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Mugikura S, Mori N, Gang M, Kanno S, Jin K, Osawa SI, Nakasato N, Takase K. Interhemispheric asymmetrical change in gray matter volume in patients with unilateral hippocampal sclerosis. J Clin Imaging Sci 2023; 13:38. [PMID: 38205275 PMCID: PMC10778066 DOI: 10.25259/jcis_77_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/14/2023] [Indexed: 01/12/2024] Open
Abstract
Objectives To clarify the interhemispheric asymmetrical change in gray matter volume (GMV) in unilateral hippocampal sclerosis (HS), we compared changes in GMV relative to normal subjects between the HS and contralateral or non-HS sides. Material and Methods Forty-five patients with unilateral HS and 30 healthy subjects were enrolled. We quantified changes in GMV in the patients with HS as compared to GMV in the normal subjects by introducing the Z-score (Z-GMV) in each region or region of interest in unilateral HS. Then, we assessed the asymmetrically decreased regions, that is, regions with significantly higher Z-GMV on the HS side than the contralateral or non-HS side. Z-GMV was calculated according to the two templates of 58 regions per hemisphere covering the whole brain by anatomical automatic labeling (AAL) and 78 regions per cerebral hemisphere using the Anatomy Toolbox. Results Seven and four regions in AAL and 17 and 11 regions in Anatomy Toolbox were asymmetrically decreased in the Left Hand Side (LHS) and Right Hand Side (RHS), respectively. Hippocampus and Caudate in AAL, five subregions of the hippocampus (CA1-3, Dentate Gyrus and hippocampus-amygdala-transition-area and 4 extrahippocampal regions including two subregions in amygdala (CM: Centromedial, SF: Superficial), basal forebrain (BF) (Ch4), and thalamus (temporal) in anatomy toolbox were common among LHS and RHS concerning asymmetrically decreased regions. Conclusion By introducing Z-GMV, we demonstrated the regions with asymmetrically decreased GMV in LHS and RHS, and found that the hippocampus and extrahippocampal regions, including the BF, were the common asymmetrically decreased regions among LHS and RHS.
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Affiliation(s)
- Shunji Mugikura
- Department of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoko Mori
- Department of Radiology, Akita University Graduate School of Medicine, Akita, Japan
| | - Miyeong Gang
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University, Sendai, Japan
| | - Shigenori Kanno
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University, Sendai, Japan
| | - Kazutaka Jin
- Department of Epileptology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shin-Ichiro Osawa
- Department of Neurosurgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nobukazu Nakasato
- Department of Epileptology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
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Tsutsumi S, Sugiyama N, Ueno H, Ishii H. Do the mammillary bodies atrophy with aging? A magnetic resonance imaging study. Surg Radiol Anat 2023; 45:1419-1425. [PMID: 37450049 DOI: 10.1007/s00276-023-03205-9] [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: 05/06/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE This retrospective study aimed to explore age-related atrophy of the mammillary bodies (MBs) based on their temporal change using magnetic resonance imaging (MRI). MATERIALS AND METHODS The study included 30 adult outpatients who presented to the hospital and were followed for more than 100 months with annual MRIs. The bi-ventricular width (BVW), third ventricle width (TVW), and bi-mammillary dimension (BMD) were measured on axial T2-weighted imaging and analyzed. RESULTS The 30 patients comprised 1 in their 40s, 5 in their 50s, 6 in their 60s, 11 in their 70s, 5 in their 80s, and 2 in their 90s. The MBs were consistently detected with left-to-right symmetry. The mean BVW was 32 ± 2.2 mm on the initial (BVW1) and 32 ± 2.4 mm on the last (BVW2) MRI. The mean TVW was 7.0 ± 2.3 mm on the initial (TVW1) and 7.6 ± 2.7 mm on the last (TVW2) MRI. Furthermore, the mean BMD was 9.9 ± 1.3 mm on the initial (BMD1) and 10 ± 1.3 mm on the last (BMD2) MRI. Statistically, no age ranges had a large dimension for BVW1, BVW2, TVW1, TVW2, BMD1, or BMD2. Changes between TVW1 and TVW2 were significantly different in the patients in their 80s; changes between BMD1 and BMD2 were not different for any age range or between sexes. CONCLUSIONS Aging alone does not seem to promote MB atrophy. In healthy brains, the MBs may be stationary structures throughout life.
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Affiliation(s)
- Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
| | - Natsuki Sugiyama
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Hideaki Ueno
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Hisato Ishii
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
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Nowak M, Schindler S, Storch M, Geyer S, Schönknecht P. Mammillary body and hypothalamic volumes in mood disorders. J Psychiatr Res 2023; 158:216-225. [PMID: 36603316 DOI: 10.1016/j.jpsychires.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/20/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
We have previously reported an in vivo enlargement of the left hypothalamus in mood disorders using 7 T magnetic resonance imaging. The aim of this follow-up study was to find out whether the hypothalamic volume difference may be located in the mammillary bodies (MB) rather than being widespread across the hypothalamus. We developed and evaluated a detailed segmentation algorithm that allowed a reliable segmentation of the MBs, and applied it to 20 unmedicated (MDDu) and 20 medicated patients with major depressive disorder, 21 medicated patients with bipolar disorder, and 23 controls. 20 out of 23 healthy controls were matched to the MDDu. We tested for group differences in MB and hypothalamus without MB (HTh) volumes using analyses of covariance. Associations between both volumes of interest were analysed using bivariate and partial correlations. In contrast to postmortem findings, we found no statistically significant differences of the MB volumes between the study groups. Left HTh volumes differed significantly across the study groups after correction for intracranial volume (ICV) and for ICV and sex. Our result of an HTh enlargement in mood disorders was confirmed by a paired t-test between the matched pairs of MDDu and healthy controls using the native MB and HTh volumes. In the whole sample, MB volumes correlated significantly with the ipsilateral HTh volumes. Our results indicate a structural relationship between both volumes, and that our previous in vivo finding of a hypothalamus enlargement does not extend to the MB, but is limited to the HTh. The enlargement is more likely related to the dysregulation of the HPA axis than to cognitive dysfunctions accompanying mood disorders.
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Affiliation(s)
- Markus Nowak
- University Hospital Leipzig, Department of Psychiatry and Psychotherapy, Semmelweisstraße 10, 04103, Leipzig, Germany; Charité University of Medicine, Department of Psychiatry and Psychotherapy and St. Hedwig Hospital Berlin, Große Hamburger Straße 5-11, 10115, Berlin, Germany.
| | - Stephanie Schindler
- University Hospital Leipzig, Department of Psychiatry and Psychotherapy, Semmelweisstraße 10, 04103, Leipzig, Germany
| | - Melanie Storch
- University Hospital Leipzig, Department of Psychiatry and Psychotherapy, Semmelweisstraße 10, 04103, Leipzig, Germany
| | - Stefan Geyer
- Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurophysics, Stephanstraße 1a, 04103, Leipzig, Germany
| | - Peter Schönknecht
- University Hospital Leipzig, Department of Psychiatry and Psychotherapy, Semmelweisstraße 10, 04103, Leipzig, Germany; University Hospital Leipzig, Out-patient Department for Sexual-therapeutic Prevention and Forensic Psychiatry, Semmelweisstraße 10, 04103, Leipzig, Germany; Academic State Hospital Arnsdorf, Hufelandstraße 15, 01477, Arnsdorf, Germany
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Cho KH, Lee HJ, Lee DA, Park KM. Mammillary Body Atrophy in Temporal Lobe Epilepsy With Hippocampal Sclerosis. J Clin Neurol 2022; 18:635-641. [DOI: 10.3988/jcn.2022.18.6.635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Kyoo Ho Cho
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
- Department of Neurology, Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje Unversity College of Medicine, Busan, Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje Unversity College of Medicine, Busan, Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje Unversity College of Medicine, Busan, Korea
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Perez FA, Elfers C, Yanovski JA, Shoemaker AH, Abuzzahab MJ, Roth CL. MRI measures of hypothalamic injury are associated with glucagon-like peptide-1 receptor agonist treatment response in people with hypothalamic obesity. Diabetes Obes Metab 2021; 23:1532-1541. [PMID: 33651438 PMCID: PMC8353597 DOI: 10.1111/dom.14366] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 12/13/2022]
Abstract
AIM To evaluate whether neuroimaging-delineated regions of hypothalamic injury are associated with a differential treatment response to a glucagon-like peptide-1 receptor agonist (GLP-1RA) in patients with hypothalamic obesity (HO). MATERIALS AND METHODS We performed a prespecified secondary analysis of a randomized, multicentre, double-blind, placebo-controlled trial of people aged 10-25 years with hypothalamic injury and HO randomized to the GLP-1RA exenatide once-weekly (ExQW) or placebo for 36 weeks. Subjects underwent MRI prior to enrolment and the degree of hypothalamic damage was assessed using an integrative hypothalamic lesion score (HLS). Mammillary body (MB) damage was specifically determined. The main clinical endpoints were % change in body mass index (BMI) and change in % body fat. Nested ANCOVA models including a treatment × imaging measure interaction were compared using partial F-tests to assess whether the effect of ExQW treatment differed by severity of hypothalamic damage. RESULTS Complete data were available in 35/42 randomized participants (placebo, n = 15; ExQW, n = 20). ExQW-treated patients with worse HLS or bilateral MB damage had greater reductions in % body fat at 36 weeks (interaction coefficient estimates for HLS: -0.9%, 95% CI -1.6% to -0.2%, p = .02; for MB damage: -7.4%, 95% CI -10.1% to -4.7%, p < .001, respectively) but not for BMI % change. Similarly, patients with more damaged and smaller MB cross-sectional areas had greater reductions in % body fat following ExQW (interaction coefficient estimate 0.3%, 95% CI 0.2%-0.4%, p < .001). CONCLUSIONS In people with HO, greater hypothalamic damage as determined by MRI, in particular MB injury, is associated with greater reductions in adiposity following GLP-1RA treatment.
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Affiliation(s)
- Francisco A. Perez
- Department of Radiology, Seattle Children’s and University of Washington, Seattle, WA 98105
| | - Clinton Elfers
- Seattle Children’s Research Institute, 1900 Ninth Ave, Seattle, WA 98101
| | - Jack A. Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National, Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892
| | - Ashley H. Shoemaker
- Vanderbilt University Medical Center, Division of Pediatric Endocrinology, Nashville, TN 37212
| | - M. Jennifer Abuzzahab
- McNeely Pediatric Diabetes Center and Endocrinology Clinic, Children’s Minnesota, St. Paul, MN
| | - Christian L. Roth
- Seattle Children’s Research Institute, 1900 Ninth Ave, Seattle, WA 98101
- Department of Pediatrics, University of Washington, 1959 NE Pacific St, Seattle, WA 98195
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Adamczyk B, Węgrzyn K, Wilczyński T, Maciarz J, Morawiec N, Adamczyk-Sowa M. The Most Common Lesions Detected by Neuroimaging as Causes of Epilepsy. ACTA ACUST UNITED AC 2021; 57:medicina57030294. [PMID: 33809843 PMCID: PMC8004256 DOI: 10.3390/medicina57030294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/24/2022]
Abstract
Epilepsy is a common neurological disorder characterized by chronic, unprovoked and recurrent seizures, which are the result of rapid and excessive bioelectric discharges in nerve cells. Neuroimaging is used to detect underlying structural abnormalities which may be associated with epilepsy. This paper reviews the most common abnormalities, such as hippocampal sclerosis, malformations of cortical development and vascular malformation, detected by neuroimaging in patients with epilepsy to help understand the correlation between these changes and the course, treatment and prognosis of epilepsy. Magnetic resonance imaging (MRI) reveals structural changes in the brain which are described in this review. Recent studies indicate the usefulness of additional imaging techniques. The use of fluorodeoxyglucose positron emission tomography (FDG-PET) improves surgical outcomes in MRI-negative cases of focal cortical dysplasia. Some techniques, such as quantitative image analysis, magnetic resonance spectroscopy (MRS), functional MRI (fMRI), diffusion tensor imaging (DTI) and fibre tract reconstruction, can detect small malformations—which means that some of the epilepsies can be treated surgically. Quantitative susceptibility mapping may become the method of choice in vascular malformations. Neuroimaging determines appropriate diagnosis and treatment and helps to predict prognosis.
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Zhang Y, Dou W, Zuo Z, You H, Lv Y, Hou B, Shi L, Feng F. Brain volume and perfusion asymmetry in temporal lobe epilepsy with and without hippocampal sclerosis. Neurol Res 2020; 43:299-306. [PMID: 33320070 DOI: 10.1080/01616412.2020.1853988] [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] [Indexed: 10/22/2022]
Abstract
Objectives: To detect and compare the features of interictal perfusion and volume asymmetry between temporal lobe epilepsy (TLE) patients with and without hippocampal sclerosis (HS).Methods: Sixty-one TLE patients (mean age 28.4 ± 9.3 years; 28 female/33 male) with unilateral signs of HS (TLE-HS+) and 25 TLE patients (mean age 29.8 ± 8.0 years; 17 female/8 male) without HS (TLE-HS-) were included. Thirty healthy volunteers served as controls (mean age 26.0 ± 8.7 years; 22 female/8 male). Brain segmentation and volume calculation were performed. Quantitative cerebral blood flow (CBF) values were measured based on arterial spin labeling (ASL). The asymmetry indices (AIs) of volume and perfusion were calculated.Results: TLE-HS+ (adjusted P = 0.001) and TLE-HS- patients (adjusted P = 0.006) had significantly higher hippocampal perfusion AIs than controls. TLE-HS+ and TLE-HS- had similar hippocampal perfusion AIs (adjusted P = 1.00). TLE-HS+ had higher hippocampal volume AIs than TLE-HS- and controls (adjusted P < 0.001). TLE-HS- and controls had similar hippocampal volume AIs (adjusted P = 1.00). All (100%) TLE-HS+ patients had positive hippocampal perfusion or volume AIs. No significant correlation between the AIs of hippocampal perfusion and volume was found in both TLE-HS+(P = 0.894) and TLE-HS- (P = 0.106) patients. TLE-HS+ patients demonstrated more extensive whole-brain asymmetry of both perfusion and volume than TLE-HS- patients.Conclusion: TLE-HS+ and TLE-HS- patients have different patterns of whole-brain perfusion and volume asymmetry. Hippocampal perfusion asymmetry was revealed in both TLE-HS+ and TLE-HS- patients.
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Affiliation(s)
- Yiwei Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wanchen Dou
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhentao Zuo
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Hui You
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuelei Lv
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Hou
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.,BrainNow Medical Technology Limited, Hong Kong Science and Technology Park, Hong Kong, China
| | - Feng Feng
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Hassankhani A, Stein JM, Haboosheh AG, Vossough A, Loevner LA, Nabavizadeh SA. Anatomical Variations, Mimics, and Pitfalls in Imaging of Patients with Epilepsy. J Neuroimaging 2020; 31:20-34. [PMID: 33314527 DOI: 10.1111/jon.12809] [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: 08/31/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/27/2022] Open
Abstract
Epilepsy is among one of the most common neurologic disorders. The role of magnetic resonance imaging (MRI) in the diagnosis and management of patients with epilepsy is well established, and most patients with epilepsy are likely to undergo at least one or more MRI examinations in the course of their disease. Recent advances in high-field MRI have enabled high resolution in vivo visualization of small and intricate anatomic structures that are of great importance in the assessment of seizure disorders. Familiarity with normal anatomic variations is essential in the accurate diagnosis and image interpretation, as these variations may be mistaken for epileptogenic foci, leading to unnecessary follow-up imaging, or worse, unnecessary treatment. After a brief overview of normal imaging anatomy of the mesial temporal lobe, this article will review a few important common and uncommon anatomic variations, mimics, and pitfalls that may be encountered in the imaging evaluation of patients with epilepsy.
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Affiliation(s)
- Alvand Hassankhani
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Joel M Stein
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Amit G Haboosheh
- Department of Radiology, Hadassah Ein Karem Hospital, Jerusalem, Israel
| | - Arastoo Vossough
- Division of Neuroradiology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Laurie A Loevner
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Seyed Ali Nabavizadeh
- Division of Neuroradiology, Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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