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Premusz V, Makai A, Veress R, Doczi T, Rocha P, Acs P. P06-05 Physical activity patterns of Hungarian women of reproductive age, preliminary study of the EUPASMOS project. Eur J Public Health 2022. [PMCID: PMC9421752 DOI: 10.1093/eurpub/ckac095.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Benefits of appropriate physical activity (PA) on reproductive performance of women are well known. In our study PA patterns recorded with the GPAQ-H questionnaire was corrected collected by RM42 traxial accelerometers first time in Hungary. Our aim was to examine PA patterns of women of reproductive age (RA) (15-49 years) and to evaluate their PA literacy.
Methods
Data collection was conducted during February-May 2019 using quota sampling by age and gender representing the Hungarian adult population. The study comprised 345 females, 175 of them in RA (mean age 32.63±10.23 years). PA was measured for 7 consecutive days using sedentary, standing, moderate to vigorous (MVPA) and vigorous activities (VA) and daily steps scores. Data were expressed as mean ± SD, Spearman’s rank correlation was applied to analyse data using SPSS 24. program, where level of significance was set at p < 0.05.
Results
Based on RM42 data females (N = 345) took 6483.75±3201.28 steps and spent 8.7 hours (523.00±114.31 min/day) sedentary per day and spent 6.5 hours (388.37±226.38 min/week) with MVPA and 19.12±33.98 minutes with VPA per week. The RA group (N = 175) seemed more active, 7619.32±2382.21 daily steps were measured and 229.25±304.84 min/week active transportation (walking vs cycling) self-reported. Although, they did not have sufficient knowledge on they activity patterns, significant difference (-250.92±906.95, p < 0.001) was found between self-reports (604.72±884.54 min/week) and objective measures (356.88±205.55 min/week) of MVPA and VPA was also significantly (p < 0.001) overestimated with GPAQ-H (248.78±424.50 min/week) compared to RM42 data (23.00±54.40 min/week). Negative correlation was found between age and RM42 standing (R=-0.209, p = 0.005), steps (R=-0.138, p = 0.069) and LPA (R=-0.217, p = 0.004) as well. However, the relationship was positive with MVPA (R = 0.367, p < 0.001) and VPA (R = 0.358, p < 0.001).
Conclusions
Development of an integrated methodological process of PA measurement would be the main purpose of the EUPASMOS Project, but relevant information could be also obtained on certain subsamples. However, our results need to be further analysed, conclusion could be drawing, that specific interventions are needed to increase physical literacy for better understanding of appropriate intensity and level of PA, and its benefits on fertility among women of reproductive age. This work was supported by the 20765/3/2018/FEKUTSTRAT grant.
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Affiliation(s)
| | - Alexandra Makai
- Faculty of Health Sciences, University of Pécs , Pécs, Hungary
| | - Reka Veress
- Hungarian Leisure Sport Association , Budapest, Hungary
| | - Tamas Doczi
- Department of Social Sciences, University of Physical Education , Budapest, Hungary
| | - Paulo Rocha
- Department of Sport and Health, Exercise and Health Laboratory, University of Lisbon , Lisbon, Portugal
| | - Pongrac Acs
- Faculty of Health Sciences, University of Pécs , Pécs, Hungary
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Toth M, Horvath Z, Doczi T, Kuperczko D, Janszky J. O211 First SEEG examination in University of Pécs. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.07.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Toth A, Kornyei B, Kovacs N, Rostas T, Buki A, Doczi T, Bogner P, Schwarcz A. Both hemorrhagic and non-hemorrhagic traumatic MRI lesions are associated with the microstructural damage of the normal appearing white matter. Behav Brain Res 2017; 340:106-116. [PMID: 28249729 DOI: 10.1016/j.bbr.2017.02.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/11/2016] [Accepted: 02/22/2017] [Indexed: 10/20/2022]
Abstract
Traumatic microbleeds (TMBs) and non-hemorrhagic lesions (NHLs) on MRI are regarded as surrogate markers of diffuse axonal injury. However, the actual relation between lesional and diffuse pathology remained unclear, since lesions were related to clinical parameters, largely influenced by extracranial factors. The aim of this study is to directly compare TMBs, NHLs and their regional features with the co-existing diffuse injury of the normal appearing white matter (NAWM) as measured by diffusion tensor imaging (DTI). Thirty-eight adults with a closed traumatic brain injury (12 mild, 4 moderate and 22 severe) who underwent susceptibility weighted imaging (SWI), T1-, T2 weighted and FLAIR MRI and routine CT were included in the study. TMB (on SWI) and NHL (on T1-, T2 weighted and FLAIR images) features and Rotterdam scores were evaluated. DTI metrics such as fractional anisotropy (FA) and mean diffusivity (MD) were measured over different NAWM regions. Clinical parameters including age; Glasgow Coma Scale; Rotterdam score; TMB and NHL features were correlated to regional NAWM diffusivity using multiple regression. Overall NHL presence and basal ganglia area TMB load were significantly, negatively correlated with the subcortical NAWM FA values (partial r=-0.37 and -0.36; p=0.006 and 0.025, respectively). The presence of any NHL, or TMBs located in the basal ganglia area indicates diffuse NAWM damage even after adjusting for clinical and CT parameters. To estimate DAI, a conventional lesional MRI pathology evaluation might at least in part substitute the use of quantitative DTI, which is yet not widely feasible in a clinical setting.
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Affiliation(s)
- Arnold Toth
- Department of Neurosurgery, Pécs Medical School, Rét. u. 2, H-7623 Pécs, Hungary; Department of Radiology, Pécs Medical School, Ifjusag str. 13, H-7624 Pécs, Hungary.
| | - Balint Kornyei
- Department of Neurosurgery, Pécs Medical School, Rét. u. 2, H-7623 Pécs, Hungary
| | - Noemi Kovacs
- Department of Neurosurgery, Pécs Medical School, Rét. u. 2, H-7623 Pécs, Hungary
| | - Tamas Rostas
- Department of Radiology, Pécs Medical School, Ifjusag str. 13, H-7624 Pécs, Hungary
| | - Andras Buki
- Department of Neurosurgery, Pécs Medical School, Rét. u. 2, H-7623 Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Hungary
| | - Tamas Doczi
- Department of Neurosurgery, Pécs Medical School, Rét. u. 2, H-7623 Pécs, Hungary; Diagnostic Center of Pécs, Rét. u. 2, H-7623 Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Hungary
| | - Peter Bogner
- Department of Neurosurgery, Pécs Medical School, Rét. u. 2, H-7623 Pécs, Hungary; Department of Radiology, Pécs Medical School, Ifjusag str. 13, H-7624 Pécs, Hungary
| | - Attila Schwarcz
- Department of Neurosurgery, Pécs Medical School, Rét. u. 2, H-7623 Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Hungary
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Nemes O, Kovacs N, Szujo S, Bodis B, Bajnok L, Buki A, Doczi T, Czeiter E, Mezosi E. Can early clinical parameters predict post-traumatic pituitary dysfunction in severe traumatic brain injury? Acta Neurochir (Wien) 2016; 158:2347-2353. [PMID: 27778105 DOI: 10.1007/s00701-016-2995-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Post-traumatic hypopituitarism is a major complication after severe head trauma. The aim of our study was to evaluate the possible role of early clinical parameters in the development of endocrine deficits. METHODS Data on endocrine function, on-admission clinical-, laboratory-, and ICU-monitored parameters were available in 63 patients of the surviving 86 severe head injury patients (post-resuscitation GCS under 8) treated at one neurosurgical center during a 10-year period. RESULTS Hypopituitarism was diagnosed in 68.3 % of the patients. The most frequently affected pituitary axis was the growth hormone (GH): GH deficiency or insufficiency was present in 50.8 %. Central hypogonadism affected 23.8 % of male patients; hypothyroidism and secondary adrenal failure were found in 22.2 and 9.5 % of the investigated population, respectively. Early onset (within 1 year of brain injury) hypopituitarism was found in 24 patients. No connection was found between the development of hypopituitarism and any of the clinical parameters assessed on-admission or at ICU. Significant correlations were found between early endocrine dysfunctions and surgical intervention (OR: 4.64) and the diagnosis of subdural hematoma (OR: 12). In our population, after road traffic accidents, the development of late-onset hypopituitarism was less prevalent (OR: 0.22). CONCLUSIONS Since our results do not indicate any reliable predictive parameter for the development of endocrine dysfunction in a cohort of patients with severe traumatic brain injury, regular endocrine screening of this specific patient population seems obligatory.
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Perlaki G, Szekeres S, Orsi G, Papp L, Suha B, Nagy SA, Doczi T, Janszky J, Zambo K, Kovacs N. Validation of an automated morphological MRI-based (123)I-FP-CIT SPECT evaluation method. Parkinsonism Relat Disord 2016; 29:24-9. [PMID: 27290659 DOI: 10.1016/j.parkreldis.2016.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/18/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Dopamine transporter imaging with (123)I-FP-CIT single photon emission computed tomography (SPECT) is helpful for the differential diagnosis between Parkinsonian syndrome (PS) and essential tremor (ET). Although visual assessment and time-consuming manual evaluation techniques are readily available, a fully objective and automated dopamine transporter quantification technique is always preferable, at least in research and follow-up investigations. Our aim was to develop a novel automated magnetic resonance imaging (MRI)-based evaluation technique of dopamine transporter SPECT images and to compare its diagnostic accuracy with those of the gold-standard visual grading and manual dopamine transporter binding quantification methods. METHODS (123)I-FP-CIT SPECT and MRI sessions were conducted in 33 patients with PS (15 men; mean age: 60.3 ± 9.7 years) and 15 patients with ET (8 men; mean age: 54.7 ± 16.3 years). Striatal dopamine transporter binding was visually classified by 2 independent experts as normal or abnormal grade I, II and III. Caudal and putaminal specific uptake ratios were calculated by both automated MRI-based and manual evaluation techniques. RESULTS We found almost perfect agreement (κ = 0.829) between the visual scores by the 2 observers. The automated method showed strong correlation with the visual and manual evaluation techniques and its diagnostic accuracy (sensitivity = 97.0%; specificity = 93.3%) was also comparable to these methods. The automatically determined uptake parameters showed negative correlation with the clinical severity of parkinsonism. Based on ordinal regression modelling, the automated MRI-based method could reliably determine the visual grading scores. CONCLUSION The novel MRI-based evaluation of (123)I-FP-CIT SPECT images is useful for the differentiation of PS from ET.
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Affiliation(s)
- Gabor Perlaki
- MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Pecs Diagnostic Centre, H-7623 Pecs, Hungary
| | - Sarolta Szekeres
- Department of Nuclear Medicine, University of Pecs, H-7624 Pecs, Hungary
| | - Gergely Orsi
- MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Pecs Diagnostic Centre, H-7623 Pecs, Hungary
| | - Laszlo Papp
- Mediso Medical Imaging Systems, H-1022 Budapest, Hungary
| | - Balazs Suha
- Department of Nuclear Medicine, University of Pecs, H-7624 Pecs, Hungary
| | - Szilvia Anett Nagy
- Pecs Diagnostic Centre, H-7623 Pecs, Hungary; MTA-PTE Neurobiology of Stress Research Group, H-7624 Pecs, Hungary
| | - Tamas Doczi
- MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Pecs Diagnostic Centre, H-7623 Pecs, Hungary; Department of Neurosurgery, University of Pecs, H-7623 Pecs, Hungary
| | - Jozsef Janszky
- MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Department of Neurology, University of Pecs, H-7623 Pecs, Hungary
| | - Katalin Zambo
- Department of Nuclear Medicine, University of Pecs, H-7624 Pecs, Hungary
| | - Norbert Kovacs
- MTA-PTE Clinical Neuroscience MR Research Group, H-7623 Pecs, Hungary; Department of Neurology, University of Pecs, H-7623 Pecs, Hungary.
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Toth A, Kovacs N, Tamas V, Kornyei B, Nagy M, Horvath A, Rostas T, Bogner P, Janszky J, Doczi T, Buki A, Schwarcz A. Microbleeds may expand acutely after traumatic brain injury. Neurosci Lett 2016; 617:207-12. [PMID: 26912192 DOI: 10.1016/j.neulet.2016.02.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/14/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND PURPOSE Susceptibility weighted imaging (SWI) is a very sensitive tool for the detection of microbleeds in traumatic brain injury (TBI). The number and extent of such traumatic microbleeds (TMBs) have been shown to correlate with the severity of the injury and the clinical outcome. However, the acute dynamics of TMBs have not been revealed so far. Since TBI is known to constitute dynamic pathological processes, we hypothesized that TMBs are not constant in their appearance, but may progress acutely after injury. MATERIALS AND METHODS We present here five closed moderate/severe (Glasgow coma scale≤13) TBI patients who underwent SWI very early (average=23.4 h), and once again a week (average=185.8 h) after the injury. The TMBs were mapped at both time points by a conventional radiological approach and their numbers and volumes were measured with manual tracing tools by two observers. TMB counts and extents were compared between time points. RESULTS TMBs were detected in four patients, three of them displaying an apparent TMB change. In these patients, TMB confluence and apparent growth were detected in the corpus callosum, coronal radiation or subcortical white matter, while unchanged TMBs were also present. These changes caused a decrease in the TMB count associated with an increase in the overall TMB volume over time. CONCLUSION We have found a compelling evidence that diffuse axonal injury-related microbleed development is not limited strictly to the moment of injury: the TMBs might expand in the acute phase of TBI. The timing of SWI acquisition may be relevant for optimizing the prognostic utility of this imaging biomarker.
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Affiliation(s)
- Arnold Toth
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary.
| | - Noemi Kovacs
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary.
| | - Viktoria Tamas
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary.
| | - Balint Kornyei
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary.
| | - Mate Nagy
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary.
| | - Andrea Horvath
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary; Diagnostic Center of Pécs, H-7623, Rét. u. 2., Pécs, Hungary.
| | - Tamas Rostas
- Department of Radiology, Pécs Medical School, H-7624, Ifjusag str. 13., Pécs, Hungary.
| | - Peter Bogner
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary; Department of Radiology, Pécs Medical School, H-7624, Ifjusag str. 13., Pécs, Hungary.
| | - Jozsef Janszky
- Department of Neurology, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Hungary.
| | - Tamas Doczi
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary; Diagnostic Center of Pécs, H-7623, Rét. u. 2., Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Hungary.
| | - Andras Buki
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Hungary.
| | - Attila Schwarcz
- Department of Neurosurgery, Pécs Medical School, H-7623, Rét. u. 2., Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Hungary.
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Perlaki G, Orsi G, Schwarcz A, Bodi P, Plozer E, Biczo K, Aradi M, Doczi T, Komoly S, Hejjel L, Kovacs N, Janszky J. Pain-related autonomic response is modulated by the medial prefrontal cortex: An ECG-fMRI study in men. J Neurol Sci 2015; 349:202-8. [PMID: 25623806 DOI: 10.1016/j.jns.2015.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 12/18/2014] [Accepted: 01/12/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Our goal was to identify brain structures responsible for pain-related autonomic changes by the correlation of simultaneously acquired functional magnetic resonance imaging (fMRI) and electrocardiogram (ECG) data. METHODS Eighteen healthy men (age: 22.89 ± 1.96) were involved. Painful sensation was evoked by heat. Simultaneously recorded brain fMRI and ECG data during pain were compared to data acquired during a non-painful heat sensation. From the ECG data, time- and frequency domain parameters of heart rate variability (HRV) were extracted. RESULTS We found that: (1) among the common elements of both pain network and central autonomic network (CAN) only the medial prefrontal frontal cortex (MPFC) showed significant correlation with HRV; (2) the parasympathetic response to the painful stimuli showed a positive, while the sympathetic response a negative association with pain related BOLD-signal change observed in MPFC; (3) time domain parameters of HRV were negatively associated with MPFC activation. CONCLUSIONS The novelty of our study-compared to previous ECG-fMRI studies-is that we used pain as stimulus and investigated both frequency- and time-domain parameters of HRV. Compared to other stimuli used in earlier studies to activate the CAN, pain sensation can be standardized easier and might allow us to better understand the functional organization of CAN. The results of the current ECG-fMRI study may have direct clinical relevance in understanding the pathomechanisms of several clinical conditions. PERSPECTIVE There are some simultaneous ECG-fMRI and ECG-Positron Emission Tomography (PET) studies, but limited information is available about the pain-related brain function-HRV relations. The novelty of our study is that we used pain as stimulus to activate the central autonomic network and investigated both frequency- and time-domain parameters of HRV.
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Affiliation(s)
- Gabor Perlaki
- Department of Neurology, University of Pécs, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Gergely Orsi
- Department of Neurology, University of Pécs, Pécs, Hungary; Pécs Diagnostic Centre, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
| | - Attila Schwarcz
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | | | - Eniko Plozer
- Department of Neurology, University of Pécs, Pécs, Hungary
| | | | | | - Tamas Doczi
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary; Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Samuel Komoly
- Department of Neurology, University of Pécs, Pécs, Hungary
| | | | - Norbert Kovacs
- Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Jozsef Janszky
- Department of Neurology, University of Pécs, Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
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Perlaki G, Orsi G, Plozer E, Altbacker A, Darnai G, Nagy SA, Horvath R, Toth A, Doczi T, Kovacs N, Bogner P, Schwarcz A, Janszky J. Are there any gender differences in the hippocampus volume after head-size correction? A volumetric and voxel-based morphometric study. Neurosci Lett 2014; 570:119-23. [DOI: 10.1016/j.neulet.2014.04.013] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 03/24/2014] [Accepted: 04/09/2014] [Indexed: 11/17/2022]
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Bijlenga P, Ebeling C, Jaegersberg M, Summers P, Rogers A, Waterworth A, Iavindrasana J, Macho J, Pereira VM, Bukovics P, Vivas E, Sturkenboom MC, Wright J, Friedrich CM, Frangi A, Byrne J, Schaller K, Rufenacht D, Narata AP, Clarke A, Yarnold J, Kover F, Schatlo B, Hudak S, Teta P, Blasco J, Gonzalez AM, Lovblad KO, Coley S, Dòczi T, Risselada R, Sola T, Lawford P, Patel U, Singh P, Wickins J, Elger B, Beyleveld D, Wood S, Hasselmeyer P, Arbona A, Meyer R, Hose R, Lonsdale G, Hofmann-Apitius M, Frangi A, Bijlenga P, Hofmann-Apitius M, Hose R, Lonsdale G, Arbona A, Hasselmeyer P, Rüfenacht D, Bijlenga P, Summers P, Jägersberg M, Rogers A, Schaller K, Byrne J, Wright J, Wilkins J, Beyleveld D, Elger B, Waterworth A, Wood S, Iavindrasana J, Meyer R, Friedrich C, Ebeling C, Ebeling C, Bijlenga P, Risselada R, Friedrich C, Sturkenboom MCJM, Bijlenga P, Jägersberg M, Rogers A, Schatlo B, Teta P, Schaller K, Mendes-Pereira V, Gonzalez AM, Narata AP, Lovblad KO, Rüfenacht DA, Yarnold J, Summers P, Clarke A, Zilani G, Byrne J, Macho J, Blasco J, Bukovics P, Kover F, Hudak I, Doczi T, Risselada R, Sturkenboom MCJM, Singh P, Waterworth A, Patel U, Coley S, Lawford P, Sola T, Vivas E. Risk of Rupture of Small Anterior Communicating Artery Aneurysms Is Similar to Posterior Circulation Aneurysms. Stroke 2013; 44:3018-26. [DOI: 10.1161/strokeaha.113.001667] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
According to the International Study of Unruptured Intracranial Aneurysms (ISUIA), anterior circulation (AC) aneurysms of <7 mm in diameter have a minimal risk of rupture. It is general experience, however, that anterior communicating artery (AcoA) aneurysms are frequent and mostly rupture at <7 mm. The aim of the study was to assess whether AcoA aneurysms behave differently from other AC aneurysms.
Methods—
Information about 932 patients newly diagnosed with intracranial aneurysms between November 1, 2006, and March 31, 2012, including aneurysm status at diagnosis, its location, size, and risk factors, was collected during the multicenter @neurIST project. For each location or location and size subgroup, the odds ratio (OR) of aneurysms being ruptured at diagnosis was calculated.
Results—
The OR for aneurysms to be discovered ruptured was significantly higher for AcoA (OR, 3.5 [95% confidence interval, 2.6–4.5]) and posterior circulation (OR, 2.6 [95% confidence interval, 2.1–3.3]) than for AC excluding AcoA (OR, 0.5 [95% confidence interval, 0.4–0.6]). Although a threshold of 7 mm has been suggested by ISUIA as a threshold for aggressive treatment, AcoA aneurysms <7 mm were more frequently found ruptured (OR, 2.0 [95% confidence interval, 1.3–3.0]) than AC aneurysms of 7 to 12 mm diameter as defined in ISUIA.
Conclusions—
We found that AC aneurysms are not a homogenous group. Aneurysms between 4 and 7 mm located in AcoA or distal anterior cerebral artery present similar rupture odds to posterior circulation aneurysms. Intervention should be recommended for this high-risk lesion group.
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Affiliation(s)
- Philippe Bijlenga
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Christian Ebeling
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Max Jaegersberg
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Paul Summers
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Alister Rogers
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Alan Waterworth
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Jimison Iavindrasana
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Juan Macho
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Vitor Mendes Pereira
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Peter Bukovics
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Elio Vivas
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Miriam C.J.M. Sturkenboom
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Jessica Wright
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Christoph M. Friedrich
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Alejandro Frangi
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - James Byrne
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Karl Schaller
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | - Daniel Rufenacht
- From the Service de Neurochirurgie/Départment de Neurosciences Cliniques (Ph.B., M.J., A.R., K.S.), Division de Neuroradiologie Diagnostique et Interventionelle (V.M.P.), Division des Services Informatiques (J.I.), Faculté de Médecine de Genève and Hôpitaux Universitaire de Genève, Switzerland; Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany (C.E., C.M.F.); Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Philippe Bijlenga
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | | | - Rod Hose
- Royal Hallamshire Hospital and University of Sheffield, United Kingdom
| | - Guy Lonsdale
- NEC Laboratories Europe, IT Research Division, Sankt Augustin, Germany
| | - Antonio Arbona
- NEC Laboratories Europe, IT Research Division, Sankt Augustin, Germany
| | - Peer Hasselmeyer
- NEC Laboratories Europe, IT Research Division, Sankt Augustin, Germany
| | - Daniel Rüfenacht
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Philippe Bijlenga
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Paul Summers
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Max Jägersberg
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Alister Rogers
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva Switzerland
| | - Karl Schaller
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - James Byrne
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | | | | | | | - Bernice Elger
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Alan Waterworth
- Royal Hallamshire Hospital and University of Sheffield, United Kingdom
| | - Steven Wood
- Royal Hallamshire Hospital and University of Sheffield, United Kingdom
| | - Jimison Iavindrasana
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Rodolphe Meyer
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva. Switzerland
| | - Christoph Friedrich
- Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany
| | - Christian Ebeling
- Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany
| | - Christian Ebeling
- Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany
| | - Philippe Bijlenga
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | | | - Christoph Friedrich
- Fraunhofer Institut Algorithmen und Wissenschaftliches Rechnen, Sankt Augustin, Germany
| | | | - Philippe Bijlenga
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Max Jägersberg
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Alister Rogers
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Bawarjan Schatlo
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Patrick Teta
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Karl Schaller
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Vitor Mendes-Pereira
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Ana Marcos Gonzalez
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Ana Paula Narata
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Karl O Lovblad
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Daniel A. Rüfenacht
- Hôpitaux Universitaire de Genève et Faculté de médecine de Genève, Geneva, Switzerland
| | - Julia Yarnold
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Paul Summers
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Alison Clarke
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Gulam Zilani
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - James Byrne
- John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | | | | | | | - Ferenc Kover
- University of Pècs Medical School, Pècs, Hungary
| | - Istvan Hudak
- University of Pècs Medical School, Pècs, Hungary
| | - Tamas Doczi
- University of Pècs Medical School, Pècs, Hungary
| | | | | | - Pankaj Singh
- Royal Hallamshire Hospital, Sheffield, United Kingdom
| | | | - Umang Patel
- Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Stuart Coley
- Royal Hallamshire Hospital, Sheffield, United Kingdom
| | | | - Teresa Sola
- Hospital General de Catalunya, San Cugat del Valles, Spain
| | - Elio Vivas
- Hospital General de Catalunya, San Cugat del Valles, Spain
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Perlaki G, Horvath R, Orsi G, Aradi M, Auer T, Varga E, Kantor G, Altbäcker A, John F, Doczi T, Komoly S, Kovacs N, Schwarcz A, Janszky J. White-matter microstructure and language lateralization in left-handers: a whole-brain MRI analysis. Brain Cogn 2013; 82:319-28. [PMID: 23792788 DOI: 10.1016/j.bandc.2013.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Revised: 05/17/2013] [Accepted: 05/20/2013] [Indexed: 01/19/2023]
Abstract
Most people are left-hemisphere dominant for language. However the neuroanatomy of language lateralization is not fully understood. By combining functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), we studied whether language lateralization is associated with cerebral white-matter (WM) microstructure. Sixteen healthy, left-handed women aged 20-25 were included in the study. Left-handers were targeted in order to increase the chances of involving subjects with atypical language lateralization. Language lateralization was determined by fMRI using a verbal fluency paradigm. Tract-based spatial statistics analysis of DTI data was applied to test for WM microstructural correlates of language lateralization across the whole brain. Fractional anisotropy and mean diffusivity were used as indicators of WM microstructural organization. Right-hemispheric language dominance was associated with reduced microstructural integrity of the left superior longitudinal fasciculus and left-sided parietal lobe WM. In left-handed women, reduced integrity of the left-sided language related tracts may be closely linked to the development of right hemispheric language dominance. Our results may offer new insights into language lateralization and structure-function relationships in human language system.
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Affiliation(s)
- Gabor Perlaki
- Department of Neurology, University of Pecs, Ret U. 2, 7623 Pecs, Hungary
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11
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Toth A, Kovacs N, Perlaki G, Orsi G, Aradi M, Komaromy H, Ezer E, Bukovics P, Farkas O, Janszky J, Doczi T, Buki A, Schwarcz A. Multi-Modal Magnetic Resonance Imaging in the Acute and Sub-Acute Phase of Mild Traumatic Brain Injury: Can We See the Difference? J Neurotrauma 2013; 30:2-10. [DOI: 10.1089/neu.2012.2486] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Arnold Toth
- Department of Neurology, University of Pécs, Pécs, Hungary
| | - Noemi Kovacs
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Gabor Perlaki
- Department of Neurology, University of Pécs, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Gergely Orsi
- Department of Neurology, University of Pécs, Pécs, Hungary
- Pécs Diagnostic Centre, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | | | | | - Erzsebet Ezer
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
| | - Peter Bukovics
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Orsolya Farkas
- Department of Radiology, University of Pécs, Pécs, Hungary
| | - Jozsef Janszky
- Department of Neurology, University of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Tamas Doczi
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Andras Buki
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
| | - Attila Schwarcz
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary
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12
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Tamas A, Reglodi D, Farkas O, Kovesdi E, Pal J, Povlishock JT, Schwarcz A, Czeiter E, Szanto Z, Doczi T, Buki A, Bukovics P. Effect of PACAP in central and peripheral nerve injuries. Int J Mol Sci 2012; 13:8430-8448. [PMID: 22942712 PMCID: PMC3430243 DOI: 10.3390/ijms13078430] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 06/25/2012] [Accepted: 06/26/2012] [Indexed: 01/07/2023] Open
Abstract
Pituitary adenylate cyclase activating polypeptide (PACAP) is a bioactive peptide with diverse effects in the nervous system. In addition to its more classic role as a neuromodulator, PACAP functions as a neurotrophic factor. Several neurotrophic factors have been shown to play an important role in the endogenous response following both cerebral ischemia and traumatic brain injury and to be effective when given exogenously. A number of studies have shown the neuroprotective effect of PACAP in different models of ischemia, neurodegenerative diseases and retinal degeneration. The aim of this review is to summarize the findings on the neuroprotective potential of PACAP in models of different traumatic nerve injuries. Expression of endogenous PACAP and its specific PAC1 receptor is elevated in different parts of the central and peripheral nervous system after traumatic injuries. Some experiments demonstrate the protective effect of exogenous PACAP treatment in different traumatic brain injury models, in facial nerve and optic nerve trauma. The upregulation of endogenous PACAP and its receptors and the protective effect of exogenous PACAP after different central and peripheral nerve injuries show the important function of PACAP in neuronal regeneration indicating that PACAP may also be a promising therapeutic agent in injuries of the nervous system.
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Affiliation(s)
- Andrea Tamas
- PTE-MTA “Lendulet” PACAP Research Team, Department of Anatomy, University of Pecs, Szigeti. u. 12, H-7624 Pecs, Hungary; E-Mails: (D.R.); (E.C.)
| | - Dora Reglodi
- PTE-MTA “Lendulet” PACAP Research Team, Department of Anatomy, University of Pecs, Szigeti. u. 12, H-7624 Pecs, Hungary; E-Mails: (D.R.); (E.C.)
| | - Orsolya Farkas
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
| | - Erzsebet Kovesdi
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
| | - Jozsef Pal
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
| | - John T. Povlishock
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, 1101 E. Marshall Street Richmond, Richmond, VA 23219, USA; E-Mail:
| | - Attila Schwarcz
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
| | - Endre Czeiter
- PTE-MTA “Lendulet” PACAP Research Team, Department of Anatomy, University of Pecs, Szigeti. u. 12, H-7624 Pecs, Hungary; E-Mails: (D.R.); (E.C.)
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
| | - Zalan Szanto
- Department of Surgery, Medical School, University of Pecs, Ret u. 2., H-7623 Pecs, Hungary; E-Mail:
| | - Tamas Doczi
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
| | - Andras Buki
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
| | - Peter Bukovics
- MTA-PTE Clinical Neuroscience MR Research Group, Department of Neurosurgery, University of Pecs, Ret u. 2, H-7623 Pecs, Hungary; E-Mails: (O.F.); (E.K.); (J.P.); (A.S.); (T.D.); (A.B.); (P.B.)
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13
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Czeiter E, Mondello S, Kovacs N, Sandor J, Gabrielli A, Schmid K, Tortella F, Wang KKW, Hayes RL, Barzo P, Ezer E, Doczi T, Buki A. Brain injury biomarkers may improve the predictive power of the IMPACT outcome calculator. J Neurotrauma 2012; 29:1770-8. [PMID: 22435839 DOI: 10.1089/neu.2011.2127] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Outcome prediction following severe traumatic brain injury (sTBI) is a widely investigated field of research. A major breakthrough is represented by the IMPACT prognostic calculator based on admission data of more than 8500 patients. A growing body of scientific evidence has shown that clinically meaningful biomarkers, including glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), and αII-spectrin breakdown product (SBDP145), could also contribute to outcome prediction. The present study was initiated to assess whether the addition of biomarkers to the IMPACT prognostic calculator could improve its predictive power. Forty-five sTBI patients (GCS score≤8) from four different sites were investigated. We utilized the core model of the IMPACT calculator (age, GCS motor score, and reaction of pupils), and measured the level of GFAP, UCH-L1, and SBDP145 in serum and cerebrospinal fluid (CSF). The forecast and actual 6-month outcomes were compared by logistic regression analysis. The results of the core model itself, as well as serum values of GFAP and CSF levels of SBDP145, showed a significant correlation with the 6-month mortality using a univariate analysis. In the core model, the Nagelkerke R(2) value was 0.214. With multivariate analysis we were able to increase this predictive power with one additional biomarker (GFAP in CSF) to R(2)=0.476, while the application of three biomarker levels (GFAP in CSF, GFAP in serum, and SBDP145 in CSF) increased the Nagelkerke R(2) to 0.700. Our preliminary results underline the importance of biomarkers in outcome prediction, and encourage further investigation to expand the predictive power of contemporary outcome calculators and prognostic models in TBI.
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Affiliation(s)
- Endre Czeiter
- Department of Neurosurgery, Medical School, University of Pecs, Pecs, Hungary.
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Toth P, Rozsa B, Springo Z, Doczi T, Koller A. Isolated human and rat cerebral arteries constrict to increases in flow: role of 20-HETE and TP receptors. J Cereb Blood Flow Metab 2011; 31:2096-105. [PMID: 21610722 PMCID: PMC3208155 DOI: 10.1038/jcbfm.2011.74] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Elevation of intraluminal pressure increases vasomotor tone, which thought to have a substantial role in regulation of cerebral blood flow (CBF). Interestingly, responses of cerebral vessels to increases in flow varied and have not been studied in human cerebral arteries. We hypothesized that increases in flow elicit constrictions of isolated human and rat cerebral arteries and aimed to elucidate the underlying mechanisms. Human cerebral arteries and rat middle cerebral arteries constricted to increases in flow (P<0.05). Simultaneous increase in intraluminal flow+pressure further reduced the diameter compared with pressure-induced changes (P<0.05), leading to constant estimated CBF. Flow-induced constrictions were abolished by HET0016 (inhibitor of synthesis of 20-hydroxyeicosatetraenoic acid (20-HETE) or inhibition of COXs or blocking TP (thromboxane A(2)/prostaglandin H(2), receptors and attenuated by scavenging reactive oxygen species (ROS). Flow-enhanced ROS formation was significantly reduced by HET0016. In conclusion, in human and rat cerebral arteries (1) increases in flow elicit constrictions, (2) signaling mechanism of flow-induced constriction of cerebral arteries involves enhanced production of ROS, COX activity, and mediated by 20-HETE via TP receptors, and (3) we propose that simultaneous operation of pressure- and flow-induced constrictions is necessary to provide an effective autoregulation of CBF.
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Affiliation(s)
- Peter Toth
- Department of Physiology, New York Medical College, Valhalla, New York 10595, USA
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15
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Orsi G, Perlaki G, Kovacs N, Aradi M, Papp Z, Karadi K, Szalay C, Karadi Z, Lenard L, Tenyi T, Plozer E, Gabriel R, Nagy F, Doczi T, Komoly S, Jokeit H, Schwarcz A, Janszky J. Body weight and the reward system: the volume of the right amygdala may be associated with body mass index in young overweight men. Brain Imaging Behav 2011; 5:149-57. [DOI: 10.1007/s11682-011-9119-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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16
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Toth P, Vamos Z, Springo Z, Komoly S, Doczi T, Koller A. Flow/shear stress‐induced constriction of rat middle cerebral artery. FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.976.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Toth
- Department of PhysiologyNew York Medical CollegeValhallaNY
- Department of Pathophysiology and Gerontology
| | | | | | | | - Tamas Doczi
- Department of NeurosurgeryUniversity of PecsPecsHungary
| | - Akos Koller
- Department of PhysiologyNew York Medical CollegeValhallaNY
- Department of Pathophysiology and Gerontology
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Szapary L, Bagoly E, Kover F, Feher G, Pozsgai E, Koltai K, Hanto K, Komoly S, Doczi T, Toth K. The effect of carotid stenting on rheological parameters, free radical production and platelet aggregation. Clin Hemorheol Microcirc 2010; 43:209-17. [PMID: 19847055 DOI: 10.3233/ch-2009-1210] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Carotid artery stenting has become a possible treatment of significant carotid stenosis. The risk of stent occlusion and restenosis might be increased by abnormal rheological conditions amplified platelet aggregation and free radical production during the operation. AIMS The aim of our study was to assess the changes in hemorheological parameters, platelet aggregation, and catalase activity after endovascular treatment of carotid stenosis. METHODS 18 patients (11 men, ages 68 +/- 9 years and 7 women, ages 62 +/- 8 years) suffering from significant carotid stenosis and treated with carotid endovascular intervention were examined. Alteration in hemorheological parameters as well as epinephrine-, ADP-, and collagen-induced platelet aggregation were evaluated. Antioxidant reserve was characterized by the determination of catalase activity. The measurements were carried out directly before and after the procedure and 1, 2, 5 days and 1 month following the intervention. Preceding the operation the patients were administered a maximum dose (300 mg) of clopidogrel. RESULTS Hematocrit, plasma fibrinogen concentration (PFC) and whole blood-, and plasma viscosity values (WBV and PV) significantly decreased immediately after stenting (p<0.001). By the fifth day following the intervention the PFC, WBV, PV, red blood cell (RBC) aggregation and ADP-induced platelet aggregation significantly increased (p<0.0001) compared to values measured postprocedurally. At 1 month follow-up these parameters, except whole blood viscosity, decreased significantly compared to measurements made on the 5th day. On the other hand, catalase activity showed significant elevation by the end of the first month. CONCLUSION Hemorheological parameters and platelet aggregation showed specific changes following carotid stenting. Abnormal changes of the rheological conditions and increasing platelet activation are the most pronounced in the first week following stenting, which may lead to early stent occlusion. Oxidative stress production returned to baseline levels only by the end of the first month.
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Affiliation(s)
- L Szapary
- Department of Neurology, School of Medicine, University of Pecs, Pecs, Hungary.
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18
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Llumiguano C, Kovacs N, Doczi T, Balas I. P2.148 Bilateral STN DBS improves manual performance time in Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70499-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Llumiguano C, Kovacs N, Schwarcz A, Doczi T, Balas I. P3.128 1H-MRS after bilateral DBS of the STN in Parkinson's disease. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70692-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Bajzik G, Auer T, Bogner P, Aradi M, Kotek G, Repa I, Doczi T, Schwarcz A. Quantitative brain proton MR spectroscopy based on measurement of the relaxation time T1of water. J Magn Reson Imaging 2008; 28:34-8. [DOI: 10.1002/jmri.21192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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21
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Czeiter E, Pal J, Kovesdi E, Bukovics P, Luckl J, Doczi T, Buki A. Traumatic axonal injury in the spinal cord evoked by traumatic brain injury. J Neurotrauma 2008; 25:205-13. [PMID: 18352834 DOI: 10.1089/neu.2007.0331] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although it is well known that traumatic brain injury (TBI) evokes traumatic axonal injury (TAI) within the brain, TBI-induced axonal damage in the spinal cord (SC) has been less extensively investigated. Detection of such axonal injury in the spinal cord would further the complexity of TBI while also challenging some functional neurobehavioral endpoints frequently used to assess recovery in various models of TBI. To assess TAI in the spinal cord associated with TBI, we analyzed the craniocervical junction (CCJ), cervico-thoracic (CT), and thoraco-lumber (ThL) spinal cord in a rodent model of impact acceleration of TBI of varying severities. Rats were transcardially fixed with aldehydes at 2, 6, and 24 h post-injury (n = 36); each group included on sham-injured rodent. Semi-serial vibratome sections were reacted with antibodies targeting TAI via alteration in cytoskeletal integrity or impaired axonal transport. Consistent with previous observations in this model, the CCJ contained numerous injured axons. Immunoreactive, damaged axonal profiles were also detected as caudal, as the ThL spinal cord displayed morphological characteristics entirely consistent with those described in the brainstem and the CCJ. Quantitative analyses demonstrated that the occurrence and extent of TAI is positively associated with the impact/energy of injury and negatively with the distance from the brainstem. These observations show that TBI can evoke TAI in regions remote from the injury site, including the spinal cord itself. This finding is relevant to shaken baby syndrome as well as during the analysis of data in functional recovery in various models of TBI.
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Affiliation(s)
- Endre Czeiter
- Department of Neurosurgery, University of Pécs, Pécs, Hungary
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22
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Schwarcz A, Auer T, Janszky J, Doczi T, Merboldt KD, Frahm J. TTC post-processing is beneficial for functional MRI at low magnetic field: a comparative study at 1 T and 3 T. Eur Radiol 2008; 18:2594-600. [PMID: 18523777 DOI: 10.1007/s00330-008-1046-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 04/18/2008] [Accepted: 04/21/2008] [Indexed: 10/22/2022]
Abstract
This study aimed to broaden the diagnostic possibilities of low-field MRI systems (i) by examining the feasibility of functional MRI of human brain activation at 1 T, and (ii) by assessing its reliability in comparison with acquisitions at 3 T. Eight subjects were studied at 1 T and 3T using standard echo-planar-imaging sequences at 3-mm isotropic spatial resolution. Paradigms included silent word generation, sequential finger-to-thumb opposition, and passive finger movements. Image post-processing was carried out either with statistical parametric mapping (SPM5, single-subject and group analysis) or with a two-threshold correlation (TTC, single-subject analysis only) analysis. Single-subject analysis with SPM5 resulted in 3-5 times more activated pixels at 3 T than at 1 T in the examined Broca and sensorimotor regions. By comparison, the TTC single-subject analysis yielded the same amount of activated pixels at 3 T and 1 T. Moreover, this number was identical to that obtained with SPM at 3 T. The group analysis with SPM5 resulted in very similar numbers of activated pixels at both field strengths. The present findings suggest that a field strength of 1 T combined with adequate post-processing allows for reliable functional MRI studies of human brain activation. High-field advantages are therefore best invested in higher spatial resolution.
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Affiliation(s)
- Attila Schwarcz
- Department of Neurosurgery, University of Pécs, Pécs, Hungary.
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23
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Kovesdi E, Czeiter E, Tamas A, Reglodi D, Szellar D, Pal J, Bukovics P, Doczi T, Buki A. Rescuing neurons and glia: is inhibition of apoptosis useful? Prog Brain Res 2007; 161:81-95. [PMID: 17618971 DOI: 10.1016/s0079-6123(06)61006-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Traumatic brain injury (TBI) represents a leading cause of death in western countries. Despite all research efforts we still lack any pharmacological agent that could effectively be utilized in the clinical treatment of TBI. Detailed unraveling of the pathobiological processes initiated by/operant in TBI is a prerequisite to the development of rational therapeutic interventions. In this review we provide a summary of those therapeutic interventions purported to inhibit the cell death (CD) cascades ignited in TBI. On noxious stimuli three major forms of CD, apoptosis, autophagia and necrosis may occur. Apoptosis can be induced either via the mitochondrial (intrinsic) or the receptor mediated (extrinsic) pathway; endoplasmic reticular stress is the third trigger of caspase-mediated apoptotic processes. Although, theoretically pan-caspase inhibition could be an efficient tool to limit apoptosis and thereby the extent of TBI, potential cross-talk between various avenues of CD suggests that more upstream events, particularly the preservation of the cellular energy homeostasis (cyclosporine-A, poly ADP ribose polymerase (PARP) inhibition, hypothermia treatment) may represent more efficient therapeutic targets hopefully also translated to the clinical care of the severely head injured.
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Affiliation(s)
- E Kovesdi
- Department of Neurosurgery, University Medical School, Pécs University, Pécs, Hungary, Rét u. 2. H-7624, Hungary
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24
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Auer T, Schwarcz A, Doczi T, Merboldt KD, Frahm J. A novel group analysis for functional MRI of the human brain based on a two-threshold correlation (TTC) method. J Neurosci Methods 2007; 167:335-9. [PMID: 17913237 DOI: 10.1016/j.jneumeth.2007.08.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Revised: 08/01/2007] [Accepted: 08/19/2007] [Indexed: 11/19/2022]
Abstract
This work presents a new group analysis for functional MRI of human brain activation. The two-threshold correlation (TTC) method determines two statistical thresholds by estimating the noise distribution underlying the summed histogram of correlation coefficients (CC) from all sections and subjects. The probabilistic CC thresholds (p<0.0001 for the identification of highly significant activation centers and p<0.05 for limiting the iterative addition of directly neighboring voxels to these centers) are applied to the group CC maps for each section. These maps may be reconstructed by taking the maximum (MAX) or mean (MEAN) CC value of all subjects for a particular voxel. Experimental analyses involved functional echo-planar imaging of sequential finger-to-thumb opposition and silent word generation at 3T (eight subjects). Preprocessing included motion correction, spatial filtering, and normalization to MNI space. While the results for the TTC MAX approach were very similar to those obtained for a standard SPM analysis, the TTC MEAN approach turned out to be more conservative emphasizing voxels that are activated in most rather than in only a few subjects. The new method is simple, fast, and robust by linking two thresholds in a physiologically meaningful manner.
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Affiliation(s)
- Tibor Auer
- Department of Neurosurgery, University of Pécs, H-7624 Pécs, Hungary
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25
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Kovacs N, Nagy F, Kover F, Feldmann A, Llumiguano C, Janszky J, Kotek G, Doczi T, Balas I. Implanted deep brain stimulator and 1.0-Tesla magnetic resonance imaging. J Magn Reson Imaging 2007; 24:1409-12. [PMID: 17083120 DOI: 10.1002/jmri.20779] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
There is a great need for MRI examinations of patients who have previously undergone deep brain stimulator (DBS) implantation. The current guidelines pertain only to a 1.5-Tesla horizontal-bore scanner complying with strict safety regulations. Moreover, almost all published in vitro and in vivo studies concerning patient safety are carried out on 1.5 Tesla MR scanners. The aim of our work is to share our clinical experience of 1.0-Tesla brain MR imaging. During the past four years, 34 patients with different types of implanted DBS systems underwent 1.0-Tesla MR examinations to answer diagnostic or clinical questions. Apart from the scanner type applied, all other safety instructions were strictly followed. The MRI itself made no significant difference to the measured impedances or the stimulation parameters required to achieve the optimal therapeutic results. From theoretical considerations, it may be assumed that 1.0-Tesla MRI can be performed safely on DBS-implanted patients, provided that all other recommendations are adhered to.
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Affiliation(s)
- Norbert Kovacs
- Department of Neurology, University of Pecs, Pecs, Hungary.
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26
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Schwarcz A, Bogner P, Meric P, Correze JL, Berente Z, Pál J, Gallyas F, Doczi T, Gillet B, Beloeil JC. The existence of biexponential signal decay in magnetic resonance diffusion-weighted imaging appears to be independent of compartmentalization. Magn Reson Med 2004; 51:278-85. [PMID: 14755652 DOI: 10.1002/mrm.10702] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It is generally believed that the apparent diffusion coefficient (ADC) changes measured by diffusion-weighted imaging (DWI) in brain pathologies are related to alterations in the water compartments. The aim of this study was to elucidate the role of compartmentalization in DWI via biexponential analysis of the signal decay due to diffusion. DWI experiments were performed on mouse brain over an extended range of b-values (up to 10,000 mm(-2) s) under intact, global ischemic, and cold-injury conditions. DWI was additionally applied to centrifuged human erythrocyte samples with a negligible extracellular space. Biexponential signal decay was found to occur in the cortex of the intact mouse brain. During global ischemia, in addition to a drop in the ADC in both components, a shift from the volume fraction of the rapidly diffusing component to the slowly diffusing one was observed. In cold injury, the biexponential signal decay was still present despite the electron-microscopically validated disintegration of the membranes. The biexponential function was also applicable for fitting of the data obtained on erythrocyte samples. The results suggest that compartmentalization is not an essential feature of biexponential decay in diffusion experiments.
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Affiliation(s)
- Attila Schwarcz
- Department of Neurosurgery, University of Pécs, Pécs, Hungary.
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27
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Abstract
Cerebral water accumulation-clinically denoted as brain edema-is a potentially life threatening complication of almost every intracranial neuropathological state. The molecular membrane water channel aquaporin-4 (AQP4) has been shown to be present at the blood-brain barrier (BBB) where it plays pivotal role in the transport of water between the tissue water compartments of the brain. Accumulating evidence indicates that the blockade of AQP4 function at the BBB would be a new therapeutic approach to the treatment and prevention of brain swelling. The cytoskeletal protein dystrophin has been shown to be involved in the maintenance of the polarized expression of AQP4 at the BBB. In order to further elucidate the mechanisms responsible for the highly polarized AQP4 expression, we studied brain tissue water accumulation during induction of brain edema in dystrophin-null transgenic mice (mdx-bgeo) and control mice. Immunofluorescence and immunoelectron microscopic analyses of dystrophin-null brains revealed a dramatic reduction of AQP4 in astroglial end-feet surrounding capillaries (BBB) and at the glia limitans (cerebrospinal fluid-brain interface). The AQP4 protein is mislocalized, because immunoblotting showed that the total AQP4 protein abundance was unaltered. Brain edema was induced by i.p. injection of distilled water and 8-deamino-arginine vasopressin. Changes in cerebral water compartments were assessed by diffusion-weighted MRI (DWI) with determination of the apparent diffusion coefficient (ADC). In dystrophin-null mice and control mice, ADC gradually decreased by 5-6% from baseline levels during the first 35 min, indicating the initial phase of intracellular water accumulation is similar in the two groups. At this point, the control mice sustained an abrupt, rapid decline in ADC to 58%+/-2.2% of the baseline at 52.5 min, and all of the animals were dead by 56 min. After a consistent delay, the dystrophin-null mice sustained a similar decline in ADC to 55%+/-3.4% at 66.5 min, when all of the mice were dead. These results demonstrate that dystrophin is necessary for polarized distribution of AQP4 protein in brain where facilitated movements of water occur across the BBB and cerebrospinal fluid-brain interface. Moreover, these results predict that interference with the subcellular localization of AQP4 may have therapeutic potential for delaying the onset of impending brain edema.
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Affiliation(s)
- Z Vajda
- Water and Salt Research Centre, Institute of Anatomy, Building 233/234, University of Aarhus, DK-8000 Aarhus, Denmark
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Doczi T, Teasdale G. EANS Winter Meeting, February 7-9, 2003, Bonn, Germany: Functional and Reconstructive Neurosurgery. Acta Neurochir (Wien) 2003; 145:327-30. [PMID: 12940269 DOI: 10.1007/s00701-003-0018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Buki A, Farkas O, Doczi T, Povlishock JT. Preinjury administration of the calpain inhibitor MDL-28170 attenuates traumatically induced axonal injury. J Neurotrauma 2003; 20:261-8. [PMID: 12820680 DOI: 10.1089/089771503321532842] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Traumatic brain injury (TBI) evokes diffuse (traumatic) axonal injury (TAI), which contributes to morbidity and mortality. Damaged axons display progressive alterations gradually evolving to axonal disconnection. In severe TAI, the tensile forces of injury lead to a focal influx of Ca2+, initiating a series of proteolytic processes wherein the cysteine proteases, calpain and caspase modify the axonal cytoskeleton, causing irreversible damage over time postinjury. Although several studies have demonstrated that the systemic administration of calpain inhibitors reduces the extent of ischemic and traumatic contusional injury a direct beneficial effect on TAI has not been established to date. The current study was initiated to address this issue in an impact acceleration rat-TBI model in order to provide further evidence on the contribution of calpain-mediated proteolytic processes in the pathogenesis of TAI, while further supporting the utility of calpain-inhibitors. A single tail vein bolus injection of 30 mg/kg MDL-28170 was administered to Wistar rats 30 min preinjury. After injury the rats were allowed to survive 120 min when they were perfused with aldehydes. Brains were processed for immunohistochemical localization of damaged axonal profiles displaying either amyloid precursor protein (APP)- or RMO-14-immunoreactivity (IR), both considered markers of specific features of TAI. Digital data acquisition and statistical analysis demonstrated that preinjury administration of MDL-28170 significantly reduced the mean number of damaged RMO-14- as well as APP-IR axonal profiles in the brainstem fiber tracts analyzed. These results further underscore the role of calpain-mediated proteolytic processes in the pathogenesis of DAI and support the potential use of cell permeable calpain-inhibitors as a rational therapeutic approach in TBI.
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Affiliation(s)
- A Buki
- Department of Neurosurgery, Medical Faculty of Pécs University, Pécs, Hungary
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30
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Abstract
Clinical manifestations, findings, management and outcome of a series of 177 cases with tumours of the limbic and paralimbic systems are presented. There was no operative mortality. Postoperatively 95% of them had no or only minor neurological deficits. Most of them were able to resume work. Pre-operatively 77% of the patients had epilepsy, but 84% became seizure-free after tumour removal. All 77 cases with malignant tumours died within 1-5 years. In the past many neurosurgeons were reluctant to attempt complete tumour removal in these areas. This series demonstrates the efficacy of highly skilled microneurosurgery.
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Affiliation(s)
- M G Yaşargil
- Department of Neurosurgery, Universitätsspital Zürich, Switzerland
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Abstract
Two series of patients (814 cases altogether) with ruptured intracranial aneurysms are analyzed in order to try to outline the clinical significance of space-occupying intracerebral haematomas (ICH) which may accompany SAH. In particular the question of whether intracerebral clots are or are not to be taken into account in planning emergency surgery is debated. From the reported series, it would appear that ICH after aneurysm rupture seldom lead to increasing intracranial hypertension warranting urgent surgery. This evolution was observed in approximately 5% of patients with expanding ICH. In 35% the intracerebral effusions were associated with irreversible lesions and in 20% the initial symptomatology definitely improved. Finally, in a relatively high percentage of cases (about 40%) ICH lacked of clinical significance.
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Affiliation(s)
- I Papo
- Division of Neurosurgery, Regional Hospital, Ancona, Italy
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Abstract
Eighty patients with subarachnoid hemorrhage underwent computerized tomography (CT) scanning before and after administration of Conray contrast medium. Abnormal enhancement was seen in visual evaluation of the CT scans in 26 cases, in the regions bordering the subarachnoid spaces. Abnormal enhancement was associated with a poor clinical condition, angiographic spasm, and a poor outcome. Measurements of absorption values in the thalamus revealed significant increases in density after contrast enhancement in those patients whose scans showed abnormal enhancement in the regions bordering the subarachnoid spaces on visual evaluation. The authors suggest that the abnormal enhancement is parenchymal, in the gyri, and is not "subarachnoid." They suggest that it is due to gyral hyperemia or extravasation of contrast material into the cortex resulting from breakdown of the blood-brain barrier, or a combination of both factors.
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Abstract
A patient with progressive signs and symptoms suggestive of a pontine lesion is described. Intracranial investigations, CAT scan, vertebral angiography, and lumbar pneumoencephalogram revealed a space-occupying lesion of the pons and midbrain. The exact nature of the lesion was not established before the operation. A posterior fossa exploration was performed and a pontine haematoma was discovered and evacuated. The pathological specimen was designated as a cryptic arteriovenous malformation. Preoperative neurological deficits disappeared except for minimal left sixth nerve palsy and mild truncal ataxia.
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