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Ardellier FD, Baloglu S, Sokolska M, Noblet V, Lersy F, Collange O, Ferré JC, Maamar A, Carsin-Nicol B, Helms J, Schenck M, Khalil A, Gaudemer A, Caillard S, Pottecher J, Lefèbvre N, Zorn PE, Matthieu M, Brisset JC, Boulay C, Mutschler V, Hansmann Y, Mertes PM, Schneider F, Fafi-Kremer S, Ohana M, Meziani F, Meyer N, Yousry T, Anheim M, Cotton F, Jäger HR, Kremer S. Cerebral perfusion using ASL in patients with COVID-19 and neurological manifestations: A retrospective multicenter observational study. J Neuroradiol 2023; 50:470-481. [PMID: 36657613 PMCID: PMC9842391 DOI: 10.1016/j.neurad.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/15/2023] [Accepted: 01/15/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE Cerebral hypoperfusion has been reported in patients with COVID-19 and neurological manifestations in small cohorts. We aimed to systematically assess changes in cerebral perfusion in a cohort of 59 of these patients, with or without abnormalities on morphological MRI sequences. METHODS Patients with biologically-confirmed COVID-19 and neurological manifestations undergoing a brain MRI with technically adequate arterial spin labeling (ASL) perfusion were included in this retrospective multicenter study. ASL maps were jointly reviewed by two readers blinded to clinical data. They assessed abnormal perfusion in four regions of interest in each brain hemisphere: frontal lobe, parietal lobe, posterior temporal lobe, and temporal pole extended to the amygdalo-hippocampal complex. RESULTS Fifty-nine patients (44 men (75%), mean age 61.2 years) were included. Most patients had a severe COVID-19, 57 (97%) needed oxygen therapy and 43 (73%) were hospitalized in intensive care unit at the time of MRI. Morphological brain MRI was abnormal in 44 (75%) patients. ASL perfusion was abnormal in 53 (90%) patients, and particularly in all patients with normal morphological MRI. Hypoperfusion occurred in 48 (81%) patients, mostly in temporal poles (52 (44%)) and frontal lobes (40 (34%)). Hyperperfusion occurred in 9 (15%) patients and was closely associated with post-contrast FLAIR leptomeningeal enhancement (100% [66.4%-100%] of hyperperfusion with enhancement versus 28.6% [16.6%-43.2%] without, p = 0.002). Studied clinical parameters (especially sedation) and other morphological MRI anomalies had no significant impact on perfusion anomalies. CONCLUSION Brain ASL perfusion showed hypoperfusion in more than 80% of patients with severe COVID-19, with or without visible lesion on conventional MRI abnormalities.
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Affiliation(s)
- François-Daniel Ardellier
- Service D'imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Engineering science, computer science and imaging laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France.
| | - Seyyid Baloglu
- Service D'imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Magdalena Sokolska
- Department of Medical Physics and Biomedical Engineering, University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU, United Kingdom; Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Vincent Noblet
- Engineering science, computer science and imaging laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France
| | - François Lersy
- Service D'imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Olivier Collange
- Service d'Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | | | - Adel Maamar
- Medical Intensive Care Unit, CHU Rennes, Rennes, France
| | | | - Julie Helms
- Service de Médecine Intensive Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Immuno-Rhumatologie Moléculaire, INSERM UMR S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France
| | - Maleka Schenck
- Service de Médecine Intensive Réanimation, Hôpitaux universitaires de Strasbourg, Hautepierre, Strasbourg, France
| | - Antoine Khalil
- Department of Radiology, Assistance Publique-Hôpitaux de Paris (APHP), Denis Diderot University and Medical School, Bichat University Hospital, Paris, France
| | - Augustin Gaudemer
- Neuroradiology Unit, Department of Radiology, Assistance Publique-Hôpitaux de Paris (APHP), Bichat University Hospital, Paris, France
| | - Sophie Caillard
- Immuno-Rhumatologie Moléculaire, INSERM UMR S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France; Nephrology and Transplantation department, Hôpitaux Universitaires de Strasbourg. Inserm UMR S1109, LabEx Transplantex, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Julien Pottecher
- Hôpital de Hautepierre, Service d'Anesthésie, Réanimation & Médecine Péri-Opératoire - Université de Strasbourg, Faculté de Médecine, FMTS, EA3072, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nicolas Lefèbvre
- Service de Maladies Infectieuses, NHC, CHU de Strasbourg, Strasbourg, France
| | - Pierre-Emmanuel Zorn
- Hôpitaux Universitaires de Strasbourg, UCIEC, Pôle d'Imagerie, Strasbourg, France
| | - Muriel Matthieu
- Hôpitaux Universitaires de Strasbourg, UCIEC, Pôle d'Imagerie, Strasbourg, France
| | | | - Clotilde Boulay
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Véronique Mutschler
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Service de Maladies Infectieuses, NHC, CHU de Strasbourg, Strasbourg, France
| | - Paul-Michel Mertes
- Service d'Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux universitaires de Strasbourg, Strasbourg, France
| | - Francis Schneider
- Service de Médecine Intensive Réanimation, Hôpitaux universitaires de Strasbourg, Hautepierre, Strasbourg, France
| | - Samira Fafi-Kremer
- Laboratoire de Virologie Médicale, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mickael Ohana
- Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Ferhat Meziani
- Service de Médecine Intensive Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; UMR 1260, Regenerative Nanomedicine (RNM), FMTS, INSERM (French National Institute of Health and Medical Research), Strasbourg, France
| | - Nicolas Meyer
- Service de Santé Publique, GMRC, CHU de Strasbourg, Strasbourg F-67091 , France
| | - Tarek Yousry
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Illkirch, France
| | - François Cotton
- MRI center, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; CREATIS-LRMN, CNRS/UMR/5220-INSERM U630, Université Lyon 1, Villeurbanne, France
| | - Hans Rolf Jäger
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Stéphane Kremer
- Service D'imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; Engineering science, computer science and imaging laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France
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Yeom JS, Kim YS, Choi DS. Focality in Febrile Seizures: A Retrospective Assessment Using Arterial Spin Labeling MRI. Neuropediatrics 2023; 54:197-205. [PMID: 36848944 DOI: 10.1055/s-0043-1761922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PURPOSE Defining focality of febrile seizures (FS) in clinical practice remains controversial. We investigated focality issues in FS with a postictal arterial spin labeling (ASL) sequence. METHODS We retrospectively reviewed 77 children (median: 19.0 months, range: 15.0-33.0 months) who consecutively visited our emergency room for FS and underwent brain magnetic resonance imaging (MRI), including the ASL sequence, within 24 hours of seizure onset. ASL data were visually analyzed to assess perfusion changes. Factors related to the perfusion changes were investigated. RESULTS The mean time to ASL acquisition was 7.0 (interquartile range: 4.0-11.0) hours. The most common seizure classification was unknown-onset seizures (n = 37, 48%), followed by focal-onset (n = 26, 34%) and generalized-onset seizures (n = 14, 18%). Perfusion changes were observed in 43 (57%) patients: most were hypoperfusion (n = 35, 83%). The temporal regions were the most common location of perfusion changes (n = 26, 60%); the majority of these were distributed in the unilateral hemisphere. Perfusion changes were independently associated with seizure classification (focal-onset seizures, adjusted odds ratio [aOR]: 9.6, p = 0.01; unknown-onset seizures aOR: 10.4, p < 0.01), and prolonged seizures (aOR: 3.1, p = 0.04), but not with other factors (age, sex, time to MRI acquisition, previous FS, repeated FS within 24 hour, family history of FS, structural abnormality on MRI, and developmental delay). The focality scale of seizure semiology positively correlated with perfusion changes (R = 0.334, p < 0.01). CONCLUSION Focality in FS may be common, and its primary origin might be the temporal regions. ASL can be useful for assessing focality in FS, particularly when seizure onset is unknown.
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Affiliation(s)
- Jung Sook Yeom
- Department of Pediatrics, Gyeongsang National University of Hospital, Jinju, South Korea.,Gyeongsang National University College of Medicine, Institute of Health Science, Jinju, South Korea
| | - Young-Soo Kim
- Gyeongsang National University College of Medicine, Institute of Health Science, Jinju, South Korea.,Department of Neurology, Gyeongsang National University of Hospital, Jinju, South Korea
| | - Dae-Seob Choi
- Gyeongsang National University College of Medicine, Institute of Health Science, Jinju, South Korea.,Department of Radiology, Gyeongsang National University of Hospital, Jinju, South Korea
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Tang S, Liu X, Ran Q, Nie L, Wu L, Pan Z, He L. Application of Three-Dimensional Pseudocontinuous Arterial Spin Labeling Perfusion Imaging in the Brains of Children With Autism. Front Neurol 2022; 13:851430. [PMID: 35280268 PMCID: PMC8905523 DOI: 10.3389/fneur.2022.851430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To explore the application of three-dimensional pseudocontinuous arterial spin labeling (3D-PCASL) perfusion imaging in the brains of children with autism and to understand the characteristics of cerebral blood perfusion in children with autism. Methods A total of 320 children with autism (160 men and 160 women) aged between 2 and 18 years and 320 age- and sex-matched healthy children participated in the study. All children were scanned by 3.0 T magnetic resonance axial T1 fluid-attenuated inversion recovery (FLAIR), T2 FLAIR, 3D-T1, and 3D-PCASL sequences. After postprocessing, cerebral blood flow (CBF) values in each brain region of children with autism and healthy children at the same age were compared and analyzed. Furthermore, CBF characteristics in each brain region of autistic children at various ages were determined. Results The CBF values of the frontal lobe, hippocampus, temporal lobe, and caudate nucleus of children with autism are lower than those of healthy children (P < 0.05). Additionally, as the ages of children with autism increase, the number of brain regions with decreased CBF values gradually increases. A receiver operating characteristic (ROC) analysis results show that the CBF values of the frontal lobe, hippocampus, temporal lobe, and caudate nucleus can distinguish children with autism [area under the ROC curve (AUC) > 0.05, P < 0.05]. Conclusion The 3D-PCASL shows lower brain CBF values in children with autism. Clinical Trial Registration www.ClinicalTrials.gov, identifier: ChiCTR2000034356.
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Affiliation(s)
- Shilong Tang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xianfan Liu
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qiying Ran
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lisha Nie
- GE Healthcare, MR Research China, Beijing, China
| | - Lan Wu
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Zhengxia Pan
- Department of Cardiovascular and Thoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Ling He
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
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Tang S, Liu X, Nie L, Chen Z, Ran Q, He L. Diagnosis of children with attention-deficit/hyperactivity disorder (ADHD) comorbid autistic traits (ATs) by applying quantitative magnetic resonance imaging techniques. Front Psychiatry 2022; 13:1038471. [PMID: 36465303 PMCID: PMC9712964 DOI: 10.3389/fpsyt.2022.1038471] [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: 09/07/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To explore the feasibility of applying quantitative magnetic resonance imaging techniques for the diagnosis of children with attention-deficit/hyperactivity disorder (ADHD) comorbid autistic traits (ATs). METHODS A prospective study was performed by selecting 56 children aged 4-5 years with ADHD-ATs as the study group and 53 sex- and age-matched children with ADHD without ATs as the control group. All children underwent magnetic resonance scans with enhanced T2*- weighted magnetic resonance angiography (ESWAN), 3D-PCASL, and 3D-T1 sequences. Iron content and cerebral blood flow parameters were obtained via subsequent software processing, and the parameter values in particular brain regions in both groups were compared and analyzed to determine the characteristics of these parameters in children with ADHD-ATs. RESULTS Iron content and cerebral blood flow in the frontal lobe, temporal lobe, hippocampus, and caudate nucleus of children with ADHD-ATs were lower than those of children with ADHD without ATs (p < 0.05). Iron content and CBF values in the frontal lobe, temporal lobe and caudate nucleus could distinguish children with ADHD-ATs from those without ATs (AUC > 0.5, p < 0.05). CONCLUSIONS Quantitative magnetic resonance techniques could distinguish children with ADHD-ATs. TRIAL REGISTRATION This study protocol was registered at the Chinese clinical trial registry (ChiCTR2100046616).
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Affiliation(s)
- Shilong Tang
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xianfan Liu
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lisha Nie
- GE Healthcare, MR Research China, Beijing, China
| | - Zhuo Chen
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qiying Ran
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling He
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
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Wang J, Sun P, Liang P. Neuropsychopharmacological effects of midazolam on the human brain. Brain Inform 2020; 7:15. [PMID: 33170396 PMCID: PMC7655878 DOI: 10.1186/s40708-020-00116-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
As a commonly used anesthetic agent, midazolam has the properties of water-soluble, rapid onset, and short duration of action. With the rapid development in the field of neuroimaging, numerous studies have investigated how midazolam acts on the human brain to induce the alteration of consciousness. However, the neural bases of midazolam-induced sedation or anesthesia remain beginning to be understood in detail. In this review, we summarize findings from neuroimaging studies that have used midazolam to study altered consciousness at different levels and content. We also compare the results to those of neuroimaging studies using diverse anesthetic agents and describe the common neural correlates of anesthetic-induced alteration of consciousness.
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Affiliation(s)
- Junkai Wang
- School of Psychology, Capital Normal University, Haidian District, Beijing, 100048, China.,Beijing Key Laboratory of Learning and Cognition, Beijing, China.,Department of Psychology, Tsinghua University, Haidian District, Beijing, 100084, China
| | - Pei Sun
- Department of Psychology, Tsinghua University, Haidian District, Beijing, 100084, China.
| | - Peipeng Liang
- School of Psychology, Capital Normal University, Haidian District, Beijing, 100048, China. .,Beijing Key Laboratory of Learning and Cognition, Beijing, China.
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Gonen OM, Kwan P, O'Brien TJ, Lui E, Desmond PM. Resting-state functional MRI of the default mode network in epilepsy. Epilepsy Behav 2020; 111:107308. [PMID: 32698105 DOI: 10.1016/j.yebeh.2020.107308] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/28/2020] [Accepted: 06/28/2020] [Indexed: 02/09/2023]
Abstract
The default mode network (DMN) is a major neuronal network that deactivates during goal-directed tasks. Recent advances in neuroimaging have shed light on its structure and function. Alterations in the DMN are increasingly recognized in a range of neurological and psychiatric conditions including epilepsy. This review first describes the current understanding of the DMN in health, normal aging, and disease as it is acquired via resting-state functional magnetic resonance imaging (MRI), before focusing on how it is affected in various types of focal and generalized epilepsy. These findings support the potential use of DMN parameters as future biomarkers in epilepsy research, diagnosis, and management.
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Affiliation(s)
- Ofer M Gonen
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia; The Alfred Hospital, VIC, Australia.
| | - Patrick Kwan
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia; The Alfred Hospital, VIC, Australia; Monash University, VIC, Australia
| | - Terence J O'Brien
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia; The Alfred Hospital, VIC, Australia; Monash University, VIC, Australia
| | - Elaine Lui
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia
| | - Patricia M Desmond
- The Royal Melbourne Hospital, VIC, Australia; The University of Melbourne, VIC, Australia
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