroscopic images of glutamate from the bilateral hippocampi.
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Douglas RM, Miyasaka N, Takahashi K, Latuszek-Barrantes A, Haddad GG, Hetherington HP. Chronic intermittent but not constant hypoxia decreases NAA/Cr ratios in neonatal mouse hippocampus and thalamus. Am J Physiol Regul Integr Comp Physiol 2006; 292:R1254-9. [PMID: 17082353 DOI: 10.1152/ajpregu.00404.2006] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Chronic constant hypoxia (CCH) and chronic intermittent hypoxia (CIH) are known to have deleterious effects on the central nervous system. Because of the difference in the pattern of hypoxic exposure, it is possible that the pathological outcome would vary. The N-acetyl aspartate/creatine (NAA/Cr) ratio is a reliable marker of neuronal integrity, and this can be noninvasively measured by proton nuclear magnetic resonance spectroscopy. P2 CD1 mouse pups with their dams were exposed to either CCH, where the Fi(O(2)) was maintained at 11% continuously or to CIH, where the Fi(O(2)) was varied between 21 and 11% every 4 min. P30 mice exposed to intermittent hypoxia for 4 wk demonstrated a significant decrease in the NAA/Cr ratio in the hippocampus and thalamus, which was reversed by a subsequent exposure to 4 wk of normoxia. Meanwhile, mice exposed to 4 wk of constant hypoxia did not demonstrate any differences in their NAA/Cr ratios from controls in these brain regions. These results indicate that an intermittent pattern of hypoxic exposure may have a more adverse effect on neuronal function and integrity than a continuous one. The reversal of NAA/Cr levels to baseline during the return to normoxia indicates that therapeutic strategies targeted at alleviating the intermittent hypoxic stress in diseases, such as obstructive sleep apnea, have the potential for inducing significant neurocognitive recovery in these patients.
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