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Rios-Zermeno J, Ballesteros-Herrera D, Dominguez-Vizcayno P, Carrillo-Ruiz JD, Moreno-Jimenez S. Dentate nucleus: a review and implications for dentatotomy. Acta Neurochir (Wien) 2024; 166:219. [PMID: 38758379 DOI: 10.1007/s00701-024-06104-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
PURPOSE The dentate nucleus (DN) is the largest, most lateral, and phylogenetically most recent of the deep cerebellar nuclei. Its pivotal role encompasses the planning, initiation, and modification of voluntary movement but also spans non-motor functions like executive functioning, visuospatial processing, and linguistic abilities. This review aims to offer a comprehensive description of the DN, detailing its embryology, anatomy, physiology, and clinical relevance, alongside an analysis of dentatotomy. METHODS AND RESULTS We delve into the history, embryology, anatomy, vascular supply, imaging characteristics, and clinical significance of the DN. Furthermore, we thoroughly review the dentatotomy, emphasizing its role in treating spasticity. CONCLUSIONS Understanding the intricacies of the anatomy, physiology, vasculature, and projections of the DN has taken on increased importance in current neurosurgical practice. Advances in technology have unveiled previously unknown functions of the deep cerebellar nuclei, predominantly related to non-motor domains. Such discoveries are revitalizing older techniques, like dentatotomy, and applying them to newer, more localized targets.
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Affiliation(s)
- Jorge Rios-Zermeno
- Department of Neurosurgery, Instituto Nacional de Neurologia y Neurocirugia, Av Insurgentes Sur 3877, Tlalpan, Mexico City, Mexico
| | - Daniel Ballesteros-Herrera
- Department of Neurosurgery, Instituto Nacional de Neurologia y Neurocirugia, Av Insurgentes Sur 3877, Tlalpan, Mexico City, Mexico
| | - Pamela Dominguez-Vizcayno
- Department of Radioneurosurgery, Instituto Nacional de Neurologia y Neurocirugia, Mexico City, Mexico
| | - José Damián Carrillo-Ruiz
- Research Direction & Stereotactic and Functional Neurosurgery, Mexico General Hospital, Mexico City, Mexico
- Neuroscience CoordinationPschycology Faculty, Mexico Anahuac University, Mexico City, Mexico
| | - Sergio Moreno-Jimenez
- Department of Neurosurgery, Instituto Nacional de Neurologia y Neurocirugia, Av Insurgentes Sur 3877, Tlalpan, Mexico City, Mexico.
- Neurological Center, American British Cowdray Medical Center, Mexico City, Mexico.
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Basedau H, May A, Mehnert J. Cerebellar somatotopy of the trigemino-cervical complex during nociception. Eur J Pain 2024; 28:719-728. [PMID: 38013614 DOI: 10.1002/ejp.2212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION The somatotopic organization of the human cerebellum processes somato-motoric input. Its role during pain perception for nociceptive input remains ambiguous. A standardized experimental trigeminal nociceptive input in functional imaging might clarify the role of the cerebellum in trigeminal nociception. Also of interest is the greater occipital nerve, which innervates the back of the head, and can influence the trigeminal perception due to functional coupling within the brainstem, forming the so-called trigemino-cervical complex. METHODS In our preregistered study (clinicaltrials.gov: NTC03999060), we stimulated the greater occipital as well as the three main branches of the trigeminal nerve during functional magnetic resonance imaging in two independent cohorts of young healthy volunteers without psychiatric, neurological or pain-related disorders to disentangle overlapping somatotopic cerebellar organization of the nerves innervating the human head. RESULTS We found a dominant effect of the first trigeminal branch in the cerebellum, underpinning its particular role for headache diseases, and somatotopic representations in bilateral cerebellar lobules I-IV, V, VIIb, VIIIa and Crus I as well as in the brainstem. SIGNIFICANCE The study expands the current knowledge on facial and head pain processing by the cerebellum and provides an initial somatotopic map of the trigemino-cervical complex in the human cerebellum with a predominant representation of the first trigeminal branch.
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Affiliation(s)
- Hauke Basedau
- Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany
| | - Arne May
- Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany
| | - Jan Mehnert
- Department of Systems Neuroscience, University Medical Center Eppendorf, Hamburg, Germany
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Cattarinussi G, Di Giorgio A, Sambataro F. Cerebellar dysconnectivity in schizophrenia and bipolar disorder is associated with cognitive and clinical variables. Schizophr Res 2024; 267:497-506. [PMID: 38582653 DOI: 10.1016/j.schres.2024.03.039] [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: 12/12/2023] [Revised: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Abnormal cerebellar functional connectivity (FC) has been implicated in the pathophysiology of schizophrenia (SCZ) and bipolar disorder (BD). However, the patterns of cerebellar dysconnectivity in these two disorders and their association with cognitive functioning and clinical symptoms have not been fully clarified. In this study, we examined cerebellar FC alterations in SCZ and BD-I and their association with cognition and psychotic symptoms. METHODS Resting-state functional magnetic resonance imaging (rs-fMRI) data of 39 SCZ, 43 BD-I, and 61 healthy controls from the Consortium for Neuropsychiatric Phenomics dataset were examined. The cerebellum was parcellated into ten functional networks, and seed-based FC was calculated for each cerebellar system. Principal component analyses were used to reduce the dimensionality of the diagnosis-related FC and cognitive variables. Multiple regression analyses were used to assess the relationship between FC and cognitive and clinical data. RESULTS We observed decreased cerebellar FC with the frontal, temporal, occipital, and thalamic areas in individuals with SCZ, and a more widespread decrease in cerebellar FC in individuals with BD-I, involving the frontal, cingulate, parietal, temporal, occipital, and thalamic regions. SCZ had increased within-cerebellum and cerebellar frontal FC compared to BD-I. In BD-I, memory and verbal learning performances, which were higher compared to SCZ, showed a greater interaction with cerebellar FC patterns. Additionally, patterns of increased cortico-cerebellar FC were marginally associated with positive symptoms in patients. CONCLUSIONS Our findings suggest that shared and distinct patterns of cortico-cerebellar dysconnectivity in SCZ and BD-I could underlie cognitive impairments and psychotic symptoms in these disorders.
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Affiliation(s)
- Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Annabella Di Giorgio
- Department of Mental Health and Addictions, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy.
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Diniz JM, Cury RG, Iglesio RF, Lepski GA, França CC, Barbosa ER, de Andrade DC, Teixeira MJ, Duarte KP. Dentate nucleus deep brain stimulation: Technical note of a novel methodology assisted by tractography. Surg Neurol Int 2021; 12:400. [PMID: 34513166 PMCID: PMC8422468 DOI: 10.25259/sni_338_2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/30/2021] [Indexed: 11/04/2022] Open
Abstract
Background The cerebellum has emerged as an attractive and promising target for neuromodulation in movement disorders due to its vast connection with important cortical and subcortical areas. Here, we describe a novel technique of deep brain stimulation (DBS) of the dentate nucleus (DN) aided by tractography. Methods Since 2015, patients with movement disorders including dystonia, ataxia, and tremor have been treated with DN DBS. The cerebellar target was initially localized using coordinates measured from the fastigial point. The target was adjusted with direct visualization of the DN in the susceptibility-weighted imaging and T2 sequences of the MRI and finally refined based on the reconstruction of the dentatorubrothalamic tract (DRTT). Results Three patients were treated with this technique. The final target was located in the anterior portion of DN in close proximity to the DRTT, with the tip of the lead on the white matter and the remaining contacts on the DN. Clinical outcomes were variable and overall positive, with no major side effect. Conclusion Targeting the DN based on tractography of the DRTT seems to be feasible and safe. Larger studies will be necessary to support our preliminary findings.
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Affiliation(s)
- Juliete Melo Diniz
- Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rubens Gisbert Cury
- Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Ricardo Ferrareto Iglesio
- Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Guilherme Alves Lepski
- Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carina Cura França
- Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Egberto Reis Barbosa
- Department of Neurology, Movement Disorders Center, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Manoel Jacobsen Teixeira
- Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Kleber Paiva Duarte
- Department of Neurology, Functional Neurosurgery Division, School of Medicine, University of São Paulo, São Paulo, Brazil
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Nie L, Jiang Y, Lv Z, Pang X, Liang X, Chang W, Li J, Zheng J. Deep Cerebellar Nuclei Functional Connectivity with Cerebral Cortex in Temporal Lobe Epilepsy With and Without Focal to Bilateral Tonic-Clonic Seizures: a Resting-State fMRI Study. THE CEREBELLUM 2021; 21:253-263. [PMID: 34164777 DOI: 10.1007/s12311-021-01266-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 12/19/2022]
Abstract
We aimed to explore the altered functional connectivity patterns within cerebello-cerebral circuits in temporal lobe epilepsy (TLE) patients with and without focal to bilateral tonic-clonic seizures (FBTCS). Forty-two patients with unilateral TLE (21 with and 21 without FBTCS) and 22 healthy controls were recruited. We chose deep cerebellar nuclei as seed regions, calculated static and dynamic functional connectivity (sFC and dFC) in the patients with and without FBTCS and healthy controls, and compared sFC and dFC among the three groups. Correlation analyses were used to assess relationships between the significantly altered imaging features and patient clinical parameters. Compared to the group without FBTCS, the FBTCS group showed decreased sFC between the right dentate nuclei and left hemisphere regions including the middle frontal gyrus, superior temporal gyrus, superior medial frontal gyrus and posterior cingulate gyrus, and significantly increased dFC between the right interposed nuclei and contralateral precuneus. Relative to HCs, the FBTCS group demonstrated prominently decreased sFC between the right dentate nuclei and left middle frontal gyrus. No significant correlations between the altered imaging features and patient clinical parameters were observed. Our results suggest that the disrupted cerebello-cerebral FC might be related to cognitive impairment, epileptogenesis, and propagation of epileptic activities in patients with FBTCS.
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Affiliation(s)
- Liluo Nie
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yanchun Jiang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zongxia Lv
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaomin Pang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiulin Liang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Weiwei Chang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jian Li
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinou Zheng
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.
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Bermudez Noguera C, Bao S, Petersen KJ, Lopez AM, Reid J, Plassard AJ, Zald DH, Claassen DO, Dawant BM, Landman BA. Using deep learning for a diffusion-based segmentation of the dentate nucleus and its benefits over atlas-based methods. J Med Imaging (Bellingham) 2019; 6:044007. [PMID: 31824980 PMCID: PMC6895566 DOI: 10.1117/1.jmi.6.4.044007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/18/2019] [Indexed: 01/17/2023] Open
Abstract
The dentate nucleus (DN) is a gray matter structure deep in the cerebellum involved in motor coordination, sensory input integration, executive planning, language, and visuospatial function. The DN is an emerging biomarker of disease, informing studies that advance pathophysiologic understanding of neurodegenerative and related disorders. The main challenge in defining the DN radiologically is that, like many deep gray matter structures, it has poor contrast in T1-weighted magnetic resonance (MR) images and therefore requires specialized MR acquisitions for visualization. Manual tracing of the DN across multiple acquisitions is resource-intensive and does not scale well to large datasets. We describe a technique that automatically segments the DN using deep learning (DL) on common imaging sequences, such as T1-weighted, T2-weighted, and diffusion MR imaging. We trained a DL algorithm that can automatically delineate the DN and provide an estimate of its volume. The automatic segmentation achieved higher agreement to the manual labels compared to template registration, which is the current common practice in DN segmentation or multiatlas segmentation of manual labels. Across all sequences, the FA maps achieved the highest mean Dice similarity coefficient (DSC) of 0.83 compared to T1 imaging ( DSC = 0.76 ), T2 imaging ( DSC = 0.79 ), or a multisequence approach ( DSC = 0.80 ). A single atlas registration approach using the spatially unbiased atlas template of the cerebellum and brainstem template achieved a DSC of 0.23, and multi-atlas segmentation achieved a DSC of 0.33. Overall, we propose a method of delineating the DN on clinical imaging that can reproduce manual labels with higher accuracy than current atlas-based tools.
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Affiliation(s)
- Camilo Bermudez Noguera
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
| | - Shunxing Bao
- Vanderbilt University, Department of Electrical Engineering and Computer Science, Nashville, Tennessee, United States
| | - Kalen J. Petersen
- Vanderbilt University, Department of Neurology, Nashville, Tennessee, United States
| | - Alexander M. Lopez
- Vanderbilt University, Department of Neurology, Nashville, Tennessee, United States
| | - Jacqueline Reid
- Vanderbilt University, Department of Neurology, Nashville, Tennessee, United States
| | - Andrew J. Plassard
- Vanderbilt University, Department of Electrical Engineering and Computer Science, Nashville, Tennessee, United States
| | - David H. Zald
- Vanderbilt University, Department of Psychology and Psychiatry, Nashville, Tennessee, United States
| | - Daniel O. Claassen
- Vanderbilt University, Department of Neurology, Nashville, Tennessee, United States
| | - Benoit M. Dawant
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
- Vanderbilt University, Department of Electrical Engineering and Computer Science, Nashville, Tennessee, United States
| | - Bennett A. Landman
- Vanderbilt University, Department of Biomedical Engineering, Nashville, Tennessee, United States
- Vanderbilt University, Department of Electrical Engineering and Computer Science, Nashville, Tennessee, United States
- Vanderbilt University, Department of Psychology and Psychiatry, Nashville, Tennessee, United States
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Broersma M, van der Stouwe AMM, Buijink AWG, de Jong BM, Groot PFC, Speelman JD, Tijssen MAJ, van Rootselaar AF, Maurits NM. Bilateral cerebellar activation in unilaterally challenged essential tremor. NEUROIMAGE-CLINICAL 2015; 11:1-9. [PMID: 26909321 PMCID: PMC4732188 DOI: 10.1016/j.nicl.2015.12.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 12/23/2015] [Accepted: 12/24/2015] [Indexed: 01/12/2023]
Abstract
Background Essential tremor (ET) is one of the most common hyperkinetic movement disorders. Previous research into the pathophysiology of ET suggested underlying cerebellar abnormalities. Objective In this study, we added electromyography as an index of tremor intensity to functional Magnetic Resonance Imaging (EMG-fMRI) to study a group of ET patients selected according to strict criteria to achieve maximal homogeneity. With this approach we expected to improve upon the localization of the bilateral cerebellar abnormalities found in earlier fMRI studies. Methods We included 21 propranolol sensitive patients, who were not using other tremor medication, with a definite diagnosis of ET defined by the Tremor Investigation Group. Simultaneous EMG-fMRI recordings were performed while patients were off tremor medication. Patients performed unilateral right hand and arm extension, inducing tremor, alternated with relaxation (rest). Twenty-one healthy, age- and sex-matched participants mimicked tremor during right arm extension. EMG power variability at the individual tremor frequency as a measure of tremor intensity variability was used as a regressor, mathematically independent of the block regressor, in the general linear model used for fMRI analysis, to find specific tremor-related activations. Results Block-related activations were found in the classical upper-limb motor network, both for ET patients and healthy participants in motor, premotor and supplementary motor areas. In ET patients, we found tremor-related activations bilaterally in the cerebellum: in left lobules V, VI, VIIb and IX and in right lobules V, VI, VIIIa and b, and in the brainstem. In healthy controls we found simulated tremor-related activations in right cerebellar lobule V. Conclusions Our results expand on previous findings of bilateral cerebellar involvement in ET. We have identified specific areas in the bilateral somatomotor regions of the cerebellum: lobules V, VI and VIII.
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Affiliation(s)
- Marja Broersma
- Department of Neurology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands; Neuroimaging Center, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands.
| | - Anna M M van der Stouwe
- Department of Neurology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands; Neuroimaging Center, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands.
| | - Arthur W G Buijink
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands.
| | - Bauke M de Jong
- Department of Neurology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands; Neuroimaging Center, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands.
| | - Paul F C Groot
- Brain Imaging Center, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands; Department of Radiology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands.
| | - Johannes D Speelman
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands.
| | - Marina A J Tijssen
- Department of Neurology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands; Neuroimaging Center, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands.
| | - Anne-Fleur van Rootselaar
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands; Brain Imaging Center, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands.
| | - Natasha M Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands; Neuroimaging Center, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB Groningen, the Netherlands.
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Batson MA, Petridou N, Klomp DWJ, Frens MA, Neggers SFW. Single session imaging of cerebellum at 7 Tesla: obtaining structure and function of multiple motor subsystems in individual subjects. PLoS One 2015; 10:e0134933. [PMID: 26259014 PMCID: PMC4530960 DOI: 10.1371/journal.pone.0134933] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 07/15/2015] [Indexed: 12/11/2022] Open
Abstract
The recent increase in the use of high field MR systems is accompanied by a demand for acquisition techniques and coil systems that can take advantage of increased power and accuracy without being susceptible to increased noise. Physical location and anatomical complexity of targeted regions must be considered when attempting to image deeper structures with small nuclei and/or complex cytoarchitechtonics (i.e. small microvasculature and deep nuclei), such as the brainstem and the cerebellum (Cb). Once these obstacles are overcome, the concomitant increase in signal strength at higher field strength should allow for faster acquisition of MR images. Here we show that it is technically feasible to quickly and accurately detect blood oxygen level dependent (BOLD) signal changes and obtain anatomical images of Cb at high spatial resolutions in individual subjects at 7 Tesla in a single one-hour session. Images were obtained using two high-density multi-element surface coils (32 channels in total) placed beneath the head at the level of Cb, two channel transmission, and three-dimensional sensitivity encoded (3D, SENSE) acquisitions to investigate sensorimotor activations in Cb. Two classic sensorimotor tasks were used to detect Cb activations. BOLD signal changes during motor activity resulted in concentrated clusters of activity within the Cb lobules associated with each task, observed consistently and independently in each subject: Oculomotor vermis (VI/VII) and CrusI/II for pro- and anti-saccades; ipsilateral hemispheres IV-VI for finger tapping; and topographical separation of eye- and hand- activations in hemispheres VI and VIIb/VIII. Though fast temporal resolution was not attempted here, these functional patches of highly specific BOLD signal changes may reflect small-scale shunting of blood in the microvasculature of Cb. The observed improvements in acquisition time and signal detection are ideal for individualized investigations such as differentiation of functional zones prior to surgery.
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Affiliation(s)
- Melissa A. Batson
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
- * E-mail:
| | - Natalia Petridou
- Radiology Department, Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Dennis W. J. Klomp
- Radiology Department, Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten A. Frens
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
- Erasmus University College, Rotterdam, The Netherlands
| | - Sebastiaan F. W. Neggers
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
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Abnormal cerebellar functional MRI connectivity in patients with paediatric multiple sclerosis. Mult Scler 2015; 22:292-301. [DOI: 10.1177/1352458515592191] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 05/29/2015] [Indexed: 11/15/2022]
Abstract
Objectives: We investigated resting state functional connectivity (RSFC) of the cerebellar dentate nuclei in paediatric MS patients and its correlations with clinical, neuropsychological and structural MRI measures. Methods: RSFC analysis was performed using a seed-region correlation approach and SPM8 from 48 paediatric MS patients and 27 matched healthy controls. Results: In both groups, dentate nuclei RSFC was significantly correlated with RSFC of several cerebellar and extra-cerebellar brain regions. Compared with healthy controls, paediatric MS patients had reduced RSFC between the right dentate nuclei and the bilateral caudate nuclei and left thalamus as well as increased RSFC between the right dentate nuclei and the left precentral and postcentral gyri. Cognitively impaired patients showed a reduced RSFC between the dentate nuclei and bilateral regions located in the parietal, frontal and temporal lobes. Decreased RSFC was correlated with longer disease duration and higher T2 lesion volumes, whereas increased RSFC correlated with shorter disease duration, lower T2 lesion volume and a better motor performance. Conclusions: Modifications of cerebellar RSFC occur in paediatric MS and are influenced by the duration of the disease and brain focal lesions. Decreased RSFC may reflect early maladaptive plasticity contributing to cognitive impairment.
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Tellmann S, Bludau S, Eickhoff S, Mohlberg H, Minnerop M, Amunts K. Cytoarchitectonic mapping of the human brain cerebellar nuclei in stereotaxic space and delineation of their co-activation patterns. Front Neuroanat 2015; 9:54. [PMID: 26029057 PMCID: PMC4429588 DOI: 10.3389/fnana.2015.00054] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/19/2015] [Indexed: 12/22/2022] Open
Abstract
The cerebellar nuclei are involved in several brain functions, including the modulation of motor and cognitive performance. To differentiate their participation in these functions, and to analyze their changes in neurodegenerative and other diseases as revealed by neuroimaging, stereotaxic maps are necessary. These maps reflect the complex spatial structure of cerebellar nuclei with adequate spatial resolution and detail. Here we report on the cytoarchitecture of the dentate, interposed (emboliform and globose) and fastigial nuclei, and introduce 3D probability maps in stereotaxic MNI-Colin27 space as a prerequisite for subsequent meta-analysis of their functional involvement. Histological sections of 10 human post mortem brains were therefore examined. Differences in cell density were measured and used to distinguish a dorsal from a ventral part of the dentate nucleus. Probabilistic maps were calculated, which indicate the position and extent of the nuclei in 3D-space, while considering their intersubject variability. The maps of the interposed and the dentate nuclei differed with respect to their interaction patterns and functions based on meta-analytic connectivity modeling and quantitative functional decoding, respectively. For the dentate nucleus, significant (p < 0.05) co-activations were observed with thalamus, supplementary motor area (SMA), putamen, BA 44 of Broca's region, areas of superior and inferior parietal cortex, and the superior frontal gyrus (SFG). In contrast, the interposed nucleus showed more limited co-activations with SMA, area 44, putamen, and SFG. Thus, the new stereotaxic maps contribute to analyze structure and function of the cerebellum. These maps can be used for anatomically reliable and precise identification of degenerative alteration in MRI-data of patients who suffer from various cerebellar diseases.
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Affiliation(s)
- Stefanie Tellmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University and JARA-BrainAachen, Germany
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Sebastian Bludau
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Simon Eickhoff
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
- Institute for Clinical Neuroscience and Medical Psychology, Heinrich Heine UniversityDüsseldorf, Germany
| | - Hartmut Mohlberg
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
| | - Katrin Amunts
- Institute of Neuroscience and Medicine (INM-1), Structural and Functional Organization of the Human Brain, Research Centre JülichJülich, Germany
- Cécile and Oskar Vogt Institute of Brain Research, Heinrich Heine UniversityDüsseldorf, Germany
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Solbach K, Kraff O, Minnerop M, Beck A, Schöls L, Gizewski E, Ladd M, Timmann D. Cerebellar pathology in Friedreich's ataxia: atrophied dentate nuclei with normal iron content. Neuroimage Clin 2014; 6:93-9. [PMID: 25379420 PMCID: PMC4215469 DOI: 10.1016/j.nicl.2014.08.018] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 08/06/2014] [Accepted: 08/21/2014] [Indexed: 01/03/2023]
Abstract
BACKGROUND In Friedreich's ataxia (FA) the genetically decreased expression of the mitochondrial protein frataxin leads to disturbance of the mitochondrial iron metabolism. Within the cerebellum the dentate nuclei (DN) are primarily affected. Histopathological studies show atrophy and accumulation of mitochondrial iron in DN. Dentate iron content has been suggested as a biomarker to measure the effects of siderophores/antioxidant treatment of FA. We assessed the iron content and the volume of DN in FA patients and controls based on ultra-high-field MRI (7 Tesla) images. METHODS Fourteen FA patients (mean age 38.1 yrs) and 14 age- and gender-matched controls participated. Multi-echo gradient echo and susceptibility weighted imaging (SWI) sequences were acquired on a 7 T whole-body scanner. For comparison SWI images were acquired on a 1.5 T MR scanner. Volumes of the DN and cerebellum were assessed at 7 and 1.5 T, respectively. Parametric maps of T2 and T2* sequences were created and proton transverse relaxation rates were estimated as a measure of iron content. RESULTS In FA, the DN and the cerebellum were significantly smaller compared to controls. However, proton transverse relaxation rates of the DN were not significantly different between both groups. CONCLUSIONS Applying in vivo MRI methods we could demonstrate significant atrophy of the DN in the presence of normal iron content. The findings suggest that relaxation rates are not reliable biomarkers in clinical trials evaluating the potential effect of FA therapy.
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Affiliation(s)
- K. Solbach
- Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
| | - O. Kraff
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Arendahls Wiese 199, Essen 45141, Germany
| | - M. Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich 52425, Germany
- Department of Neurology, University Hospital Bonn, Sigmund-Freud-straße 25, Bonn 53127, Germany
| | - A. Beck
- Department of Computer Sciences, University of Düsseldorf, Universitätsstraße 1, Düsseldorf 40225, Germany
| | - L. Schöls
- Department of Neurology, Eberhard Karls-University, Geschwister-Scholl-platz, Tübingen, Tübingen 72074, Germany
- Hertie Institute for Clinical Brain Research, Eberhard Karls-University Tübingen, Hoppe-Seyler-straße 3, Tübingen 72076, Germany
- German Research Center for Neurodegenerative Diseases (DZNE), Otfried-Müller-straße 27, Tübingen 72076, Germany
| | - E.R. Gizewski
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
| | - M.E. Ladd
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Arendahls Wiese 199, Essen 45141, Germany
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
| | - D. Timmann
- Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, Essen 45147, Germany
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13
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Mariën P, Ackermann H, Adamaszek M, Barwood CHS, Beaton A, Desmond J, De Witte E, Fawcett AJ, Hertrich I, Küper M, Leggio M, Marvel C, Molinari M, Murdoch BE, Nicolson RI, Schmahmann JD, Stoodley CJ, Thürling M, Timmann D, Wouters E, Ziegler W. Consensus paper: Language and the cerebellum: an ongoing enigma. CEREBELLUM (LONDON, ENGLAND) 2014; 13:386-410. [PMID: 24318484 PMCID: PMC4090012 DOI: 10.1007/s12311-013-0540-5] [Citation(s) in RCA: 208] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In less than three decades, the concept "cerebellar neurocognition" has evolved from a mere afterthought to an entirely new and multifaceted area of neuroscientific research. A close interplay between three main strands of contemporary neuroscience induced a substantial modification of the traditional view of the cerebellum as a mere coordinator of autonomic and somatic motor functions. Indeed, the wealth of current evidence derived from detailed neuroanatomical investigations, functional neuroimaging studies with healthy subjects and patients and in-depth neuropsychological assessment of patients with cerebellar disorders shows that the cerebellum has a cardinal role to play in affective regulation, cognitive processing, and linguistic function. Although considerable progress has been made in models of cerebellar function, controversy remains regarding the exact role of the "linguistic cerebellum" in a broad variety of nonmotor language processes. This consensus paper brings together a range of different viewpoints and opinions regarding the contribution of the cerebellum to language function. Recent developments and insights in the nonmotor modulatory role of the cerebellum in language and some related disorders will be discussed. The role of the cerebellum in speech and language perception, in motor speech planning including apraxia of speech, in verbal working memory, in phonological and semantic verbal fluency, in syntax processing, in the dynamics of language production, in reading and in writing will be addressed. In addition, the functional topography of the linguistic cerebellum and the contribution of the deep nuclei to linguistic function will be briefly discussed. As such, a framework for debate and discussion will be offered in this consensus paper.
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Affiliation(s)
- Peter Mariën
- Department of Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Brussels, Belgium,
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14
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Weier K, Fonov V, Lavoie K, Doyon J, Collins DL. Rapid automatic segmentation of the human cerebellum and its lobules (RASCAL)--implementation and application of the patch-based label-fusion technique with a template library to segment the human cerebellum. Hum Brain Mapp 2014; 35:5026-39. [PMID: 24777876 DOI: 10.1002/hbm.22529] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 03/27/2014] [Accepted: 04/02/2014] [Indexed: 12/20/2022] Open
Abstract
Reliable and fast segmentation of the human cerebellum with its complex architecture of lobes and lobules has been a challenge for the past decades. Emerging knowledge of the functional integration of the cerebellum in various sensori-motor and cognitive-behavioral circuits demands new automatic segmentation techniques, with accuracies similar to manual segmentations, but applicable to large subject numbers in a reasonable time frame. This article presents the development and application of a novel pipeline for rapid automatic segmentation of the human cerebellum and its lobules (RASCAL) combining patch-based label-fusion and a template library of manually labeled cerebella of 16 healthy controls from the International Consortium for Brain Mapping (ICBM) database. Leave-one-out experiments revealed a good agreement between manual and automatic segmentations (Dice kappa = 0.82). Intraclass correlation coefficients (ICC) were calculated to test reliability of segmented volumes and were highest (ICC > 0.9) for global measures (total and hemispherical grey and white matter) followed by larger lobules of the posterior lobe (ICC > 0.8). Further we applied the pipeline to all 152 young healthy controls of the ICBM database to look for hemispheric and gender differences. The results demonstrated larger native space volumes in men then women (mean (± SD) total cerebellar volume in women = 217 cm(3) (± 26), men = 259 cm(3) (± 29); P < 0.001). Significant gender-by-hemisphere interaction was only found in stereotaxic space volumes for white matter core (men > women) and anterior lobe volume (women > men). This new method shows great potential for the precise and efficient analysis of the cerebellum in large patient cohorts.
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Affiliation(s)
- Katrin Weier
- McConnell Brain Imaging Center, Montreal Neurological Hospital and Institute, McGill University, Montreal, Canada; Department Biomedical Engineering, McGill University, Montreal, Canada
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15
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Abstract
Clinicoanatomic correlation in the spinocerebellar ataxias (SCA) and Friedreich's ataxia (FRDA) is difficult as these diseases differentially affect multiple sites in the central and peripheral nervous systems. A new way to study cerebellar ataxia is the systematic analysis of the "reciprocal cerebellar circuitry" that consists of tightly organized reciprocal connections between Purkinje cells, dentate nuclei (DN), and inferior olivary nuclei (ION). This circuitry is similar to but not identical with the "cerebellar module" in experimental animals. Neurohumoral transmitters operating in the circuitry are both inhibitory (γ-aminobutyric acid in corticonuclear and dentato-olivary fibers) and excitatory (glutamate in olivocerebellar or climbing fibers). Glutamatergic climbing fibers also issue collaterals to the DN. The present study applied five immunohistochemical markers in six types of SCA (1, 2, 3, 6, 7, 17), genetically undefined SCA, FRDA, and FRDA carriers to identify interruptions within the circuitry: calbindin-D28k, neuron-specific enolase, glutamic acid decarboxylase, and vesicular glutamate transporters 1 and 2. Lesions of the cerebellar cortex, DN, and ION were scored according to a guide as 0 (normal), 1 (mild), 2 (moderate), and 3 (severe). Results of each of the five immunohistochemical stains were examined separately for each of the three regions. Combining scores of each anatomical region and each stain yielded a total score as an indicator of pathological severity. Total scores ranged from 16 to 38 in SCA-1 (nine cases); 22 to 39 in SCA-2 (six cases); 9 to 15 in SCA-3 (four cases); and 13 and 25 in SCA-6 (two cases). In single cases of SCA-7 and SCA-17, scores were 16 and 31, respectively. In two genetically undefined SCA, scores were 36 and 37, respectively. In nine cases of FRDA, total scores ranged from 11 to 19. The low scores in SCA-3 and FRDA reflect selective atrophy of the DN. The FRDA carriers did not differ from normal controls. These observations offer a semiquantitative assessment of the critical role of the DN in the ataxic phenotype of SCA and FRDA while other parts of the circuitry appear less important.
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16
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A 7T fMRI study of cerebellar activation in sequential finger movement tasks. Exp Brain Res 2013; 228:243-54. [DOI: 10.1007/s00221-013-3558-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 05/02/2013] [Indexed: 11/25/2022]
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17
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Bostan AC, Dum RP, Strick PL. Cerebellar networks with the cerebral cortex and basal ganglia. Trends Cogn Sci 2013; 17:241-54. [PMID: 23579055 PMCID: PMC3645327 DOI: 10.1016/j.tics.2013.03.003] [Citation(s) in RCA: 497] [Impact Index Per Article: 45.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 03/18/2013] [Accepted: 03/18/2013] [Indexed: 01/18/2023]
Abstract
The dominant view of cerebellar function has been that it is exclusively concerned with motor control and coordination. Recent findings from neuroanatomical, behavioral, and imaging studies have profoundly changed this view. Neuroanatomical studies using virus transneuronal tracers have demonstrated that cerebellar output reaches vast areas of the neocortex, including regions of prefrontal and posterior parietal cortex. Furthermore, it has recently become clear that the cerebellum is reciprocally connected with the basal ganglia, which suggests that the two subcortical structures are part of a densely interconnected network. Taken together, these findings elucidate the neuroanatomical substrate for cerebellar involvement in non-motor functions mediated by the prefrontal and posterior parietal cortex, as well as in processes traditionally associated with the basal ganglia.
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Affiliation(s)
- Andreea C. Bostan
- Center for the Neural Basis of Cognition, Systems Neuroscience Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
| | - Richard P. Dum
- Center for the Neural Basis of Cognition, Systems Neuroscience Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
| | - Peter L. Strick
- Pittsburgh Veterans Affairs Medical Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
- Center for the Neural Basis of Cognition, Systems Neuroscience Institute and Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261
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18
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Maderwald S, Thürling M, Küper M, Theysohn N, Müller O, Beck A, Aurich V, Ladd ME, Timmann D. Direct visualization of cerebellar nuclei in patients with focal cerebellar lesions and its application for lesion-symptom mapping. Neuroimage 2012; 63:1421-31. [PMID: 22892334 DOI: 10.1016/j.neuroimage.2012.07.063] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 07/30/2012] [Accepted: 07/31/2012] [Indexed: 02/07/2023] Open
Abstract
As yet, human cerebellar lesion studies have not taken advantage of direct magnetic resonance imaging (MRI) of the cerebellar nuclei in individual patients. In the present study, susceptibility weighted imaging (SWI) was used to visualize lesions of the dentate nuclei in patients with chronic focal lesions. Fifteen patients with cerebellar lesions either due to stroke or tumor surgery underwent SWI imaging using a 1.5T MRI scanner. Dentate nuclei were seen as hypointensities in all patients. Three of the patients underwent additional SWI imaging at 3T and 7T. Compared to 1.5T, corrugation of the dentate wall was seen with greater precision and the dorsal, iron-poorer part was seen more fully. Lesion-symptom mapping was performed based on the 1.5T MR images. Patients were divided into two groups with and without upper limb ataxia. A region-of-interest-(ROI)-driven normalization technique was used which had initially been developed by Diedrichsen et al. (2011) for functional MRI (fMRI) of the dentate nuclei. Compared to conventional normalization of the cerebellum, overlap of dentate lesions improved and lead to increased sensitivity of lesion-symptom maps. Subtraction analysis revealed that the more dorsal and rostral parts of the dentate nuclei were related to upper limb ataxia. Findings were in good accordance with the dentate hand area shown in recent fMRI studies. These data provide evidence that direct identification of dentate lesions together with the ROI-driven normalization technique allows for improved lesion-symptom mapping at the level of the cerebellar nuclei already at conventional 1.5T MRI field strength.
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Affiliation(s)
- S Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, Germany
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19
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Moser E, Stahlberg F, Ladd ME, Trattnig S. 7-T MR--from research to clinical applications? NMR IN BIOMEDICINE 2012; 25:695-716. [PMID: 22102481 DOI: 10.1002/nbm.1794] [Citation(s) in RCA: 143] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 08/25/2011] [Accepted: 08/31/2011] [Indexed: 05/31/2023]
Abstract
Over 20,000 MR systems are currently installed worldwide and, although the majority operate at magnetic fields of 1.5 T and below (i.e. about 70%), experience with 3-T (in high-field clinical diagnostic imaging and research) and 7-T (research only) human MR scanners points to a future in functional and metabolic MR diagnostics. Complementary to previous studies, this review attempts to provide an overview of ultrahigh-field MR research with special emphasis on emerging clinical applications at 7 T. We provide a short summary of the technical development and the current status of installed MR systems. The advantages and challenges of ultrahigh-field MRI and MRS are discussed with special emphasis on radiofrequency inhomogeneity, relaxation times, signal-to-noise improvements, susceptibility effects, chemical shifts, specific absorption rate and other safety issues. In terms of applications, we focus on the topics most likely to gain significantly from 7-T MR, i.e. brain imaging and spectroscopy and musculoskeletal imaging, but also body imaging, which is particularly challenging. Examples are given to demonstrate the advantages of susceptibility-weighted imaging, time-of-flight MR angiography, high-resolution functional MRI, (1)H and (31)P MRSI in the human brain, sodium and functional imaging of cartilage and the first results (and artefacts) using an eight-channel body array, suggesting future areas of research that should be intensified in order to fully explore the potential of 7-T MR systems for use in clinical diagnosis.
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Affiliation(s)
- Ewald Moser
- Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
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20
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Habas C. Functional Imaging and the Cerebellum: Recent Developments and Challenges. Editorial. THE CEREBELLUM 2012; 11:311-3. [DOI: 10.1007/s12311-012-0375-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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