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Ebrahimi T, Tafakhori A, Hashemi H, Ali Oghabian M. An interictal measurement of cerebral oxygen extraction fraction in MRI-negative refractory epilepsy using quantitative susceptibility mapping. Phys Med 2021; 85:87-97. [PMID: 33984822 DOI: 10.1016/j.ejmp.2021.03.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Oxygen extraction fraction (OEF) can be a factor to identify brain tissue's disability in epileptic patients. This study aimed to assess the OEF's level measurement in refractory epileptic patients (REPs) using a quantitative susceptibility mapping (QSM) method and to determine whether the OEF parameters change. METHODS QSM-OEF maps of 26 REPs and 16 healthy subjects were acquired using 3T MRI with a 64-channel coil. Eighteen regions-of-interest (ROIs) were chosen around the cortex in one appropriate slice of the brain and the mean QSM-OEF for each ROI was obtained. The correlations of QSM-OEF among different clinical characteristics of the disease, as well as between the patients and normal subjects, were also investigated. RESULTS QSM-OEF was shown to be significantly higher in REPs (44.9 ± 5.8) than that in HS (41.9 ± 6.2) (p < 0.05). Mean QSM-OEF was statistically lower in the ipsilateral side (44.5 ± 6.6) compared to the contralateral side (46.4 ± 6.8) (P < 0.01). QSM-OEF was illustrated to have a strong positive correlation with the attack duration (r = 0.6), and a moderate negative correlation with the attack frequency (r = -0.3). Using an optimized support vector machine algorithm, we could predict the disease in subjects having abnormal OEF values in the brain-selected-ROIs with sensitivity, specificity, AUC, and the precision of 0.96, 1, 0.98, and 1, respectively. CONCLUSIONS The results of this study revealed that QSM-OEF of the REPs' brain is higher than that of HS, which indicates that QSM-OEF is associated with disease activity.
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Affiliation(s)
- Tayyebeh Ebrahimi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroimaging and Analysis, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
| | - Abbas Tafakhori
- Iranian Center of Neurological Research (ICNR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hassan Hashemi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Ali Oghabian
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Neuroimaging and Analysis, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Molecular and Cellular Imaging, Tehran University of Medical Science, Tehran, Iran.
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Tsougos I, Kousi E, Georgoulias P, Kapsalaki E, Fountas KN. Neuroimaging methods in Epilepsy of Temporal Origin. Curr Med Imaging 2018; 15:39-51. [DOI: 10.2174/1573405613666170622114920] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/04/2017] [Accepted: 05/11/2017] [Indexed: 11/22/2022]
Abstract
Background:
Temporal Lobe Epilepsy (TLE) comprises the most common form of
symptomatic refractory focal epilepsy in adults. Accurate lateralization and localization of the
epileptogenic focus are a significant prerequisite for determining surgical candidacy once the
patient has been deemed medically intractable. Structural MR imaging, clinical,
electrophysiological, and neurophysiological data have an established role in the localization of the
epileptogenic foci. Nevertheless, hippocampal sclerosis cannot be detected on MR images in more
than 30% of patients with TLE, and the presurgical assessment remains controversial.
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Discussion: In the last years, advanced MR imaging techniques, such as 1H-MRS, DWI, DTI,
DSCI, and fMRI, may provide valuable additional information regarding the physiological and
metabolic characterization of brain tissue. MR imaging has shifted towards functional and
molecular imaging, thus, promising to improve the accuracy regarding the lateralization and the
localization of the epileptogenic focus. Additionally, nuclear medicine studies, such as SPECT and
PET imaging modalities, have become an asset for the decoding of brain function and activity, and
can be diagnostically helpful as well, since they provide valuable data regarding the altered
metabolic activity of the seizure foci.
Conclusion:
Overall, advanced MRI, SPECT, and PET imaging techniques are increasingly
becoming an essential part of TLE diagnostics, when the epileptogenic area is not identified on
structural MRI or when structural MRI, clinical, and electrophysiological findings are not in
concordance.
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Affiliation(s)
- Ioannis Tsougos
- Department of Medical Physics, School of Medicine, University of Thessaly, Larisa, Greece
| | - Evanthia Kousi
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Panagiotis Georgoulias
- Department of Medical Physics, School of Medicine, University of Thessaly, Larisa, Greece
| | - Eftychia Kapsalaki
- Department of Medical Physics, School of Medicine, University of Thessaly, Larisa, Greece
| | - Kostas N. Fountas
- Department of Medical Physics, School of Medicine, University of Thessaly, Larisa, Greece
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Changes in the interictal and early postictal diffusion and perfusion magnetic resonance parameters in familial spontaneous epileptic cats. Epilepsy Res 2017; 133:76-82. [DOI: 10.1016/j.eplepsyres.2017.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/13/2017] [Accepted: 04/20/2017] [Indexed: 11/23/2022]
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Identification of cerebral perfusion using arterial spin labeling in patients with seizures in acute settings. PLoS One 2017; 12:e0173538. [PMID: 28291816 PMCID: PMC5349669 DOI: 10.1371/journal.pone.0173538] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 02/21/2017] [Indexed: 11/28/2022] Open
Abstract
This study aimed to explore the utility of arterial spin labeling perfusion-weighted imaging (ASL-PWI) in patients with suspected seizures in acute settings. A total of 164 patients who underwent ASL-PWI for suspected seizures in acute settings (with final diagnoses of seizure [n = 129], poststroke seizure [n = 18], and seizure mimickers [n = 17]), were included in this retrospective study. Perfusion abnormality was analyzed for: (1) pattern, (2) multifocality, and (3) atypical distribution against vascular territories. Perfusion abnormality was detected in 39% (50/129) of the seizure patients, most (94%, 47/50) being the hyperperfusion pattern. Of the patients with perfusion abnormality, multifocality or hemispheric involvement and atypical distribution against vascular territory were revealed in 46% (23/50) and 98% (49/50), respectively. In addition, seizures showed characteristic features including hyperperfusion (with or without non-territorial distribution) on ASL-PWI, thus differentiating them from poststroke seizures or seizure mimickers. In patients in whom seizure focus could be localized on both EEG and ASL-PWI, the concordance rate was 77%. The present study demonstrates that ASL-PWI can provide information regarding cerebral perfusion status in patients with seizures in acute settings and has the potential to be used as a non-invasive imaging tool to identify the cerebral perfusion in patients with seizures.
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Kim BS, Lee ST, Yun TJ, Lee SK, Paeng JC, Jun J, Kang KM, Choi SH, Kim JH, Sohn CH. Capability of arterial spin labeling MR imaging in localizing seizure focus in clinical seizure activity. Eur J Radiol 2016; 85:1295-303. [PMID: 27235877 DOI: 10.1016/j.ejrad.2016.04.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/15/2016] [Accepted: 04/28/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to evaluate cerebral blood flow using arterial spin labeling (ASL) perfusion magnetic resonance (MR) imaging in patients with clinical seizure activity and determine its diagnostic performance in identifying seizure focus. MATERIALS AND METHODS Institutional Review Board of our hospital approved this retrospective study. Informed consent was waived. Clinical seizure focus was determined by a neurologist based on seizure semiology, electroencephalography, and conventional imaging modalities. The diagnostic performance of ASL perfusion MR imaging to identifying seizure focus compared to clinical seizure focus was analyzed. RESULTS Clinical seizure focus was localized in 95% (42/44) of patients. The sensitivity and specificity of ASL perfusion MR imaging for identifying seizure focus were 74% (95% CI: 58%, 86%) (clinical seizure focus was localizable in 31 of 42 patients, including complete concordance in 10 patients and partial concordance in 21 patients) and 0% (95% CI: 0%, 84%) (for the two patients whose clinical seizure foci were not localizable, they were identified by ASL perfusion MR imaging), respectively. Thus, the overall accuracy of ASL perfusion MR imaging for localizing seizure focus was 70% (33/44). For 4 patients who had abnormal perfusion on ASL, their seizure foci based on ASL perfusion MR imaging were discordant with clinical seizure foci. CONCLUSION ASL perfusion MR imaging can provide information about perfusion status and important diagnostic clue in localizing seizure focus in patients with clinical seizure activity. It has the potential as a non-invasive complementary diagnostic tool for patients with clinical seizure activity.
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Affiliation(s)
- Beom Su Kim
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soon-Tae Lee
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae Jin Yun
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Chul Paeng
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jinsun Jun
- Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Koung Mi Kang
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung Hong Choi
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji-Hoon Kim
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul-Ho Sohn
- Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea; Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
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Brunecker P, Endres M, Nolte CH, Schultze J, Wegener S, Jungehülsing GJ, Müller B, Kerskens CM, Fiebach JB, Villringer A, Steinbrink J. Evaluation of an AIF correction algorithm for dynamic susceptibility contrast-enhanced perfusion MRI. Magn Reson Med 2008; 60:102-10. [DOI: 10.1002/mrm.21612] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Lee WT, Chang C. Magnetic resonance imaging and spectroscopy in assessing 3-nitropropionic acid-induced brain lesions: an animal model of Huntington’s disease. Prog Neurobiol 2004; 72:87-110. [PMID: 15063527 DOI: 10.1016/j.pneurobio.2004.02.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2003] [Accepted: 02/03/2004] [Indexed: 10/26/2022]
Abstract
Huntington's disease (HD) is an inherited neurodegenerative disease, in which there is progressive motor and cognitive deterioration, and for which the pathogenesis of neuronal death remains controversial. Mitochondrial toxins like 3-nitropropionic acid (3-NP) and malonate, functioning as the inhibitors of the complex II of mitochondrial respiratory chain, have been found to effectively induce specific behavioral changes and selective striatal lesions in rats and non-human primates mimicking those in HD. Furthermore, several kinds of transgenic mouse models of HD have been recently developed, and used in the development and assessment of novel treatments for HD. In the past, most studies evaluating the animal models for HD were based on histological changes or in vitro neuronal cultures. With the emergence of advanced magnetic resonance technologies, non-invasive magnetic resonance imaging (MRI) and spectroscopy provide more detail of cerebral alterations, including the changes of cerebral structure, function and metabolites. These studies support the hypothesis that mitochondrial dysfunction with increased excitation of N-methyl-D-aspartate (NMDA) receptors can replicate the neurobehavioral changes, selective brain injury and neurochemical alterations in HD. The present review focuses on our work as well as that of others regarding 3-NP-induced neurotoxicity and other animal models of HD. Using both conventional and advanced MRI and spectroscopy, we summarize the pathogenesis and possible therapeutic strategies in chemical and transgenic models of HD. The results show magnetic resonance techniques to be powerful techniques in the evaluation of pathogenesis and therapeutic intervention for both chemical and transgenic models of HD.
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Affiliation(s)
- Wang-Tso Lee
- Department of Pediatrics, College of Medicine, National Taiwan University, Taipei 100, Taiwan
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