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Kokkinos V, Chatzisotiriou A, Seimenis I. Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging-Tractography in Resective Brain Surgery: Lesion Coverage Strategies and Patient Outcomes. Brain Sci 2023; 13:1574. [PMID: 38002534 PMCID: PMC10670090 DOI: 10.3390/brainsci13111574] [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: 09/26/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Diffusion tensor imaging (DTI)-tractography and functional magnetic resonance imaging (fMRI) have dynamically entered the presurgical evaluation context of brain surgery during the past decades, providing novel perspectives in surgical planning and lesion access approaches. However, their application in the presurgical setting requires significant time and effort and increased costs, thereby raising questions regarding efficiency and best use. In this work, we set out to evaluate DTI-tractography and combined fMRI/DTI-tractography during intra-operative neuronavigation in resective brain surgery using lesion-related preoperative neurological deficit (PND) outcomes as metrics. We retrospectively reviewed medical records of 252 consecutive patients admitted for brain surgery. Standard anatomical neuroimaging protocols were performed in 127 patients, 69 patients had additional DTI-tractography, and 56 had combined DTI-tractography/fMRI. fMRI procedures involved language, motor, somatic sensory, sensorimotor and visual mapping. DTI-tractography involved fiber tracking of the motor, sensory, language and visual pathways. At 1 month postoperatively, DTI-tractography patients were more likely to present either improvement or preservation of PNDs (p = 0.004 and p = 0.007, respectively). At 6 months, combined DTI-tractography/fMRI patients were more likely to experience complete PND resolution (p < 0.001). Low-grade lesion patients (N = 102) with combined DTI-tractography/fMRI were more likely to experience complete resolution of PNDs at 1 and 6 months (p = 0.001 and p < 0.001, respectively). High-grade lesion patients (N = 140) with combined DTI-tractography/fMRI were more likely to have PNDs resolved at 6 months (p = 0.005). Patients with motor symptoms (N = 80) were more likely to experience complete remission of PNDs at 6 months with DTI-tractography or combined DTI-tractography/fMRI (p = 0.008 and p = 0.004, respectively), without significant difference between the two imaging protocols (p = 1). Patients with sensory symptoms (N = 44) were more likely to experience complete PND remission at 6 months with combined DTI-tractography/fMRI (p = 0.004). The intraoperative neuroimaging modality did not have a significant effect in patients with preoperative seizures (N = 47). Lack of PND worsening was observed at 6 month follow-up in patients with combined DTI-tractography/fMRI. Our results strongly support the combined use of DTI-tractography and fMRI in patients undergoing resective brain surgery for improving their postoperative clinical profile.
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Affiliation(s)
- Vasileios Kokkinos
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02215, USA
| | | | - Ioannis Seimenis
- Department of Medicine, School of Health Sciences, Democritus University of Thrace, 387479 Alexandroupolis, Greece;
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Yearley AG, Goedmakers CMW, Panahi A, Doucette J, Rana A, Ranganathan K, Smith TR. FDA-approved machine learning algorithms in neuroradiology: A systematic review of the current evidence for approval. Artif Intell Med 2023; 143:102607. [PMID: 37673576 DOI: 10.1016/j.artmed.2023.102607] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 09/08/2023]
Abstract
Over the past decade, machine learning (ML) and artificial intelligence (AI) have become increasingly prevalent in the medical field. In the United States, the Food and Drug Administration (FDA) is responsible for regulating AI algorithms as "medical devices" to ensure patient safety. However, recent work has shown that the FDA approval process may be deficient. In this study, we evaluate the evidence supporting FDA-approved neuroalgorithms, the subset of machine learning algorithms with applications in the central nervous system (CNS), through a systematic review of the primary literature. Articles covering the 53 FDA-approved algorithms with applications in the CNS published in PubMed, EMBASE, Google Scholar and Scopus between database inception and January 25, 2022 were queried. Initial searches identified 1505 studies, of which 92 articles met the criteria for extraction and inclusion. Studies were identified for 26 of the 53 neuroalgorithms, of which 10 algorithms had only a single peer-reviewed publication. Performance metrics were available for 15 algorithms, external validation studies were available for 24 algorithms, and studies exploring the use of algorithms in clinical practice were available for 7 algorithms. Papers studying the clinical utility of these algorithms focused on three domains: workflow efficiency, cost savings, and clinical outcomes. Our analysis suggests that there is a meaningful gap between the FDA approval of machine learning algorithms and their clinical utilization. There appears to be room for process improvement by implementation of the following recommendations: the provision of compelling evidence that algorithms perform as intended, mandating minimum sample sizes, reporting of a predefined set of performance metrics for all algorithms and clinical application of algorithms prior to widespread use. This work will serve as a baseline for future research into the ideal regulatory framework for AI applications worldwide.
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Affiliation(s)
- Alexander G Yearley
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA.
| | - Caroline M W Goedmakers
- Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA; Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Netherlands
| | - Armon Panahi
- The George Washington University School of Medicine and Health Sciences, 2300 I St NW, Washington, DC 20052, USA
| | - Joanne Doucette
- Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA; School of Pharmacy, MCPHS University, 179 Longwood Ave, Boston, MA 02115, USA
| | - Aakanksha Rana
- Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA; Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139, USA
| | - Kavitha Ranganathan
- Division of Plastic Surgery, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115, USA
| | - Timothy R Smith
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Computational Neuroscience Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
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Gimenez U, Deloulme JC, Lahrech H. Rapid microscopic 3D-diffusion tensor imaging fiber-tracking of mouse brain in vivo by super resolution reconstruction: validation on MAP6-KO mouse model. MAGMA (NEW YORK, N.Y.) 2023; 36:577-587. [PMID: 36695926 DOI: 10.1007/s10334-023-01061-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 12/10/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023]
Abstract
OBJECT Exploring mouse brains by rapid 3D-Diffusion Tensor Imaging (3D-DTI) of high spatial resolution (HSR) is challenging in vivo. Here we use the super resolution reconstruction (SRR) postprocessing method to demonstrate its performance on Microtubule-Associated-Protein6 Knock-Out (MAP6-KO) mice. MATERIALS AND METHODS Two spin-echo DTI were acquired (9.4T, CryoProbe RF-coil): (i)-multislice 2D-DTI, (echo-planar integrating reversed-gradient) acquired in vivo in the three orthogonal orientations (360 μm slice-thickness, 120 × 120 μm in-plane resolution, 56 min scan duration); used in SRR software to reconstruct SRR 3D-DTI with HSR in slice-plane (120 × 120 × 120 µm) and (ii)-microscopic 3D-DTI (µ-3D-DTI), (100 × 100 × 100 µm; 8 h 6 min) on fixed-brains ex vivo, that were removed after paramagnetic contrast-agent injection to accelerate scan acquisition using short repetition-times without NMR-signal sensitivity loss. RESULTS White-matter defects, quantified from both 3D-DTI fiber-tracking were found very similar. Indeed, as expected the fornix and cerebral-peduncle volume losses were - 39% and - 35% in vivo (SRR 3D-DTI) versus - 34% and - 32% ex vivo (µ-3D-DTI), respectively (p<0.001). This finding is robust since the µ-3D-DTI feasibility on MAP6-KO ex vivo was already validated by fluorescent-microscopy of cleared brains. DISCUSSION First performance of the SRR to generate rapid HSR 3D-DTI of mouse brains in vivo is demonstrated. The method is suitable in neurosciences for longitudinal studies to identify molecular and genetic abnormalities in mouse models that are of growing developments.
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Affiliation(s)
- Ulysse Gimenez
- University. Grenoble Alpes, Inserm, U1205, BrainTech Lab, 1, place Commandant Nal, 38700, La Tronche, Grenoble, France
- , BioSerenity company 20 Rue Berbier de Mets, 75013, Paris, France
| | - Jean Christophe Deloulme
- University. Grenoble Alpes, Inserm, U1216, CEA, Grenoble Institut Neurosciences, 31, chemin Fortuné Ferrini, 38700, La Tronche, Grenoble, France
| | - Hana Lahrech
- University. Grenoble Alpes, Inserm, U1205, BrainTech Lab, 1, place Commandant Nal, 38700, La Tronche, Grenoble, France.
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Cunnane B, Sinha U, Malis V, Hernandez R, Smitaman E, Sinha S. MRI Based Fiber Strain Mapping of the Medial Gastrocnemius Muscle at Submaximal Isometric Contractions at Different Ankle Angles. RESEARCH SQUARE 2023:rs.3.rs-2548171. [PMID: 36798385 PMCID: PMC9934733 DOI: 10.21203/rs.3.rs-2548171/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Muscle force production is influenced by muscle fiber and aponeurosis architecture. This prospective cohort study utilizes special MR imaging sequences to examine the structure-function in-vivo in the Medial Gastrocnemius (MG) at three-ankle angles (dorsiflexion, neutral, and plantar flexion) and two sub-maximal levels of maximum voluntary contraction (25% and 50% MVC). The study was performed on 6 young male subjects. Muscle fiber and aponeurosis strain, fiber strain normalized to force, fiber length and pennation angle (at rest and peak contraction) were analyzed for statistical differences between ankle positions and %MVC. A two-way repeated measures ANOVA and post hoc Bonferroni-adjusted tests were conducted for normal data. A related samples test with Friedman's 2-way ANOVA by ranks with corrections for multiple comparisons was conducted for non-normal data. The dorsiflexed ankle position generated significantly higher force with lower fiber strain than neutral and plantarflexed positions. Sarcomere length extracted from muscle fiber length at each ankle angle was used to track the location on the Force-Length curve and showed the MG operates on the curve's ascending limb. Muscle force changes predicted from the F-L curve going from dorsi- to plantarflexion was less than that experimentally observed suggesting other determinants of force changes with ankle position.
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Kender Z, Jende JME, Kurz FT, Tsilingiris D, Schimpfle L, Sulaj A, von Rauchhaupt E, Bartl H, Mooshage C, Göpfert J, Nawroth P, Herzig S, Szendroedi J, Bendszus M, Kopf S. Sciatic nerve fractional anisotropy and neurofilament light chain protein are related to sensorimotor deficit of the upper and lower limbs in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1046690. [PMID: 37008917 PMCID: PMC10053786 DOI: 10.3389/fendo.2023.1046690] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/06/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Diabetic sensorimotor polyneuropathy (DSPN) is one of the most prevalent and poorly understood diabetic microvascular complications. Recent studies have found that fractional anisotropy (FA), a marker for microstructural nerve integrity, is a sensitive parameter for the structural and functional nerve damage in DSPN. The aim of this study was to investigate the significance of proximal sciatic nerve's FA on different distal nerve fiber deficits of the upper and lower limbs and its correlation with the neuroaxonal biomarker, neurofilament light chain protein (NfL). MATERIALS AND METHODS Sixty-nine patients with type 2 diabetes (T2DM) and 30 healthy controls underwent detailed clinical and electrophysiological assessments, complete quantitative sensory testing (QST), and diffusion-weighted magnetic resonance neurography of the sciatic nerve. NfL was measured in the serum of healthy controls and patients with T2DM. Multivariate models were used to adjust for confounders of microvascular damage. RESULTS Patients with DSPN showed a 17% lower sciatic microstructural integrity compared to healthy controls (p<0.001). FA correlated with tibial and peroneal motor nerve conduction velocity (NCV) (r=0.6; p<0.001 and r=0.6; p<0.001) and sural sensory NCV (r=0.50; p<0.001). Participants with reduced sciatic nerve´s FA showed a loss of function of mechanical and thermal sensation of upper (r=0.3; p<0.01 and r=0.3; p<0.01) and lower (r=0.5; p<0.001 and r=0.3; p=<0.01) limbs and reduced functional performance of upper limbs (Purdue Pegboard Test for dominant hand; r=0.4; p<0.001). Increased levels of NfL and urinary albumin-creatinine ratio (ACR) were associated with loss of sciatic nerve´s FA (r=-0.5; p<0.001 and r= -0.3, p= 0.001). Of note, there was no correlation between sciatic FA and neuropathic symptoms or pain. CONCLUSION This is the first study showing that microstructural nerve integrity is associated with damage of different nerve fiber types and a neuroaxonal biomarker in DSPN. Furthermore, these findings show that proximal nerve damage is related to distal nerve function even before clinical symptoms occur. The microstructure of the proximal sciatic nerve and is also associated with functional nerve fiber deficits of the upper and lower limbs, suggesting that diabetic neuropathy involves structural changes of peripheral nerves of upper limbs too.
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Affiliation(s)
- Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
- *Correspondence: Zoltan Kender,
| | - Johann M. E. Jende
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T. Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Dimitrios Tsilingiris
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
| | - Lukas Schimpfle
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Alba Sulaj
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
| | - Ekaterina von Rauchhaupt
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
| | - Hannelore Bartl
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Mooshage
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jens Göpfert
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Peter Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
- Joint-IDC Institute for Diabetes and Cancer, Heidelberg University, Heidelberg, Germany
| | - Stephan Herzig
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
- Joint-IDC Institute for Diabetes and Cancer, Heidelberg University, Heidelberg, Germany
- Joint-IDC Institute for Diabetes and Cancer, Helmholtz-Zentrum Munich, Munich, Germany
| | - Julia Szendroedi
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
- Joint-IDC Institute for Diabetes and Cancer, Heidelberg University, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research [Deutsches Zentrum für Diabetesforschung (DZD)], München, Germany
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Christidi F, Tsiptsios D, Fotiadou A, Kitmeridou S, Karatzetzou S, Tsamakis K, Sousanidou A, Psatha EA, Karavasilis E, Seimenis I, Kokkotis C, Aggelousis N, Vadikolias K. Diffusion Tensor Imaging as a Prognostic Tool for Recovery in Acute and Hyperacute Stroke. Neurol Int 2022; 14:841-874. [PMID: 36278693 PMCID: PMC9589952 DOI: 10.3390/neurolint14040069] [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: 09/17/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 11/16/2022] Open
Abstract
Stroke represents a major cause of mortality and long-term disability among adult populations, leaving a devastating socioeconomic impact globally. Clinical manifestation of stroke is characterized by great diversity, ranging from minor disability to considerable neurological impairment interfering with activities of daily living and even death. Prognostic ambiguity has stimulated the interest for implementing stroke recovery biomarkers, including those provided by structural neuroimaging techniques, i.e., diffusion tensor imaging (DTI) and tractography for the study of white matter (WM) integrity. Considering the necessity of prompt and accurate prognosis in stroke survivors along with the potential capacity of DTI as a relevant imaging biomarker, the purpose of our study was to review the pertinent literature published within the last decade regarding DTI as a prognostic tool for recovery in acute and hyperacute stroke. We conducted a thorough literature search in two databases (MEDLINE and Science Direct) in order to trace all relevant studies published between 1 January 2012 and 16 March 2022 using predefined terms as key words. Only full-text human studies published in the English language were included. Forty-four studies were identified and are included in this review. We present main findings and by describing several methodological issues, we highlight shortcomings and gaps in the current literature so that research priorities for future research can be outlined. Our review suggests that DTI can track longitudinal changes and identify prognostic correlates in acute and hyperacute stroke patients.
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Affiliation(s)
- Foteini Christidi
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Dimitrios Tsiptsios
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Aggeliki Fotiadou
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Sofia Kitmeridou
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Stella Karatzetzou
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Konstantinos Tsamakis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AB, UK
| | - Anastasia Sousanidou
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Evlampia A. Psatha
- Department of Radiology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | | | - Ioannis Seimenis
- Medical Physics Laboratory, School of Medicine, National and Kapodistrian University, 11527 Athens, Greece
| | - Christos Kokkotis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece
| | - Nikolaos Aggelousis
- Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece
| | - Konstantinos Vadikolias
- Neurology Department, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
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Safri AA, Nassir CMNCM, Iman IN, Mohd Taib NH, Achuthan A, Mustapha M. Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects. World J Clin Cases 2022; 10:8450-8462. [PMID: 36157806 PMCID: PMC9453345 DOI: 10.12998/wjcc.v10.i24.8450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/20/2022] [Accepted: 07/17/2022] [Indexed: 02/05/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is a leading cause of age-related microvascular cognitive decline, resulting in significant morbidity and decreased quality of life. Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging (MRI), key questions on CSVD remain elusive. Enhanced relationships and reliable lesion studies, such as white matter tractography using diffusion-based MRI (dMRI) are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD. Diffusion tensor imaging (DTI) and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage. However, due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting, interpreting the findings remain contentious, especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use. In this minireview, we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD, even for subclinical CSVD in at-risk individuals.
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Affiliation(s)
- Amanina Ahmad Safri
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Che Mohd Nasril Che Mohd Nassir
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ismail Nurul Iman
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Nur Hartini Mohd Taib
- Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
| | - Anusha Achuthan
- School of Computer Sciences, Universiti Sains Malaysia, 11800 USM, Penang, Malaysia
| | - Muzaimi Mustapha
- Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Yoon K, Archer DB, Clarke MA, Smith SA, Oguz I, Cutter G, Xu J, Bagnato F. Transcallosal and Corticospinal White Matter Disease and Its Association With Motor Impairment in Multiple Sclerosis. Front Neurol 2022; 13:811315. [PMID: 35785345 PMCID: PMC9240189 DOI: 10.3389/fneur.2022.811315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/19/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose In this cross-sectional, proof-of-concept study, we propose that using the more pathologically-specific neurite orientation dispersion and density imaging (NODDI) method, in conjunction with high-resolution probabilistic tractography, white matter tract templates can improve the assessment of regional axonal injury and its association with disability of people with multiple sclerosis (pwMS). Methods Parametric maps of the neurite density index, orientation dispersion index, and the apparent isotropic volume fraction (IVF) were estimated in 18 pwMS and nine matched healthy controls (HCs). Tract-specific values were measured in transcallosal (TC) fibers from the paracentral lobules and TC and corticospinal fibers from the ventral and dorsal premotor areas, presupplementary and supplementary motor areas, and primary motor cortex. The nonparametric Mann–Whitney U test assessed group differences in the NODDI-derived metrics; the Spearman's rank correlation analyses measured associations between the NODDI metrics and other clinical or radiological variables. Results IVF values of the TC fiber bundles from the paracentral, presupplementary, and supplementary motor areas were both higher in pwMS than in HCs (p ≤ 0.045) and in pwMS with motor disability compared to those without motor disability (p ≤ 0.049). IVF in several TC tracts was associated with the Expanded Disability Status Scale score (p ≤ 0.047), while regional and overall lesion burden correlated with the Timed 25-Foot Walking Test (p ≤ 0.049). Conclusion IVF alterations are present in pwMS even when the other NODDI metrics are still mostly preserved. Changes in IVF are biologically non-specific and may not necessarily drive irreversible functional loss. However, by possibly preceding downstream pathologies that are strongly associated with disability accretion, IVF changes are indicators of, otherwise, occult prelesional tissue injury.
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Affiliation(s)
- Keejin Yoon
- Neuroimaging Unit, Division of Neuroimmunology, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
- College of Arts and Sciences, Vanderbilt University, Nashville, TN, United States
| | - Derek B. Archer
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, United States
- Vanderbilt University School of Medicine, Vanderbilt Genetics Institute, Nashville, TN, United States
| | - Margareta A. Clarke
- Neuroimaging Unit, Division of Neuroimmunology, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Seth A. Smith
- Department of Radiology and Radiological Sciences, Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ipek Oguz
- Department of Science, Vanderbilt University, Nashville, TN, United States
| | - Gary Cutter
- Department of Biostatistics, School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Junzhong Xu
- Department of Radiology and Radiological Sciences, Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Francesca Bagnato
- Neuroimaging Unit, Division of Neuroimmunology, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Neurology, VA Medical Center, TN Valley Healthcare System, Nashville, TN, United States
- *Correspondence: Francesca Bagnato
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De Stefano N, Battaglini M, Pareto D, Cortese R, Zhang J, Oesingmann N, Prados F, Rocca MA, Valsasina P, Vrenken H, Gandini Wheeler-Kingshott CAM, Filippi M, Barkhof F, Rovira À. MAGNIMS recommendations for harmonization of MRI data in MS multicenter studies. Neuroimage Clin 2022; 34:102972. [PMID: 35245791 PMCID: PMC8892169 DOI: 10.1016/j.nicl.2022.102972] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/24/2022]
Abstract
Sharing data from cooperative studies is essential to develop new biomarkers in MS. Differences in MRI acquisition, analysis, storage represent a substantial constraint. We review the state of the art and developments in the harmonization of MRI. We provide recommendations to harmonize large MRI datasets in the MS field.
There is an increasing need of sharing harmonized data from large, cooperative studies as this is essential to develop new diagnostic and prognostic biomarkers. In the field of multiple sclerosis (MS), the issue has become of paramount importance due to the need to translate into the clinical setting some of the most recent MRI achievements. However, differences in MRI acquisition parameters, image analysis and data storage across sites, with their potential bias, represent a substantial constraint. This review focuses on the state of the art, recent technical advances, and desirable future developments of the harmonization of acquisition, analysis and storage of large-scale multicentre MRI data of MS cohorts. Huge efforts are currently being made to achieve all the requirements needed to provide harmonized MRI datasets in the MS field, as proper management of large imaging datasets is one of our greatest opportunities and challenges in the coming years. Recommendations based on these achievements will be provided here. Despite the advances that have been made, the complexity of these tasks requires further research by specialized academical centres, with dedicated technical and human resources. Such collective efforts involving different professional figures are of crucial importance to offer to MS patients a personalised management while minimizing consumption of resources.
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Affiliation(s)
- Nicola De Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
| | - Marco Battaglini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Deborah Pareto
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosa Cortese
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Jian Zhang
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | - Ferran Prados
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Center for Medical Imaging Computing, Medical Physics and Biomedical Engineering, UCL, London, WC1V 6LJ, United Kingdom; e-Health Center, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Maria A Rocca
- Neuroimaging Research Unit, Division of Neuroscience, and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Valsasina
- Neuroimaging Research Unit, Division of Neuroscience, and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Hugo Vrenken
- Amsterdam Neuroscience, MS Center Amsterdam, Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Claudia A M Gandini Wheeler-Kingshott
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Brain MRI 3T Research Center, C. Mondino National Neurological Institute, Pavia, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy; Neurorehabilitation Unit, and Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy; Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Frederik Barkhof
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Center for Medical Imaging Computing, Medical Physics and Biomedical Engineering, UCL, London, WC1V 6LJ, United Kingdom; Amsterdam Neuroscience, MS Center Amsterdam, Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam, Netherlands
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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10
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Kok CY, Lock C, Ang TY, Keong NC. Modeling the Properties of White Matter Tracts Using Diffusion Tensor Imaging to Characterize Patterns of Injury in Aging and Neurodegenerative Disease. Front Aging Neurosci 2022; 14:787516. [PMID: 35572145 PMCID: PMC9093601 DOI: 10.3389/fnagi.2022.787516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/15/2022] [Indexed: 11/13/2022] Open
Abstract
Diffusion tensor imaging (DTI) is a relatively novel magnetic resonance-based imaging methodology that can provide valuable insight into the microstructure of white matter tracts of the brain. In this paper, we evaluated the reliability and reproducibility of deriving a semi-automated pseudo-atlas DTI tractography method vs. standard atlas-based analysis alternatives, for use in clinical cohorts with neurodegeneration and ventriculomegaly. We showed that the semi-automated pseudo-atlas DTI tractography method was reliable and reproducible across different cohorts, generating 97.7% of all tracts. However, DTI metrics obtained from both methods were significantly different across the majority of cohorts and white matter tracts (p < 0.001). Despite this, we showed that both methods produced patterns of white matter injury that are consistent with findings reported in the literature and with DTI profiles generated from these methodologies. Scatter plots comparing DTI metrics obtained from each methodology showed that the pseudo-atlas method produced metrics that implied a more preserved neural structure compared to its counterpart. When comparing DTI metrics against a measure of ventriculomegaly (i.e., Evans’ Index), we showed that the standard atlas-based method was able to detect decreasing white matter integrity with increasing ventriculomegaly, while in contrast, metrics obtained using the pseudo-atlas method were sensitive for stretch or compression in the posterior limb of the internal capsule. Additionally, both methods were able to show an increase in white matter disruption with increasing ventriculomegaly, with the pseudo-atlas method showing less variability and more specificity to changes in white matter tracts near to the ventricles. In this study, we found that there was no true gold-standard for DTI methodologies or atlases. Whilst there was no congruence between absolute values from DTI metrics, differing DTI methodologies were still valid but must be appreciated to be variably sensitive to different changes within white matter injury occurring concurrently. By combining both atlas and pseudo-atlas based methodologies with DTI profiles, it was possible to navigate past such challenges to describe white matter injury changes in the context of confounders, such as neurodegenerative disease and ventricular enlargement, with transparency and consistency.
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Affiliation(s)
- Chun Yen Kok
- Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
| | - Christine Lock
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Ting Yao Ang
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Nicole C Keong
- Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
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11
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Jende JME, Mooshage C, Kender Z, Kopf S, Groener JB, Heiland S, Juerchott A, Nawroth P, Bendszus M, Kurz FT. Magnetic Resonance Neurography Reveals Smoking-Associated Decrease in Sciatic Nerve Structural Integrity in Type 2 Diabetes. Front Neurosci 2022; 15:811085. [PMID: 35242003 PMCID: PMC8886720 DOI: 10.3389/fnins.2021.811085] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
Objective It is controversially discussed in how far smoking contributes to diabetic polyneuropathy (DPN) in type 2 diabetes (T2D). Diffusion-weighted magnetic resonance neurography (MRN) at 3 Tesla has been shown to provide objective values for structural nerve integrity in patients with T2D. The aim of this study was to investigate the contribution of cigarette smoking on structural nerve integrity in T2D. Methods This cross-sectional prospective cohort study investigated the structural integrity of the sciatic nerve in 10 smokers, 40 never-smokers, and 20 ex-smokers with T2D and 10 healthy control subjects, using diffusion tensor imaging MRN at 3 Tesla and semi-automated nerve fiber tracking. Results were correlated with clinical, electrophysiological, and serological data. Results The sciatic nerve’s fractional anisotropy (FA), a parameter for structural nerve integrity, was significantly lower in smokers with T2D when compared to controls (p = 0.002) and never-smokers (p = 0.015), and lower in ex-smokers when compared to controls (p = 0.015). In addition, sciatic nerve radial diffusivity, a marker of myelin damage, was increased in smokers versus controls and never-smokers (p = 0.048, p = 0.049, respectively). Furthermore, FA in T2D patients was negatively correlated with clinical and electrophysiological markers of DPN. FA also showed negative correlations with the pulse wave velocity, a marker of arterial stiffness and associated microangiopathy, in controls (r = −0.70; p = 0.037), never-smokers (r = −0.45; p = 0.004), ex-smokers (r = −0.55; p = 0.009), and a similar trend in smokers (r = −0.63; p = 0.076). Negative correlations were found between FA and skin auto-fluorescence, a marker of tissue advanced glycation end product accumulation and therefore long-term glycemic stress in T2D, in never-smokers (r = −0.39; p = 0.020) and smokers (r = −0.84; p = 0.004), but not in ex-smokers (r = −0.07; p = 0.765). Conclusion The findings indicate that smoking contributes to sciatic nerve damage in T2D, potentially worsening DPN due to glycemic stress and less microangiopathy-associated myelin damage in active smokers, while angiopathic effects predominate in ex-smokers. To stop smoking may therefore pose a promising preventive measure to slow the progression of DPN in T2D.
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Affiliation(s)
- Johann M E Jende
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Mooshage
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research, München-Neuherberg, Germany
| | - Jan B Groener
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research, München-Neuherberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.,Division of Experimental Radiology, Department of Neuroradiology, Heidelberg, Germany
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research, München-Neuherberg, Germany.,Joint Institute for Diabetes and Cancer at Helmholtz-Zentrum Munich and Heidelberg University, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix T Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Radiology (E010), German Cancer Research Center, Heidelberg, Germany
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12
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Germann J, Elias GJB, Neudorfer C, Boutet A, Chow CT, Wong EHY, Parmar R, Gouveia FV, Loh A, Giacobbe P, Kim SJ, Jung HH, Bhat V, Kucharczyk W, Chang JW, Lozano AM. Potential optimization of focused ultrasound capsulotomy for obsessive compulsive disorder. Brain 2021; 144:3529-3540. [PMID: 34145884 DOI: 10.1093/brain/awab232] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/19/2021] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
Obsessive-compulsive disorder is a debilitating and often refractory psychiatric disorder. Magnetic resonance-guided focused ultrasound is a novel, minimally invasive neuromodulatory technique that has shown promise in treating this condition. We investigated the relationship between lesion location and long-term outcome in obsessive-compulsive disorder patients treated with focused ultrasound to discern the optimal lesion location and elucidate the efficacious network underlying symptom alleviation. Postoperative images of eleven patients who underwent focused ultrasound capsulotomy were used to correlate lesion characteristics with symptom improvement at one year follow-up. Normative resting-state functional MRI and normative diffusion MRI-based tractography analyses were used to determine the networks associated with successful lesions. Obsessive-compulsive disorder patients treated with inferior thalamic peduncle deep brain stimulation (n = 5) and lesions from the literature implicated in obsessive-compulsive disorder (n = 18) were used for external validation. Successful long-term relief of obsessive-compulsive disorder was associated with lesions that included a specific area in the dorsal anterior limb of the internal capsule. Normative resting-state functional MRI analysis showed that lesion engagement of areas 24 and 46 was significantly associated with clinical outcomes (R = 0.79, p = 0.004). The key role of areas 24 and 46 was confirmed by (1) normative diffusion MRI-based tractography analysis showing that streamlines associated with better outcome projected to these areas, (2) association of these areas with inferior thalamic peduncle deep brain stimulation patients' outcome (R = 0.83, p = 0.003); (3) the connectedness of these areas to obsessive-compulsive disorder-causing lesions, as identified using literature-based lesion network mapping. These results provide considerations for target improvement, outlining the specific area of the internal capsule critical for successful magnetic resonance-guided focused ultrasound outcome and demonstrating that discrete frontal areas are involved in symptom relief. This could help refine focused ultrasound treatment for obsessive-compulsive disorder and provide a network-based rationale for potential alternative targets.
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Affiliation(s)
- Jürgen Germann
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Gavin J B Elias
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Clemens Neudorfer
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Alexandre Boutet
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada.,Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Clement T Chow
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Emily H Y Wong
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Roohie Parmar
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Flavia Venetucci Gouveia
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Aaron Loh
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
| | - Peter Giacobbe
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Se Joo Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Ho Jung
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Venkat Bhat
- Centre for Mental Health and Krembil Research Centre, University Health Network, Toronto, Canada
| | - Walter Kucharczyk
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada.,Joint Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Jin Woo Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Andres M Lozano
- Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, Canada
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13
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Papadopoulou M, Karavasilis E, Christidi F, Argyropoulos GD, Skitsa I, Makrydakis G, Efstathopoulos E, Zambelis T, Karandreas N. Multimodal Neurophysiological and Neuroimaging Evidence of Genetic Influence on Motor Control: A Case Report of Monozygotic Twins. Cogn Behav Neurol 2021; 34:53-62. [PMID: 33652469 DOI: 10.1097/wnn.0000000000000262] [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: 02/26/2020] [Accepted: 07/06/2020] [Indexed: 11/26/2022]
Abstract
Considering genetic influence on brain structure and function, including motor control, we report a case of right-handed monozygotic twins with atypical organization of fine motor movement control that might imply genetic influence. Structural and functional organization of the twins' motor function was assessed using transcranial magnetic stimulation (TMS), fMRI with a motor-task paradigm, and diffusion tensor imaging (DTI) tractography. TMS revealed that both twins presented the same unexpected activation and inhibition of both motor cortices during volitional unilateral fine hand movement. The right ipsilateral corticospinal tract was weaker than the left contralateral one. The motor-task fMRI identified activation in the left primary motor cortex and bilateral secondary motor areas during right-hand (dominant) movement and activation in the bilateral primary motor cortex and secondary motor areas during left-hand movement. Based on DTI tractography, both twins showed a significantly lower streamline count (number of fibers) in the right corticospinal tract compared with a control group, which was not the case for the left corticospinal tract. Neither twin reported any difficulty in conducting fine motor movements during their activities of daily living. The combination of TMS and advanced neuroimaging techniques identified an atypical motor control organization that might be influenced by genetic factors. This combination emphasizes that activation of the unilateral uncrossed pyramidal tract represents an alternative scheme to a "failure" of building a standard pattern but may not necessarily lead to disability.
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Affiliation(s)
| | - Efstratios Karavasilis
- Second Department of Radiology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Christidi
- Department of Physiotherapy, University of West Attica, Athens, Greece
- First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios D Argyropoulos
- Second Department of Radiology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioulia Skitsa
- DNA Analysis Laboratory, Athens Legal Medicine Service Hellenic Ministry of Justice, Athens, Greece
| | - George Makrydakis
- First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Efstathopoulos
- Second Department of Radiology, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Thomas Zambelis
- First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Karandreas
- First Department of Neurology, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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14
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Jende JME, Kender Z, Mooshage C, Groener JB, Alvarez-Ramos L, Kollmer J, Juerchott A, Hahn A, Heiland S, Nawroth P, Bendszus M, Kopf S, Kurz FT. Diffusion Tensor Imaging of the Sciatic Nerve as a Surrogate Marker for Nerve Functionality of the Upper and Lower Limb in Patients With Diabetes and Prediabetes. Front Neurosci 2021; 15:642589. [PMID: 33746707 PMCID: PMC7966816 DOI: 10.3389/fnins.2021.642589] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/10/2021] [Indexed: 12/23/2022] Open
Abstract
Background Nerve damage in diabetic neuropathy (DN) is assumed to begin in the distal legs with a subsequent progression to hands and arms at later stages. In contrast, recent studies have found that lower limb nerve lesions in DN predominate at the proximal sciatic nerve and that, in the upper limb, nerve functions can be impaired at early stages of DN. Materials and Methods In this prospective, single-center cross-sectional study, participants underwent diffusion-weighted 3 Tesla magnetic resonance neurography in order to calculate the sciatic nerve’s fractional anisotropy (FA), a surrogate parameter for structural nerve integrity. Results were correlated with clinical and electrophysiological assessments of the lower limb and an examination of hand function derived from the Purdue Pegboard Test. Results Overall, 71 patients with diabetes, 11 patients with prediabetes and 25 age-matched control subjects took part in this study. In patients with diabetes, the sciatic nerve’s FA showed positive correlations with tibial and peroneal nerve conduction velocities (r = 0.62; p < 0.001 and r = 0.56; p < 0.001, respectively), and tibial and peroneal nerve compound motor action potentials (r = 0.62; p < 0.001 and r = 0.63; p < 0.001, respectively). Moreover, the sciatic nerve’s FA was correlated with the Pegboard Test results in patients with diabetes (r = 0.52; p < 0.001), prediabetes (r = 0.76; p < 0.001) and in controls (r = 0.79; p = 0.007). Conclusion This study is the first to show that the sciatic nerve’s FA is a surrogate marker for functional and electrophysiological parameters of both upper and lower limbs in patients with diabetes and prediabetes, suggesting that nerve damage in these patients is not restricted to the level of the symptomatic limbs but rather affects the entire peripheral nervous system.
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Affiliation(s)
- Johann M E Jende
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Mooshage
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan B Groener
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany.,Medicover Neuroendocrinology, Munich, Germany.,German Center of Diabetes Research (DZD), Associated Partner in the DZD, München-Neuherberg, Germany
| | - Lucia Alvarez-Ramos
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Jennifer Kollmer
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Artur Hahn
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany.,Division of Experimental Radiology, Department of Neuroradiology, Heidelberg, Germany
| | - Peter Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research (DZD), Associated Partner in the DZD, München-Neuherberg, Germany.,Joint Institute for Diabetes and Cancer at Helmholtz-Zentrum Munich and Heidelberg University, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry, Heidelberg University Hospital, Heidelberg, Germany.,German Center of Diabetes Research (DZD), Associated Partner in the DZD, München-Neuherberg, Germany
| | - Felix T Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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15
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Three-dimensional reconstruction of the upper limb from anatomical slices of the Korean visible human: simulation and educational application. Surg Radiol Anat 2021; 43:547-558. [PMID: 33616684 DOI: 10.1007/s00276-021-02704-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/02/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE Digital anatomy is a novel emerging discipline. Use of virtual reality brings a revolution in educational anatomy by improving retention and learning outcomes. Indeed, virtual dissection is a new learning tool for students and surgeons. Three-dimensional vectorial models of the human body can be created from anatomical slices obtained by lengthy series of cryosection from the visible human projects. The aim of this paper is to show how these mesh models could be embedded into an Acrobat® 3dpdf interface, to produce an easy-to-use fully interactive educational tool. METHODS The learning of this method and its practical application were evaluated on a multicentric cohort of 86 people divided into 3 groups, according to the duration of their training (1, 2 or 3 days, respectively). Participants learned how to use the Mesh tool and how to model 3D structures from anatomical sections. At the end of the training, they were given a survey form. Participants were also asked to rate the training (Poor; Average; Good; Very Good; Excellent). RESULTS Ninety four percent of the subjects rated the device as excellent and would continue to use digital anatomy in their practice. CONCLUSION This result is the Diva3d® virtual dissection table, a powerful educational tool for anatomists and students. It could also be the basis of future simulation tools for hand surgeons training.
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16
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Argyropoulos GD, Christidi F, Karavasilis E, Velonakis G, Antoniou A, Bede P, Seimenis I, Kelekis N, Douzenis A, Papakonstantinou O, Efstathopoulos E, Ferentinos P. Cerebro-cerebellar white matter connectivity in bipolar disorder and associated polarity subphenotypes. Prog Neuropsychopharmacol Biol Psychiatry 2021; 104:110034. [PMID: 32710925 DOI: 10.1016/j.pnpbp.2020.110034] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The cerebellum has a crucial role in mood regulation. While cerebellar grey matter (GM) alterations have been previously reported in bipolar disorder (BD), cerebro-cerebellar white matter (WM) connectivity alterations and cerebellar GM profiles have not been characterised in the context of predominant polarity (PP) and onset polarity (OP) subphenotypes of BD patients which is the aim of the present study. METHODS Forty-two euthymic BD patients stratified for PP and OP and 42 healthy controls (HC) were included in this quantitative neuroimaging study to evaluate cerebellar GM patterns and cerebro-cerebellar WM connections. Diffusion tensor tractography was used to characterise afferent and efferent cerebro-cerebellar tract integrity. False discovery rate corrections were applied in post-hoc comparisons. RESULTS BD patients exhibited higher fractional anisotropy (FA) in fronto-ponto-cerebellar tracts bilaterally compared to HC. Subphenotype-specific FA profiles were identified within the BD cohort. Regarding PP subgroups, we found FA changes in a) left contralateral fronto-ponto-cerebellar tract (depressive-PP > HC) and b) contralateral/ipsilateral fronto-ponto-cerebellar tracts bilaterally (manic-PP > HC). Regarding OP subgroups, we observed FA changes in a) left/right contralateral fronto-ponto-cerebellar tracts (depressive-OP > HC) and b) all fronto-ponto-cerebellar, most parieto-ponto-cerebellar and right contralateral occipito-ponto-cerebellar tracts (manic-OP>HC). In general, greater and more widespread cerebro-cerebellar changes were observed in manic-OP patients than in depressive-OP patients compared to HC. Manic-OP showed higher FA compared to depressive-OP patients in several afferent WM tracts. No GM differences were identified between BD and HC and across BD subgroups. CONCLUSIONS Our findings highlight fronto-ponto-cerebellar connectivity alterations in euthymic BD. Polarity-related subphenotypes have distinctive cerebro-cerebellar WM signatures with potential clinical and pathobiological implications.
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Affiliation(s)
- Georgios D Argyropoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Christidi
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Efstratios Karavasilis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Velonakis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Antoniou
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Peter Bede
- Biomedical Imaging Laboratory, Sorbonne University, CNRS, INSERM, Paris, France; Computational Neuroimaging Group, Trinity College Dublin, Ireland
| | - Ioannis Seimenis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Douzenis
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Olympia Papakonstantinou
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios Efstathopoulos
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Ferentinos
- 2nd Department of Psychiatry, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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17
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Srisaikaew P, Wongpakaran N, Anderson ND, Chen JJ, Kothan S, Varnado P, Unsrisong K, Mahakkanukrauh P. Fornix Integrity Is Differently Associated With Cognition in Healthy Aging and Non-amnestic Mild Cognitive Impairment: A Pilot Diffusion Tensor Imaging Study in Thai Older Adults. Front Aging Neurosci 2020; 12:594002. [PMID: 33343334 PMCID: PMC7745667 DOI: 10.3389/fnagi.2020.594002] [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: 08/12/2020] [Accepted: 11/02/2020] [Indexed: 02/05/2023] Open
Abstract
Damage to the fornix leads to significant memory impairment and executive dysfunction and is associated with dementia risk. We sought to identify if fornix integrity and fiber length are disrupted in mild cognitive impairment (MCI) and how they associate with cognition. Data from 14 healthy older adult controls (HCs) and 17 subjects with non-amnestic MCI (n-aMCI) were analyzed. Diffusion tensor imaging (DTI) at 1.5 Tesla MRI was performed to enable manual tracing of the fornix and calculation of DTI parameters. Higher fractional anisotropy of body and column of the fornix was associated with better executive functioning and memory, more strongly in the HC than in the n-aMCI group. Fornix fiber tract length (FTL) was associated with better executive function, more strongly in the n-aMCI than in the HC group, and with better memory, more strongly in the HC than in the n-aMCI group. These results highlight a decline in the contributions of the fornix to cognition in n-aMCI and suggest that maintenance of fornix FTL is essential for sustaining executive functioning in people with n-aMCI.
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Affiliation(s)
- Patcharaporn Srisaikaew
- Ph.D. Program in Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nicole D. Anderson
- Rotman Research Institute, Baycrest Health Science, Toronto, ON, Canada
- Department of Psychology and Psychiatry, University of Toronto, Toronto, ON, Canada
| | - J. Jean Chen
- Rotman Research Institute, Baycrest Health Science, Toronto, ON, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Suchart Kothan
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Pairada Varnado
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kittisak Unsrisong
- Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pasuk Mahakkanukrauh
- Department of Anatomy, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, Thailand
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18
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Jende JME, Groener JB, Kender Z, Hahn A, Morgenstern J, Heiland S, Nawroth PP, Bendszus M, Kopf S, Kurz FT. Troponin T Parallels Structural Nerve Damage in Type 2 Diabetes: A Cross-sectional Study Using Magnetic Resonance Neurography. Diabetes 2020; 69:713-723. [PMID: 31974140 DOI: 10.2337/db19-1094] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/11/2020] [Indexed: 11/13/2022]
Abstract
Clinical studies have suggested that changes in peripheral nerve microcirculation may contribute to nerve damage in diabetic polyneuropathy (DN). High-sensitivity troponin T (hsTNT) assays have been recently shown to provide predictive values for both cardiac and peripheral microangiopathy in type 2 diabetes (T2D). This study investigated the association of sciatic nerve structural damage in 3 Tesla (3T) magnetic resonance neurography (MRN) with hsTNT and N-terminal pro-brain natriuretic peptide serum levels in patients with T2D. MRN at 3T was performed in 51 patients with T2D (23 without DN, 28 with DN) and 10 control subjects without diabetes. The sciatic nerve's fractional anisotropy (FA), a marker of structural nerve integrity, was correlated with clinical, electrophysiological, and serological data. In patients with T2D, hsTNT showed a negative correlation with the sciatic nerve's FA (r = -0.52, P < 0.001), with a closer correlation in DN patients (r = -0.66, P < 0.001). hsTNT further correlated positively with the neuropathy disability score (r = 0.39, P = 0.005). Negative correlations were found with sural nerve conduction velocities (NCVs) (r = -0.65, P < 0.001) and tibial NCVs (r = -0.44, P = 0.002) and amplitudes (r = -0.53, P < 0.001). This study is the first to show that hsTNT is a potential indicator for structural nerve damage in T2D. Our results indirectly support the hypothesis that microangiopathy contributes to structural nerve damage in T2D.
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Affiliation(s)
- Johann M E Jende
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan B Groener
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research (DZD), Neuherberg, Germany
| | - Zoltan Kender
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Artur Hahn
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jakob Morgenstern
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter P Nawroth
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research (DZD), Neuherberg, Germany
- Joint Institute for Diabetes and Cancer at Helmholtz-Zentrum Munich and Heidelberg University, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Kopf
- Department of Endocrinology, Diabetology and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, Germany
- German Center of Diabetes Research (DZD), Neuherberg, Germany
| | - Felix T Kurz
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
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19
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D’Alessandro M, Gallitto G, Greco A, Lombardi L. A Joint Modelling Approach to Analyze Risky Decisions by Means of Diffusion Tensor Imaging and Behavioural Data. Brain Sci 2020; 10:E138. [PMID: 32121566 PMCID: PMC7139494 DOI: 10.3390/brainsci10030138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/22/2020] [Accepted: 02/28/2020] [Indexed: 11/16/2022] Open
Abstract
Understanding dependencies between brain functioning and cognition is a challenging task which might require more than applying standard statistical models to neural and behavioural measures to be accomplished. Recent developments in computational modelling have demonstrated the advantage to formally account for reciprocal relations between mathematical models of cognition and brain functional, or structural, characteristics to relate neural and cognitive parameters on a model-based perspective. This would allow to account for both neural and behavioural data simultaneously by providing a joint probabilistic model for the two sources of information. In the present work we proposed an architecture for jointly modelling the reciprocal relation between behavioural and neural information in the context of risky decision-making. More precisely, we offered a way to relate Diffusion Tensor Imaging data to cognitive parameters of a computational model accounting for behavioural outcomes in the popular Balloon Analogue Risk Task (BART). Results show that the proposed architecture has the potential to account for individual differences in task performances and brain structural features by letting individual-level parameters to be modelled by a joint distribution connecting both sources of information. Such a joint modelling framework can offer interesting insights in the development of computational models able to investigate correspondence between decision-making and brain structural connectivity.
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Affiliation(s)
- Marco D’Alessandro
- Department of Psychology and Cognitive Science, University of Trento, TN I-38068 Rovereto, Italy; (G.G.); (A.G.); (L.L.)
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20
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Kalyvas A, Koutsarnakis C, Komaitis S, Karavasilis E, Christidi F, Skandalakis GP, Liouta E, Papakonstantinou O, Kelekis N, Duffau H, Stranjalis G. Mapping the human middle longitudinal fasciculus through a focused anatomo-imaging study: shifting the paradigm of its segmentation and connectivity pattern. Brain Struct Funct 2019; 225:85-119. [PMID: 31773331 DOI: 10.1007/s00429-019-01987-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/14/2019] [Indexed: 12/11/2022]
Abstract
Τhe middle longitudinal fasciculus (MdLF) was initially identified in humans as a discrete subcortical pathway connecting the superior temporal gyrus (STG) to the angular gyrus (AG). Further anatomo-imaging studies, however, proposed more sophisticated but conflicting connectivity patterns and have created a vague perception on its functional anatomy. Our aim was, therefore, to investigate the ambiguous structural architecture of this tract through focused cadaveric dissections augmented by a tailored DTI protocol in healthy participants from the Human Connectome dataset. Three segments and connectivity patterns were consistently recorded: the MdLF-I, connecting the dorsolateral Temporal Pole (TP) and STG to the Superior Parietal Lobule/Precuneus, through the Heschl's gyrus; the MdLF-II, connecting the dorsolateral TP and the STG with the Parieto-occipital area through the posterior transverse gyri and the MdLF-III connecting the most anterior part of the TP to the posterior border of the occipital lobe through the AG. The lack of an established termination pattern to the AG and the fact that no significant leftward asymmetry is disclosed tend to shift the paradigm away from language function. Conversely, the theory of "where" and "what" auditory pathways, the essential relationship of the MdLF with the auditory cortex and the functional role of the cortical areas implicated in its connectivity tend to shift the paradigm towards auditory function. Allegedly, the MdLF-I and MdLF-II segments could underpin the perception of auditory representations; whereas, the MdLF-III could potentially subserve the integration of auditory and visual information.
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Affiliation(s)
- Aristotelis Kalyvas
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece.,Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Koutsarnakis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece. .,Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece. .,Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Spyridon Komaitis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece.,Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstratios Karavasilis
- Second Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Foteini Christidi
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios P Skandalakis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece.,Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Liouta
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece.,Hellenic Center for Neurosurgical Research, "PetrosKokkalis", Athens, Greece
| | - Olympia Papakonstantinou
- Second Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Kelekis
- Second Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Hugues Duffau
- Department of Neurosurgery, Montpellier University Medical Center, Gui de Chauliac Hospital, Montpellier, France
| | - George Stranjalis
- Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece.,Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Center for Neurosurgical Research, "PetrosKokkalis", Athens, Greece
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21
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Conner AK, Briggs RG, Rahimi M, Sali G, Baker CM, Burks JD, Glenn CA, Battiste JD, Sughrue ME. A Connectomic Atlas of the Human Cerebrum-Chapter 10: Tractographic Description of the Superior Longitudinal Fasciculus. Oper Neurosurg (Hagerstown) 2019; 15:S407-S422. [PMID: 30260421 DOI: 10.1093/ons/opy264] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/18/2018] [Indexed: 11/15/2022] Open
Abstract
The superior longitudinal fasciculus/arcuate white matter complex (SLF/AC) is the largest and most complex white matter tract of the human cerebrum with multiple inter-linked connections encompassing multiple cognitive functions such as language, attention, memory, emotion, and visuospatial function. However, little is known regarding the overall connectivity of this complex. Recently, the Human Connectome Project parcellated the human cortex into 180 distinct regions. Utilizing diffusion spectrum magnetic resonance imaging tractography coupled with the human cortex parcellation data presented earlier in this supplement, we aim to describe the macro-connectome of the SLF/AC in relation to the linked parcellations present within the human cortex. The purpose of this study is to present this information in an indexed, illustrated, and tractographically aided series of figures and tables for anatomic and clinical reference.
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Affiliation(s)
- Andrew K Conner
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Robert G Briggs
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Meherzad Rahimi
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Goksel Sali
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Cordell M Baker
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Joshua D Burks
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Chad A Glenn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - James D Battiste
- Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Michael E Sughrue
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.,Department of Neurosurgery, Prince of Wales Private Hospital, Sydney, Australia
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22
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Nowacki A, Schlaier J, Debove I, Pollo C. Validation of diffusion tensor imaging tractography to visualize the dentatorubrothalamic tract for surgical planning. J Neurosurg 2019; 130:99-108. [PMID: 29570012 DOI: 10.3171/2017.9.jns171321] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/05/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The dentatorubrothalamic tract (DRTT) has been suggested as the anatomical substrate for deep brain stimulation (DBS)-induced tremor alleviation. So far, little is known about how accurately and reliably tracking results correspond to the anatomical DRTT. The objective of this study was to systematically investigate and validate the results of different tractography approaches for surgical planning. METHODS The authors retrospectively analyzed 4 methodological approaches for diffusion tensor imaging (DTI)-based fiber tracking using different regions of interest in 6 patients with essential tremor. Tracking results were analyzed and validated with reference to MRI-based anatomical landmarks, were projected onto the stereotactic atlas of Morel at 3 predetermined levels (vertical levels -3.6, -1.8, and 0 mm below the anterior commissure-posterior commissure line), and were correlated to clinical outcome. RESULTS The 4 different methodologies for tracking the DRTT led to divergent results with respect to the MRI-based anatomical landmarks and when projected onto the stereotactic atlas of Morel. There was a statistically significant difference in the lateral and anteroposterior coordinates at the 3 vertical levels (p < 0.001, 2-way ANOVA). Different fractional anisotropy values ranging from 0.1 to 0.46 were required for anatomically plausible tracking results and led to varying degrees of success. Tracking results were not correlated to postoperative tremor reduction. CONCLUSIONS Different tracking methods can yield results with good anatomical approximation. The authors recommend using 3 regions of interest including the dentate nucleus of the cerebellum, the posterior subthalamic area, and the precentral gyrus to visualize the DRTT. Tracking results must be cautiously evaluated for anatomical plausibility and accuracy in each patient.
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Affiliation(s)
| | - Jürgen Schlaier
- 2Department of Neurosurgery, University of Regensburg Medical Center, Regensburg, Germany
| | - Ines Debove
- 3Neurology, University Hospital Inselspital Bern, University of Bern, Switzerland; and
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23
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Mishra VR, Sreenivasan KR, Zhuang X, Yang Z, Cordes D, Banks SJ, Bernick C. Understanding white matter structural connectivity differences between cognitively impaired and nonimpaired active professional fighters. Hum Brain Mapp 2019; 40:5108-5122. [PMID: 31403734 DOI: 10.1002/hbm.24761] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/20/2019] [Accepted: 07/31/2019] [Indexed: 11/06/2022] Open
Abstract
Long-term traumatic brain injury due to repeated head impacts (RHI) has been shown to be a risk factor for neurodegenerative disorders, characterized by a loss in cognitive performance. Establishing the correlation between changes in the white matter (WM) structural connectivity measures and neuropsychological test scores might help to identify the neural correlates of the scores that are used in daily clinical setting to investigate deficits due to repeated head blows. Hence, in this study, we utilized high angular diffusion MRI (dMRI) of 69 cognitively impaired and 70 nonimpaired active professional fighters from the Professional Fighters Brain Health Study, and constructed structural connectomes to understand: (a) whether there is a difference in the topological WM organization between cognitively impaired and nonimpaired active professional fighters, and (b) whether graph-theoretical measures exhibit correlations with neuropsychological scores in these groups. A dMRI derived structural connectome was constructed for every participant using brain regions defined in AAL atlas as nodes, and the product of fiber number and average fractional anisotropy of the tracts connecting the nodes as edges. Our study identified a topological WM reorganization due to RHI in fighters prone to cognitive decline that was correlated with neuropsychological scores. Furthermore, graph-theoretical measures were correlated differentially with neuropsychological scores between groups. We also found differentiated WM connectivity involving regions of hippocampus, precuneus, and insula within our cohort of cognitively impaired fighters suggesting that there is a discernible WM topological reorganization in fighters prone to cognitive decline.
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Affiliation(s)
- Virendra R Mishra
- Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Las Vegas, Nevada
| | | | - Xiaowei Zhuang
- Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Las Vegas, Nevada
| | - Zhengshi Yang
- Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Las Vegas, Nevada
| | - Dietmar Cordes
- Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Las Vegas, Nevada.,Department of Psychology and Neuroscience, University of Colorado, Boulder, Colorado
| | - Sarah J Banks
- Department of Neurosciences, University of California at San Diego, San Diego, California
| | - Charles Bernick
- Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Las Vegas, Nevada
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24
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Pudas J, Björnholm L, Nikkinen J, Veijola J. Cerebellar white matter in young adults with a familial risk for psychosis. Psychiatry Res Neuroimaging 2019; 287:41-48. [PMID: 30952031 DOI: 10.1016/j.pscychresns.2019.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 11/20/2022]
Affiliation(s)
- Juho Pudas
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
| | - Lassi Björnholm
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | - Juha Nikkinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland; Department of Radiotherapy, Oulu University Hospital, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
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25
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Karavasilis E, Christidi F, Velonakis G, Giavri Z, Kelekis NL, Efstathopoulos EP, Evdokimidis I, Dellatolas G. Ipsilateral and contralateral cerebro-cerebellar white matter connections: A diffusion tensor imaging study in healthy adults. J Neuroradiol 2019; 46:52-60. [DOI: 10.1016/j.neurad.2018.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 07/02/2018] [Accepted: 07/26/2018] [Indexed: 01/23/2023]
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26
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Budzinski RC, Boaretto BRR, Prado TL, Lopes SR. Phase synchronization and intermittent behavior in healthy and Alzheimer-affected human-brain-based neural network. Phys Rev E 2019; 99:022402. [PMID: 30934289 DOI: 10.1103/physreve.99.022402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Indexed: 06/09/2023]
Abstract
We study the dynamical proprieties of phase synchronization and intermittent behavior of neural systems using a network of networks structure based on an experimentally obtained human connectome for healthy and Alzheimer-affected brains. We consider a network composed of 78 neural subareas (subnetworks) coupled with a mean-field potential scheme. Each subnetwork is characterized by a small-world topology, composed of 250 bursting neurons simulated through a Rulkov model. Using the Kuramoto order parameter we demonstrate that healthy and Alzheimer-affected brains display distinct phase synchronization and intermittence properties as a function of internal and external coupling strengths. In general, for the healthy case, each subnetwork develops a substantial level of internal synchronization before a global stable phase-synchronization state has been established. For the unhealthy case, despite the similar internal subnetwork synchronization levels, we identify higher levels of global phase synchronization occurring even for relatively small internal and external coupling. Using recurrence quantification analysis, namely the determinism of the mean-field potential, we identify regions where the healthy and unhealthy networks depict nonstationary behavior, but the results denounce the presence of a larger region or intermittent dynamics for the case of Alzheimer-affected networks. A possible theoretical explanation based on two locally stable but globally unstable states is discussed.
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Affiliation(s)
- R C Budzinski
- Departamento de Física, Universidade Federal do Paraná, 81531-980, Curitiba, PR, Brazil
| | - B R R Boaretto
- Departamento de Física, Universidade Federal do Paraná, 81531-980, Curitiba, PR, Brazil
| | - T L Prado
- Instituto de Engenharia, Ciência e Tecnologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 39440-000 Janaúba, MG, Brazil
| | - S R Lopes
- Departamento de Física, Universidade Federal do Paraná, 81531-980, Curitiba, PR, Brazil
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27
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Sledge runner fasciculus: anatomic architecture and tractographic morphology. Brain Struct Funct 2019; 224:1051-1066. [DOI: 10.1007/s00429-018-01822-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 12/19/2018] [Indexed: 12/13/2022]
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28
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Speckter H, Bido J, Hernandez G, Rivera D, Suazo L, Valenzuela S, Gonzalez C, Stoeter P. Compression of the middle cerebellar tract by posterior fossa tumors before and after Gamma Knife radiosurgery studied with diffusion tensor imaging. JOURNAL OF RADIOSURGERY AND SBRT 2019; 6:11-17. [PMID: 30775070 PMCID: PMC6355455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/18/2018] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate if clinically asymptomatic compression of the middle cerebellar tract by extracerebral posterior fossa tumors can produce changes in diffusion tensor imaging (DTI) parameters and if these changes return to normal after Gamma Knife radiosurgery (GKRS). MATERIAL AND METHODS In 22 patients (12 female, mean age 53.8 years) with posterior fossa tumors (14 schwannomas and 8 meningiomas), the middle cerebellar tract was tracked using DTI data. DTI parameters, such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) within these tracts were determined separately on the tumor side and on the contra-lateral side. As a surrogate parameter of tract compression, we used the distance between a tangential line extending between the anterior, not affected part of the pons and the cerebellum, and the furthest extension of the tumor into the lateral rim of the pons. In a subgroup of 15 patients, DTI parameters were recorded after a follow-up of more than 2 years (mean follow-up time 37.5 months) after GKRS and compared to initial findings. RESULTS Before GKRS, all DTI parameters within the compressed tract had increased. The increase in MD correlated significantly with the degree of tract compression (c = 0.443, p < 0.05). Follow-up examinations after GKRS showed reduction in FA and AD, whereas MD and RD increased. After correction for time elapsed after treatment and tumor type, the changes of MD and AD following treatment correlated significantly with the reduction of tract compression, but not with radiation dose. CONCLUSION Although without obvious clinical symptoms, disorders of the middle cerebellar tract, as in the case of posterior fossa tumors, persist after reduction of tumor size. Because of the significant correlation between the change of parameters and the reduction of tract compression, initial compression and consequent relief are regarded as the main factors responsible for persistent disorders of the middle cerebellar tract. Radiosurgery dose did not contribute significantly to changes in DTI parameters.
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Affiliation(s)
- Herwin Speckter
- Centro Gamma Knife Dominicano, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
- Department of Radiology, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Jose Bido
- Centro Gamma Knife Dominicano, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Giancarlo Hernandez
- Centro Gamma Knife Dominicano, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Diones Rivera
- Centro Gamma Knife Dominicano, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Luis Suazo
- Centro Gamma Knife Dominicano, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Santiago Valenzuela
- Centro Gamma Knife Dominicano, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Cesar Gonzalez
- Department of Radiology, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
| | - Peter Stoeter
- Centro Gamma Knife Dominicano, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
- Department of Radiology, CEDIMAT, Plaza de la Salud, Santo Domingo, Dominican Republic
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29
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Gomez-Tames J, Kutsuna T, Tamura M, Muragaki Y, Hirata A. Intraoperative direct subcortical stimulation: comparison of monopolar and bipolar stimulation. Phys Med Biol 2018; 63:225013. [PMID: 30418938 DOI: 10.1088/1361-6560/aaea06] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Intraoperative subcortical electrical stimulation is used to identify and preserve white matter tracts so that tumor resection can be performed while avoiding postsurgical deficits. The effects of the stimulating electrodes in identifying the white matter tracts have not been characterized; thus, different hospitals use different electrode configurations. Computational modeling can be used to conduct a systematic assessment of the effects of the stimulating electrode parameters. However, no realistic computational model of subcortical electrical stimulation has been implemented and verified. In this study, we investigated the interaction between the corticospinal tract (CST) and subcortical stimulation and compared different electrode configurations during monopolar and bipolar stimulation. For that, we computed the induced electric field in a realistic human head model coupled with a CST axon model. The implemented model was verified with available experimental data that were acquired during subcortical stimulation, and a systematic sensitivity analysis of parameters related to the stimulation was conducted. The results showed that the optimal stimulation varies according to the surgery conditions. If the CST was close to the resection border, bipolar stimulation could produce more selective activation. Monopolar stimulation was more robust and more effective for the CST far from the stimulation point.
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Affiliation(s)
- Jose Gomez-Tames
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya, Aichi 466-8555, Japan. Author to whom any correspondence should be addressed
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Bonmati E, Bardera A, Feixas M, Boada I. Novel Brain Complexity Measures Based on Information Theory. ENTROPY 2018; 20:e20070491. [PMID: 33265581 PMCID: PMC7513017 DOI: 10.3390/e20070491] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/06/2018] [Accepted: 06/19/2018] [Indexed: 12/26/2022]
Abstract
Brain networks are widely used models to understand the topology and organization of the brain. These networks can be represented by a graph, where nodes correspond to brain regions and edges to structural or functional connections. Several measures have been proposed to describe the topological features of these networks, but unfortunately, it is still unclear which measures give the best representation of the brain. In this paper, we propose a new set of measures based on information theory. Our approach interprets the brain network as a stochastic process where impulses are modeled as a random walk on the graph nodes. This new interpretation provides a solid theoretical framework from which several global and local measures are derived. Global measures provide quantitative values for the whole brain network characterization and include entropy, mutual information, and erasure mutual information. The latter is a new measure based on mutual information and erasure entropy. On the other hand, local measures are based on different decompositions of the global measures and provide different properties of the nodes. Local measures include entropic surprise, mutual surprise, mutual predictability, and erasure surprise. The proposed approach is evaluated using synthetic model networks and structural and functional human networks at different scales. Results demonstrate that the global measures can characterize new properties of the topology of a brain network and, in addition, for a given number of nodes, an optimal number of edges is found for small-world networks. Local measures show different properties of the nodes such as the uncertainty associated to the node, or the uniqueness of the path that the node belongs. Finally, the consistency of the results across healthy subjects demonstrates the robustness of the proposed measures.
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Affiliation(s)
- Ester Bonmati
- Correspondence: (E.B.); (A.B.); Tel.: +34-638-222-355 (A.B.)
| | - Anton Bardera
- Correspondence: (E.B.); (A.B.); Tel.: +34-638-222-355 (A.B.)
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31
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Rodriguez-Rojas R, Carballo-Barreda M, Alvarez L, Guridi J, Pavon N, Garcia-Maeso I, Mací As R, Rodriguez-Oroz MC, Obeso JA. Subthalamotomy for Parkinson's disease: clinical outcome and topography of lesions. J Neurol Neurosurg Psychiatry 2018; 89:572-578. [PMID: 29222224 DOI: 10.1136/jnnp-2017-316241] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/18/2017] [Accepted: 11/20/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Subthalamotomy is an effective alternative for the treatment of Parkinson's disease (PD). However, uncertainty about the optimal target location and the possibility of inducing haemichorea-ballism have limited its application. We assessed the correlation between the topography of radiofrequency-based lesions of the subthalamic nucleus (STN) with motor improvement and the emergence of haemichorea-ballism. METHODS Sixty-four patients with PD treated with subthalamotomy were evaluated preoperatively and postoperatively using the Unified Parkinson's Disease Rating Scale motor score (UPDRSm), MRI and tractography. Patients were classified according to the degree of clinical motor improvement and dyskinesia scale. Lesions were segmented on MRI and averaged in a standard space. We examined the relationship between the extent of lesion-induced disruption of fibres surrounding the STN and the development of haemichorea-ballism. RESULTS Maximum antiparkinsonian effect was obtained with lesions located within the dorsolateral motor region of the STN as compared with those centre-placed in the dorsal border of the STN and the zona incerta (71.3%, 53.5% and 20.8% UPDRSm reduction, respectively). However, lesions that extended dorsally beyond the STN showed lower probability of causing haemichorea-ballism than those placed entirely within the nucleus. Tractography findings indicate that interruption of pallidothalamic fibres probably determines a low probability of haemichorea-ballism postoperatively. CONCLUSIONS The topography of the lesion is a major factor in the antiparkinsonian effect of subthalamotomy in patients with PD. Lesions involving the motor STN and pallidothalamic fibres induced significant motor improvement and were associated with a low incidence of haemichorea-ballism.
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Affiliation(s)
- Rafael Rodriguez-Rojas
- HM CINAC, Hospital Universitario HM Puerta del Sur, CEU-San Pablo University, Madrid, Spain.,CIBERNED, Institute Carlos III, Madrid, Spain
| | - Maylen Carballo-Barreda
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Lazaro Alvarez
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Jorge Guridi
- Service of Neurosurgery, Clinica Universidad de Navarra, Pamplona, Spain
| | - Nancy Pavon
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Ivan Garcia-Maeso
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Raul Mací As
- Brain Images Processing Group and Movement Disorder Unit, International Center for Neurological Restoration, Havana, Cuba
| | - Maria C Rodriguez-Oroz
- CIBERNED, Institute Carlos III, Madrid, Spain.,BioDonostia Health Research Institute, Basque Center on Cognition Brain and Language, San Sebastian, Guipuzcoa, Spain
| | - Jose Angel Obeso
- HM CINAC, Hospital Universitario HM Puerta del Sur, CEU-San Pablo University, Madrid, Spain.,CIBERNED, Institute Carlos III, Madrid, Spain
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Nikolakaros G, Kurki T, Paju J, Papageorgiou SG, Vataja R, Ilonen T. Korsakoff Syndrome in Non-alcoholic Psychiatric Patients. Variable Cognitive Presentation and Impaired Frontotemporal Connectivity. Front Psychiatry 2018; 9:204. [PMID: 29910747 PMCID: PMC5992887 DOI: 10.3389/fpsyt.2018.00204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/02/2018] [Indexed: 12/14/2022] Open
Abstract
Background: Non-alcoholic Wernicke's encephalopathy and Korsakoff syndrome are greatly underdiagnosed. There are very few reported cases of neuropsychologically documented non-alcoholic Korsakoff syndrome, and diffusion tensor imaging (DTI) data are scarce. Methods: We report clinical characteristics and neuropsychological as well as radiological findings from three psychiatric patients (one woman and two men) with a history of probable undiagnosed non-alcoholic Wernicke's encephalopathy and subsequent chronic memory problems. Results: All patients had abnormal neuropsychological test results, predominantly in memory. Thus, the neuropsychological findings were compatible with Korsakoff syndrome. However, the neuropsychological findings were not uniform. The impairment of delayed verbal memory of the first patient was evident only when the results of the memory tests were compared to her general cognitive level. In addition, the logical memory test and the verbal working memory test were abnormal, but the word list memory test was normal. The second patient had impaired attention and psychomotor speed in addition to impaired memory. In the third patient, the word list memory test was abnormal, but the logical memory test was normal. All patients had intrusions in the neuropsychological examination. Executive functions were preserved, except for planning and foresight, which were impaired in two patients. Conventional MRI examination was normal. DTI showed reduced fractional anisotropy values in the uncinate fasciculus in two patients, and in the corpus callosum and in the subgenual cingulum in one patient. Conclusions: Non-alcoholic Korsakoff syndrome can have diverse neuropsychological findings. This may partly explain its marked underdiagnosis. Therefore, a strong index of suspicion is needed. The presence of intrusions in the neuropsychological examination supports the diagnosis. Damage in frontotemporal white matter tracts, particularly in the uncinate fasciculus, may be a feature of non-alcoholic Korsakoff syndrome in psychiatric patients.
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Affiliation(s)
- Georgios Nikolakaros
- "Specialists in Psychiatry" Medical Center, Turku, Finland.,Satakunta Hospital District, Psychiatric Care Division, General Psychiatry Outpatient Clinic, Pori, Finland.,Turku University Central Hospital, Salo Psychiatry Outpatient Clinic, Salo, Finland
| | - Timo Kurki
- Terveystalo Pulssi Medical Center, Turku, Finland.,Department of Radiology, University of Turku, Turku, Finland
| | - Janina Paju
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Sokratis G Papageorgiou
- Cognitive Disorders/Dementia Unit, 2nd University Department of Neurology, Medical School, National and Kapodistrian University of Athens, University General Hospital "ATTIKON", Athens, Greece
| | - Risto Vataja
- Division of Neuropsychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Tuula Ilonen
- Department of Psychiatry, University of Turku, Turku, Finland
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Havsteen I, Ovesen C, Willer L, Nybing JD, Ægidius K, Marstrand J, Meden P, Rosenbaum S, Folke MN, Christensen H, Christensen A. Comparison of 3- and 20-Gradient Direction Diffusion-Weighted Imaging in a Clinical Subacute Cohort of Patients with Transient Ischemic Attack: Application of Standard Vendor Protocols for Lesion Detection and Final Infarct Size Projection. Front Neurol 2017; 8:691. [PMID: 29326651 PMCID: PMC5741597 DOI: 10.3389/fneur.2017.00691] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/04/2017] [Indexed: 11/13/2022] Open
Abstract
Objective Diffusion tensor imaging may aid brain ischemia assessment but is more time consuming than conventional diffusion-weighted imaging (DWI). We compared 3-gradient direction DWI (3DWI) and 20-gradient direction DWI (20DWI) standard vendor protocols in a hospital-based prospective cohort of patients with transient ischemic attack (TIA) for lesion detection, lesion brightness, predictability of persisting infarction, and final infarct size. Methods We performed 3T-magnetic resonance imaging including diffusion and T2-fluid attenuated inversion recovery (FLAIR) within 72 h and 8 weeks after ictus. Qualitative lesion brightness was assessed by visual inspection. We measured lesion area and brightness with manual regions of interest and compared with homologous normal tissue. Results 117 patients with clinical TIA showed 78 DWI lesions. 2 lesions showed only on 3DWI. No lesions were uniquely 20DWI positive. 3DWI was visually brightest for 34 lesions. 12 lesions were brightest on 20DWI. The median 3DWI lesion area was larger for lesions equally bright, or brightest on 20DWI [median (IQR) 39 (18–95) versus 18 (10–34) mm2, P = 0.007]. 3DWI showed highest measured relative lesion signal intensity [median (IQR) 0.77 (0.48–1.17) versus 0.58 (0.34–0.81), P = 0.0006]. 3DWI relative lesion signal intensity was not correlated to absolute signal intensity, but 20DWI performed less well for low-contrast lesions. 3DWI lesion size was an independent predictor of persistent infarction. 3-gradient direction apparent diffusion coefficient areas were closest to 8-week FLAIR infarct size. Conclusion 3DWI detected more lesions and had higher relative lesion SI than 20DWI. 20DWI appeared blurred and did not add information. Clinical Trial Registration http://www.clinicaltrials.gov. Unique Identifier NCT01531946.
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Affiliation(s)
- Inger Havsteen
- Department of Radiology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Ovesen
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lasse Willer
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Janus Damm Nybing
- Department of Radiology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Karen Ægidius
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jacob Marstrand
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Per Meden
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sverre Rosenbaum
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marie Norsker Folke
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Christensen
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anders Christensen
- Department of Radiology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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Zarabi H, Roy A, Jha A, Pradilla G. Refining Surgical Corridors with Whole Brain Tractography: A Case Series. Cureus 2017; 9:e1672. [PMID: 29152429 PMCID: PMC5679770 DOI: 10.7759/cureus.1672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Recent advancements in automated diffusion tensor imaging (DTI) and whole brain tractography (WBT) may be of great use to the neurosurgeon in selecting surgical corridors that can minimize disruption of surrounding white matter tracts. This is especially important in cases where the lesion displaces white matter tracts and traditional operative approaches may inadvertently violate these fibers. Here, we present automated DTI seeding and WBT as a practical and efficient means for preoperative surgical planning, in an effort to spare white matter tracts that may be displaced by a variety of lesions and may be vulnerable during surgery. We retrospectively reviewed the records of seven patients with various intracranial lesions, who underwent preoperative magnetic resonance imaging (MRI) with automated DTI analysis. These images were used to guide operative planning so that we could select white matter corridors that would allow for minimal damage to vulnerable fiber tracts. The patients had various pathologies, ranging from neoplasms to intracranial hemorrhage, in a number of different intracranial locations. All the patients underwent preoperative intracranial imaging with post-processing of these images to generate white matter tracts. These images were then used to design an appropriate surgical approach that would minimize injury to white matter tracts. For the patients with neoplasms, all were totally or near-totally resected with a stability of symptoms postoperatively. In the case of the patient with intracranial hemorrhage, the hematoma was evacuated, with significant improvement in the postoperative period. Automated DTI seeding and WBT, which have become increasingly prevalent in recent years, can be of significant use to the neurosurgeon for preoperative planning. Their application is especially important in cases where white matter tracts are displaced by the lesion in question and are put at risk of injury during surgery. Using WBT to design customized surgical approaches appropriate to the case at hand can be of immense value in preserving these white matter tracts, minimizing postoperative deficits, and improving surgical outcomes. Further studies are needed to validate these results and better define their applicability to other regions and pathologies.
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Affiliation(s)
| | - Anil Roy
- Neurosurgery, Emory University School of Medicine
| | - Avilasha Jha
- Neurosurgery, Emory University School of Medicine
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Zakaria H, Haider S, Lee I. Automated Whole Brain Tractography Affects Preoperative Surgical Decision Making. Cureus 2017; 9:e1656. [PMID: 29147631 PMCID: PMC5673476 DOI: 10.7759/cureus.1656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Surgery in and around eloquent brain structures poses a technical challenge when the goal of surgery is maximal safe resection. Magnetic resonance imaging (MRI) has revolutionized the diagnosis and treatment of neurological disorders, but tractography still remains limited in terms of utility because of the requisite manual labor and time required combined with the high risk of bias and inaccuracy. Automated whole brain tractography (AWBT) has simplified this workflow, overcoming historical barriers, and allowing for integration into modern neuronavigation. However, current literature showing the usefulness of this new technology is limited. In this study, we aimed to illustrate the utility of AWBT during cranial surgery and its ability to affect presurgical and intraoperative clinical decision making. We performed a retrospective chart review of cases that underwent AWBT for one year from July 2016 to July 2017. All patients underwent conventional anatomic MRI with and without contrast sequences, in addition to diffusion tensor imaging (DTI) on a 3 Tesla MRI scanner (Ingenia 3.0T, Philips, Amsterdam NL). Post-hoc AWBT processing was performed on a separate workstation. Patients were subsequently grouped into those that had undergone either language or motor mapping and those that did not. We compared both sets of patients to see any differences in patient age, sex, laterality of surgery, depth of resection from cortical surface, and smallest distance between the lesion and adjacent eloquent white matter tracts. We identified illustrative cases which demonstrated the ability of AWBT to affect surgical decision making. In this single-center series, we identified 73 total patients who underwent AWBT for intracranial surgery, of which 28 patients underwent either speech or language mapping. When comparing mapping to non-mapping patients, we found no difference with respect to age, gender, laterality of surgery, or whether the surgery was a revision. The distance between the lesion and eloquent white matter tracts demonstrated a statistically significant difference between mapping and non-mapping patients, namely in the corticospinal tract (p < 0.0001), the superior longitudinal fasciculus (p < 0.0001), and the arcuate fasciculus (p < 0.004). Patients who underwent mapping were at equal risk for having a postoperative deficit (p = 0.772) but had an improved chance of recovery (p = 0.041) after surgery. We believe this phenomenon is related to increased awareness and avoidance of functional tissue during surgery, which occurs due to the combination of preoperatively identifying white matter tracts with AWBT and intraoperatively testing margins with mapping. We provide two illustrative cases that show the impact of AWBT on patient outcomes. In conclusion, AWBT is relatively simple to perform and provides vital information for surgeons about eloquent white matter tracts that can be used to help improve patient outcomes.
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Affiliation(s)
- Hesham Zakaria
- Department of Neurological Surgery, Henry Ford Health System
| | - Sameah Haider
- Department of Neurological Surgery, Henry Ford Health System
| | - Ian Lee
- Department of Neurological Surgery, Henry Ford Health System
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36
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Haller S. Advance MR imaging in sports-related concussion and mild traumatic brain injury - ready for clinical use? (Commentary on Tremblay et al
. 2017). Eur J Neurosci 2017; 46:1954-1955. [DOI: 10.1111/ejn.13643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Sven Haller
- Affidea CDRC Centre Diagnostique Radiologique de Carouge Clos de la Fonderie; 1, 1227 Carouge Switzerland
- Department of Surgical Sciences, Radiology; Uppsala University; Uppsala Sweden
- Department of Neuroradiology; University Hospital Freiburg; Freiburg Germany
- Faculty of Medicine; University of Geneva; Geneva Switzerland
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Wu C, Mohamed FB. Letter: Evaluation of Diffusion Tensor Imaging-Based Tractography of the Corticospinal Tract: A Correlative Study with Intraoperative Magnetic Resonance Imaging and Direct Electrical Subcortical Stimulation. Neurosurgery 2017; 81:E7-E8. [DOI: 10.1093/neuros/nyx082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Schaeffer DJ, Adam R, Gilbert KM, Gati JS, Li AX, Menon RS, Everling S. Diffusion-weighted tractography in the common marmoset monkey at 9.4T. J Neurophysiol 2017; 118:1344-1354. [PMID: 28615334 DOI: 10.1152/jn.00259.2017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 05/08/2017] [Accepted: 06/08/2017] [Indexed: 11/22/2022] Open
Abstract
The common marmoset (Callithrix jacchus) is a small New World primate that is becoming increasingly popular in the neurosciences as an animal model of preclinical human disease. With several major disorders characterized by alterations in neural white matter (e.g., multiple sclerosis, Alzheimer's disease, schizophrenia), proposed to be transgenically modeled using marmosets, the ability to isolate and characterize reliably major white matter fiber tracts with MRI will be of use for evaluating structural brain changes related to disease processes and symptomatology. Here, we propose protocols for isolating major white matter fiber tracts in the common marmoset using in vivo ultrahigh-field MRI (9.4T) diffusion-weighted imaging (DWI) data. With the use of a high angular-resolution DWI (256 diffusion-encoding directions) sequence, collected on four anesthetized marmosets, we provide guidelines for manually drawing fiber-tracking regions of interest, based on easily identified anatomical landmarks in DWI native space. These fiber-tract isolation protocols are expected to be experimentally useful for visualization and quantification of individual white matter fiber tracts in both control and experimental groups of marmosets (e.g., transgenic models). As disease models in the marmoset advance, the determination of how macroscopic white matter anatomy is altered as a function of disease state will be relevant in bridging the existing translational gap between preclinical rodent models and human patients.NEW & NOTEWORTHY Although significant progress has been made in mapping white matter connections in the marmoset brain using ex vivo tracing techniques, the application of in vivo virtual dissection of major white matter fiber tracts has been established by few studies in the marmoset literature. Here, we demonstrate the feasibility of whole-brain diffusion-weighted tractography in anesthetized marmosets at ultrahigh-field MRI (9.4T) and propose protocols for isolating nine major white matter fiber tracts in the marmoset brain.
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Affiliation(s)
- David J Schaeffer
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; and
| | - Ramina Adam
- Graduate Program in Neuroscience, University of Western Ontario, London, Ontario, Canada
| | - Kyle M Gilbert
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; and
| | - Joseph S Gati
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; and
| | - Alex X Li
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; and
| | - Ravi S Menon
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; and
| | - Stefan Everling
- Robarts Research Institute, University of Western Ontario, London, Ontario, Canada; and
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Narayana PA. White matter changes in patients with mild traumatic brain injury: MRI perspective. Concussion 2017; 2:CNC35. [PMID: 30202576 PMCID: PMC6093760 DOI: 10.2217/cnc-2016-0028] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 02/10/2017] [Indexed: 12/20/2022] Open
Abstract
This review focuses on white matter (WM) changes in mild traumatic brain injury (mTBI) as assessed by multimodal MRI. All the peer reviewed publications on WM changes in mTBI from January 2011 through September 2016 are included in this review. This review is organized as follows: introduction to mTBI, the basics of multimodal MRI techniques that are potentially useful for probing the WM integrity, summary and critical evaluation of the published literature on the application of multimodal MRI techniques to assess the changes of WM in mTBI, and correlation of MRI measures with behavioral deficits. The MRI–pathology correlation studies based on preclinical models of mTBI are also reviewed. Finally, the author's perspective of future research directions is described.
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Affiliation(s)
- Ponnada A Narayana
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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40
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Brain Mapping Using Neuroimaging. Appl Microsc 2016. [DOI: 10.9729/am.2016.46.4.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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41
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The New Findings in the Genetics and Pathology of Structural Brain Diseases. CURRENT PEDIATRICS REPORTS 2016. [DOI: 10.1007/s40124-016-0112-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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42
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Barkovich E, Robinson C, Gropman A. Brain biomarkers and neuroimaging to diagnose urea cycle disorders and assess prognosis. Expert Opin Orphan Drugs 2016. [DOI: 10.1080/21678707.2016.1242407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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