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Rissardo JP, Byroju VV, Mukkamalla S, Caprara ALF. A Narrative Review of Stroke of Cortical Hand Knob Area. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:318. [PMID: 38399606 PMCID: PMC10890039 DOI: 10.3390/medicina60020318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
The cortical hand knob region of the brain is a knob-like segment of the precentral gyrus, projecting into the middle genu of the central sulcus. This anatomic landmark is responsible for intricate control of hand motor movements and has often been implicated in motor weakness following stroke. In some instances, damage to this area has been mistaken for peripheral causes of hand weakness. Our article aims to consolidate clinically relevant information on the cortical hand knob area in a comprehensive review to guide clinicians regarding diagnosis and treatment strategies. We conducted a systematic search within the Medline/PubMed database for reports of strokes in the cortical hand knob region. All studies were published electronically up until December 2023. The search was conducted using the keyword "hand knob". A total of 24 reports containing 150 patients were found. The mean and median ages were 65 and 67 years, respectively. Sixty-two percent of the individuals were male. According to the TOAST criteria for the classification of the stroke, 59 individuals had a stroke due to large-artery atherosclerosis, 8 had small-vessel occlusion, 20 had cardioembolism, 25 were determined, and 38 were undetermined. The most common etiologies for stroke in the hand knob area can be attributed to large vessel occlusions, small vessel occlusions, or cardioembolism. Presentations following damage to this area can mimic ulnar, median, or radial neuropathy as well. Our comprehensive review serves as a resource for recognizing and managing stroke in the cortical hand knob area.
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Affiliation(s)
- Jamir Pitton Rissardo
- Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA; (J.P.R.); (V.V.B.)
| | - Vishnu Vardhan Byroju
- Neurology Department, Cooper University Hospital, Camden, NJ 08103, USA; (J.P.R.); (V.V.B.)
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Rabiee S, Kankam SB, Shafizadeh M, Ahmadi M, Khoshnevisan A, Hashemi A. Supratentorial Meningioma Consistency Prediction Utilizing Tumor to Cerebellar Peduncle Intensity on T1 and T2-Weighted and Fluid Attenuated Inversion Recovery Magnetic Resonance Imaging Sequences. World Neurosurg 2023; 170:e180-e187. [PMID: 36328167 DOI: 10.1016/j.wneu.2022.10.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Predicting meningioma consistency with preoperative imaging is critical for surgery planning. Preoperative T1 and T2-weighted and fluid attenuated inversion recovery magnetic resonance imaging (MRI) findings of supratentorial meningioma tumors were studied and compared with intraoperative supratentorial meningioma tumor consistency based on the Cavitron ultrasound surgical aspirator (CUSA) and ZADA grading scales in this cohort to predict the tumor consistency before surgery. METHODS MRI from 78 consecutive patients who underwent supratentorial meningioma tumor resection between 2018 and 2021 were evaluated preoperatively. An intraoperative tumor consistency grade was applied to these lesions prospectively by the operating surgeon based on CUSA and ZADA grading scales. Tumor/cerebellar peduncle T2-weighted intensity, tumor/cerebellar peduncle T1-weighted intensity (TCT1I), and tumor/cerebellar peduncle fluid attenuated inversion recovery intensity (TCFI) ratios were calculated. Tumor consistency grades and MRI intensity ratios were correlated using one-way ANOVA. RESULTS Of the 78 patients, 52 (66.7%) were female and 26 (33.3%) were male. Tumor volume correlated with tumor consistency grades on both CUSA (P = 0.005) and ZADA (P = 0.024) grading scales. Also patients age correlated with tumor consistency according to ZADA grading scale (P = 0.024). TCT1I (P = 0.009) and TCFI (P < 0.005) ratios correlated significantly with tumor consistency grade according to CUSA. Similarly, TCT1I (P = 0.0032) and TCFI (P = 0.001) ratios was significantly associated with tumor consistency according to ZADA grading scales. CONCLUSIONS Our findings suggest that higher tumor/cerebellar peduncle T2-weighted intensity and TCFI ratios correlate with softer tumors, while higher TCT1I ratios reveal firmer tumors. These data can assist the surgeon predict the supratentorial meningioma consistency before surgery.
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Affiliation(s)
- Shervin Rabiee
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samuel Berchi Kankam
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; International Neurosurgery Group (ING), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Milad Shafizadeh
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; International Neurosurgery Group (ING), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Ahmadi
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Khoshnevisan
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; International Neurosurgery Group (ING), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
| | - Amirpajman Hashemi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Bakhaidar M, Bokhari R, Hall JA, Mirza FA. The Central Sulcus of the Insula: A Highly Reliable Radiographic Landmark for Identification of the Rolandic Sulcus. World Neurosurg 2022; 167:e165-e171. [PMID: 35940504 DOI: 10.1016/j.wneu.2022.07.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Anatomic studies have suggested that the central insular sulcus (CIS) runs in line with the Rolandic sulcus (RS). The radiographic relationship between the RS and CIS has not been systematically studied. This study aims to evaluate the applicability of using the CIS as a radiologic landmark to identify the RS. METHODS We retrospectively reviewed 100 consecutive normal magnetic resonance imaging (MRI) scans (200 hemispheres) performed at a single institution. MRI scans with any intracranial pathology or finding were excluded. Sagittal and axial fluid-attenuated inversion recovery sequences were used in this study. Two evaluators independently evaluated the relationship of the CIS and RS in all MRI scans. A predefined 3-step method was then used to identify the CIS, RS, and hand motor area in sagittal and axial images. RESULTS The CIS was found to be correlated with the RS in 191 hemispheres (95.5%). In the remaining 9 hemispheres, the postcentral sulcus represented the most correlated sulcus with the CIS (7 hemispheres). The interrater agreement was 0.673 (P < 0.05), indicating a substantial agreement. The hand motor area was identified in the same section as the CIS in 175 hemispheres (87.5%). CONCLUSIONS The CIS is a highly reliable radiographic landmark for the identification of the RS. The hand motor area can also be identified reliably using this method.
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Affiliation(s)
- Mohamad Bakhaidar
- Departments of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada; Neurosurgical Simulation and Artificial Intelligence Learning Centre, Department of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada; Department of Surgery, Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Rakan Bokhari
- Departments of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada; Department of Surgery, Division of Neurosurgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jeffery Alan Hall
- Departments of Neurology and Neurosurgery, Montreal Neurological Hospital and Institute, McGill University, Montreal, Quebec, Canada
| | - Farhan A Mirza
- Department of Neurosurgery, Kentucky Neuroscience Institute, University of Kentucky, Lexington, Kentucky, USA
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Anatomy of the Cerebral Cortex, Lobes, and Cerebellum. Neuroimaging Clin N Am 2022; 32:463-473. [PMID: 35843656 DOI: 10.1016/j.nic.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Strong foundational knowledge of the anatomy of the cerebral cortex, lobes, and cerebellum is key to guide the search for potential lesions based on clinical presentation and known focal neurologic deficits. This article provides an introduction and overview of cerebral cortical anatomy, including the key sulci that divide the 4 lobes of the cerebral cortex, as well as the major gyral and sulcal landmarks within each lobe. The organization of the cerebellum and its major anatomic constituents are also described. Commonly encountered anatomic variants and asymmetries in cerebral cortical anatomy are presented and discussed.
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Cho S, Kurokawa R, Hagiwara A, Gonoi W, Mori H, Kawahara T, Nakaya M, Sakamoto N, Fujita N, Kamio S, Koyama H, Abe O. Localization of the central sulcus using the distinctive high signal intensity of the paracentral lobule on T1-weighted images. Neuroradiology 2021; 64:289-299. [PMID: 33959791 DOI: 10.1007/s00234-021-02729-4] [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: 12/06/2020] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The central sulcus is an important landmark in the brain. This study aimed to investigate the distinctive signal of the paracentral lobule (PL) on T1-weighted images (T1WIs; the white PL sign) and evaluate its usefulness as a new method of identifying the central sulcus. METHODS T1WIs of the brain of 96 participants (age, 58.9 ± 17.9 years; range, 8-87 years) scanned at 3-T MR system were retrospectively reviewed. First, we qualitatively analyzed the signal of the cortex of the PL by comparing it with that of the ipsilateral superior frontal gyrus on a 4-point grading score. Second, we compared the cortical signal intensity and gray/white-matter contrast between the PL and superior frontal gyrus. Third, we evaluated the usefulness of the PL signal for identifying the central sulcus. RESULTS The PL cortex was either mildly hyperintense (grade 2) or definitely hyperintense (grade 3) in comparison with that of superior frontal cortex in all participants. The signal intensity of the PL cortex was significantly higher than that of the superior frontal cortex (p < 0.001), whereas the gray/white-matter contrast of the PL was weaker than that of the superior frontal gyrus (p < 0.001). The central sulci were identified with 94.3% accuracy (181/192) using the new method. CONCLUSION The white PL sign may be helpful in identifying the central sulcus, and this approach can be recognized as a new method for identification of the central sulcus.
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Affiliation(s)
- Shinichi Cho
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Ryo Kurokawa
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | | | - Wataru Gonoi
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Harushi Mori
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Takuya Kawahara
- Clinical Research Promotion Center, Biostatistics Unit, The University of Tokyo Hospital, Tokyo, Japan
| | - Moto Nakaya
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Naoya Sakamoto
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Nana Fujita
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Satoru Kamio
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hiroaki Koyama
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Osamu Abe
- Department of Radiology, The University of Tokyo, 1-2-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Joshi H, Hoch MJ, Braileanu M, Gore A, Willie JT, Hu R. Reduced gray-white matter contrast localizes the motor cortex on double inversion recovery (DIR) 3T MRI. Neuroradiology 2021; 63:1071-1078. [PMID: 33415349 DOI: 10.1007/s00234-020-02631-5] [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: 09/03/2020] [Accepted: 12/27/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Reduced gray-white matter contrast along the central sulcus has been described on T1- and T2-weighted magnetic resonance imaging (MRI). The purpose of this study was to assess the gray-white matter contrast of the motor cortex on double inversion recovery (DIR), a sequence with superior gray-white matter differentiation. METHODS The gray-white matter signal on DIR was retrospectively compared to T1-weighted magnetization-prepared rapid gradient echo (T1-MPRAGE) using normal (n = 25) and abnormal (n = 25) functional MRI (fMRI) exams. Quantitative gray-white matter contrast ratios (CR) of the precentral and adjacent gyri were obtained on normal exams. Two neuroradiologists qualitatively rated reduced gray-white matter contrast of the hemispheres of both normal and abnormal exams. Hand motor functional mapping was used as a reference. RESULTS In normal hemispheres (n = 50), the mean CR was significantly lower on DIR (0.44) vs T1-MPRAGE (0.63, p < 0.001). Reduced gray-white matter contrast was categorized as "definitely present" more frequently on DIR than T1-MPRAGE by reviewers in both normal (n = 50; reviewer 1 DIR 88% and MPRAGE 68%, p = 0.02; reviewer 2 DIR 86% and T1-MPRAGE 64%; p=0.01) and abnormal hemispheres (n = 50; reviewer 1 DIR 80% and T1-MPRAGE 38%, p < 0.001; reviewer 2 DIR 74% and T1-MPRAGE 46%, p = 0.005). CONCLUSION Reduced gray-white matter contrast of the motor cortex is more pronounced on DIR compared to T1-MPRAGE on quantitative and qualitative assessments of normal MRI exams. In abnormal cases, reviewers more definitively identified the motor cortex on DIR. In cases with distorted brain anatomy, DIR may be a useful adjunct sequence to localize the motor cortex.
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Affiliation(s)
- Hena Joshi
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Michael J Hoch
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Maria Braileanu
- Department of Radiology, Division of Neuroradiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Ashwani Gore
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jon T Willie
- Department of Neurosurgery, Washington University in St. Louis, St. Louis, MO, USA
| | - Ranliang Hu
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA
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Zhang Z, Wang Y, Gao Y, Li Z, Zhang S, Lin X, Hou Z, Yu Q, Wang X, Liu S. Morphological changes in the central sulcus of children with isolated growth hormone deficiency versus idiopathic short stature. Dev Neurobiol 2020; 81:36-46. [PMID: 33277816 DOI: 10.1002/dneu.22797] [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: 01/02/2020] [Revised: 08/25/2020] [Accepted: 11/27/2020] [Indexed: 11/10/2022]
Abstract
In this study, the morphological changes in the central sulcus between children with isolated growth hormone deficiency (IGHD) and those with idiopathic short stature (ISS) were analyzed. Thirty children with IGHD (peak growth hormone < 5 µg/L) and 30 children with ISS (peak growth hormone > 10.0 µg/L) were included. Morphological measurements of the central sulcus were obtained from T1-weighted MRIs using BrainVISA, including the average sulcal width, maximum depth, average depth, top length, bottom length, and depth position-based profiles (DPPs). The bilateral average width of the central sulci was significantly wider, while the left maximum depth and right average depth of the central sulcus were significantly smaller, in children with IGHD than in children with ISS. There were no significant differences in the right maximum depth, left average depth, or bilateral top length and bottom length of the central sulcus between groups. The DPPs of the middle part of both central sulci (corresponding to the hand motor activation area) and the inferior part of the right central sulcus (corresponding to the oral movement area) near the Sylvian fissure were significantly smaller in children with IGHD than in controls before false discovery rate (FDR) correction. However, all the above significant DPP sites disappeared after FDR correction. There were significant morphological changes in the three-dimensional structure of the central sulcus in children with IGHD, which were the outcome of other more essential cortical or subcortical changes, resulting in their relatively slower development in motor, cognitive, and linguistic functional performance.
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Affiliation(s)
- Zhonghe Zhang
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China.,Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Shandong, China
| | - Yu Wang
- Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Shandong, China
| | - Yue Gao
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Zhuoran Li
- Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Shandong, China
| | - Shuhan Zhang
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Xiangtao Lin
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China.,Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Shandong, China
| | - Zhongyu Hou
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China.,Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Shandong, China
| | - Qiaowen Yu
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China.,Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Shandong, China
| | - Ximing Wang
- Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China.,Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Shuwei Liu
- Research Center for Sectional and Imaging Anatomy, Shandong University Cheeloo College of Medicine, Shandong, China
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Mark IT, Luetmer PH, Rydberg CH, Witte RJ, Geske JR, Johnson MP, Lehman VT. Signal intensity of peri-rolandic cortex identifies the central sulcus on double inversion recovery MRI. J Neurosurg Sci 2019; 66:1-8. [PMID: 30942050 DOI: 10.23736/s0390-5616.19.04634-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Identification of the central sulcus can require inspection of subtle differences or require certain pulse sequences. This study identifies the central sulcus by signal intensity on Double Inversion Recovery (DIR) images in multiple anatomic locations and imaging planes. METHODS 49 patients (98 hemispheres) were retrospectively reviewed by three neuroradiologists and one radiology resident. The central sulcus was compared to the surrounding sulci for differences in signal intensity at axial hand knob, axial operculum, and lateral convexity sagittal images (294 locations) on DIR images. The use of the 'disappearing central sulcus sign' where the window level is increased at constant width and black/white inversion were also assessed. RESULTS In 49 patients (22 female, 27 male; median age 36 years), the central sulcus cortex signal intensity was lower than adjacent sulci with a frequency of 90/98 (91.8%) at the axial hand knob level, 68/98 (69.4%) at the axial operculum level, and 76/98 (77.5%) at the sagittal level. With black and white inversion, the frequencies were of 96/98 (98%), 92/98 (94%), and 87/98 (89%). The central sulcus was the first to disappear at all three levels with high degrees of inter-reader agreement (86%-99%). Traditional anatomic landmarks were absent or conflicting in seven hemispheres (5 patients). The central sulcus was identified by DIR signal intensity in all seven hemispheres. CONCLUSIONS The central sulcus can be identified by differences in signal intensity of the peri-rolandic cortex on DIR. Use of black/white inversion and the disappearing central sulcus sign may further facilitate identification.
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Affiliation(s)
- Ian T Mark
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Robert J Witte
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jennifer R Geske
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew P Johnson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Vance T Lehman
- Department of Radiology, Mayo Clinic, Rochester, MN, USA -
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Su S, Yang N, Gaillard F. Invisible cortex sign: A highly accurate feature to localize the inferolateral central sulcus. J Med Imaging Radiat Oncol 2019; 63:439-445. [PMID: 30874376 DOI: 10.1111/1754-9485.12875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 02/17/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The central sulcus is a key landmark on MRI of the brain, but its inferolateral portion is difficult to identify if unable to trace the sulcus superoinferiorly. The authors observed that the cortex abutting the central sulcus appears isointense to the adjacent white matter on DWI, we named this the 'invisible cortex sign' and our study evaluates whether it could be used to identify the inferolateral central sulcus. METHODS Observational study of 108 consecutive 'normal' MRI studies performed from May 2016 to January 2017. A single axial DWI image - obtained in the anterior commissure-posterior commissure plane - was selected from each scan just above the subcentral gyrus such that it included the most inferolateral portion of the central sulcus. These single images were given to 10 readers (neuroradiologists, a neuroradiology fellow and radiology trainees) who marked the central sulcus based on the presence of the 'invisible cortex sign'. Their accuracy in identifying the central sulcus was compared with that of the principal investigators, who used tri-planar T1 volumetric MRI sequences. RESULTS One hundred and eight consecutive patients (55 female, 53 male) were selected, ranging from 18 to 81 years old (mean = 40.5, σ = 18.2). The central sulcus was correctly identified in 95.5% of cases (σ = 3.7%; range 89.4-99.1%). CONCLUSION The 'invisible cortex sign' is a highly accurate method of identifying the inferolateral central sulcus on a single axial DWI slice without relying on the more superior aspects of the sulcus.
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Affiliation(s)
- Shu Su
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Natalie Yang
- Department of Radiology, The Austin Hospital, Melbourne, Victoria, Australia
| | - Frank Gaillard
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Radiology, The University of Melbourne, Melbourne, Victoria, Australia
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Buard I, Kronberg E, Steinmetz S, Hepburn S, Rojas DC. Neuromagnetic Beta-Band Oscillations during Motor Imitation in Youth with Autism. AUTISM RESEARCH AND TREATMENT 2018; 2018:9035793. [PMID: 30147953 PMCID: PMC6083595 DOI: 10.1155/2018/9035793] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/22/2018] [Accepted: 07/12/2018] [Indexed: 12/28/2022]
Abstract
Children with ASD often exhibit early difficulties with action imitation, possibly due to low-level sensory or motor impairments. Impaired cortical rhythms have been demonstrated in adults with ASD during motor imitation. While those oscillations reflect an age-dependent process, they have not been fully investigated in youth with ASD. We collected magnetoencephalography data to examine patterns of oscillatory activity in the mu (8-13 Hz) and beta frequency (15-30 Hz) range in 14 adolescents with and 14 adolescents without ASD during a fine motor imitation task. Typically developing adolescents exhibited adult-like patterns of motor signals, e.g., event-related beta and mu desynchronization (ERD) before and during the movement and a postmovement beta rebound (PMBR) after the movement. In contrast, those with ASD exhibited stronger beta and mu-ERD and reduced PMBR. Behavioral performance was similar between groups despite differences in motor cortical oscillations. Finally, we observed age-related increases in PBMR and beta-ERD in the typically developing children, but this correlation was not present in the autism group. These results suggest reduced inhibitory drive in cortical rhythms in youth with autism during intact motor imitation. Furthermore, impairments in motor brain signals in autism may not be due to delayed brain development. In the context of the excitation-inhibition imbalance perspectives of autism, we offer new insights into altered organization of neurophysiological networks.
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Affiliation(s)
- I. Buard
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - E. Kronberg
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S. Steinmetz
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S. Hepburn
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D. C. Rojas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
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