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Esze R, Balkay L, Barna S, Egeresi LS, Emri M, Páll D, Paragh G, Rajnai L, Somodi S, Képes Z, Garai I, Káplár M. Impact of Fat Distribution and Metabolic Diseases on Cerebral Microcirculation: A Multimodal Study on Type 2 Diabetic and Obese Patients. J Clin Med 2024; 13:2900. [PMID: 38792441 PMCID: PMC11122647 DOI: 10.3390/jcm13102900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Since metabolic diseases and atherosclerotic vascular events are firmly associated, herein we investigate changes in central microcirculation and atherosclerosis-related body fat distribution in patients with type 2 diabetes mellitus and obesity. Methods: Resting brain perfusion single-photon emission computed tomography (SPECT) imaging with Technetium-99m hexamethylpropylene amine oxime ([99mTc]Tc-HMPAO SPECT) was performed, and the breath-holding index (BHI) and carotid intima-media thickness (cIMT) were measured to characterise central microcirculation. Besides CT-based abdominal fat tissue segmentation, C-peptide level, glycaemic and anthropometric parameters were registered to search for correlations with cerebral blood flow and vasoreactivity. Results: Although no significant difference was found between the resting cerebral perfusion of the two patient cohorts, a greater blood flow increase was experienced in the obese after the breath-holding test than in the diabetics (p < 0.05). A significant positive correlation was encountered between resting and provocation-triggered brain perfusion and C-peptide levels (p < 0.005). BMI and cIMT were negatively correlated (rho = -0.27 and -0.23 for maximum and mean cIMT, respectively), while BMI and BHI showed a positive association (rho = 0.31 and rho = 0.29 for maximum and mean BHI, respectively), which could be explained by BMI-dependent changes in fat tissue distribution. cIMT demonstrated a disproportional relationship with increasing age, and higher cIMT values were observed for the men. Conclusions: Overall, C-peptide levels and circulatory parameters seem to be strong applicants to predict brain microvascular alterations and related cognitive decline in such patient populations.
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Affiliation(s)
- Regina Esze
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (D.P.); (G.P.); (L.R.); (S.S.); (M.K.)
- Kálmán Laki Doctoral School, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary
| | - László Balkay
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (L.B.); (S.B.); (M.E.); (Z.K.); (I.G.)
| | - Sándor Barna
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (L.B.); (S.B.); (M.E.); (Z.K.); (I.G.)
| | - Lilla Szatmáriné Egeresi
- Division of Radiology and Imaging Science, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary;
| | - Miklós Emri
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (L.B.); (S.B.); (M.E.); (Z.K.); (I.G.)
| | - Dénes Páll
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (D.P.); (G.P.); (L.R.); (S.S.); (M.K.)
- Department of Medical Clinical Pharmacology, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary
| | - György Paragh
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (D.P.); (G.P.); (L.R.); (S.S.); (M.K.)
| | - Liliána Rajnai
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (D.P.); (G.P.); (L.R.); (S.S.); (M.K.)
| | - Sándor Somodi
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (D.P.); (G.P.); (L.R.); (S.S.); (M.K.)
| | - Zita Képes
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (L.B.); (S.B.); (M.E.); (Z.K.); (I.G.)
| | - Ildikó Garai
- Division of Nuclear Medicine and Translational Imaging, Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (L.B.); (S.B.); (M.E.); (Z.K.); (I.G.)
- ScanoMed Ltd., Nuclear Medicine Centers, Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary
| | - Miklós Káplár
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei St. 98, H-4032 Debrecen, Hungary; (D.P.); (G.P.); (L.R.); (S.S.); (M.K.)
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2
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Lee S, Park S, Hong S, Kim S, Yoon J, Choi J. Comparison of computed tomography perfusion and magnetic resonance dynamic susceptibility contrast perfusion-weighted imaging in canine brain. Front Vet Sci 2024; 11:1298215. [PMID: 38528871 PMCID: PMC10961344 DOI: 10.3389/fvets.2024.1298215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/22/2024] [Indexed: 03/27/2024] Open
Abstract
Brain perfusion allows for the evaluation of cerebral hemodynamics, particularly in brain infarcts and tumors. Computed tomography (CT) perfusion (CTP) provides reliable data; however, it has a limited scan field of view and radiation exposure. Magnetic resonance (MR) perfusion provides detailed imaging of small structures and a wide scan field of view. However, no study has compared CTP and MR perfusion and assessed the correlation between the perfusion parameters measured using CTP and MR perfusion. The aim of the present study was to assess the correlation and agreement of the cerebral perfusion derived from dynamic susceptibility contrast (DSC)-MRI and CTP in dogs. In this crossover design study, the cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time, and time to peak were measured in the temporal cerebral cortex, caudate nucleus, thalamus, piriform lobe, and hippocampus using CTP and DSC-MRI in six healthy beagle dogs and a dog with a pituitary tumor. On the color map of healthy beagles, blood vessels and the perivascular brain parenchyma appeared as red-green, indicating high perfusion, and the areas distant from the vessels appeared as green-blue, indicating low perfusion levels in CTP and DSC-MRI. CTP parameters were highest in the piriform lobe (CBF = 121.11 ± 12.78 mL/100 g/min and CBV = 8.70 ± 2.04 mL/100 g) and lowest in the thalamus (CBF = 63.75 ± 25.24 mL/100 g/min and CBV = 4.02 ± 0.55 mL/100 g). DSC-MRI parameters were also highest in the piriform lobe (CBF = 102.31 ± 14.73 mL/100 g/min and CBV = 3.17 ± 1.23 mL/100 g) and lowest in the thalamus (CBF = 37.73 ± 25.11 mL/100 g/min and CBV = 0.81 ± 0.44 mL/100 g) although there was no statistical correlation in the quantitative perfusion parameters between CTP and DSC-MRI. In a dog with a pituitary tumor, the color map of the tumor appeared as a red scale, indicating high perfusion and higher CBF and CBV on CTP (149 mL/100 g and 20 mL/100 g/min) and on DSC-MRI (116.3 mL/100 g and 15.32 mL/100 g/min) compared to those measured in healthy dogs. These findings indicate that DSC-MRI and CTP maps exhibit comparability and interchangeability in the assessment of canine brain perfusion.
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Affiliation(s)
| | | | | | | | | | - Jihye Choi
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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3
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An S, Hwang G, Noh SA, Lee HC, Hwang TS. Quantitative Analysis of Brain CT Perfusion in Healthy Beagle Dogs: A Pilot Study. Vet Sci 2023; 10:469. [PMID: 37505873 PMCID: PMC10385523 DOI: 10.3390/vetsci10070469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/11/2023] [Accepted: 07/16/2023] [Indexed: 07/29/2023] Open
Abstract
Brain computed tomography (CT) perfusion is a technique that allows for the fast evaluation of cerebral hemodynamics. However, quantitative studies of brain CT perfusion in veterinary medicine are lacking. The purpose of this study was to investigate the normal range of perfusion determined via CT in brains of healthy dogs and to compare values between white matter and gray matter, differences in aging, and each hemisphere. Nine intact male beagle dogs were prospectively examined using dynamic CT scanning and post-processing for brain perfusion. Regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), mean transit time, and time to peak were calculated. Tissue ROIs were drawn in the gray matter and white matter of the frontal, temporal, parietal, and occipital lobes; caudate nucleus; thalamus; piriform lobe; hippocampus; and cerebellum. Significant differences were observed between the white matter regions and gray matter regions for rCBV and rCBF (p < 0.05). However, no significant differences were identified between hemispheres and between young and old groups in brain regions. The findings obtained in this study involving healthy beagle dogs might serve as a reference for regional CT perfusion values in specific brain regions. These results may aid in the characterization of various brain diseases in dogs.
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Affiliation(s)
- Soyon An
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Gunha Hwang
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Seul Ah Noh
- AniCom Medical Center, Animal Hospital, Seoul 04599, Republic of Korea
| | - Hee Chun Lee
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Tae Sung Hwang
- Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Republic of Korea
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4
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Wang H, Chai C, Wu G, Li J, Zhao C, Fu D, Zhang S, Wang H, Wang B, Zhu J, Shen W, Xia S. Cerebral blood flow regulates iron overload in the cerebral nuclei of hemodialysis patients with anemia. J Cereb Blood Flow Metab 2023; 43:749-762. [PMID: 36545834 PMCID: PMC10108183 DOI: 10.1177/0271678x221147363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/16/2022] [Accepted: 10/09/2022] [Indexed: 12/24/2022]
Abstract
Hemodialysis patients exhibit anemia-related cerebral hyperperfusion and iron deposition (ID). However, the mechanisms underlying the pathology of cerebral ID are not clear. We investigated the role of cerebral blood flow (CBF) in the pathophysiology of cerebral ID in hemodialysis patients with anemia. This study recruited 33 hemodialysis patients with anemia and thirty-three healthy controls (HCs). All the subjects underwent quantitative susceptibility mapping (QSM) and arterial spin labeling (ASL) to measure ID and CBF in the cerebral nuclei. Furthermore, we evaluated lacunar infarction (LI), cerebral microbleeds, and total white matter hyperintensity volume (TWMHV). Hemodialysis patients with anemia showed significantly higher ID and CBF in some nuclei compared to the HCs after adjusting for age, sex, and total intracranial volume (TIV) [P < 0.05, false discovery rate (FDR) corrected]. CBF showed a positive correlation with ID in both patients and HCs after adjustments for age, gender, and TIV (P < 0.05, FDR corrected). Serum phosphorus, calcium, TWMHV, hypertension, and dialysis duration were independently associated with ID (P < 0.05). Hemoglobin, serum phosphorus, and LI were independently associated with CBF (P < 0.05). Mediation analysis demonstrated that CBF mediated the effects between hemoglobin and ID. Our study demonstrated that CBF mediated aberrant cerebral ID in hemodialysis patients with anemia.
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Affiliation(s)
- Huiying Wang
- The School of Medicine, Nankai
University, Tianjin, China
| | - Chao Chai
- Department of Radiology, Tianjin
First Central Hospital, School of Medicine, Nankai University, Tianjin,
China
- Imaging Medicine Institute of
Tianjin, Tianjin, China
| | - Gemuer Wu
- The School of Medicine, Nankai
University, Tianjin, China
| | - Jinping Li
- Department of Hemodialysis, Tianjin
First Central Hospital, School of Medicine, Nankai University, Tianjin,
China
| | - Chenxi Zhao
- Department of Radiology, First
Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Dingwei Fu
- Department of Radiology, First
Central Clinical College, Tianjin Medical University, Tianjin, China
| | | | - Huapeng Wang
- Department of Radiology, First
Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Beini Wang
- Department of Radiology, First
Central Clinical College, Tianjin Medical University, Tianjin, China
| | - Jinxia Zhu
- MR Collaboration, Siemens
Healthcare, Northeast Asia, Beijing, China
| | - Wen Shen
- Department of Radiology, Tianjin
First Central Hospital, School of Medicine, Nankai University, Tianjin,
China
- Imaging Medicine Institute of
Tianjin, Tianjin, China
| | - Shuang Xia
- Department of Radiology, Tianjin
First Central Hospital, School of Medicine, Nankai University, Tianjin,
China
- Imaging Medicine Institute of
Tianjin, Tianjin, China
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5
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Murata T, Hayashi Y, Onoguchi M, Shibutani T, Iimori T, Sawada K, Umezawa T, Masuda Y, Uno T. Optimization of the Attenuation Coefficient for Chang Attenuation Correction in 123I Brain Perfusion SPECT. J Nucl Med Technol 2023; 51:49-56. [PMID: 36750381 DOI: 10.2967/jnmt.122.264990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023] Open
Abstract
N-isopropyl-p-123I-iodoamphetamine brain perfusion SPECT has been used with various attenuation coefficients (μ-values); however, optimization is required. This study aimed to determine the optimal μ-value (μopt-value) for Chang attenuation correction (AC) using clinical data by comparing the Chang method and CT-based AC. Methods: We used 100 patients (reference group, 60; disease group, 40) who underwent N-isopropyl-p-123I-iodoamphetamine SPECT. SPECT images of the reference group were obtained to calculate the AC using the Chang method (μ-values, 0.07-0.20; 0.005 interval) and the CT-based method, both without scatter correction (SC) and with SC. The μopt-value with the smallest mean percentage error for the brain regions of the reference group was calculated. Agreement between the Chang and CT-based methods applying the μopt-value was evaluated using Bland-Altman analysis. Additionally, the percentage error in the region of hypoperfusion in the diseased group was compared with the percentage error in the same region in the reference group when the μopt-value was applied. Results: The μopt-values were 0.140 for Chang without SC and 0.160 for Chang with SC. In the Chang method, with the μopt-value applied, fixed and proportional biases were observed in the Bland-Altman analysis (both P < 0.05), and there was a tendency for the percentage error to be underestimated in the limbic regions and overestimated in the central brain regions. There was no significant difference between the disease group and the reference group in the region of hypoperfusion in either Chang without SC or Chang with SC. Conclusion: The present study revealed that the μopt-values of the Chang method are 0.140 without SC and 0.160 with SC.
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Affiliation(s)
- Taisuke Murata
- Department of Radiology, Chiba University Hospital, Chiba, Japan.,Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Yuri Hayashi
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan; and
| | - Takashi Iimori
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Koichi Sawada
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Tetsuro Umezawa
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Takashi Uno
- Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
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6
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Lubben N, Ensink E, Coetzee GA, Labrie V. The enigma and implications of brain hemispheric asymmetry in neurodegenerative diseases. Brain Commun 2021; 3:fcab211. [PMID: 34557668 PMCID: PMC8454206 DOI: 10.1093/braincomms/fcab211] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/16/2021] [Accepted: 08/10/2021] [Indexed: 01/15/2023] Open
Abstract
The lateralization of the human brain may provide clues into the pathogenesis and progression of neurodegenerative diseases. Though differing in their presentation and underlying pathologies, neurodegenerative diseases are all devastating and share an intriguing theme of asymmetrical pathology and clinical symptoms. Parkinson’s disease, with its distinctive onset of motor symptoms on one side of the body, stands out in this regard, but a review of the literature reveals asymmetries in several other neurodegenerative diseases. Here, we review the lateralization of the structure and function of the healthy human brain and the common genetic and epigenetic patterns contributing to the development of asymmetry in health and disease. We specifically examine the role of asymmetry in Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis, and multiple sclerosis, and interrogate whether these imbalances may reveal meaningful clues about the origins of these diseases. We also propose several hypotheses for how lateralization may contribute to the distinctive and enigmatic features of asymmetry in neurodegenerative diseases, suggesting a role for asymmetry in the choroid plexus, neurochemistry, protein distribution, brain connectivity and the vagus nerve. Finally, we suggest how future studies may reveal novel insights into these diseases through the lens of asymmetry.
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Affiliation(s)
- Noah Lubben
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503, USA
| | - Elizabeth Ensink
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503, USA
| | - Gerhard A Coetzee
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503, USA
| | - Viviane Labrie
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, MI 49503, USA
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7
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Dahl RH, Taudorf S, Bailey DM, Møller K, Berg RMG. A method for modelling the oxyhaemoglobin dissociation curve at the level of the cerebral capillary in humans. Exp Physiol 2020; 105:1063-1070. [PMID: 32436618 DOI: 10.1113/ep088615] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/18/2020] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Can the change in haemoglobin's affinity for oxygen in the human cerebral circulation be modelled in vivo? What is the main finding and its importance? We provide a novel method for modelling the oxyhaemoglobin dissociation curve at the cerebral capillary level in humans, so that the cerebral capillary and mitochondrial oxygen tensions can reliably be estimated. This may be useful in future human-experimental studies on cerebral oxygen transport. ABSTRACT We provide a method for modelling the oxyhaemoglobin dissociation curve (ODC) in the cerebral capillary in humans. In contrast to most previous approaches, our method involves the construction of an averaged ODC based on paired arterial-jugular venous blood gas values, which enables the estimation of oxygen parameters in cerebral capillary blood. The method was used to determine the mean cerebral capillary oxygen saturation and tension from data previously collected from 30 healthy volunteers. The averaged ODC provided systematically higher capillary oxygen tensions than when assuming a 'fixed' standard arterial ODC. When the averaged and measured arterial ODC were used for constructing the capillary ODC, similar values were obtained during resting breathing, but not when the arterial ODC was modulated by hypocapnia. The findings suggest that our method for modelling the cerebral capillary ODC provides robust and physiologically reliable estimates of the cerebral capillary oxygen tension, which may be of use in future studies of cerebral oxygen transport in humans.
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Affiliation(s)
- Rasmus H Dahl
- Department of Neuroanaesthesiology, University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Radiology, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sarah Taudorf
- Department of Neurology, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Damian M Bailey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Kirsten Møller
- Department of Neuroanaesthesiology, University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ronan M G Berg
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Physiology, Nuclear Medicine & PET and Centre for Physical Activity Research, University Hospital Rigshospitalet, Copenhagen, Denmark
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8
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Göttler J, Kaczmarz S, Nuttall R, Griese V, Napiórkowski N, Kallmayer M, Wustrow I, Eckstein HH, Zimmer C, Preibisch C, Finke K, Sorg C. The stronger one-sided relative hypoperfusion, the more pronounced ipsilateral spatial attentional bias in patients with asymptomatic carotid stenosis. J Cereb Blood Flow Metab 2020; 40:314-327. [PMID: 30480463 PMCID: PMC7370612 DOI: 10.1177/0271678x18815790] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/05/2018] [Accepted: 10/23/2018] [Indexed: 11/16/2022]
Abstract
Patients with asymptomatic, high-grade internal carotid artery stenosis often suffer from subtle cognitive impairments with unclear underlying neuro-cognitive mechanisms. Thus, we hypothesized that stenosis-related unilateral cerebral hypoperfusion leads to an ipsilateral attentional bias; 22 patients with asymptomatic, one-sided high-grade carotid stenosis and 24 age-matched healthy controls underwent pseudo-continuous arterial spin labeling to assess brain perfusion in the territory of the carotid arteries. Furthermore, a parametric assessment of attention functions was carried out on the basis of the computational Theory of Visual Attention. Both patients' perfusion and spatial attention were significantly more lateralized than those of healthy controls. Critically, both asymmetry indices were significantly correlated in patients, i.e. the stronger one-sided relative hypoperfusion, the stronger ipsilateral bias of attention. This association was specifically pronounced in parietal cortices and independent of white matter hyperintensities as a surrogate for cerebrovascular brain damage. Results provide evidence for a link between lateralized hypoperfusion and lateralized attentional weighting in asymptomatic, high-grade carotid stenosis. Data suggest that lateralized hypoperfusion with simultaneous spatial attentional bias might serve as a potential therapeutic target in one-sided carotid stenosis.
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Affiliation(s)
- Jens Göttler
- Department of Diagnostic and
Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität
München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC),
Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Department of Diagnostic and
Interventional Radiology, Klinikum rechts der Isar, Technische Universität München,
Munich, Germany
- Magnetic Resonance Research Center, Yale
University, New Haven, CT, USA
| | - Stephan Kaczmarz
- Department of Diagnostic and
Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität
München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC),
Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Magnetic Resonance Research Center, Yale
University, New Haven, CT, USA
| | - Rachel Nuttall
- Department of Diagnostic and
Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität
München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC),
Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Vanessa Griese
- Department of Diagnostic and
Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität
München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC),
Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Natan Napiórkowski
- Department of Psychology,
Ludwig-Maximilians-Universität München, Munich, Germany
- Graduate School of Systemic
Neurosciences, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Michael Kallmayer
- Department of Vascular and Endovascular
Surgery, Klinikum rechts der Isar, Technische Universität München, Munich,
Germany
| | - Isabel Wustrow
- I. Medizinische Klinik und Poliklinik,
Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Hans-Henning Eckstein
- Department of Vascular and Endovascular
Surgery, Klinikum rechts der Isar, Technische Universität München, Munich,
Germany
| | - Claus Zimmer
- Department of Diagnostic and
Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität
München, Munich, Germany
| | - Christine Preibisch
- Department of Diagnostic and
Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität
München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC),
Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Clinic for Neurology, Klinikum rechts
der Isar, Technische Universität München, Munich, Germany
| | - Kathrin Finke
- Department of Psychology,
Ludwig-Maximilians-Universität München, Munich, Germany
- Hans-Berger-Department of Neurology,
Jena University Hospital, Jena, Germany
| | - Christian Sorg
- Department of Diagnostic and
Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität
München, Munich, Germany
- TUM Neuroimaging Center (TUM-NIC),
Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- Department of Psychiatry, Klinikum
rechts der Isar, Technische Universität München, Munich, Germany
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9
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McKetton L, Cohn M, Tang-Wai DF, Sobczyk O, Duffin J, Holmes KR, Poublanc J, Sam K, Crawley AP, Venkatraghavan L, Fisher JA, Mikulis DJ. Cerebrovascular Resistance in Healthy Aging and Mild Cognitive Impairment. Front Aging Neurosci 2019; 11:79. [PMID: 31031616 PMCID: PMC6474328 DOI: 10.3389/fnagi.2019.00079] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 03/19/2019] [Indexed: 12/04/2022] Open
Abstract
Measures of cerebrovascular reactivity (CVR) are used to judge the health of the brain vasculature. In this study, we report the use of several different analyses of blood oxygen dependent (BOLD) fMRI responses to CO2 to provide a number of metrics of CVR based on the sigmoidal resistance response to CO2. To assess possible differences in these metrics with age, we compiled atlases reflecting voxel-wise means and standard deviations for four different age ranges and for a group of patients with mild cognitive impairment (MCI) and compared them. Sixty-seven subjects were recruited for this study and scanned at 3T field strength. Of those, 51 healthy control volunteers between the ages of 18–83 were recruited, and 16 (MCI) subjects between the ages of 61–83 were recruited. Testing was carried out using an automated computer-controlled gas blender to induce hypercapnia in a step and ramp paradigm while monitoring end-tidal partial pressures of CO2. Surprisingly, some resistance sigmoid parameters in the oldest control group were increased compared to the youngest control group. Resistance amplitude maps showed increases in clusters within the temporal cortex, thalamus, corpus callosum and brainstem, and resistance reserve maps showed increases in clusters within the cingulate cortex, frontal gyrus, and corpus callosum. These findings suggest that some aspects of vascular reactivity in parts of the brain are initially maintained with age but then may increase in later years. We found significant reductions in all resistance sigmoid parameters (amplitude, reserve, sensitivity, midpoint, and range) when comparing MCI patients to controls. Additionally, in controls and in MCI patients, amplitude, range, reserve, and sensitivity in white matter (WM) was significantly reduced compared to gray matter (GM). WM midpoints were significantly above those of GM. Our general conclusion is that vascular regulation in terms of cerebral blood flow (CBF) responsiveness to CO2 is not significantly affected by age, but is reduced in MCI. These changes in cerebrovascular regulation demonstrate the value of resistance metrics for mapping areas of dysregulated blood flow in individuals with MCI. They may also be of value in the investigation of patients with vascular risk factors at risk for developing vascular dementia.
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Affiliation(s)
- Larissa McKetton
- Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
| | - Melanie Cohn
- Krembil Brain Institute, University Health Network (UHN), Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - David F Tang-Wai
- Krembil Brain Institute, University Health Network (UHN), Toronto, ON, Canada.,Department of Medicine, Division of Neurology, University of Toronto and the University Health Network Memory Clinic, Toronto, ON, Canada
| | - Olivia Sobczyk
- Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
| | - James Duffin
- Department of Physiology, University of Toronto, Toronto, ON, Canada
| | - Kenneth R Holmes
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Julien Poublanc
- Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
| | - Kevin Sam
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Adrian P Crawley
- Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada
| | - Lashmi Venkatraghavan
- Department of Anaesthesia and Pain Management, University Health Network (UHN), Toronto, ON, Canada
| | - Joseph A Fisher
- Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Department of Anaesthesia and Pain Management, University Health Network (UHN), Toronto, ON, Canada
| | - David J Mikulis
- Joint Department of Medical Imaging, University Health Network (UHN), Toronto, ON, Canada.,Krembil Brain Institute, University Health Network (UHN), Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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Kellner-Weldon F, El-Koussy M, Jung S, Jossen M, Klinger-Gratz PP, Wiest R. Cerebellar Hypoperfusion in Migraine Attack: Incidence and Significance. AJNR Am J Neuroradiol 2018; 39:435-440. [PMID: 29326138 DOI: 10.3174/ajnr.a5508] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 11/05/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Patients diagnosed with migraine with aura have an increased lifetime risk of ischemic stroke. It is not yet clear whether prolonged cortical hypoperfusion during an aura increases the immediate risk of cerebellar infarction because it may induce crossed cerebellar diaschisis and subsequent tissue damage. To address this question, we retrospectively analyzed potential relationships between cortical oligemia and cerebellar hypoperfusion in patients with migraine with aura and their potential relation to small infarct-like cerebellar lesions. MATERIALS AND METHODS One hundred six migraineurs who underwent MR imaging, including DSC perfusion, were included in the study. In patients with apparent perfusion asymmetry, we used ROI analysis encompassing 18 infra- and supratentorial ROIs to account for differences in regional cerebral blood flow and volume. The presence of cerebellar hypoperfusion was calculated using an asymmetry index, with values of >10% being considered significant. RESULTS We observed perfusion asymmetries in 23/106 patients, 22 in patients with migraine with aura (20.8%). Cerebellar hypoperfusion was observed in 12/23 patients (52.2%), and crossed cerebellar diaschisis, in 9/23 patients (39.1%) with abnormal perfusion. In none of the 106 patients were DWI restrictions observed during migraine with aura. CONCLUSIONS Cerebellar hypoperfusion and crossed cerebellar diaschisis are common in patients with migraine with aura and cortical perfusion abnormalities. Crossed cerebellar diaschisis in migraine with aura may be considered a benign phenomenon because we observed no association with DWI restriction or manifest cerebellar infarctions, even in patients with prolonged symptom-related perfusion abnormalities persisting for up to 24 hours.
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Affiliation(s)
- F Kellner-Weldon
- From the Support Center for Advanced Neuroimaging (F.K.-W., M.E.-K., M.J., P.P.K.-G., R.W.), Institute for Diagnostic and Interventional Neuroradiology
| | - M El-Koussy
- From the Support Center for Advanced Neuroimaging (F.K.-W., M.E.-K., M.J., P.P.K.-G., R.W.), Institute for Diagnostic and Interventional Neuroradiology
| | - S Jung
- Department of Neurology (S.J.), University Hospital Inselspital, Bern, Switzerland
| | - M Jossen
- From the Support Center for Advanced Neuroimaging (F.K.-W., M.E.-K., M.J., P.P.K.-G., R.W.), Institute for Diagnostic and Interventional Neuroradiology
| | - P P Klinger-Gratz
- From the Support Center for Advanced Neuroimaging (F.K.-W., M.E.-K., M.J., P.P.K.-G., R.W.), Institute for Diagnostic and Interventional Neuroradiology
- Department of Radiology (P.P.K.-G.), University of Basel, Basel, Switzerland
| | - R Wiest
- From the Support Center for Advanced Neuroimaging (F.K.-W., M.E.-K., M.J., P.P.K.-G., R.W.), Institute for Diagnostic and Interventional Neuroradiology
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Leblanc R. Beyond descriptive neurology: Broca, cerebral hemodynamics, and cortical function. JOURNAL OF THE HISTORY OF THE NEUROSCIENCES 2018; 27:36-55. [PMID: 28777693 DOI: 10.1080/0964704x.2017.1347413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pierre-Paul Broca's studies in neurobiology remain of interest. I review a previously neglected aspect of Broca's work in which he presages the use of modern scanning techniques. Broca's goal was to correlate cerebral metabolism to regional cerebral blood flow (CBF) using a novel method, to which he referred as cerebral thermometry. Broca attempted to measure changes in temperatures from the ischemic area and across the watershed regions during a stroke, and the increased CBF produced by performing a cognitive task such as reading aloud. The method involved measurements of local temperatures at specific points about the head with an array of strategically placed thermometers much as EEG electrodes are arrayed to record the electrical activity of the brain. Although his technique was inaccurate and unreliable, the concept of measuring CBF as a diagnostic aid and as a cognitive research tool was prescient. Broca's limitation was not conceptual but purely technological. Broca's attempt to measure CBF as a surrogate for cerebral metabolism was conceptually valid but premature because he lacked the technology necessary to do so.
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Affiliation(s)
- Richard Leblanc
- a Montreal Neurological Institute , Montreal , Quebec , Canada
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12
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Hartmann A, Driesen A, Lautenschläger IE, Scholz VB, Schmidt MJ. Quantitative analysis of brain perfusion in healthy dogs by means of magnetic resonance imaging. Am J Vet Res 2016; 77:1227-1235. [DOI: 10.2460/ajvr.77.11.1227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Frings L, Hellwig S, Spehl TS, Bormann T, Buchert R, Vach W, Minkova L, Heimbach B, Klöppel S, Meyer PT. Asymmetries of amyloid-β burden and neuronal dysfunction are positively correlated in Alzheimer's disease. Brain 2015; 138:3089-99. [PMID: 26280595 DOI: 10.1093/brain/awv229] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/17/2015] [Indexed: 01/11/2023] Open
Abstract
Clinical Alzheimer's disease affects both cerebral hemispheres to a similar degree in clinically typical cases. However, in atypical variants like logopenic progressive aphasia, neurodegeneration often presents asymmetrically. Yet, no in vivo imaging study has investigated whether lateralized neurodegeneration corresponds to lateralized amyloid-β burden. Therefore, using combined (11)C-Pittsburgh compound B and (18)F-fluorodeoxyglucose positron emission tomography, we explored whether asymmetric amyloid-β deposition in Alzheimer's disease is associated with asymmetric hypometabolism and clinical symptoms. From our database of patients who underwent positron emission tomography with both (11)C-Pittsburgh compound B and (18)F-fluorodeoxyglucose (n = 132), we included all amyloid-positive patients with prodromal or mild-to-moderate Alzheimer's disease (n = 69). The relationship between (11)C-Pittsburgh compound B binding potential and (18)F-fluorodeoxyglucose uptake was assessed in atlas-based regions of interest covering the entire cerebral cortex. Lateralizations of amyloid-β and hypometabolism were tested for associations with each other and with type and severity of cognitive symptoms. Positive correlations between asymmetries of Pittsburgh compound B binding potential and hypometabolism were detected in 6 of 25 regions (angular gyrus, middle frontal gyrus, middle occipital gyrus, superior parietal gyrus, inferior and middle temporal gyrus), i.e. hypometabolism was more pronounced on the side of greater amyloid-β deposition (range: r = 0.41 to 0.53, all P < 0.001). Stronger leftward asymmetry of amyloid-β deposition was associated with more severe language impairment (P < 0.05), and stronger rightward asymmetry with more severe visuospatial impairment (at trend level, P = 0.073). Similarly, patients with predominance of language deficits showed more left-lateralized amyloid-β burden and hypometabolism than patients with predominant visuospatial impairment and vice versa in several cortical regions. Associations between amyloid-β deposition and hypometabolism or cognitive impairment were predominantly observed in brain regions with high amyloid-β load. The relationship between asymmetries of amyloid-β deposition and hypometabolism in cortical regions with high amyloid-β load is in line with the detrimental effect of amyloid-β burden on neuronal function. Asymmetries were also concordant with lateralized cognitive symptoms, indicating their clinical relevance.
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Affiliation(s)
- Lars Frings
- 1 Department of Nuclear Medicine, University Medical Centre, Freiburg, Germany 2 Centre of Geriatrics and Gerontology, University Medical Centre, Freiburg, Germany
| | - Sabine Hellwig
- 2 Centre of Geriatrics and Gerontology, University Medical Centre, Freiburg, Germany 3 Department of Psychiatry and Psychotherapy, University Medical Centre, Freiburg, Germany
| | - Timo S Spehl
- 1 Department of Nuclear Medicine, University Medical Centre, Freiburg, Germany
| | - Tobias Bormann
- 4 Department of Neurology, University Medical Centre, Freiburg, Germany
| | - Ralph Buchert
- 5 Department of Nuclear Medicine, Charité Universitätsmedizin Berlin, Germany
| | - Werner Vach
- 6 Centre for Medical Biometry and Medical Informatics, University Medical Centre, Freiburg, Germany
| | - Lora Minkova
- 3 Department of Psychiatry and Psychotherapy, University Medical Centre, Freiburg, Germany 7 Freiburg Brain Imaging, University Medical Centre Freiburg, Germany
| | - Bernhard Heimbach
- 2 Centre of Geriatrics and Gerontology, University Medical Centre, Freiburg, Germany
| | - Stefan Klöppel
- 2 Centre of Geriatrics and Gerontology, University Medical Centre, Freiburg, Germany 3 Department of Psychiatry and Psychotherapy, University Medical Centre, Freiburg, Germany 7 Freiburg Brain Imaging, University Medical Centre Freiburg, Germany
| | - Philipp T Meyer
- 1 Department of Nuclear Medicine, University Medical Centre, Freiburg, Germany
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Godefroy J, Noblet V, Wolff V, Lauer V, Rouyer O, Marescaux C, Dromson G, Namer IJ. Scintigraphie de perfusion cérébrale positionnelle : résultats physiologiques et applications cliniques. MEDECINE NUCLEAIRE-IMAGERIE FONCTIONNELLE ET METABOLIQUE 2014. [DOI: 10.1016/j.mednuc.2014.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Aortic stiffness is associated with white matter integrity in patients with type 1 diabetes. Eur Radiol 2014; 24:2031-7. [DOI: 10.1007/s00330-014-3179-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 03/19/2014] [Accepted: 04/07/2014] [Indexed: 10/25/2022]
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16
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The influence of the tracer injection–acquisition interval on the distribution of 99mTc-ECD in the brain of laboratory cats. J Vet Behav 2013. [DOI: 10.1016/j.jveb.2013.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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17
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Van Audenhaege K, Vandenberghe S, Deprez K, Vandeghinste B, Van Holen R. Design and simulation of a full-ring multi-lofthole collimator for brain SPECT. Phys Med Biol 2013; 58:6317-36. [PMID: 23966017 DOI: 10.1088/0031-9155/58/18/6317] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Currently, clinical brain single photon emission computed tomography (SPECT) is mostly performed using rotating dual-head gamma cameras equipped with low-energy-high-resolution parallel-beam collimators (LEHR PAR). The resolution of these systems is rather poor (8-10 mm) and the rotation of the heavy gamma cameras can introduce misalignment errors. Therefore, we designed a static full-ring multi-lofthole brain SPECT insert for an existing ring of LaBr3 (5% Ce) detectors. The novelty of the design is found in the shutter mechanism that makes the system very flexible and eliminates the need for rotating parts. A stationary SPECT insert is not only more robust, it is also easier to integrate in a magnetic resonance imaging system (MRI) for simultaneous SPECT-MRI. The target spatial resolution of our design is 6 mm. In this study we used analytical calculations to optimize the collimator for an existing ring of LaBr3 (5% Ce) detectors. We fixed the target spatial resolution at 6 mm in the center of the field-of-view and maximized the volume sensitivity by changing the collimator radius, the aperture and the number of loftholes. Based on these optimal parameters we simulated phantom data and evaluated the image quality of our multi-lofthole system. We simulated a noiseless uniform and Defrise phantom to assess artifacts and sampling completeness and a noiseless hot-rod phantom to assess the reconstructed spatial resolution. We visually evaluated a simulated noisy Hoffman phantom with two lesions. Then, we evaluated the non-prewhitening matched filter signal-to-noise ratio (NPW-SNR) in two lesion detectability phantoms: one with hot lesions and one with cold lesions. Finally, a contrast-to-noise (CNR) study was performed on a phantom with both hot and cold lesions of different sizes (6-16 mm). All results were compared to a LEHR PAR system. The optimization resulted in a final collimator design with a volume sensitivity of 1.55 × 10(-4) cps Bq(-1), which is 2.5 times lower than the sensitivity of a dual-head system with LEHR PAR collimators. Spatial resolution, on the other hand, has clearly improved compared to LEHR PAR: with the multi-lofthole system we successfully reconstructed 4 mm hot rods. Although this improved resolution did not result in an unambiguous improvement in CNR or NPW-SNR, we believe that the flexibility of the shutter mechanism opens interesting perspectives toward time-multiplexing and integration with MRI.
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Affiliation(s)
- Karen Van Audenhaege
- Ghent University-iMinds, Department of Electronics and Information Systems, MEDISIP-IBiTech, De Pintelaan 185 block B/5, B-9000 Ghent, Belgium.
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18
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Martlé V, Peremans K, Van Ham L, Vermeire S, Waelbers T, Dobbeleir A, Gielen I, Boon P, Claes K, Bhatti S. High-resolution micro-SPECT to evaluate the regional brain perfusion in the adult Beagle dog. Res Vet Sci 2013; 94:701-6. [DOI: 10.1016/j.rvsc.2012.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 10/29/2012] [Accepted: 11/17/2012] [Indexed: 11/30/2022]
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Brain perfusion asymmetry in patients with oral somatic delusions. Eur Arch Psychiatry Clin Neurosci 2013; 263:315-23. [PMID: 23354990 PMCID: PMC3668126 DOI: 10.1007/s00406-013-0390-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 01/15/2013] [Indexed: 12/15/2022]
Abstract
Oral cenesthopathy is a somatic delusion or hallucination involving the oral area and is categorized as a delusional disorder, somatic type. The pathophysiology of this intractable condition remains obscure. In this study, we clarified the pathophysiology of oral cenesthopathy by evaluating regional brain perfusion. We performed single photon emission computed tomography (SPECT) using (99m)Tc-ethylcysteinate dimer in 16 subjects (cenesthopathy:control = 8:8). The SPECT images were visually assessed qualitatively, and quantitative analyses were also performed using a three-dimensional stereotactic region-of-interest template. The visual assessment revealed a right > left perfusion asymmetry in broad areas of the brain among the patients. The quantitative analysis confirmed that the regional cerebral blood flow values on the right side were significantly larger than those on the left side for most areas of the brain in the patients. A comparison of the R/(R + L) ratios in both groups confirmed the significant brain perfusion asymmetry between the two sides in the callosomarginal, precentral, and temporal regions in the patients. Qualitative evaluation of the SPECT images revealed right > left brain perfusion asymmetry in broad regions of the brain. Moreover, the quantitative analyses confirmed the perfusion asymmetry between the two sides in the frontal and temporal areas. Those may provide the key for elucidation of the pathophysiology of oral cenesthopathy.
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Apostolova I, Wunder A, Dirnagl U, Michel R, Stemmer N, Lukas M, Derlin T, Gregor-Mamoudou B, Goldschmidt J, Brenner W, Buchert R. Brain perfusion SPECT in the mouse: Normal pattern according to gender and age. Neuroimage 2012; 63:1807-17. [DOI: 10.1016/j.neuroimage.2012.08.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 08/12/2012] [Accepted: 08/15/2012] [Indexed: 11/29/2022] Open
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Geier DA, Pretorius HT, Richards NM, Geier MR. A quantitative evaluation of brain dysfunction and body-burden of toxic metals. Med Sci Monit 2012; 18:CR425-31. [PMID: 22739732 PMCID: PMC3560777 DOI: 10.12659/msm.883210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Toxic metal exposure (e.g. Hg, Pb, As) exposure is known to induce significant adverse effects on human brain function. The aim this study was to assess toxic metal body-burden in relation to potential brain dysfunction in patients diagnosed with neurological disorders (NDs). Material/Methods The Liberty Institutional Review Board (Deland, FL) approved the present study. Quantitative, fractionated, random urinary porphyrin testing (μg/L) from the Clinical Laboratory Improvement Act/Amendment (CLIA)-approved Laboratory Corporation of America (LabCorp) and cortical perfusion index (CPi) values from single-photon-emission-computed-tomography (SPECT) brain scans were employed to evaluate a prospective cohort of qualifying patients with diagnosed NDs (n=52) presenting for medical care at an endocrinology practice in the Cincinnati, OH area. Results Patients with more severe in comparison to mild brain dysfunction had significant increases in the mean urinary concentration of uroporphyrins (uP), coproporphyrins I (cP I), and total cP (cP I + III), as well as a trend towards significantly increased mean urinary concentration of pentacarboxyporphyins (5cxP) and cP III. A significant positive correlation between Hg body-burden associated porphyrins (5cxP + cP I + cP III) and increased brain dysfunction was observed. Conclusions The present study associated brain dysfunction with Hg body-burden in a cohort of patients diagnosed with NDs, but the contributions of other heavy metals or genetic factors cannot be ruled-out. Additional studies should be conducted to evaluate the consistency of the present findings with examinations of other populations.
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Affiliation(s)
- David A Geier
- Institute of Chronic Illnesses, Inc., Silver Spring, MD 20905, USA.
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22
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Modzelewski R, Janvresse E, de la Rue T, Vera P. Comparison of heterogeneity quantification algorithms for brain SPECT perfusion images. EJNMMI Res 2012; 2:40. [PMID: 22818866 PMCID: PMC3508867 DOI: 10.1186/2191-219x-2-40] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 06/18/2012] [Indexed: 11/21/2022] Open
Abstract
Background Several algorithms from the literature were compared with the original random walk (RW) algorithm for brain perfusion heterogeneity quantification purposes. Algorithms are compared on a set of 210 brain single photon emission computed tomography (SPECT) simulations and 40 patient exams. Methods Five algorithms were tested on numerical phantoms. The numerical anthropomorphic Zubal head phantom was used to generate 42 (6 × 7) different brain SPECT simulations. Seven diffuse cortical heterogeneity levels were simulated with an adjustable Gaussian noise function and six focal perfusion defect levels with temporoparietal (TP) defects. The phantoms were successively projected and smoothed with Gaussian kernel with full width at half maximum (FWHM = 5 mm), and Poisson noise was added to the 64 projections. For each simulation, 5 Poisson noise realizations were performed yielding a total of 210 datasets. The SPECT images were reconstructed using filtered black projection (Hamming filter: α = 0.5). The five algorithms or measures tested were the following: the coefficient of variation, the entropy and local entropy, fractal dimension (FD) (box counting and Fourier power spectrum methods), the gray-level co-occurrence matrix (GLCM), and the new RW. The heterogeneity discrimination power was obtained with a linear regression for each algorithm. This regression line is a mean function of the measure of heterogeneity compared to the different diffuse heterogeneity and focal defect levels generated in the phantoms. A greater slope denotes a larger separation between the levels of diffuse heterogeneity. The five algorithms were computed using 40 99mTc-ethyl-cysteinate-dimer (ECD) SPECT images of patients referred for memory impairment. Scans were blindly ranked by two physicians according to the level of heterogeneity, and a consensus was obtained. The rankings obtained by the algorithms were compared with the physicians' consensus ranking. Results The GLCM method (slope = 58.5), the fractal dimension (35.9), and the RW method (31.6) can differentiate the different levels of diffuse heterogeneity. The GLCM contrast parameter method is not influenced by a focal defect contrary to the FD and RW methods. A significant correlation was found between the RW method and the physicians' classification (r = 0.86; F = 137; p < 0.0001). Conclusions The GLCM method can quantify the different levels of diffuse heterogeneity in brain-simulated SPECT images without an influence from the focal cortical defects. However, GLCM classification was not correlated with the physicians' classification (Rho = −0.099). The RW method was significantly correlated with the physicians' heterogeneity perception but is influenced by the existence of a focal defect.
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Affiliation(s)
- Romain Modzelewski
- Laboratoire d'Informatique, de Traitement de l'Information et des Systemes (EA-LITIS 4108), QUANT, I, F, (Quantification en Imagerie Fonctionnelle, Faculty of Medicine, Rouen University, Saint Etienne du Rouvray, 76801, France.
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Santos-Galduróz RF, Bueno OF, Yamaga LI, Armani F, Galduróz JCF. Influence of blood viscosity to cerebral blood flow in older humans compared to young subjects. Clin Neurophysiol 2012; 123:117-20. [DOI: 10.1016/j.clinph.2011.05.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 04/21/2011] [Accepted: 05/24/2011] [Indexed: 11/26/2022]
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Brinkmann BH, Jones DT, Stead M, Kazemi N, O'Brien TJ, So EL, Blumenfeld H, Mullan BP, Worrell GA. Statistical parametric mapping demonstrates asymmetric uptake with Tc-99m ECD and Tc-99m HMPAO SPECT in normal brain. J Cereb Blood Flow Metab 2012; 32:190-8. [PMID: 21934696 PMCID: PMC3323300 DOI: 10.1038/jcbfm.2011.123] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Tc-99m ethyl cysteinate diethylester (ECD) and Tc-99m hexamethyl propylene amine oxime (HMPAO) are commonly used for single-photon emission computed tomography (SPECT) studies of a variety of neurologic disorders. Although these tracers have been very helpful in diagnosing and guiding treatment of neurologic disease, data describing the distribution and laterality of these tracers in normal resting brain are limited. Advances in quantitative functional imaging have demonstrated the value of using resting studies from control populations as a baseline to account for physiologic fluctuations in cerebral perfusion. Here, we report results from 30 resting Tc-99m ECD SPECT scans and 14 resting Tc-99m HMPAO scans of normal volunteers with no history of neurologic disease. Scans were analyzed with regions of interest and with statistical parametric mapping, with comparisons performed laterally (left vs. right), as well as for age, gender, and handedness. The results show regions of significant asymmetry in the normal controls affecting widespread areas in the cerebral hemispheres, but most marked in superior parietotemporal region and frontal lobes. The results have important implications for the use of normal control SPECT images in the evaluation of patients with neurologic disease.
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Affiliation(s)
- Benjamin H Brinkmann
- Mayo Systems Electrophysiology Laboratory, Mayo Clinic, Rochester, Minnesota 55905, USA
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Hägerström D, Jakobsson D, Stomrud E, Andersson AM, Ryding E, Londos E, Minthon L, Rosén I, Edenbrandt L. A new automated method for analysis of rCBF-SPECT images based on the active-shape algorithm: normal values. Clin Physiol Funct Imaging 2011; 32:114-9. [PMID: 22296631 PMCID: PMC3440586 DOI: 10.1111/j.1475-097x.2011.01063.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Most nuclear medicine clinicians use only visual assessment when interpreting regional cerebral blood flow (rCBF) from single-photon emission computed tomography (SPECT) images in clinical practice. The aims of this study were to develop a new, easy to use, automated method for quantification of rCBF-SPECT and to create normal values by using the method on a normal population. We developed a 3-dimensional method based on a brain-shaped model and the active-shape algorithm. The method defines the surface shape of the brain and then projects the maximum counts 0–1·5 cm deep for designated surface points. These surface projection values are divided into cortical regions representing the different lobes and presented relative to the whole cortex, cerebellum or cerebellar maximum. 99mTc-hexa methyl propylene amine oxime (HMPAO) SPECT was performed on 30 healthy volunteers with a mean age of 74 years (range 64–98). The ability of the active-shape algorithm to define the shape of the brain was satisfactory when visually scrutinized. The results of the quantification show rCBF values in the frontal, temporal and parietal lobes of 87–88% using cerebellum as the reference. There were no significant differences in normal rCBF values between male and female subjects and only a weak relation between rCBF and age. In conclusion, our new automated method was able to quantify rCBF-SPECT images and create normal values in ranges as expected. Further studies are needed to assess the clinical value of this method and the normal values.
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Affiliation(s)
- Douglas Hägerström
- Clinical Neurophysiology Unit, Department of Clinical Sciences, Lund University, Sweden.
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Amen DG, Trujillo M, Newberg A, Willeumier K, Tarzwell R, Wu JC, Chaitin B. Brain SPECT Imaging in Complex Psychiatric Cases: An Evidence-Based, Underutilized Tool. Open Neuroimag J 2011; 5:40-8. [PMID: 21863144 PMCID: PMC3149839 DOI: 10.2174/1874440001105010040] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/28/2011] [Accepted: 04/01/2011] [Indexed: 11/22/2022] Open
Abstract
Over the past 20 years brain Single Photon Emission Computed Tomography (SPECT) imaging has developed a substantial, evidence-based foundation and is now recommended by professional societies for numerous indications relevant to psychiatric practice. Unfortunately, SPECT in clinical practice is utilized by only a handful of clinicians. This article presents a rationale for a more widespread use of SPECT in clinical practice for complex cases, and includes seven clinical applications where it may help optimize patient care.
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van Elderen SGC, Brandts A, van der Grond J, Westenberg JJM, Kroft LJM, van Buchem MA, Smit JWA, de Roos A. Cerebral perfusion and aortic stiffness are independent predictors of white matter brain atrophy in type 1 diabetic patients assessed with magnetic resonance imaging. Diabetes Care 2011; 34:459-63. [PMID: 21216862 PMCID: PMC3024367 DOI: 10.2337/dc10-1446] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To identify vascular mechanisms of brain atrophy in type 1 diabetes mellitus (DM) patients by investigating the relationship between brain volumes and cerebral perfusion and aortic stiffness using magnetic resonance imaging (MRI). RESEARCH DESIGN AND METHODS Approval from the local institutional review board was obtained, and patients gave informed consent. Fifty-one type 1 DM patients (30 men; mean age 44 ± 11 years; mean DM duration 23 ± 12 years) and 34 age- and sex-matched healthy control subjects were prospectively enrolled. Exclusion criteria comprised hypertension, stroke, aortic disease, and standard MRI contraindications. White matter (WM) and gray matter (GM) brain volumes, total cerebral blood flow (tCBF), total brain perfusion, and aortic pulse wave velocity (PWV) were assessed using MRI. Multivariable linear regression analysis was used for statistics, with covariates age, sex, mean arterial pressure, BMI, smoking, heart rate, DM duration, and HbA(1c). RESULTS Both WM and GM brain volumes were decreased in type 1 DM patients compared with control subjects (WM P = 0.04; respective GM P = 0.03). Total brain perfusion was increased in type 1 DM compared with control subjects (β = -0.219, P < 0.05). Total CBF and aortic PWV predicted WM brain volume (β = 0.352, P = 0.024 for tCBF; respective β = -0.458, P = 0.016 for aortic PWV) in type 1 DM. Age was the independent predictor of GM brain volume (β = -0.695, P < 0.001). CONCLUSIONS Type 1 DM patients without hypertension showed WM and GM volume loss compared with control subjects concomitant with a relative increased brain perfusion. Total CBF and stiffness of the aorta independently predicted WM brain atrophy in type 1 DM. Only age predicted GM brain atrophy.
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Development and validation of the random walk algorithm: application to the classification of diffuse heterogeneity in brain SPECT perfusion images. J Comput Assist Tomogr 2008; 32:651-9. [PMID: 18664857 DOI: 10.1097/rct.0b013e31814fae48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
UNLABELLED Heterogeneity analysis has been studied for radiological imaging, but few methods have been developed for functional images. Diffuse heterogeneous perfusion frequently appears in brain single photon emission computed tomography (SPECT) images, but objective quantification is lacking. An automatic method, based on random walk (RW) theory, has been developed to quantify perfusion heterogeneity. We assess the robustness of our algorithm in differentiating levels of diffuse heterogeneity even when focal defects are present. METHODS Heterogeneity is quantified by counting R (percentage), the mean rate of visited pixels in a fixed number of steps of the stochastic RW process. The algorithm has been tested on the numerical anthropomorphic Zubal head phantom. Seven diffuse cortical heterogeneity levels were simulated with an adjustable Gaussian function and 6 temporoparietal focal defects simulating Alzheimer Disease, leading to 42 phantoms. Data were projected and smoothed (full width at half maximum, 5.5 mm), and Poisson noise was added to the 64 projections. The SPECT data were reconstructed using filtered backprojection (Hamming filter, 0.5 c/p). R values for different levels of perfusion defect and diffuse heterogeneity were evaluated on 3 parameters: the number of slices studied (20 vs 40), the use of Talairach normalization versus original space, and the use of a cortical mask within the Talairach space. For each parameter, regression lines for heterogeneity and temporoparietal defect quantification were analyzed by covariance statistics. R values were also evaluated on SPECT images performed on 25 subjects with suspected focal dementia and on 15 normal controls. Scans were blindly ranked by 2 experienced nuclear physicians according to the degree of diffuse heterogeneity. RESULTS Variability of R was smaller than 0.17% for repeated measurements. R was more particularly influenced by diffuse heterogeneity compared with focal perfusion defect. The Talairach normalization had a significant influence on the heterogeneity quantification. The number of slices visited by the RW and the cortical masking have a weak influence on the heterogeneity quantification but only for very low heterogeneity levels. The Spearman coefficient between physicians' consensus and RW automatic ranking is 0.85, in the same order of magnitude as the Spearman coefficient between the rankings of the 2 senior physicians (0.86). CONCLUSIONS Random walk is an original and objective method and is able to quantify heterogeneous brain perfusion, even in presence of cortical defects. This method is repeatable, robust, and mainly influenced by spatial normalization.
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Sar V, Unal SN, Ozturk E. Frontal and occipital perfusion changes in dissociative identity disorder. Psychiatry Res 2007; 156:217-23. [PMID: 17961993 DOI: 10.1016/j.pscychresns.2006.12.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2006] [Revised: 12/14/2006] [Accepted: 12/26/2006] [Indexed: 11/29/2022]
Abstract
The aim of the study was to investigate if there were any characteristics of regional cerebral blood flow (rCBF) in dissociative identity disorder. Twenty-one drug-free patients with dissociative identity disorder and nine healthy volunteers participated in the study. In addition to a clinical evaluation, dissociative psychopathology was assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders, the Dissociative Experiences Scale and the Clinician-Administered Dissociative States Scale. A semi-structured interview for borderline personality disorder, the Hamilton Depression Rating Scale, and the Childhood Trauma Questionnaire were also administered to all patients. Normal controls had to be without a history of childhood trauma and without any depressive or dissociative disorder. Regional cerebral blood flow (rCBF) was studied with single photon emission computed tomography (SPECT) with Tc99m-hexamethylpropylenamine (HMPAO) as a tracer. Compared with findings in the control group, the rCBF ratio was decreased among patients with dissociative identity disorder in the orbitofrontal region bilaterally. It was increased in median and superior frontal regions and occipital regions bilaterally. There was no significant correlation between rCBF ratios of the regions of interest and any of the psychopathology scale scores. An explanation for the neurophysiology of dissociative psychopathology has to invoke a comprehensive model of interaction between anterior and posterior brain regions.
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Affiliation(s)
- Vedat Sar
- Clinical Psychotherapy Unit and Dissociative Disorders Program, Department of Psychiatry, Medical Faculty of Istanbul, University of Istanbul, Istanbul, Turkey.
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Chang YC, Bien CM, Lee H, Espenshade PJ, Kwon-Chung KJ. Sre1p, a regulator of oxygen sensing and sterol homeostasis, is required for virulence in Cryptococcus neoformans. Mol Microbiol 2007; 64:614-29. [PMID: 17462012 DOI: 10.1111/j.1365-2958.2007.05676.x] [Citation(s) in RCA: 164] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cryptococcus neoformans is an environmental pathogen requiring atmospheric levels of oxygen for optimal growth. Upon inhalation, C. neoformans disseminates to the brain and causes meningoencephalitis, but the mechanisms by which the pathogen adapts to the low-oxygen environment in the brain have not been investigated. We found that SRE1, a homologue of the mammalian sterol regulatory element-binding protein (SREBP), functions in an oxygen-sensing pathway. Low oxygen decreased sterol synthesis in C. neoformans and triggered activation of membrane-bound Sre1p by the cleavage-activating protein, Scp1p. Microarray and Northern blot analysis demonstrated that under low oxygen, Sre1p activates genes required for ergosterol biosynthesis and iron uptake. Consistent with these regulatory functions, sre1Delta cells were hypersensitive to azole drugs and failed to grow under iron-limiting conditions. Importantly, sre1Delta cells failed to produce fulminating brain infection in mice. Our in vitro data support a model in which Sre1p is activated under low oxygen leading to the upregulation of genes required for sterol biosynthesis and growth in a nutrient-limiting environment. Animal studies confirm the importance of SRE1 for C. neoformans to adapt to the host environment and to cause fatal meningoencephalitis, thereby identifying the SREBP pathway as a therapeutic target for cryptococcosis.
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Affiliation(s)
- Yun C Chang
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA
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Sierra C, de la Sierra A, Lomeña F, Paré JC, Larrousse M, Coca A. Relation of left ventricular hypertrophy to regional cerebral blood flow: single photon emission computed tomography abnormalities in essential hypertension. J Clin Hypertens (Greenwich) 2007; 8:700-5. [PMID: 17028483 PMCID: PMC8109536 DOI: 10.1111/j.1524-6175.2006.05700.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several reports have shown that left ventricular hypertrophy (LVH) is an independent predictor of acute cerebrovascular events. The aim of the present study was to investigate the relationship between LVH and cerebral blood flow in middle-aged patients with essential hypertension. Forty never-treated hypertensive patients (24 men, 16 women, aged 50-60 years) without clinical evidence of target organ damage were studied. Regional cerebral blood flow was measured by means of single photon emission computed tomography of the brain. Twenty-nine patients showed echocardiographic criteria of LVH; 11 patients did not show this feature. No differences were found in regional cerebral blood flow ratio of all brain areas studied between hypertensives with or without LVH except for the striatum area. The regional cerebral blood flow ratio was significantly reduced in the striatum region of hypertensive patients with LVH, compared with patients without LVH (91.5+/-7.4 vs 98.1+/-8.3; P=.023). This relationship remained significant after adjusting for blood pressure. The authors conclude that the presence of LVH in middle-aged patients with essential hypertension is associated with a reduction of regional cerebral blood flow in the striatum area.
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Affiliation(s)
- Cristina Sierra
- Hypertension Unit, Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Hospital ClAnic, University of Barcelona, Spain.
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Hermes M, Hagemann D, Britz P, Lieser S, Rock J, Naumann E, Walter C. Reproducibility of continuous arterial spin labeling perfusion MRI after 7 weeks. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2007; 20:103-15. [PMID: 17429703 DOI: 10.1007/s10334-007-0073-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2006] [Revised: 03/14/2007] [Accepted: 03/14/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Continuous arterial spin labeling (CASL) is a non-invasive technique for the measurement of cerebral blood flow (CBF). The aim of the present study was to examine the reproducibility of CASL measurements and its suitability to consistently detect differences between groups, regions, and resting states. MATERIALS AND METHODS Thirty-eight healthy subjects (19 female) were examined at 1.5 T on two measurement occasions that were seven weeks apart. Resting CBF was measured with eyes open and eyes closed. RESULTS In different regions of interest (ROIs) the repeatability estimates varied between 9 and 19 ml/100 g/min. There were no significant mean differences between occasions in all ROIs (P > 0.05). Greater CBF in the eyes-open than in the eyes-closed state was consistently present in the primary and secondary visual areas. Furthermore, CBF was consistently greater in the right than in the left hemisphere (P < 0.05) and differed between lobes and between arterial territories (P < 0.001). Finally, we consistently observed greater CBF in women than in men (P < 0.001). CONCLUSION This study demonstrates the suitability of CASL to consistently detect differences between groups, regions, and resting states even after seven weeks. This emphasizes its usefulness for longitudinal designs.
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Affiliation(s)
- Michael Hermes
- Department of Psychology, University of Trier, Trier, Germany.
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Jodzio K, Drumm DA, Nyka WM, Lass P, Gasecki D. The contribution of the left and right hemispheres to early recovery from aphasia: A SPECT prospective study. Neuropsychol Rehabil 2007; 15:588-604. [PMID: 16381142 DOI: 10.1080/09602010443000137] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This prospective study examined the relationship between post-stroke recovery of aphasia and changes in cerebral blood flow (CBF). To address the question of right hemisphere (RH) involvement in restitution of language, we tested the hypothesis that the increase in perfusion of the RH is crucial for early recovery from aphasia. Twenty-four right-handed patients with acute aphasia following left hemisphere (LH) ischaemic stroke were examined twice with a six-month interval. At each session CBF and language scores were measured on the same stroke patients. Language was measured by selected tasks derived from the Boston Diagnostic Aphasia Examination (BDAE). The SPECT scans were obtained using (99m)Tc-ECD on a triple-head gamma camera Multispect-3. Although initial CBF measured for the whole group of aphasic patients was not a predictor for future language recovery for either hemisphere, increased perfusion of the RH during a six-month interval was found to parallel the recovery of aphasic disorders. There was a correlation between the change in the right parietal CBF (but not the left) and a change in numerous language abilities. Nevertheless, only CBF values on the left predicted performance on the language tests at initial and follow-up examinations. When the area damaged on structural imaging was excluded from perfusion analysis, only subcortical CBF change on the left showed a positive correlation with language improvement. Thus, the cerebral mechanism associated with early recovery from aphasia is a dynamic and complex process that may involve both hemispheres. Probably this mechanism involves functional reorganisation in the speech-dominant (damaged) hemisphere and regression of haemodynamic disturbances in the non-dominant (structurally intact) hemisphere.
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Affiliation(s)
- Krzysztof Jodzio
- Institute of Psychology, University of Gdańsk, Pomorska 68, 80-343 Gdańsk, Poland.
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Poblete García V, García Vicente A, Soriano Castrejón A, Beato Fernández L, García-Vilches I, Rodríguez-Cano T, Cortés Romera M, Ruiz Solís S, Rodado Marina S, Talavera Rubio M. Valoración del flujo cortical cerebral mediante SPECT de perfusión cerebral en pacientes con diagnóstico de trastornos de la conducta alimentaria. ACTA ACUST UNITED AC 2007. [DOI: 10.1157/13097377] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sfyroeras GS, Arsos G, Karkos CD, Liasidis C, Spyridis C, Boundas D, Dimitriadis AS, Gerassimidis TS. Interhemispheric Asymmetry in Brain Perfusion Before and After Carotid Stenting:A99mTc-HMPAO SPECT Study. J Endovasc Ther 2006; 13:729-37. [PMID: 17154707 DOI: 10.1583/06-1857.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the effect of unilateral carotid angioplasty and stenting (CAS) on cerebral perfusion asymmetry in patients with severe extracranial carotid stenosis by means of technetium Tc 99m hexamethyl-propyleneamine oxime brain single photon emission computed tomography ((99m)Tc-HMPAO SPECT). METHODS Twenty-nine consecutive patients (22 men; median age 68 years, range 58-80; 13 symptomatic) undergoing unilateral CAS were included in the study. Brain perfusion was assessed by (99m)Tc-HMPAO brain SPECT prior to the procedure and postoperatively at 8 hours and at 2 to 4 months. The asymmetry index (AI), a measure of the interhemispheric asymmetry in perfusion, was calculated as [(counts in "healthy" hemisphere-counts in hemisphere with carotid stenosis)/counts in "healthy" hemisphere]x100. RESULTS The preoperative AI demonstrated a wide variation (mean -0.5%+/-8.4%, range -19.5% to 14.1%). There was no significant correlation between the degree of carotid stenosis and preoperative AI. The mean preoperative AI in the asymptomatic patients was lower than in the symptomatic group [-4.0%+/-8.5% (range -19.5% to 8.2%) versus 3.8%+/-6.4% (range -5.2% to 14.1%), p=0.01], suggesting reduced perfusion of the ipsilateral cerebral hemisphere compared to the contralateral side in symptomatic patients. AI variation did not improve after CAS; there was no difference in AI among the 3 SPECT studies (p=0.75). Preoperative AI correlated significantly with late AI (r=0.74, p<0.0001); however, there was no statistically significant correlation between immediate postoperative AI and either preoperative (r=0.24, p=0.217) or late (r=0.24, p=0.249) AI. CONCLUSION Asymmetry in cerebral perfusion in patients with severe extracranial carotid atherosclerosis does not correlate with the degree of carotid stenosis. Symptomatic patients demonstrate compromised perfusion of the ipsilateral hemisphere compared to asymptomatic patients. As judged by (99m)Tc-HMPAO SPECT scanning, cerebral perfusion patterns do not significantly change after CAS.
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Affiliation(s)
- Giorgos S Sfyroeras
- 5th Surgical Clinic, Medical School, Aristotle University of Thessaloniki, Hippocratio Hospital, Konstantinoupoleos 49, Thessaloniki 546 42, Greece
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Ghoorun S, Baete K, Nuyts J, Groenewald W, Dupont P. The influence of attenuation correction and reconstruction techniques on the detection of hypo-perfused lesions in brain SPECT images. Nucl Med Commun 2006; 27:765-72. [PMID: 16969257 DOI: 10.1097/01.mnm.0000230076.40856.6a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND We evaluated the effects of attenuation correction and reconstruction techniques on the detection of hypoperfused lesions in brain SPECT imaging. METHODS A software phantom was constructed using the data available on the BrainWeb database by assigning activity values to grey and white matter. The true attenuation map was generated by assigning attenuation coefficients to six different tissue classes to create a non-uniform attenuation map. The uniform attenuation map was calculated using an attenuation coefficient of 0.15 cm(-1). Hypoperfused lesions of varying intensities and sizes were added. The phantom was then projected as typical SPECT projection data, taking into account attenuation and collimator blurring with the addition of Poisson noise. The projection data were reconstructed using four different methods: filtered back-projection in combination with Chang's first-order attenuation correction using the uniform or the true attenuation map and maximum likelihood iterative reconstruction using the uniform or the true attenuation map. Different Gaussian post-smoothing kernels were applied onto the reconstructed images and the performance of each procedure was analysed using figures of merit such as signal-to-noise ratio, bias and variance. RESULTS Uniform attenuation correction offered only slight deterioration of the signal-to-noise ratio compared to the true attenuation map. Maximum likelihood produced superior signal-to-noise ratios and lower bias at the same variance in comparison to the filtered back-projection. CONCLUSION Uniform attenuation correction is adequate for lesion detection while maximum likelihood provides enhanced lesion detection when compared to filtered back-projection.
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Affiliation(s)
- Shivani Ghoorun
- Department of Nuclear Medicine, UZ Gasthuisberg-KULeuven, Leuven, Belgium
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Inoue K, Ito H, Goto R, Nakagawa M, Kinomura S, Sato T, Sato K, Fukuda H. Apparent CBF decrease with normal aging due to partial volume effects: MR-based partial volume correction on CBF SPECT. Ann Nucl Med 2005; 19:283-90. [PMID: 16097637 DOI: 10.1007/bf02984620] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Several studies using single photon emission tomography (SPECT) have shown changes in cerebral blood flow (CBF) with age, which were associated with partial volume effects by some authors. Some studies have also demonstrated gender-related differences in CBF. The present study aimed to examine age and gender effects on CBF SPECT images obtained using the 99mTc-ethyl cysteinate dimer and a SPECT scanner, before and after partial volume correction (PVC) using magnetic resonance (MR) imaging. Forty-four healthy subjects (29 males and 15 females; age range, 27-64 y; mean age, 50.0 +/- 9.8 y) participated. Each MR image was segmented to yield grey and white matter images and coregistered to a corresponding SPECT image, followed by convolution to approximate the SPECT spatial resolution. PVC-SPECT images were produced using the convoluted grey matter MR (GM-MR) and white matter MR images. The age and gender effects were assessed using SPM99. Decreases with age were detected in the anterolateral prefrontal cortex and in areas along the lateral sulcus and the lateral ventricle, bilaterally, in the GM-MR images and the SPECT images. In the PVC-SPECT images, decreases in CBF in the lateral prefrontal cortex lost their statistical significance. Decreases in CBF with age found along the lateral sulcus and the lateral ventricle, on the other hand, remained statistically significant, but observation of the spatially normalized MR images suggests that these findings are associated with the dilatation of the lateral sulcus and lateral ventricle, which was not completely compensated for by the spatial normalization procedure. Our present study demonstrated that age effects on CBF in healthy subjects could reflect morphological differences with age in grey matter.
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Affiliation(s)
- Kentaro Inoue
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
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Jeong GW, Park K, Youn G, Kang HK, Kim HJ, Seo JJ, Ryu SB. ORIGINAL RESEARCH—FEMALE SEXUAL DYSFUNCTION: Assessment of Cerebrocortical Regions Associated with Sexual Arousal in Premenopausal and Menopausal Women by Using BOLD‐Based Functional MRI. J Sex Med 2005; 2:645-51. [PMID: 16422822 DOI: 10.1111/j.1743-6109.2005.00134.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to compare the cerebral regions associated with sexual arousal between premenopausal and menopausal women by using functional magnetic resonance imaging (f MRI). MATERIALS AND METHODS Ten premenopausal and 10 menopausal women underwent fMRI on a 1.5T MR scanner using the blood oxygen level dependent technique. To identify the activated brain regions associated with sexual response, brain activation was assessed during 1 minute of a nonerotic film, followed by 4 minutes of an erotic film. RESULTS The overall activation ratios of the premenopausal women were greater than those of the menopausal women by approximately 8% on average. The limbic, temporal association areas, and parietal lobe showed greater enhancement of signal intensities in premenopausal women. However, signal enhancement in the genu of the corpus callosum and superior frontal gyrus was dominant in menopausal women. CONCLUSIONS The activated brain center associated with visually evoked sexual arousal showed qualitative and quantitative differences between premenopausal and menopausal women.
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Affiliation(s)
- Gwang-Woo Jeong
- Department of Radiology, Medical School, Chonnam National University, 5 Hakdong, Dongku, Gwangju 501-757, Korea
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Lorberboym M, Watemberg N, Nissenkorn A, Nir B, Lerman-Sagie T. Technetium 99m ethylcysteinate dimer single-photon emission computed tomography (SPECT) during intellectual stress test in children and adolescents with pure versus comorbid attention-deficit hyperactivity disorder (ADHD). J Child Neurol 2004; 19:91-6. [PMID: 15072100 DOI: 10.1177/08830738040190020201] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children and adolescents with the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnosis of attention-deficit hyperactivity disorder (ADHD) can have comorbid conditions such as conduct disorder, oppositional defiant disorder, and obsessive-compulsive disorder (comorbid type). The purpose of our study was to compare the pattern of regional cerebral perfusion in these two groups of children with ADHD during a computerized performance test. Nineteen children and adolescents were enrolled in the study. Seven boys and one girl with pure ADHD (group 1: mean age 12 years, range 9-16 years) and nine boys and two girls with comorbid ADHD (group 2: mean age 11 years, range 8-16 years) were studied by single-photon emission computed tomography (SPECT). The patients were not receiving any medication for at least 48 hours prior to the study. All patients were injected with 99mTc-ethylcysteinate dimer while doing a computerized performance test. Nine age-matched control children (five boys and four girls, mean age 12 years, range 9-17 years) with a normal brain SPECT served as controls. All patients in group 2 showed significantly decreased perfusion in the temporal lobes (P < .005). Five patients had decreased frontal lobe perfusion. Additionally, two patients in group 2 had decreased perfusion in the basal ganglia (not significant). Four of eight patients in group 1 had decreased frontal lobe perfusion (not significant). In addition, two patients had bilateral temporal lobe abnormalities, whereas two patients had a normal SPECT. Three patients in group 1 also had decreased basal ganglia perfusion. In contrast to previous studies of brain perfusion in ADHD that focused mainly on frontal and prefrontal cortical abnormalities, our study demonstrates that temporal lobe perfusion abnormalities are more common in patients with the comorbid type of ADHD. We postulate that these findings can have therapeutic implications and explain the decreased response to stimulants in this group of patients.
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Affiliation(s)
- Mordechai Lorberboym
- Department of Nuclear Medicine, Edith Wolfson Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Helenius J, Perkiö J, Soinne L, Østergaard L, Carano RAD, Salonen O, Savolainen S, Kaste M, Aronen HJ, Tatlisumak T. Cerebral hemodynamics in a healthy population measured by dynamic susceptibility contrast MR imaging. Acta Radiol 2003. [PMID: 14510762 DOI: 10.1034/j.1600-0455.2003.00104.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To establish reference data and to study age-dependency for cerebral perfusion in various regions of the brain in a healthy population. MATERIAL AND METHODS Eighty healthy subjects of both genders from 22 to 85 years of age were studied with spin echo echo-planar dynamic susceptibility contrast MR imaging (DSC MRI) at 1.5 T. Cerebral blood volume (CBV), cerebral blood flow (CBF), and contrast agent mean transit time (MTT) were calculated bilaterally for 20 distinct neuroanatomic structures. RESULTS In gray matter, the following values were found (mean +/- SD): CBV (4.6 +/- 1.0 ml/100 g), CBF (94.2 +/- 23.0 ml/100 g/min), and MTT (3.0 +/- 0.6 s), and in white matter: CBV (1.3 +/- 0.4 ml/100 g), CBF (19.6 +/- 5.8 ml/100 g/min), and MTT (4.3 +/- 0.7 s). The perfusion parameters did not change with age, except for a tendency to an increase in gray matter MTT and CBV. Males exhibited higher MTT and CBV than females. No hemispheric difference was found in either gender. CONCLUSION Cerebral hemodynamics can be assessed with DSC MRI. Age itself seems to have only a marginal effect on cerebral perfusion in healthy population.
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Affiliation(s)
- J Helenius
- Department of Neurology, Helsinki University Central Hospital, Haartmaninkatu 4, FIN-00290 Helsinki, Finland
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41
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Inoue K, Nakagawa M, Goto R, Kinomura S, Sato T, Sato K, Fukuda H. Regional differences between 99mTc-ECD and 99mTc-HMPAO SPET in perfusion changes with age and gender in healthy adults. Eur J Nucl Med Mol Imaging 2003; 30:1489-97. [PMID: 14579088 DOI: 10.1007/s00259-003-1234-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2003] [Accepted: 04/29/2003] [Indexed: 10/26/2022]
Abstract
A number of studies using single-photon emission tomography (SPET) have shown perfusion changes with age in several cortical and subcortical areas, which might distort the results of perfusion imaging studies of neuropsychiatric disorders. Technetium-99m labelled ethyl cysteinate dimer (ECD) and hexamethylpropylene amine oxime (HMPAO) are both used as markers of cerebral perfusion, but have different pharmacokinetics and retention patterns. The aim of this study was to determine whether age and gender effects on perfusion SPET differ depending on whether (99m)Tc-HMPAO or (99m)Tc-ECD is used. Forty-five subjects (20 male and 25 female, mean age 52.8+/-6.6 years) were assigned to (99m)Tc-HMPAO SPET (HMPAO group), and 39 subjects (24 male and 15 female, mean age 52.6+/-6.7 years) to (99m)Tc-ECD SPET (ECD group). SPET images were obtained about 10 min after intravenous injection of approximately 800 MBq (99m)Tc-HMPAO or (99m)Tc-ECD using the same SPET scanner. Three-dimensional volumetric magnetic resonance imaging was performed to as7sess morphological changes in the grey matter. All image processing and statistical analyses were performed using SPM99 software. An area in the right anterior frontal lobe showed an increase in perfusion with age only in the HMPAO group, whereas areas in the bilateral retrosplenial cortex showed decreases in perfusion with age only in the ECD group; neither group showed corresponding changes in the grey matter. The present study shows that different effects of age on perfusion are observed depending on whether (99m)Tc-HMPAO and (99m)Tc-ECD is used. This suggests that the results of perfusion SPET are differently confounded depending on the tracer used, and that perfusion SPET with these tracers has limitations when used in research on subtle perfusion changes.
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Affiliation(s)
- Kentaro Inoue
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi Aoba-ku, 980-8575, Sendai, Japan.
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42
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Kaufman JA, Phillips-Conroy JE, Black KJ, Perlmutter JS. Asymmetric regional cerebral blood flow in sedated baboons measured by positron emission tomography (PET). AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2003; 121:369-77. [PMID: 12884319 DOI: 10.1002/ajpa.10181] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The analysis of structural brain asymmetry has been a focal point in anthropological theories of human brain evolution and the development of lateralized behaviors. While physiological brain asymmetries have been documented for humans and animals presenting with pathological conditions or under certain activation tasks, published studies on baseline asymmetries in healthy individuals have produced conflicting results. We tested for the presence of cerebral blood flow asymmetries in 7 healthy, sedated baboons using positron emission tomography, a method of in vivo autoradiography. Five of the 7 baboons exhibited hemispheric asymmetries in which left-sided flow was significantly greater than right-sided flow. Furthermore, the degree of asymmetry in 8 of 24 brain regions was found to be significantly correlated with age; older individuals exhibited a higher degree of asymmetry than younger individuals. Cerebral blood flow itself was uncorrelated with age, and differences between males and females were not significant.
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Affiliation(s)
- Jason A Kaufman
- Department of Anthropology, Washington University, St. Louis, Missouri 63130, USA.
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43
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Eren I, Tükel R, Polat A, Karaman R, Unal S. Evaluation of regional cerebral blood flow changes in panic disorder with Tc99m-HMPAO SPECT. Psychiatry Res 2003; 123:135-43. [PMID: 12850252 DOI: 10.1016/s0925-4927(03)00062-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study is to investigate differences in regional cerebral blood flow (rCBF) and rCBF asymmetry index values between panic disorder patients (n=22) and normal comparison subjects (n=19) using Tc99m-hexamethylpropyleneamine oxime single photon emission tomography imaging. A decrease in perfusion in the bilateral frontal regions and a relative increase in perfusion in the right medial and superior frontal regions were found. There were significant positive correlations between scores on the Panic and Agoraphobia Scale and rCBF asymmetry index values of the parietal, superior temporal and lateral temporal regions in the panic disorder patients. These correlations point to a relationship between the severity of panic disorder and relative right brain activation. Activation of the amygdala, increased CBF in the frontal region, or hyperactivation of the locus ceruleus seen in panic disorder may explain the decrease in the rCBF in the inferior frontal region.
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Affiliation(s)
- Ibrahim Eren
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34390, Turkey
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44
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Peremans K, Audenaert K, Blanckaert P, Jacobs F, Coopman F, Verschooten F, Van Bree H, Van Heeringen C, Mertens J, Slegers G, Dierckx R. Effects of aging on brain perfusion and serotonin-2A receptor binding in the normal canine brain measured with single photon emission tomography. Prog Neuropsychopharmacol Biol Psychiatry 2002; 26:1393-404. [PMID: 12502029 DOI: 10.1016/s0278-5846(02)00306-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Normal aging is associated with a decrease in number and size of neurons, loss of synapses and neuronal branching and with a reduced functioning neurotransmitter systems, such as the serotonergic system. These structural and functional alterations have important impact on the behavioural, cognitive and affective status of the individual. With the introduction of functional brain imaging in veterinary medicine, the canine brain can be examined in vivo, evaluating changes in perfusion, metabolism and neurotransmitter systems. Since cognitive decline is recognised in the aging dog, it was our aim to investigate whether age related changes concerning cerebral perfusion and binding index of the selective 5-HT2A receptor ligand 123I-5-I-R91150 could be found in the canine brain. A group of twelve normal, aging dogs, older than 96 months, was compared to a normal reference group (n = 12), younger than 96 months. SPET images were obtained, using the radiopharmaceutical 99mTc-N,N''-1,2-ethylene-diylbis-L-cysteine diethylester dihydrochloride (99mTc-ECD) for evaluation of the regional perfusion and the selective radioligand 123I-5-I-R91150 for visualization of the 5-HT2A receptor. Regional decrease of cerebral blood-flow was noted in the fronto- and temporocortical area and in the subcortical region. Age was negatively correlated with perfusion in the left and right fronto-cortical region. The binding index of the neuroreceptor radioligand was decreased in the fronto-cortical region, with a significant negative correlation with age in the right fronto-cortical area. No correlation was found between alteration of perfusion and binding index of the receptor ligand, suggesting that age related perfusion differences do not influence the binding of this radioligand. These results suggest that age related effects should be considered in functional canine brain imaging.
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Affiliation(s)
- Kathelijne Peremans
- Department of Medical Imaging, Faculty of Veterinary Medicine, Ghent University Salisburylaan 133, B-9820 Merelbeke, Belgium.
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Schmidt K. Can normalized tissue activities be used instead of absolute blood flow measurements in the brain? [corrected]. Eur J Nucl Med Mol Imaging 2002; 29:953-6. [PMID: 12212548 DOI: 10.1007/s00259-002-0838-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kathleen Schmidt
- Laboratory of Cerebral Metabolism, National Institute of Mental Health, Bethesda, MD 20892-4030, USA.
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46
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Peremans K, De Bondt P, Audenaert K, Van Laere K, Gielen I, Koole M, Versijpt J, Van Bree H, Verschooten F, Dierckx R. Regional brain perfusion in 10 normal dogs measured using Technetium-99m ethyl cysteinate dimer spect. Vet Radiol Ultrasound 2001; 42:562-8. [PMID: 11768526 DOI: 10.1111/j.1740-8261.2001.tb00987.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Single photon emission computed tomography (SPECT) of the brain using perfusion tracers allows estimation of regional brain perfusion. This allows in vivo examination of brain function in the setting of neuropsychologic and pathophysiologic changes. However functional imaging data on brain perfusion in dogs are limited. Hence, the aim of this study was to determine the scintigraphic regional perfusion pattern of the normal canine brain. Ten healthy shepherd type dogs were injected with 925 MBq Technetium-99m ethyl cysteinate (ECD) 20 minutes before the examination. Acquisition was performed using a triple head gamma camera equipped with fanbeam collimators. Uniform attenuation correction and triple energy window correction were applied. Computed tomographic images were obtained from the same dogs, reoriented along the orbito-meatal axis and SPECT perfusion data were coregistered to the CT-volume data. Based on morphological and suggested brain divisions, regions-of-interest (ROIs) were defined for the bilateral frontocerebral, temporocerebral, parietocerebral, occipitocerebral, cerebellar, thalamic, and striatal area. Regional count density was normalized on total counts. All dogs had the highest uptake in the thalamic/striatal area compared to a rather homogeneous cerebral uptake. No significant left/right count differences were found, but a rostro-caudal gradient (+12-13%) was present. In this group, age and gender did not influence the perfusion pattern.
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Affiliation(s)
- K Peremans
- Department of Medical Imaging, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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47
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Smith YR, Zubieta JK. Neuroimaging of aging and estrogen effects on central nervous system physiology. Fertil Steril 2001; 76:651-9. [PMID: 11591393 DOI: 10.1016/s0015-0282(01)01985-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To review the literature on neuroimaging studies focusing on gender differences in the aging process and on the effects of postmenopausal estrogen use on the brain. DESIGN Pertinent studies were identified through a computer MEDLINE search. References of selected articles were hand-searched for additional citations. CONCLUSION(S) The current literature suggests that estrogen replacement may decrease brain white matter lesions, increase cerebral blood flow, alter regional brain activation patterns during cognitive processing, and have modulatory effects on various neurotransmitter systems. Overall, this points to a functional plasticity in higher order brain processing that can be altered by gonadal steroids.
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Affiliation(s)
- Y R Smith
- University of Michigan, Department of Obstetrics and Gynecology, Women's Hospital, Ann Arbor, Michigan 48109-0276, USA.
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Larsson A, Skoog I, Arlig A, Jacobsson L, Larsson L, Ostling S, Wikkelsö C. Regional cerebral blood flow in normal individuals aged 40, 75 and 88 years studied by 99Tc(m)-d,l-HMPAO SPET. Nucl Med Commun 2001; 22:741-6. [PMID: 11453045 DOI: 10.1097/00006231-200107000-00003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Age-related changes in cerebral blood flow (CBF) were examined with [99Tc(m)]-d,l-hexamethylpropylene amine oxime (HMPAO), using a single photon emission tomography (SPET) gamma camera system equipped with a high resolution collimator, in 33 normal individuals in three age groups: 40 years old (n = 11), 75 years old (n = 9) and 88 years old (n = 13). A standard activity of 1000 MBq [99Tc(m)]-d,l-HMPAO was administered. Regional CBF (rCBF) (relative to cerebellar counts) was quantified in 28 grey and white matter regions. The mean rCBF of all the regions was 0.80 (95% confidence interval [CI] 0.77-0.83) in 40 year olds, 0.77 (0.74-0.80) in 75 year olds and 0.76 (0.73-0.78) in 88 year olds. rCBF in the hippocampus, angular and cingular gyri, and frontal association and motor cortices was 5-10% lower in the 75 and 88 year olds than in the middle-aged subjects (P < 0.05). The annual reduction in rCBF was 0.10% between the ages of 40 and 75 years and 0.13% between the ages of 75 and 88 years. The reduction in rCBF in the hippocampus rose from 0.14% between the ages of 40 and 75 years to 0.33% between the ages of 75 and 88 years. The mean rCBF in all 33 individuals showed no sex-related differences.
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Affiliation(s)
- A Larsson
- Section of Neurology, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg University, Sweden.
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Ring HA, Acton PD, Scull D, Costa DC, Gacinovik S, Trimble MR. Patterns of brain activity in patients with epilepsy and depression. Seizure 1999; 8:390-7. [PMID: 10600579 DOI: 10.1053/seiz.1999.0320] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Depression is a recognized feature of epilepsy. This study tested the hypothesis that depression arising in patients with epilepsy would be associated with decreased activity in brain regions previously demonstrated to be hypoperfused both in primary depression and in depression secondary to movement disorders. Two groups of patients with temporal lobe epilepsy were studied, one of which also met DSM IV criteria for a major depressive episode. All underwent a SPECT scan using the blood flow marker,(99m)Tc-HMPAO. An automated voxel-based analysis demonstrated no regions of relatively decreased activity in the depressed compared with the non-depressed patients. Sites of relative hyperactivity in the depressed group were concentrated in the left hemisphere, particularly in dorsolateral prefrontal cortex, striatum, thalamus and temporo-parietal regions. Comparison of these data with normal population data revealed that in the depressed epilepsy group regional activities were within the normal range whilst corresponding results from the non-depressed group were below it. Depressed patients with epilepsy have cerebral regions with greater perfusion than non-depressed people with epilepsy, although they are not hyperperfused compared with normals. Our results suggest that depression in people with epilepsy may arise from a mechanism which differs from that underlying the development of depression in patients with movement disorders.
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Affiliation(s)
- H A Ring
- Department of Psychological Medicine, St Bartholomew's and the Royal London School of Medicine, London E1, UK.
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50
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Orthostatic hypotension in Alzheimer’s disease: Result or cause of brain dysfunction? Aging Clin Exp Res 1999. [DOI: 10.1007/bf03399657] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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