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Sample records for infarct volume brain

  1. Whole-brain perfusion CT using a toggling table technique to predict final infarct volume in acute ischemic stroke.

    Science.gov (United States)

    Schrader, I; Wilk, D; Jansen, O; Riedel, C

    2013-09-01

    To evaluate how accurately final infarct volume in acute ischemic stroke can be predicted with perfusion CT (PCT) using a 64-MDCT unit and the toggling table technique. Retrospective analysis of 89 patients with acute ischemic stroke who underwent CCT, CT angiography (CTA) and PCT using the "toggling table" technique within the first three hours after symptom onset. In patients with successful thrombolytic therapy (n = 48) and in those without effective thrombolytic therapy (n = 41), the infarct volume and the volume of the penumbra on PCT were compared to the infarct size on follow-up images (CT or MRI) performed within 8 days. The feasibility of complete infarct volume prediction by 8 cm cranio-caudal coverage was evaluated. The correlation between the volume of hypoperfusion on PCT defined by cerebral blood volume reduction and final infarct volume was strongest in patients with successful thrombolytic therapy with underestimation of the definite infarct volume by 8.5 ml on average. The CBV map had the greatest prognostic value. In patients without successful thrombolytic therapy, the final infarct volume was overestimated by 12.1 ml compared to the MTT map on PCT. All infarcts were detected completely. There were no false-positive or false-negative results. Using PCT and the "toggling table" technique in acute stroke patients is helpful for the rapid and accurate quantification of the minimal final infarct and is therefore a prognostic parameter which has to be evaluated in further studies to assess its impact on therapeutic decision. ▶ Using PCT and the “toggling table technique” allows accurate quantification of the infarct core and penumbra. ▶ It is possible to record dynamic perfusion parameters quickly and easily of almost the entire supratentorial brain volume on a 64-slice MDCT unit. ▶ The technique allows identification of those patients who could profit from thrombolytic therapy outside the established time intervals. © Georg Thieme Verlag

  2. Inhibition of VEGF Signaling Reduces Diabetes-Exacerbated Brain Swelling, but Not Infarct Size, in Large Cerebral Infarction in Mice.

    Science.gov (United States)

    Kim, Eunhee; Yang, Jiwon; Park, Keun Woo; Cho, Sunghee

    2017-12-30

    In light of repeated translational failures with preclinical neuroprotection-based strategies, this preclinical study reevaluates brain swelling as an important pathological event in diabetic stroke and investigates underlying mechanism of the comorbidity-enhanced brain edema formation. Type 2 (mild), type 1 (moderate), and mixed type 1/2 (severe) diabetic mice were subjected to transient focal ischemia. Infarct volume, brain swelling, and IgG extravasation were assessed at 3 days post-stroke. Expression of vascular endothelial growth factor (VEGF)-A, endothelial-specific molecule-1 (Esm1), and the VEGF receptor 2 (VEGFR2) was determined in the ischemic brain. Additionally, SU5416, a VEGFR2 inhibitor, was treated in the type 1/2 diabetic mice, and stroke outcomes were determined. All diabetic groups displayed bigger infarct volume and brain swelling compared to nondiabetic mice, and the increased swelling was disproportionately larger relative to infarct enlargement. Diabetic conditions significantly increased VEGF-A, Esm1, and VEGFR2 expressions in the ischemic brain compared to nondiabetic mice. Notably, in diabetic mice, VEGFR2 mRNA levels were positively correlated with brain swelling, but not with infarct volume. Treatment with SU5416 in diabetic mice significantly reduced brain swelling. The study shows that brain swelling is a predominant pathological event in diabetic stroke and that an underlying event for diabetes-enhanced brain swelling includes the activation of VEGF signaling. This study suggests consideration of stroke therapies aiming at primarily reducing brain swelling for subjects with diabetes.

  3. The broad-spectrum cation channel blocker pinokalant (LOE 908 MS) reduces brain infarct volume in rats

    DEFF Research Database (Denmark)

    Christensen, Thomas; Wienrich, Marion; Ensinger, Helmut A

    2005-01-01

    this period and the spontaneous temperature after course in control rats established in other experiments was imitated. Seven days later histological brain sections were prepared and the infarct volumes measured. Body temperature did not differ between the groups. Mean arterial blood pressure was slightly...... higher in the pinokalant group. Pinokalant treatment significantly reduced cortical infarct volume from 33.8+/-15.8 mm3 to 24.5+/-13.1 mm3 (control group versus pinokalant group, P=0.017, t-test). Taking the effective drug plasma concentration established in other experiments into account revealed...... and electrophysiologic status of the ischemic penumbra and to reduce lesion size on magnetic resonance images in the acute phase following middle cerebral artery occlusion in rats. The purpose of the present study was to investigate whether these beneficial effects of pinokalant are translated into permanent...

  4. MRI assessment of cerebral blood volume in patients with brain infarcts

    International Nuclear Information System (INIS)

    Wu, R.H.; Bruening, R.; Berchtenbreiter, C.; Weber, J.; Peller, M.; Penzkofer, H.; Reiser, M.; Steiger, H.J.

    1998-01-01

    MRI perfusion studies have focussed mainly on acute ischaemia and characterisation in ischaemia. Our purpose was to analyse regional brain haemodynamic information in acute, subacute, and chronic ischaemia. We performed 16 examinations of 11 patients on a 1.5 T MR images. Conventional and dynamic contrast-enhanced imaging were employed in all examinations. For the dynamic susceptibility sequences, a bolus (0.2 mmol/kg) of gadopentetate dimeglumine was injected. Reconstructed regional relative cerebral blood volume (rCBV) maps, bolus maps, and conventional images were analysed by consensus reading. In all examinations decreases in rCBV were observed in the lesions. The distribution of regional rCBV in lesions was heterogeneous. The rCBV of the periphery of the lesions was higher than that at their center. There was a correlation between the time since onset and abnormalities on the rCBV map and T2-weighted images (T2WI). In the early stage of acute stroke, the abnormalities tended to be larger on the rCBV than on T2WI. Many patterns of bolus passage were observed in ischaemic regions. rCBV maps provide additional haemodynamic information in patients with brain infarcts. (orig.)

  5. Aggravation of brain infarction through an increase in acrolein production and a decrease in glutathione with aging.

    Science.gov (United States)

    Uemura, Takeshi; Watanabe, Kenta; Ishibashi, Misaki; Saiki, Ryotaro; Kuni, Kyoshiro; Nishimura, Kazuhiro; Toida, Toshihiko; Kashiwagi, Keiko; Igarashi, Kazuei

    2016-04-29

    We previously reported that tissue damage during brain infarction was mainly caused by inactivation of proteins by acrolein. This time, it was tested why brain infarction increases in parallel with aging. A mouse model of photochemically induced thrombosis (PIT) was studied using 2, 6, and 12 month-old female C57BL/6 mice. The size of brain infarction in the mouse PIT model increased with aging. The volume of brain infarction in 12 month-old mice was approximately 2-fold larger than that in 2 month-old mice. The larger brain infarction in 12 month-old mice was due to an increase in acrolein based on an increase in the activity of spermine oxidase, together with a decrease in glutathione (GSH), a major acrolein-detoxifying compound in cells, based on the decrease in one of the subunits of glutathione biosynthesizing enzymes, γ-glutamylcysteine ligase modifier subunit, with aging. The results indicate that aggravation of brain infarction with aging was mainly due to the increase in acrolein production and the decrease in GSH in brain. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    International Nuclear Information System (INIS)

    Wagner, Marlies; Kyriakou, Yiannis; Mesnil de Rochemont, Richard du; Singer, Oliver C.; Berkefeld, Joachim

    2013-01-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy

  7. Intense correlation between brain infarction and protein-conjugated acrolein.

    Science.gov (United States)

    Saiki, Ryotaro; Nishimura, Kazuhiro; Ishii, Itsuko; Omura, Tomohiro; Okuyama, Shigeru; Kashiwagi, Keiko; Igarashi, Kazuei

    2009-10-01

    We recently found that increases in plasma levels of protein-conjugated acrolein and polyamine oxidases, enzymes that produce acrolein, are good markers for stroke. The aim of this study was to determine whether the level of protein-conjugated acrolein is increased and levels of spermine and spermidine, the substrates of acrolein production, are decreased at the locus of infarction. A unilateral infarction was induced in mouse brain by photoinduction after injection of Rose Bengal. The volume of the infarction was analyzed using the public domain National Institutes of Health image program. The level of protein-conjugated acrolein at the locus of infarction and in plasma was measured by Western blotting and enzyme-linked immunosorbent assay, respectively. The levels of polyamines at the locus of infarction and in plasma were measured by high-performance liquid chromatography. The level of protein-conjugated acrolein was greatly increased, and levels of spermine and spermidine were decreased at the locus of infarction at 24 hours after the induction of stroke. The size of infarction was significantly decreased by N-acetylcysteine, a scavenger of acrolein. It was also found that the increases in the protein-conjugated acrolein, polyamines, and polyamine oxidases in plasma were observed after the induction of stroke. The results indicate that the induction of infarction is well correlated with the increase in protein-conjugated acrolein at the locus of infarction and in plasma.

  8. Evaluation of cat brain infarction model using microPET

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Jin; Lee, Dong Soo; Kim, Yun Hui; Hwang, Do Won; Kim, Jin Su; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of); Lim, Sang Moo [Korea Institite of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2004-12-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advent of microPET scanner, it is possible to image small animals. However, the image quality was not good enough as human image. Due to larger brain, cat brain imaging was superior to mouse or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCI. A burr hole was made at 1 cm right lateral to the bregma. Collagenase type IV 10 {mu}l was injected using 30 G needle for 5 minutes to establish the infarction model. {sup 18}F-FDG microPET (Concorde Microsystems Inc., Knoxville, TN) scans were performed 1, 11 and 32 days after the infarction. In addition, {sup 18}F-FDG PET scans were performed using human PET scanner (Gemini, Philips medical systems, CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infarction lesion improved with time. An infarction lesion was also distinguishable in the human PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using {sup 18}F-FDG microPET scanner.

  9. Evaluation of cat brain infarction model using microPET

    International Nuclear Information System (INIS)

    Lee, Jong Jin; Lee, Dong Soo; Kim, Yun Hui; Hwang, Do Won; Kim, Jin Su; Chung, June Key; Lee, Myung Chul; Lim, Sang Moo

    2004-01-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advent of microPET scanner, it is possible to image small animals. However, the image quality was not good enough as human image. Due to larger brain, cat brain imaging was superior to mouse or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCI. A burr hole was made at 1 cm right lateral to the bregma. Collagenase type IV 10 μl was injected using 30 G needle for 5 minutes to establish the infarction model. 18 F-FDG microPET (Concorde Microsystems Inc., Knoxville, TN) scans were performed 1, 11 and 32 days after the infarction. In addition, 18 F-FDG PET scans were performed using human PET scanner (Gemini, Philips medical systems, CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infarction lesion improved with time. An infarction lesion was also distinguishable in the human PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using 18 F-FDG microPET scanner

  10. Asymmetry in the brain influenced the neurological deficits and infarction volume following the middle cerebral artery occlusion in rats

    Directory of Open Access Journals (Sweden)

    Zhang Meizeng

    2008-12-01

    Full Text Available Abstract Background Paw preference in rats is similar to human handedness, which may result from dominant hemisphere of rat brain. However, given that lateralization is the uniqueness of the humans, many researchers neglect the differences between the left and right hemispheres when selecting the middle cerebral artery occlusion (MCAO in rats. The aim of this study was to evaluate the effect of ischemia in the dominant hemisphere on neurobehavioral function and on the cerebral infarction volume following MCAO in rats. Methods The right-handed male Sprague-Dawley rats asserted by the quadrupedal food-reaching test were subjected to 2 hours MCA occlusion and then reperfusion. Results The neurological scores were significantly worse in the left MCAO group than that in the right MCAO group at 1 h, 24 h, 48 h and 72 h (p 0.05 respectively. There was a trend toward better neurobehavioral function recovery in the right MCAO group than in the left MCAO group. The total infarct volume in left MCAO was significantly larger than that in the right (p Conclusion The neurobehavioral function result and the pathological result were consistent with the hypothesis that paw preference in rats is similar to human handedness, and suggested that ischemia in dominant hemisphere caused more significant neurobehavioral consequence than in another hemisphere following MCAO in adult rats. Asymmetry in rat brain should be considered other than being neglected in choice of rat MCAO model.

  11. Validation of a simple and inexpensive method for the quantitation of infarct in the rat brain

    Directory of Open Access Journals (Sweden)

    C.L.R. Schilichting

    2004-04-01

    Full Text Available A gravimetric method was evaluated as a simple, sensitive, reproducible, low-cost alternative to quantify the extent of brain infarct after occlusion of the medial cerebral artery in rats. In ether-anesthetized rats, the left medial cerebral artery was occluded for 1, 1.5 or 2 h by inserting a 4-0 nylon monofilament suture into the internal carotid artery. Twenty-four hours later, the brains were processed for histochemical triphenyltetrazolium chloride (TTC staining and quantitation of the schemic infarct. In each TTC-stained brain section, the ischemic tissue was dissected with a scalpel and fixed in 10% formalin at 0ºC until its total mass could be estimated. The mass (mg of the ischemic tissue was weighed on an analytical balance and compared to its volume (mm³, estimated either by plethysmometry using platinum electrodes or by computer-assisted image analysis. Infarct size as measured by the weighing method (mg, and reported as a percent (% of the affected (left hemisphere, correlated closely with volume (mm³, also reported as % estimated by computerized image analysis (r = 0.88; P < 0.001; N = 10 or by plethysmography (r = 0.97-0.98; P < 0.0001; N = 41. This degree of correlation was maintained between different experimenters. The method was also sensitive for detecting the effect of different ischemia durations on infarct size (P < 0.005; N = 23, and the effect of drug treatments in reducing the extent of brain damage (P < 0.005; N = 24. The data suggest that, in addition to being simple and low cost, the weighing method is a reliable alternative for quantifying brain infarct in animal models of stroke.

  12. Evaluation of cat brain infarction model using microPET

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. J.; Lee, D. S.; Kim, J. H.; Hwang, D. W.; Jung, J. G.; Lee, M. C [College of Medicine, Seoul National University, Seoul (Korea, Republic of); Lim, S. M [Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)

    2004-07-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advance of microPET scanner, it is possible to image small animals. However, the image quality was not so much satisfactory as human image. As cats have relatively large sized brain, cat brain imaging was superior to mice or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCl. A burr hole was made at 1cm right lateral to the bregma. Collagenase type IV 10 ul was injected using 30G needle for 5 minutes to establish the infarction model. F-18 FDG microPET (Concorde Microsystems Inc., Knoxville. TN) scans were performed 1. 11 and 32 days after the infarction. In addition. 18F-FDG PET scans were performed using Gemini PET scanner (Philips medical systems. CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infraction lesion improved with time. An infarction lesion was also distinguishable in the Gemini PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using F-18 FDG microPET scanner.

  13. Evaluation of cat brain infarction model using microPET

    International Nuclear Information System (INIS)

    Lee, J. J.; Lee, D. S.; Kim, J. H.; Hwang, D. W.; Jung, J. G.; Lee, M. C; Lim, S. M

    2004-01-01

    PET has some disadvantage in the imaging of small animal due to poor resolution. With the advance of microPET scanner, it is possible to image small animals. However, the image quality was not so much satisfactory as human image. As cats have relatively large sized brain, cat brain imaging was superior to mice or rat. In this study, we established the cat brain infarction model and evaluate it and its temporal change using microPET scanner. Two adult male cats were used. Anesthesia was done with xylazine and ketamine HCl. A burr hole was made at 1cm right lateral to the bregma. Collagenase type IV 10 ul was injected using 30G needle for 5 minutes to establish the infarction model. F-18 FDG microPET (Concorde Microsystems Inc., Knoxville. TN) scans were performed 1. 11 and 32 days after the infarction. In addition. 18F-FDG PET scans were performed using Gemini PET scanner (Philips medical systems. CA, USA) 13 and 47 days after the infarction. Two cat brain infarction models were established. The glucose metabolism of an infraction lesion improved with time. An infarction lesion was also distinguishable in the Gemini PET scan. We successfully established the cat brain infarction model and evaluated the infarcted lesion and its temporal change using F-18 FDG microPET scanner

  14. Stroke infarct volume estimation in fixed tissue

    DEFF Research Database (Denmark)

    Bay, Vibeke; Kjølby, Birgitte F; Iversen, Nina K

    2018-01-01

    be investigated in fixed tissue and therefore allows a more direct comparison between lesion volumes from MRI and histology. Additionally, the larger MKT infarct lesion indicates that MKT do provide increased sensitivity to microstructural changes in the lesion area compared to MD....... and prepared. The infarct was clearly visible in both MD and MKT maps. The MKT lesion volume was roughly 31% larger than the MD lesion volume. Subsequent histological analysis (hematoxylin) revealed similar lesion volumes to MD. Our study shows that structural components underlying the MD/MKT mismatch can...

  15. Brain infarcts due to scorpion stings in children: MRI

    International Nuclear Information System (INIS)

    Fernandez-Bouzas, A.; Ballesteros-Maresma, A.; Morales-Resendiz, M.L.; Llamas-Ibarra, F.; Martinez-Lopez, M.

    2000-01-01

    We report two children with severe neurological complications after having been stung by a scorpion. Clinical and MRI findings suggested brain infarcts. The lesions seen were in pons in one child and the right hemisphere in the other. The latter also showed possible hyperemia in the infarcted area. No vascular occlusions were observed and we therefore think the brain infarcts were a consequence of the scorpion sting. The cause of the infarct may be hypotension, shock or depressed left ventricular function, all of which are frequent in severe poisoning by scorpion sting. (orig.)

  16. Gd-DTPA enhanced MRI of the brain infarction: correlation between onset of infarction and enhancing patterns

    International Nuclear Information System (INIS)

    Joo, An Young; Kim, Myung Soon; Lee, Sung Soo

    1994-01-01

    To evaluate the correlation between onset of brain infarction and Gd-DTPA enhancing patterns on MRI. We reviewed MRI of 58 lesions in 45 patients with clinically documented brain infarction retrospectively. Axial, coronal and sagittal T1WI (TR/TE 450-520/20), T2WI (TR/TE 2190/90) and Gd-DTPA enhanced T1WI were performed with a 0.5T superconductive MR system. We analyzed Gd-enhancing patterns that were divided into intravascular, meningeal, and parenchymal enhancement. Parenchymal pattern was subdivided into mottled, partial ring like and dense enhancement. Intravascular enhancement was seen at 1-10 days in 30(53%) of 58 infarctions. Meningeal enhancement (13%) was noted at 1-6 days. Parenchymal enhancement (50%) was seen at 2-28 days and subdividing patterns are as follows: The mottled enhancement pattern was seen earlier at 2-8 days and partial ring like or dense enhancement patterns at 5-28 days. After reviewing Gd-enhanced MRI of infarction, the intravascular and meningeal enhancement patterns were earlier than parenchymal enhancement. Among parenchymal patterns, the mottled pattern was seen earlier than partial ring like or dense patterns. In conclusion, Gd-enhancing patterns of brain infarction are useful in estimating the age of infarction including acute infarction

  17. CONTRAST STUDY ON CT AND BA IN DIAGNOSIS OF PATIENTS WITH ATHEROTHROMBOTIC BRAIN INFARCTION

    Institute of Scientific and Technical Information of China (English)

    Mingshun Liu; Haixiang Gao; Xiaomei Fu; Po Ma

    2007-01-01

    Objectives: To explore applied value on CT and BA in diagnosis of patients with atherothrombotic brain infarction. Methods:CT and BA were examined in 246 patients with atherothrombotic brain infarction. Results:The different change of CT and BA were showed in 246 patients with atherothrombotic brain infarction. Conclusions: There were separately different advantage and shortcoming in CT and BA in diagnosis of atherothrombotic brain infarction. The value of clinical application of BA was important in diagnosis of atherothrombotic brain infarction.

  18. Correlation between increased platelet ADP aggregability and silent brain infarcts

    International Nuclear Information System (INIS)

    Ono, Kenichiro; Arimoto, Hirohiko; Shirotani, Toshiki

    2012-01-01

    The purpose of this study was to investigate the correlation between platelet aggregability and silent brain infarcts. The study subjects were 445 people (264 men, 181 women; mean age, 53±14 years) with no neurologic signs, history of brain tumor, trauma, cerebrovascular disease, or antiplatelet medications. Adenosine diphosphate (ADP)-induced platelet aggregation was measured by the aggregation-size analytic method. Platelet aggregability was classified into 9 classes. The presence of headache/vertigo, hypertension, diabetes mellitus, hyperlipidemia, or smoking was elicited by questioning or blood sampling. A head MRI scan was performed, and if marked atherosclerosis or obvious stenosis in the intracranial vessels was detected, it was defined as a positive MR angiography (MRA) finding. Silent brain infarcts were detected in 26.3% of subjects. Hyperaggregability defined as that above class 6, 7, and 8 was present in 43.8%, 30.8%, and 15.7% of subjects, respectively. The risk factors for silent brain infarcts by multiple logistic regression analysis were aging, hypertension, positive MRA findings, and hyperaggregability. Platelet ADP hyperaggregability might be a risk factor for silent brain infarcts. (author)

  19. Diffusion-weighted magnetic resonance imaging (MRI) in acute brain stem infarction

    International Nuclear Information System (INIS)

    Narisawa, Aya; Shamoto, Hiroshi; Shimizu, Hiroaki; Tominaga, Teiji; Yoshimoto, Takashi

    2001-01-01

    Diffusion-weighted magnetic resonance imaging (DWI) provides one of the earliest demonstrations of ischemic lesions. However some lesions may be missed in the acute stage due to technical limitation of DWI. We therefore conducted the study to clarify the sensitivity of DWI to acute brain stem infarctions. Twenty-eight patients with the final diagnosis of brain stem infarction (midbrain 2, pons 9, medulla oblongata 17) who had been examined by DWI within 24 hours of onset were retrospectively analyzed for how sensitively the initial DWI demonstrated the final ischemic lesion. Only obvious (distinguishable with DWI alone without referring clinical symptoms and other informations) hyperintensity on DWI was regarded to show an ischemic lesion. Sixteen (57.1%) out of 28 patients had brain stem infarctions demonstrated by initial DWI. In the remaining 12 cases, no obvious ischemic lesion was evident on initial DWI. Subsequent MRI studies obtained 127 hours, on average after the onset showed infarction in the medulla oblongate in 11 cases and in the pons in one case. Negative findings of DWI in the acute stage does not exclude possibility of the brain stem infarction, in particularly medulla oblongata infarction. (author)

  20. Know your tools - concordance of different methods for measuring brain volume change after ischemic stroke

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    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew [The University of Melbourne, Departments of Medicine and Neurology, Melbourne Brain Centre rate at The Royal Melbourne Hospital, Parkville, Victoria (Australia); Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M. [The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Parkville (Australia); Churilov, Leonid [The University of Melbourne, The Florey Institute of Neurosciences and Mental Health, Parkville (Australia); Parsons, Mark W. [University of Newcastle and Hunter Medical Research Institute, Priority Research Centre for Translational Neuroscience and Mental Health, Newcastle (Australia)

    2015-07-15

    Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clinical outcome. In stroke, unique methodological challenges are posed by dynamic structural changes occurring after onset, particularly those relating to the infarct lesion. We aimed to evaluate agreement between different analysis methods for the measurement of post-stroke brain volume change, and to explore technical challenges inherent to these methods. Fifteen patients with anterior circulation stroke underwent magnetic resonance imaging within 1 week of onset and at 1 and 3 months. Whole-brain as well as grey- and white-matter volume were estimated separately using both an intensity-based and a surface watershed-based algorithm. In the case of the intensity-based algorithm, the analysis was also performed with and without exclusion of the infarct lesion. Due to the effects of peri-infarct edema at the baseline scan, longitudinal volume change was measured as percentage change between the 1 and 3-month scans. Intra-class and concordance correlation coefficients were used to assess agreement between the different analysis methods. Reduced major axis regression was used to inspect the nature of bias between measurements. Overall agreement between methods was modest with strong disagreement between some techniques. Measurements were variably impacted by procedures performed to account for infarct lesions. Improvements in volumetric methods and consensus between methodologies employed in different studies are necessary in order to increase the validity of conclusions derived from post-stroke cerebral volumetric studies. Readers should be aware of the potential impact of different methods on study conclusions. (orig.)

  1. Know your tools - concordance of different methods for measuring brain volume change after ischemic stroke

    International Nuclear Information System (INIS)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew; Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M.; Churilov, Leonid; Parsons, Mark W.

    2015-01-01

    Longitudinal brain volume changes have been investigated in a number of cerebral disorders as a surrogate marker of clinical outcome. In stroke, unique methodological challenges are posed by dynamic structural changes occurring after onset, particularly those relating to the infarct lesion. We aimed to evaluate agreement between different analysis methods for the measurement of post-stroke brain volume change, and to explore technical challenges inherent to these methods. Fifteen patients with anterior circulation stroke underwent magnetic resonance imaging within 1 week of onset and at 1 and 3 months. Whole-brain as well as grey- and white-matter volume were estimated separately using both an intensity-based and a surface watershed-based algorithm. In the case of the intensity-based algorithm, the analysis was also performed with and without exclusion of the infarct lesion. Due to the effects of peri-infarct edema at the baseline scan, longitudinal volume change was measured as percentage change between the 1 and 3-month scans. Intra-class and concordance correlation coefficients were used to assess agreement between the different analysis methods. Reduced major axis regression was used to inspect the nature of bias between measurements. Overall agreement between methods was modest with strong disagreement between some techniques. Measurements were variably impacted by procedures performed to account for infarct lesions. Improvements in volumetric methods and consensus between methodologies employed in different studies are necessary in order to increase the validity of conclusions derived from post-stroke cerebral volumetric studies. Readers should be aware of the potential impact of different methods on study conclusions. (orig.)

  2. Clinical values of CT and dynamic CT in brain infarction

    International Nuclear Information System (INIS)

    Lim, Soo Il; Jang, Do; Seo, Eun Joo; Sohn, Myung Hee; Choi, Ki Chul

    1985-01-01

    With the advent of faster scan time and new computer program, a scanning technique called 'dynamic computed tomography' has become possible. Dynamic computed tomography consisted of performing multiple rapid sequence scans after injection of contrast material. The authors have evaluated the clinical usefulness of computed tomography and dynamic computed tomography of 93 patients with brain infarction and/or ischemia during the period of 17 months from April 1983 to August 1984 in Department of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The age distribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59 years (40.9%). 2. The sites of brain infarction were cerebral lobes (63 cases,68), basal ganglia (15 cases, 16.1%) and multiple sites (6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. The contrast enhancement of acute infarction was noted in 14 cases (17.5%) which occurred commonly between 3 days and 2 weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a. Depression of slow wash-in phase was 20 cases (59%). b. Lower peak concentration was 17 cases (50%). c. Lower and delayed peak concentration was 7 cases (21%). d. No definite peak concentration was 6 cases (18%). First three patterns of time-density curve were thought as relatively characteristic curve of brain infarction and/or ischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings as hypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entity of dynamic CT scan were as follows; a. large artery thrombotic infarction were 23 cases (58%). b. lacnar infarction were 6 cases (15%). c. ischemia were 5 cases (13%). d. normal were 5 cases (13%). In six cases of lacunar infarction which was double hypodensity on pre-and postcontrast CT

  3. Clinical values of CT and dynamic CT in brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Soo Il; Jang, Do; Seo, Eun Joo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National University College of Medicine, Jeonju (Korea, Republic of)

    1985-04-15

    With the advent of faster scan time and new computer program, a scanning technique called 'dynamic computed tomography' has become possible. Dynamic computed tomography consisted of performing multiple rapid sequence scans after injection of contrast material. The authors have evaluated the clinical usefulness of computed tomography and dynamic computed tomography of 93 patients with brain infarction and/or ischemia during the period of 17 months from April 1983 to August 1984 in Department of Radiology, Chonbuk National University Hospital. The results were as follows; 1. The age distribution ranged from 18 years to 78 years. Among them the most common age group was between 50 years and 59 years (40.9%). 2. The sites of brain infarction were cerebral lobes (63 cases,68), basal ganglia (15 cases, 16.1%) and multiple sites (6 cases, 6.4%). The common affected site was middle cerebral artery territories. 3. The contrast enhancement of acute infarction was noted in 14 cases (17.5%) which occurred commonly between 3 days and 2 weeks from ictus. 4. The patterns of time-density curve in brain infarction and/or ischemia were as follow: a. Depression of slow wash-in phase was 20 cases (59%). b. Lower peak concentration was 17 cases (50%). c. Lower and delayed peak concentration was 7 cases (21%). d. No definite peak concentration was 6 cases (18%). First three patterns of time-density curve were thought as relatively characteristic curve of brain infarction and/or ischemia. 5. Two cases that showed negative findings on precontrast CT scan appeared to be positive findings as hypodensity on postcontrast CT scan and were confirmed as brain infarction by dynamic CT. 6. The diagnostic entity of dynamic CT scan were as follows; a. large artery thrombotic infarction were 23 cases (58%). b. lacnar infarction were 6 cases (15%). c. ischemia were 5 cases (13%). d. normal were 5 cases (13%). In six cases of lacunar infarction which was double hypodensity on pre

  4. Edaravone, a free radical scavenger, attenuates cerebral infarction and hemorrhagic infarction in rats with hyperglycemia.

    Science.gov (United States)

    Okamura, Koichi; Tsubokawa, Tamiji; Johshita, Hiroo; Miyazaki, Hiroshi; Shiokawa, Yoshiaki

    2014-01-01

    Thrombolysis due to acute ischemic stroke is associated with the risk of hemorrhagic infarction, especially after reperfusion. Recent experimental studies suggest that the main mechanism contributing to hemorrhagic infarction is oxidative stress caused by disruption of the blood-brain barrier. Edaravone, a free radical scavenger, decreases oxidative stress, thereby preventing hemorrhagic infarction during ischemia and reperfusion. In this study, we investigated the effects of edaravone on hemorrhagic infarction in a rat model of hemorrhagic transformation. We used a previously established hemorrhagic transformation model of rats with hyperglycemia. Hyperglycemia was induced by intraperitoneal injection of glucose to all rats (n  =  20). The rats with hyperglycemia showed a high incidence of hemorrhagic infarction. Middle cerebral artery occlusion (MCAO) for 1.5 hours followed by reperfusion for 24 hours was performed in edaravone-treated rats (n  =  10) and control rats (n  =  10). Upon completion of reperfusion, both groups were evaluated for infarct size and hemorrhage volume and the results obtained were compared. Edaravone significantly decreased infarct volume, with the average infarct volume in the edaravone-treated rats (227.6 mm(3)) being significantly lower than that in the control rats (264.0 mm(3)). Edaravone treatment also decreased the postischemic hemorrhage volumes (53.4 mm(3) in edaravone-treated rats vs 176.4 mm(3) in controls). In addition, the ratio of hemorrhage volume to infarct volume was lower in the edaravone-treated rats (23.5%) than in the untreated rats (63.2%). Edaravone attenuates cerebral infarction and hemorrhagic infarction in rats with hyperglycemia.

  5. Migraine with aura and silent brain infarcts lack of mediation of patent foramen ovale.

    Science.gov (United States)

    Calviere, L; Tall, P; Massabuau, P; Bonneville, F; Larrue, V

    2013-12-01

    Population-based studies have shown a heightened prevalence of clinically silent brain infarcts in subjects who have migraine with aura (MA). We sought to determine whether this association could be confirmed in young patients with cryptogenic ischemic stroke, and explored the role of patent foramen ovale (PFO) as a potential underlying mechanism. Patients were selected from a registry of young patients consecutively treated for ischemic stroke in a tertiary university hospital among those without definite cause of stroke. Patients with PFO were matched for age and gender with patients with normal atrial septum. Migraine and MA were evaluated after patient selection and matching. Silent brain infarcts were independently evaluated on MRI. We included 100 patients [60 men; mean age (SD), 44.8 years (8.3)], 50 patients with PFO. We found silent brain infarcts in 36 patients and MA in 13 patients. MA was more frequent in patients with silent brain infarcts than in patients without silent brain infarcts (25.0% vs. 6.3%; OR, 5; 95% CI, 1.4-17.6; P = 0.01). Traditional cardiovascular risk factors were not associated with silent brain infarcts. PFO was neither associated with MA (OR, 1.7; 95% CI, 0.5-5.3) nor silent brain infarcts (OR, 0.7; 95% CI, 0.3-1.5). The association of MA with silent brain infarcts was not altered after adjustment for PFO. Findings suggest that silent brain infarcts in young patients with cryptogenic stroke is associated with MA. We found no evidence for a mediating effect of PFO on this association. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

  6. Clinical estimation of myocardial infarct volume with MR imaging

    International Nuclear Information System (INIS)

    Johns, J.A.; Leavitt, M.B.; Field, B.D.; Yasuda, T.; Gold, H.; Leinbach, R.C.; Brady, T.J.; Dinsmore, R.E.

    1987-01-01

    MR imaging has not previously been used to assess infarct size in humans. Short-axis spin-echo cardiac MR imaging was performed in 20 patients who had undergone intravenous thrombolytic therapy and angiography, 10 days after myocardial infarct. A semi-automated computer program was used to outline the infarct region on each section. The outlines were algorithmically stacked and a three-dimensional representation of the infarct was created. The MR imaging infarct volume was then computed using the Simpson rule. Comparison with ventriculographic infarct size as determined by the computed severely hypokinetic segment length showed excellent correlation (r = .84, P < .001)

  7. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study.

    Science.gov (United States)

    Snowdon, D A; Greiner, L H; Mortimer, J A; Riley, K P; Greiner, P A; Markesbery, W R

    1997-03-12

    To determine the relationship of brain infarction to the clinical expression of Alzheimer disease (AD). Cognitive function and the prevalence of dementia were determined for participants in the Nun Study who later died. At autopsy, lacunar and larger brain infarcts were identified, and senile plaques and neurofibrillary tangles in the neocortex were quantitated. Participants with abundant senile plaques and some neurofibrillary tangles in the neocortex were classified as having met the neuropathologic criteria for AD. Convents in the Midwestern, Eastern, and Southern United States. A total of 102 college-educated women aged 76 to 100 years. Cognitive function assessed by standard tests and dementia and AD assessed by clinical and neuropathologic criteria. Among 61 participants who met the neuropathologic criteria for AD, those with brain infarcts had poorer cognitive function and a higher prevalence of dementia than those without infarcts. Participants with lacunar infarcts in the basal ganglia, thalamus, or deep white matter had an especially high prevalence of dementia, compared with those without infarcts (the odds ratio [OR] for dementia was 20.7, 95% confidence interval [95% CI], 1.5-288.0). Fewer neuropathologic lesions of AD appeared to result in dementia in those with lacunar infarcts in the basal ganglia, thalamus, or deep white matter than in those without infarcts. In contrast, among 41 participants who did not meet the neuropathologic criteria for AD, brain infarcts were only weakly associated with poor cognitive function and dementia. Among all 102 participants, atherosclerosis of the circle of Willis was strongly associated with lacunar and large brain infarcts. These findings suggest that cerebrovascular disease may play an important role in determining the presence and severity of the clinical symptoms of AD.

  8. Diagnostic accuracy of whole-brain CT perfusion in the detection of acute infratentorial infarctions

    Energy Technology Data Exchange (ETDEWEB)

    Bollwein, Christine; Sommer, Wieland H.; Thierfelder, Kolja M.; Reiser, Maximilian F. [Ludwig-Maximilians-University Hospital of Munich, Institute for Clinical Radiology, Munich (Germany); Plate, Annika; Straube, Andreas; Baumgarten, Louisa von [Ludwig-Maximilians-University Hospital of Munich, Department of Neurology, Munich (Germany); Janssen, Hendrik [South Nuremberg Hospital, Department of Neuroradiology, Nuremberg (Germany)

    2016-11-15

    Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes. Two blinded readers evaluated NECT and four different CTP maps independently for the presence and location of infratentorial ischemic perfusion deficits. The study was designed as a retrospective case-control study and included 280 patients (cases/controls = 1/3). WB-CTP revealed a greater diagnostic sensitivity than NECT (41.4 vs. 17.1 %, P = 0.003). The specificity, however, was comparable (93.3 vs. 95.0 %). Mean transit time (MTT) and time to drain (TTD) were the most sensitive (41.4 and 40.0 %) and cerebral blood volume (CBV) the most specific (99.5 %) perfusion maps. Infarctions detected using WB-CTP were significantly larger than those not detected (15.0 vs. 2.2 ml; P = 0.0007); infarct location, however, did not influence the detection rate. The detection of infratentorial infarctions can be improved by assessing WB-CTP as part of the multimodal stroke workup. However, it remains a diagnostic challenge, especially small volume infarctions in the brainstem are likely to be missed. (orig.)

  9. Diagnostic accuracy of whole-brain CT perfusion in the detection of acute infratentorial infarctions

    International Nuclear Information System (INIS)

    Bollwein, Christine; Sommer, Wieland H.; Thierfelder, Kolja M.; Reiser, Maximilian F.; Plate, Annika; Straube, Andreas; Baumgarten, Louisa von; Janssen, Hendrik

    2016-01-01

    Although the diagnostic performance of whole-brain computed tomographic perfusion (WB-CTP) in the detection of supratentorial infarctions is well established, its value in the detection of infratentorial strokes remains less well defined. We examined its diagnostic accuracy in the detection of infratentorial infarctions and compared it to nonenhanced computed tomography (NECT), aiming to identify factors influencing its detection rate. Out of a cohort of 1380 patients who underwent WB-CTP due to suspected stroke, we retrospectively included all patients with MRI-confirmed infratentorial strokes and compared it to control patients without infratentorial strokes. Two blinded readers evaluated NECT and four different CTP maps independently for the presence and location of infratentorial ischemic perfusion deficits. The study was designed as a retrospective case-control study and included 280 patients (cases/controls = 1/3). WB-CTP revealed a greater diagnostic sensitivity than NECT (41.4 vs. 17.1 %, P = 0.003). The specificity, however, was comparable (93.3 vs. 95.0 %). Mean transit time (MTT) and time to drain (TTD) were the most sensitive (41.4 and 40.0 %) and cerebral blood volume (CBV) the most specific (99.5 %) perfusion maps. Infarctions detected using WB-CTP were significantly larger than those not detected (15.0 vs. 2.2 ml; P = 0.0007); infarct location, however, did not influence the detection rate. The detection of infratentorial infarctions can be improved by assessing WB-CTP as part of the multimodal stroke workup. However, it remains a diagnostic challenge, especially small volume infarctions in the brainstem are likely to be missed. (orig.)

  10. The study of low level laser irradiation therapy on brain infarction with SPECT

    Institute of Scientific and Technical Information of China (English)

    Xiao Xuechang; Jia Shaowei; Zleng Xiyuan

    2000-01-01

    Objective: Effect of rCBF and brain function on ILIB treating brain infarction will be investigated by SPECT brain perfusion imaging. Method: 3 1 patients with brain infarction, 17 patients were treated by ILIB on standard pharmaceutial treatment. SPECT brain perfusion imaging was performed before and after ILIB therapy with comparison of oneself. They were quantified with BFCR% model effect during ILIB in 14 patients were observed. Result: ILIB 30 rnme SPECT showed the improvement of rCBF and cerebral function in 14 patients with brain infarction, and in 17 patients locus were prominence than mirror regions att er ILIB therapy, both are higher singnitficant difference ( t=4.4052, P<0.0001 ), but mirror regions were not singnificant difference before and after ILIB (t=1.6995, P>0.05). BFCR% quantitative results of locus were higher mirror regions, and higher singnificant difference (t=4.5278 p<0.0001 )。 Conclusion: ILIB can improve the rCBF and cerebral function of patients with brain infarction, and provoke function of brain cells. Some new evidence was provided for ILIB treatment of cerebral ischemia

  11. Infarct volume predicts critical care needs in stroke patients treated with intravenous thrombolysis

    Energy Technology Data Exchange (ETDEWEB)

    Faigle, Roland; Marsh, Elisabeth B.; Llinas, Rafael H.; Urrutia, Victor C. [Johns Hopkins University School of Medicine, Department of Neurology, Baltimore, MD (United States); Wozniak, Amy W. [Johns Hopkins University, Department of Biostatistics, Bloomberg School of Public Health, Baltimore, MD (United States)

    2014-10-26

    Patients receiving intravenous thrombolysis with recombinant tissue plasminogen activator (IVT) for ischemic stroke are monitored in an intensive care unit (ICU) or a comparable unit capable of ICU interventions due to the high frequency of standardized neurological exams and vital sign checks. The present study evaluates quantitative infarct volume on early post-IVT MRI as a predictor of critical care needs and aims to identify patients who may not require resource intense monitoring. We identified 46 patients who underwent MRI within 6 h of IVT. Infarct volume was measured using semiautomated software. Logistic regression and receiver operating characteristics (ROC) analysis were used to determine factors associated with ICU needs. Infarct volume was an independent predictor of ICU need after adjusting for age, sex, race, systolic blood pressure, NIH Stroke Scale (NIHSS), and coronary artery disease (odds ratio 1.031 per cm{sup 3} increase in volume, 95 % confidence interval [CI] 1.004-1.058, p = 0.024). The ROC curve with infarct volume alone achieved an area under the curve (AUC) of 0.766 (95 % CI 0.605-0.927), while the AUC was 0.906 (95 % CI 0.814-0.998) after adjusting for race, systolic blood pressure, and NIHSS. Maximum Youden index calculations identified an optimal infarct volume cut point of 6.8 cm{sup 3} (sensitivity 75.0 %, specificity 76.7 %). Infarct volume greater than 3 cm{sup 3} predicted need for critical care interventions with 81.3 % sensitivity and 66.7 % specificity. Infarct volume may predict needs for ICU monitoring and interventions in stroke patients treated with IVT. (orig.)

  12. Infarct volume predicts critical care needs in stroke patients treated with intravenous thrombolysis

    International Nuclear Information System (INIS)

    Faigle, Roland; Marsh, Elisabeth B.; Llinas, Rafael H.; Urrutia, Victor C.; Wozniak, Amy W.

    2015-01-01

    Patients receiving intravenous thrombolysis with recombinant tissue plasminogen activator (IVT) for ischemic stroke are monitored in an intensive care unit (ICU) or a comparable unit capable of ICU interventions due to the high frequency of standardized neurological exams and vital sign checks. The present study evaluates quantitative infarct volume on early post-IVT MRI as a predictor of critical care needs and aims to identify patients who may not require resource intense monitoring. We identified 46 patients who underwent MRI within 6 h of IVT. Infarct volume was measured using semiautomated software. Logistic regression and receiver operating characteristics (ROC) analysis were used to determine factors associated with ICU needs. Infarct volume was an independent predictor of ICU need after adjusting for age, sex, race, systolic blood pressure, NIH Stroke Scale (NIHSS), and coronary artery disease (odds ratio 1.031 per cm 3 increase in volume, 95 % confidence interval [CI] 1.004-1.058, p = 0.024). The ROC curve with infarct volume alone achieved an area under the curve (AUC) of 0.766 (95 % CI 0.605-0.927), while the AUC was 0.906 (95 % CI 0.814-0.998) after adjusting for race, systolic blood pressure, and NIHSS. Maximum Youden index calculations identified an optimal infarct volume cut point of 6.8 cm 3 (sensitivity 75.0 %, specificity 76.7 %). Infarct volume greater than 3 cm 3 predicted need for critical care interventions with 81.3 % sensitivity and 66.7 % specificity. Infarct volume may predict needs for ICU monitoring and interventions in stroke patients treated with IVT. (orig.)

  13. Prominent hypointense veins on susceptibility weighted image in the cat brain with acute infarction: DWI, SWI, and PWI.

    Science.gov (United States)

    Kim, Yong-Woo; Kim, Hak Jin; Choi, Seon Hee; Kim, Dong Chan

    2014-10-01

    The multiple prominent hypointense veins on susceptibility-weighted imaging (SWI) have been found in the ischemic territory of patients with acute ischemic stroke. Venous side is the unknown area in the hemodynamics of brain infarction. To evaluate the venous aspect in acute brain infarction through an animal study. The acute infarction in cat brains was induced with a bolus infusion of 0.25 mL of triolein through one side of the common carotid artery. The magnetic resonance (MR) images, including diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) map, SW, and perfusion-weighted (PWI) images, were obtained serially at 2 h (n = 17), 1 day (n = 11), and 4 days (n = 4) after triolein infusion. The obtained MR images were evaluated qualitatively and quantitatively. For qualitative assessment, the signal intensity of the serial MR images was evaluated. The presence or absence and the location with serial changes of infarction were identified on DWI and ADC map images. The presence or absence of prominent hypointense veins and the serial changes of cortical veins were also evaluated on SWI. Quantitative assessment was performed by comparing the relative cerebral blood volume (rCBV), cerebral blood flow (rCBF), and mean transit times (MTT) of the lesions with those of the contralateral normal side calculated on PWI. The serial changes of rCBV, rCBF, and MTT ratio were also evaluated. Acute infarction in the first and second medial gyrus of lesion hemisphere was found by qualitative evaluation of DWI and ADC map images. On the serial evaluation of SWI, the cortical veins of cat brain with infarction were obscured at 2 h and then re-appeared at 1 day. The hemorrhage transformation and prominent hypointense veins were seen at 4 days on SWI. The quantitative evaluation revealed increased MTT ratios and decreased rCBV and rCBF ratios on PWIs in the acute infarction of cat brain. The prominent hypointense veins on SWI were seen in the half of the acute

  14. NeuroSPECT assessment of ischemic penumbra in acute brain infarct: control of intra-arterial thrombolysis

    International Nuclear Information System (INIS)

    Mena, F.J.; Mena, I.; Contreras, I.; Soto, F.; Ducci, H.; Fruns, M.

    2002-01-01

    Introduction: Brain infarct is the most common cause of incapacity in adults, the second cause of dementia and the 2nd or 3rd cause of death. Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis in the first hours of evolution. Thrombolysis is now an approved and efficacious method of treatment for acute ischemic stroke. During the first 3 hours of evolution, intravenous administration of plasminogen activator (tPA) can be performed. The window of time of treatment is expanded to 6 hours with the intra-arterial super selective route for thrombolysis. Aim: The aim of this study was to define levels of reversible ischemia (penumbra) demonstrated by statistically evaluated HMPAO Tc99m NeuroSPECT performed before and after intra-arterial thrombolysis in the treatment of acute infarct. Materials and Methods: 21 patients were treated during the first 6 hours of evolution of an acute ischemic stroke with the following protocol. 1) Admission, and complete neurological evaluation. 2) Brain CT scan to rule hemorrhage or established infarct. 3) I.V injection of 1100MBq Tc99m HMPAO (Ceretec tm) 4) Conventional cerebral angiography and intra-arterial thrombolysis and/or angioplasty/stenting if necessary. 5) NeuroSPECT assessment of ischemic penumbra. 6) Control at 24 hrs with NeuroSPECT. NeuroSPECT image acquisition is performed immediately following arterial thrombolysis with a dual Head Camera, SHR collimators and conventional protocol. Image processing was performed using the Segami Software, as previously reported in Alasbimn Journal2 (7): April 2000. http://www.alasbimnjournal.cl. The analysis consists of 1) Tallairach brain volume normalization. 2) Voxel by voxel comparison of the individual brain cortex uptake normalized to the maximum in the cortex with a normal database of 24 age-matched controls. Results: The results are expressed in standard deviations (S.D.) below the normal mean. Normal mean is 72% + 6. Only voxels between

  15. Generalised brain edema and brain infarct in ergotamine abuse: Visualization by CT, MR and angiography

    International Nuclear Information System (INIS)

    Toedt, C.; Hoetzinger, H.; Salbeck, R.; Beyer, H.K.

    1989-01-01

    Abuse of ergotamine can release a generalised brain edema and brain infarctions. This can be visualized by CT, MR and angiography. The reason, however, can only be found in the patients history. (orig.) [de

  16. Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

    International Nuclear Information System (INIS)

    Rossi, Maija E; Jason, Eeva; Marchesotti, Silvia; Dastidar, Prasun; Ollikainen, Jyrki; Soimakallio, Seppo

    2010-01-01

    Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acute phase (within 3-4 hours) and magnetic resonance imaging (MRI) in the chronic phase (follow-up at 12 months, with a range of 8-27 months). The chronic-phase fractional anisotropy (FA) and mean diffusivity (MD) values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10) were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons. Several MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume. A larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations

  17. Automated analysis for early signs of cerebral infarctions on brain X-ray CT images

    International Nuclear Information System (INIS)

    Oshima, Kazuki; Hara, Takeshi; Zhou, X.; Muramatsu, Chisako; Fujita, Hiroshi; Sakashita, Keiji

    2010-01-01

    t-PA (tissue plasminogen activator) thrombolysis is an effective clinical treatment for the acute cerebral infarction by breakdown to blood clots. However there is a risk of hemorrhage with its use. The guideline of the treatment is denying cerebral hemorrhage and widespread Early CT sign (ECS) on CT images. In this study, we analyzed the CT value of normal brain and ECS with normal brain model by comparing patient brain CT scan with a statistical normal model. Our method has constructed normal brain models consisted of 60 normal brain X-ray CT images. We calculated Z-score based on statistical model for 16 cases of cerebral infarction with ECS, 3 cases of cerebral infarction without ECS, and 25 cases of normal brain. The results of statistical analysis showed that there was a statistically significant difference between control and abnormal groups. This result implied that the automated detection scheme for ECS by using Z-score would be a possible application for brain computer-aided diagnosis (CAD). (author)

  18. Effectiveness of early decompressive surgery for massive hemispheric embolic infarction

    International Nuclear Information System (INIS)

    Osada, Hideo; Mori, Kentaro; Yamamoto, Takuji; Nakao, Yasuaki; Oyama, Kazutaka; Esaki, Takanori; Watanabe, Mitsuya

    2008-01-01

    Massive hemispheric embolic infarction associated with acute brain swelling and rapid clinical deterioration is known as malignant infarction because of the significant rates of mortality and morbidity. Decompressive hemicraniectomy is effective; however, the timing and outcome still remain unclear. Ninety-four patients with massive embolic hemispheric infarctions (infarct volume >200 ml) were retrospectively divided into 3 groups: 29 patients, treated conservatively (conservative group); 33 patients, operated on after the appearance of signs of brain herniation (late surgery group); and 32 patients, operated on before the onset of signs of brain herniation signs (early surgery group). The mortality at 1 and 6 months in the late surgery group (15.2% and 24.2%, respectively) was significantly improved as compared to the conservative group (62.1% and 69.0%, respectively) (p 200 ml) should be performed before the onset of brain herniation. Early surgery may achieve a satisfactory functional recovery. (author)

  19. Computerized detection of lacunar infarcts in brain MR images

    International Nuclear Information System (INIS)

    Uchiyama, Yoshikazu; Matsui, Atsushi; Yokoyama, Ryujiro

    2007-01-01

    Asymptomatic lacunar infarcts are often found in the Brain Dock. The presence of asymptomatic lacunar infarcts increases the risk of serious cerebral infarction. Thus, it is an important task for radiologists and/or neurosurgeons to detect asymptomatic lacunar infarctions in MRI images. However, it is difficult for radiologists and/or neurosurgeons to identify lacunar infarcts correctly in MRI images, because it is hard to distinguish between lacunar infarcts and enlarged Virchow-Robin space. Therefore, the purpose of our study was to develop a computer-aided diagnosis scheme for detection of lacunar infarctions in order to assist radiologists and/or neurosurgeons' interpretation as a ''second opinion.'' Our database consisted of 1143 T2-weighted MR images and 1143 T1-weighted MR images, which were selected from 132 patients. First, we segmented the cerebral parenchyma region by use of a region growing technique. The white-tophat transformation was then applied for enhancement of lacunar infarcts. The multiple-phase binarization was used for identifying initial candidates of lacunar infarcts. For removal of false positives (FPs), 12 features were determined in each of the initial candidates in T2 and T1-weighted MR images. The rule-based schemes and an artificial neural network with these features were used for distinguishing between lacunar infarcts and FPs. The sensitivity of detection of lacunar infarcts was 96.8% (90/93) with 0.69 (737/1063) FP per image. This computerized method may be useful for radiologists and/or neurosurgeons in detecting lacunar infracts in MRI images. (author)

  20. Cortical laminar necrosis in brain infarcts: serial MRI

    Energy Technology Data Exchange (ETDEWEB)

    Siskas, N.; Lefkopoulos, A.; Ioannidis, I.; Charitandi, A.; Dimitriadis, A.S. [Radiology Department, AHEPA University Hospital, Aristotele University of Thessaloniki (Greece)

    2003-05-01

    High-signal cortical lesions are observed on T1-weighted images in cases of brain infarct. Histological examination has demonstrated these to be ''cortical laminar necrosis'', without haemorrhage or calcification. We report serial MRI in this condition in 12 patients with brain infarcts. We looked at high-signal lesions on T1-weighted images, chronological changes in signal intensity and contrast enhancement. High-signal cortical lesions began to appear about 2 weeks after the ictus, were prominent at 1 - 2 months, then became less evident, but occasionally remained for up to 1.5 years. They gave high signal or were isointense on T2-weighted images and did not give low signal at any stage. Contrast enhancement of these lesions was prominent at 1 - 2 months, and less apparent from 3 months, but was seen up to 5 months. (orig.)

  1. Tc99m-HMPAO Neuro--SPECT Assessment of Ischemic Penumbra in Acute Brain Infarct: Control of Intra-arterial Thrombolysis Treatment

    International Nuclear Information System (INIS)

    Mena, Francisco; Mena, Ismael; Ducci, Hector; Soto, Francisco; Pedraza, Luis; Contreras, Andrea; Miranda, Marcelo; Basaez, Esteban; Fruns, Manuel

    2004-01-01

    (7): April 2000. http://www.alasbimnjournal.cl. The analysis consists of 1) Talairach brain volume normalization. 2) Voxel by voxel comparison of the individual brain cortex uptake normalized to the maximum in the cortex with a normal database of 24 age-matched controls. Results: The results were expressed in standard deviations (SD) below the normal mean. Normal mean is 72 5 % of maximum in the brain cortex. Thrombolysis significantly reduced the brain hypoperfusion of the studied patients. Overall, 7 of 16 patients made good clinical recovery (mR 0-1) after the thrombolysis treatment. 7 of 16 patients made a moderate to poor clinical recovery (mR 2-4) and 2 of 16 patients died. The best clinical outcomes were found when successful recanalization of the occluded vessel was achieved in the presence of only moderate or superficial cerebral hypoperfusion. Patients that presented with large areas of severe brain hypoperfusion tended to have a worse outcome. Conclusions: NeuroSPECT examination 1) Provides useful information of infarct/penumbra during the first hours of evolution. 2) Evaluates the efficacy of thrombolysis and also angioplasty and stenting therapy. 3) Helps anticipate post therapy evolution. Key Words: Brain infarct; Thrombolysis; HMPAO; SPECT (Au)

  2. A study of whole brain perfusion CT and CT angiography in hyperacute and acute cerebral infarction

    International Nuclear Information System (INIS)

    Zhang Yonghai; Bai Junhu; Zhang Ming; Yang Guocai; Tang Guibo; Fang Jun; Shi Wei; Li Xinghua; Liu Suping; Lu Qing; Tang Jun

    2005-01-01

    Objective: To evaluate the diagnostic value of whole-brain perfusion blood volume-weighted CT imaging (PWCT) and simultaneous CT angiography (CTA) on early stage of cerebral ischemic infarction. Methods: Non-contrast CT (NCCT), CT perfusion-weighted imaging (PWCT) and delayed CT (DCT) were conducted on 20 cases of early ischemic infarction of whose onset time ranged from 2 to 24 hours. All cases were reexamined with CT or MRI one week to one month later. CT values and perfusion blood volume (PBV) of central and peripheral low perfusion areas as well as those of collateral side were measured. CTA was reconstructed with PWCT as source images to evaluate occlusion or stenosis of blood vessel, and DCT was used to detect the collateral circulation. Results: Of the 20 cases, NCCT, PWCT and CTA were negative in 10 cases in which 6 were confirmed as Transient Ischemic Attack (TIA) on reexamined CT and clinical features, and the other 4 were confirmed as lacunar infarction. For the remaining 10 cases, a comparison was made with ANOVA between low perfusion area (central, peripheral inside and outside) and collateral side. The difference was significant (P<0.01). However, no significant difference was revealed in the central, peripheral inside and outside areas. PBV values were significant in low perfusion area and collateral side (P<0.05). The area of the final infarction was larger than that of the low perfusion area, and the percentage of enlargement exhibited medium negative correlation to the time of ischemia. CTA indicated that 2 cases suffered from left middle cerebral artery occlusion, meanwhile anterior and middle branches of MCA in the other 3 cases were not identified. The sensitivity of NCCT, PWCT and CTA were 28.5%, 71.4% and 35.7% respectively. DCT indicated that 5 cases had asymmetrical blood vessels. Conclusion: The whole-brain perfusion-weighted CT imaging and simultaneous CT angiography (CTA) is p roved to be a simple, timesaving and effective method for the

  3. Diffusion Tensor Tractography Imaging in a Case of Acute Brain Stem Infarct

    Directory of Open Access Journals (Sweden)

    Nilgül Yardımcı

    2009-03-01

    Full Text Available Diffusion tensor tractography enables graphical reconstruction of the white matter pathways in the brain and quantitative study of white matter integrity. With this method virtual dissection of the living human brain can be performed. This technique has many potential clinical applications in neurological disorders, including the investigation of stroke. We present tractography findings of a patient that had an acute ischemic infarct in the brain stem. We aimed to report the disintegration of the white matter tracts at the infarct location in vivo, as well as the associated clinical symptoms. The current use of tractography in neurological disorders shows that it has the potential to improve our understanding of the damage and recovery process in diseases of the brain and spinal cord. From a clinical point of view tractography might be used to test new hypotheses, and to provide important new insights into the organization of the brain and the effects of brain disorders

  4. Proposal for a universal definition of cerebral infarction.

    Science.gov (United States)

    Saver, Jeffrey L

    2008-11-01

    Cerebral infarction is a leading cause of disability and death worldwide but has no uniform international definition. Recent diagnostic advances have revised fundamental concepts in cerebral and cardiac ischemia. Cardiologists, already possessed of a nosologic framework distinguishing myocardial infarction from unstable angina on the basis of tissue state, promulgated a new "universal" tissue definition of myocardial infarction incorporating insights afforded by assays of cardiac troponin, a serum biomarker exquisitely sensitive to myocardial injury. Concurrently, vascular neurologists proposed a new tissue, rather than time, criterion to distinguish transient ischemia attack from cerebral infarction, responding to perspectives provided by diffusion MRI and cerebral blood volume CT, imaging biomarkers highly sensitive to neuronal injury. To complete this conceptual realignment, vascular neurology must now advance a clear, uniform, and operationalizable tissue definition of cerebral infarction. This review proposes cerebral infarction be defined as brain or retinal cell death due to prolonged ischemia. This definition categorizes both pannecrosis and neuronal dropout ("complete" and "incomplete" infarcts in classic neuropathologic terminology) as cerebral infarcts. Making the presence of any neuronal or glial cell death essential yields a definition of cerebral infarction that has high relevance to patients, physicians, and policymakers; is more easily applied in clinical practice; fosters action in acute care; harmonizes with myocardial ischemia classification; and focuses diagnostic evaluation on the cause of brain ischemia and the occurrence of end organ injury. The term cerebral infarction should be used when there is evidence of brain or retinal cell death due to cerebral ischemia.

  5. Ginsenoside Rg1 nanoparticle penetrating the blood–brain barrier to improve the cerebral function of diabetic rats complicated with cerebral infarction

    Directory of Open Access Journals (Sweden)

    Shen J

    2017-09-01

    Full Text Available Junyi Shen, Zhiming Zhao, Wei Shang, Chunli Liu, Beibei Zhang, Lingjie Zhao, Hui Cai Department of Integrated Traditional and Western Medicine, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China Abstract: Diabetic cerebral infarction is with poorer prognosis and high rates of mortality. Ginsenoside Rg1 (Rg1 has a wide variety of therapeutic values for central nervous system (CNS diseases for the neuron protective effects. However, the blood–brain barrier (BBB restricts Rg1 in reaching the CNS. In this study, we investigated the therapeutic effects of Rg1 nanoparticle (PHRO, fabricated with γ-PGA, L-PAE (H, Rg1, and OX26 antibody, targeting transferrin receptor, on the diabetes rats complicated with diabetic cerebral infarction in vitro and in vivo. Dynamic light scattering analysis shows the average particle size of PHRO was 79±18 nm and the polydispersity index =0.18. The transmission electron microscope images showed that all NPs were spherical in shape with diameters of 89±23 nm. PHRO released Rg1 with sustained release manner and could promote the migration of cerebrovascular endothelial cells and tube formation and even penetrated the BBB in vitro. PHRO could penetrate the BBB with high concentration in brain tissue to reduce the cerebral infarction volume and promote neuronal recovery in vivo. PHRO was promising to be a clinical treatment of diabetes mellitus with cerebral infarction. Keywords: poly-γ-glutamic acid, ginsenoside Rg1, OX26, blood–brain barrier

  6. Splenectomy reduces infarct volume and neuroinflammation in male but not female mice in experimental stroke

    Science.gov (United States)

    Dotson, Abby L.; Wang, Jianming; Saugstad, Julie; Murphy, Stephanie J.; Offner, Halina

    2014-01-01

    The peripheral immune response contributes to neurodegeneration after stroke yet little is known about how this process differs between males and females. The current study demonstrates that splenectomy prior to experimental stroke eliminates sex differences in infarct volume and activated brain monocytes/microglia. In the periphery of both sexes, activated T cells correlate directly with stroke outcome while monocytes are reduced by splenectomy only in males. This study provides new information about the sex specific mechanisms of the peripheral immune response in neurodegeneration after stroke and demonstrates the need for representation of both sexes in basic and clinical stroke research. PMID:25434281

  7. Purinergic receptor stimulation reduces cytotoxic edema and brain infarcts in mouse induced by photothrombosis by energizing glial mitochondria.

    Directory of Open Access Journals (Sweden)

    Wei Zheng

    2010-12-01

    Full Text Available Treatments to improve the neurological outcome of edema and cerebral ischemic stroke are severely limited. Here, we present the first in vivo single cell images of cortical mouse astrocytes documenting the impact of single vessel photothrombosis on cytotoxic edema and cerebral infarcts. The volume of astrocytes expressing green fluorescent protein (GFP increased by over 600% within 3 hours of ischemia. The subsequent growth of cerebral infarcts was easily followed as the loss of GFP fluorescence as astrocytes lysed. Cytotoxic edema and the magnitude of ischemic lesions were significantly reduced by treatment with the purinergic ligand 2-methylthioladenosine 5' diphosphate (2-MeSADP, an agonist with high specificity for the purinergic receptor type 1 isoform (P2Y(1R. At 24 hours, cytotoxic edema in astrocytes was still apparent at the penumbra and preceded the cell lysis that defined the infarct. Delayed 2MeSADP treatment, 24 hours after the initial thrombosis, also significantly reduced cytotoxic edema and the continued growth of the brain infarction. Pharmacological and genetic evidence are presented indicating that 2MeSADP protection is mediated by enhanced astrocyte mitochondrial metabolism via increased inositol trisphosphate (IP(3-dependent Ca(2+ release. We suggest that mitochondria play a critical role in astrocyte energy metabolism in the penumbra of ischemic lesions, where low ATP levels are widely accepted to be responsible for cytotoxic edema. Enhancement of this energy source could have similar protective benefits for a wide range of brain injuries.

  8. MR imaging of acute hemorrhagic brain infarction

    International Nuclear Information System (INIS)

    Uchino, Akira; Ohnari, Norihiro; Ohno, Masato

    1989-01-01

    Six patients with acute hemorrhagic brain infarct were imaged using spin-echo (SE) pulse sequences on a 1.5 Tesla MR scanner. Including two patients with repeated MR imaging, a total of eight examinations, all performed within 15 days after stroke, were analyzed retrospectively. Four patients revealed massive hemorrhages in the basal ganglia or cerebellum and three cases demonstrated multiple linear hemorrhages in the cerebral cortex. On T1-weighted images, hemorrhages were either mildly or definitely hyperintense relative to gray matter, while varied from mildly hypointense to hyperintense on T2-weighted images. T1-weighted images were superior to T2-weighted images in detection of hemorrhgage. CT failed to detect hemorrhage in two of five cases: indicative of MR superiority to CT in the diagnosis of acute hemorrhagic infarcts. (author)

  9. Whole brain CT perfusion in acute anterior circulation ischemia: coverage size matters

    International Nuclear Information System (INIS)

    Emmer, B.J.; Rijkee, M.; Walderveen, M.A.A. van; Niesten, J.M.; Velthuis, B.K.; Wermer, M.J.H.

    2014-01-01

    Our aim was to compare infarct core volume on whole brain CT perfusion (CTP) with several limited coverage sizes (i.e., 3, 4, 6, and 8 cm), as currently used in routine clinical practice. In total, 40 acute ischemic stroke patients with non-contrast CT (NCCT) and CTP imaging of anterior circulation ischemia were included. Imaging was performed using a 320-multislice CT. Average volumes of infarct core of all simulated partial coverage sizes were calculated. Infarct core volume of each partial brain coverage was compared with infarct core volume of whole brain coverage and expressed using a percentage. To determine the optimal starting position for each simulated CTP coverage, the percentage of infarct coverage was calculated for every possible starting position of the simulated partial coverage in relation to Alberta Stroke Program Early CT Score in Acute Stroke Triage (ASPECTS 1) level. Whole brain CTP coverage further increased the percentage of infarct core volume depicted by 10 % as compared to the 8-cm coverage when the bottom slice was positioned at the ASPECTS 1 level. Optimization of the position of the region of interest (ROI) in 3 cm, 4 cm, and 8 cm improved the percentage of infarct depicted by 4 % for the 8-cm, 7 % for the 4-cm, and 13 % for the 3-cm coverage size. This study shows that whole brain CTP is the optimal coverage for CTP with a substantial improvement in accuracy in quantifying infarct core size. In addition, our results suggest that the optimal position of the ROI in limited coverage depends on the size of the coverage. (orig.)

  10. Whole brain CT perfusion in acute anterior circulation ischemia: coverage size matters

    Energy Technology Data Exchange (ETDEWEB)

    Emmer, B.J. [Erasmus Medical Centre, Department of Radiology, Postbus 2040, Rotterdam (Netherlands); Rijkee, M.; Walderveen, M.A.A. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Niesten, J.M.; Velthuis, B.K. [University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); Wermer, M.J.H. [Leiden University Medical Centre, Department of Neurology, Leiden (Netherlands)

    2014-12-15

    Our aim was to compare infarct core volume on whole brain CT perfusion (CTP) with several limited coverage sizes (i.e., 3, 4, 6, and 8 cm), as currently used in routine clinical practice. In total, 40 acute ischemic stroke patients with non-contrast CT (NCCT) and CTP imaging of anterior circulation ischemia were included. Imaging was performed using a 320-multislice CT. Average volumes of infarct core of all simulated partial coverage sizes were calculated. Infarct core volume of each partial brain coverage was compared with infarct core volume of whole brain coverage and expressed using a percentage. To determine the optimal starting position for each simulated CTP coverage, the percentage of infarct coverage was calculated for every possible starting position of the simulated partial coverage in relation to Alberta Stroke Program Early CT Score in Acute Stroke Triage (ASPECTS 1) level. Whole brain CTP coverage further increased the percentage of infarct core volume depicted by 10 % as compared to the 8-cm coverage when the bottom slice was positioned at the ASPECTS 1 level. Optimization of the position of the region of interest (ROI) in 3 cm, 4 cm, and 8 cm improved the percentage of infarct depicted by 4 % for the 8-cm, 7 % for the 4-cm, and 13 % for the 3-cm coverage size. This study shows that whole brain CTP is the optimal coverage for CTP with a substantial improvement in accuracy in quantifying infarct core size. In addition, our results suggest that the optimal position of the ROI in limited coverage depends on the size of the coverage. (orig.)

  11. Multiphasic perfusion CT in acute middle cerebral artery ischemic stroke: prediction of final infarct volume and correlation with clinical outcome

    International Nuclear Information System (INIS)

    Yi, Chin A; Na, Dong Gyu; Ryoo, Jae Wook; Moon, Chan Hong; Byun, Hong Sik; Roh, Hong Gee; Moon, Won Jin; Lee, Kwang Ho; Lee, Soo Joo

    2002-01-01

    To assess the utility of multiphasic perfusion CT in the prediction of final infarct volume, and the relationship between lesion volume revealed by CT imaging and clinical outcome in acute ischemic stroke patients who have not undergone thrombolytic therapy. Thirty-five patients underwent multiphasic perfusion CT within six hours of stroke onset. After baseline unenhanced helical CT scanning, contrast-enhanced CT scans were obtained 20, 34, 48, and 62 secs after the injection of 90 mL contrast medium at a rate of 3 mL/sec. CT peak and total perfusion maps were obtained from serial CT images, and the initial lesion volumes revealed by CT were compared with final infarct volumes and clinical scores. Overall, the lesion volumes seen on CT peak perfusion maps correlated most strongly with final infarct volumes (R2=0.819, p<0.001, slope of regression line=1.016), but individual data showed that they were less than final infarct volume in 31.4% of patients. In those who showed early clinical improvement (n=6), final infarct volume tended to be overestimated by CT peak perfusion mapping and only on total perfusion maps was there significant correlation between lesion volume and final infarct volume (R2=0.854, p=0.008). The lesion volumes depicted by CT maps showed moderate correlation with baseline clinical scores and clinical outcomes (R=0.445-0.706, p≤0.007). CT peak perfusion maps demonstrate strong correlation between lesion volume and final infarct volume, and accurately predict final infarct volume in about two-thirds of the 35 patients. The lesion volume seen on CT maps shows moderate correlation with clinical outcome

  12. Prediction of infarct volume in patients undergoing reperfusion therapy by Tc-99m antimyosin SPECT

    International Nuclear Information System (INIS)

    Yasuda, T.; Leinbach, R.C.; Khaw, B.A.; Gold, H.K.; Strauss, H.W.

    1984-01-01

    The predictability of infarct volume by Tc-99m antimyosin SPECT was evaluated within 24 hours of chest pain and this was compared to the length of akinesis (AK) from the pre-discharge left ventriculogram (LVgram). Ten patients (pts) with acute myocardial infarction who underwent streptokinase thrombolytic therapy (success 8, failure 2) were subjects of this investigation. None had previous infarction. Average reperfusion time was within 4.5 hours and 20mCi of Tc-99m antimyosin was given intravenously within 8 hours after chest pain; SPECT imaging was performed within 18 hours after injection. Infarct volume was calculated from SPECT and expressed as grams of myocardial infarction (GMI). Ten days later, a 30 0 RAO contrast LVgram was recorded and the length of AK (corrected for magnification) was measured along the LV border at the end-diastolic phase and expressed as cm of AK. GMI and AK were measured independently without knowledge of each other. Results are given. The data demonstrate a good correlation of GMI and AK. Infarct volume can be measured by antimyosin SPECT within 24 hours of chest pain and predict residual LV dysfunction in pts undergoing reperfusion therapy

  13. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zhaosheng, Luan; Pengyong,; Xiqin, Sun; Wei, Wang; Huisheng, Liu; Wen, Zhou [88 Hospital PLA, Taian, SD (China). Dept. of Nuclear Medicine

    1992-11-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed.

  14. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    International Nuclear Information System (INIS)

    Luan Zhaosheng; Pengyong; Sun Xiqin; Wang Wei; Liu Huisheng; Zhou Wen

    1992-01-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed

  15. Self-rated function, self-rated health, and postmortem evidence of brain infarcts: findings from the Nun Study.

    Science.gov (United States)

    Greiner, P A; Snowdon, D A; Greiner, L H

    1999-07-01

    Self-rated function is a new global measure. Previous findings suggest that self-rated function predicts future functional decline and is strongly associated with all-cause mortality. We hypothesized that the strength of the relationship of self-rated function to all-cause mortality was in part due to functional decline, such as would occur with brain infarcts. Self-ratings of function and health (on a 5-point scale, ranging from excellent to poor) were assessed annually on 630 participants in the Nun Study. Mortality surveillance extended from October 31, 1991 to March 1, 1998, and, among those who died, neuropathological examination determined postmortem evidence of brain infarcts. Cox regression modeling with self-rated function and health as time-dependent covariates and stratification by assessment period were used in these analyses. Self-rated function and health ratings of good, fair, and poor were significantly associated with doubling of the risk of mortality, compared with ratings of very good and excellent. Self-rated function ratings of fair or poor were associated with a threefold increase in the risk of mortality with brain infarcts, but self-rated function and health ratings of fair and poor were comparable in their association with all-cause mortality and mortality without brain infarcts. Self-rated function was significantly associated with mortality with brain infarcts, suggesting that brain infarcts may be experienced as functional loss but not recognized or labeled as disease. Our results suggest that self-rated function and health should be explored simultaneously in future research.

  16. Dietary Virgin Olive Oil Reduces Blood Brain Barrier Permeability, Brain Edema, and Brain Injury in Rats Subjected to Ischemia-Reperfusion

    Directory of Open Access Journals (Sweden)

    Fatemeh Mohagheghi

    2010-01-01

    Full Text Available Recent studies suggest that dietary virgin olive oil (VOO reduces hypoxia-reoxygenation injury in rat brain slices. We sought to extend these observations in an in vivo study of rat cerebral ischemia-reperfusion injury. Four groups, each consisting of 18 Wistar rats, were studied. One group (control received saline, while three treatment groups received oral VOO (0.25, 0.5, and 0.75 mL/kg/day, respectively. After 30 days, blood lipid profiles were determined, before a 60-min period of middle cerebral artery occlusion (MCAO. After 24-h reperfusion, neurological deficit scores, infarct volume, brain edema, and blood brain barrier permeability were each assessed in subgroups of six animals drawn from each main group. VOO reduced the LDL/HDL ratio in doses of 0.25, 0.5, and 0.75 mL/kg/day in comparison to the control group (p < 0.05, and offered cerebroprotection from ischemia-reperfusion. For controls vs. doses of 0.25 vs. 0.5 vs. 0.75 mL/kg/day, attenuated corrected infarct volumes were 207.82 ± 34.29 vs. 206.41 ± 26.23 vs. 124.21 ± 14.73 vs. 108.46 ± 31.63 mm3; brain water content of the infarcted hemisphere was 82 ±± 0.25 vs. 81.5 ± 0.56 vs. 80.5 ± 0.22 vs. 80.5 ± 0.34%; and blood brain barrier permeability of the infarcted hemisphere was 11.31 ± 2.67 vs. 9.21 ± 2.28 vs. 5.83 ± 1.6 vs. 4.43 ± 0.93 µg/g tissue (p < 0.05 for measures in doses 0.5 and 0.75 mL/kg/day vs. controls. Oral administration of VOO reduces infarct volume, brain edema, blood brain barrier permeability, and improves neurologic deficit scores after transient MCAO in rats.

  17. Diffusion weighted MR imaging in non-infarct lesions of the brain

    Energy Technology Data Exchange (ETDEWEB)

    Karaarslan, E. [Department of Radiology, American Hospital, Sisli, Istanbul (Turkey)], E-mail: ercankaraarslan@yahoo.com; Arslan, A. [Department of Radiology, Kocaeli University Medical School, Kocaeli (Turkey)], E-mail: arzuarslan@netscape.net

    2008-03-15

    Diffusion weighted imaging (DWI) is a relatively new method in which the images are formed by the contrast produced by the random microscopic motion of water molecules in different tissues. Although DWI has been tried for different organ systems, it has been found its primary use in the central nervous system. The most widely used clinical application is in the detection of hyperacute infarcts and the differentiation of acute or subacute infarction from chronic infarction. Recently DWI has been applied to various other cerebral diseases. In this pictorial paper the authors demonstrated different DWI patterns of non-infarct lesions of the brain which are hyperintense in the diffusion trace image, such as infectious, neoplastic and demyelinating diseases, encephalopathies - including hypoxic-ischemic, hypertensive, eclamptic, toxic, metabolic and mitochondrial encephalopathies - leukodystrophies, vasculitis and vasculopathies, hemorrhage and trauma.

  18. [Correlation between post-stroke pneumonia and outcome in patients with acute brain infarction].

    Science.gov (United States)

    Li, S J; Hu, H Q; Wang, X L; Cao, B Z

    2016-09-20

    Objective: To investigate the correlation between post-stroke pneumonia and outcome in patients with acute brain infarction. Methods: Consecutive acute cerebral infarction patients who were hospitalized in Department of Neurology, Jinan Military General Hospital were prospectively recruited from August 2010 to August 2014. The baseline data including age, sex, the National Institute of Health Stroke Scale (NIHSS) scores, type of Oxfordshire Community Stroke Project (OCSP: total anterior circulation infarct, partial anterior circulation infarct, posterior circulation infarct and lacunar infarct), fasting blood glucose etc. after admission were recorded. Post-stroke pneumonia was diagnosed by treating physician according to criteria for hospital-acquired pneumonia of the Centers for Disease Control and Prevention. Recovery was assessed by modified Rankin Scale (mRS) 180 days after stroke by telephone interview (mRS≤2 reflected good prognosis, and mRS>2 reflected unfavorable prognosis). Multinominal Logistic regression analysis, Kaplan-Meier curve and log rank test were used. Results: A total of 1 249 patients were enrolled, among them 173 patients were lost during follow-up. A total of 159 patients had post-stroke pneumonia, while 1 090 patients were without post-stroke. Compared with patients without post-stoke pneumonia, patients with post-stroke pneumonia were older (67±13 vs 63±12 years, P =0.000), more severe (NIHSS, 15(14) vs 4(4), P =0.000). Compared with patients without post-stoke pneumonia, more patients with post-stroke pneumonia suffered from heart failure (12.58% vs 3.40%, P =0.000), atrial fibrillation (26.42% vs 8.81%, P =0.000), myocardial infarction (10.06% vs 5.05%, P =0.016), recurrent brain infarction (30.19% vs 22.66%, P =0.045), total anterior circulation infarct type of OCSP (46.54% vs 19.63%, P =0.000), posterior circulation infarct of OCSP (39.62% vs 25.51%, P =0.001); more patients suffered from disorder of consciousness (60.38% vs 9

  19. Risk reduction of brain infarction during carotid endarterectomy or stenting using sonolysis - Prospective randomized study pilot data

    Science.gov (United States)

    Kuliha, Martin; Školoudík, David; Martin Roubec, Martin; Herzig, Roman; Procházka, Václav; Jonszta, Tomáš; Krajča, Jan; Czerný, Dan; Hrbáč, Tomáš; Otáhal, David; Langová, Kateřina

    2012-11-01

    Sonolysis is a new therapeutic option for the acceleration of arterial recanalization. The aim of this study was to confirm risk reduction of brain infarction during endarterectomy (CEA) and stenting (CAS) of the internal carotid artery (ICA) using sonolysis with continuous transcranial Doppler (TCD) monitoring by diagnostic 2 MHz probe, additional interest was to assess impact of new brain ischemic lesions on cognitive functions. Methods: All consecutive patients 1/ with ICA stenosis >70%, 2/ indicated to CEA or CAS, 3/ with signed informed consent, were enrolled to the prospective study during 17 months. Patients were randomized into 2 groups: Group 1 with sonolysis during intervention and Group 2 without sonolysis. Neurological examination, assessment of cognitive functions and brain magnetic resonance imaging (MRI) were performed before and 24 hours after intervention in all patients. Occurrence of new brain infarctions (including infarctions >0.5 cm3), and the results of Mini-Mental State Examination, Clock Drawing and Verbal Fluency tests were statistically evaluated using T-test. Results: 97 patients were included into the study. Out of the 47 patients randomized to sonolysis group (Group 1) 25 underwent CEA (Group 1a) and 22 CAS (Group 1b). Out of the 50 patients randomized to control group (Group 2), 22 underwent CEA (Group 2a) and 28 CAS (Group 2b). New ischemic brain infarctions on follow up MRI were found in 14 (29.8%) patients in Group 1-4 (16.0%) in Group 1a and 10 (45.5%) in Group 1b. In Group 2, new ischemic brain infarctions were found in 18 (36.0%) patients-6 (27.3%) in Group 2a and 12 (42.9%) in Group 2b (p>0.05 in all cases). New ischemic brain infarctions >0.5 cm3 were found in 4 (8.5 %) patients in Group 1 and in 11 (22.0 %) patients in Group 2 (p= 0.017). No significant differences were found in cognitive tests results between subgroups (p>0.05 in all tests). Conclusion: Sonolysis seems to be effective in the prevention of large ischemic

  20. Oxygen Mapping within Healthy and Acutely Infarcted Brain Tissue in Humans Using the NMR Relaxation of Lipids: A Proof-Of-Concept Translational Study.

    Science.gov (United States)

    Colliez, Florence; Safronova, Marta M; Magat, Julie; Joudiou, Nicolas; Peeters, André P; Jordan, Bénédicte F; Gallez, Bernard; Duprez, Thierry

    2015-01-01

    The clinical applicability of brain oxygenation mapping using the MOBILE (Mapping of Oxygen By Imaging Lipids relaxation Enhancement) magnetic resonance (MR) technique was assessed in the clinical setting of normal brain and of acute cerebral ischemia as a founding proof-of-concept translational study. Changes in the oxygenation level within healthy brain tissue can be detected by analyzing the spin-lattice proton relaxation ('Global T1' combining water and lipid protons) because of the paramagnetic properties of molecular oxygen. It was hypothesized that selective measurement of the relaxation of the lipid protons ('Lipids T1') would result in enhanced sensitivity of pO2 mapping because of higher solubility of oxygen in lipids than in water, and this was demonstrated in pre-clinical models using the MOBILE technique. In the present study, 12 healthy volunteers and eight patients with acute (48-72 hours) brain infarction were examined with the same clinical 3T MR system. Both Lipids R1 (R1 = 1/T1) and Global R1 were significantly different in the infarcted area and the contralateral unaffected brain tissue, with a higher statistical significance for Lipids R1 (median difference: 0.408 s-1; pbrain tissue of stroke patients were not significantly different from the R1 values calculated in the brain tissue of healthy volunteers. The main limitations of the present prototypic version of the MOBILE sequence are the long acquisition time (4 min), hampering robustness of data in uncooperative patients, and a 2 mm slice thickness precluding accurate measurements in small infarcts because of partial volume averaging effects.

  1. Asymmetry in the brain influenced the neurological deficits and infarction volume following the middle cerebral artery occlusion in rats

    OpenAIRE

    Zhang Meizeng; Gao Huanmin

    2008-01-01

    Abstract Background Paw preference in rats is similar to human handedness, which may result from dominant hemisphere of rat brain. However, given that lateralization is the uniqueness of the humans, many researchers neglect the differences between the left and right hemispheres when selecting the middle cerebral artery occlusion (MCAO) in rats. The aim of this study was to evaluate the effect of ischemia in the dominant hemisphere on neurobehavioral function and on the cerebral infarction vol...

  2. Genome-wide association studies of mri-defined brain infarcts: Meta-analysis from the charge consortium

    NARCIS (Netherlands)

    S. Debette (Stéphanie); J.C. Bis (Joshua); M. Fornage (Myriam); H.A. Schmid (Herbert); M.A. Ikram (Arfan); S. Sigurdsson (Stefan); G. Heiss (Gerardo); M.V. Struchalin (Maksim); A.V. Smith (Albert Vernon); A. van der Lugt (Aad); C. DeCarli (Charles); T. Lumley (Thomas); D.S. Knopman (David); C. Enzinger (Christian); G. Eiriksdottir (Gudny); P.J. Koudstaal (Peter Jan); A.L. DeStefano (Anita); B.M. Psaty (Bruce); C. Dufouil (Carole); D.J. Catellier (Diane); F. Fazekas (Franz); T. Aspelund (Thor); Y.S. Aulchenko (Yurii); A. Beiser (Alexa); J.I. Rotter (Jerome); C. Tzourio (Christophe); D.K. Shibata (Dean); M. Tscherner (Maria); T.B. Harris (Tamara); F. Rivadeneira Ramirez (Fernando); L.D. Atwood (Larry); K. Rice (Kenneth); R.F. Gottesman (Rebecca); M.A. van Buchem (Mark); A.G. Uitterlinden (André); M. Kelly-Hayes (Margaret); M. Cushman (Mary Ann); Y. Zhu (Yicheng); E.A. Boerwinkle (Eric); V. Gudnason (Vilmundur); A. Hofman (Albert); J.R. Romero (Jose Rafael); M.M.B. Breteler (Monique); R. Schmidt (Reinhold); L.J. Launer (Lenore); W.T. Longstreth Jr

    2010-01-01

    textabstractBackground and Purpose-Previous studies examining genetic associations with MRI-defined brain infarct have yielded inconsistent findings. We investigated genetic variation underlying covert MRI infarct in persons without histories of transient ischemic attack or stroke. We performed

  3. Prediction of infarction development after endovascular stroke therapy with dual-energy computed tomography.

    Science.gov (United States)

    Djurdjevic, Tanja; Rehwald, Rafael; Knoflach, Michael; Matosevic, Benjamin; Kiechl, Stefan; Gizewski, Elke Ruth; Glodny, Bernhard; Grams, Astrid Ellen

    2017-03-01

    After intraarterial recanalisation (IAR), the haemorrhage and the blood-brain barrier (BBB) disruption can be distinguished using dual-energy computed tomography (DECT). The aim of the present study was to investigate whether future infarction development can be predicted from DECT. DECT scans of 20 patients showing 45 BBB disrupted areas after IAR were assessed and compared with follow-up examinations. Receiver operator characteristic (ROC) analyses using densities from the iodine map (IM) and virtual non-contrast (VNC) were performed. Future infarction areas are denser than future non-infarction areas on IM series (23.44 ± 24.86 vs. 5.77 ± 2.77; p VNC series (29.71 ± 3.33 vs. 35.33 ± 3.50; p 17.13 HU; p VNC series allowed prediction of infarction volume. Future infarction development after IAR can be reliably predicted with the IM series. The prediction of haemorrhages and of infarction size is less reliable. • The IM series (DECT) can predict future infarction development after IAR. • Later haemorrhages can be predicted using the IM and the BW series. • The volume of definable hypodense areas in VNC correlates with infarction volume.

  4. Endogenous neurogenesis in the human brain following cerebral infarction.

    Science.gov (United States)

    Minger, Stephen L; Ekonomou, Antigoni; Carta, Eloisa M; Chinoy, Amish; Perry, Robert H; Ballard, Clive G

    2007-01-01

    Increased endogenous neurogenesis has a significant regenerative role in many experimental models of cerebrovascular diseases, but there have been very few studies in humans. We therefore examined whether there was evidence of altered endogenous neurogenesis in an 84-year-old patient who suffered a cerebrovascular accident 1 week prior to death. Using antibodies that specifically label neural stem/neural progenitor cells, we examined the presence of immunopositive cells around and distant from the infarcted area, and compared this with a control, age-matched individual. Interestingly, a large number of neural stem cells, vascular endothelial growth factor-immunopositive cells and new blood vessels were observed only around the region of infarction, and none in the corresponding brain areas of the healthy control. In addition, an increased number of neural stem cells was observed in the neurogenic region of the lateral ventricle wall. Our results suggest increased endogenous neurogenesis associated with neovascularization and migration of newly-formed cells towards a region of cerebrovascular damage in the adult human brain and highlight possible mechanisms underlying this process.

  5. Incidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Population: The AGES-Reykjavik Study (Age Gene/Environment Susceptibility-Reykjavik Study).

    Science.gov (United States)

    Sigurdsson, Sigurdur; Aspelund, Thor; Kjartansson, Olafur; Gudmundsson, Elias F; Jonsdottir, Maria K; Eiriksdottir, Gudny; Jonsson, Palmi V; van Buchem, Mark A; Gudnason, Vilmundur; Launer, Lenore J

    2017-09-01

    The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia. Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines. Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5-2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3-2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9-3.4). Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels. © 2017 American Heart Association, Inc.

  6. Brain volume reduction after whole-brain radiotherapy: quantification and prognostic relevance.

    Science.gov (United States)

    Hoffmann, Christian; Distel, Luitpold; Knippen, Stefan; Gryc, Thomas; Schmidt, Manuel Alexander; Fietkau, Rainer; Putz, Florian

    2018-01-22

    Recent studies have questioned the value of adding whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) for brain metastasis treatment. Neurotoxicity, including radiation-induced brain volume reduction, could be one reason why not all patients benefit from the addition of WBRT. In this study, we quantified brain volume reduction after WBRT and assessed its prognostic significance. Brain volumes of 91 patients with cerebral metastases were measured during a 150-day period after commencing WBRT and were compared with their pretreatment volumes. The average daily relative change in brain volume of each patient, referred to as the "brain volume reduction rate," was calculated. Univariate and multivariate Cox regression analyses were performed to assess the prognostic significance of the brain volume reduction rate, as well as of 3 treatment-related and 9 pretreatment factors. A one-way analysis of variance was used to compare the brain volume reduction rate across recursive partitioning analysis (RPA) classes. On multivariate Cox regression analysis, the brain volume reduction rate was a significant predictor of overall survival after WBRT (P < 0.001), as well as the number of brain metastases (P = 0.002) and age (P = 0.008). Patients with a relatively favorable prognosis (RPA classes 1 and 2) experienced significantly less brain volume decrease after WBRT than patients with a poor prognosis (RPA class 3) (P = 0.001). There was no significant correlation between delivered radiation dose and brain volume reduction rate (P = 0.147). In this retrospective study, a smaller decrease in brain volume after WBRT was an independent predictor of longer overall survival. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  7. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

    Energy Technology Data Exchange (ETDEWEB)

    Seeters, Tom van; Schaaf, Irene C. van der; Dankbaar, Jan Willem; Horsch, Alexander D.; Niesten, Joris M.; Luitse, Merel J.A.; Mali, Willem P.T.M.; Velthuis, Birgitta K. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Biessels, Geert Jan; Kappelle, L.J. [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Majoie, Charles B.L.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Vos, Jan Albert [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Schonewille, Wouter J. [St. Antonius Hospital, Department of Neurology, Nieuwegein (Netherlands); Walderveen, Marianne A.A. van [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Wermer, Marieke J.H. [Leiden University Medical Center, Department of Neurology, Leiden (Netherlands); Duijm, Lucien E.M. [Catharina Hospital, Department of Radiology, Eindhoven (Netherlands); Keizer, Koos [Catharina Hospital, Department of Neurology, Eindhoven (Netherlands); Bot, Joseph C.J. [VU University Medical Center, Department of Radiology, Amsterdam (Netherlands); Visser, Marieke C. [VU University Medical Center, Department of Neurology, Amsterdam (Netherlands); Lugt, Aad van der [Erasmus MC University Medical Center, Department of Radiology, Rotterdam (Netherlands); Dippel, Diederik W.J. [Erasmus MC University Medical Center, Department of Neurology, Rotterdam (Netherlands); Kesselring, F.O.H.W. [Rijnstate Hospital, Department of Radiology, Arnhem (Netherlands); Hofmeijer, Jeannette [Rijnstate Hospital, Department of Neurology, Arnhem (Netherlands); Lycklama a Nijeholt, Geert J. [Medical Center Haaglanden, Department of Radiology, The Hague (Netherlands); Boiten, Jelis [Medical Center Haaglanden, Department of Neurology, The Hague (Netherlands); Rooij, Willem Jan van [St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Kort, Paul L.M. de [St. Elisabeth Hospital, Department of Neurology, Tilburg (Netherlands); Roos, Yvo B.W.E.M. [Academic Medical Center, Department of Neurology, Amsterdam (Netherlands); Meijer, Frederick J.A. [Radboud University Medical Center, Department of Radiology, Nijmegen (Netherlands); Pleiter, C.C. [St. Franciscus Hospital, Department of Radiology, Rotterdam (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: Dutch acute stroke study (DUST) investigators

    2016-04-15

    We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R{sup 2} was assessed to determine the additional value of CTA and CTP. At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8-69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79-0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82-0.87); p < 0.001) and was even higher after addition of CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001) and combined CTA/CTP measures (AUC 0.89 (95 % CI 0.87-0.91); p < 0.001). For infarct volume, adding combined CTA/CTP measures (R{sup 2} = 0.58) was superior to patient characteristics and non-contrast CT alone (R{sup 2} = 0.44) and to addition of CTA alone (R{sup 2} = 0.55) or CTP alone (R{sup 2} = 0.54; all p < 0.001). In the acute stage, CTA and CTP have additional value over patient characteristics and non-contrast CT for predicting infarct presence and infarct volume on follow-up imaging. These findings could be applied for patient selection in future trials on ischemic stroke treatment. (orig.)

  8. The role in thanatogenesis of generalized brain edema in ischemic cerebral infarction (computer-morphometric research

    Directory of Open Access Journals (Sweden)

    E. A. Dyadyk

    2012-12-01

    Full Text Available This work presents the results of computer-morphometric study of perivascular and pericellular free (oedematous spaces in brain cortex at death from the ischemic cerebral infarction and from reasons unconnected directly with cerebral pathology. It was revealed, that the mean area of perivascular spaces (vasogenic edema index at brain infarction in 13 times exceeds such at extracerebral pathology, and mean area of pericellular spaces (cytotoxic edema index – almost in 12 times, but also it substantially differs on the degree of variation (in 2,5 times higher, than area of perivascular spaces.

  9. Brain infarction correlates more closely with acrolein than with reactive oxygen species.

    Science.gov (United States)

    Saiki, Ryotaro; Park, Hyerim; Ishii, Itsuko; Yoshida, Madoka; Nishimura, Kazuhiro; Toida, Toshihiko; Tatsukawa, Hideki; Kojima, Soichi; Ikeguchi, Yoshihiko; Pegg, Anthony E; Kashiwagi, Keiko; Igarashi, Kazuei

    2011-01-28

    Although it is thought that the major factor responsible for cell damage is reactive oxygen species (ROS), our recent studies have shown that acrolein is more toxic than ROS. Thus, the relative importance of acrolein and ROS in cell damage during brain infarction was compared using photochemically induced thrombosis model mice. The levels of acrolein-conjugated albumin, and of 4-hydroxynonenal (HNE)-conjugated albumin and 8-OHdG were evaluated as indicators of damage produced by acrolein and ROS, respectively. The increase in acrolein-conjugated albumin was much greater than the increase in HNE-conjugated albumin or 8-OHdG, suggesting that acrolein is more strongly involved in cell damage than ROS during brain infarction. It was also shown that infarction led more readily to RNA damage than to DNA or phospholipid damage. As a consequence, polyamines were released from RNA, and acrolein was produced from polyamines, especially from spermine by spermine oxidase. Production of acrolein from spermine by spermine oxidase was clarified using spermine synthase-deficient Gy mice and transglutaminase 2-knockout mice, in which spermine content is negligible or spermidine/spermine N(1)-acetyltransferase activity is elevated. Copyright © 2010 Elsevier Inc. All rights reserved.

  10. Right ventricular function after acute myocardial infarction: dependence upon infarct related coronary artery

    International Nuclear Information System (INIS)

    Cho, Ihn Ho; Chun, Kyung A; Won, Kyu Chang; Lee, Hyung Woo; Hong, Geu Ru; Park, Jong Seon; Shin, Dong Gu; Kim, Young Jo; Shim, Bong Sub

    2004-01-01

    We studied to know the relation between right ventricular function and infarct-related artery after acute myocardial infarction. The right and left ventricular function after a first myocardial infarction was assessed ECG-gated blood pool single photon emission computed tomography (GBPS) algorithms (Cedars-Sinai Medical Center, Los Angels, Calif) (12 after LAD related infarction (group 1) and 15 after RCA related infarction (group 2)). The left ventricular ejection fraction, end-diastolic volume and end-systolic volume did not differ significantly between two groups( group 1 vs 2 :LVEF 50.8% vs 55.1%. LVEDV=73.2 vs 79.7 ml, LVESV=38 vs 44 ml : P>0.05), but right ventricular ejection fraction, end-diastolic volume and end-systolic volume were significantly different after anterior myocardial infarction between two groups( group 1 vs 2 : RVEF=57.3% vs 46.3%. RVEDV=56.4 vs 95.1 ml, RVESV=25.6 vs 54.6ml : P<0.05). There was evidence of right ventricular dilatation in the group with RCA related infarction. Six with inferior infarction had abnormal right ventricular ejection fractions (< 40%). The relation between right and left ventricular ejection fractions was markedly different in the two groups. In the group with RCA related infarction there was a significant linear relation between right and left ventricular ejection fraction(R=0.5). Whereas in the group with LAD related infarction there was not (R=-0.3). Thus right ventricular dysfunction commonly occurs after RCA related infarction. Right ventricular impairment is related after RCA related infarction, but are independent after LAD related infarction. Finally, the different effects of LAD and RCA related infarction on right ventricular function may be explained by site of the myocardial wall involvement after infarction

  11. Leucoariaosis influence on cognitive status of patients with lacunar brain infarcts

    Directory of Open Access Journals (Sweden)

    Filipović-Danić S.

    2015-01-01

    Full Text Available Leukoaraiosis is a change in brain white matter with characteristic manifestation in MR and CT head scans. Common leukoaraiosis risk factors include aging and arterial hypertension. A quarter of symptomatic ischemic infarcts belongs to small blood vessel disease group and could be presented as lacunar infarcts. These two crucial pathophysiological mechanisms are in the root of cognitive dysfunction related to small blood vessel disease. 60 lacunar infarct patients were examined and parameters for groups with and with-out leukoaraiosis were determined. It was found that leukoaraiosis incidence was highest in the group of women older than 70. Neurological assessment was scored on NIH-NINDS scale, functional status was scored with Barthelo index, and cognitive status was determined using Mini Mental State Examination (MMSE and Alzheimer Disease Assessment Scale Late (ADAS-L. Correlation analysis of these parameters on significance level of *p<0.05, **p<0.01, suggests decrease in neurological status and cognitive performance.

  12. A Simulation-based Approach for Improving Utilization of Thrombolysis in Acute Brain Infarction

    NARCIS (Netherlands)

    Lahr, M. M. H.; van der Zee, D. J.; Luijckx, G. J.; Vroomen, Patrick; Buskens, E.

    2013-01-01

    BACKGROUND: Treatment with tissue plasminogen activator (tPA) is the most effective treatment in acute brain infarction. However, estimated worldwide treatment rates are <10%, with many barriers hampering broad implementation. Organization and resource-intense randomized controlled trials cannot

  13. Hyper-attenuating brain lesions on CT after ischemic stroke and thrombectomy are associated with final brain infarction.

    Science.gov (United States)

    Cabral, F B; Castro-Afonso, L H; Nakiri, G S; Monsignore, L M; Fábio, Src; Dos Santos, A C; Pontes-Neto, O M; Abud, D G

    2017-12-01

    Purpose Hyper-attenuating lesions, or contrast staining, on a non-contrast brain computed tomography (NCCT) scan have been investigated as a predictor for hemorrhagic transformation after endovascular treatment of acute ischemic stroke (AIS). However, the association of hyper-attenuating lesions and final ischemic areas are poorly investigated in this setting. The aim of the present study was to assess correlations between hyper-attenuating lesions and final brain infarcted areas after thrombectomy for AIS. Methods Data from patients with AIS of the anterior circulation who underwent endovascular treatment were retrospectively assessed. Images of the brain NCCT scans were analyzed in the first hours and late after treatment. The hyper-attenuating areas were compared to the final ischemic areas using the Alberta Stroke Program Early CT Score (ASPECTS). Results Seventy-one of the 123 patients (65.13%) treated were included. The association between the hyper-attenuating region in the post-thrombectomy CT scan and final brain ischemic area were sensitivity (58.3% to 96.9%), specificity (42.9% to 95.6%), positive predictive values (71.4% to 97.7%), negative predictive values (53.8% to 79.5%), and accuracy values (68% to 91%). The highest sensitivity values were found for the lentiform (96.9%) and caudate nuclei (80.4%) and for the internal capsule (87.5%), and the lowest values were found for the M1 (58.3%) and M6 (66.7%) cortices. Conclusions Hyper-attenuating lesions on head NCCT scans performed after endovascular treatment of AIS may predict final brain infarcted areas. The prediction appears to be higher in the deep brain regions compared with the cortical regions.

  14. Chromium supplementation improved post-stroke brain infarction and hyperglycemia.

    Science.gov (United States)

    Chen, Wen-Ying; Mao, Frank Chiahung; Liu, Chia-Hsin; Kuan, Yu-Hsiang; Lai, Nai-Wei; Wu, Chih-Cheng; Chen, Chun-Jung

    2016-04-01

    Hyperglycemia is common after acute stroke and is associated with a worse outcome of stroke. Thus, a better understanding of stress hyperglycemia is helpful to the prevention and therapeutic treatment of stroke. Chromium is an essential nutrient required for optimal insulin activity and normal carbohydrate and lipid metabolism. Beyond its nutritional effects, dietary supplement of chromium causes beneficial outcomes against several diseases, in particular diabetes-associated complications. In this study, we investigated whether post-stroke hyperglycemia involved chromium dynamic mobilization in a rat model of permanent focal cerebral ischemia and whether dietary supplement of chromium improved post-stroke injury and alterations. Stroke rats developed brain infarction, hyperglycemia, hyperinsulinemia, glucose intolerance, and insulin resistance. Post-stroke hyperglycemia was accompanied by elevated secretion of counter-regulatory hormones including glucagon, corticosterone, and norepinephrine, decreased insulin signaling in skeletal muscles, and increased hepatic gluconeogenesis. Correlation studies revealed that counter-regulatory hormone secretion showed a positive correlation with chromium loss and blood glucose increased together with chromium loss. Daily chromium supplementation increased tissue chromium levels, attenuated brain infarction, improved hyperglycemia, and decreased plasma levels of glucagon and corticosterone in stroke rats. Our findings suggest that stroke rats show disturbance of tissue chromium homeostasis with a net loss through urinary excretion and chromium mobilization and loss might be an alternative mechanism responsible for post-stroke hyperglycemia.

  15. MR imaging of neonatal cerebral infarction

    International Nuclear Information System (INIS)

    McArdle, C.B.; Mehta, S.D.; Kulkarni, M.V.; Keeney, S.A.; Hayden, C.K.; Adcock, E.W. III.

    1987-01-01

    Twenty-six neonatal infarcts were imaged with 0.6 T and 1.5-T magnets and correlated with US and/or CT. Periventricular leukomalacia (PVL) was seen in six cases: lobar infarction, ten cases; global infarction, six cases; and basal ganglia infarction, four cases. MR imaging was superior to US and CT in detecting hemorrhagic PVL and basal ganglia infarcts. MR demonstrates lobar infarcts better than US and CT because of a wider field of view, specificty, and improved gray and white matter differentiation. US underestimates the extent of brain destruction in global infarcts. These results indicate that MR is the single best imaging modality for detecting ischemic brain injury

  16. Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke

    International Nuclear Information System (INIS)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew; Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M.; Churilov, Leonid; Donnan, Geoffrey A.; Parsons, Mark W.

    2016-01-01

    Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1 week of onset, and at 1 and 3 months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3 months. Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3 months, with lower NAA being associated with subsequent white matter atrophy (Spearman's rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman's rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies. (orig.)

  17. Association between baseline peri-infarct magnetic resonance spectroscopy and regional white matter atrophy after stroke

    Energy Technology Data Exchange (ETDEWEB)

    Yassi, Nawaf; Campbell, Bruce C.V.; Davis, Stephen M.; Bivard, Andrew [Melbourne Brain Centre rate at The Royal Melbourne Hospital, Departments of Medicine and Neurology, Parkville, Victoria (Australia); Moffat, Bradford A.; Steward, Christopher; Desmond, Patricia M. [The University of Melbourne, Department of Radiology, The Royal Melbourne Hospital, Parkville (Australia); Churilov, Leonid; Donnan, Geoffrey A. [The University of Melbourne, Florey Institute of Neuroscience and Mental Health, Parkville (Australia); Parsons, Mark W. [University of Newcastle and Hunter Medical Research Institute, Priority Research Centre for Translational Neuroscience and Mental Health, Newcastle (Australia)

    2016-01-15

    Cerebral atrophy after stroke is associated with poor functional outcome. The prediction and prevention of post-stroke brain atrophy could therefore represent a target for neurorestorative therapies. We investigated the associations between peri-infarct metabolite concentrations measured by quantitative MRS and brain volume change in the infarct hemisphere after stroke. Twenty patients with ischemic stroke were enrolled. Patients underwent 3T-MRI within 1 week of onset, and at 1 and 3 months. At the baseline scan, an MRS voxel was placed manually in the peri-infarct area and another in the corresponding contralateral region. Volumetric analysis of T1 images was performed using two automated processing packages. Changes in gray and white matter volume were assessed as percentage change between 1 and 3 months. Mean concentrations (institutional units) of N-acetylaspartic acid (NAA) (6.1 vs 7.0, p = 0.039), total creatine (Cr+PCr) (5.4 vs 5.8, p = 0.043), and inositol (4.5 vs 5.0, p = 0.014), were significantly lower in the peri-infarct region compared with the contralateral hemisphere. There was a significant correlation between baseline peri-infarct NAA and white matter volume change in the infarct hemisphere between 1 and 3 months, with lower NAA being associated with subsequent white matter atrophy (Spearman's rho = 0.66, p = 0.010). The baseline concentration of Cr+PCr was also significantly correlated with white matter atrophy in the infarct hemisphere (Spearman's rho = 0.59, p = 0.027). Both of these associations were significant after adjustment for the false discovery rate and were validated using the secondary volumetric method. MRS may be useful in the prediction of white matter atrophy post-stroke and in the testing of novel neurorestorative therapies. (orig.)

  18. Brain volume measurement using three-dimensional magnetic resonance images

    International Nuclear Information System (INIS)

    Ishimaru, Yoshihiro

    1996-01-01

    This study was designed to validate accurate measurement method of human brain volume using three dimensional (3D) MRI data on a workstation, and to establish optimal correcting method of human brain volume on diagnosis of brain atrophy. 3D MRI data were acquired by fast SPGR sequence using 1.5 T MR imager. 3D MRI data were segmented by region growing method and 3D image was displayed by surface rendering method on the workstation. Brain volume was measured by the volume measurement function of the workstation. In order to validate the accurate measurement method, phantoms and a specimen of human brain were examined. Phantom volume was measured by changing the lower level of threshold value. At the appropriate threshold value, percentage of error of phantoms and the specimen were within 0.6% and 0.08%, respectively. To establish the optimal correcting method, 130 normal volunteers were examined. Brain volumes corrected with height weight, body surface area, and alternative skull volume were evaluated. Brain volume index, which is defined as dividing brain volume by alternative skull volume, had the best correlation with age (r=0.624, p<0.05). No gender differences was observed in brain volume index in contrast to in brain volume. The clinical usefulness of this correcting method for brain atrophy diagnosis was evaluated in 85 patients. Diagnosis by 2D spin echo MR images was compared with brain volume index. Diagnosis of brain atrophy by 2D MR image was concordant with the evaluation by brain volume index. These results indicated that this measurement method had high accuracy, and it was important to set the appropriate threshold value. Brain volume index was the appropriate indication for evaluation of human brain volume, and was considered to be useful for the diagnosis of brain atrophy. (author)

  19. Headache, migraine, and structural brain lesions and function: population based Epidemiology of Vascular Ageing-MRI study

    International Nuclear Information System (INIS)

    Kurth, T.; Mohamed, S.; Zhu, Y.C.; Dufouil, C.; Tzourio, Ch.; Kurth, T.; Zhu, Y.C.; Dufouil, C.; Tzourio, Ch.; Kurth, T.; Maillard, P.; Mazoyer, B.; Zhu, Y.C.; Chabriat, H.; Bousser, M.G.; Tzourio, Ch.; Zhu, Y.C.; Chabriat, H.; Bousser, M.G.; Mazoyer, B.

    2011-01-01

    Objective: To evaluate the association of overall and specific headaches with volume of white matter hyper-intensities, brain infarcts, and cognition. Design: Population based, cross sectional study. Setting: Epidemiology of Vascular Ageing study, Nantes, France. Participants: 780 participants (mean age 69, 58.5% women) with detailed headache assessment. Main outcome measures: Brain scans were evaluated for volume of white matter hyper-intensities (by fully automated imaging processing) and for classification of infarcts (by visual reading with a standardised assessment grid). Cognitive function was assessed by a battery of tests including the mini-mental state examination. Results: 163 (20.9%) participants reported a history of severe headache and 116 had migraine, of whom 17 (14.7%) reported aura symptoms. An association was found between any history of severe headache and increasing volume of white matter hyper-intensities. The adjusted odds ratio of being in the highest third for total volume of white matter hyper-intensities was 2.0 (95% confidence interval 1.3 to 3.1, P for trend 0.002) for participants with any history of severe headache when compared with participants without severe headache being in the lowest third. The association pattern was similar for all headache types. Migraine with aura was the only headache type strongly associated with volume of deep white matter hyper-intensities (highest third odds ratio 12.4, 1.6 to 99.4, P for trend 0.005) and with brain infarcts (3.4, 1.2 to 9.3). The location of infarcts was predominantly outside the cerebellum and brain stem. Evidence was lacking for cognitive impairment for any headache type with or without brain lesions. Conclusions: In this population based study, any history of severe headache was associated with an increased volume of white matter hyper-intensities. Migraine with aura was the only headache type associated with brain infarcts. Evidence that headache of any type by itself or in

  20. Structural MRI markers of brain aging early after ischemic stroke.

    Science.gov (United States)

    Werden, Emilio; Cumming, Toby; Li, Qi; Bird, Laura; Veldsman, Michele; Pardoe, Heath R; Jackson, Graeme; Donnan, Geoffrey A; Brodtmann, Amy

    2017-07-11

    To examine associations between ischemic stroke, vascular risk factors, and MRI markers of brain aging. Eighty-one patients (mean age 67.5 ± 13.1 years, 31 left-sided, 61 men) with confirmed first-ever (n = 66) or recurrent (n = 15) ischemic stroke underwent 3T MRI scanning within 6 weeks of symptom onset (mean 26 ± 9 days). Age-matched controls (n = 40) completed identical testing. Multivariate regression analyses examined associations between group membership and MRI markers of brain aging (cortical thickness, total brain volume, white matter hyperintensity [WMH] volume, hippocampal volume), normalized against intracranial volume, and the effects of vascular risk factors on these relationships. First-ever stroke was associated with smaller hippocampal volume ( p = 0.025) and greater WMH volume ( p = 0.004) relative to controls. Recurrent stroke was in turn associated with smaller hippocampal volume relative to both first-ever stroke ( p = 0.017) and controls ( p = 0.001). These associations remained significant after adjustment for age, sex, education, and, in stroke patients, infarct volume. Total brain volume was not significantly smaller in first-ever stroke patients than in controls ( p = 0.056), but the association became significant after further adjustment for atrial fibrillation ( p = 0.036). Cortical thickness and brain volumes did not differ as a function of stroke type, infarct volume, or etiology. Brain structure is likely to be compromised before ischemic stroke by vascular risk factors. Smaller hippocampal and total brain volumes and increased WMH load represent proxies for underlying vascular brain injury. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  1. The influence of meteorological and geomagnetic factors on acute myocardial infarction and brain stroke in Moscow, Russia.

    Science.gov (United States)

    Shaposhnikov, Dmitry; Revich, Boris; Gurfinkel, Yuri; Naumova, Elena

    2014-07-01

    Evidence of the impact of air temperature and pressure on cardiovascular morbidity is still quite limited and controversial, and even less is known about the potential influence of geomagnetic activity. The objective of this study was to assess impacts of air temperature, barometric pressure and geomagnetic activity on hospitalizations with myocardial infarctions and brain strokes. We studied 2,833 myocardial infarctions and 1,096 brain strokes registered in two Moscow hospitals between 1992 and 2005. Daily event rates were linked with meteorological and geomagnetic conditions, using generalized linear model with controls for day of the week, seasonal and long-term trends. The number of myocardial infarctions decreased with temperature, displayed a U-shaped relationship with pressure and variations in pressure, and increased with geomagnetic activity. The number of strokes increased with temperature, daily temperature range and geomagnetic activity. Detrimental effects on strokes of low pressure and falling pressure were observed. Relative risks of infarctions and strokes during geomagnetic storms were 1.29 (95% CI 1.19-1.40) and 1.25 (1.10-1.42), respectively. The number of strokes doubled during cold spells. The influence of barometric pressure on hospitalizations was relatively greater than the influence of geomagnetic activity, and the influence of temperature was greater than the influence of pressure. Brain strokes were more sensitive to inclement weather than myocardial infarctions. This paper provides quantitative estimates of the expected increases in hospital admissions on the worst days and can help to develop preventive health plans for cardiovascular diseases.

  2. Brain atrophy during aging

    International Nuclear Information System (INIS)

    Matsuzawa, Taiju; Yamada, Kenji; Yamada, Susumu; Ono, Shuichi; Takeda, Shunpei; Hatazawa, Jun; Ito, Masatoshi; Kubota, Kazuo

    1985-01-01

    Age-related brain atrophy was investigated in thousands of persons with no neurologic disturbances using X-CT and NMR-CT. Brain atrophy was minimal in 34-35 years old in both sexes, increased exponentially to the increasing age after 34-35 years, and probably resulted in dementia, such as vascular or multi-infarct dementia. Brain atrophy was significantly greater in men than in women at all ages. Brain volumes were maximal in 34-35 years old in both sexes with minimal individual differences which increased proportionally to the increasing age. Remarkable individual differences in the extent of brain atrophy (20 - 30 %) existed among aged subjects. Progression of brain atrophy was closely related to loss of mental activities independently of their ages. Our longitudinal study has revealed that the most important factors promoting brain atrophy during aging was the decrease in the cerebral blood flow. We have classified brain atrophy into sulcal and cisternal enlargement type (type I), ventricular enlargement type (type II) and mixed type (type III) according to the clinical study using NMR-CT. Brain atrophy of type I progresses significantly in almost all of the geriatric disorders. This type of brain atrophy progresses significantly in heavy smokers and drinkers. Therefore this type of brain atrophy might be caused by the decline in the blood flow in anterior and middle cerebral arteries. Brain atrophy of type II was caused by the disturbance of cerebrospinal fluid circulation after cerebral bleeding and subarachnoid bleeding. Brain atrophy of type III was seen in vascular dementia or multi-infarct dementia which was caused by loss of brain matter after multiple infarction, and was seen also in dementia of Alzheimer type in which degeneration of nerve cells results in brain atrophy. NMR-CT can easily detect small infarction (lacunae) and edematous lesions resulting from ischemia and hypertensive encephalopathy. (J.P.N.)

  3. The Selvester QRS Score is more accurate than Q waves and fragmented QRS complexes using the Mason-Likar configuration in estimating infarct volume in patients with ischemic cardiomyopathy.

    Science.gov (United States)

    Carey, Mary G; Luisi, Andrew J; Baldwa, Sunil; Al-Zaiti, Salah; Veneziano, Marc J; deKemp, Robert A; Canty, John M; Fallavollita, James A

    2010-01-01

    Infarct volume independently predicts cardiovascular events. Fragmented QRS complexes (fQRS) may complement Q waves for identifying infarction; however, their utility in advanced coronary disease is unknown. We tested whether fQRS could improve the electrocardiographic prediction of infarct volume by positron emission tomography in 138 patients with ischemic cardiomyopathy (ejection fraction, 0.27 +/- 0.09). Indices of infarction (pathologic Q waves, fQRS, and Selvester QRS Score) were analyzed by blinded observers. In patients with QRS duration less than 120 milliseconds, number of leads with pathologic Q waves (mean, 1.6 +/- 1.7) correlated weakly with infarct volume (r = 0.30, P wave prediction of infarct volume; but Selvester Score was more accurate. Published by Elsevier Inc.

  4. Reperfusion is a more accurate predictor of follow-up infarct volume than recanalization: a proof of concept using CT in acute ischemic stroke patients.

    Science.gov (United States)

    Soares, Bruno P; Tong, Elizabeth; Hom, Jason; Cheng, Su-Chun; Bredno, Joerg; Boussel, Loic; Smith, Wade S; Wintermark, Max

    2010-01-01

    The purpose of this study was to compare recanalization and reperfusion in terms of their predictive value for imaging outcomes (follow-up infarct volume, infarct growth, salvaged penumbra) and clinical outcome in acute ischemic stroke patients. Twenty-two patients admitted within 6 hours of stroke onset were retrospectively included in this study. These patients underwent a first stroke CT protocol including CT-angiography (CTA) and perfusion-CT (PCT) on admission, and similar imaging after treatment, typically around 24 hours, to assess recanalization and reperfusion. Recanalization was assessed by comparing arterial patency on admission and posttreatment CTAs; reperfusion, by comparing the volumes of CBV, CBF, and MTT abnormality on admission and posttreatment PCTs. Collateral flow was graded on the admission CTA. Follow-up infarct volume was measured on the discharge noncontrast CT. The groups of patients with reperfusion, no reperfusion, recanalization, and no recanalization were compared in terms of imaging and clinical outcomes. Reperfusion (using an MTT reperfusion index >75%) was a more accurate predictor of follow-up infarct volume than recanalization. Collateral flow and recanalization were not accurate predictors of follow-up infarct volume. An interaction term was found between reperfusion and the volume of the admission penumbra >50 mL. Our study provides evidence that reperfusion is a more accurate predictor of follow-up infarct volume in acute ischemic stroke patients than recanalization. We recommend an MTT reperfusion index >75% to assess therapy efficacy in future acute ischemic stroke trials that use perfusion-CT.

  5. Early changes in left atrial volume after acute myocardial infarction

    DEFF Research Database (Denmark)

    Bakkestrom, R.; Andersen, Mads J; Ersboll, M.

    2016-01-01

    . The objective was to assess changes in LA volume early after MI in patients with diastolic dysfunction and the relation to invasive hemodynamics and natriuretic peptides. Methods: 62 patients with left ventricle ejection fraction (LVEF) >= 45%, diastolic E/e' > 8 and LA volume index >34 ml/m(2) within 48 h......Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise...... of MI were enrolled. After 1 and 4 months blood sampling, echocardiography and right heart catheterization were performed during exercise test. Results: LA remodeling was considered in patients with a change from mild (35-41 ml/m(2)), to severe (>48ml/m(2)) dilatation after 4 months (Found in 22...

  6. Distribution of brain infarction in children with tuberculous meningitis and correlation with outcome score at 6 months

    International Nuclear Information System (INIS)

    Andronikou, Savvas; Wilmshurst, Jo; Hatherill, Mark; VanToorn, Ronald

    2006-01-01

    Prognostic indicators for tuberculous meningitis (TBM) offer realistic expectations for parents of affected children. Infarctions affecting the basal ganglia are associated with a poor outcome. To correlate the distribution of infarction in children with TBM on CT with an outcome score (OS). CT brain scans in children with TBM were retrospectively reviewed and the distribution of infarctions recorded. The degree of correlation with OS at 6 months was determined. There was a statistically significant association between all sites of infarction (P = 0.0001-0.001), other than hemispheric (P = 0.35), and outcome score. There was also a statistically significant association between all types of infarction (P = 0.0001-0.02), other than hemispheric (P = 0.05), and overall poor outcome. The odds ratio for poor outcome with bilateral basal ganglia and internal capsule infarction was 12. The odds ratio for poor outcome with 'any infarction' was 4.91 (CI 2.24-10.74), with 'bilateral infarctions' 8.50 (CI 2.49-28.59), with basal ganglia infarction 5.73 (CI 2.60-12.64), and for hemispheric infarction 2.30 (CI 1.00-5.28). Infarction is associated with a poor outcome unless purely hemispheric. MRI diffusion-weighted imaging was not part of this study, but is likely to play a central role in detecting infarctions not demonstrated by CT. (orig.)

  7. Distribution of brain infarction in children with tuberculous meningitis and correlation with outcome score at 6 months

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas [University of Stellenbosch, Department of Radiology, Tygerberg Hospital, P.O. Box 19063, Tygerberg (South Africa); Wilmshurst, Jo; Hatherill, Mark [University of Cape Town, Pediatric Neurology, Red Cross Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); VanToorn, Ronald [University of Stellenbosch, Department of Pediatric Neurology, Tygerberg Hospital, Cape Town (South Africa)

    2006-12-15

    Prognostic indicators for tuberculous meningitis (TBM) offer realistic expectations for parents of affected children. Infarctions affecting the basal ganglia are associated with a poor outcome. To correlate the distribution of infarction in children with TBM on CT with an outcome score (OS). CT brain scans in children with TBM were retrospectively reviewed and the distribution of infarctions recorded. The degree of correlation with OS at 6 months was determined. There was a statistically significant association between all sites of infarction (P = 0.0001-0.001), other than hemispheric (P = 0.35), and outcome score. There was also a statistically significant association between all types of infarction (P = 0.0001-0.02), other than hemispheric (P = 0.05), and overall poor outcome. The odds ratio for poor outcome with bilateral basal ganglia and internal capsule infarction was 12. The odds ratio for poor outcome with 'any infarction' was 4.91 (CI 2.24-10.74), with 'bilateral infarctions' 8.50 (CI 2.49-28.59), with basal ganglia infarction 5.73 (CI 2.60-12.64), and for hemispheric infarction 2.30 (CI 1.00-5.28). Infarction is associated with a poor outcome unless purely hemispheric. MRI diffusion-weighted imaging was not part of this study, but is likely to play a central role in detecting infarctions not demonstrated by CT. (orig.)

  8. Three-dimensional anisotropy contrast MRI and functional MRI of the human brain. Clinical application to assess pyramidal tract in patients with brain tumor and infarction

    International Nuclear Information System (INIS)

    Morikawa, Minoru; Kaminogo, Makio; Ishimaru, Hideki; Nakashima, Kazuaki; Kitagawa, Naoki; Ochi, Makoto; Hayashi, Kuniaki; Shibata, Shobu; Kabasawa, Hiroyuki

    2001-01-01

    We describe and evaluate the findings of three-dimensional anisotropy contrast MR axonography (3DAC MRX) and functional MRI (fMRI) in brain tumor and infarction. We obtained diffusion-weighted images (DWI) in 28 patients including 23 brain tumors and 15 acute infarctions located in or near pyramidal tract. Three anisotropic DWIs were transformed into graduations color-coded as red, green and blue, and then composed to form a combined color 3DAC MRX. We also performed functional MRI in 7 of the 28 patients and compared with cortical mapping of 3DAC MRX. 3DAC MRX with 23 brain tumors showed that the ipsilateral pyramidal tract was either discontinuous due to impaired anisotropy (n=8) or compressed due to mass effect (n=15). In 10 patients of acute infarction with motor impairment, pyramidal tract involvement was visually more conspicuous on 3DAC MRX compared to standard DWI. On functional MRI, hand motor activation was observed between blue vertical directional colors of pre- and post central gyrus. In conclusion, 3DAC MRX is a new noninvasive approach for visualization of the white matter neuronal tract and provides the information concerning pyramidal tract involvement. (author)

  9. Pharmacoepidemiological analysis of the drugs used for secondary prevention of brain infarction on dispensary stage

    Directory of Open Access Journals (Sweden)

    Miheyeva N.V.

    2014-03-01

    Full Text Available Aim. The secondary prevention of cerebral infarction on dispensary stage to current clinical guidelines was analyzed. Adherence of patients to prescribe medications was evaluated. Material and methods. 106 patients of hospital neurologic department with brain infarction were included in prospective pharmacoepidemiological study of the drugs used for secondary prevention of brain infarction on dispensary stage since 1 January 2009 to 31 December 2009. Duration of outpatient observation was 3 years. Results. All of the patients were of 64,9 ± 10,3 years old. Hypertension was diagnosed in 102 of them (96.2%, atrial fibrillation — in 33 (31.1% patients. 39 (36.8% patients died during 3 years after discharge from the hospital. ACE inhibitors/angiotensin II receptor antagonist were prescribed for 83 (78.3% patients, antiplatelet- 76 (71,7%, statins — 16 (15,1% patients in discharge from hospital. Warfarin was prescribed only for 1 (3.05% patient with atrial fibrillation and ischemic stroke.consumption of drugs with evidence efficiency were diminished already after one year of observation in outpatient clinics. Conclusion.Therapy for secondary stroke prevention is not fully comply with current clinical guidelines

  10. Recombinant Tissue Plasminogen Activator Induces Neurological Side Effects Independent on Thrombolysis in Mechanical Animal Models of Focal Cerebral Infarction: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Mei-Xue Dong

    Full Text Available Recombinant tissue plasminogen activator (rtPA is the only effective drug approved by US FDA to treat ischemic stroke, and it contains pleiotropic effects besides thrombolysis. We performed a meta-analysis to clarify effect of tissue plasminogen activator (tPA on cerebral infarction besides its thrombolysis property in mechanical animal stroke.Relevant studies were identified by two reviewers after searching online databases, including Pubmed, Embase, and ScienceDirect, from 1979 to 2016. We identified 6, 65, 17, 12, 16, 12 and 13 comparisons reporting effect of endogenous tPA on infarction volume and effects of rtPA on infarction volume, blood-brain barrier, brain edema, intracerebral hemorrhage, neurological function and mortality rate in all 47 included studies. Standardized mean differences for continuous measures and risk ratio for dichotomous measures were calculated to assess the effects of endogenous tPA and rtPA on cerebral infarction in animals. The quality of included studies was assessed using the Stroke Therapy Academic Industry Roundtable score. Subgroup analysis, meta-regression and sensitivity analysis were performed to explore sources of heterogeneity. Funnel plot, Trim and Fill method and Egger's test were obtained to detect publication bias.We found that both endogenous tPA and rtPA had not enlarged infarction volume, or deteriorated neurological function. However, rtPA would disrupt blood-brain barrier, aggravate brain edema, induce intracerebral hemorrhage and increase mortality rate.This meta-analysis reveals rtPA can lead to neurological side effects besides thrombolysis in mechanical animal stroke, which may account for clinical exacerbation for stroke patients that do not achieve vascular recanalization with rtPA.

  11. Spatial patterns of progressive brain volume loss after moderate-severe traumatic brain injury

    Science.gov (United States)

    Jolly, Amy; de Simoni, Sara; Bourke, Niall; Patel, Maneesh C; Scott, Gregory; Sharp, David J

    2018-01-01

    Abstract Traumatic brain injury leads to significant loss of brain volume, which continues into the chronic stage. This can be sensitively measured using volumetric analysis of MRI. Here we: (i) investigated longitudinal patterns of brain atrophy; (ii) tested whether atrophy is greatest in sulcal cortical regions; and (iii) showed how atrophy could be used to power intervention trials aimed at slowing neurodegeneration. In 61 patients with moderate-severe traumatic brain injury (mean age = 41.55 years ± 12.77) and 32 healthy controls (mean age = 34.22 years ± 10.29), cross-sectional and longitudinal (1-year follow-up) brain structure was assessed using voxel-based morphometry on T1-weighted scans. Longitudinal brain volume changes were characterized using a novel neuroimaging analysis pipeline that generates a Jacobian determinant metric, reflecting spatial warping between baseline and follow-up scans. Jacobian determinant values were summarized regionally and compared with clinical and neuropsychological measures. Patients with traumatic brain injury showed lower grey and white matter volume in multiple brain regions compared to controls at baseline. Atrophy over 1 year was pronounced following traumatic brain injury. Patients with traumatic brain injury lost a mean (± standard deviation) of 1.55% ± 2.19 of grey matter volume per year, 1.49% ± 2.20 of white matter volume or 1.51% ± 1.60 of whole brain volume. Healthy controls lost 0.55% ± 1.13 of grey matter volume and gained 0.26% ± 1.11 of white matter volume; equating to a 0.22% ± 0.83 reduction in whole brain volume. Atrophy was greatest in white matter, where the majority (84%) of regions were affected. This effect was independent of and substantially greater than that of ageing. Increased atrophy was also seen in cortical sulci compared to gyri. There was no relationship between atrophy and time since injury or age at baseline. Atrophy rates were related to memory performance at the end of the

  12. Spatial patterns of progressive brain volume loss after moderate-severe traumatic brain injury.

    Science.gov (United States)

    Cole, James H; Jolly, Amy; de Simoni, Sara; Bourke, Niall; Patel, Maneesh C; Scott, Gregory; Sharp, David J

    2018-01-04

    Traumatic brain injury leads to significant loss of brain volume, which continues into the chronic stage. This can be sensitively measured using volumetric analysis of MRI. Here we: (i) investigated longitudinal patterns of brain atrophy; (ii) tested whether atrophy is greatest in sulcal cortical regions; and (iii) showed how atrophy could be used to power intervention trials aimed at slowing neurodegeneration. In 61 patients with moderate-severe traumatic brain injury (mean age = 41.55 years ± 12.77) and 32 healthy controls (mean age = 34.22 years ± 10.29), cross-sectional and longitudinal (1-year follow-up) brain structure was assessed using voxel-based morphometry on T1-weighted scans. Longitudinal brain volume changes were characterized using a novel neuroimaging analysis pipeline that generates a Jacobian determinant metric, reflecting spatial warping between baseline and follow-up scans. Jacobian determinant values were summarized regionally and compared with clinical and neuropsychological measures. Patients with traumatic brain injury showed lower grey and white matter volume in multiple brain regions compared to controls at baseline. Atrophy over 1 year was pronounced following traumatic brain injury. Patients with traumatic brain injury lost a mean (± standard deviation) of 1.55% ± 2.19 of grey matter volume per year, 1.49% ± 2.20 of white matter volume or 1.51% ± 1.60 of whole brain volume. Healthy controls lost 0.55% ± 1.13 of grey matter volume and gained 0.26% ± 1.11 of white matter volume; equating to a 0.22% ± 0.83 reduction in whole brain volume. Atrophy was greatest in white matter, where the majority (84%) of regions were affected. This effect was independent of and substantially greater than that of ageing. Increased atrophy was also seen in cortical sulci compared to gyri. There was no relationship between atrophy and time since injury or age at baseline. Atrophy rates were related to memory performance at the end of the follow

  13. Prediction of infarction and reperfusion in stroke by flow- and volume-weighted collateral signal in MR angiography.

    Science.gov (United States)

    Ernst, M; Forkert, N D; Brehmer, L; Thomalla, G; Siemonsen, S; Fiehler, J; Kemmling, A

    2015-02-01

    In proximal anterior circulation occlusive strokes, collateral flow is essential for good outcome. Collateralized vessel intensity in TOF- and contrast-enhanced MRA is variable due to different acquisition methods. Our purpose was to quantify collateral supply by using flow-weighted signal in TOF-MRA and blood volume-weighted signal in contrast-enhanced MRA to determine each predictive contribution to tissue infarction and reperfusion. Consecutively (2009-2013), 44 stroke patients with acute proximal anterior circulation occlusion met the inclusion criteria with TOF- and contrast-enhanced MRA and penumbral imaging. Collateralized vessels in the ischemic hemisphere were assessed by TOF- and contrast-enhanced MRA using 2 methods: 1) visual 3-point collateral scoring, and 2) collateral signal quantification by an arterial atlas-based collateral index. Collateral measures were tested by receiver operating characteristic curve and logistic regression against 2 imaging end points of tissue-outcome: final infarct volume and percentage of penumbra saved. Visual collateral scores on contrast-enhanced MRA but not TOF were significantly higher in patients with good outcome. Visual collateral scoring on contrast-enhanced MRA was the best rater-based discriminator for final infarct volume 50% (area under the curve, 0.67; P = .04). Atlas-based collateral index of contrast-enhanced MRA was the overall best independent discriminator for final infarct volume of collateral index combining the signal of TOF- and contrast-enhanced MRA was the overall best discriminator for effective reperfusion (percentage of penumbra saved >50%; area under the curve, 0.89; P collateral assessment, TOF- and contrast-enhanced MRA both contain predictive signal information for penumbral reperfusion. This could improve risk stratification in further studies. © 2015 by American Journal of Neuroradiology.

  14. Language and Brain Volumes in Children with Epilepsy

    Science.gov (United States)

    Caplan, Rochelle; Levitt, Jennifer; Siddarth, Prabha; Wu, Keng Nei; Gurbani, Suresh; Shields, W. Donald; Sankar, Raman

    2010-01-01

    This study compared the relationship of language skill with fronto-temporal volumes in 69 medically treated epilepsy subjects and 34 healthy children, aged 6.1-16.6 years. It also determined if the patients with linguistic deficits had abnormal volumes and atypical associations between volumes and language skills in these brain regions. The children underwent language testing and magnetic resonance imaging scans at 1.5 Tesla. Brain tissue was segmented and fronto-temporal volumes were computed. Higher mean language scores were significantly associated with larger inferior frontal gyrus, temporal lobe, and posterior superior temporal gyrus gray matter volumes in the epilepsy group and in the children with epilepsy with average language scores. Increased total brain and dorsolateral prefrontal gray and white matter volumes, however, were associated with higher language scores in the healthy controls. Within the epilepsy group, linguistic deficits were related to smaller anterior superior temporal gyrus gray matter volumes and a negative association between language scores and dorsolateral prefrontal gray matter volumes. These findings demonstrate abnormal development of language related brain regions, and imply differential reorganization of brain regions subserving language in children with epilepsy with normal linguistic skills and in those with impaired language. PMID:20149755

  15. The relationship between brain volumes and intelligence in bipolar disorder.

    Science.gov (United States)

    Vreeker, Annabel; Abramovic, Lucija; Boks, Marco P M; Verkooijen, Sanne; van Bergen, Annet H; Ophoff, Roel A; Kahn, René S; van Haren, Neeltje E M

    2017-12-01

    Bipolar disorder type-I (BD-I) patients show a lower Intelligence Quotient (IQ) and smaller brain volumes as compared with healthy controls. Considering that in healthy individuals lower IQ is related to smaller total brain volume, it is of interest to investigate whether IQ deficits in BD-I patients are related to smaller brain volumes and to what extent smaller brain volumes can explain differences between premorbid IQ estimates and IQ after a diagnosis of BD-I. Magnetic resonance imaging brain scans, IQ and premorbid IQ scores were obtained from 195 BDI patients and 160 controls. We studied the relationship of (global, cortical and subcortical) brain volumes with IQ and IQ change. Additionally, we investigated the relationship between childhood trauma, lithium- and antipsychotic use and IQ. Total brain volume and IQ were positively correlated in the entire sample. This correlation did not differ between patients and controls. Although brain volumes mediated the relationship between BD-I and IQ in part, the direct relationship between the diagnosis and IQ remained significant. Childhood trauma and use of lithium and antipsychotic medication did not affect the relationship between brain volumes and IQ. However, current lithium use was related to lower IQ in patients. Our data suggest a similar relationship between brain volume and IQ in BD-I patients and controls. Smaller brain volumes only partially explain IQ deficits in patients. Therefore, our findings indicate that in addition to brain volumes and lithium use other disease factors play a role in IQ deficits in BD-I patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Brain volume reductions in adolescent heavy drinkers.

    Science.gov (United States)

    Squeglia, Lindsay M; Rinker, Daniel A; Bartsch, Hauke; Castro, Norma; Chung, Yoonho; Dale, Anders M; Jernigan, Terry L; Tapert, Susan F

    2014-07-01

    Brain abnormalities in adolescent heavy drinkers may result from alcohol exposure, or stem from pre-existing neural features. This longitudinal morphometric study investigated 40 healthy adolescents, ages 12-17 at study entry, half of whom (n=20) initiated heavy drinking over the 3-year follow-up. Both assessments included high-resolution magnetic resonance imaging. FreeSurfer was used to segment brain volumes, which were measured longitudinally using the newly developed quantitative anatomic regional change analysis (QUARC) tool. At baseline, participants who later transitioned into heavy drinking showed smaller left cingulate, pars triangularis, and rostral anterior cingulate volume, and less right cerebellar white matter volumes (pteens. Over time, participants who initiated heavy drinking showed significantly greater volume reduction in the left ventral diencephalon, left inferior and middle temporal gyrus, and left caudate and brain stem, compared to substance-naïve youth (pbrain regions in future drinkers and greater brain volume reduction in subcortical and temporal regions after alcohol use was initiated. This is consistent with literature showing pre-existing cognitive deficits on tasks recruited by frontal regions, as well as post-drinking consequences on brain regions involved in language and spatial tasks. Published by Elsevier Ltd.

  17. Detection of lacunar infarction in brain CT-scans: No evidence of bias from accompanying patient information

    International Nuclear Information System (INIS)

    Bonke, B.; Knippenberg, F.C.E. van; Duivenvoorden, H.J.; Kappelle, L.J.

    1989-01-01

    Interobserver agreement in assessing brain CT-scans is, in general, high. The extent, however, to which such agreement is caused by bias through knowledge of other clinical details remains uncertain. The hypothesis that observers are somehow prejudiced before assessing ambiguous, CT-scans in this particular situation was tested. Sixteen neurologists and 16 radiologists volunteered to interpret two ambiguous brain CT-scans, with regard to the presence or absence of a lacunar infarct in the region of the internal capsule. The scans were accompanied by 'patient' information that was or was not suggestive of a stroke. These scans were camouflaged by a variety of other scans, to be assessed in the same way, to mask the purpose of the study. I was assumed that the observers, in their assessments of the scans, would somehow let their ratings of the likelihood of a lacunar infarction in or near the internal capsule be subject to the accompanying information. Results showed lower ratings produced by neurologists (i.e., less likelihood of an infarction) than by radiologists in the majority of all assessments, but no bias by the accompanying information. (orig.)

  18. Evaluation of the effects of rehabilitation exercise on cerebral infarction with 99Tcm-ECD SPECT brain imaging

    International Nuclear Information System (INIS)

    Jiang Ningyi; Lu Xianping; Liu Xingguang; Xiao Xiuhong; Xu Jianxing

    2003-01-01

    Objective: To investigate the therapeutic effects of motor therapy on hemiplegia with SPECT brain perfusion imaging. Methods: The study population consisted of 59 patients with cerebral infarction, and all patients were treated with motor therapy. Among them, 30 cases were assigned to undertake single bridging exercise and 29 cases passive exercise. SPECT brain perfusion imaging was performed before and after motor therapy under the same condition, and the regional cerebral blood flow (rCBF) changes were compared and analysed with visual and semi-quantitative methods; in addition, the relationship between rCBF changes and scores of Fugl-Meyer or Barthel index were also analysed. Results: After motor therapy, various degrees of radioactivity increase were compared with the pretreatment radioactivity hypoperfusion in patients with cerebral infarction, and showed that motor therapy could evidently improve rCBF of regional hypoperfusion. The posttreatment rCBF was higher than the pretreatment level (P<0.01), and the rCBF of group of single bridging was higher than that of passive exercise group. And the changes of rCBF were all significant after motor therapy. In addition, the variation of the rCBF after motor therapy was positively correlated with the variation of Fugl-Meyer and Barthel score. Conclusions: SPECT brain perfusion imaging can serve as a useful method for evaluating the effectiveness of motor therapy in cerebral infarction rehabilitation. The single bridging exercise and the passive exercise are both beneficial to brain rehabilitation, but the former improves the rCBF in lesions better than the later does

  19. A study on cognitive impairment and gray matter volume abnormalities in silent cerebral infarction patients

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Wei; Wei, Xiaofeng; Li, Mengxiong [The First Affiliated Hospital of Yangtze University, Biomedical Engineering Laboratory, Jingzhou, Hubei (China); Jiang, Xun [Renmin Hospital of Wuhan University, Biomedical Engineering Laboratory, Wuhan, Hubei (China); Li, Shanshan [JingZhou City Central Blood Bank, Jingzhou, Hubei (China)

    2015-08-15

    The relationship between silent cerebral infarction (SCI) and the integrity of cognitive function is unknown. We intended to investigate whether cognitive impairment is associated with gray matter volume (GMV) in the SCI patients. Sixty-two patients with SCI and 62 age- and gender-matched healthy controls (HC) were evaluated with P300 test, Montreal Cognitive Assessment (MoCA) test, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HDRS). Whole brain high-resolution T1-weighted images were processed with SPM12b software and analyzed by voxel-based morphometry (VBM). Correlation analysis was performed between the GMV and the scores of MoCA Scale, P300 latency, P300 amplitude, HAMA, HDRS, age, and educational level. The brains of the SCI patients have a significant reduction in GMV in the left superior and inferior frontal gyrus, left superior temporal gyrus, right middle temporal gyrus, and bilateral hippocampus gyrus (p < 0.01, FDR correction). No significant increase of GMV was detected. The GMV of their frontal and temporal lobes is positively correlated with the score of MoCA scale and P300 amplitude (r ≥ 0.62, p < 0.01). The GMV of frontal, temporal, and hippocampus is negatively correlated with P300 latency (r ≤ -0.71, p < 0.05). No significant correlation between the GMV of abnormal brain regions and another two clinical characteristics was found. SCI patients have impaired cognitive function and reduced GMV compared to the HC subjects. The neuropathological basis of such cognitive deficits in SCI patients might be a reduced GMV. (orig.)

  20. A study on cognitive impairment and gray matter volume abnormalities in silent cerebral infarction patients

    International Nuclear Information System (INIS)

    Luo, Wei; Wei, Xiaofeng; Li, Mengxiong; Jiang, Xun; Li, Shanshan

    2015-01-01

    The relationship between silent cerebral infarction (SCI) and the integrity of cognitive function is unknown. We intended to investigate whether cognitive impairment is associated with gray matter volume (GMV) in the SCI patients. Sixty-two patients with SCI and 62 age- and gender-matched healthy controls (HC) were evaluated with P300 test, Montreal Cognitive Assessment (MoCA) test, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HDRS). Whole brain high-resolution T1-weighted images were processed with SPM12b software and analyzed by voxel-based morphometry (VBM). Correlation analysis was performed between the GMV and the scores of MoCA Scale, P300 latency, P300 amplitude, HAMA, HDRS, age, and educational level. The brains of the SCI patients have a significant reduction in GMV in the left superior and inferior frontal gyrus, left superior temporal gyrus, right middle temporal gyrus, and bilateral hippocampus gyrus (p < 0.01, FDR correction). No significant increase of GMV was detected. The GMV of their frontal and temporal lobes is positively correlated with the score of MoCA scale and P300 amplitude (r ≥ 0.62, p < 0.01). The GMV of frontal, temporal, and hippocampus is negatively correlated with P300 latency (r ≤ -0.71, p < 0.05). No significant correlation between the GMV of abnormal brain regions and another two clinical characteristics was found. SCI patients have impaired cognitive function and reduced GMV compared to the HC subjects. The neuropathological basis of such cognitive deficits in SCI patients might be a reduced GMV. (orig.)

  1. Brain Volume Estimation Enhancement by Morphological Image Processing Tools

    Directory of Open Access Journals (Sweden)

    Zeinali R.

    2017-12-01

    Full Text Available Background: Volume estimation of brain is important for many neurological applications. It is necessary in measuring brain growth and changes in brain in normal/ abnormal patients. Thus, accurate brain volume measurement is very important. Magnetic resonance imaging (MRI is the method of choice for volume quantification due to excellent levels of image resolution and between-tissue contrast. Stereology method is a good method for estimating volume but it requires to segment enough MRI slices and have a good resolution. In this study, it is desired to enhance stereology method for volume estimation of brain using less MRI slices with less resolution. Methods: In this study, a program for calculating volume using stereology method has been introduced. After morphologic method, dilation was applied and the stereology method enhanced. For the evaluation of this method, we used T1-wighted MR images from digital phantom in BrainWeb which had ground truth. Results: The volume of 20 normal brain extracted from BrainWeb, was calculated. The volumes of white matter, gray matter and cerebrospinal fluid with given dimension were estimated correctly. Volume calculation from Stereology method in different cases was made. In three cases, Root Mean Square Error (RMSE was measured. Case I with T=5, d=5, Case II with T=10, D=10 and Case III with T=20, d=20 (T=slice thickness, d=resolution as stereology parameters. By comparing these results of two methods, it is obvious that RMSE values for our proposed method are smaller than Stereology method. Conclusion: Using morphological operation, dilation allows to enhance the estimation volume method, Stereology. In the case with less MRI slices and less test points, this method works much better compared to Stereology method.

  2. Comparison of ADC map with trace map in the normal and infarct areas of the brains of stroke patients

    International Nuclear Information System (INIS)

    Kim, Seung Hyung; Yoon, Pyeong Ho; Jeong, Eun Kee; Oh, Young Taick; Kim, Dong Ik

    1999-01-01

    To compare ADC mapping with trace mapping in normal and infarct areas of the brains of stroke patients. Eighteen patients diagnosed on the basis of clinical and brain MRI examinations as suffering from brain infarction were included in this study (hyperacute-1, acute-4, subacute-12, chronic-1). Diffusion weighted images of three orthogonal directions of a patient's brain were obtained by means of a single shot EPI pulse sequence, using a diffusion gradient with four serial b-factors. Three ADC maps were then reconstructed by post-image processing and were summed pixel by pixel to yield a trace map. ROIs were selected in the normal areas of white matter, gray matter and CSF of one hemisphere, and other ROIs of the same size were selected at the same site of the contralateral hemisphere. ADC and trace values were measured and right/left ratios of ADC and trace values were calculated. Using these values, we then compared the ADC map with the trace map, and compared the degree of anisotropic diffusion between white matter, gray matter and CSF. Except for three, whose infarct lesions were small and lay over white and gray matter, patients were divided into two groups. Those with infarct in the white matter (n=10) were assigned to one group, and those with infarct in the gray matter (n=5) to the other. ROIs were selected in the infarct area and other ROIs of the same size were selected at the same site of the contralateral hemisphere. ADC and trace values were measured and infarct/contralateral ratios were calculated. We then compared ADC ratio with trace ratio in white matter and gray matter infarct. In normal white matter, the Dxx ratio was 0.980±0.098, the Dyy ratio 1.019±0.086, the Dzz ratio 0.999±0.111, and the trace ratio 0.995±0.031. In normal gray matter, the Dxx ratio was 1.001±0.058, the Dyy ratio 0.996±0.063, Dzz ratio 1.005±0.070, and the trace ratio 1.001±0.028. In CSF, the Dxx ratio was 1.002±0.064, the Dyy ratio 1.023±0.055, the Dzz ratio 0.999

  3. Brain Stem Infarction Due to Basilar Artery Dissection in a Patient with Moyamoya Disease Four Years after Successful Bilateral Revascularization Surgeries.

    Science.gov (United States)

    Abe, Takatsugu; Fujimura, Miki; Mugikura, Shunji; Endo, Hidenori; Tominaga, Teiji

    2016-06-01

    Moyamoya disease (MMD) is a rare cerebrovascular disease with an unknown etiology and is characterized by intrinsic fragility in the intracranial vascular walls such as the affected internal elastic lamina and thinning medial layer. The association of MMD with intracranial arterial dissection is extremely rare, whereas that with basilar artery dissection (BAD) has not been reported previously. A 46-year-old woman developed brain stem infarction due to BAD 4 years after successful bilateral superficial temporal artery-middle cerebral artery anastomosis with indirect pial synangiosis for ischemic-onset MMD. She presented with sudden occipitalgia and subsequently developed transient dysarthria and mild hemiparesis. Although a transient ischemic attack was initially suspected, her condition deteriorated in a manner that was consistent with left hemiplegia with severe dysarthria. Magnetic resonance (MR) imaging revealed brain stem infarction, and MR angiography delineated a double-lumen sign in the basilar artery, indicating BAD. She was treated conservatively and brain stem infarction did not expand. One year after the onset of brain stem infarction, her activity of daily living is still dependent (modified Rankin Scale of 4), and there were no morphological changes associated with BAD or recurrent cerebrovascular events during the follow-up period. The association of MMD with BAD is extremely rare. While considering the common underlying pathology such as an affected internal elastic lamina and fragile medial layer, the occurrence of BAD in a patient with MMD in a stable hemodynamic state is apparently unique. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. Findings of bedside swallowing assessment and brain computerized tomography in patients with chronic cerebral infarction, and their outcome

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Toshihiko; Koshibu, Junko; Kikawada, Masayuki; Yoneda, Youichi; Uno, Masanobu; Takasaki, Masaru [Tokyo Medical Coll. (Japan); Imamura, Toshiharu

    2001-09-01

    To estimate the usefulness of the bedside swallowing assessment proposed by Smithard et al and neuroimaging findings characteristic for dysphagia, we studied the outcome of 102 patients with chronic cerebral infarction after assessment of swallowing by this test with brain computerized tomography (CT). All patients had a variety of motor disturbance and were admitted on a long-term medicare basis. They were divided into two groups according to the findings: the positive group (n=33), who showed any of the listed types of difficulty in swallowing water, and the negative group (n=69). Followed up to 2.2 years, their outcomes were studied. CT findings were studied on type of infarction, number and laterality of infarction, grade of periventricular lucency (PVL), presence of ventricular dilatation (VD), and severity of cortical atrophy (CA). The mean age was 76.4 years at registration and 61 were men. The frequency of severe dementia and disturbed ADL were significantly higher in the positive group. Eighteen patients died during the observation period and 15 of those were in the positive group, indicating higher, annual death rate (29.9% vs 2.2% in the negative group). All of the 15 patients in the positive group died of pneumonia. CT findings showed high incidence of multiple infarction, bilateral hemispheric lesion, severe PVL, VD, and severe CA in the positive group. These findings indicated that this evaluation method was useful in screening swallow function for patients with cerebral infarction in the chronic phase. Furthermore, CT findings suggested that severe white matter lesion, VD, and severe CA as well as multiple infarction seen in bilateral hemisphere was related to dysphagia, probably due to multiple factors involving pyramidal- and extrapyramidal-tracts with higher brain function. (author)

  5. Findings of bedside swallowing assessment and brain computerized tomography in patients with chronic cerebral infarction, and their outcome

    International Nuclear Information System (INIS)

    Iwamoto, Toshihiko; Koshibu, Junko; Kikawada, Masayuki; Yoneda, Youichi; Uno, Masanobu; Takasaki, Masaru; Imamura, Toshiharu

    2001-01-01

    To estimate the usefulness of the bedside swallowing assessment proposed by Smithard et al and neuroimaging findings characteristic for dysphagia, we studied the outcome of 102 patients with chronic cerebral infarction after assessment of swallowing by this test with brain computerized tomography (CT). All patients had a variety of motor disturbance and were admitted on a long-term medicare basis. They were divided into two groups according to the findings: the positive group (n=33), who showed any of the listed types of difficulty in swallowing water, and the negative group (n=69). Followed up to 2.2 years, their outcomes were studied. CT findings were studied on type of infarction, number and laterality of infarction, grade of periventricular lucency (PVL), presence of ventricular dilatation (VD), and severity of cortical atrophy (CA). The mean age was 76.4 years at registration and 61 were men. The frequency of severe dementia and disturbed ADL were significantly higher in the positive group. Eighteen patients died during the observation period and 15 of those were in the positive group, indicating higher, annual death rate (29.9% vs 2.2% in the negative group). All of the 15 patients in the positive group died of pneumonia. CT findings showed high incidence of multiple infarction, bilateral hemispheric lesion, severe PVL, VD, and severe CA in the positive group. These findings indicated that this evaluation method was useful in screening swallow function for patients with cerebral infarction in the chronic phase. Furthermore, CT findings suggested that severe white matter lesion, VD, and severe CA as well as multiple infarction seen in bilateral hemisphere was related to dysphagia, probably due to multiple factors involving pyramidal- and extrapyramidal-tracts with higher brain function. (author)

  6. Volumetric quantification of brain volume in children using sequential CT scans

    International Nuclear Information System (INIS)

    Hamano, K.; Iwasaki, N.; Kawashima, K.; Takita, H.

    1990-01-01

    We devised a three dimensional method for the accurate measurement of brain volume and applied it to 32 neurologically normal children, 7 children with only mental retardation and 15 children with both mental retardation and motor disturbance. In the group of neurologically normal children, the total brain volume increased from 723 cm 3 to 1407 cm 3 in order of age. The correlation ratio between the total brain volume and age was significant (P 00600.0001). The values of the total brain volume and the developmental curve were similar to those of the total brain weight of normal children previously reported. The combined volume of the cerebellum, the midbrain, the pons, and the medulla also increased from 76 cm 3 to 200 cm 3 in a manner similar to that of the total brain. The correlation between total brain volume and head circumference was significant (P<0.0001). In the group of children with mental retardation, the total brain volume was relatively smaller than that of neurologically normal children. In the group of the children with mental retardation and motor disturbance, 10 out of 15 cases showed values below -2 SD of those of neurologically normal children. The values of the total brain volume were each less than -3 SD in 3 cases whose head circumferences were each more than -3 SD. Our method for the direct measurement of brain volume based on serial CT scans may be useful for the accurate examination of brain development. (orig.)

  7. Familial and environmental influences on brain volumes in twins with schizophrenia.

    Science.gov (United States)

    Picchioni, Marco M; Rijsdijk, Fruhling; Toulopoulou, Timothea; Chaddock, Christopher; Cole, James H; Ettinger, Ulrich; Oses, Ana; Metcalfe, Hugo; Murray, Robin M; McGuire, Philip

    2017-03-01

    Reductions in whole brain and grey matter volumes are robust features of schizophrenia, yet their etiological influences are unclear. We investigated the association between the genetic and environmental risk for schizophrenia and brain volumes. Whole brain, grey matter and white matter volumes were established from structural MRIs from twins varying in their zygosity and concordance for schizophrenia. Hippocampal volumes were measured manually. We conducted between-group testing and full genetic modelling. We included 168 twins in our study. Whole brain, grey matter, white matter and right hippocampal volumes were smaller in twins with schizophrenia. Twin correlations were larger for whole brain, grey matter and white matter volumes in monozygotic than dizygotic twins and were significantly heritable, whereas hippocampal volume was the most environmentally sensitive. There was a significant phenotypic correlation between schizophrenia and reductions in all the brain volumes except for that of the left hippocampus. For whole brain, grey matter and the right hippocampus the etiological links with schizophrenia were principally associated with the shared familial environment. Lower birth weight and perinatal hypoxia were both associated with lower whole brain volume and with lower white matter and grey matter volumes, respectively. Scan data were collected across 2 sites, and some groups were modest in size. Whole brain, grey matter and right hippocampal volume reductions are linked to schizophrenia through correlated familial risk (i.e., the shared familial environment). The degree of influence of etiological factors varies between brain structures, leading to the possibility of a neuroanatomically specific etiological imprint.

  8. Change in brain and lesion volumes after CEE therapies

    Science.gov (United States)

    Espeland, Mark A.; Hogan, Patricia E.; Resnick, Susan M.; Bryan, R. Nick; Robinson, Jennifer G.; Goveas, Joseph S.; Davatzikos, Christos; Kuller, Lewis H.; Williamson, Jeff D.; Bushnell, Cheryl D.; Shumaker, Sally A.

    2014-01-01

    Objectives: To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen–based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. Methods: A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixed-effect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Results: Total brain volume decreased an average of 3.22 cm3/y in the active arm and 3.07 cm3/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm3/y (p = 0.88). Conclusions: Conjugated equine estrogen–based postmenopausal HT, previously assigned at WHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings. PMID:24384646

  9. Cerebral hemorrhagic infarction after radiation for pituitary adenoma

    International Nuclear Information System (INIS)

    Ogaki, Satoko; Suzuki, Masatsune; Shimano, Hitoshi; Toyoshima, Hideo; Sone, Hirohito; Okuda, Yukichi; Yamada, Nobuhiro

    2002-01-01

    We report a case of cerebral hemorrhagic infarction after radiation for pituitary adenoma. A 55-year-old woman was hospitalized to check for aldosteronism, post-operative pituitary function, and recurrence of thyroid cancer. She had short-term memory disturbance beginning two months prior to admission. Brain MRI showed a T1 and T2 high intensity lesion of her left anterolateral thalamus. Brain MRA revealed a narrowing in her left middle cerebral artery. The abnormal brain lesion was diagnosed as cerebral hemorrhagic infarction. She had received radiation therapy for pituitary adenoma 20 years earlier. It was considered that her cerebral hemorrhagic infarction was caused by radiation therapy. (author)

  10. Brain tumor locating in 3D MR volume using symmetry

    Science.gov (United States)

    Dvorak, Pavel; Bartusek, Karel

    2014-03-01

    This work deals with the automatic determination of a brain tumor location in 3D magnetic resonance volumes. The aim of this work is not the precise segmentation of the tumor and its parts but only the detection of its location. This work is the first step in the tumor segmentation process, an important topic in neuro-image processing. The algorithm expects 3D magnetic resonance volumes of brain containing a tumor. The detection is based on locating the area that breaks the left-right symmetry of the brain. This is done by multi-resolution comparing of corresponding regions in left and right hemisphere. The output of the computation is the probabilistic map of the tumor location. The created algorithm was tested on 80 volumes from publicly available BRATS databases containing 3D brain volumes afflicted by a brain tumor. These pathological structures had various sizes and shapes and were located in various parts of the brain. The locating performance of the algorithm was 85% for T1-weighted volumes, 91% for T1-weighted contrast enhanced volumes, 96% for FLAIR and T2-wieghted volumes and 95% for their combinations.

  11. Subcortical Brain Morphology in Schizophrenia : Descriptive analysis based on MRI findings of subcortical brain volumes

    OpenAIRE

    Gunleiksrud, Sindre

    2009-01-01

    The aim of this study was to investigate magnetic resonance images (MR) from patients with schizophrenia and healthy control subjects for difference in brain morphology with focus on subcortical brain volumes. Method: The study compared fourteen subcortical brain structure volumes of 96 patients diagnosed with schizophrenia (n=81) or schizoaffective disorder (n=15) with 106 healthy control subjects. Volume measures were obtained using voxel-based morphometry (FreeSurfer software suite) of ...

  12. RISK FACTORS AND ETIOLOGY OF TRANSIENT ISCHEMIC ATTACKS IN PATIENTS WITH BRAIN INFARCTION

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari

    2010-12-01

    Full Text Available   Abstract INTRODUCTION: Transient ischemic attacks (TIA are warnings of future stroke. There is no difference in risk factors, pathophysiology and prevention between TIA and brain infarction. methods: Consecutive patients with brain infarction admitted to Ghaem Hospital, Mashhad, Northeastern Iran, were enrolled in a prospective study during 2006. Diagnosis of ischemic stroke was established by a neurologist who also obtained history of TIA and vascular risk factors. All of the stroke patients underwent a standard battery of diagnostic investigations and etiology of ischemic stroke was determined by the Practical Iranian Criteria classification. Fisher’s exact test was used for statistical analysis. results: 348 stroke patients (186 women, 162 men were studied. History of TIA was present in 42 patients (29 women, 13 men, i.e. 12% of the stroke patients. TIA was more common in women (df=1, P=0.02. The frequency of hypertension, diabetes and ipsilateral carotid stenosis was not significantly different between patients with history of TIA and other stroke patients (P=0.87, P=0.64 and P=0.61, respectively. Hyper-cholesterolemia and smoking were significantly more frequent in stroke patients with history of TIA (P=0.011 and P=0.014, respectively. The frequency of TIA was not significantly different among patients with lacunar, versus large vessel territory infarcts (df=1, P=0.84. There was no significant difference in the frequency of various stroke etiologies in patients with and without history of TIA (df=4, P=0.61. CONCLUSIONS: Stroke patients with history of TIA have vascular risk factors similar to other stroke patients. A positive history of TIA does not affirm any specific etiology of ischemic stroke.     Keywords: Risk factors, etiology, transient ischemic attacks.

  13. Evolution of brain region volumes during artificial selection for relative brain size.

    Science.gov (United States)

    Kotrschal, Alexander; Zeng, Hong-Li; van der Bijl, Wouter; Öhman-Mägi, Caroline; Kotrschal, Kurt; Pelckmans, Kristiaan; Kolm, Niclas

    2017-12-01

    The vertebrate brain shows an extremely conserved layout across taxa. Still, the relative sizes of separate brain regions vary markedly between species. One interesting pattern is that larger brains seem associated with increased relative sizes only of certain brain regions, for instance telencephalon and cerebellum. Till now, the evolutionary association between separate brain regions and overall brain size is based on comparative evidence and remains experimentally untested. Here, we test the evolutionary response of brain regions to directional selection on brain size in guppies (Poecilia reticulata) selected for large and small relative brain size. In these animals, artificial selection led to a fast response in relative brain size, while body size remained unchanged. We use microcomputer tomography to investigate how the volumes of 11 main brain regions respond to selection for larger versus smaller brains. We found no differences in relative brain region volumes between large- and small-brained animals and only minor sex-specific variation. Also, selection did not change allometric scaling between brain and brain region sizes. Our results suggest that brain regions respond similarly to strong directional selection on relative brain size, which indicates that brain anatomy variation in contemporary species most likely stem from direct selection on key regions. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

  14. Volume of the crocodilian brain and endocast during ontogeny.

    Directory of Open Access Journals (Sweden)

    Daniel Jirak

    Full Text Available Understanding complex situations and planning difficult actions require a brain of appropriate size. Animal encephalisation provides an indirect information about these abilities. The brain is entirely composed of soft tissue and, as such, rarely fossilises. As a consequence, the brain proportions and morphology of some extinct vertebrates are usually only inferred from their neurocranial endocasts. However, because the morphological configuration of the brain is not fully reflected in the endocast, knowledge of the brain/endocast relationship is essential (especially the ratio of brain volume to endocast volume or the equivalent proportion of interstitial tissue for studying the endocasts of extinct animals. Here we assess the encephalic volume and structure of modern crocodilians. The results we obtained using ex vivo magnetic resonance imaging reveal how the endoneurocranial cavity and brain compartments of crocodilians change configuration during ontogeny. We conclude that the endocasts of adult crocodilians are elongated and expanded while their brains are more linearly organised. The highest proportion of brain tissue to endocast volume is in the prosencephalon at over 50% in all but the largest animals, whereas the proportion in other brain segments is under 50% in all but the smallest animals and embryos. Our results may enrich the field of palaeontological study by offering more precise phylogenetic interpretations of the neuroanatomic characteristics of extinct vertebrates at various ontogenetic stages.

  15. Mild focal cerebral ischemia in the rat. The effect of local temperature on infarct size

    DEFF Research Database (Denmark)

    Hildebrandt-Eriksen, Elisabeth S; Christensen, Thomas; Diemer, Nils Henrik

    2002-01-01

    . The effect of local temperature at the occlusion site in this model was furthermore tested. Thirty-three Wistar rats were subjected to 30 min of simultaneous common carotid artery and distal middle cerebral artery occlusion or sham treatment. Animals were magnetic resonance-scanned repeatedly between day one...... and day 14 after surgery, then sacrificed, and paraffin brain sections stained. All animals scanned 24 h after reperfusion showed an area of edema in the affected cortex, which later was identified as an infarct. Animals with a temperature of 33.9 +/- 1.5 degrees C at the MCA site (hypothermic) showed...... smaller infarcts (14.4 +/- 10 mm3) than animals with normothermic local temperature (36.7 +/- 0.2 degrees C, 57.7 +/- 26.4 mm3). Infarct size was maximal on day 3 after ischemia but decreased as edema subsided. Infarct volumes from histology and magnetic resonance imaging correlated well. The model...

  16. Could infarct location predict the long-term functional outcome in childhood arterial ischemic stroke?

    Directory of Open Access Journals (Sweden)

    Mauricio López-Espejo

    Full Text Available ABSTRACT Objective: To explore the influence of infarct location on long-term functional outcome following a first-ever arterial ischemic stroke (AIS in non-neonate children. Method: The MRIs of 39 children with AIS (median age 5.38 years; 36% girls; mean follow-up time 5.87 years were prospectively evaluated. Infarct location was classified as the absence or presence of subcortical involvement. Functional outcome was measured using the modified Rankin scale (mRS for children after the follow-up assessment. We utilized multivariate logistic regression models to estimate the odds ratios (ORs for the outcome while adjusting for age, sex, infarct size and middle cerebral artery territory involvement (significance < 0.05. Results: Both infarcts ≥ 4% of total brain volume (OR 9.92; CI 1.76 – 55.9; p 0.009 and the presence of subcortical involvement (OR 8.36; CI 1.76 – 53.6; p 0.025 independently increased the risk of marked functional impairment (mRS 3 to 5. Conclusion: Infarct extension and location can help predict the extent of disability after childhood AIS.

  17. Incidence of postangiographic silent brain infarction detected by diffusion-weighted MR imaging

    International Nuclear Information System (INIS)

    Mori, Harushi; Hayashi, Naoto; Aoki, Shigeki

    2002-01-01

    We surveyed to assess for the incidence of clinically silent brain infarction after cerebral catheter angiography. Diffusion-weighted images were performed shortly after 33 cerebral catheter angiographies. We found totally 11 abnormally high intensity spots in 5 of 33 patients on diffusion-weighted images and, therefore, the incidence was calculated as 15.2%. This incidence is higher than has been estimated based on the incidence of neurological deficits (about 0.5%) after cerebral angiography. Diffusion-weighted MR imaging is suitable to monitor the safety of angiographic procedures and material. (author)

  18. Prediction of infarction development after endovascular stroke therapy with dual-energy computed tomography

    International Nuclear Information System (INIS)

    Djurdjevic, Tanja; Gizewski, Elke Ruth; Grams, Astrid Ellen; Rehwald, Rafael; Glodny, Bernhard; Knoflach, Michael; Matosevic, Benjamin; Kiechl, Stefan

    2017-01-01

    After intraarterial recanalisation (IAR), the haemorrhage and the blood-brain barrier (BBB) disruption can be distinguished using dual-energy computed tomography (DECT). The aim of the present study was to investigate whether future infarction development can be predicted from DECT. DECT scans of 20 patients showing 45 BBB disrupted areas after IAR were assessed and compared with follow-up examinations. Receiver operator characteristic (ROC) analyses using densities from the iodine map (IM) and virtual non-contrast (VNC) were performed. Future infarction areas are denser than future non-infarction areas on IM series (23.44 ± 24.86 vs. 5.77 ± 2.77; p < 0.0001) and more hypodense on VNC series (29.71 ± 3.33 vs. 35.33 ± 3.50; p < 0.0001). ROC analyses for the IM series showed an area under the curve (AUC) of 0.99 (cut-off: <9.97 HU; p < 0.05; sensitivity 91.18 %; specificity 100.00 %; accuracy 0.93) for the prediction of future infarctions. The AUC for the prediction of haemorrhagic infarctions was 0.78 (cut-off >17.13 HU; p < 0.05; sensitivity 90.00 %; specificity 62.86 %; accuracy 0.69). The VNC series allowed prediction of infarction volume. Future infarction development after IAR can be reliably predicted with the IM series. The prediction of haemorrhages and of infarction size is less reliable. (orig.)

  19. Prediction of infarction development after endovascular stroke therapy with dual-energy computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Djurdjevic, Tanja; Gizewski, Elke Ruth; Grams, Astrid Ellen [Medical University of Innsbruck, Department of Neuroradiology, Innsbruck (Austria); Rehwald, Rafael; Glodny, Bernhard [Medical University of Innsbruck, Department of Radiology, Innsbruck (Austria); Knoflach, Michael; Matosevic, Benjamin; Kiechl, Stefan [Medical University of Innsbruck, Department of Neurology, Innsbruck (Austria)

    2017-03-15

    After intraarterial recanalisation (IAR), the haemorrhage and the blood-brain barrier (BBB) disruption can be distinguished using dual-energy computed tomography (DECT). The aim of the present study was to investigate whether future infarction development can be predicted from DECT. DECT scans of 20 patients showing 45 BBB disrupted areas after IAR were assessed and compared with follow-up examinations. Receiver operator characteristic (ROC) analyses using densities from the iodine map (IM) and virtual non-contrast (VNC) were performed. Future infarction areas are denser than future non-infarction areas on IM series (23.44 ± 24.86 vs. 5.77 ± 2.77; p < 0.0001) and more hypodense on VNC series (29.71 ± 3.33 vs. 35.33 ± 3.50; p < 0.0001). ROC analyses for the IM series showed an area under the curve (AUC) of 0.99 (cut-off: <9.97 HU; p < 0.05; sensitivity 91.18 %; specificity 100.00 %; accuracy 0.93) for the prediction of future infarctions. The AUC for the prediction of haemorrhagic infarctions was 0.78 (cut-off >17.13 HU; p < 0.05; sensitivity 90.00 %; specificity 62.86 %; accuracy 0.69). The VNC series allowed prediction of infarction volume. Future infarction development after IAR can be reliably predicted with the IM series. The prediction of haemorrhages and of infarction size is less reliable. (orig.)

  20. Massive cerebellar infarction: a neurosurgical approach

    Directory of Open Access Journals (Sweden)

    Salazar Luis Rafael Moscote

    2015-12-01

    Full Text Available Cerebellar infarction is a challenge for the neurosurgeon. The rapid recognition will crucial to avoid devastating consequences. The massive cerebellar infarction has pseudotumoral behavior, should affect at least one third of the volume of the cerebellum. The irrigation of the cerebellum presents anatomical diversity, favoring the appearance of atypical infarcts. The neurosurgical management is critical for massive cerebellar infarction. We present a review of the literature.

  1. Brain stem infarction: Imaging diagnosis and endovascular therapy

    International Nuclear Information System (INIS)

    Schulte-Altedorneburg, G.; Mayer, T.E.

    2004-01-01

    This review article describes the vascular anatomy and pathophysiology of the vertebrobasilar ischaemia as well as the most important clinical syndromes of brainstem infarctions. An overview of the literature presents the role of invasive and non-invasive techniques (ultrasound, MRI, MRA, CT, CTA, intraarterial angiography) to diagnose an acute brainstem infarction. Current concepts are described for treating acute vertebrobasilar thrombosis, including local intraarterial fibrinolysis, mechanical recanalization and medical treatment, and for preventing brainstem infarction, including angioplasty and stent-assisted angioplasty of the brainstem supplying arteries. (orig.)

  2. Dose-volume considerations in stereotaxic brain radiation therapy

    International Nuclear Information System (INIS)

    Houdek, P.V.; Schwade, J.G.; Pisciotta, V.J.; Medina, A.J.; Lewin, A.A.; Abitbol, A.A.; Serago, C.F.

    1988-01-01

    Although brain radiation therapy experience suggests that a gain in the therapeutic ratio may be achieved by optimizing the dose-volume relationship, no practical system for quantitative assessment of dose-volume data has been developed. This presentation describes the rationale for using the integral dose function for this purpose and demonstrates that with the use of a conventional treatment planning computer and a series of computed tomographic scans, first-order optimization of the dose-volume function can be accomplished in two steps: first, high-dose volume is minimized by selecting an appropriate treatment technique and tumor margin, and then dosage is maximized by calculating the brain tolerance dose as a function of the irradiated volume

  3. Computerized tomography and morphological findings in brain infarcts and intracerebral haematonous for identical image planes

    Energy Technology Data Exchange (ETDEWEB)

    Clar, H E; Bock, W J; Hahse, H C; Gerhard, L; Flossdorf, R [Essen Univ. (Gesamthochschule) (Germany, F.R.). Neurochirurgische Klinik; Duesseldorf Univ. (Germany, F.R.). Neurochirurgische Klinik; Essen Univ. (Gesamthochschule) (Germany, F.R.). Roentgendiagnostisches Zentralinstitut; Essen Univ. (Gesamthochschule) (Germany, F.R.). Neuropathologisches Inst.)

    1979-01-01

    Contrary to earlier, more optimistic publications, CT findings do not always agree with brain sections of the same image plane. For example, in spite of a clinically proved infrarot anamnesis, Huber was unable to detect a pathological CT finding in 20% of the cases. Still, CT is the method that yields the best information on cerebral ischaemios, haemorrhaegic infarcts, and haemorrhagies if purposefully applied.

  4. Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Ting [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Department of Radiology, Taichung Veterans General Hospital, Taichung City (China); Amouyal, Gregory; Pereira, Helena; Del Giudice, Costantino; Dean, Carole [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Correas, Jean-Michel [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Hopital Necker, Radiology Department, Paris (France); Pellerin, Olivier; Sapoval, Marc [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Inserm (Institut national de la sante et de la recherche medicale) U970, Paris (France); Universite Paris Descartes, Paris (France); Thiounn, Nicolas [Assistance Publique Hopitaux de Paris, Hopital Europeen Georges-Pompidou, Urology, Paris (France)

    2016-10-15

    To assess the impact of prostatic arterial embolisation (PAE) on various prostate gland anatomical zones. We retrospectively reviewed paired MRI scans obtained before and after PAE for 25 patients and evaluated changes in volumes of the median lobe (ML), central gland (CG), peripheral zone (PZ) and whole prostate gland (WPV) following PAE. We used manual segmentation to calculate volume on axial view T2-weighted images for ML, CG and WPV. We calculated PZ volume by subtracting CG volume from WPV. Enhanced phase on dynamic contrasted-enhanced MRI was used to evaluate the infarction areas after PAE. Clinical results of International Prostate Symptom Score and International Index of Erectile Function questionnaires and the urodynamic study were evaluated before and after PAE. Significant reductions in volume were observed after PAE for ML (26.2 % decrease), CG (18.8 %), PZ (16.4 %) and WPV (19.1 %; p < 0.001 for all these volumes). Patients with clinical failure had smaller volume reductions for WPV, ML and CG (all p < 0.05). Patients with significant CG infarction after PAE displayed larger WPV, ML and CG volume reductions (all p < 0.01). PAE can significantly decrease WPV, ML, CG and PZ volumes, and poor clinical outcomes are associated with smaller volume reductions. (orig.)

  5. Effect of percutaneous coronary intervention on ventricular systolic synchrony and brain natriuretic peptide in acute myocardial infarction patients with aneurysm

    International Nuclear Information System (INIS)

    Xue Ling; Fu Xianghua; Liu Jun; Wu Weili; Li Liang; Miao Qing; Jiang Yunfa; Gu Xinshun

    2010-01-01

    Objective: To evaluate the reversed effect on the left ventricular aneurysm (LVA) formation and influence on systolic performance and synchrony using percutaneous coronary intervention (PCI) therapy in patients with acute myocardial infarction (AMI) at different time intervals equilibrium radionuclide angiography (ERNA). Methods: A total of 326 patients with primary anterior AMI accompanied LVA diagnosed by left ventricular graphy were enrolled in this study from January 2001 to July 2004. They were divided into 4 groups according to the time accepting PCI. Group A ( 1 week, n=76). The parameters of the paradox volume image of ventricular movement on the dynamic cine of cardiac blood pool, and the paradox volume index (PVI) as well as the parameters of left ventricular systolic function (LVSF), left ventricular diastolic function (LVDF) and left ventricular systolic synchrony (LVSS) were measured by ERNA with the ventricular phase analysis (PA) at 1st week and 6th month after AMI. The plasma brain natriuretic peptide (BNP) was measured in 18th hour, 5th day and 24th week after AMI. During 3-year follow-up, the major adverse cardiac events (MACE) were recorded.Analysis of variance and χ 2 -test were used. Results: At 6th month post AMI, the left ventricular ejection fraction (LVEF) in group A, B and C was increased than that in group D, hut phase shift (PS) and full width at half maximum (FWHM) were decreased (F=5.90, 6.80, all P 2 =10.05, P<0.05). Conclusion: The early, fully and permanently opening of infarction related artery can effectively inhibit the left ventricular remodeling process, improve its function, prevent LVA formation, and finally improve the prognosis. (authors)

  6. Recirculation usually precedes malignant edema in middle cerebral artery infarcts

    DEFF Research Database (Denmark)

    Nielsen, T H; Ståhl, N; Schalén, W

    2012-01-01

    In patients with large middle cerebral artery (MCA) infarcts, maximum brain swelling leading to cerebral herniation and death usually occurs 2-5 days after onset of stroke. The study aimed at exploring the pattern of compounds related to cerebral energy metabolism in infarcted brain tissue....

  7. The free radical spin-trap alpha-PBN attenuates periinfarct depolarizations following permanent middle cerebral artery occlusion in rats without reducing infarct volume

    DEFF Research Database (Denmark)

    Christensen, Thomas; Bruhn, Torben; Diemer, Nils Henrik

    2003-01-01

    The effect of the free radical spin-trap alpha-phenyl-butyl-tert-nitrone (alpha-PBN) in permanent focal cerebral ischemia in rats was examined in two series of experiments. In the first, rats were subjected to permanent occlusion of the middle cerebral artery (MCAO) and treated 1 h after occlusion...... with a single dose of alpha-PBN (100 mg/kg) or saline. Body temperature was measured and controlled for the first 24 h to obtain identical temperature curves in the two groups. Cortical infarct volumes were determined on histological sections 7 days later. alpha-PBN did not significantly reduce infarct volume...

  8. Remote Zone Extracellular Volume and Left Ventricular Remodeling in Survivors of ST-Elevation Myocardial Infarction

    Science.gov (United States)

    Carberry, Jaclyn; Carrick, David; Haig, Caroline; Rauhalammi, Samuli M.; Ahmed, Nadeem; Mordi, Ify; McEntegart, Margaret; Petrie, Mark C.; Eteiba, Hany; Hood, Stuart; Watkins, Stuart; Lindsay, Mitchell; Davie, Andrew; Mahrous, Ahmed; Ford, Ian; Sattar, Naveed; Welsh, Paul; Radjenovic, Aleksandra; Oldroyd, Keith G.

    2016-01-01

    The natural history and pathophysiological significance of tissue remodeling in the myocardial remote zone after acute ST-elevation myocardial infarction (STEMI) is incompletely understood. Extracellular volume (ECV) in myocardial regions of interest can now be measured with cardiac magnetic resonance imaging. Patients who sustained an acute STEMI were enrolled in a cohort study (BHF MR-MI [British Heart Foundation Magnetic Resonance Imaging in Acute ST-Segment Elevation Myocardial Infarction study]). Cardiac magnetic resonance was performed at 1.5 Tesla at 2 days and 6 months post STEMI. T1 modified Look-Locker inversion recovery mapping was performed before and 15 minutes after contrast (0.15 mmol/kg gadoterate meglumine) in 140 patients at 2 days post STEMI (mean age: 59 years, 76% male) and in 131 patients at 6 months post STEMI. Remote zone ECV was lower than infarct zone ECV (25.6±2.8% versus 51.4±8.9%; Premote zone ECV (Premote zone ECV (P=0.010). No ST-segment resolution (P=0.034) and extent of ischemic area at risk (Premote zone ECV at 6 months (ΔECV). ΔECV was a multivariable associate of the change in left ventricular end-diastolic volume at 6 months (regression coefficient [95% confidence interval]: 1.43 (0.10–2.76); P=0.036). ΔECV is implicated in the pathophysiology of left ventricular remodeling post STEMI, but because the effect size is small, ΔECV has limited use as a clinical biomarker of remodeling. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique identifier: NCT02072850. PMID:27354423

  9. Brain atrophy during aging. Quantitative studies with X-CT and NMR-CT

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzawa, Taiju; Yamada, Kenji; Yamada, Susumu; Ono, Shuichi; Takeda, Shunpei; Hatazawa, Jun; Ito, Masatoshi; Kubota, Kazuo

    1985-12-01

    Age-related brain atrophy was investigated in thousands of persons with no neurologic disturbances using X-CT and NMR-CT. Brain atrophy was minimal in 34-35 years old in both sexes, increased exponentially to the increasing age after 34-35 years, and probably resulted in dementia, such as vascular or multi-infarct dementia. Brain atrophy was significantly greater in men than in women at all ages. Brain volumes were maximal in 34-35 years old in both sexes with minimal individual differences which increased proportionally to the increasing age. Remarkable individual differences in the extent of brain atrophy (20 - 30 %) existed among aged subjects. Progression of brain atrophy was closely related to loss of mental activities independently of their ages. Our longitudinal study has revealed that the most important factors promoting brain atrophy during aging was the decrease in the cerebral blood flow. We have classified brain atrophy into sulcal and cisternal enlargement type (type I), ventricular enlargement type (type II) and mixed type (type III) according to the clinical study using NMR-CT. Brain atrophy of type I progresses significantly in almost all of the geriatric disorders. This type of brain atrophy progresses significantly in heavy smokers and drinkers. Therefore this type of brain atrophy might be caused by the decline in the blood flow in anterior and middle cerebral arteries. Brain atrophy of type II was caused by the disturbance of cerebrospinal fluid circulation after cerebral bleeding and subarachnoid bleeding. Brain atrophy of type III was seen in vascular dementia or multi-infarct dementia which was caused by loss of brain matter after multiple infarction, and was seen also in dementia of Alzheimer type in which degeneration of nerve cells results in brain atrophy. NMR-CT can easily detect small infarction (lacunae) and edematous lesions resulting from ischemia and hypertensive encephalopathy. (J.P.N.).

  10. Near-infrared diffuse reflectance imaging of infarct core and peri-infarct depolarization in a rat middle cerebral artery occlusion model

    Science.gov (United States)

    Kawauchi, Satoko; Nishidate, Izumi; Nawashiro, Hiroshi; Sato, Shunichi

    2014-03-01

    To understand the pathophysiology of ischemic stroke, in vivo imaging of the brain tissue viability and related spreading depolarization is crucial. In the infarct core, impairment of energy metabolism causes anoxic depolarization (AD), which considerably increases energy consumption, accelerating irreversible neuronal damage. In the peri-infarct penumbra region, where tissue is still reversible despite limited blood flow, peri-infarct depolarization (PID) occurs, exacerbating energy deficit and hence expanding the infarct area. We previously showed that light-scattering signal, which is sensitive to cellular/subcellular structural integrity, was correlated with AD and brain tissue viability in a rat hypoxia-reoxygenation model. In the present study, we performed transcranial NIR diffuse reflectance imaging of the rat brain during middle cerebral artery (MCA) occlusion and examined whether the infarct core and PIDs can be detected. Immediately after occluding the left MCA, light scattering started to increase focally in the occlusion site and a bright region was generated near the occlusion site and spread over the left entire cortex, which was followed by a dark region, showing the occurrence of PID. The PID was generated repetitively and the number of times of occurrence in a rat ranged from four to ten within 1 hour after occlusion (n=4). The scattering increase in the occlusion site was irreversible and the area with increased scattering expanded with increasing the number of PIDs, indicating an expansion of the infarct core. These results suggest the usefulness of NIR diffuse reflectance signal to visualize spatiotemporal changes in the infarct area and PIDs.

  11. A longitudinal study of brain volume changes in normal aging

    Energy Technology Data Exchange (ETDEWEB)

    Takao, Hidemasa, E-mail: takaoh-tky@umin.ac.jp [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Hayashi, Naoto [Department of Computational Diagnostic Radiology and Preventive Medicine, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan); Ohtomo, Kuni [Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655 (Japan)

    2012-10-15

    Purpose: To evaluate the effect of normal aging on brain volumes and examine the effects of age and sex on the rates of changes in global and regional brain volumes. Methods: A total of 199 normal subjects (65 females and 134 males, mean age = 56.4 ± 9.9 years, age range = 38.1–82.9 years) were included in this study. Each subject was scanned twice, at an interval of about 2 years (range = 1.5–2.3 years). Two-time-point percentage brain volume change (PBVC) was estimated with SIENA 2.6. Results: The mean annualized PBVC was −0.23%/y. Analysis of covariance (ANCOVA) for annual brain volume changes revealed a main effect of age. There was no main effect of sex, nor was there a sex-by-age interaction. Voxel-wise analysis revealed a negative correlation between age and edge displacement values mainly in the periventricular region. Conclusions: The results of our study indicate that brain atrophy accelerates with increasing age and that there is no gender difference in the rate of brain atrophy.

  12. A longitudinal study of brain volume changes in normal aging

    International Nuclear Information System (INIS)

    Takao, Hidemasa; Hayashi, Naoto; Ohtomo, Kuni

    2012-01-01

    Purpose: To evaluate the effect of normal aging on brain volumes and examine the effects of age and sex on the rates of changes in global and regional brain volumes. Methods: A total of 199 normal subjects (65 females and 134 males, mean age = 56.4 ± 9.9 years, age range = 38.1–82.9 years) were included in this study. Each subject was scanned twice, at an interval of about 2 years (range = 1.5–2.3 years). Two-time-point percentage brain volume change (PBVC) was estimated with SIENA 2.6. Results: The mean annualized PBVC was −0.23%/y. Analysis of covariance (ANCOVA) for annual brain volume changes revealed a main effect of age. There was no main effect of sex, nor was there a sex-by-age interaction. Voxel-wise analysis revealed a negative correlation between age and edge displacement values mainly in the periventricular region. Conclusions: The results of our study indicate that brain atrophy accelerates with increasing age and that there is no gender difference in the rate of brain atrophy

  13. Estimated maximal and current brain volume predict cognitive ability in old age

    Science.gov (United States)

    Royle, Natalie A.; Booth, Tom; Valdés Hernández, Maria C.; Penke, Lars; Murray, Catherine; Gow, Alan J.; Maniega, Susana Muñoz; Starr, John; Bastin, Mark E.; Deary, Ian J.; Wardlaw, Joanna M.

    2013-01-01

    Brain tissue deterioration is a significant contributor to lower cognitive ability in later life; however, few studies have appropriate data to establish how much influence prior brain volume and prior cognitive performance have on this association. We investigated the associations between structural brain imaging biomarkers, including an estimate of maximal brain volume, and detailed measures of cognitive ability at age 73 years in a large (N = 620), generally healthy, community-dwelling population. Cognitive ability data were available from age 11 years. We found positive associations (r) between general cognitive ability and estimated brain volume in youth (male, 0.28; females, 0.12), and in measured brain volume in later life (males, 0.27; females, 0.26). Our findings show that cognitive ability in youth is a strong predictor of estimated prior and measured current brain volume in old age but that these effects were the same for both white and gray matter. As 1 of the largest studies of associations between brain volume and cognitive ability with normal aging, this work contributes to the wider understanding of how some early-life factors influence cognitive aging. PMID:23850342

  14. Measurement of the infarcted area by 201Tl myocardial emission CT

    International Nuclear Information System (INIS)

    Tamaki, Shunichi; Murakami, Tomoyuki; Kambara, Hirofumi

    1982-01-01

    201 Tl-ECT was performed in 28 cases 4 weeks after the onset of acute myocardial infarction to calculate the volume of infarction for comparison with the CK-MB infarction size obtained in the acute phase. The infarct area obtained by two-dimensional 201 Tl scintigraphy in 18 cases treated by the conventional method showed a positive correlation with the CK-MB infarct size, but the volume of infarction by 201 Tl-ECT produced a better correlation. In the group with successful thrombolysis, the serum CK-MB level reached a peak soon after the onset, accompanied by release of more CK-MB for a constant volume of infarction obtained by 201 Tl-ECT, as compared with the group with unsuccessful thrombolysis or conventional therapy. This suggests the involvement of washout phenomenon by reperfusion. Although there are some limitations, the three-dimensional detection of the distribution of myocardial blood flow by 201 Tl-ECT is useful, covering disadvantages of two-dimensional images. (Chiba, N.)

  15. Difference in MRI findings and risk factors between multiple infarction without dementia and multi-infarct dementia

    International Nuclear Information System (INIS)

    Yanagisawa, Masashi; Kaieda, Makoto; Nagatsumi, Atsushi; Terashi, Akiro

    1995-01-01

    MRI findings and risk factors for vascular dementia were evaluated with multi-variate analysis in 96 multi-infarct patients without dementia and 40 multi-infarct patients with dementia (MID). Only subjects with small infarcts in the territory of the perforator artery or deep white matter were studied. The diagnosis of MID was diagnosed according to DMS-III criteria and Hachinski's ischemia score. Location and area of patchy high-intensity areas including small infarcts, the degree of periventricular high intensity (PVH), and the degree of brain atrophy were examined with MR images. Independent variables were: history of hypertension, diabetes mellitus, other complications; systolic and diastolic blood pressure, atherosclerotic index, hematocrit, history of smoking, level of education, and activities of daily life (ADL). Hayashi's quantification method II was used to analyze the data. The most significant correlation was found between history of hypertension and dementia (partial correlation coefficient: 0.39). Significant correlations were also found between ADL and dementia (0.32), between thalamic infarction and dementia (0.31), and between PVH and dementia (0.27). Age, brain atrophy index, and history of diabetes mellitus contributed little to dementia. The contribution to dementia did not differ significantly between right and left patchy high-intensity areas on MR images. Location of infarcts, except for bilateral thalamic infarcts and large PVH, contributed little to dementia. Thus it would be difficult to base a prediction of the prevalence of vascular dementia on MRI findings. However, both hypertention and ADL contribute to vascular dementia and both are treatable, which may be significant for the prevention of dementia. (author)

  16. Gender dimorphism of brain reward system volumes in alcoholism.

    Science.gov (United States)

    Sawyer, Kayle S; Oscar-Berman, Marlene; Barthelemy, Olivier J; Papadimitriou, George M; Harris, Gordon J; Makris, Nikos

    2017-05-30

    The brain's reward network has been reported to be smaller in alcoholic men compared to nonalcoholic men, but little is known about the volumes of reward regions in alcoholic women. Morphometric analyses were performed on magnetic resonance brain scans of 60 long-term chronic alcoholics (ALC; 30 men) and 60 nonalcoholic controls (NC; 29 men). We derived volumes of total brain, and cortical and subcortical reward-related structures including the dorsolateral prefrontal (DLPFC), orbitofrontal, and cingulate cortices, and the temporal pole, insula, amygdala, hippocampus, nucleus accumbens septi (NAc), and ventral diencephalon (VDC). We examined the relationships of the volumetric findings to drinking history. Analyses revealed a significant gender interaction for the association between alcoholism and total reward network volumes, with ALC men having smaller reward volumes than NC men and ALC women having larger reward volumes than NC women. Analyses of a priori subregions revealed a similar pattern of reward volume differences with significant gender interactions for DLPFC and VDC. Overall, the volume of the cerebral ventricles in ALC participants was negatively associated with duration of abstinence, suggesting decline in atrophy with greater length of sobriety. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  17. Comparing patients with spinal cord infarction and cerebral infarction: clinical characteristics, and short-term outcome

    Directory of Open Access Journals (Sweden)

    Naess H

    2011-08-01

    Full Text Available Halvor Naess, Fredrik RomiDepartment of Neurology, Haukeland University Hospital, N-5021 Bergen, NorwayBackground: To compare the clinical characteristics, and short-term outcome of spinal cord infarction and cerebral infarction.Methods: Risk factors, concomitant diseases, neurological deficits on admission, and short-term outcome were registered among 28 patients with spinal cord infarction and 1075 patients with cerebral infarction admitted to the Department of Neurology, Haukeland University Hospital, Bergen, Norway. Multivariate analyses were performed with location of stroke (cord or brain, neurological deficits on admission, and short-term outcome (both Barthel Index [BI] 1 week after symptom onset and discharge home or to other institution as dependent variables.Results: Multivariate analysis showed that patients with spinal cord infarction were younger, more often female, and less afflicted by hypertension and cardiac disease than patients with cerebral infarction. Functional score (BI was lower among patients with spinal cord infarctions 1 week after onset of symptoms (P < 0.001. Odds ratio for being discharged home was 5.5 for patients with spinal cord infarction compared to cerebral infarction after adjusting for BI scored 1 week after onset (P = 0.019.Conclusion: Patients with spinal cord infarction have a risk factor profile that differs significantly from that of patients with cerebral infarction, although there are some parallels to cerebral infarction caused by atherosclerosis. Patients with spinal cord infarction were more likely to be discharged home when adjusting for early functional level on multivariate analysis.Keywords: spinal cord infarction, cerebral infarction, risk factors, short-term outcome

  18. Temporal Patterns of Soluble Adhesion Molecules in Cerebrospinal Fluid and Plasma in Patients with the Acute Brain Infraction

    Directory of Open Access Journals (Sweden)

    Vesna Selakovic

    2009-01-01

    Full Text Available The aim of this study was to define concentration changes of soluble adhesion molecules (sICAM-1, sVCAM-1 and sE-Selectin in cerebrospinal fluid and plasma, as well as, number of peripheral blood leukocytes and the albumin coefficient in the patients with the acute brain infarction. We also, analyzed the correlation between the measured levels, the infarct volume and the degree of neurological and the functional deficit. The study included 50 patients with the acute cerebral infarction and the control group consisted of 16 patients, age and sex matched. Obtained results showed significant increase in number of leukocytes, the albumin coefficient and the level of soluble adhesion molecules within the first seven days in patients. The highest values of measured parameters were noted within the third and the fourth day after the insult, which is the suggested period of maximal intensity of inflammatory reactions. Significant correlation was found between measured parameters and the infarct volume, the degree of neurological and the functional deficit. The results suggest that investigated parameters in CSF and blood represent a dynamic index of inflammatory events as one of the fundametal mechanisms responsible for neuron damage during acute phase of brain infarction.

  19. Hyperfixation of Tc-99m ECD in subacute cortical infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Seung; Kweon, Sun Uck; Ryu, Jin Sook; Moon, Dae Hyuk; Lee, Hee Kyung [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)

    2001-07-01

    It has been known that hyperfixation of Tc-99m ECD (HF) is not shown in subacute cerebral infarction because the brain distribution of Tc-99m ECD reflects not only perfusion but also the metabolic status of brain tissue. However, we observed several cases with HF in the subacute pure cortical infarction. To find out the cause of HF in subacute cortical infarction. We assessed the difference in associated cerebral hemodynamics and clinical findings between the subacute cortical infarctions with and without HF. We reviewed 16 patients (63.8{+-}8.6 yr, M/F: 15/1) with pure cortical infarction not involving adjacent subcortical white matter on MRI. All patients underwent acetazolamide stress brain perfusion SPECT using Tc-99m ECD and MRI at subacute period (7.3{+-}4.4 days from ictus). Uptake of Tc-99m ECD in infarcted cortex was assessed visually comparing the contralateral side. To assess the difference in associate clinical findings between the infarctions with and without HF, rCVR of the cerebral territory including infarcted cortex, extent of Gd-enhancement on MRI. Intervals between SPECT and ictus, and the presence of associated ICA stenosis were evaluated. Infarctions were focal (n=8) or multifocal (n=8) and located in frontoparietal cortices on MRI. Twelve patients were accompanied with ipsilateral ICA stenosis. Resting SPECT showed increased cortical uptake (=HF) in 7 patients and decreased in 9. rCVR of the MCA territory was preserved in all of the 7 patients with HF, compared with 4 of the 9 patients without HF (p=0.03). Gd-enhancement was minimal in all of the 7 patients with HF, compared with of the 0 patients without HF (p=0.03). Presence of ipsilateral ICA stenosis and intervals from ictus were not different (p>0.1) Subacute cerebral cortical infarction with HF was more frequently associated with preserved rCVR and minimal destruction of the blood-brain barrier than that without HF. Our findings suggest that HF may result from luxury perfusion of

  20. The relationship between brain volumes and intelligence in bipolar disorder

    NARCIS (Netherlands)

    Vreeker, Annabel; Abramovic, Lucija; Boks, Marco P.M.; Verkooijen, Sanne; van Bergen, Annet H.; Ophoff, Roel A.; Kahn, René S.; van Haren, Neeltje E.M.

    2017-01-01

    Objectives Bipolar disorder type-I (BD-I) patients show a lower Intelligence Quotient (IQ) and smaller brain volumes as compared with healthy controls. Considering that in healthy individuals lower IQ is related to smaller total brain volume, it is of interest to investigate whether IQ deficits in

  1. Relative cerebral blood volume is associated with collateral status and infarct growth in stroke patients in SWIFT PRIME.

    Science.gov (United States)

    Arenillas, Juan F; Cortijo, Elisa; García-Bermejo, Pablo; Levy, Elad I; Jahan, Reza; Goyal, Mayank; Saver, Jeffrey L; Albers, Gregory W

    2017-01-01

    We aimed to evaluate how predefined candidate cerebral perfusion parameters correlate with collateral circulation status and to assess their capacity to predict infarct growth in patients with acute ischemic stroke (AIS) eligible for endovascular therapy. Patients enrolled in the SWIFT PRIME trial with baseline computed tomography perfusion (CTP) scans were included. RAPID software was used to calculate mean relative cerebral blood volume (rCBV) in hypoperfused regions, and hypoperfusion index ratio (HIR). Blind assessments of collaterals were performed using CT angiography in the whole sample and cerebral angiogram in the endovascular group. Reperfusion was assessed on 27-h CTP; infarct volume was assessed on 27-h magnetic resonance imaging/CT scans. Logistic and rank linear regression models were conducted. We included 158 patients. High rCBV ( p = 0.03) and low HIR ( p = 0.03) were associated with good collaterals. A positive association was found between rCBV and better collateral grades on cerebral angiography ( p = 0.01). Baseline and 27-h follow-up CTP were available for 115 patients, of whom 74 (64%) achieved successful reperfusion. Lower rCBV predicted a higher infarct growth in successfully reperfused patients ( p = 0.038) and in the endovascular treatment group ( p = 0.049). Finally, rCBV and HIR may serve as markers of collateral circulation in AIS patients prior to endovascular therapy. Unique identifier: NCT0165746.

  2. Infarct fogging on immediate postinterventional CT - a not infrequent occurrence

    Energy Technology Data Exchange (ETDEWEB)

    Dekeyzer, Sven [Onze-Lieve-Vrouw (OLV) Ziekenhuis Aalst, Department of Medical Imaging, Aalst (Belgium); RWTH University Hospital Aachen, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Reich, Arno [RWTH University Hospital Aachen, Department of Neurology, Aachen (Germany); Othman, Ahmed E. [University Hospital Tuebingen, Department of Radiology, Tuebingen (Germany); Wiesmann, Martin; Nikoubashman, Omid [RWTH University Hospital Aachen, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany)

    2017-09-15

    A pseudo-normalization of infarcted brain parenchyma, similar to the ''fogging effect'' which usually occurs after 2-3 weeks, can be observed on CT performed immediately after endovascular stroke treatment (EST). Goal of this study was to analyze the incidence of this phenomenon and its evolution on follow-up imaging. One hundred fifty-two patients in our database of 949 patients, who were treated for acute stroke between January 2010 and January 2015, fulfilled the inclusion criteria of (a) EST for an acute stroke in the anterior circulation, (b) an ASPECT-score < 10 on pre-interventional CT, and (c) postinterventional CT imaging within 4.5 h after the procedure. Two independent reviewers analyzed imaging data of these patients. Transformation of brain areas from hypoattenuated on pre-interventional CT to isodense on postinterventional CT was seen in 37 patients in a total of 49 ASPECTS areas (Cohen's kappa 0.819; p < 0.001). In 17 patients, the previously hypoattenuated brain areas became isodense, but appeared swollen. In 20 patients (13%), the previously hypodense brain area could not be distinguished from normal brain parenchyma. On follow-up imaging, all isodense brain areas showed signs of infarction. Pseudo-normalization of infarct hypoattenuation on postinterventional CT is not infrequent. It is most likely caused by contrast leakage in infarcted parenchyma and does not represent salvage of ischemic brain parenchyma. (orig.)

  3. Relationship between hippocampal subfield volumes and memory deficits in patients with thalamus infarction.

    Science.gov (United States)

    Chen, Li; Luo, Tianyou; Lv, Fajin; Shi, Dandan; Qiu, Jiang; Li, Qi; Fang, Weidong; Peng, Juan; Li, Yongmei; Zhang, Zhiwei; Li, Yang

    2016-09-01

    Clinical studies have shown that thalamus infarction (TI) affects memory function. The thalamic nucleus is directly or indirectly connected to the hippocampal system in animal models. However, this connection has not been investigated using structural magnetic resonance imaging (MRI) in humans. From the pathological perspective, TI patients may serve as valid models for revealing the interaction between the thalamus and hippocampus in memory function. In this study, we aim to assess different hippocampal subfield volumes in TI patients and control subjects using MRI and test their associations with memory function. A total of 37 TI patients (TI group), 38 matched healthy control subjects (HC group), and 22 control patients with other stroke location (SC group) underwent 3.0-T MRI scans and clinical memory examinations. Hippocampal subfield volumes were measured and compared by using FreeSurfer software. We examined the correlation between hippocampal subfield volumes and memory scores. Smaller ipsilesional presubiculum and subiculum volumes were observed, and former was related to graphics recall in both left and right TI patients. The left subiculum volume was correlated with short-delayed recall in left TI patients. The right presubiculum volume was correlated with short- and long-delayed recall in right TI patients. TI was found to result in hippocampal abnormality and memory deficits, and its neural mechanisms might be related with and interaction between the thalamus and hippocampus.

  4. Apolipoprotein D is elevated in oligodendrocytes in the peri-infarct region after experimental stroke

    DEFF Research Database (Denmark)

    Rickhag, Karl Mattias; Deierborg, Tomas; Patel, Shutish

    2008-01-01

    Injury to the brain (e.g., stroke) results in a disruption of neuronal connectivity and loss of fundamental sensori-motor functions. The subsequent recovery of certain functions involves structural rearrangements in areas adjacent to the infarct. This remodeling of the injured brain requires...... experimental stroke in the rat brain. In the core of the brain infarct, apoD immunoreactivity but not mRNA increased in dying pyramidal neurons, indicative of cellular redistribution of lipids. During 2 to 7 days of recovery after stroke, the apoD levels increased in the peri-infarct and white matter areas...

  5. Quantitation of size of myocardial infarctions by computerized transmission tomography. Comparison with hot-spot and cold-spot radionuclide scans

    International Nuclear Information System (INIS)

    Gerber, K.H.; Higgins, C.B.

    1983-01-01

    The current study evaluated the ability to quantitate the volume of myocardial infarctions when they are outlined by intravenously administered contrast media in the myocardial perfusion phase and in the phase of delayed contrast enhancement of the infarct. Quantitation by contrast media was assessed from computerized transmission tomography (CTT) scans of the ex situ heart and compared with quantitation by technetium-99m (/sup 99m/Tc)pyrophosphate (/sup 99m/Tc PYP) and thallium-201 (201Tl) scans of the same ex situ hearts. True volume was defined by histochemical morphometry. CTT during the contrast perfusion phase uniformly underestimated infarct size but had a good correlation with true volume. CTT during enhancement phase correlated closely with true volume (r . 0.98) and most precisely measured true size (y . 1.06 X 0.23). The /sup 99m/Tc PYP scan overestimated infarct volume (predictive overestimation of 6 to 199%) but had a good correlation with true volume. 201Tl underestimated infarct volume but correlated well with true volume. Thus, quantitation of infarct volume from CTT scans performed during either the perfusion or infarct enhancement phase after intravenous contrast media provides a good estimate of true infarct volume. Delineation of the infarct by contrast media in the ex situ heart is more precise during the phase of delayed enhancement of the infarct

  6. Quantitative assessment of the infarct size with the unfolded map method of sup 201 Tl myocardial SPECT in patient with acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kubota, Masahiro (Sapporo Medical Coll. (Japan))

    1992-03-01

    The unfolded map method of {sup 201}Tl single photon emission computed tomography (SPECT) was evaluated as to the ability to quantify and the clinical reliability in estimation of infarct size. The following results were obtained from basic experiments using a thoracic phantom. The defect area estimated by the unfolded map method was well correlated with the real defect area, in spite of overestimation of the defect area, when the defect area was determined by an isocount method (below 80% of maximum count) (y=1.941 + 2.292x, r=0.971). The defect volume estimated by short-axis images of {sup 201}Tl SPECT was closely correlated with real defect volume in spite of overestimation of defect volume (y=0.762 + 2.156x, r=0.982). When the defect area was estimated by division of the defect volume by the mean myocardial compartment thickness, it was closely correlated with real defect area (y=0.946 + 1.232x, r=0.990). When the volume was calculated from the summation of voxels in the regions districted by isocount threshold level at each section of the {sup 99m}Tc SPECT, the optimal isocount threshold level (percentage to maximum count) was 55%. Then, the clinical reliability of the unfolded map method as infarct sizing was evaluated in 26 patients with acute myocardial infarction by comparing it with enzymatic method, Bull's eye method, and {sup 99m}Tc pyrophosphate (PYP) SPECT method. In 14 first attack patients without right ventricular infarction, infarct area (IA) of the unfolded map method correlated most closely with the accumulated creatine kinase MB isoenzyme release (CK-MBr) (r=0.897), compared with the extent score (ES) (r=0.853) and the severity score (SS) (r=0.871) of Bull's eye method and the infarct volume (IV) (r=0.595) of {sup 99m}Tc PYP SPECT. In conclusion, although the unfolded map method of {sup 201}Tl SPECT has the tendency for overestimating infarct size, it is accurate and clinically reliable in estimating infarct size. (author).

  7. Brain atrophy during aging

    International Nuclear Information System (INIS)

    Matsuzawa, Taiju; Takeda, Shumpei; Hatazawa, Jun

    1985-01-01

    Age-related brain atrophy was investigated in thousands of persons with no neurologic disturbances using X-CT and NMR-CT and following results were obtained. Brain atrophy was minimal in 34 -- 35 years old in both sexes, increased exponentially to the increasing age after 34 -- 35 years, and probably resulted in dementia, such as vascular or multiinfarct dementia. Brain atrophy was significantly greater in men than in women at all ages. Brain volumes were maximal in 34 -- 35 years old in both sexes with minimal individual differences which increased proportionally to the increasing age. Remarkable individual differences in the extents of brain atrophy (20 -- 30 %) existed among aged subjects. Some aged subjects had little or no atrophy of their brains, as seen in young subjects, and others had markedly shrunken brains associated with senility. From these results there must be pathological factors promoting brain atrophy with a great individual difference. We have studied the relation of intelligence to brain volume, and have ascertained that progression of brain atrophy was closely related to loss of mental activities independently of their ages. Our longitudinal study has revealed that the most important factors promoting brain atrophy during aging was decrease in the cerebral blood flow. MNR-CT can easily detected small infarction (lacunae) and edematous lesions resulting from ischemia and hypertensive encephalopathy, while X-CT can not. Therefore NMR-CT is very useful for detection of subtle changes in the brain. (J.P.N.)

  8. Brain volumes in relatives of patients with schizophrenia - A meta-analysis

    NARCIS (Netherlands)

    Boos, Heleen B. M.; Aleman, Andre; Cahn, Wiepke; Pol, Hilleke Hulshoff; Kahn, Rene S.

    Context: Smaller brain volumes have consistently been found in patients with schizophrenia, particularly in gray matter and medial temporal lobe structures. Although several studies have investigated brain volumes in nonpsychotic relatives of patients with schizophrenia, results have been

  9. Estimation of infarct size by myocardial emission computed tomography with thallium-201 and its relation to creatine kinase-MB release after myocardial infarction in man

    International Nuclear Information System (INIS)

    Tamaki, S.; Nakajima, H.; Murakami, T.

    1982-01-01

    Emission computed tomography (ECT) for thallium-201 ( 201 Tl) myocardial imaging was evaluated in estimating infarct size (IS). In 18 patients in whom IS was estimated enzymatically at the time of the acute episode, planar 201 Tl perfusion scintigraphy and ECT with a rotating gamma camera were performed 4 weeks after the first myocardial infarction. From the size of 201 Tl perfusion defects, the infarct area in planar images and the infarct volume in reconsturcted ECT images were measured by computerized planimetry. When scintigraphic IS was compared with the accumulated creatine kinase-MB isoenzyme release (CK-MBr), infarct volume determined from ECT correlated closely with CK-MBr (r=0.89), whereas infarct area measured from planar images correlated less satisfactorily with the enzymatic IS (for an average infarct area from three views, r=0.69; for the largest infarct area, r=0.73). Although conventional scintigraphic evaluation is useful for detecting and localizing infarction, quantification of ischemic injury with this two-dimensional technique has a significant inherent limitation. The ECT approach can provide a more accurate three-dimensional quantitative estimate of infarction, and can corroborate the enzymatic estimate of IS

  10. Estimation of infarct size by myocardial emission computed tomography with 201Tl and its relation to creatine kinase-MB release after myocardial infarction in man

    International Nuclear Information System (INIS)

    Tamaki, S.; Nakajima, H.; Murakami, T.

    1982-01-01

    We evaluated emission computed tomography (ECT) 201 Tl myocardial imaging in estimating infarct size (IS). In 18 patients in whom IS was estimated enzymatically at the time of the acute episode, planar 201 Tl perfusion scintigraphy and ECT with a rotating gamma camera were performed 4 weeks after the first myocardial infarction. From the size of 201 Tl perfusion defects, the infarct area in planar images and the infarct volume in reconstructed ECT images were measured by computerized planimetry. When scintigraphic IS was compared with the accumulated creatine kinase-MB isoenzyme release (CK-MBr), infarct volume determined from ECT correlated closely with CK-MBr (r . 0.89), whereas infarct area measured from planar images correlated less satisfactorily with the enzymatic IS (for an average infarct area from three views, r . 0.69; for the largest infarct area, r . 0.73). Although conventional scintigraphic evaluation is useful for detecting and localizing infarction, quantification of ischemic injury with this two-dimensional technique has a significant inherent limitation. The ECT approach can provide a more accurate three-dimensional quantitative estimate of infarction, and can corroborate the enzymatic estimate of IS

  11. Genetic influences on schizophrenia and subcortical brain volumes

    DEFF Research Database (Denmark)

    Franke, Barbara; Stein, Jason L; Ripke, Stephan

    2016-01-01

    and subcortical volume measures either at the level of common variant genetic architecture or for single genetic markers. These results provide a proof of concept (albeit based on a limited set of structural brain measures) and define a roadmap for future studies investigating the genetic covariance between...... genome-wide data to investigate genetic overlap. Here we integrated results from common variant studies of schizophrenia (33,636 cases, 43,008 controls) and volumes of several (mainly subcortical) brain structures (11,840 subjects). We did not find evidence of genetic overlap between schizophrenia risk...

  12. Factors associated with the misdiagnosis of cerebellar infarction.

    Science.gov (United States)

    Masuda, Yoko; Tei, Hideaki; Shimizu, Satoru; Uchiyama, Shinichiro

    2013-10-01

    Cerebellar infarction is easily misdiagnosed or underdiagnosed. In this study, we investigated factors leading to misdiagnosis of cerebellar infarction in patients with acute ischemic stroke. Data on neurological and radiological findings from 114 consecutive patients with acute cerebellar infarction were analyzed. We investigated factors associated with misdiagnosis from the data on clinical findings. Thirty-two (28%) patients were misdiagnosed on admission. Misdiagnosis was significantly more frequent in patients below 60 years of age and in patients with vertebral artery dissection, and significantly less frequent in patients with dysarthria. It tended to be more frequent in patients with the medial branch of posterior inferior cerebellar artery territory infarction, and infrequent in patients with the medial branch of the superior cerebellar artery territory infarction. Thirty out of 32 (94%) misdiagnosed patients were seen by physicians that were not neurologists at the first visit. Twenty-four of 32 (75%) misdiagnosed patients were screened only by brain CT. However, patients were not checked by brain MRI or follow-up CT until their conditions worsened. Patients below 60 years of age and patients with vertebral artery dissection are more likely to have a cerebellar infarction misdiagnosed by physicians other than neurologists. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Symptom dimensions are associated with progressive brain volume changes in schizophrenia

    NARCIS (Netherlands)

    Collin, G.; Derks, E. M.; van Haren, N. E. M.; Schnack, H. G.; Hulshoff Pol, H. E.; Kahn, R. S.; Cahn, W.

    2012-01-01

    Background: There is considerable variation in progressive brain volume changes in schizophrenia. Whether this is related to the clinical heterogeneity that characterizes the illness remains to be determined. This study examines the relationship between change in brain volume over time and

  14. Multiple determinants of whole and regional brain volume among terrestrial carnivorans.

    Directory of Open Access Journals (Sweden)

    Eli M Swanson

    Full Text Available Mammalian brain volumes vary considerably, even after controlling for body size. Although several hypotheses have been proposed to explain this variation, most research in mammals on the evolution of encephalization has focused on primates, leaving the generality of these explanations uncertain. Furthermore, much research still addresses only one hypothesis at a time, despite the demonstrated importance of considering multiple factors simultaneously. We used phylogenetic comparative methods to investigate simultaneously the importance of several factors previously hypothesized to be important in neural evolution among mammalian carnivores, including social complexity, forelimb use, home range size, diet, life history, phylogeny, and recent evolutionary changes in body size. We also tested hypotheses suggesting roles for these variables in determining the relative volume of four brain regions measured using computed tomography. Our data suggest that, in contrast to brain size in primates, carnivoran brain size may lag behind body size over evolutionary time. Moreover, carnivore species that primarily consume vertebrates have the largest brains. Although we found no support for a role of social complexity in overall encephalization, relative cerebrum volume correlated positively with sociality. Finally, our results support negative relationships among different brain regions after accounting for overall endocranial volume, suggesting that increased size of one brain regions is often accompanied by reduced size in other regions rather than overall brain expansion.

  15. Immunological profile of silent brain infarction and lacunar stroke.

    Directory of Open Access Journals (Sweden)

    Paola Sarchielli

    Full Text Available Neuroinflammation is believed to be involved in the pathophysiological mechanisms of silent brain infarcts (SBI. However, the immunological profile of SBI has been scarcely investigated. In the context of a national research project named SILENCE, aimed at investigating clinical, biochemical and pathogenic features of SBI, we have measured the plasma profile of some inflammatory-related molecules in SBI patients (n = 21, patients with recent lacunar infarcts (LI, n = 28 and healthy controls (n = 31, consecutively enrolled in four Italian centres. A panel of chemokines (MIG, CTACK, IL16, SDF1a, MCP1, growth factors (SCF, SCGFb, HGF, IL3, immunoglobulin-type adhesion molecules (ICAM1, VCAM1, proinflammatory cytokines (IL18, INFa2, MIF, IL12p40, cell surface receptors on T-cells (IL2Ra, and inductors of apoptosis (TRAIL was assessed in plasma samples by Luminex xMAP™ technology. Immunological parameters were compared using non-parametric statistics and performance to distinguish SBI and LI was evaluated by receiver operating characteristic (ROC analysis. Plasma levels of ICAM1 were significantly higher in both SBI and LI patients as compared to controls (SBI≥LI>Ctrl. A different trend was observed for IL16 (SBICtrl, SCF (LICtrl and SCGFb (SBI>LICtrl and IL18 when compared to LI patients (Ctrl≤SBI>LI. All the other immunological markers did not significantly differ among groups. According to ROC analysis, the best predictor for SBI condition was the chemokine MIG (AUC = 0.84, sensitivity 86%, specificity 77%, while SCF had the best performance in distinguishing LI patients (AUC = 0.84, sensitivity 86%, specificity 68%. These results confirm the involvement of inflammatory processes in cerebrovascular disorders, particularly in SBI, a very common age-related condition. The differences in plasma profile of inflammatory molecules may underlie different pathological mechanisms in SBI and LI patients.

  16. Sevoflurane postconditioning against cerebral ischemic neuronal injury is abolished in diet-induced obesity: role of brain mitochondrial KATP channels.

    Science.gov (United States)

    Yang, Zecheng; Chen, Yunbo; Zhang, Yan; Jiang, Yi; Fang, Xuedong; Xu, Jingwei

    2014-03-01

    Obesity is associated with increased infarct volumes and adverse outcomes following ischemic stroke. However, its effect on anesthetic postconditioning‑induced neuroprotection has not been investigated. The present study examined the effect of sevoflurane postconditioning on focal ischemic brain injury in diet‑induced obesity. Sprague‑Dawley rats were fed a high‑fat diet (HF; 45% kcal as fat) for 12 weeks to develop obesity syndrome. Rats fed a low‑fat diet (LF; 10% kcal as fat) served as controls. The HF or LF‑fed rats were subjected to focal cerebral ischemia for 60 min, followed by 24 h of reperfusion. Postconditioning was performed by exposure to sevoflurane for 15 min immediately at the onset of reperfusion. The involvement of the mitochondrial KATP (mitoKATP) channel was analyzed by the administration of a selective inhibitor of 5‑hydroxydecanoate (5‑HD) prior to sevoflurane postconditioning or by administration of diazoxide (DZX), a mitoKATP channel opener, instead of sevoflurane. The cerebral infarct volume, neurological score and motor coordination were evaluated 24 h after reperfusion. The HF‑fed rats had larger infarct volumes, and lower neurological scores than the LF‑fed rats and also failed to respond to neuroprotection by sevoflurane or DZX. By contrast, sevoflurane and DZX reduced the infarct volumes and improved the neurological scores and motor coordination in the LF‑fed rats. Pretreatment with 5‑HD inhibited sevoflurane‑induced neuroprotection in the LF‑fed rats, whereas it had no effect in the HF‑fed rats. Molecular studies demonstrated that the expression of Kir6.2, a significant mitoKATP channel component, was reduced in the brains of the HF‑fed rats compared with the LF‑fed rats. The results of this study indicate that diet‑induced obesity eliminates the ability of anesthetic sevoflurane postconditioning to protect the brain against cerebral ischemic neuronal injury, most likely due to an impaired brain

  17. Brain volumes predict neurodevelopment in adolescents after surgery for congenital heart disease.

    Science.gov (United States)

    von Rhein, Michael; Buchmann, Andreas; Hagmann, Cornelia; Huber, Reto; Klaver, Peter; Knirsch, Walter; Latal, Beatrice

    2014-01-01

    Patients with complex congenital heart disease are at risk for neurodevelopmental impairments. Evidence suggests that brain maturation can be delayed and pre- and postoperative brain injury may occur, and there is limited information on the long-term effect of congenital heart disease on brain development and function in adolescent patients. At a mean age of 13.8 years, 39 adolescent survivors of childhood cardiopulmonary bypass surgery with no structural brain lesions evident through conventional cerebral magnetic resonance imaging and 32 healthy control subjects underwent extensive neurodevelopmental assessment and cerebral magnetic resonance imaging. Cerebral scans were analysed quantitatively using surface-based and voxel-based morphometry. Compared with control subjects, patients had lower total brain (P = 0.003), white matter (P = 0.004) and cortical grey matter (P = 0.005) volumes, whereas cerebrospinal fluid volumes were not different. Regional brain volume reduction ranged from 5.3% (cortical grey matter) to 11% (corpus callosum). Adolescents with cyanotic heart disease showed more brain volume loss than those with acyanotic heart disease, particularly in the white matter, thalami, hippocampi and corpus callosum (all P-values Brain volume reduction correlated significantly with cognitive, motor and executive functions (grey matter: P < 0.05, white matter: P < 0.01). Our findings suggest that there are long-lasting cerebral changes in adolescent survivors of cardiopulmonary bypass surgery for congenital heart disease and that these changes are associated with functional outcome.

  18. Corpus callosum thickness on mid-sagittal MRI as a marker of brain volume: a pilot study in children with HIV-related brain disease and controls

    Energy Technology Data Exchange (ETDEWEB)

    Andronikou, Savvas [University of the Witwatersrand, Department of Radiology, Faculty of Health Sciences, Cape Town (South Africa); Ackermann, Christelle [University of Stellenbosch, Department of Radiology, Stellenbosch (South Africa); Laughton, Barbara; Cotton, Mark [Stellenbosch University and Tygerberg Children' s Hospital, Children' s Infectious Diseases Research Unit, Stellenbosch (South Africa); Tomazos, Nicollette [University of Cape Town, Faculty of Commerce, Department of Management Studies, Cape Town (South Africa); Spottiswoode, Bruce [University of Cape Town, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Cape Town (South Africa); Mauff, Katya [University of Cape Town, Department of Statistical Sciences, Cape Town (South Africa); Pettifor, John M. [University of the Witwatersrand, MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, Witwatersrand (South Africa)

    2015-07-15

    Corpus callosum thickness measurement on mid-sagittal MRI may be a surrogate marker of brain volume. This is important for evaluation of diseases causing brain volume gain or loss, such as HIV-related brain disease and HIV encephalopathy. To determine if thickness of the corpus callosum on mid-sagittal MRI is a surrogate marker of brain volume in children with HIV-related brain disease and in controls without HIV. A retrospective MRI analysis in children (<5 years old) with HIV-related brain disease and controls used a custom-developed semi-automated tool, which divided the midline corpus callosum and measured its thickness in multiple locations. Brain volume was determined using volumetric analysis. Overall corpus callosum thickness and thickness of segments of the corpus callosum were correlated with overall and segmented (grey and white matter) brain volume. Forty-four children (33 HIV-infected patients and 11 controls) were included. Significant correlations included overall corpus callosum (mean) and total brain volume (P = 0.05); prefrontal corpus callosum maximum with white matter volume (P = 0.02); premotor corpus callosum mean with total brain volume (P = 0.04) and white matter volume (P = 0.02), premotor corpus callosum maximum with white matter volume (P = 0.02) and sensory corpus callosum mean with total brain volume (P = 0.02). Corpus callosum thickness correlates with brain volume both in HIV-infected patients and controls. (orig.)

  19. Corpus callosum thickness on mid-sagittal MRI as a marker of brain volume: a pilot study in children with HIV-related brain disease and controls

    International Nuclear Information System (INIS)

    Andronikou, Savvas; Ackermann, Christelle; Laughton, Barbara; Cotton, Mark; Tomazos, Nicollette; Spottiswoode, Bruce; Mauff, Katya; Pettifor, John M.

    2015-01-01

    Corpus callosum thickness measurement on mid-sagittal MRI may be a surrogate marker of brain volume. This is important for evaluation of diseases causing brain volume gain or loss, such as HIV-related brain disease and HIV encephalopathy. To determine if thickness of the corpus callosum on mid-sagittal MRI is a surrogate marker of brain volume in children with HIV-related brain disease and in controls without HIV. A retrospective MRI analysis in children (<5 years old) with HIV-related brain disease and controls used a custom-developed semi-automated tool, which divided the midline corpus callosum and measured its thickness in multiple locations. Brain volume was determined using volumetric analysis. Overall corpus callosum thickness and thickness of segments of the corpus callosum were correlated with overall and segmented (grey and white matter) brain volume. Forty-four children (33 HIV-infected patients and 11 controls) were included. Significant correlations included overall corpus callosum (mean) and total brain volume (P = 0.05); prefrontal corpus callosum maximum with white matter volume (P = 0.02); premotor corpus callosum mean with total brain volume (P = 0.04) and white matter volume (P = 0.02), premotor corpus callosum maximum with white matter volume (P = 0.02) and sensory corpus callosum mean with total brain volume (P = 0.02). Corpus callosum thickness correlates with brain volume both in HIV-infected patients and controls. (orig.)

  20. The effect of ultrasound on thromboembolic model of brain stroke in rat

    Directory of Open Access Journals (Sweden)

    Shabanzadeh A

    2007-08-01

    Full Text Available Background: Ultrasound (US has been used in neuroprotection after cerebral ischemia; however, its use is controversial. Application of US in combination with fibrinolytic agents may improve fibrinolytic effects. In this study the effects of US, alone or in combination with tissue plasminogen activator (tPA, on brain ischemic injury were examined and we studied whether US is protective in the brain injured by ischemia under normothermic conditions. Methods: We performed two studies. In the first study, rectal and brain temperatures were compared. In the second study, we studied whether US alone or in combination with tPA is neuroprotective in thromboembolic stroke. To induce focal cerebral ischemia, a clot was formed in a catheter. Once the clot had formed, the catheter was advanced 17 mm in the internal carotid artery until its tip was 1-2 mm away from the origin of the middle cerebral artery (MCA. The preformed clot in the catheter was then injected, and the catheter was removed. The wound was then closed and the infarction volume, edema and neurological deficits were measured after MCA occlusion. Results: The temperature in the brain was approximately 0.50 ºC lower than the rectal temperature. In the control, US+low tPA, low tPA, US+high tPA and, high tPA groups, the infarct volume (% was 34.56±4.16, 17.09±6.72, 21.25±7.8, 13.5±10.72 and 20.61±6.17 (mean ±SD at 48 h after MCA occlusion, respectively. The results indicate that US alone reduces the infarct volume by 30% compared to that of the control group (P<0.05. US improved neurological deficits and reduced brain edema significantly (p<0.05. Conclusions: This study indicate that US appears to have a protective effect, alone and in combination with tPA, in an embolic model of stroke.

  1. Increased brain iron deposition is a risk factor for brain atrophy in patients with haemodialysis: a combined study of quantitative susceptibility mapping and whole brain volume analysis.

    Science.gov (United States)

    Chai, Chao; Zhang, Mengjie; Long, Miaomiao; Chu, Zhiqiang; Wang, Tong; Wang, Lijun; Guo, Yu; Yan, Shuo; Haacke, E Mark; Shen, Wen; Xia, Shuang

    2015-08-01

    To explore the correlation between increased brain iron deposition and brain atrophy in patients with haemodialysis and their correlation with clinical biomarkers and neuropsychological test. Forty two patients with haemodialysis and forty one age- and gender-matched healthy controls were recruited in this prospective study. 3D whole brain high resolution T1WI and susceptibility weighted imaging were scanned on a 3 T MRI system. The brain volume was analyzed using voxel-based morphometry (VBM) in patients and to compare with that of healthy controls. Quantitative susceptibility mapping was used to measure and compare the susceptibility of different structures between patients and healthy controls. Correlation analysis was used to investigate the relationship between the brain volume, iron deposition and neuropsychological scores. Stepwise multiple regression analysis was used to explore the effect of clinical biomarkers on the brain volumes in patients. Compared with healthy controls, patients with haemodialysis showed decreased volume of bilateral putamen and left insular lobe (All P brain iron deposition is negatively correlated with the decreased volume of bilateral putamen (P brain iron deposition and dialysis duration was risk factors for brain atrophy in patients with haemodialysis. The decreased gray matter volume of the left insular lobe was correlated with neurocognitive impairment.

  2. Associations Between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results

    Directory of Open Access Journals (Sweden)

    Hannah Lyden

    2016-09-01

    Full Text Available Associations between brain structure and early adversity have been inconsistent in the literature. These inconsistencies may be partially due to methodological differences. Different methods of brain segmentation may produce different results, obscuring the relationship between early adversity and brain volume. Moreover, adolescence is a time of significant brain growth and certain brain areas have distinct rates of development, which may compromise the accuracy of automated segmentation approaches. In the current study, 23 adolescents participated in two waves of a longitudinal study. Family aggression was measured when the youths were 12 years old, and structural scans were acquired an average of 4 years later. Bilateral amygdalae and hippocampi were segmented using three different methods (manual tracing, FSL, and NeuroQuant. The segmentation estimates were compared, and linear regressions were run to assess the relationship between early family aggression exposure and all three volume segmentation estimates. Manual tracing results showed a positive relationship between family aggression and right amygdala volume, whereas FSL segmentation showed negative relationships between family aggression and both the left and right hippocampi. However, results indicate poor overlap between methods, and different associations between early family aggression exposure and brain volume depending on the segmentation method used.

  3. Associations between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results.

    Science.gov (United States)

    Lyden, Hannah; Gimbel, Sarah I; Del Piero, Larissa; Tsai, A Bryna; Sachs, Matthew E; Kaplan, Jonas T; Margolin, Gayla; Saxbe, Darby

    2016-01-01

    Associations between brain structure and early adversity have been inconsistent in the literature. These inconsistencies may be partially due to methodological differences. Different methods of brain segmentation may produce different results, obscuring the relationship between early adversity and brain volume. Moreover, adolescence is a time of significant brain growth and certain brain areas have distinct rates of development, which may compromise the accuracy of automated segmentation approaches. In the current study, 23 adolescents participated in two waves of a longitudinal study. Family aggression was measured when the youths were 12 years old, and structural scans were acquired an average of 4 years later. Bilateral amygdalae and hippocampi were segmented using three different methods (manual tracing, FSL, and NeuroQuant). The segmentation estimates were compared, and linear regressions were run to assess the relationship between early family aggression exposure and all three volume segmentation estimates. Manual tracing results showed a positive relationship between family aggression and right amygdala volume, whereas FSL segmentation showed negative relationships between family aggression and both the left and right hippocampi. However, results indicate poor overlap between methods, and different associations were found between early family aggression exposure and brain volume depending on the segmentation method used.

  4. Gastroschisis, destructive brain lesions, and placental infarction in the second trimester suggest a vascular pathogenesis.

    Science.gov (United States)

    Folkerth, Rebecca D; Habbe, Donald M; Boyd, Theonia K; McMillan, Kristin; Gromer, Jessica; Sens, Mary Ann; Elliott, Amy J

    2013-01-01

    The cause and pathogenesis of gastroschisis are uncertain. We report the autopsy and placental pathology of a stillbirth at 20 gestational weeks, in which gastroschisis was accompanied by destructive lesions in the cerebral cortex and brainstem, as well as cardiac calcification, consistent with ischemic injury during the 2nd trimester. An important potential underlying mechanism explaining the fetal abnormalities is the presence of infarcts in the placenta, indicative at this gestational age of maternal vascular underperfusion. The association of gastroschisis with ischemic lesions in the brain, heart, and placenta in this case supports the concept that gastroschisis, at least in some instances, may result from vascular event(s) causing disruption of the fetal abdominal wall and resulting in the extrusion of the abdominal organs, as well as hypoxic-ischemic brain and cardiac injury.

  5. Dynamic CT scan in cerebral infarction

    International Nuclear Information System (INIS)

    Kobayashi, Shigeki; Oka, Nobuo; Mitsuhashi, Hiromitsu

    1984-01-01

    Forty-two dynamic CT studies were performed on 27 patients with cerebral infarction (11 to 75 years of age), and perfusion patterns of low density areas on plain CT were evaluated. The initial studies were performed 1.5 hours to 60 days after acute onset. The following results were obtained. 1) The perfusion pattern in the low density area on plain CT varies among patients at any periods after onset, ranging from absent perfusion pattern to hyperfusion pattern. No consisitent perfusion pattern was obtained at any given time after onset. 2) Repeat dynamic CT revealed that the perfusion pattern in the low density area changed with time variously. 3) The perfusion pattern or change of perfusion pattern did not correlate with outcome of the patient. 4) At an acute stage, when no abnormal findings were obtained on plain CT, dynamic CT revealed abnormal perfusion pattern, enabling early diagnosis of cerebral infarction and estimation of blood perfusion in the infarcted area. In determining the treatment for the cerebral infarction at an acute stage, it is important to know the condition of the blood perfusion in the infarcted area. For the patients in whom recanalization has already taken place, mannitol or steroid might be effective, providing protection against severe brain edema and hemorrhagic infarction. On the other hand, if recanalization has not taken place, revascularization therapy might be worth trying within 6 hours since the onset. It has been said that ischemic brain damage may not be reversed by the revascularization after 6 hours. Dynamic CT is safe, less invasive, convenient and very useful for early diagnosis of the cerebral infarction and determination of the treatment at the acute stage. (J.P.N.)

  6. Serial MR observation of cortical laminar necrosis caused by brain infarction

    Energy Technology Data Exchange (ETDEWEB)

    Komiyama, M.; Nakajima, H.; Nishikawa, M.; Yasui, T. [Department of Neurosurgery, Osaka City General Hospital (Japan)

    1998-12-01

    To examine the chronological changes characteristic of cortical laminar necrosis caused by brain infarction, 16 patients were repeatedly examined using T1-, T2-weighted spin-echo, T2{sup *}-weighted gradient echo, fluid attenuated inversion recovery (FLAIR) images, and contrast enhanced T1-weighted images at 1.0 or 1.5 T. High intensity cortical lesions were visible on the T1-weighted images from 2 weeks after ictus and became prominent at 1 to 3 months, then became less apparent, but occasionally remained at high intensity for 2 years. High intensity cortical lesions on FLAIR images became prominent from 1 month, and then became less prominent from 1 year, but occasionally remained at high intensity for 2 years. Subcortical lesions did not display high intensity on T1-weighted images at any stage. On FLAIR images, subcortical lesions initially showed slightly high intensity and then low intensity from 6 months due to encephalomalacia. Cortical lesions showed prominent contrast enhancement from 2 weeks to 3 months, but subcortical lesions were prominent from 2 weeks only up to 1 month. T2*-weighted images disclosed haemosiderin in 3 of 7 patients, but there was no correlation with cortical short T1 lesions. Cortical laminar necrosis showed characteristic chronological signal changes on T1-weighted images and FLAIR images. Cortical short T1 lesions were found not to be caused by haemorrhagic infarction. (orig.) With 5 figs., 1 tab., 9 refs.

  7. MRI volume measurement of the brain in schizophrenia

    International Nuclear Information System (INIS)

    Someya, Yasuhiro; Abe, Tetsuo; Asai, Kunihiko; Okubo, Yoshirou; Toru, Michio.

    1996-01-01

    The T1-weighted images of whole-brain three-dimensional MRI (thickness, 3 mm; interval, 3 mm) were obtained from schizophrenic patients and 20 healthy volunteers. Detailed volumetric measurement of each part in the brain was carried out. As the result, the volume of both ventricles and third ventriculus cerebri in the schizophrenic group was significantly larger than that of the control group. No significant difference was observed in terms of the volume of the bilateral frontal lobe, bilateral body of caudate nucleus division and right temporal lobe. The volume of bilateral hippocampus and left temporal lobe of the schizophrenic group was significantly smaller than that of the control group. Negative correlation was observed between symptoms and the right temporal lobe volume (r=-0.41) in the schizophrenic group. In the schizophrenic group, morphological abnormality was admitted in the hippocampus, ventriculus cerebri and left temporal lobe. The morphological abnormality of the right temporal lobe seemed to involve the expression of negative symptoms. (S.Y.)

  8. Postmenopausal hormone therapy and regional brain volumes: the WHIMS-MRI Study.

    Science.gov (United States)

    Resnick, S M; Espeland, M A; Jaramillo, S A; Hirsch, C; Stefanick, M L; Murray, A M; Ockene, J; Davatzikos, C

    2009-01-13

    To determine whether menopausal hormone therapy (HT) affects regional brain volumes, including hippocampal and frontal regions. Brain MRI scans were obtained in a subset of 1,403 women aged 71-89 years who participated in the Women's Health Initiative Memory Study (WHIMS). WHIMS was an ancillary study to the Women's Health Initiative, which consisted of two randomized, placebo-controlled trials: 0.625 mg conjugated equine estrogens (CEE) with or without 2.5 mg medroxyprogesterone acetate (MPA) in one daily tablet. Scans were performed, on average, 3.0 years post-trial for the CEE + MPA trial and 1.4 years post-trial for the CEE-Alone trial; average on-trial follow-up intervals were 4.0 years for CEE + MPA and 5.6 years for CEE-Alone. Total brain, ventricular, hippocampal, and frontal lobe volumes, adjusted for age, clinic site, estimated intracranial volume, and dementia risk factors, were the main outcome variables. Compared with placebo, covariate-adjusted mean frontal lobe volume was 2.37 cm(3) lower among women assigned to HT (p = 0.004), mean hippocampal volume was slightly (0.10 cm(3)) lower (p = 0.05), and differences in total brain volume approached significance (p = 0.07). Results were similar for CEE + MPA and CEE-Alone. HT-associated reductions in hippocampal volumes were greatest in women with the lowest baseline Modified Mini-Mental State Examination scores (scores equine estrogens with or without MPA are associated with greater brain atrophy among women aged 65 years and older; however, the adverse effects are most evident in women experiencing cognitive deficits before initiating hormone therapy.

  9. Zingiber officinale Mitigates Brain Damage and Improves Memory Impairment in Focal Cerebral Ischemic Rat

    Science.gov (United States)

    Wattanathorn, Jintanaporn; Jittiwat, Jinatta; Tongun, Terdthai; Muchimapura, Supaporn; Ingkaninan, Kornkanok

    2011-01-01

    Cerebral ischemia is known to produce brain damage and related behavioral deficits including memory. Recently, accumulating lines of evidence showed that dietary enrichment with nutritional antioxidants could reduce brain damage and improve cognitive function. In this study, possible protective effect of Zingiber officinale, a medicinal plant reputed for neuroprotective effect against oxidative stress-related brain damage, on brain damage and memory deficit induced by focal cerebral ischemia was elucidated. Male adult Wistar rats were administrated an alcoholic extract of ginger rhizome orally 14 days before and 21 days after the permanent occlusion of right middle cerebral artery (MCAO). Cognitive function assessment was performed at 7, 14, and 21 days after MCAO using the Morris water maze test. The brain infarct volume and density of neurons in hippocampus were also determined. Furthermore, the level of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) in cerebral cortex, striatum, and hippocampus was also quantified at the end of experiment. The results showed that cognitive function and neurons density in hippocampus of rats receiving ginger rhizome extract were improved while the brain infarct volume was decreased. The cognitive enhancing effect and neuroprotective effect occurred partly via the antioxidant activity of the extract. In conclusion, our study demonstrated the beneficial effect of ginger rhizome to protect against focal cerebral ischemia. PMID:21197427

  10. Zingiber officinale Mitigates Brain Damage and Improves Memory Impairment in Focal Cerebral Ischemic Rat

    Directory of Open Access Journals (Sweden)

    Jintanaporn Wattanathorn

    2011-01-01

    Full Text Available Cerebral ischemia is known to produce brain damage and related behavioral deficits including memory. Recently, accumulating lines of evidence showed that dietary enrichment with nutritional antioxidants could reduce brain damage and improve cognitive function. In this study, possible protective effect of Zingiber officinale, a medicinal plant reputed for neuroprotective effect against oxidative stress-related brain damage, on brain damage and memory deficit induced by focal cerebral ischemia was elucidated. Male adult Wistar rats were administrated an alcoholic extract of ginger rhizome orally 14 days before and 21 days after the permanent occlusion of right middle cerebral artery (MCAO. Cognitive function assessment was performed at 7, 14, and 21 days after MCAO using the Morris water maze test. The brain infarct volume and density of neurons in hippocampus were also determined. Furthermore, the level of malondialdehyde (MDA, superoxide dismutase (SOD, catalase (CAT, and glutathione peroxidase (GSH-Px in cerebral cortex, striatum, and hippocampus was also quantified at the end of experiment. The results showed that cognitive function and neurons density in hippocampus of rats receiving ginger rhizome extract were improved while the brain infarct volume was decreased. The cognitive enhancing effect and neuroprotective effect occurred partly via the antioxidant activity of the extract. In conclusion, our study demonstrated the beneficial effect of ginger rhizome to protect against focal cerebral ischemia.

  11. Comparison of Perfusion CT Software to Predict the Final Infarct Volume After Thrombectomy.

    Science.gov (United States)

    Austein, Friederike; Riedel, Christian; Kerby, Tina; Meyne, Johannes; Binder, Andreas; Lindner, Thomas; Huhndorf, Monika; Wodarg, Fritz; Jansen, Olav

    2016-09-01

    Computed tomographic perfusion represents an interesting physiological imaging modality to select patients for reperfusion therapy in acute ischemic stroke. The purpose of our study was to determine the accuracy of different commercial perfusion CT software packages (Philips (A), Siemens (B), and RAPID (C)) to predict the final infarct volume (FIV) after mechanical thrombectomy. Single-institutional computed tomographic perfusion data from 147 mechanically recanalized acute ischemic stroke patients were postprocessed. Ischemic core and FIV were compared about thrombolysis in cerebral infarction (TICI) score and time interval to reperfusion. FIV was measured at follow-up imaging between days 1 and 8 after stroke. In 118 successfully recanalized patients (TICI 2b/3), a moderately to strongly positive correlation was observed between ischemic core and FIV. The highest accuracy and best correlation are shown in early and fully recanalized patients (Pearson r for A=0.42, B=0.64, and C=0.83; P<0.001). Bland-Altman plots and boxplots demonstrate smaller ranges in package C than in A and B. Significant differences were found between the packages about over- and underestimation of the ischemic core. Package A, compared with B and C, estimated more than twice as many patients with a malignant stroke profile (P<0.001). Package C best predicted hypoperfusion volume in nonsuccessfully recanalized patients. Our study demonstrates best accuracy and approximation between the results of a fully automated software (RAPID) and FIV, especially in early and fully recanalized patients. Furthermore, this software package overestimated the FIV to a significantly lower degree and estimated a malignant mismatch profile less often than other software. © 2016 American Heart Association, Inc.

  12. Senior Dance Experience, Cognitive Performance, and Brain Volume in Older Women

    Directory of Open Access Journals (Sweden)

    Claudia Niemann

    2016-01-01

    Full Text Available Physical activity is positively related to cognitive functioning and brain volume in older adults. Interestingly, different types of physical activity vary in their effects on cognition and on the brain. For example, dancing has become an interesting topic in aging research, as it is a popular leisure activity among older adults, involving cardiovascular and motor fitness dimensions that can be positively related to cognition. However, studies on brain structure are missing. In this study, we tested the association of long-term senior dance experience with cognitive performance and gray matter brain volume in older women aged 65 to 82 years. We compared nonprofessional senior dancers (n=28 with nonsedentary control group participants without any dancing experience (n=29, who were similar in age, education, IQ score, lifestyle and health factors, and fitness level. Differences neither in the four tested cognitive domains (executive control, perceptual speed, episodic memory, and long-term memory nor in brain volume (VBM whole-brain analysis, region-of-interest analysis of the hippocampus were observed. Results indicate that moderate dancing activity (1-2 times per week, on average has no additional effects on gray matter volume and cognitive functioning when a certain lifestyle or physical activity and fitness level are reached.

  13. The free radical spin-trap alpha-PBN attenuates periinfarct depolarizations following permanent middle cerebral artery occlusion in rats without reducing infarct volume

    DEFF Research Database (Denmark)

    Christensen, Thomas; Bruhn, Torben; Diemer, Nils Henrik

    2003-01-01

    (control: 28.3+/-16.3 mm3 vs. alpha-PBN 23.7+/-7.4 mm3). In the second series of experiments, periinfarct depolarizations (PIDs) were recorded with an extracellular DC electrode at two locations in the ischemic penumbra for the initial 3 h following MCAO. alpha-PBN (100 mg/kg, single dose in conjunction...... with occlusion) significantly reduced the total number (median value of 3 PIDs in the control groups vs. 1 PID in alpha-PBN groups, p...... with a single dose of alpha-PBN (100 mg/kg) or saline. Body temperature was measured and controlled for the first 24 h to obtain identical temperature curves in the two groups. Cortical infarct volumes were determined on histological sections 7 days later. alpha-PBN did not significantly reduce infarct volume...

  14. Clinical Relevance of Brain Volume Measures in Multiple Sclerosis

    DEFF Research Database (Denmark)

    De Stefano, Nicola; Airas, Laura; Grigoriadis, Nikolaos

    2014-01-01

    Multiple sclerosis (MS) is a chronic disease with an inflammatory and neurodegenerative pathology. Axonal loss and neurodegeneration occurs early in the disease course and may lead to irreversible neurological impairment. Changes in brain volume, observed from the earliest stage of MS...... therefore have important clinical implications affecting treatment decisions, with several clinical trials now demonstrating an effect of disease-modifying treatments (DMTs) on reducing brain volume loss. In clinical practice, it may therefore be important to consider the potential impact of a therapy...

  15. Relations between brain volumes, neuropsychological assessment and parental questionnaire in prematurely born children.

    Science.gov (United States)

    Lind, Annika; Haataja, Leena; Rautava, Liisi; Väliaho, Anniina; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Korkman, Marit

    2010-05-01

    The objective of this study is to assess the relationship between brain volumes at term equivalent age and neuropsychological functions at 5 years of age in very low birth weight (VLBW) children, and to compare the results from a neuropsychological assessment and a parental questionnaire at 5 years of age. The study group included a regional cohort of 97 VLBW children and a control group of 161 children born at term. At term equivalent age, brain magnetic resonance imaging (MRI) was performed on the VLBW children, and analysed for total and regional brain volumes. At 5 years of age, a psychologist assessed the neuropsychological performance with NEPSY II, and parents completed the Five to fifteen (FTF) questionnaire on development and behaviour. The results of the control group were used to give the age-specific reference values. No significant associations were found between the brain volumes and the NEPSY II domains. As for the FTF, significant associations were found between a smaller total brain tissue volume and poorer executive functions, between a smaller cerebellar volume and both poorer executive functions and motor skills, and, surprisingly, between a larger volume of brainstem and poorer language functions. Even after adjustment for total brain tissue volume, the two associations between the cerebellar volume and the FTF domains remained borderline significant (P = 0.05). The NEPSY II domains Executive Functioning, Language and Motor Skills were significantly associated with the corresponding FTF domains. In conclusion, altered brain volumes at term equivalent age appear to affect development still at 5 years of age. The FTF seems to be a good instrument when used in combination with other neuropsychological assessment.

  16. Regional cerebral blood flow and brain atrophy in senile dementia of Alzheimer type (SDAT). Comparing with multi-infarct dementia (MID), and aged control

    Energy Technology Data Exchange (ETDEWEB)

    Okada, K; Kobayashi, S; Yamaguchi, S; Kitani, M; Tsunematsu, T

    1987-05-01

    To investigate the relationship between the reduction of cerebal blood flow and brain atrophy in SDAT, these were measured in 13 cases of senile dementia of Alzheimer type, and compared to 15 cases of multi-infarct Dementia, 39 cases of lacunar infarction without dementia (non-demented CVD group) and 69 cases of aged normal control. Brain atrophy was evaluated by two-dimensional method on CT film by digitizer and regional cerebral blood flow (rCBF) was measured by /sup 133/Xe inhalation method. The degree of brain atrophy in SDAT was almost similar of that of MID. But it was more severe than that of non-demented group. MID showed the lowest rCBF among these groups. SDAT showed significantly lower rCBF than that of aged control, but rCBF in SDAT was equal to that of lacunar stroke without dementia. Focal reduction of cerebral blood flow in bilateral fronto-parietal and left occipital regions were observed in SDAT. Verbal intelligence score (Hasegawa's score) correlated with rCBF and brain atrophy index in MID, and a tendency of correlation between rCBF and brain atrophy in MID was also observed. However, there was no correlation among those indices in SDAT. These findings suggest that the loss of brain substance dose not correspond to the reduction of rCBF in SDAT and simultaneous measurement of rCBF and brain atrophy was useful to differ SDAT from MID.

  17. Change in brain and lesion volumes after CEE therapies: the WHIMS-MRI studies.

    Science.gov (United States)

    Coker, Laura H; Espeland, Mark A; Hogan, Patricia E; Resnick, Susan M; Bryan, R Nick; Robinson, Jennifer G; Goveas, Joseph S; Davatzikos, Christos; Kuller, Lewis H; Williamson, Jeff D; Bushnell, Cheryl D; Shumaker, Sally A

    2014-02-04

    To determine whether smaller brain volumes in older women who had completed Women's Health Initiative (WHI)-assigned conjugated equine estrogen-based hormone therapy (HT), reported by WHI Memory Study (WHIMS)-MRI, correspond to a continuing increased rate of atrophy an average of 6.1 to 7.7 years later in WHIMS-MRI2. A total of 1,230 WHI participants were contacted: 797 (64.8%) consented, and 729 (59%) were rescanned an average of 4.7 years after the initial MRI scan. Mean annual rates of change in total brain volume, the primary outcome, and rates of change in ischemic lesion volumes, the secondary outcome, were compared between treatment groups using mixed-effect models with adjustment for trial, clinical site, age, intracranial volumes, and time between MRI measures. Total brain volume decreased an average of 3.22 cm(3)/y in the active arm and 3.07 cm(3)/y in the placebo arm (p = 0.53). Total ischemic lesion volumes increased in both arms at a rate of 0.12 cm(3)/y (p = 0.88). Conjugated equine estrogen-based postmenopausal HT, previously assigned at WHI baseline, did not affect rates of decline in brain volumes or increases in brain lesion volumes during the 4.7 years between the initial and follow-up WHIMS-MRI studies. Smaller frontal lobe volumes were observed as persistent group differences among women assigned to active HT compared with placebo. Women with a history of cardiovascular disease treated with active HT, compared with placebo, had higher rates of accumulation in white matter lesion volume and total brain lesion volume. Further study may elucidate mechanisms that explain these findings.

  18. Big Cat Coalitions: A Comparative Analysis of Regional Brain Volumes in Felidae.

    Science.gov (United States)

    Sakai, Sharleen T; Arsznov, Bradley M; Hristova, Ani E; Yoon, Elise J; Lundrigan, Barbara L

    2016-01-01

    Broad-based species comparisons across mammalian orders suggest a number of factors that might influence the evolution of large brains. However, the relationship between these factors and total and regional brain size remains unclear. This study investigated the relationship between relative brain size and regional brain volumes and sociality in 13 felid species in hopes of revealing relationships that are not detected in more inclusive comparative studies. In addition, a more detailed analysis was conducted of four focal species: lions ( Panthera leo ), leopards ( Panthera pardus ), cougars ( Puma concolor ), and cheetahs ( Acinonyx jubatus ). These species differ markedly in sociality and behavioral flexibility, factors hypothesized to contribute to increased relative brain size and/or frontal cortex size. Lions are the only truly social species, living in prides. Although cheetahs are largely solitary, males often form small groups. Both leopards and cougars are solitary. Of the four species, leopards exhibit the most behavioral flexibility, readily adapting to changing circumstances. Regional brain volumes were analyzed using computed tomography. Skulls ( n = 75) were scanned to create three-dimensional virtual endocasts, and regional brain volumes were measured using either sulcal or bony landmarks obtained from the endocasts or skulls. Phylogenetic least squares regression analyses found that sociality does not correspond with larger relative brain size in these species. However, the sociality/solitary variable significantly predicted anterior cerebrum (AC) volume, a region that includes frontal cortex. This latter finding is despite the fact that the two social species in our sample, lions and cheetahs, possess the largest and smallest relative AC volumes, respectively. Additionally, an ANOVA comparing regional brain volumes in four focal species revealed that lions and leopards, while not significantly different from one another, have relatively larger AC

  19. Big Cat Coalitions: A comparative analysis of regional brain volumes in Felidae

    Directory of Open Access Journals (Sweden)

    Sharleen T Sakai

    2016-10-01

    Full Text Available Broad-based species comparisons across mammalian orders suggest a number of factors that might influence the evolution of large brains. However, the relationship between these factors and total and regional brain size remains unclear. This study investigated the relationship between relative brain size and regional brain volumes and sociality in 13 felid species in hopes of revealing relationships that are not detected in more inclusive comparative studies. In addition, a more detailed analysis was conducted of 4 focal species: lions (Panthera leo, leopards (Panthera pardus, cougars (Puma concolor, and cheetahs (Acinonyx jubatus. These species differ markedly in sociality and behavioral flexibility, factors hypothesized to contribute to increased relative brain size and/or frontal cortex size. Lions are the only truly social species, living in prides. Although cheetahs are largely solitary, males often form small groups. Both leopards and cougars are solitary. Of the four species, leopards exhibit the most behavioral flexibility, readily adapting to changing circumstances. Regional brain volumes were analyzed using computed tomography (CT. Skulls (n=75 were scanned to create three-dimensional virtual endocasts, and regional brain volumes were measured using either sulcal or bony landmarks obtained from the endocasts or skulls. Phylogenetic least squares (PGLS regression analyses found that sociality does not correspond with larger relative brain size in these species. However, the sociality/solitary variable significantly predicted anterior cerebrum (AC volume, a region that includes frontal cortex. This latter finding is despite the fact that the two social species in our sample, lions and cheetahs, possess the largest and smallest relative AC volumes, respectively. Additionally, an ANOVA comparing regional brain volumes in 4 focal species revealed that lions and leopards, while not significantly different from one another, have relatively

  20. Malignant Hemispheric Cerebral Infarction Associated with Idiopathic Systemic Capillary Leak Syndrome

    Directory of Open Access Journals (Sweden)

    Kei Miyata

    2013-10-01

    Full Text Available Idiopathic systemic capillary leak syndrome (ISCLS is a rare condition that is characterized by unexplained episodic capillary hyperpermeability due to a shift of fluid and protein from the intravascular to the interstitial space. This results in diffuse general swelling, fetal hypovolemic shock, hypoalbuminemia, and hemoconcentration. Although ISCLS rarely induces cerebral infarction, we experienced a patient who deteriorated and was comatose as a result of massive cerebral infarction associated with ISCLS. In this case, severe hypotensive shock, general edema, hemiparesis, and aphasia appeared after serious antecedent gastrointestinal symptoms. Progressive life-threatening ischemic cerebral edema required decompressive hemicraniectomy. The patient experienced another episode of severe hypotension and limb edema that resulted in multiple extremity compartment syndrome. Treatment entailed forearm and calf fasciotomies. Cerebral edema in the ischemic brain progresses rapidly in patients suffering from ISCLS. Strict control of fluid volume resuscitation and aggressive diuretic therapy may be needed during the post-leak phase of fluid remobilization.

  1. Exacerbation of Brain Injury by Post-Stroke Exercise Is Contingent Upon Exercise Initiation Timing

    Directory of Open Access Journals (Sweden)

    Fengwu Li

    2017-10-01

    Full Text Available Accumulating evidence has demonstrated that post-stroke physical rehabilitation may reduce morbidity. The effectiveness of post-stroke exercise, however, appears to be contingent upon exercise initiation. This study assessed the hypothesis that very early exercise exacerbates brain injury, induces reactive oxygen species (ROS generation, and promotes energy failure. A total of 230 adult male Sprague-Dawley rats were subjected to middle cerebral artery (MCA occlusion for 2 h, and randomized into eight groups, including two sham injury control groups, three non-exercise and three exercise groups. Exercise was initiated after 6 h, 24 h and 3 days of reperfusion. Twenty-four hours after completion of exercise (and at corresponding time points in non-exercise controls, infarct volumes and apoptotic cell death were examined. Early brain oxidative metabolism was quantified by examining ROS, ATP and NADH levels 0.5 h after completion of exercise. Furthermore, protein expressions of angiogenic growth factors were measured in order to determine whether post-stroke angiogenesis played a role in rehabilitation. As expected, ischemic stroke resulted in brain infarction, apoptotic cell death and ROS generation, and diminished NADH and ATP production. Infarct volumes and apoptotic cell death were enhanced (p < 0.05 by exercise that was initiated after 6 h of reperfusion, but decreased by late exercise (24 h, 3 days. This exacerbated brain injury at 6 h was associated with increased ROS levels (p < 0.05, and decreased (p < 0.05 NADH and ATP levels. In conclusion, very early exercise aggravated brain damage, and early exercise-induced energy failure with ROS generation may underlie the exacerbation of brain injury. These results shed light on the manner in which exercise initiation timing may affect post-stroke rehabilitation.

  2. US evaluation of volume brain lesions produced by high-intensity focused US

    International Nuclear Information System (INIS)

    Chua, R.V.; Chua, G.T.; Fry, F.J.; Franklin, T.D.; Wills, E.R.; Hastings, J.S.; Sanghui, N.T.

    1987-01-01

    Eighteen volume brain lesions produced by high-intensity focused US in the right cerebral hemispheres of research canines were evaluated by diagnostic US from immediately after ablation up to 62 days later. Animals were killed and perfused for whole-brain recovery. US evaluation of whole-brain specimens was performed. Histologic analysis of brain sections verified lesion placement, size, and tissue response to US. These sections were compared with US studies for correlation data. Correlation data suggest that US visualization may aid in accurate placement of volume brain lesions and in evaluation of effects of high-intensity focuses US in normal brain

  3. [Analysis of 58 neonatal cases with cerebral infarction].

    Science.gov (United States)

    Li, Zhi-hua; Chen, Chao

    2013-01-01

    Cerebral infarction (CI) is one of severe diseases of central nervous system in neonates, and some infants with CI could have poor prognosis in the long term. This study aimed to analyze the clinical data and prognosis of all neonatal cases with cerebral infarction in recent years and to help future clinical work. Totally 58 neonatal cases with CI admitted to NICU of the hospital from January 1999 to December 2010 were included in this study. We analyzed all clinical data and prognosis by retrospective analysis. Fifty-two term babies and six preterm babies were included. There were altogether 51 cases with asphyxia and 7 with hemorrhagic cerebral infarction. Perinatal hypoxia-ischemia was the most common high-risk factor and it accounted for 46.6%. Seizure was the most frequent initial symptom and the most common clinical manifestation (accounted for 77.6%), and it was followed by intermittent cyanosis, apnea and lethargy. Cerebral CT scan and magnetic resonance imaging were major methods to help to make the diagnosis and they also had close relation with prognosis. Diffusion weighted imaging was very helpful to diagnose infarction in early stage. Left middle cerebral artery was the most common artery to be involved. Supportive therapy and symptomatic treatment were the main methods in the acute stage of neonatal cerebral infarction. Those babies with poor prognosis mostly had large infarction involving cerebral hemisphere, thalamus and basal ganglia. Neonatal cerebral infarction was a severe brain injury affecting long tern nervous system prognosis. Perinatal hypoxia was the most common high-risk factor and seizure was the most frequent initial symptom. Diffusion weighted imaging was valuable to diagnose infarction in early stage. Most of infants with poor prognosis had large infarction involving hemisphere, thalamus and basal ganglia. Early diagnosis with brain imaging would be helpful for rehabilitation therapy and improving prognosis.

  4. Ribbon scanning confocal for high-speed high-resolution volume imaging of brain.

    Directory of Open Access Journals (Sweden)

    Alan M Watson

    Full Text Available Whole-brain imaging is becoming a fundamental means of experimental insight; however, achieving subcellular resolution imagery in a reasonable time window has not been possible. We describe the first application of multicolor ribbon scanning confocal methods to collect high-resolution volume images of chemically cleared brains. We demonstrate that ribbon scanning collects images over ten times faster than conventional high speed confocal systems but with equivalent spectral and spatial resolution. Further, using this technology, we reconstruct large volumes of mouse brain infected with encephalitic alphaviruses and demonstrate that regions of the brain with abundant viral replication were inaccessible to vascular perfusion. This reveals that the destruction or collapse of large regions of brain micro vasculature may contribute to the severe disease caused by Venezuelan equine encephalitis virus. Visualization of this fundamental impact of infection would not be possible without sampling at subcellular resolution within large brain volumes.

  5. A new prognostic index - leucocyte infiltration - in human cerebral infarcts by 99Tcm-HMPAO-labelled white blood cell brain SPECT

    International Nuclear Information System (INIS)

    Kao, C.H.; Wang, P.Y.; Wang, Y.L.; Chang, L.; Wang, S.J.; Yeh, S.H.

    1991-01-01

    Twenty-six patients with acute cerebral infarction were imaged by 99 Tc m -hexamethylpropylene-amine oxime (HMPAO)-labelled white blood cell brain (Tc-WBC) single photon emission computed tomography (SPECT). The regions of interest were equally placed in the whole hemispheres of both sides with summation of all transaxial slices in the Tc-WBC SPECT. The asymmetric indices (AI) were calculated as 200 [|(right -left)|/(right + left)]. Grouping of patients with cerebral infarction was based on activities of daily living (ADL) at outcome. The results showed that the poor outcome patient group had a higher AI of Tc-WBC than that of the other patients (13.0 ± 3.0 S.E.M. versus 5.4 ± 1.0 S.E.M., and P < 0.05 by Wilcoxon rank sum test). In conclusion, the Tc-WBC SPECT may be considered as a new prognostic index to predict patient outcome in human cerebral ischaemic infarctions consistent with newly established ischaemic injury theories. (author)

  6. Brain size and brain/intracranial volume ratio in major mental illness

    Directory of Open Access Journals (Sweden)

    Teale Peter

    2010-10-01

    Full Text Available Abstract Background This paper summarizes the findings of a long term study addressing the question of how several brain volume measure are related to three major mental illnesses in a Colorado subject group. It reports results obtained from a large N, collected and analyzed by the same laboratory over a multiyear period, with visually guided MRI segmentation being the primary initial analytic tool. Methods Intracerebral volume (ICV, total brain volume (TBV, ventricular volume (VV, ventricular/brain ratio (VBR, and TBV/ICV ratios were calculated from a total of 224 subject MRIs collected over a period of 13 years. Subject groups included controls (C, N = 89, and patients with schizophrenia (SZ, N = 58, bipolar disorder (BD, N = 51, and schizoaffective disorder (SAD, N = 26. Results ICV, TBV, and VV measures compared favorably with values obtained by other research groups, but in this study did not differ significantly between groups. TBV/ICV ratios were significantly decreased, and VBR increased, in the SZ and BD groups compared to the C group. The SAD group did not differ from C on any measure. Conclusions In this study TBV/ICV and VBR ratios separated SZ and BD patients from controls. Of interest however, SAD patients did not differ from controls on these measures. The findings suggest that the gross measure of TBV may not reliably differ in the major mental illnesses to a degree useful in diagnosis, likely due to the intrinsic variability of the measures in question; the differences in VBR appear more robust across studies. Differences in some of these findings compared to earlier reports from several laboratories finding significant differences between groups in VV and TBV may relate to phenomenological drift, differences in analytic techniques, and possibly the "file drawer problem".

  7. Development and heritability of subcortical brain volumes at age 9 and 12

    NARCIS (Netherlands)

    Swagerman, S.C.; Brouwer, R.; de Geus, E.J.C.; Hulshoff Pol, H.E.; Boomsma, D.I.

    2014-01-01

    Subcortical brain structures are involved in a variety of cognitive and emotional functions and follow different trajectories of increase and decrease in volume from childhood to adulthood. The heritability of development of subcortical brain volumes during adolescence has not been studied

  8. Contribution of contractile state of the non-infarcted area to global ventricular performance after acute myocardial infarction

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Yasuda, Tsunehiro; Gold, H.K.; Leinbach, R.C.; Boucher, C.A.; McKusick, K.A.; Strauss, H.W.

    1986-01-01

    To evaluate the regional contractile state of the non-infarcted zone and to determine the contribution of this area to left ventricular (LV) performance, 112 patients (42 anterior and 70 inferior infarction) with their first acute myocardial infarction were investigated by radionuclide ventriculography at admission and 10 days after admission. Wall motion at the non-infarcted area was defined as hyperkinetic, normal, or hypokinetic, if radial chord shortening had above normal, normal, or below normal values, respectively, by quantitative wall motion analysis. Hyperkinetic, normal, and hypokinetic wall motion of the non-infarcted area were observed in three (7 %), 12 (29 %), and 27 (64 %) patients in anterior infarction and 14 (20 %), 28 (40 %), and 28 (40 %) in inferior infarction, respectively. In the patients with hypokinetic wall motion at the non-infarcted area, the infarct involved more than 30 % of the left ventricle manifesting akinetic contractile segment (ACS), radial chord shortening in the infarcted area was severely depressed, and the incidence of multi-vessel involvement was higher compared with those with hyperkinetic or normal wall motion. In serial measurements, radial chord shortening in the infarcted and non-infarcted area, percent ACS, left ventricular ejection fraction, and left ventricular end-diastolic volume index did not change significantly from acute to follow-up study in any group. In conclusion, our data indicated that the non-infarcted area following acute infarction had various contractile states and these conditions were determined primarily by the severity and extent of infarct and underlying coronary artery disease. Furthermore, the contractile state of the non-infarcted area has a supplemental role in determination of LV function following acute infarction. (author)

  9. The influences of silent cerebral infarction and hypertension on brain atrophy in normal adults

    International Nuclear Information System (INIS)

    Zhefeng, Quan; Bokura, Hirokazu; Iijima, Kenichi; Oguro, Hiroaki; Yamaguchi, Shuhei

    2008-01-01

    We studied the influences of silent brain infarction (SBI) and hypertension on brain atrophy and its longitudinal progression in healthy adults. MRI scans were performed on 109 neurologically normal adults (mean age, 58.6±5.8 years), with follow-up at an average of 4.9 years later. Patient histories of hypertension, smoking habits, and alcohol consumption were examined. We evaluated brain atrophy using the brain atrophy index (BAI; the ratio of the brain area to the intracranial area) and the ventricular atrophy index (VAI; the ratio of the ventricular area to the brain area) on MRI T1-weighted images at the levels of the basal ganglia and lateral ventricle in horizontal sections. There were no differences in age, sex, dyslipidemia, body mass index (BMI), smoking habit, and alcohol consumption between the normal group and the SBI or hypertension group. The BAI was significantly lower at entry for the SBI (+) group than for the SBI (-) group at both the basal ganglia and lateral ventricle levels (basal ganglia level, p=0.02; and lateral ventricle level, p=0.05). Moreover, the VAI was significantly higher at entry for the SBI (+) group than for the SBI (-) group at the lateral ventricle level (p=0.03). Furthermore, the BAI was significantly lower at entry for the hypertensive group than for the non-hypertensive group at the basal ganglia level (p=0.007). There were no significant differences in the annual variations of the BAI and VAI between the normal group and the SBI (+) or hypertensive group. The present results suggest that the SBI and hypertension are accelerating factors for brain atrophy and ventricular dilatation. (author)

  10. The influences of silent cerebral infarction and hypertension on brain atrophy in normal adults

    Energy Technology Data Exchange (ETDEWEB)

    Zhefeng, Quan; Bokura, Hirokazu; Iijima, Kenichi; Oguro, Hiroaki; Yamaguchi, Shuhei [Shimane Univ., Faculty of Medicine, Izumo, Shimane (Japan)

    2008-03-15

    We studied the influences of silent brain infarction (SBI) and hypertension on brain atrophy and its longitudinal progression in healthy adults. MRI scans were performed on 109 neurologically normal adults (mean age, 58.6{+-}5.8 years), with follow-up at an average of 4.9 years later. Patient histories of hypertension, smoking habits, and alcohol consumption were examined. We evaluated brain atrophy using the brain atrophy index (BAI; the ratio of the brain area to the intracranial area) and the ventricular atrophy index (VAI; the ratio of the ventricular area to the brain area) on MRI T1-weighted images at the levels of the basal ganglia and lateral ventricle in horizontal sections. There were no differences in age, sex, dyslipidemia, body mass index (BMI), smoking habit, and alcohol consumption between the normal group and the SBI or hypertension group. The BAI was significantly lower at entry for the SBI (+) group than for the SBI (-) group at both the basal ganglia and lateral ventricle levels (basal ganglia level, p=0.02; and lateral ventricle level, p=0.05). Moreover, the VAI was significantly higher at entry for the SBI (+) group than for the SBI (-) group at the lateral ventricle level (p=0.03). Furthermore, the BAI was significantly lower at entry for the hypertensive group than for the non-hypertensive group at the basal ganglia level (p=0.007). There were no significant differences in the annual variations of the BAI and VAI between the normal group and the SBI (+) or hypertensive group. The present results suggest that the SBI and hypertension are accelerating factors for brain atrophy and ventricular dilatation. (author)

  11. 脑梗死急性期合并抑郁障碍的康复与功能预后%Rehabilitation and functional prognosis of acute brain infarct complicated with depression

    Institute of Scientific and Technical Information of China (English)

    戴慧寒; 张纯

    2001-01-01

    Objective To observe rehabilitation and functional prognosis of patients suffered from brain infarction of acute phase complicated by depression. Method We selected 38 cases of acute brain infarct complicated with depression disorder as depression group, 40 cases of non- depression patient admitted at the same period were selected as non depression group.Antidepressants drugs administration and rehabilitation therapy were performed.We evaluated patients according to functional independence measure(FIM)of Chinese edition. HAMD grading comparison was carried out in depression group. Result Before treatment,two groups score nearly the same,compared with pretreatment. After treatment,patients in depression group and non depression group showed significant improvement esp non- depression group (P<0.01).11 cases with severe depression in the depression showed no changes in FIM score before and after treatment. Conclusion Compared with non- depression patients,functional recovery of patients with depression following brain infarction of acute stage is much slower,especially for patients with severe depression.

  12. Optimal delivery route of bone marrow stromal cells for rat infarct brain – A study using non-invasive optical imaging

    Directory of Open Access Journals (Sweden)

    Tamaki N

    2010-01-01

    Full Text Available BACKGROUND - Recent studies have indicated that bone marrow stromal cells (BMSC have the potential to improve neurological function when transplanted into animal model of central nervous system (CNS disorders. However, there still exist several questions to solved prior to clinical application. In this study, therefore, we aimed to clarify the optimal delivery route of BMSC transplantation over a reasonable time window.MATERIALS AND METHODS - The rats were subjected to permanent middle cerebral artery occlusion. The BMSC were labeled with quantum dot (QD 800. The labeled BMSC were transplanted into the infarct brain directly or intravenously at 7 days after the insult. Motor function was serially assessed. The BMSC were also tracked using near infrared (NIR fluorescence imaging technique every week. The fate of the transplanted BMSC was examined at 5 weeks after transplantation, using Immunohistochemistry. RESULTS - Direct, but not intravenous, transplantation of BMSC significantly enhanced functional recovery. NIR fluorescence imaging could visualize their migration towards cerebral infarct in directly, but not intravenously, injected animals. The findings were supported on histological analysis. Thus, the BMSC were widely engrafted in the infarct brain in the directly injected animals, but few BMSC were observed in the intravenously injected ones. CONCLUSION - This study strongly suggests that direct transplantation of BMSC may be more beneficial in treating patients with ischemic stroke than their intravenous transplantation. Therapeutic time window must be called into account when considering the route of BMSC transplantation.

  13. Assessment of collateral status by dynamic ct angiography in acute mca stroke : Timing of acquisition and relationship with final infarct volume

    NARCIS (Netherlands)

    Van Den Wijngaard, I. R.; Holswilder, G.; Wermer, M. J H; Boiten, J.; Algra, A.; Dippel, D. W J; Dankbaar, J. W.; Velthuis, B. K.; Boers, A. M M; Majoie, C. B L M; Van Walderveen, M. A A

    2016-01-01

    BACKGROUND AND PURPOSE: Dynamic CTA is a promising technique for visualization of collateral filling in patients with acute ischemic stroke. Our aim was to describe collateral filling with dynamic CTA and assess the relationship with infarct volume at follow-up. MATERIALS AND METHODS: We selected

  14. Assessment of collateral status by dynamic ct angiography in acute mca stroke: Timing of acquisition and relationship with final infarct volume

    NARCIS (Netherlands)

    I.R. Van Den Wijngaard (Ido R.); G. Holswilder (Ghislaine); M.J.H. Wermer (Marieke); J. Boiten (Jelis); A. Algra (Ale); D.W.J. Dippel (Diederik); J.W. Dankbaar (Jan); B.K. Velthuis (Birgitta); A.M.M. Boers (Anna); C.B. Majoie (Charles); M.A.A. van Walderveen (Marianne)

    2016-01-01

    textabstractBACKGROUND AND PURPOSE: Dynamic CTA is a promising technique for visualization of collateral filling in patients with acute ischemic stroke. Our aim was to describe collateral filling with dynamic CTA and assess the relationship with infarct volume at follow-up. MATERIALS AND METHODS: We

  15. Diffuse corpus callosum infarction - Rare vascular entity with differing etiology.

    Science.gov (United States)

    Mahale, Rohan; Mehta, Anish; Buddaraju, Kiran; John, Aju Abraham; Javali, Mahendra; Srinivasa, Rangasetty

    2016-01-15

    Infarctions of the corpus callosum are rare vascular events. It is relatively immune to vascular insult because of its rich vascular supply from anterior and posterior circulations of brain. Report of 3 patients with largely diffuse acute corpus callosum infarction. 3 patients with largely diffuse acute corpus callosum infarction were studied and each of these 3 patients had 3 different aetiologies. The 3 different aetiologies of largely diffuse acute corpus callosum infarction were cardioembolism, tuberculous arteritis and takayasu arteritis. Diffuse corpus callosum infarcts are rare events. This case series narrates the three different aetiologies of diffuse acute corpus callosum infarction which is a rare vascular event. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Three-dimensional whole-brain perfused blood volume imaging with multimodal CT for evaluation of acute ischaemic stroke

    International Nuclear Information System (INIS)

    Lu, J.; Zhang, M.; Cao, Y.; Ma, Q.; Chen, J.; Ji, X.; Li, K.

    2011-01-01

    Aim: To determine the diagnostic value of integrating three-dimensional perfused blood volume (3D PBV) with multimodal computed tomography (CT) [non-enhanced CT (NECT), CT perfusion (CTP), and CT angiography (CTA)] in acute ischaemic stroke. Materials and methods: NECT, CTP, and CTA were performed in 25 acute ischaemic stroke patients. The ischaemia detection rate of 3D PBV was compared with the results of baseline NECT and CTP. The correlation of ischaemic lesion volume between 3D PBV, CTP images, and follow-up NECT were analysed. Results: NECT demonstrated ischaemic signs in 12 of 25 patients with proven infarction. CTP maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP) all demonstrated perfusion deficits in 21 of 25 patients. However, 3D PBV demonstrated perfusion deficits in all of the 25 patients. Among the 25 patients, a strong correlation was found between PBV and the follow-up NECT infarct (r = 0.858). The correlation between CTP and the follow-up NECT infarct as following: CBF (r = 0.718), CBV (r = 0.785), and TTP (r = 0.569). In 14 thrombolytic patients, strong correlation was found between the ischaemic volume on 3D PBV and follow-up NECT (r = 0.798). Conclusion: In acute stroke patients, the combination of 3D PBV and multimodal CT (NECT, CTP, and CTA) can improve the detection rate of ischaemia and enable assessment of the full extent of ischaemia, which correlates well with follow-up NECT.

  17. Comparison of usefulness of N-terminal pro-brain natriuretic peptide as an independent predictor of cardiac function among admission cardiac serum biomarkers in patients with anterior wall versus nonanterior wall ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

    Science.gov (United States)

    Haeck, Joost D E; Verouden, Niels J W; Kuijt, Wichert J; Koch, Karel T; Van Straalen, Jan P; Fischer, Johan; Groenink, Maarten; Bilodeau, Luc; Tijssen, Jan G P; Krucoff, Mitchell W; De Winter, Robbert J

    2010-04-15

    The purpose of the present study was to determine the prognostic value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP), among other serum biomarkers, on cardiac magnetic resonance (CMR) imaging parameters of cardiac function and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. We measured NT-pro-BNP, cardiac troponin T, creatinine kinase-MB fraction, high-sensitivity C-reactive protein, and creatinine on the patients' arrival at the catheterization laboratory in 206 patients with ST-segment elevation myocardial infarction. The NT-pro-BNP levels were divided into quartiles and correlated with left ventricular function and infarct size measured by CMR imaging at 4 to 6 months. Compared to the lower quartiles, patients with nonanterior wall myocardial infarction in the highest quartile of NT-pro-BNP (> or = 260 pg/ml) more often had a greater left ventricular end-systolic volume (68 vs 39 ml/m(2), p pro-BNP level of > or = 260 pg/ml was the strongest independent predictor of left ventricular ejection fraction in patients with nonanterior wall myocardial infarction compared to the other serum biomarkers (beta = -5.8; p = 0.019). In conclusion, in patients with nonanterior wall myocardial infarction undergoing primary percutaneous coronary intervention, an admission NT-pro-BNP level of > or = 260 pg/ml was a strong, independent predictor of left ventricular function assessed by CMR imaging at follow-up. Our findings suggest that NT-pro-BNP, a widely available biomarker, might be helpful in the early risk stratification of patients with nonanterior wall myocardial infarction. Copyright 2010 Elsevier Inc. All rights reserved.

  18. Moral values are associated with individual differences in regional brain volume.

    Science.gov (United States)

    Lewis, Gary J; Kanai, Ryota; Bates, Timothy C; Rees, Geraint

    2012-08-01

    Moral sentiment has been hypothesized to reflect evolved adaptations to social living. If so, individual differences in moral values may relate to regional variation in brain structure. We tested this hypothesis in a sample of 70 young, healthy adults examining whether differences on two major dimensions of moral values were significantly associated with regional gray matter volume. The two clusters of moral values assessed were "individualizing" (values of harm/care and fairness) and "binding" (deference to authority, in-group loyalty, and purity/sanctity). Individualizing was positively associated with left dorsomedial pFC volume and negatively associated with bilateral precuneus volume. For binding, a significant positive association was found for bilateral subcallosal gyrus and a trend to significance for the left anterior insula volume. These findings demonstrate that variation in moral sentiment reflects individual differences in brain structure and suggest a biological basis for moral sentiment, distributed across multiple brain regions.

  19. Assessment of Collateral Status by Dynamic CT Angiography in Acute MCA Stroke: Timing of Acquisition and Relationship with Final Infarct Volume

    NARCIS (Netherlands)

    van den Wijngaard, I. R.; Holswilder, G.; Wermer, M. J. H.; Boiten, J.; Algra, A.; Dippel, D. W. J.; Dankbaar, J. W.; Velthuis, B. K.; Boers, A. M. M.; Majoie, C. B. L. M.; van Walderveen, M. A. A.

    2016-01-01

    Dynamic CTA is a promising technique for visualization of collateral filling in patients with acute ischemic stroke. Our aim was to describe collateral filling with dynamic CTA and assess the relationship with infarct volume at follow-up. We selected patients with acute ischemic stroke due to

  20. Diffusion-weighted MR imaging in animal modil with acute ischemic brain infarction : evaluation of reversible brain injury

    International Nuclear Information System (INIS)

    Byun, Woo Mok; Chang, Han Won; Cho, Inn Ho; Hah, Jung Sang; Sung, Eon Gi

    2001-01-01

    To determine whether the analysis of abnormally high signal intensities in ischemic tissue, as revealed by diffusion-weighted MR imaging (DWI) can be used to evaluate reversible brain lesions in a cat model of acute ischemia. Ten cats were divided into two groups of five (Group I and Group II), and in all animals the middle cerebral artery was temporarily occluded. Group I underwent T2-DWI 30 minutes after occlusion, and Group II 120 minutes after occlusion. In both groups, DWI was performed one hour and 24 hours after reperfusion (at one hour, non-T2-weighted; at 24 hours, T2-weighted). Both occlusion and reperfusion were monitored by 99m TC-ECD brain perfusion SPECT. All animals were sacrificed 24 hours later and their brain tissue was stained with TTC. Signal intensity ratios (SIR, signifying average signal intensity within the region of interest divided by that in the contralateral, nonischemic, homologous region) of the two groups, as seen on DWI were compared. The percentage of hemispheric lesions occurring in the two groups was also compared. SIR after occlusion of the middle cerebral artery was 1.29 in Group I and 1.59 in Group II. Twenty-four hours after reperfusion, SIR in Group I was higher than in Group II (p<0.01). After occlusion and reperfusion, the percentage of hemispheric lesions in Group I was less than in Group II. For the latter, the percentage of these lesions revealed by TTC staining and T2-weighted imaging was 48% and 59%, respectively, findings distinctly different from those for Group I. In addition, in group I, infarction was revealed by neither TTC staining nor T2-weighted imaging (p<0.01). The use of DWI to evaluate signal intensity ratios can help determine whether or not brain injury after temporary cerebral ischemia is reversible

  1. MR manifestations of the brain in neuropsychiatric systemic lupus erythematosus patients

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kyu Chan; Byun, Woo Mok; Jang, Han Won; Kim, Kum Rae [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2008-01-15

    The primary goal of this study was to evaluate the MR findings of systemic lupus erythematosus (SLE) patients with neuropsychiatric symptoms. The MR images of 38 patients with SLE were evaluated based on the presence of the following abnormal lesions: the locations of the abnormal signal intensity lesions in the white matter, infarctions, a small vessel vasculopathy, leukoencephalopathy, hemorrhage, abscess, and other lesions. The MR images showed an abnormality in 22 of 38 (58%) episodes. Abnormal signal intensities were noted in the subcortical and periventricular white matter in six cases, acute territorial infarctions in five cases, multiple small acute embolic infarctions in four cases and a brain abscess in two cases. A reversible posterior leukoencephalopathy was found in one case. In addition, another patient had vasogenic edema with focal central cytotoxic edema at the pons. The entire cerebral and corpus callosum volumes were significantly smaller in four patients with SLE as compared to the volumes in healthy control subjects. SLE may induce variable MR imaging findings of the CNS. Recognition of the variable findings is helpful for easy diagnosis and prompt treatment.

  2. MR manifestations of the brain in neuropsychiatric systemic lupus erythematosus patients

    International Nuclear Information System (INIS)

    Oh, Kyu Chan; Byun, Woo Mok; Jang, Han Won; Kim, Kum Rae

    2008-01-01

    The primary goal of this study was to evaluate the MR findings of systemic lupus erythematosus (SLE) patients with neuropsychiatric symptoms. The MR images of 38 patients with SLE were evaluated based on the presence of the following abnormal lesions: the locations of the abnormal signal intensity lesions in the white matter, infarctions, a small vessel vasculopathy, leukoencephalopathy, hemorrhage, abscess, and other lesions. The MR images showed an abnormality in 22 of 38 (58%) episodes. Abnormal signal intensities were noted in the subcortical and periventricular white matter in six cases, acute territorial infarctions in five cases, multiple small acute embolic infarctions in four cases and a brain abscess in two cases. A reversible posterior leukoencephalopathy was found in one case. In addition, another patient had vasogenic edema with focal central cytotoxic edema at the pons. The entire cerebral and corpus callosum volumes were significantly smaller in four patients with SLE as compared to the volumes in healthy control subjects. SLE may induce variable MR imaging findings of the CNS. Recognition of the variable findings is helpful for easy diagnosis and prompt treatment

  3. Novel whole brain segmentation and volume estimation using quantitative MRI

    International Nuclear Information System (INIS)

    West, J.; Warntjes, J.B.M.; Lundberg, P.

    2012-01-01

    Brain segmentation and volume estimation of grey matter (GM), white matter (WM) and cerebro-spinal fluid (CSF) are important for many neurological applications. Volumetric changes are observed in multiple sclerosis (MS), Alzheimer's disease and dementia, and in normal aging. A novel method is presented to segment brain tissue based on quantitative magnetic resonance imaging (qMRI) of the longitudinal relaxation rate R 1 , the transverse relaxation rate R 2 and the proton density, PD. Previously reported qMRI values for WM, GM and CSF were used to define tissues and a Bloch simulation performed to investigate R 1 , R 2 and PD for tissue mixtures in the presence of noise. Based on the simulations a lookup grid was constructed to relate tissue partial volume to the R 1 -R 2 -PD space. The method was validated in 10 healthy subjects. MRI data were acquired using six resolutions and three geometries. Repeatability for different resolutions was 3.2% for WM, 3.2% for GM, 1.0% for CSF and 2.2% for total brain volume. Repeatability for different geometries was 8.5% for WM, 9.4% for GM, 2.4% for CSF and 2.4% for total brain volume. We propose a new robust qMRI-based approach which we demonstrate in a patient with MS. (orig.)

  4. Novel whole brain segmentation and volume estimation using quantitative MRI

    Energy Technology Data Exchange (ETDEWEB)

    West, J. [Linkoeping University, Radiation Physics, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); SyntheticMR AB, Linkoeping (Sweden); Warntjes, J.B.M. [Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); SyntheticMR AB, Linkoeping (Sweden); Linkoeping University and Department of Clinical Physiology UHL, County Council of Oestergoetland, Clinical Physiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Lundberg, P. [Linkoeping University, Center for Medical Imaging Science and Visualization (CMIV), Linkoeping (Sweden); Linkoeping University and Department of Radiation Physics UHL, County Council of Oestergoetland, Radiation Physics, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden); Linkoeping University and Department of Radiology UHL, County Council of Oestergoetland, Radiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linkoeping (Sweden)

    2012-05-15

    Brain segmentation and volume estimation of grey matter (GM), white matter (WM) and cerebro-spinal fluid (CSF) are important for many neurological applications. Volumetric changes are observed in multiple sclerosis (MS), Alzheimer's disease and dementia, and in normal aging. A novel method is presented to segment brain tissue based on quantitative magnetic resonance imaging (qMRI) of the longitudinal relaxation rate R{sub 1}, the transverse relaxation rate R{sub 2} and the proton density, PD. Previously reported qMRI values for WM, GM and CSF were used to define tissues and a Bloch simulation performed to investigate R{sub 1}, R{sub 2} and PD for tissue mixtures in the presence of noise. Based on the simulations a lookup grid was constructed to relate tissue partial volume to the R{sub 1}-R{sub 2}-PD space. The method was validated in 10 healthy subjects. MRI data were acquired using six resolutions and three geometries. Repeatability for different resolutions was 3.2% for WM, 3.2% for GM, 1.0% for CSF and 2.2% for total brain volume. Repeatability for different geometries was 8.5% for WM, 9.4% for GM, 2.4% for CSF and 2.4% for total brain volume. We propose a new robust qMRI-based approach which we demonstrate in a patient with MS. (orig.)

  5. Longitudinal changes in total brain volume in schizophrenia: relation to symptom severity, cognition and antipsychotic medication.

    Directory of Open Access Journals (Sweden)

    Juha Veijola

    Full Text Available Studies show evidence of longitudinal brain volume decreases in schizophrenia. We studied brain volume changes and their relation to symptom severity, level of function, cognition, and antipsychotic medication in participants with schizophrenia and control participants from a general population based birth cohort sample in a relatively long follow-up period of almost a decade. All members of the Northern Finland Birth Cohort 1966 with any psychotic disorder and a random sample not having psychosis were invited for a MRI brain scan, and clinical and cognitive assessment during 1999-2001 at the age of 33-35 years. A follow-up was conducted 9 years later during 2008-2010. Brain scans at both time points were obtained from 33 participants with schizophrenia and 71 control participants. Regression models were used to examine whether brain volume changes predicted clinical and cognitive changes over time, and whether antipsychotic medication predicted brain volume changes. The mean annual whole brain volume reduction was 0.69% in schizophrenia, and 0.49% in controls (p = 0.003, adjusted for gender, educational level, alcohol use and weight gain. The brain volume reduction in schizophrenia patients was found especially in the temporal lobe and periventricular area. Symptom severity, functioning level, and decline in cognition were not associated with brain volume reduction in schizophrenia. The amount of antipsychotic medication (dose years of equivalent to 100 mg daily chlorpromazine over the follow-up period predicted brain volume loss (p = 0.003 adjusted for symptom level, alcohol use and weight gain. In this population based sample, brain volume reduction continues in schizophrenia patients after the onset of illness, and antipsychotic medications may contribute to these reductions.

  6. Associations between Family Adversity and Brain Volume in Adolescence: Manual vs. Automated Brain Segmentation Yields Different Results

    OpenAIRE

    Lyden, Hannah; Gimbel, Sarah I.; Del Piero, Larissa; Tsai, A. Bryna; Sachs, Matthew E.; Kaplan, Jonas T.; Margolin, Gayla; Saxbe, Darby

    2016-01-01

    Associations between brain structure and early adversity have been inconsistent in the literature. These inconsistencies may be partially due to methodological differences. Different methods of brain segmentation may produce different results, obscuring the relationship between early adversity and brain volume. Moreover, adolescence is a time of significant brain growth and certain brain areas have distinct rates of development, which may compromise the accuracy of automated segmentation appr...

  7. A physical multifield model predicts the development of volume and structure in the human brain

    Science.gov (United States)

    Rooij, Rijk de; Kuhl, Ellen

    2018-03-01

    The prenatal development of the human brain is characterized by a rapid increase in brain volume and a development of a highly folded cortex. At the cellular level, these events are enabled by symmetric and asymmetric cell division in the ventricular regions of the brain followed by an outwards cell migration towards the peripheral regions. The role of mechanics during brain development has been suggested and acknowledged in past decades, but remains insufficiently understood. Here we propose a mechanistic model that couples cell division, cell migration, and brain volume growth to accurately model the developing brain between weeks 10 and 29 of gestation. Our model accurately predicts a 160-fold volume increase from 1.5 cm3 at week 10 to 235 cm3 at week 29 of gestation. In agreement with human brain development, the cortex begins to form around week 22 and accounts for about 30% of the total brain volume at week 29. Our results show that cell division and coupling between cell density and volume growth are essential to accurately model brain volume development, whereas cell migration and diffusion contribute mainly to the development of the cortex. We demonstrate that complex folding patterns, including sinusoidal folds and creases, emerge naturally as the cortex develops, even for low stiffness contrasts between the cortex and subcortex.

  8. Stereological brain volume changes in post-weaned socially isolated rats

    DEFF Research Database (Denmark)

    Fabricius, Katrine; Helboe, Lone; Steiniger-Brach, Björn

    2010-01-01

    Lister Hooded rats isolated from postnatal day 25 for 15 weeks. We observed the expected gender differences in total brain volume with males having larger brains than females. Further, we found that isolated males had significantly smaller brains than group-housed controls and larger lateral ventricles...... have evaluated the neuroanatomical changes in this animal model in comparison to changes seen in schizophrenia. In this study, we applied stereological volume estimates to evaluate the total brain, the ventricular system, and the pyramidal and granular cell layers of the hippocampus in male and female...... than controls. However, this was not seen in female rats. Isolated males had a significant smaller hippocampus, dentate gyrus and CA2/3 where isolated females had a significant smaller CA1 compared to controls. Thus, our results indicate that long-term isolation of male rats leads to neuroanatomical...

  9. Postmenopausal hormone therapy, type 2 diabetes mellitus, and brain volumes.

    Science.gov (United States)

    Espeland, Mark A; Brinton, Roberta Diaz; Manson, JoAnn E; Yaffe, Kristine; Hugenschmidt, Christina; Vaughan, Leslie; Craft, Suzanne; Edwards, Beatrice J; Casanova, Ramon; Masaki, Kamal; Resnick, Susan M

    2015-09-29

    To examine whether the effect of postmenopausal hormone therapy (HT) on brain volumes in women aged 65-79 years differs depending on type 2 diabetes status during postintervention follow-up of a randomized controlled clinical trial. The Women's Health Initiative randomized clinical trials assigned women to HT (0.625 mg/day conjugated equine estrogens with or without 2.5 mg/day medroxyprogesterone acetate) or placebo for an average of 5.6 years. A total of 1,402 trial participants underwent brain MRI 2.4 years after the trials; these were repeated in 699 women 4.7 years later. General linear models were used to assess the interaction between diabetes status and HT assignment on brain volumes. Women with diabetes at baseline or during follow-up who had been assigned to HT compared to placebo had mean decrement in total brain volume of -18.6 mL (95% confidence interval [CI] -29.6, -7.6). For women without diabetes, this mean decrement was -0.4 (95% CI -3.8, 3.0) (interaction p=0.002). This interaction was evident for total gray matter (pNeurology.

  10. Mesenchymal stem cells attenuate blood-brain barrier leakage after cerebral ischemia in mice.

    Science.gov (United States)

    Cheng, Zhuo; Wang, Liping; Qu, Meijie; Liang, Huaibin; Li, Wanlu; Li, Yongfang; Deng, Lidong; Zhang, Zhijun; Yang, Guo-Yuan

    2018-05-03

    Ischemic stroke induced matrixmetallo-proteinase-9 (MMP-9) upregulation, which increased blood-brain barrier permeability. Studies demonstrated that mesenchymal stem cell therapy protected blood-brain barrier disruption from several cerebrovascular diseases. However, the underlying mechanism was largely unknown. We therefore hypothesized that mesenchymal stem cells reduced blood-brain barrier destruction by inhibiting matrixmetallo-proteinase-9 and it was related to intercellular adhesion molecule-1 (ICAM-1). Adult ICR male mice (n = 118) underwent 90-min middle cerebral artery occlusion and received 2 × 10 5 mesenchymal stem cell transplantation. Neurobehavioral outcome, infarct volume, and blood-brain barrier permeability were measured after ischemia. The relationship between myeloperoxidase (MPO) activity and ICAM-1 release was further determined. We found that intracranial injection of mesenchymal stem cells reduced infarct volume and improved behavioral function in experimental stroke models (p mesenchymal stem cell-treated mice compared to the control group following ischemia (p cells and myeloperoxidase activity were decreased in mesenchymal stem cell-treated mice (p mesenchymal stem cell therapy attenuated blood-brain barrier disruption in mice after ischemia. Mesenchymal stem cells attenuated the upward trend of MMP-9 and potentially via downregulating ICAM-1 in endothelial cells. Adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) pathway may influence MMP-9 expression of neutrophils and resident cells, and ICAM-1 acted as a key factor in the paracrine actions of mesenchymal stem cell.

  11. Volume-regulated anion channel--a frenemy within the brain.

    Science.gov (United States)

    Mongin, Alexander A

    2016-03-01

    The volume-regulated anion channel (VRAC) is a ubiquitously expressed yet highly enigmatic member of the superfamily of chloride/anion channels. It is activated by cellular swelling and mediates regulatory cell volume decrease in a majority of vertebrate cells, including those in the central nervous system (CNS). In the brain, besides its crucial role in cellular volume regulation, VRAC is thought to play a part in cell proliferation, apoptosis, migration, and release of physiologically active molecules. Although these roles are not exclusive to the CNS, the relative significance of VRAC in the brain is amplified by several unique aspects of its physiology. One important example is the contribution of VRAC to the release of the excitatory amino acid neurotransmitters glutamate and aspartate. This latter process is thought to have impact on both normal brain functioning (such as astrocyte-neuron signaling) and neuropathology (via promoting the excitotoxic death of neuronal cells in stroke and traumatic brain injury). In spite of much work in the field, the molecular nature of VRAC remained unknown until less than 2 years ago. Two pioneer publications identified VRAC as the heterohexamer formed by the leucine-rich repeat-containing 8 (LRRC8) proteins. These findings galvanized the field and are likely to result in dramatic revisions to our understanding of the place and role of VRAC in the brain, as well as other organs and tissues. The present review briefly recapitulates critical findings in the CNS and focuses on anticipated impact on the LRRC8 discovery on further progress in neuroscience research.

  12. Diffusion-weighted echo-planar MRI of lacunar infarcts

    International Nuclear Information System (INIS)

    Noguchi, K.; Nagayoshi, T.; Watanabe, N.; Kanazawa, T.; Toyoshima, S.; Morijiri, M.; Shojaku, H.; Shimizu, M.; Seto, H.

    1998-01-01

    We studied 35 patients with lacunar infarcts, using diffusion-weighted echo-planar imaging (DW-EPI) at 1.5 T. The relative apparent diffusion coefficient ratio (ADCR) of each lesion was calculated and lesion conspicuity on DW-EPI was compared to that on images aquired with fast fluid-attenuated inversion recovery and T2-weighted fast spin-echo sequences. Acute small infarcts (within 3 days) were identified with DW-EPI as an area of decreased ADCR (range 0.33-0.87; mean 0.67) and high signal, subacute small infarcts (4-30 days) as a high-signal or isointense areas of decreased or nearly normal ADCR (0.54-0.98; 0.73), and chronic small infarcts (> 30 days) as low- or high-signal areas of nearly normal or increased ADCR (0.97-1.92; 1.32). In three patients, small infarcts of the brain stem in the hyperacute phase (within 6 h) were seen only with DW-EPI. In five patients, fresh small infarcts adjacent to multiple old infarcts could be distinguished only with DW-EPI. (orig.)

  13. Basic MR sequence parameters systematically bias automated brain volume estimation

    International Nuclear Information System (INIS)

    Haller, Sven; Falkovskiy, Pavel; Roche, Alexis; Marechal, Benedicte; Meuli, Reto; Thiran, Jean-Philippe; Krueger, Gunnar; Lovblad, Karl-Olof; Kober, Tobias

    2016-01-01

    Automated brain MRI morphometry, including hippocampal volumetry for Alzheimer disease, is increasingly recognized as a biomarker. Consequently, a rapidly increasing number of software tools have become available. We tested whether modifications of simple MR protocol parameters typically used in clinical routine systematically bias automated brain MRI segmentation results. The study was approved by the local ethical committee and included 20 consecutive patients (13 females, mean age 75.8 ± 13.8 years) undergoing clinical brain MRI at 1.5 T for workup of cognitive decline. We compared three 3D T1 magnetization prepared rapid gradient echo (MPRAGE) sequences with the following parameter settings: ADNI-2 1.2 mm iso-voxel, no image filtering, LOCAL- 1.0 mm iso-voxel no image filtering, LOCAL+ 1.0 mm iso-voxel with image edge enhancement. Brain segmentation was performed by two different and established analysis tools, FreeSurfer and MorphoBox, using standard parameters. Spatial resolution (1.0 versus 1.2 mm iso-voxel) and modification in contrast resulted in relative estimated volume difference of up to 4.28 % (p < 0.001) in cortical gray matter and 4.16 % (p < 0.01) in hippocampus. Image data filtering resulted in estimated volume difference of up to 5.48 % (p < 0.05) in cortical gray matter. A simple change of MR parameters, notably spatial resolution, contrast, and filtering, may systematically bias results of automated brain MRI morphometry of up to 4-5 %. This is in the same range as early disease-related brain volume alterations, for example, in Alzheimer disease. Automated brain segmentation software packages should therefore require strict MR parameter selection or include compensatory algorithms to avoid MR parameter-related bias of brain morphometry results. (orig.)

  14. Basic MR sequence parameters systematically bias automated brain volume estimation

    Energy Technology Data Exchange (ETDEWEB)

    Haller, Sven [University of Geneva, Faculty of Medicine, Geneva (Switzerland); Affidea Centre de Diagnostique Radiologique de Carouge CDRC, Geneva (Switzerland); Falkovskiy, Pavel; Roche, Alexis; Marechal, Benedicte [Siemens Healthcare HC CEMEA SUI DI BM PI, Advanced Clinical Imaging Technology, Lausanne (Switzerland); University Hospital (CHUV), Department of Radiology, Lausanne (Switzerland); Meuli, Reto [University Hospital (CHUV), Department of Radiology, Lausanne (Switzerland); Thiran, Jean-Philippe [LTS5, Ecole Polytechnique Federale de Lausanne, Lausanne (Switzerland); Krueger, Gunnar [Siemens Medical Solutions USA, Inc., Boston, MA (United States); Lovblad, Karl-Olof [University of Geneva, Faculty of Medicine, Geneva (Switzerland); University Hospitals of Geneva, Geneva (Switzerland); Kober, Tobias [Siemens Healthcare HC CEMEA SUI DI BM PI, Advanced Clinical Imaging Technology, Lausanne (Switzerland); LTS5, Ecole Polytechnique Federale de Lausanne, Lausanne (Switzerland)

    2016-11-15

    Automated brain MRI morphometry, including hippocampal volumetry for Alzheimer disease, is increasingly recognized as a biomarker. Consequently, a rapidly increasing number of software tools have become available. We tested whether modifications of simple MR protocol parameters typically used in clinical routine systematically bias automated brain MRI segmentation results. The study was approved by the local ethical committee and included 20 consecutive patients (13 females, mean age 75.8 ± 13.8 years) undergoing clinical brain MRI at 1.5 T for workup of cognitive decline. We compared three 3D T1 magnetization prepared rapid gradient echo (MPRAGE) sequences with the following parameter settings: ADNI-2 1.2 mm iso-voxel, no image filtering, LOCAL- 1.0 mm iso-voxel no image filtering, LOCAL+ 1.0 mm iso-voxel with image edge enhancement. Brain segmentation was performed by two different and established analysis tools, FreeSurfer and MorphoBox, using standard parameters. Spatial resolution (1.0 versus 1.2 mm iso-voxel) and modification in contrast resulted in relative estimated volume difference of up to 4.28 % (p < 0.001) in cortical gray matter and 4.16 % (p < 0.01) in hippocampus. Image data filtering resulted in estimated volume difference of up to 5.48 % (p < 0.05) in cortical gray matter. A simple change of MR parameters, notably spatial resolution, contrast, and filtering, may systematically bias results of automated brain MRI morphometry of up to 4-5 %. This is in the same range as early disease-related brain volume alterations, for example, in Alzheimer disease. Automated brain segmentation software packages should therefore require strict MR parameter selection or include compensatory algorithms to avoid MR parameter-related bias of brain morphometry results. (orig.)

  15. The Corpus Callosum Area and Brain Volume in Alzheimer's Disease, Mild Cognitive Impairment and Healthy Controls

    International Nuclear Information System (INIS)

    Choi, Hee Seok; Kim, Kwang Ki; Yoon, Yup Yoon; Seo, Hyung Suk

    2009-01-01

    To compare the corpus callosum (CC) area and brain volume among individuals with Alzheimer's disease (AD), mild cognitive impairment (MCI) and healthy controls (HC). To evaluate the relationship of CC area and brain volume in 111 subjects (M:F = 48:63; mean age, 56.9 years) without memory disturbance and 28 subjects (11:17; 66.7years) with memory disturbance. The 11 AD (3:8; 75.7 years), 17 MCI (8:9; 60.9 years) and 28 selected HC (11:17; 66.4 years) patients were investigated for comparison of their CC area and brain volume. A good positive linear correlation was found between CC area and brain volume in subjects without and with memory disturbance (r = 0.64 and 0.66, respectively, p 2 , 715.4 ± 107 cm3) were significantly smaller than in MCI patients (595.9 ± 108, 844.1 ± 85) and the HCs (563.2 ± 75, 818.9 ± 109) (p < 0.05). The CC area and brain volume were not significantly different between MCI patients and the HCs. The CC area was significantly correlated with brain volume. Both CC area and brain volume were significantly smaller in the AD patients

  16. Bilateral cerebral hemispheric infarction associated with sildenafil citrate (Viagra) use.

    Science.gov (United States)

    Kim, K-K; Kim, D G; Ku, Y H; Lee, Y J; Kim, W-C; Kim, O J; Kim, H S

    2008-03-01

    Sildenafil citrate (Viagra) is one of the frequently prescribed drugs for men with erectile dysfunction. We describe a 52-year-old man with bilateral middle cerebral artery (MCA) territory infarction after sildenafil use. He ingested 100 mg of sildenafil and about 1 h later, he complained of chest discomfort, palpitation and dizziness followed by mental obtundation, global aphasia and left hemiparesis. Brain magnetic resonance imaging documented acute bilateral hemispheric infarction, and cerebral angiography showed occluded bilateral MCA. Despite significant bilateral MCA stenosis and cerebral infarction, systemic hypotension persisted for a day. We presume that cerebral infarction was caused by cardioembolism with sildenafil use.

  17. Sex differences in the risk profile and male predominance in silent brain infarction in community-dwelling elderly subjects. The Sefuri brain MRI study

    International Nuclear Information System (INIS)

    Takashima, Yuki; Mori, Takahiro; Hashimoto, Manabu; Yuzuriha, Takefumi; Yao, Hiroshi; Miwa, Yoshikazu; Sasaguri, Toshiyuki; Uchino, Akira

    2010-01-01

    Although brain infarction is more common in men, the male predominance of silent brain infarction (SBI) was inconsistent in the earlier studies. This study was to examine the relationship between sex differences in the risk profile and SBI. We conducted a population-based, cross-sectional analysis of cardiovascular risk factors and SBI on MRI. We asked all the female participants about the age at natural menopause and parity. SBI was detected in 77 (11.3%) of 680 participants (266 men and 414 women) with a mean age of 64.5 (range 40-93) years. In the logistic analysis, age (odds ratio (OR)=2.760/10 years, 95% confidence interval (CI)=2.037-3.738), hypertension (OR=3.465, 95% CI=1.991-6.031), alcohol intake (OR=2.494, 95% CI=1.392-4.466) and smoking (OR=2.302, 95% CI=1.161-4.565) were significant factors concerning SBI. Although SBI was more prevalent among men, this sex difference disappeared on the multivariate model after adjustment for other confounders. In 215 women aged 60 years or older, age at natural menopause, early menopause, duration of menopause, number of children and age at the last parity were not significantly associated with SBI after adjustment for age. Hypertension and age were considered to be the major risk factors for SBI in community-dwelling people. Male predominance in SBI was largely due to higher prevalence of alcohol habit and smoking in men than in women in our population. (author)

  18. Volume of Structures in the Fetal Brain Measured with a New Semiautomated Method.

    Science.gov (United States)

    Ber, R; Hoffman, D; Hoffman, C; Polat, A; Derazne, E; Mayer, A; Katorza, E

    2017-11-01

    Measuring the volume of fetal brain structures is challenging due to fetal motion, low resolution, and artifacts caused by maternal tissue. Our aim was to introduce a new, simple, Matlab-based semiautomated method to measure the volume of structures in the fetal brain and present normal volumetric curves of the structures measured. The volume of the supratentorial brain, left and right hemispheres, cerebellum, and left and right eyeballs was measured retrospectively by the new semiautomated method in MR imaging examinations of 94 healthy fetuses. Four volume ratios were calculated. Interobserver agreement was calculated with the intraclass correlation coefficient, and a Bland-Altman plot was drawn for comparison of manual and semiautomated method measurements of the supratentorial brain. We present normal volumetric curves and normal percentile values of the structures measured according to gestational age and of the ratios between the cerebellum and the supratentorial brain volume and the total eyeball and the supratentorial brain volume. Interobserver agreement was good or excellent for all structures measured. The Bland-Altman plot between manual and semiautomated measurements showed a maximal relative difference of 7.84%. We present a technologically simple, reproducible method that can be applied prospectively and retrospectively on any MR imaging protocol, and we present normal volumetric curves measured. The method shows results like manual measurements while being less time-consuming and user-dependent. By applying this method on different cranial and extracranial structures, anatomic and pathologic, we believe that fetal volumetry can turn from a research tool into a practical clinical one. © 2017 by American Journal of Neuroradiology.

  19. High frequency of silent brain infarcts associated with cognitive deficits in an economically disadvantaged population.

    Science.gov (United States)

    Squarzoni, Paula; Tamashiro-Duran, Jaqueline H; Duran, Fabio L S; Leite, Claudia C; Wajngarten, Mauricio; Scazufca, Marcia; Menezes, Paulo R; Lotufo, Paulo A; Alves, Tania C T F; Busatto, Geraldo F

    2017-08-01

    Using magnetic resonance imaging, we aimed to assess the presence of silent brain vascular lesions in a sample of apparently healthy elderly individuals who were recruited from an economically disadvantaged urban region (São Paulo, Brazil). We also wished to investigate whether the findings were associated with worse cognitive performance. A sample of 250 elderly subjects (66-75 years) without dementia or neuropsychiatric disorders were recruited from predefined census sectors of an economically disadvantaged area of Sao Paulo and received structural magnetic resonance imaging scans and cognitive testing. A high proportion of individuals had very low levels of education (4 years or less, n=185; 21 with no formal education). The prevalence of at least one silent vascular-related cortical or subcortical lesion was 22.8% (95% confidence interval, 17.7-28.5), and the basal ganglia was the most frequently affected site (63.14% of cases). The subgroup with brain infarcts presented significantly lower levels of education than the subgroup with no brain lesions as well as significantly worse current performance in cognitive test domains, including memory and attention (pcognitive deficits, and in the absence of magnetic resonance imaging data, this cognitive impairment may be considered simply related to ageing. Emphatic attention should be paid to potentially deleterious effects of vascular brain lesions in poorly educated elderly individuals from economically disadvantaged environments.

  20. Scintigraphic evaluation of coronary thrombolysis with urokinase using /sup 201/Tl-emission computed tomography. Effect on infarct size

    Energy Technology Data Exchange (ETDEWEB)

    Kambara, Hirofumi; Tamaki, Shunichi; Kadota, Kazunori; Nohara, Takashi; Suzuki, Yukisono; Tamaki, Nagara; Torizuka, Kanji; Kawai, Chuichi [Kyoto Univ. (Japan). Faculty of Medicine

    1984-09-01

    Twenty-seven patients with first acute myocardial infarction were evaluated by serial determination of creatine kinase (CK) and thallium-201 myocardial emission computed tomography (ECT) performed four weeks after infarction. Total release of CK-MB and peak CK-MB had a linear correlation with infarct volume calculated by ECT, but a different relationship was found in between patients with successful coronary thrombolysis and those without. The former group of patients had an earlier peak of CK-MB and larger release of the cardiac enzyme comparative to infarct volume than the latter group. In 28 cases with proximal occlusion of the anterior descending coronary artery ECT-infarct volume was smaller with ealier recanalization within 10 hours after onset of infarction and, therefore, the time delay of recanalization may be allowed up to 10 hours. In conclusion, early coronary recanalization is an effective method to limit infarct size and time limit may be up to 10 hours after onset of infarction. But enzymatic calculation of infarct size should be modified when early coronary recanalization was expected.

  1. Restraint of appetite and reduced regional brain volumes in anorexia nervosa: a voxel-based morphometric study

    Directory of Open Access Journals (Sweden)

    Brooks Samantha J

    2011-11-01

    Full Text Available Abstract Background Previous Magnetic Resonance Imaging (MRI studies of people with anorexia nervosa (AN have shown differences in brain structure. This study aimed to provide preliminary extensions of this data by examining how different levels of appetitive restraint impact on brain volume. Methods Voxel based morphometry (VBM, corrected for total intracranial volume, age, BMI, years of education in 14 women with AN (8 RAN and 6 BPAN and 21 women (HC was performed. Correlations between brain volume and dietary restraint were done using Statistical Package for the Social Sciences (SPSS. Results Increased right dorsolateral prefrontal cortex (DLPFC and reduced right anterior insular cortex, bilateral parahippocampal gyrus, left fusiform gyrus, left cerebellum and right posterior cingulate volumes in AN compared to HC. RAN compared to BPAN had reduced left orbitofrontal cortex, right anterior insular cortex, bilateral parahippocampal gyrus and left cerebellum. Age negatively correlated with right DLPFC volume in HC but not in AN; dietary restraint and BMI predicted 57% of variance in right DLPFC volume in AN. Conclusions In AN, brain volume differences were found in appetitive, somatosensory and top-down control brain regions. Differences in regional GMV may be linked to levels of appetitive restraint, but whether they are state or trait is unclear. Nevertheless, these discrete brain volume differences provide candidate brain regions for further structural and functional study in people with eating disorders.

  2. Protective effect of Kombucha tea on brain damage induced by transient cerebral ischemia and reperfusion in rat

    OpenAIRE

    Najmeh Kabiri; Mahbubeh Setorki

    2016-01-01

    The aim of study was to investigate the potential neuroprotective effects of Kombucha on cerebral damage induced by ischemia in rats (n=99). Cerebral infarct volume in the ischemic rats received Kombucha solution showed no significance alteration. However, the permeability of blood-brain barrier significantly decreased in both ischemic rats received 15 mg/kg Kombucha tea and Sham group. In addition, brain water content in the ischemic groups treated with Kombucha solution was significantly hi...

  3. Multiple small hemorrhagic infarcts in cerebral air embolism: a case report.

    Science.gov (United States)

    Togo, Masaya; Hoshi, Taku; Matsuoka, Ryosuke; Imai, Yukihiro; Kohara, Nobuo

    2017-11-16

    Cerebral air embolism is a rare cause of cerebral infarction. In cerebral air embolism, T2 star-weighted imaging shows numerous spotty hypointense signals. Previous reports have suggested that these signals represent air in the brain and are gradually diminished and absorbed. We experienced two cases of cerebral air embolism, and in one of them, we conducted an autopsy. Case 1 was a 76-year-old Japanese man with lung cancer and emphysema. A spasmodic cough induced massive cerebral and cardiac air embolisms and the patient died because of cerebral herniation. T2 star-weighted imaging of brain magnetic resonance imaging showed multiple spotty low signals. Brain autopsy showed numerous spotty hemorrhagic infarcts in the area of T2 star-weighted imaging signals. Case 2 was an 85-year-old Japanese man with emphysema who suffered from acute stroke. Similar spotty T2 star-weighted imaging signals were observed and remained unchanged 2 months after the onset. These findings indicate that T2 star-weighted imaging in cerebral air embolism partially represents micro-hemorrhagic infarction caused by air bubbles that have migrated into the brain.

  4. Dose-dependent neuroprotective effect of enoxaparin on cold-induced traumatic brain injury.

    Science.gov (United States)

    Keskin, Ilknur; Gunal, M Yalcin; Ayturk, Nilufer; Kilic, Ulkan; Ozansoy, Mehmet; Kilic, Ertugrul

    2017-05-01

    Recent evidence exists that enoxaparin can reduce brain injury because of its anticoagulant activity. To investigate the potential therapeutic effect of enoxaparin on cold-induced traumatic brain injury, at 20 minutes after modeling, male BALB/c mouse models of cold-induced traumatic brain injury were intraperitoneally administered 3 and 10 mg/kg enoxaparin or isotonic saline solution. Twenty-four hours later, enoxaparin at 10 mg/kg greatly reduced infarct volume, decreased cell apoptosis in the cortex and obviously increased serum level of total antioxidant status. By contrast, administration of enoxaparin at 3 mg/kg did not lead to these changes. These findings suggest that enoxaparin exhibits neuroprotective effect on cold-induced traumatic brain injury in a dose-dependent manner.

  5. Quantitative estimation of infarct size by simultaneous dual radionuclide single photon emission computed tomography: comparison with peak serum creatine kinase activity

    International Nuclear Information System (INIS)

    Kawaguchi, K.; Sone, T.; Tsuboi, H.; Sassa, H.; Okumura, K.; Hashimoto, H.; Ito, T.; Satake, T.

    1991-01-01

    To test the hypothesis that simultaneous dual energy single photon emission computed tomography (SPECT) with technetium-99m (99mTc) pyrophosphate and thallium-201 (201TI) can provide an accurate estimate of the size of myocardial infarction and to assess the correlation between infarct size and peak serum creatine kinase activity, 165 patients with acute myocardial infarction underwent SPECT 3.2 +/- 1.3 (SD) days after the onset of acute myocardial infarction. In the present study, the difference in the intensity of 99mTc-pyrophosphate accumulation was assumed to be attributable to difference in the volume of infarcted myocardium, and the infarct volume was corrected by the ratio of the myocardial activity to the osseous activity to quantify the intensity of 99mTc-pyrophosphate accumulation. The correlation of measured infarct volume with peak serum creatine kinase activity was significant (r = 0.60, p less than 0.01). There was also a significant linear correlation between the corrected infarct volume and peak serum creatine kinase activity (r = 0.71, p less than 0.01). Subgroup analysis showed a high correlation between corrected volume and peak creatine kinase activity in patients with anterior infarctions (r = 0.75, p less than 0.01) but a poor correlation in patients with inferior or posterior infarctions (r = 0.50, p less than 0.01). In both the early reperfusion and the no reperfusion groups, a good correlation was found between corrected infarct volume and peak serum creatine kinase activity (r = 0.76 and r = 0.76, respectively; p less than 0.01)

  6. Lacunar infarction in brain tumor patients. Chronic stage complication after radiation therapy

    International Nuclear Information System (INIS)

    Nakazaki, Kiyoshi; Titoku, Shirou; Ota, Shinzou; Sato, Mitiyoshi; Kobanawa, Satoshi; Tutida, Kazuyuki; Tanaka, Yasue; Goto, Katsuya; Ota, Taisei

    2007-01-01

    The authors reported two relatively young adults with lacunar infarction that took place many years after radiation therapy. The first case was that of a 41-year-old male presenting with a slight decrease in consciousness and right hemiparesis of sudden occurrence. MRI revealed a lacunar infarction in the left internal capsule. This patient had received radiation therapy and chemotherapy for a right basal ganglia germinoma when he was 24 years old. The tumor completely disappeared and he was able to return to work. The second case was a 24-year-old female presenting with dysesthesia in the right upper extremity and nausea of sudden occurrence. MRI disclosed a lacunar infarct in the right corona radiata. The patient had received radiation therapy for a suprasellar tumor when she was 11 years old. The tumor considerably decreased in size and the patient conducted normal social life thereafter. MRI showed a lacunar infarction in the right corona radiata. Review of the literature was made and the possibility of radiation therapy as a causative factor of the lacunar infarction in relatively young adults was discussed. (author)

  7. Correlation among body height, intelligence, and brain gray matter volume in healthy children.

    Science.gov (United States)

    Taki, Yasuyuki; Hashizume, Hiroshi; Sassa, Yuko; Takeuchi, Hikaru; Asano, Michiko; Asano, Kohei; Kotozaki, Yuka; Nouchi, Rui; Wu, Kai; Fukuda, Hiroshi; Kawashima, Ryuta

    2012-01-16

    A significant positive correlation between height and intelligence has been demonstrated in children. Additionally, intelligence has been associated with the volume of gray matter in the brains of children. Based on these correlations, we analyzed the correlation among height, full-scale intelligence quotient (IQ) and gray matter volume applying voxel-based morphometry using data from the brain magnetic resonance images of 160 healthy children aged 5-18 years of age. As a result, body height was significantly positively correlated with brain gray matter volume. Additionally, the regional gray matter volume of several regions such as the bilateral prefrontal cortices, temporoparietal region, and cerebellum was significantly positively correlated with body height and that the gray matter volume of several of these regions was also significantly positively correlated with full-scale intelligence quotient (IQ) scores after adjusting for age, sex, and socioeconomic status. Our results demonstrate that gray and white matter volume may mediate the correlation between body height and intelligence in healthy children. Additionally, the correlations among gray and white matter volume, height, and intelligence may be at least partially explained by the effect of insulin-like growth factor-1 and growth hormones. Given the importance of the effect of environmental factors, especially nutrition, on height, IQ, and gray matter volume, the present results stress the importance of nutrition during childhood for the healthy maturation of body and brain. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Cerebral Taurine Levels are Associated with Brain Edema and Delayed Cerebral Infarction in Patients with Aneurysmal Subarachnoid Hemorrhage.

    Science.gov (United States)

    Kofler, Mario; Schiefecker, Alois; Ferger, Boris; Beer, Ronny; Sohm, Florian; Broessner, Gregor; Hackl, Werner; Rhomberg, Paul; Lackner, Peter; Pfausler, Bettina; Thomé, Claudius; Schmutzhard, Erich; Helbok, Raimund

    2015-12-01

    Cerebral edema and delayed cerebral infarction (DCI) are common complications after aneurysmal subarachnoid hemorrhage (aSAH) and associated with poor functional outcome. Experimental data suggest that the amino acid taurine is released into the brain extracellular space secondary to cytotoxic edema and brain tissue hypoxia, and therefore may serve as a biomarker for secondary brain injury after aSAH. On the other hand, neuroprotective mechanisms of taurine treatment have been described in the experimental setting. We analyzed cerebral taurine levels using high-performance liquid chromatography in the brain extracellular fluid of 25 consecutive aSAH patients with multimodal neuromonitoring including cerebral microdialysis (CMD). Patient characteristics and clinical course were prospectively recorded. Associations with CMD-taurine levels were analyzed using generalized estimating equations with an autoregressive process to handle repeated observations within subjects. CMD-taurine levels were highest in the first days after aSAH (11.2 ± 3.2 µM/l) and significantly decreased over time (p taurine levels compared to those without (Wald = 7.3, df = 1, p taurine supplementation and brain extracellular taurine (p = 0.6). Moreover, a significant correlation with brain extracellular glutamate (r = 0.82, p taurine levels were found in patients with brain edema or DCI after aneurysmal subarachnoid hemorrhage. Its value as a potential biomarker deserves further investigation.

  9. Measurement of brain perfusion, blood volume, and blood-brain barrier permeability, using dynamic contrast-enhanced T(1)-weighted MRI at 3 tesla

    DEFF Research Database (Denmark)

    Larsson, Henrik B W; Courivaud, Frédéric; Rostrup, Egill

    2009-01-01

    Assessment of vascular properties is essential to diagnosis and follow-up and basic understanding of pathogenesis in brain tumors. In this study, a procedure is presented that allows concurrent estimation of cerebral perfusion, blood volume, and blood-brain permeability from dynamic T(1)-weighted...... on a pixel-by-pixel basis of cerebral perfusion, cerebral blood volume, and blood-brain barrier permeability.......Assessment of vascular properties is essential to diagnosis and follow-up and basic understanding of pathogenesis in brain tumors. In this study, a procedure is presented that allows concurrent estimation of cerebral perfusion, blood volume, and blood-brain permeability from dynamic T(1)-weighted...... imaging of a bolus of a paramagnetic contrast agent passing through the brain. The methods are applied in patients with brain tumors and in healthy subjects. Perfusion was estimated by model-free deconvolution using Tikhonov's method (gray matter/white matter/tumor: 72 +/- 16/30 +/- 8/56 +/- 45 mL/100 g...

  10. A genetic analysis of brain volumes and IQ in children

    NARCIS (Netherlands)

    van Leeuwen, M.; Peper, J.S.; van den Berg, S.M.; Brouwer, R.M.; Hulshoff Pol, H.E.; Kahn, R.S.; Boomsma, D.I.

    2009-01-01

    In a population-based sample of 112 nine-year old twin pairs, we investigated the association among total brain volume, gray matter and white matter volume, intelligence as assessed by the Raven IQ test, verbal comprehension, perceptual organization and perceptual speed as assessed by the Wechsler

  11. Effect of decompressive hemicraniectomy on mortality of malignant middle cerebral artery infarction

    OpenAIRE

    Bahram Aminmansour; Majeed Rezvany; Davood Sharifi; Hamidreza Shemshaki

    2010-01-01

    Background: Increasing intracranial pressure (ICP) is one of the leading causes of mortality in patients with malignant infarction of the middle cerebral artery (MCA). We prospectively evaluated patients with MCA infarction for one month survival after decompressive hemicraniectomy. Methods: This study was conducted at Alzahra University Hospital, Isfahan (Iran). Twenty patients with infarction in total MCA distribution area, resulting in midline shift of brain tissue for greater than 5mm...

  12. Cerebellar cortical infarct cavities and vertebral artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Cocker, Laurens J.L. de [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Kliniek Sint-Jan Radiologie, Brussels (Belgium); Compter, A.; Kappelle, L.J.; Worp, H.B. van der [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, Utrecht (Netherlands); Luijten, P.R.; Hendrikse, J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

    2016-09-15

    Cerebellar cortical infarct cavities are a newly recognised entity associated with atherothromboembolic cerebrovascular disease and worse physical functioning. We aimed to investigate the relationship of cerebellar cortical infarct cavities with symptomatic vertebrobasilar ischaemia and with vascular risk factors. We evaluated the MR images of 46 patients with a recent vertebrobasilar TIA or stroke and a symptomatic vertebral artery stenosis ≥50 % from the Vertebral Artery Stenting Trial (VAST) for the presence of cerebellar cortical infarct cavities ≤1.5 cm. At inclusion in VAST, data were obtained on age, sex, history of vertebrobasilar TIA or stroke, and vascular risk factors. Adjusted risk ratios were calculated with Poisson regression analyses for the relation between cerebellar cortical infarct cavities and vascular risk factors. Sixteen out of 46 (35 %) patients showed cerebellar cortical infarct cavities on the initial MRI, and only one of these 16 patients was known with a previous vertebrobasilar TIA or stroke. In patients with symptomatic vertebrobasilar ischaemia, risk factor profiles of patients with cerebellar cortical infarct cavities were not different from patients without these cavities. Cerebellar cortical infarct cavities are seen on MRI in as much as one third of patients with recently symptomatic vertebral artery stenosis. Since patients usually have no prior history of vertebrobasilar TIA or stroke, cerebellar cortical infarct cavities should be added to the spectrum of common incidental brain infarcts visible on routine MRI. (orig.)

  13. Zinc translocation accelerates infarction after mild transient focal ischemia.

    Science.gov (United States)

    Lee, J-M; Zipfel, G J; Park, K H; He, Y Y; Hsu, C Y; Choi, D W

    2002-01-01

    Excess release of chelatable zinc (Zn(2+)) from central synaptic vesicles may contribute to the pathogenesis of selective neuronal cell death following transient forebrain ischemia, but a role in neurodegeneration after focal ischemia has not been defined. Adult male Long-Evans rats subjected to middle cerebral artery occlusion (MCAO) for 30 min followed by reperfusion developed delayed cerebral infarction reaching completion 3 days after the insult. One day after the insult, many degenerating cerebral neurons exhibited increased intracellular Zn(2+), and some labeled with the antibody against activated caspase-3. I.c.v. administration of the Zn(2+) chelator, EDTA saturated with equimolar Ca(2+) (CaEDTA), 15 min prior to ischemia attenuated subsequent Zn(2+) translocation into cortical neurons, and reduced infarct volume measured 3 days after ischemia. Although the protective effect of CaEDTA at this endpoint was substantial (about 70% infarct reduction), it was lost when insult severity was increased (from 30 to 60 min MCAO), or when infarct volume was measured at a much later time point (14 days instead of 3 days after ischemia). These data suggest that toxic Zn(2+) translocation, from presynaptic terminals to post-synaptic cell bodies, may accelerate the development of cerebral infarction following mild transient focal ischemia.

  14. Etiology, Localization and Prognosis in Cerebellar Infarctions

    Directory of Open Access Journals (Sweden)

    Yavuz Yücel

    2006-01-01

    Full Text Available Cerebrovasculer disease are the most frequent disease of the brain. Cerebellar infarct remains % 1.5-4.2 of these diseases. Etiological factors, lesion localization, symptoms and findings and relationship with prognosis of our patients with cerebellar infarct were investigated in our study. For this purpose, 32 patients were evaluated who were admitted to the Dicle University Medical School Department of Neurology in 1995-2001 hospitalized with the diagnosis of clinically and radiological confirmed cerebellar infarction.All of patients in the study group, 21 (%65.6 were male and 11 (%34.3 female. Age of overall patients ranged between 40 and 75 years with a mean of 57.8±10.2 years. Atherothrombotic infarct was the most frequent reason at the etiologic clinical classification. The most frequently found localization was the posterior inferior cerebellar artery infarct (%50. The leading two risk factors were hypertension (%78.1 and cigarette smoking (%50. The most common sign and symptoms were vertigo (%93.7, vomiting (%75, headache (%68.7 and cerebellar dysfunction findings (%50. The mean duration of hospitalization was 16.3±7.6 days. Overall mortality rate was found to be % 6.2. Finally, the most remarkable risk factors at cerebellar infarct patients are hypertension and atherosclerosis at etiology. We are considering that, controlling of these factors will reduce the appearance frequency of cerebellar infarcts.

  15. A Computational Model for the Automatic Diagnosis of Attention Deficit Hyperactivity Disorder Based on Functional Brain Volume

    Directory of Open Access Journals (Sweden)

    Lirong Tan

    2017-09-01

    Full Text Available In this paper, we investigated the problem of computer-aided diagnosis of Attention Deficit Hyperactivity Disorder (ADHD using machine learning techniques. With the ADHD-200 dataset, we developed a Support Vector Machine (SVM model to classify ADHD patients from typically developing controls (TDCs, using the regional brain volumes as predictors. Conventionally, the volume of a brain region was considered to be an anatomical feature and quantified using structural magnetic resonance images. One major contribution of the present study was that we had initially proposed to measure the regional brain volumes using fMRI images. Brain volumes measured from fMRI images were denoted as functional volumes, which quantified the volumes of brain regions that were actually functioning during fMRI imaging. We compared the predictive power of functional volumes with that of regional brain volumes measured from anatomical images, which were denoted as anatomical volumes. The former demonstrated higher discriminative power than the latter for the classification of ADHD patients vs. TDCs. Combined with our two-step feature selection approach which integrated prior knowledge with the recursive feature elimination (RFE algorithm, our SVM classification model combining functional volumes and demographic characteristics achieved a balanced accuracy of 67.7%, which was 16.1% higher than that of a relevant model published previously in the work of Sato et al. Furthermore, our classifier highlighted 10 brain regions that were most discriminative in distinguishing between ADHD patients and TDCs. These 10 regions were mainly located in occipital lobe, cerebellum posterior lobe, parietal lobe, frontal lobe, and temporal lobe. Our present study using functional images will likely provide new perspectives about the brain regions affected by ADHD.

  16. The Corpus Callosum Area and Brain Volume in Alzheimer's Disease, Mild Cognitive Impairment and Healthy Controls

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    Choi, Hee Seok; Kim, Kwang Ki; Yoon, Yup Yoon [Dongguk University Medical Center, Goyang (Korea, Republic of); Seo, Hyung Suk [Korea University Ansan Hospital, Ansan (Korea, Republic of)

    2009-07-15

    To compare the corpus callosum (CC) area and brain volume among individuals with Alzheimer's disease (AD), mild cognitive impairment (MCI) and healthy controls (HC). To evaluate the relationship of CC area and brain volume in 111 subjects (M:F = 48:63; mean age, 56.9 years) without memory disturbance and 28 subjects (11:17; 66.7years) with memory disturbance. The 11 AD (3:8; 75.7 years), 17 MCI (8:9; 60.9 years) and 28 selected HC (11:17; 66.4 years) patients were investigated for comparison of their CC area and brain volume. A good positive linear correlation was found between CC area and brain volume in subjects without and with memory disturbance (r = 0.64 and 0.66, respectively, p < 0.01). The CC area and brain volume in AD patients (498.7 +- 72 mm{sup 2}, 715.4 +- 107 cm3) were significantly smaller than in MCI patients (595.9 +- 108, 844.1 +- 85) and the HCs (563.2 +- 75, 818.9 +- 109) (p < 0.05). The CC area and brain volume were not significantly different between MCI patients and the HCs. The CC area was significantly correlated with brain volume. Both CC area and brain volume were significantly smaller in the AD patients

  17. Current self-reported symptoms of attention deficit/hyperactivity disorder are associated with total brain volume in healthy adults.

    Directory of Open Access Journals (Sweden)

    Martine Hoogman

    Full Text Available BACKGROUND: Reduced total brain volume is a consistent finding in children with Attention Deficit/Hyperactivity Disorder (ADHD. In order to get a better understanding of the neurobiology of ADHD, we take the first step in studying the dimensionality of current self-reported adult ADHD symptoms, by looking at its relation with total brain volume. METHODOLOGY/PRINCIPAL FINDINGS: In a sample of 652 highly educated adults, the association between total brain volume, assessed with magnetic resonance imaging, and current number of self-reported ADHD symptoms was studied. The results showed an association between these self-reported ADHD symptoms and total brain volume. Post-hoc analysis revealed that the symptom domain of inattention had the strongest association with total brain volume. In addition, the threshold for impairment coincides with the threshold for brain volume reduction. CONCLUSIONS/SIGNIFICANCE: This finding improves our understanding of the biological substrates of self-reported ADHD symptoms, and suggests total brain volume as a target intermediate phenotype for future gene-finding in ADHD.

  18. Genetic Schizophrenia Risk Variants Jointly Modulate Total Brain and White Matter Volume

    DEFF Research Database (Denmark)

    Terwisscha van Scheltinga, Afke F; Bakker, Steven C; van Haren, Neeltje E M

    2013-01-01

    with total brain volume (R(2)=.048, p=1.6×10(-4)) and white matter volume (R(2)=.051, p=8.6×10(-5)) equally in patients and control subjects. The number of (independent) SNPs that substantially influenced both disease risk and white matter (n=2020) was much smaller than the entire set of SNPs that modulated...... modulating schizophrenia and brain volume. METHODS: Odds ratios for genome-wide SNP data were calculated in the sample collected by the Psychiatric Genome-wide Association Study Consortium (8690 schizophrenia patients and 11,831 control subjects, excluding subjects from the present study). These were used...

  19. Structural covariance of brain region volumes is associated with both structural connectivity and transcriptomic similarity.

    Science.gov (United States)

    Yee, Yohan; Fernandes, Darren J; French, Leon; Ellegood, Jacob; Cahill, Lindsay S; Vousden, Dulcie A; Spencer Noakes, Leigh; Scholz, Jan; van Eede, Matthijs C; Nieman, Brian J; Sled, John G; Lerch, Jason P

    2018-05-18

    An organizational pattern seen in the brain, termed structural covariance, is the statistical association of pairs of brain regions in their anatomical properties. These associations, measured across a population as covariances or correlations usually in cortical thickness or volume, are thought to reflect genetic and environmental underpinnings. Here, we examine the biological basis of structural volume covariance in the mouse brain. We first examined large scale associations between brain region volumes using an atlas-based approach that parcellated the entire mouse brain into 318 regions over which correlations in volume were assessed, for volumes obtained from 153 mouse brain images via high-resolution MRI. We then used a seed-based approach and determined, for 108 different seed regions across the brain and using mouse gene expression and connectivity data from the Allen Institute for Brain Science, the variation in structural covariance data that could be explained by distance to seed, transcriptomic similarity to seed, and connectivity to seed. We found that overall, correlations in structure volumes hierarchically clustered into distinct anatomical systems, similar to findings from other studies and similar to other types of networks in the brain, including structural connectivity and transcriptomic similarity networks. Across seeds, this structural covariance was significantly explained by distance (17% of the variation, up to a maximum of 49% for structural covariance to the visceral area of the cortex), transcriptomic similarity (13% of the variation, up to maximum of 28% for structural covariance to the primary visual area) and connectivity (15% of the variation, up to a maximum of 36% for structural covariance to the intermediate reticular nucleus in the medulla) of covarying structures. Together, distance, connectivity, and transcriptomic similarity explained 37% of structural covariance, up to a maximum of 63% for structural covariance to the

  20. Region-specific reduction in brain volume in young adults with perinatal hypoxic-ischaemic encephalopathy.

    Science.gov (United States)

    Bregant, Tina; Rados, Milan; Vasung, Lana; Derganc, Metka; Evans, Alan C; Neubauer, David; Kostovic, Ivica

    2013-11-01

    A severe form of perinatal hypoxic-ischaemic encephalopathy (HIE) carries a high risk of perinatal death and severe neurological sequelae while in mild HIE only discrete cognitive disorders may occur. To compare total brain volumes and region-specific cortical measurements between young adults with mild-moderate perinatal HIE and a healthy control group of the same age. MR imaging was performed in a cohort of 14 young adults (9 males, 5 females) with a history of mild or moderate perinatal HIE. The control group consisted of healthy participants, matched with HIE group by age and gender. Volumetric analysis was done after the processing of MR images using a fully automated CIVET pipeline. We measured gyrification indexes, total brain volume, volume of grey and white matter, and of cerebrospinal fluid. We also measured volume, thickness and area of the cerebral cortex in the parietal, occipital, frontal, and temporal lobe, and of the isthmus cinguli, parahippocampal and cingulated gyrus, and insula. The HIE patient group showed smaller absolute volumetric data. Statistically significant (p right hemisphere, of cortical areas in the right temporal lobe and parahippocampal gyrus, of cortical volumes in the right temporal lobe and of cortical thickness in the right isthmus of the cingulate gyrus were found. Comparison between the healthy group and the HIE group of the same gender showed statistically significant changes in the male HIE patients, where a significant reduction was found in whole brain volume; left parietal, bilateral temporal, and right parahippocampal gyrus cortical areas; and bilateral temporal lobe cortical volume. Our analysis of total brain volumes and region-specific corticometric parameters suggests that mild-moderate forms of perinatal HIE lead to reductions in whole brain volumes. In the study reductions were most pronounced in temporal lobe and parahippocampal gyrus. Copyright © 2013 European Paediatric Neurology Society. All rights reserved.

  1. A Genetic Analysis of Brain Volumes and IQ in Children

    Science.gov (United States)

    van Leeuwen, Marieke; Peper, Jiska S.; van den Berg, Stephanie M.; Brouwer, Rachel M.; Hulshoff Pol, Hilleke E.; Kahn, Rene S.; Boomsma, Dorret I.

    2009-01-01

    In a population-based sample of 112 nine-year old twin pairs, we investigated the association among total brain volume, gray matter and white matter volume, intelligence as assessed by the Raven IQ test, verbal comprehension, perceptual organization and perceptual speed as assessed by the Wechsler Intelligence Scale for Children-III. Phenotypic…

  2. Total brain, cortical and white matter volumes in children previously treated with glucocorticoids

    DEFF Research Database (Denmark)

    Holm, Sara K; Madsen, Kathrine S; Vestergaard, Martin

    2018-01-01

    BACKGROUND: Perinatal exposure to glucocorticoids and elevated endogenous glucocorticoid-levels during childhood can have detrimental effects on the developing brain. Here, we examined the impact of glucocorticoid-treatment during childhood on brain volumes. METHODS: Thirty children and adolescents...... with rheumatic or nephrotic disease previously treated with glucocorticoids and 30 controls matched on age, sex, and parent education underwent magnetic resonance imaging (MRI) of the brain. Total cortical grey and white matter, brain, and intracranial volume, and total cortical thickness and surface area were...... were mainly driven by the children with rheumatic disease. Total cortical thickness and cortical surface area did not significantly differ between groups. We found no significant associations between glucocorticoid-treatment variables and volumetric measures. CONCLUSION: Observed smaller total brain...

  3. Quantitative analysis of normal fetal brain volume and flow by three-dimensional power Doppler ultrasound

    Directory of Open Access Journals (Sweden)

    Ju-Chun Hsu

    2013-09-01

    Conclusion: 3D ultrasound can be used to assess the fetal brain volume and blood flow development quantitatively. Our study indicates that the fetal brain vascularization and blood flow correlates significantly with the advancement of GA. This information may serve as a reference point for further studies of the fetal brain volume and blood flow in abnormal conditions.

  4. Myocardial infarction in the conscious dog: three dimensional mapping of infarct, collateral flow and region at risk

    International Nuclear Information System (INIS)

    Jugdutt, B.I.; Hutchins, G.M.; Bulkley, B.H.; Becker, L.C.

    1979-01-01

    Myocardial infarcts were examined in dogs to determine the spatial distribution of infarction in the region at risk and the relation between infarction and collateral blood flow. Permanent occlusion of the left circumflex (LC) coronary artery at a constant site was made in 27 conscious dogs that were sacrificed 2 days later. The anatomic region at risk was defined by postmortem coronary arteriography as the volume of the occluded LC coronary bed. The masses of the left ventricle (LV), infarct (I) and risk region (R) were calculated from planimetered areas of weighted bread-loaf sections of LV. Infarct size was directly related to the mass of the risk region (I = 0.53 R - 9.87; r = 0.97; p < 0.001). There was no infarction when R was less than about 20 g or 20% of the LV. The infarcts were mainly subendocardial and tapered from base to apex of the LV; 34% of the risk region became infarcted at the base compared with 22% at the apex. In all dogs, a significant rim of noninfarcted myocardium was identified at lateral aspects of the risk region, even at the endocardial surface. Using 9-μ radioactive microspheres, initial postocclusion flow at the margin of the infarct, but well within the risk region, was higher than at the center, and outer flows were higher than inner flows. Postocclusion flow was even higher in the noninfarcted rim within the risk region, but was still significantly less than flow to normal, nonrisk areas. Collateral flows throughout the risk region increased during the first hour after occlusion, and were even higher at 2 days.Epicardially and laterally within the anatomic risk region there is a substantial amount of tissue that does not infarct despite initally reduced blood flow

  5. Blocking of platelets or intrinsic coagulation pathway-driven thrombosis does not prevent cerebral infarctions induced by photothrombosis.

    Science.gov (United States)

    Kleinschnitz, Christoph; Braeuninger, Stefan; Pham, Mirko; Austinat, Madeleine; Nölte, Ingo; Renné, Thomas; Nieswandt, Bernhard; Bendszus, Martin; Stoll, Guido

    2008-04-01

    Models of photochemically-induced thrombosis are widely used in cerebrovascular research. Photothrombotic brain infarctions can be induced by systemic application of photosensitizing dyes followed by focal illumination of the cerebral cortex. Although the ensuing activation of platelets is well established, their contribution for thrombosis and tissue damage has not formally been proved. Infarction to the cerebral cortex was induced in mice by Rose Bengal and a cold light source. To assess the functional role of platelets, animals were platelet-depleted by anti-GPIbalpha antibodies or treated with GPIIb/IIIa-blocking F(ab)(2) fragments. The significance of the plasmatic coagulation cascade was determined by using blood coagulation factor XII (FXII)-deficient mice or heparin. Infarct development and infarct volumes were determined by serial MRI and conventional and electron microscopy. There was no difference in development and final size of photothrombotic infarctions in mice with impaired platelet function. Moreover, deficiency of FXII, which initiates the intrinsic pathway of coagulation and is essential for thrombus formation, or blockade of FXa, the key protease during the waterfall cascade of plasmatic coagulation, by heparin likewise did not affect lesion development. Our data demonstrate that platelet activation, factor XII-driven thrombus formation, and plasmatic coagulation pathways downstream of FX are not a prerequisite for ensuing tissue damage in models of photothrombotic vessel injury indicating that other pathomechanisms are involved. We suggest that this widely used model does not depend on platelet- or plasmatic coagulation-derived thrombosis.

  6. Wiring economy and volume exclusion determine neuronal placement in the Drosophila brain.

    Science.gov (United States)

    Rivera-Alba, Marta; Vitaladevuni, Shiv N; Mishchenko, Yuriy; Mischenko, Yuriy; Lu, Zhiyuan; Takemura, Shin-Ya; Scheffer, Lou; Meinertzhagen, Ian A; Chklovskii, Dmitri B; de Polavieja, Gonzalo G

    2011-12-06

    Wiring economy has successfully explained the individual placement of neurons in simple nervous systems like that of Caenorhabditis elegans [1-3] and the locations of coarser structures like cortical areas in complex vertebrate brains [4]. However, it remains unclear whether wiring economy can explain the placement of individual neurons in brains larger than that of C. elegans. Indeed, given the greater number of neuronal interconnections in larger brains, simply minimizing the length of connections results in unrealistic configurations, with multiple neurons occupying the same position in space. Avoiding such configurations, or volume exclusion, repels neurons from each other, thus counteracting wiring economy. Here we test whether wiring economy together with volume exclusion can explain the placement of neurons in a module of the Drosophila melanogaster brain known as lamina cartridge [5-13]. We used newly developed techniques for semiautomated reconstruction from serial electron microscopy (EM) [14] to obtain the shapes of neurons, the location of synapses, and the resultant synaptic connectivity. We show that wiring length minimization and volume exclusion together can explain the structure of the lamina microcircuit. Therefore, even in brains larger than that of C. elegans, at least for some circuits, optimization can play an important role in individual neuron placement. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Cerebral infarctions due to CNS infection with Enterobacter sakazakii

    International Nuclear Information System (INIS)

    Gallagher, P.G.; Ball, W.S.

    1991-01-01

    Recent reports have implicated Enterobacter sakazakii, a gram-negative enteric bacillus, in neonatal sepsis and meningitis. Cases of severe central nervous system involvement, including ventriculitis, brain abscess, infarction, and cyst formation, have been described. We present serial head CT findings in a case of neonatal E. sakazakii meningitis complicated by a ring enhancing cerebral infarction which mimicked abscess formation. In meningitis secondary to this agent, a recognized pattern of cerebral hypodensity with or without cystic degeneration late in the course of the infection is likely to represent cerebral infarction rather than an abscess especially if there is a lack of culture evidence of a bacterial infection. (orig.)

  8. Therapeutic effects of human multilineage-differentiating stress enduring (MUSE cell transplantation into infarct brain of mice.

    Directory of Open Access Journals (Sweden)

    Tomohiro Yamauchi

    Full Text Available Bone marrow stromal cells (BMSCs are heterogeneous and their therapeutic effect is pleiotropic. Multilineage-differentiating stress enduring (Muse cells are recently identified to comprise several percentages of BMSCs, being able to differentiate into triploblastic lineages including neuronal cells and act as tissue repair cells. This study was aimed to clarify how Muse and non-Muse cells in BMSCs contribute to functional recovery after ischemic stroke.Human BMSCs were separated into stage specific embryonic antigen-3-positive Muse cells and -negative non-Muse cells. Immunodeficient mice were subjected to permanent middle cerebral artery occlusion and received transplantation of vehicle, Muse, non-Muse or BMSCs (2.5×104 cells into the ipsilateral striatum 7 days later.Motor function recovery in BMSC and non-Muse groups became apparent at 21 days after transplantation, but reached the plateau thereafter. In Muse group, functional recovery was not observed for up to 28 days post-transplantation, but became apparent at 35 days post-transplantation. On immunohistochemistry, only Muse cells were integrated into peri-infarct cortex and differentiate into Tuj-1- and NeuN-expressing cells, while negligible number of BMSCs and non-Muse cells remained in the peri-infarct area at 42 days post-transplantation.These findings strongly suggest that Muse cells and non-Muse cells may contribute differently to tissue regeneration and functional recovery. Muse cells may be more responsible for replacement of the lost neurons through their integration into the peri-infarct cortex and spontaneous differentiation into neuronal marker-positive cells. Non-Muse cells do not remain in the host brain and may exhibit trophic effects rather than cell replacement.

  9. Time series analysis of brain regional volume by MR image

    International Nuclear Information System (INIS)

    Tanaka, Mika; Tarusawa, Ayaka; Nihei, Mitsuyo; Fukami, Tadanori; Yuasa, Tetsuya; Wu, Jin; Ishiwata, Kiichi; Ishii, Kenji

    2010-01-01

    The present study proposed a methodology of time series analysis of volumes of frontal, parietal, temporal and occipital lobes and cerebellum because such volumetric reports along the process of individual's aging have been scarcely presented. Subjects analyzed were brain images of 2 healthy males and 18 females of av. age of 69.0 y, of which T1-weighted 3D SPGR (spoiled gradient recalled in the steady state) acquisitions with a GE SIGNA EXCITE HD 1.5T machine were conducted for 4 times in the time series of 42-50 months. The image size was 256 x 256 x (86-124) voxels with digitization level 16 bits. As the template for the regions, the standard gray matter atlas (icbn452 a tlas p robability g ray) and its labeled one (icbn.Labels), provided by UCLA Laboratory of Neuro Imaging, were used for individual's standardization. Segmentation, normalization and coregistration were performed with the MR imaging software SPM8 (Statistic Parametric Mapping 8). Volumes of regions were calculated as their voxel ratio to the whole brain voxel in percent. It was found that the regional volumes decreased with aging in all above lobes examined and cerebellum in average percent per year of -0.11, -0.07, -0.04, -0.02, and -0.03, respectively. The procedure for calculation of the regional volumes, which has been manually operated hitherto, can be automatically conducted for the individual brain using the standard atlases above. (T.T.)

  10. Assessing brain volume changes in older women with breast cancer receiving adjuvant chemotherapy: a brain magnetic resonance imaging pilot study.

    Science.gov (United States)

    Chen, Bihong T; Sethi, Sean K; Jin, Taihao; Patel, Sunita K; Ye, Ningrong; Sun, Can-Lan; Rockne, Russell C; Haacke, E Mark; Root, James C; Saykin, Andrew J; Ahles, Tim A; Holodny, Andrei I; Prakash, Neal; Mortimer, Joanne; Waisman, James; Yuan, Yuan; Somlo, George; Li, Daneng; Yang, Richard; Tan, Heidi; Katheria, Vani; Morrison, Rachel; Hurria, Arti

    2018-05-02

    Cognitive decline is among the most feared treatment-related outcomes of older adults with cancer. The majority of older patients with breast cancer self-report cognitive problems during and after chemotherapy. Prior neuroimaging research has been performed mostly in younger patients with cancer. The purpose of this study was to evaluate longitudinal changes in brain volumes and cognition in older women with breast cancer receiving adjuvant chemotherapy. Women aged ≥ 60 years with stage I-III breast cancer receiving adjuvant chemotherapy and age-matched and sex-matched healthy controls were enrolled. All participants underwent neuropsychological testing with the US National Institutes of Health (NIH) Toolbox for Cognition and brain magnetic resonance imaging (MRI) prior to chemotherapy, and again around one month after the last infusion of chemotherapy. Brain volumes were measured using Neuroreader™ software. Longitudinal changes in brain volumes and neuropsychological scores were analyzed utilizing linear mixed models. A total of 16 patients with breast cancer (mean age 67.0, SD 5.39 years) and 14 age-matched and sex-matched healthy controls (mean age 67.8, SD 5.24 years) were included: 7 patients received docetaxel and cyclophosphamide (TC) and 9 received chemotherapy regimens other than TC (non-TC). There were no significant differences in segmented brain volumes between the healthy control group and the chemotherapy group pre-chemotherapy (p > 0.05). Exploratory hypothesis generating analyses focusing on the effect of the chemotherapy regimen demonstrated that the TC group had greater volume reduction in the temporal lobe (change = - 0.26) compared to the non-TC group (change = 0.04, p for interaction = 0.02) and healthy controls (change = 0.08, p for interaction = 0.004). Similarly, the TC group had a decrease in oral reading recognition scores (change = - 6.94) compared to the non-TC group (change = - 1.21, p for

  11. Global and regional annual brain volume loss rates in physiological aging.

    Science.gov (United States)

    Schippling, Sven; Ostwaldt, Ann-Christin; Suppa, Per; Spies, Lothar; Manogaran, Praveena; Gocke, Carola; Huppertz, Hans-Jürgen; Opfer, Roland

    2017-03-01

    The objective is to estimate average global and regional percentage brain volume loss per year (BVL/year) of the physiologically ageing brain. Two independent, cross-sectional single scanner cohorts of healthy subjects were included. The first cohort (n = 248) was acquired at the Medical Prevention Center (MPCH) in Hamburg, Germany. The second cohort (n = 316) was taken from the Open Access Series of Imaging Studies (OASIS). Brain parenchyma (BP), grey matter (GM), white matter (WM), corpus callosum (CC), and thalamus volumes were calculated. A non-parametric technique was applied to fit the resulting age-volume data. For each age, the BVL/year was derived from the age-volume curves. The resulting BVL/year curves were compared between the two cohorts. For the MPCH cohort, the BVL/year curve of the BP was an increasing function starting from 0.20% at the age of 35 years increasing to 0.52% at 70 years (corresponding values for GM ranged from 0.32 to 0.55%, WM from 0.02 to 0.47%, CC from 0.07 to 0.48%, and thalamus from 0.25 to 0.54%). Mean absolute difference between BVL/year trajectories across the age range of 35-70 years was 0.02% for BP, 0.04% for GM, 0.04% for WM, 0.11% for CC, and 0.02% for the thalamus. Physiological BVL/year rates were remarkably consistent between the two cohorts and independent from the scanner applied. Average BVL/year was clearly age and compartment dependent. These results need to be taken into account when defining cut-off values for pathological annual brain volume loss in disease models, such as multiple sclerosis.

  12. Peri-infarct zone pacing to prevent adverse left ventricular remodelling in patients with large myocardial infarction

    DEFF Research Database (Denmark)

    Stone, Gregg W; Chung, Eugene S; Stancak, Branislav

    2016-01-01

    AIMS: We sought to determine whether peri-infarct pacing prevents left ventricular (LV) remodelling and improves functional and clinical outcomes in patients with large first myocardial infarction (MI). METHODS AND RESULTS: A total of 126 patients at 27 international sites within 10 days of onset.......92). There were also no significant between-group differences in the change in LV end-systolic volume or ejection fraction over time. Quality of life, as assessed by the Minnesota Living with Heart Failure (HF) and European Quality of Life-5 Dimension questionnaires and New York Heart Association class, was also...

  13. Genomic regulation of natural variation in cortical and noncortical brain volume

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    Laughlin Rick E

    2006-02-01

    Full Text Available Abstract Background The relative growth of the neocortex parallels the emergence of complex cognitive functions across species. To determine the regions of the mammalian genome responsible for natural variations in cortical volume, we conducted a complex trait analysis using 34 strains of recombinant inbred (Rl strains of mice (BXD, as well as their two parental strains (C57BL/6J and DBA/2J. We measured both neocortical volume and total brain volume in 155 coronally sectioned mouse brains that were Nissl stained and embedded in celloidin. After correction for shrinkage, the measured cortical and noncortical brain volumes were entered into a multiple regression analysis, which removed the effects of body size and age from the measurements. Marker regression and interval mapping were computed using WebQTL. Results An ANOVA revealed that more than half of the variance of these regressed phenotypes is genetically determined. We then identified the regions of the genome regulating this heritability. We located genomic regions in which a linkage disequilibrium was present using WebQTL as both a mapping engine and genomic database. For neocortex, we found a genome-wide significant quantitative trait locus (QTL on chromosome 11 (marker D11Mit19, as well as a suggestive QTL on chromosome 16 (marker D16Mit100. In contrast, for noncortex the effect of chromosome 11 was markedly reduced, and a significant QTL appeared on chromosome 19 (D19Mit22. Conclusion This classic pattern of double dissociation argues strongly for different genetic factors regulating relative cortical size, as opposed to brain volume more generally. It is likely, however, that the effects of proximal chromosome 11 extend beyond the neocortex strictly defined. An analysis of single nucleotide polymorphisms in these regions indicated that ciliary neurotrophic factor (Cntf is quite possibly the gene underlying the noncortical QTL. Evidence for a candidate gene modulating neocortical

  14. The cerebrovascular structure and brain tissue volume: a comparative study between beagle dogs and mongrel dogs

    International Nuclear Information System (INIS)

    Liu Sheng; Shi Haibin; Hu Weixing; Zu Qingquan; Lu Shanshan; Xu Xiaoquan; Sun Lei; Li Linsun

    2011-01-01

    Objective: To compare the differences of cerebrovascular structure and brain tissue volume between beagle and mongrel dogs by using angiography and MR scanning. Methods: A total of 40 dogs, including 20 beagle dogs (beagle group) and 20 mongrel dogs (mongrel group), were enrolled in this study. Under general anesthesia, all dogs were examined with cerebral angiography and MR scanning. The cerebrovascular structure was evaluated with angiography via selective catheterization of aortic arch, bilateral external cerebral arteries (ECA), maxillary arteries, internal cerebral arteries (ICA) and vertebral arteries separately. The diameters of the ICA, middle cerebral artery (MCA), rostral cerebral artery (RCA), the anastomosis channel ICA and ECA, and basilar artery (BA) were measured at the similar point of each dog. Meanwhile the volumes of the brain tissue were calculated in coronal T2 view of MR scanning. The statistical analysis was performed among the weight of dogs, the diameter of arteries and the volume of brain tissue. The differences in the diameters and brain tissue volume were compared between the two groups. Results: No obvious variations in the cerebrovascular structure and brain tissue volume were found in these dogs. One mongrel dog was excluded from this study because of the severe stenosis of ICA. The mean weight of 20 beagle dogs and 19 mongrel dogs was (12.81±1.29) kg and (12.85±1.12) kg, respectively. The diameters of the ICA, MCA, RCA, the anastomosis channel between ICA and ECA and BA in beagle group were (1.26±0.07) mm, (0.90±0.05) mm, (0.58±0.07) mm, (0.55±0.07) mm and (0.95±0.06) mm, respectively. These parameters in mongrel group were (1.27±0.07) mm, (0.92±0.05) mm, (0.59±0.06) mm, (0.67±0.07) mm and (0.94±0.05) mm, respectively. The volume of brain in two groups was (76232.33±5018.51) mm 3 and (71863.96±4626.87) mm 3 , respectively. There were no obvious correlation among the body weight, the cerebrovascular diameters and brain

  15. Gd-DTPA and volume acquisitions in brain and spine tumors

    International Nuclear Information System (INIS)

    Ross, J.S.; Masaryk, T.J.; Modic, M.T.; Clampitt, M.

    1988-01-01

    Seventeen cases referred for evaluation of suspected neoplasms were studied with anisotropic three-dimensional fast low-angle shot imaging (30-60/9-14/50) with partitions of 1.5-3 mm before and after 0.1 mmol/kg of Gd-DTPA (Berlex Laboratories). Multiplanar reconstructions were performed on a Kontron work station. Sagittal and axial T1-weighted two-dimensional spin-echo (SE) sequences were acquired for comparison. Diagnoses included normal (N = 3), brain neoplasms (N = 7), spine neoplasms (N = 6), and brain inflammation (N = 1). Volume studies were of sufficient quality to allow reconstructions in 12 cases and were comparable diagnostically with two-dimensional SE images. Advantages of the three-dimensional technique were capacity to reconstruct any plane, decreased partial volume averaging, and a shorter examination time. Tissue contrast appeared equivalent. In five patients the examinations were inferior to SE studies because of motion and lack of contrast between vessels and enhancing regions. Paramagnetic contrast increases the sensitivity of volume studies in the detection of disease

  16. Brain MRI findings of carbon disulfide poisoning

    International Nuclear Information System (INIS)

    Cha, Joo Hee; Kim, Mi Jung; Yim, Sang Hyuk; Kim, Sam Soo; Han, Heon; Kim, Rok Ho

    2002-01-01

    To evaluate the findings of brain MRI in patients with carbon disulfide poisoning. Ninety-one patients who had suffered carbon disulfide poisoning [male:female=87:4; age, 32-74 (mean 53.3) years] were included in this study. To determine the extent of white matter hyperintensity (Grade 0-V) and lacunar infarction, T2-weighted MR imaging of the brain was performed. T2-weighted images depicted white matter hyperintensity in 70 patients (76.9%) and lacunar infarcts in 27 (29.7%). In these patients, the prevalent findings at T2-weighted MR imaging of the brain were white matter hyperintensity and lacunar infarcts. Disturbance of the cardiovascular system by carbon disulfide might account for these results

  17. Anatomically guided voxel-based partial volume effect correction in brain PET : Impact of MRI segmentation

    NARCIS (Netherlands)

    Gutierrez, Daniel; Montandon, Marie-Louise; Assal, Frederic; Allaoua, Mohamed; Ratib, Osman; Loevblad, Karl-Olof; Zaidi, Habib

    2012-01-01

    Partial volume effect is still considered one of the main limitations in brain PET imaging given the limited spatial resolution of current generation PET scanners. The accuracy of anatomically guided partial volume effect correction (PVC) algorithms in brain PET is largely dependent on the

  18. Atorvastatin therapy during the peri-infarct period attenuates left ventricular dysfunction and remodeling after myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Xian-Liang Tang

    Full Text Available Although statins impart a number of cardiovascular benefits, whether statin therapy during the peri-infarct period improves subsequent myocardial structure and function remains unclear. Thus, we evaluated the effects of atorvastatin on cardiac function, remodeling, fibrosis, and apoptosis after myocardial infarction (MI. Two groups of rats were subjected to permanent coronary occlusion. Group II (n = 14 received oral atorvastatin (10 mg/kg/d daily for 3 wk before and 4 wk after MI, while group I (n = 12 received equivalent doses of vehicle. Infarct size (Masson's trichrome-stained sections was similar in both groups. Compared with group I, echocardiographic left ventricular ejection fraction (LVEF and fractional area change (FAC were higher while LV end-diastolic volume (LVEDV and LV end-systolic and end-diastolic diameters (LVESD and LVEDD were lower in treated rats. Hemodynamically, atorvastatin-treated rats exhibited significantly higher dP/dt(max, end-systolic elastance (Ees, and preload recruitable stroke work (PRSW and lower LV end-diastolic pressure (LVEDP. Morphometrically, infarct wall thickness was greater in treated rats. The improvement of LV function by atorvastatin was associated with a decrease in hydroxyproline content and in the number of apoptotic cardiomyocyte nuclei. We conclude that atorvastatin therapy during the peri-infarct period significantly improves LV function and limits adverse LV remodeling following MI independent of a reduction in infarct size. These salubrious effects may be due in part to a decrease in myocardial fibrosis and apoptosis.

  19. Cortical thickness and subcortical brain volumes in professional rugby league players

    Directory of Open Access Journals (Sweden)

    Magdalena Wojtowicz

    Full Text Available Purpose: The purpose of this study was to examine cortical thickness and subcortical volumes in professional rugby players with an extensive history of concussions compared to control subjects. Method: Participants included 24 active and former professional rugby league players [Age M(SD = 33.3(6.3; Range = 21–44] with an extensive history of concussion and 18 age- and education-matched controls with no history of neurotrauma or participation in contact sports. Participants underwent T1-weighted imaging and completed a neuropsychological battery, including two tests of memory. Whole brain cortical thickness analysis and structural volume analysis was performed using FreeSurfer version 6.0. Results: Professional rugby league players reported greater alcohol consumption (p < .001 and had significantly worse delayed recall of a visually complex design (p = .04. They did not differ from controls on other clinical outcome measures. There were no differences in cortical thickness between the groups. Professional players had smaller whole brain (p = .003, bilateral hippocampi (ps = .03, and left amygdala volumes (p = .01 compared to healthy controls. Within the players group, there were significant associations between greater alcohol use and smaller bilateral hippocampi and left amygdala volumes. There were no associations between structural volumes and history of concussions or memory performance. Conclusions: The literature examining cortical thickness in athletes with a history of multiple concussions is mixed. We did not observe differences in cortical thickness in professional rugby league players compared to controls. However, smaller subcortical volumes were found in players that were, in part, associated with greater alcohol consumption. Keywords: Volumetric MRI, Cortical thickness, Concussion, Brain morphometry, Athletes, Rugby

  20. Brain-derived Neurotrophic Factor (BDNF) and gray matter volume in bipolar disorder.

    Science.gov (United States)

    Poletti, S; Aggio, V; Hoogenboezem, T A; Ambrée, O; de Wit, H; Wijkhuijs, A J M; Locatelli, C; Colombo, C; Arolt, V; Drexhage, H A; Benedetti, F

    2017-02-01

    Bipolar Disorder (BD) is a severe psychiatric condition characterized by grey matter (GM) volumes reduction. Neurotrophic factors have been suggested to play a role in the neuroprogressive changes during the illness course. In particular peripheral brain-derived neurotrophic factor (BDNF) has been proposed as a potential biomarker related to disease activity and neuroprogression in BD. The aim of our study was to investigate if serum levels of BDNF are associated with GM volumes in BD patients and healthy controls (HC). We studied 36 inpatients affected by a major depressive episode in course of BD type I and 17 HC. Analysis of variance was performed to investigate the effect of diagnosis on GM volumes in the whole brain. Threshold for significance was PBDNF levels compared with HC. Reduced GM volumes in BD patients compared to HC were observed in several brain areas, encompassing the caudate head, superior temporal gyrus, insula, fusiform gyrus, parahippocampal gyrus, and anterior cingulate cortex. The interaction analysis between BDNF levels and diagnosis showed a significant effect in the middle frontal gyrus. HC reported higher BDNF levels associated with higher GM volumes, whereas no association between BDNF and GM volumes was observed in BD. Our study seems to suggest that although the production of BDNF is increased in BD possibly to prevent and repair neural damage, its effects could be hampered by underlying neuroinflammatory processes interfering with the neurodevelopmental role of BDNF. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Three-dimensional sonographic measurement of normal fetal brain volume during the second half of pregnancy

    NARCIS (Netherlands)

    N.M. Roelfsema; W.C.J. Hop (Wim); S.M. Boito; J.W. Wladimiroff (Juriy)

    2004-01-01

    textabstractObjectives: This study was undertaken to develop a three-dimensional (3D) ultrasound method of measuring fetal brain volume. Study design: Serial 3D sonographic measurements of fetal brain volume were made in 68 normal singleton pregnancies at 18 to 34 weeks of gestation. A comparison

  2. A case of myxedema coma presenting as a brain stem infarct in a 74-year-old Korean woman.

    Science.gov (United States)

    Ahn, Ji Yun; Kwon, Hyuk-Sool; Ahn, Hee Chol; Sohn, You Dong

    2010-09-01

    Myxedema coma is the extreme form of untreated hypothyroidism. In reality, few patients present comatose with severe myxedema. We describe a patient with myxedema coma which was initially misdiagnosed as a brain stem infarct. She presented to the hospital with alteration of the mental status, generalized edema, hypothermia, hypoventilation, and hypotension. Initially her brain stem reflexes were absent. After respiratory and circulatory support, her neurologic status was not improved soon. The diagnosis of myxedema coma was often missed or delayed due to various clinical findings and concomitant medical condition and precipitating factors. It is more difficult to diagnose when a patient has no medical history of hypothyroidism. A high index of clinical suspicion can make a timely diagnosis and initiate appropriate treatment. We report this case to alert clinicians considering diagnosis of myxedema coma in patients with severe decompensated metabolic state including mental change.

  3. Brain volume and cognitive function in patients with revascularized coronary artery disease

    NARCIS (Netherlands)

    Ottens, Thomas H; Hendrikse, Jeroen; Nathoe, Hendrik M; Biessels, Geert Jan; van Dijk, Diederik

    2017-01-01

    BACKGROUND: The pathogenesis of cognitive dysfunction in patients with CAD remains unclear. CAD is associated with brain atrophy and specific lesions. Detailed knowledge about the association of brain volume measured with MRI, and cognitive function in patients with CAD is lacking. We therefore

  4. Brain renin angiotensin system in cardiac hypertrophy and failure

    Directory of Open Access Journals (Sweden)

    Luciana eCampos

    2012-01-01

    Full Text Available Brain renin-angiotensin system (RAS is significantly involved in the roles of the endocrine RAS in cardiovascular regulation. Our studies indicate that the brain RAS participates in the development of cardiac hypertrophy and fibrosis through sympathetic activation. Inhibition of sympathetic hyperactivity after myocardial infarction through suppression of the brain RAS appears beneficial. The brain RAS is involved in the modulation of circadian rhythms of arterial pressure, contributing to nondipping hypertension. We conclude that the brain RAS in pathophysiological states interacts synergistically with the chronically overactive RAS through a positive biofeedback in order to maintain a state of alert diseased conditions, such as cardiac hypertrophy and failure. Therefore, targeting brain RAS with drugs such as angiotensin converting inhibitors or receptor blockers having increased brain penetrability could be of advantage. These RAS-targeting drugs are first-line therapy for all heart failure patients. Since the RAS has both endocrine and local tissue components, RAS drugs are being developed to attain increased tissue penetrability and volume of distribution and consequently an efficient inhibition of both RAS components.

  5. Relationship between extent of brain hypoperfused area and functional outcome in patients with a small subcortical infarction

    International Nuclear Information System (INIS)

    Isaka, Yoshinari; Imaizumi, Masatoshi; Ashida, Keiichi; Nakayama, Hirofumi; Iiji, Osamu; Itoi, Yoshihito; Furukawa, Toshiyuki

    1992-01-01

    We performed 123 I-IMP single photon emission computed tomography (SPECT) in 43 patients who had a small infarction ( 2 =29.3; p 123 I-IMP SPECT in patients with a small infarction may discriminate lacunar infarction from embolic or hemodynamic infarction, which was caused by vascular lesions of major cerebral arteries, in subcortical area. Our study suggests that functional outcome is better in lacunar infarction than embolic or hemodynamic infarction in subcortical area. (author)

  6. CT scan and histological findings in experimental cerebral infarctions in cats

    International Nuclear Information System (INIS)

    Morimoto, Tetsuya

    1981-01-01

    Experimental cerebral infarctions were made in sixty-five cats by the transorbital approach. CT scanning was done at various periods after right-middle cerebral artery occlusion, and all cases were studied histopathologically. Cerebral microcirculation was studied by the carbon perfusion method, and blood-brain barrier (BBB) dysfunction was studied by intravenous fluorescein administration. The iodine content of brain tissue was measured and this value was compared with the findings on CT scan. Experimental cerebral infarction was divided into four stages according to CT scan findings. These are the pre-edema stage, edema stage, edema diminishing stage, and cavity stage. The low density area (LDA) in the edema stage has a mass effect and a spongy appearance is seen histopathologically. LDA in the edema diminishing stage is localized to the extent of the macroscopic infarcted region, and macrophage (so called ''gitter cells'') and capillaries are seen. Fluorescein stain indicating the area of BBB dysfunction shows almost the same extent as the area of disturbed microcirculation indicated by impaired carbon filling. In the edema diminishing stage, there is good carbon filling in the infarcted region, and enlarged capillaries with carbon black inside are seen. The study of iodine content showed that the iodine level is very high in the infarcted region, and the level has good correlation with the number of capillaries. The mechanism of contrast enhancement in the cerebral infarction seems to be well linked to the capillaries with BBB dysfunction. This study indicates that the contrast medium leaks through the capillary wall. (author)

  7. Longitudinal Changes in Total Brain Volume in Schizophrenia: Relation to Symptom Severity, Cognition and Antipsychotic Medication

    NARCIS (Netherlands)

    Veijola, J.; Guo, J.Y.; Moilanen, J.S.; Jaaskelainen, E.; Miettunen, J.; Kyllonen, M.; Haapea, M.; Huhtaniska, S.; Alaraisanen, A.; Maki, P.; Kiviniemi, V.; Nikkinen, J.; Starck, T.; Remes, J.J.; Tanskanen, P.; Tervonen, O.; Wink, A.M.; Kehagia, A.; Suckling, J.; Kobayashi, H.; Barnett, J.H.; Barnes, A.; Koponen, H.J.; Jones, P.B.; Isohanni, M.; Murray, G.K.

    2014-01-01

    Studies show evidence of longitudinal brain volume decreases in schizophrenia. We studied brain volume changes and their relation to symptom severity, level of function, cognition, and antipsychotic medication in participants with schizophrenia and control participants from a general population

  8. Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children

    International Nuclear Information System (INIS)

    Lind, Annika; Parkkola, Riitta; Lehtonen, Liisa; Maunu, Jonna; Lapinleimu, Helena; Munck, Petriina; Haataja, Leena

    2011-01-01

    Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children. (orig.)

  9. Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children

    Energy Technology Data Exchange (ETDEWEB)

    Lind, Annika [Turku University Hospital, Department of Pediatrics, Turku (Finland); Aabo Akademi University, Department of Psychology, Turku (Finland); Parkkola, Riitta [University of Turku and Turku University Hospital, Department of Radiology and Turku PET Center, PO Box 52, Turku (Finland); Lehtonen, Liisa; Maunu, Jonna; Lapinleimu, Helena [University of Turku and Turku University Hospital, Department of Pediatrics, Turku (Finland); Munck, Petriina [Turku University Hospital, Department of Pediatrics, Turku (Finland); University of Turku, Department of Psychology, Turku (Finland); Haataja, Leena [University of Turku and Turku University Hospital, Department of Pediatric Neurology, Turku (Finland)

    2011-08-15

    Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children. (orig.)

  10. Infarct size in patients with acute myocardial infarction estimated by emission computed tomography with technetium-99m pyrophosphate. Relation to creatine phosphokinase release

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Jun-ichi; Onodera, Sokichi; Imura, Suguru; Marutani, Yoshiaki; Takahori, Takashi; Nasuhara, Koh-ichi

    1986-09-01

    To evaluate the usefulness of single photon emission computed tomography (SPECT) with technetium-99m-pyrophosphate (/sup 99m/Tc-PYP) for estimating infarct size, we compared SPECT data with maximum creatine phosphokinase values. Background threshold was established in a series of phantom experiments. When a 40 % cut-off was applied, the SPECT data most closely approximated actual phantom volumes. Therefore, the 40 % cut-off level was used in the present study. In 10 patients with acute myocardial infarction, planar /sup 99m/Tc-PYP myocardial scintigraphy and SPECT using a rotating gamma camera were performed two days after the initial myocardial infarction episode. The maximum creatine phosphokinase value (CPKmax) was also measured repeatedly following the episode. When the infarct size measured by SPECT using transaxial images and calculated by the pixel counts, it correlated very closely with CPKmax (r = 0.94). Most studies so far have reported that the CPKmax level reflects infarct size. We conclude that the infarct size as measured by /sup 99m/Tc-PYP SPECT closely approximates the actual infarct size, and that this method is useful to determine the severity of infarcts clinically. Among the 10 patients in this series, three of five with infarcts greater than 60 ml died of pump failure. Therefore, we may be able to predict prognosis after accumulating more such cases and improving the methodology.

  11. The findings of Tc-99m ECD brain perfusion SPECT in the patients with left anterior thalamic infarction

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Y. A.; Kim, S. H.; Sohn, H. S.; Jeong, S. G. [The Catholic University of Korea, Seoul (Korea, Republic of)

    2005-07-01

    The thalamus has multiple connections with areas of the cerebral cortex involved in arousal and cognition. Thalamic damage has been reported to be associated with variable neuropsychological dysfunctions and dementia. This study evaluates the changes of regional cerebral blood flow (rCBF) by using SPM analysis of brain perfusion SPECT and examining the neuropsychological abnormalities of 4 patients with anterior thalamic infarctions. Four patients with left anterior thalamic infarctions and eleven normal controls were evaluated. K-MMSE and the Seoul Neuropsychological Screening Battery were performed within 2 days after stroke. The normalized SPECT data of 4 patients were compared to those of 11 controls for the detection of areas with decreased rCBF by SPM analysis. All 4 patients showed anterograde amnesia in their verbal memory, which was not improved by recognition. Dysexecutive features were occasionally present, such as decreased word fluency and impaired Stroop test results. SPM analysis revealed decreased rCBF in the left supra marginal gyrus, the superior temporal gyrus, the middle and inferior frontal gyrus, the medial dorsal and anterior nucleus of the left thalamus. The changes of rCBF in patients with left anterior thalamic infarctions may be due to the remote suppression on metabolism by the interruption of the cortico-subcortical circuit, which connects the anterior thalamic nucleus and various cortical areas. The executive dysfunction and dysnomia may be caused by the left dorsolateral frontal dysfunction of the thalamo-cortical circuit. Anterograde amnesia with storage deficit may be caused by the disruption of mamillothalamic tract.

  12. The findings of Tc-99m ECD brain perfusion SPECT in the patients with left anterior thalamic infarction

    International Nuclear Information System (INIS)

    Jeong, Y. A.; Kim, S. H.; Sohn, H. S.; Jeong, S. G.

    2005-01-01

    The thalamus has multiple connections with areas of the cerebral cortex involved in arousal and cognition. Thalamic damage has been reported to be associated with variable neuropsychological dysfunctions and dementia. This study evaluates the changes of regional cerebral blood flow (rCBF) by using SPM analysis of brain perfusion SPECT and examining the neuropsychological abnormalities of 4 patients with anterior thalamic infarctions. Four patients with left anterior thalamic infarctions and eleven normal controls were evaluated. K-MMSE and the Seoul Neuropsychological Screening Battery were performed within 2 days after stroke. The normalized SPECT data of 4 patients were compared to those of 11 controls for the detection of areas with decreased rCBF by SPM analysis. All 4 patients showed anterograde amnesia in their verbal memory, which was not improved by recognition. Dysexecutive features were occasionally present, such as decreased word fluency and impaired Stroop test results. SPM analysis revealed decreased rCBF in the left supra marginal gyrus, the superior temporal gyrus, the middle and inferior frontal gyrus, the medial dorsal and anterior nucleus of the left thalamus. The changes of rCBF in patients with left anterior thalamic infarctions may be due to the remote suppression on metabolism by the interruption of the cortico-subcortical circuit, which connects the anterior thalamic nucleus and various cortical areas. The executive dysfunction and dysnomia may be caused by the left dorsolateral frontal dysfunction of the thalamo-cortical circuit. Anterograde amnesia with storage deficit may be caused by the disruption of mamillothalamic tract

  13. Malignant infarction of the middle cerebral artery in a porcine model. A pilot study.

    Directory of Open Access Journals (Sweden)

    Fuat Arikan

    Full Text Available Interspecies variability and poor clinical translation from rodent studies indicate that large gyrencephalic animal stroke models are urgently needed. We present a proof-of-principle study describing an alternative animal model of malignant infarction of the middle cerebral artery (MCA in the common pig and illustrate some of its potential applications. We report on metabolic patterns, ionic profile, brain partial pressure of oxygen (PtiO2, expression of sulfonylurea receptor 1 (SUR1, and the transient receptor potential melastatin 4 (TRPM4.A 5-hour ischemic infarct of the MCA territory was performed in 5 2.5-to-3-month-old female hybrid pigs (Large White x Landrace using a frontotemporal approach. The core and penumbra areas were intraoperatively monitored to determine the metabolic and ionic profiles. To determine the infarct volume, 2,3,5-triphenyltetrazolium chloride staining and immunohistochemistry analysis was performed to determine SUR1 and TRPM4 expression.PtiO2 monitoring showed an abrupt reduction in values close to 0 mmHg after MCA occlusion in the core area. Hourly cerebral microdialysis showed that the infarcted tissue was characterized by reduced concentrations of glucose (0.03 mM and pyruvate (0.003 mM and increases in lactate levels (8.87mM, lactate-pyruvate ratio (4202, glycerol levels (588 μM, and potassium concentration (27.9 mmol/L. Immunohistochemical analysis showed increased expression of SUR1-TRPM4 channels.The aim of the present proof-of-principle study was to document the feasibility of a large animal model of malignant MCA infarction by performing transcranial occlusion of the MCA in the common pig, as an alternative to lisencephalic animals. This model may be useful for detailed studies of cerebral ischemia mechanisms and the development of neuroprotective strategies.

  14. Brain Volume Changes After Withdrawal of Atypical Antipsychotics in Patients With First-Episode Schizophrenia

    NARCIS (Netherlands)

    Boonstra, Geartsje; van Haren, Neeltje E. M.; Schnack, Hugo G.; Cahn, Wiepke; Burger, Huibert; Boersma, Maria; de Kroon, Bart; Grobbee, Diederick E.; Pol, Hilleke E. Hulshoff; Kahn, Rene S.

    The influence of antipsychotic medication on brain morphology in schizophrenia may confound interpretation of brain changes over time. We aimed to assess the effect of discontinuation of atypical antipsychotic medication on change in brain volume in patients. Sixteen remitted, stable patients with

  15. Isolated vertigo and possibility of brain ischemia.

    Science.gov (United States)

    Mosarrezai, Arash; Toghae, Mansoureh; Majed, Masoud; Aloosh, Mehdi

    2012-08-01

    In cases of isolated vertigo, physicians are unable to definitely distinguish between central or peripheral vertigo by history and physical examination. Some central causes of isolated vertigo such as cerebellar stroke can be life-threatening and require intervention. Brain infarction can be detected shortly after the onset of clinical symptoms by using diffusion-weighted MRI (DWI). We have conducted this study to perform DWI on isolated vertigo patients with a higher probability of brain infarction. We enrolled 55 consecutive patients with isolated vertigo who had at least one cardiovascular risk factor. A questionnaire that consisted of cardiovascular risk factors was completed and DWI performed for each patient. We analyzed the association of cardiovascular risk factors with infarction as identified by DWI. Using DWI, 5 (9.1%) patients had an acute ischemic stroke. Among cardiovascular risk factors, analysis showed a significant relationship between diabetes mellitus (DM) and infarction. Isolated vertigo may occur due to the occlusion of a small artery in the area of brain circulated by the posterior inferior cerebellar artery. According to our results, DWI may be used in diabetic patients with isolated vertigo to locate a probable infarction.

  16. Differential effect of NMDA and AMPA receptor blockade on protein synthesis in the rat infarct borderzone

    DEFF Research Database (Denmark)

    Christensen, Thomas; Bruhn, T; Frank, L

    1996-01-01

    treated with either saline, MK-801 (5 mg/kg i.p.) or NBQX (30 mg/kg i.p. x 3) were subjected to permanent MCAO. Regional CPSR and volumes of gray matter structures displaying normal CPSR were measured in coronal cryosections of the brain by quantitative autoradiography following an i.v. bolus injection....... Treatment with MK-801 significantly increased the volume of tissue with normal CPSR in the ischemic hemisphere compared to controls, whereas this was not seen with NBQX treatment. The results suggest that MK-801 and NBQX have different effects on peri-infarct protein synthesis after MCAO. Since both......We investigated whether the known neuroprotective effects of two selective glutamate receptor antagonists, the NMDA antagonist MK-801 and the AMPA antagonist NBQX, are reflected in the regional cerebral protein synthesis rates (CPSR) in rats with middle cerebral artery occlusion (MCAO). Rats...

  17. The contribution of nuclear medicine in the six months following a myocardium infarction

    International Nuclear Information System (INIS)

    Franken, Ph.R.

    2002-01-01

    The techniques of nuclear medicine allow to estimate the myocardial infarction size, to measure the ejection fraction and the ventricles volumes and to identify the presence of high-risk and viable myocardium. This information is essential to evaluate the important complications risks after an acute myocardial infarction, that is to say the infarction recurrence and the cardiac death coming from rhythm troubles or a left ventricle failure. (N.C.)

  18. Reduced astrocyte density underlying brain volume reduction in activity-based anorexia rats

    NARCIS (Netherlands)

    Frintrop, Linda; Liesbrock, Johanna; Paulukat, Lisa; Johann, Sonja; Kas, Martien J; Tolba, Rene; Heussen, Nicole; Neulen, Joseph; Konrad, Kerstin; Herpertz-Dahlmann, Beate; Beyer, Cordian; Seitz, Jochen

    2017-01-01

    OBJECTIVES: Severe grey and white matter volume reductions were found in patients with anorexia nervosa (AN) that were linked to neuropsychological deficits while their underlying pathophysiology remains unclear. For the first time, we analysed the cellular basis of brain volume changes in an animal

  19. The use of MRI apparent diffusion coefficient (ADC in monitoring the development of brain infarction

    Directory of Open Access Journals (Sweden)

    Yuan Jian-Jun

    2011-01-01

    Full Text Available Abstract Background To study the rules that apparent diffusion coefficient (ADC changes with time and space in cerebral infarction, and to provide the evidence in defining the infarction stages. Methods 117 work-ups in 98 patients with cerebral infarction (12 hyperacute, 43 acute, 29 subacute, 10 steady, and 23 chronic infarctions were imaged with both conventional MRI and diffusion weighted imaging. The average ADC values, the relative ADC (rADC values, and the ADC values or rADC values from the center to the periphery of the lesion were calculated. Results The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously. rADC values in hyperacute and acute stage was minimized, and increased progressively as time passed and appeared as "pseudonormal" values in approximately 8 to 14 days. Thereafter, rADC values became greater than normal in chronic stage. There was positive correlation between rADC values and time (P Conclusion The ADC values of infarction lesions have evolution rules with time and space. The evolution rules with time and those in space can be helpful to decide the clinical stage, and to provide the evidence in guiding the treatment or judging the prognosis in infarction.

  20. Specificity of abnormal brain volume in major depressive disorder: a comparison with borderline personality disorder.

    Science.gov (United States)

    Depping, Malte S; Wolf, Nadine D; Vasic, Nenad; Sambataro, Fabio; Thomann, Philipp A; Christian Wolf, R

    2015-03-15

    Abnormal brain volume has been frequently demonstrated in major depressive disorder (MDD). It is unclear if these findings are specific for MDD since aberrant brain structure is also present in disorders with depressive comorbidity and affective dysregulation, such as borderline personality disorder (BPD). In this transdiagnostic study, we aimed to investigate if regional brain volume loss differentiates between MDD and BPD. Further, we tested for associations between brain volume and clinical variables within and between diagnostic groups. 22 Females with a DSM-IV diagnosis of MDD, 17 females with a DSM-IV diagnosis of BPD and without comorbid posttraumatic stress disorder, and 22 age-matched female healthy controls (HC) were investigated using magnetic resonance imaging. High-resolution structural data were analyzed using voxel-based morphometry. A significant (pdisorders. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Personal peculiarities in patients with middle cerebral artery infarction

    Directory of Open Access Journals (Sweden)

    Antonova N.A.

    2013-12-01

    Full Text Available The purpose of the work is to reveal personal peculiarities in patients who have suffered middle cerebral artery infarction. Material and Methods. 39 patients with middle cerebral artery infarction have been under the study. All patients have received clinical instrumental inspection (neurologic survey, duplex ultrasound investigation of vessels of neck, head and brain, the research CT or MRT. Personal peculiarities have been studied by "The standard multiple-factor method of research of the personality" (PITCHES. Results. Psychological reactions for the disease have been determined. They include hypochondria, depression, psychasthenia and anxiety. Conclusion. Personal peculiarities in patients suffered from middle cerebral artery infarction may be characterized by the appearance of psychological response to the psychotraumatic situation. Therefore it is necessary to give psychotherapeutic aid.

  2. Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

    Energy Technology Data Exchange (ETDEWEB)

    Coban, Goekcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem [Baskent University Faculty of Medicine, Department of Radiology, Konya (Turkey)

    2015-05-01

    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

  3. Predisposing factors in posterior circulation infarcts: a vascular morphological assessment

    International Nuclear Information System (INIS)

    Coban, Goekcen; Cifci, Egemen; Yildirim, Erkan; Agildere, Ahmet Muhtesem

    2015-01-01

    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving. (orig.)

  4. Predisposing factors in posterior circulation infarcts: a vascular morphological assessment.

    Science.gov (United States)

    Çoban, Gökçen; Çifçi, Egemen; Yildirim, Erkan; Ağıldere, Ahmet Muhteşem

    2015-05-01

    The aim of the study is to assess the effect of shape, diameter, elongation and deviation criteria of basilar artery (BA), convergence angle and diameter variations of vertebral arteries, and concurrent chronic diseases on posterior circulation infarcts. Between January 2010 and May 2013, 186 patients who underwent brain and diffusion magnetic resonance imaging (MRI) with suspected cerebrovascular accident and were diagnosed with posterior circulation infarct and 120 infarct negative control subjects were included in this case-control retrospective study. Vertebral artery (VA) and BA diameter, right (R) and left (L) VA angles at the level of bifurcation, and BA elongation-deviation, and shape of BA were assessed in a total of 306 subjects. Ischemic lesions in the posterior circulation were classified according to their anatomical location and vascular perfusion areas. No significant difference was noted between the control and patient groups with respect to BA diameter (p = 0.676). The most effective risk factors for posterior circulation infarcts were as follows: BA elongation of 2 or 3, BA transverse location of 2 or 3, increase in left VA angle, and history of hypertension, hypercholesterolemia, and diabetes mellitus. Our results suggest that prominent elongation and deviation, C and J shape of BA, and increased L VA angle may be the predictors of at-risk patients in posterior circulation infarcts. Reporting marked morphological BA and VA variations detected at routine brain MRI will aid in selection of patients. Timely detection and treatment of at-risk patients may be life-saving.

  5. Age dependent white matter lesions and brain volume changes in healthy volunteers

    DEFF Research Database (Denmark)

    Christiansen, P; Larsson, H B; Thomsen, C

    1994-01-01

    The brain of 142 healthy volunteers aged 21 to 80 years were investigated using MR imaging. The number and size of the white matter hyperintensity lesions (WMHL) in the cerebral hemispheres were determined. Furthermore, the volume of the cerebral hemispheres and of the lateral ventricles was meas......The brain of 142 healthy volunteers aged 21 to 80 years were investigated using MR imaging. The number and size of the white matter hyperintensity lesions (WMHL) in the cerebral hemispheres were determined. Furthermore, the volume of the cerebral hemispheres and of the lateral ventricles...... was measured. An almost linear increase in the number of volunteers with WMHL was seen with aging for males and females. With aging a significant decrease in the volume of the cerebral hemispheres was found for males, and a significant increase in the volume of the lateral ventricles was seen for both males...... and females. Our results suggest that with aging central atrophy increases more (relatively) than cortical atrophy. No correlation was found between the decreasing volume of the cerebral hemispheres and the increasing number and size of WMHL, nor between the increasing volume of the lateral ventricles...

  6. Effects on infarct size and left ventricular function of early intravenous injection of anistreplase in acute myocardial infarction. The APSIM Study Investigators.

    Science.gov (United States)

    Bassand, J P; Bernard, Y; Lusson, J R; Machecourt, J; Cassagnes, J; Borel, E

    1990-03-01

    A total of 231 patients suffering from a first acute myocardial infarction were randomly allocated within 4 hours following the onset of symptoms either to anistreplase or anisoylated plasminogen streptokinase activator complex (APSAC), 30 U over 5 minutes, or to conventional heparin therapy, 5000 IU in bolus injection. Heparin was reintroduced in both groups 4 h after initial therapy at a dosage of 500 IU/kg per day. A total of 112 patients received anistreplase and 119 received heparin within a mean period of 188 +/- 62 min following the onset of symptoms. Infarct size was estimated from single photon emission computerized tomography and expressed in percentage of the total myocardial volume. The patency rate of the infarct-related artery was 77% in the anistreplase group and 36% in the heparin group (p less than 0.001). Left ventricular ejection fraction determined from contrast angiography was significantly higher in the anistreplase group than in the heparin group (6 absolute percentage point difference). A significant 31% reduction in infarct size was found in the anistreplase group (33% for the anterior wall infarction subgroup [p less than 0.05] and 16% for the inferior wall infarction subgroup, NS). A close inverse relation was found between the values of left ventricular ejection fraction and infarct size (r = -.73, p less than 0.01). In conclusion, early infusion of anistreplase in acute myocardial infarction produced a high early patency rate, a significant limitation of infarct size, and a significant preservation of left ventricular systolic function, mainly in the anterior wall infarctions.

  7. Evidence that the EphA2 receptor exacerbates ischemic brain injury.

    Directory of Open Access Journals (Sweden)

    John Thundyil

    Full Text Available Ephrin (Eph signaling within the central nervous system is known to modulate axon guidance, synaptic plasticity, and to promote long-term potentiation. We investigated the potential involvement of EphA2 receptors in ischemic stroke-induced brain inflammation in a mouse model of focal stroke. Cerebral ischemia was induced in male C57Bl6/J wild-type (WT and EphA2-deficient (EphA2(-/- mice by middle cerebral artery occlusion (MCAO; 60 min, followed by reperfusion (24 or 72 h. Brain infarction was measured using triphenyltetrazolium chloride staining. Neurological deficit scores and brain infarct volumes were significantly less in EphA2(-/- mice compared with WT controls. This protection by EphA2 deletion was associated with a comparative decrease in brain edema, blood-brain barrier damage, MMP-9 expression and leukocyte infiltration, and higher expression levels of the tight junction protein, zona occludens-1. Moreover, EphA2(-/- brains had significantly lower levels of the pro-apoptotic proteins, cleaved caspase-3 and BAX, and higher levels of the anti-apoptotic protein, Bcl-2 as compared to WT group. We confirmed that isolated WT cortical neurons express the EphA2 receptor and its ligands (ephrin-A1-A3. Furthermore, expression of all four proteins was increased in WT primary cortical neurons following 24 h of glucose deprivation, and in the brains of WT mice following stroke. Glucose deprivation induced less cell death in primary neurons from EphA2(-/- compared with WT mice. In conclusion, our data provide the first evidence that the EphA2 receptor directly contributes to blood-brain barrier damage and neuronal death following ischemic stroke.

  8. Unilateral traumatic hemorrhage of the basal ganglion and bihemisferic cerebral infarction

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2017-09-01

    Full Text Available Among the various injuries caused by the cerebral tramatic lesion are traumatic brain contusions. Hemorrhagic contusions of the basal ganglia are unusual. Different injuries such as cranial fractures, epidural hemorrhage, subdural hematoma, subarachnoid hemorrhage among others may be associated with brain contusions. In some cases traumatic brain injury arises. We present a case of a patient with unilateral cerebral contusion associated with bihemispheric cerebral infarction.

  9. Cerebral infarction secondary to temporal lobe herniation in head trauma: a CT study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hyoung; Park, Eui Dong; Kim, Hyung Jin; Han, Jong Woo; Chung, Sung Hoon; Ha, Choong Kun; Kim, Jae Il [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)

    1992-11-15

    Cerebral infarction is a known complication of temporal lobe herniation caused by a traumatic intracranial lesion. To ascertain the frequency, time of recognition, and influence on mortality of posttraumatic cerebral infarction secondary to temporal lobe herniation, we retrospectively reviewed brain CT scans and clinical records of 55 patients who had CT and clinical signs of temporal lobe herniation on admission date. Cerebral infarctions were recognized in seven (12.7%) patients on CT scans taken within two days after admission (mean: 1.3 days). Cerebral infarctions were in the terrtiories of the posterior cerebral artery in all seven patients, two of whom had infarctions of the anterior choroidal artery as well. Mortality (71.4%) for these seven patients was not statistically significant from that (50%) of patients without cerebral infarction admitted with the same range of Glasgow Coma Scale score. The result suggests that such cerebral infarction dose not greatly influence patient's mortality.

  10. Associations between subjective sleep quality and brain volume in Gulf War veterans.

    Science.gov (United States)

    Chao, Linda L; Mohlenhoff, Brian S; Weiner, Michael W; Neylan, Thomas C

    2014-03-01

    To investigate whether subjective sleep quality is associated with brain volume independent of comorbid psychiatric conditions. Cross-sectional. Department of Veterans Affairs (VA) Medical Center. One hundred forty-four Gulf War Veterans (mean age 45 years; range: 31-70 years; 14% female). None. Total cortical, lobar gray matter, and hippocampal volumes were quantified from 1.5 Tesla magnetic resonance images using Freesurfer version 4.5. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Multiple linear regressions were used to determine the association of sleep quality with total and regional brain volumes. The global PSQI score was positively correlated with lifetime and current posttraumatic stress disorder (PTSD) and current depressive symptoms (P sleep quality. Poorer subjective sleep quality was associated with reduced total cortical and regional frontal lobe volumes independent of comorbid psychiatric conditions. Future work will be needed to examine if effective treatment of disturbed sleep leads to improved structural and functional integrity of the frontal lobes.

  11. Numerical simulation model of hyperacute/acute stage white matter infarction.

    Science.gov (United States)

    Sakai, Koji; Yamada, Kei; Oouchi, Hiroyuki; Nishimura, Tsunehiko

    2008-01-01

    Although previous studies have revealed the mechanisms of changes in diffusivity (apparent diffusion coefficient [ADC]) in acute brain infarction, changes in diffusion anisotropy (fractional anisotropy [FA]) in white matter have not been examined. We hypothesized that membrane permeability as well as axonal swelling play important roles, and we therefore constructed a simulation model using random walk simulation to replicate the diffusion of water molecules. We implemented a numerical diffusion simulation model of normal and infarcted human brains using C++ language. We constructed this 2-pool model using simple tubes aligned in a single direction. Random walk simulation diffused water. Axon diameters and membrane permeability were then altered in step-wise fashion. To estimate the effects of axonal swelling, axon diameters were changed from 6 to 10 microm. Membrane permeability was altered from 0% to 40%. Finally, both elements were combined to explain increasing FA in the hyperacute stage of white matter infarction. The simulation demonstrated that simple water shift into the intracellular space reduces ADC and increases FA, but not to the extent expected from actual human cases (ADC approximately 50%; FA approximately +20%). Similarly, membrane permeability alone was insufficient to explain this phenomenon. However, a combination of both factors successfully replicated changes in diffusivity indices. Both axonal swelling and reduced membrane permeability appear important in explaining changes in ADC and FA based on eigenvalues in hyperacute-stage white matter infarction.

  12. Embolic Brain Infarcts: A Rare Fatal Complication of Preoperative Embolization of a Massive Solitary Fibrous Tumor of the Pleura

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Shreyas R., E-mail: Shrey000@gmail.com; Vachhani, Prasann; Moeslein, Fred [University of Maryland Medical Center, Department of Diagnostic Radiology and Nuclear Medicine (United States)

    2017-02-15

    Solitary fibrous tumor of the pleura (SFTP) is a rare intrathoracic neoplasm, often giant in size and highly vascular, which can make surgical resection very challenging. Preoperative percutaneous embolization before surgical removal can significantly reduce the risk of uncontrollable intraoperative hemorrhage. However, a rare potential life threatening complication could result from embolization of SFTP and must be taken into consideration. This report describes a 69-year-old female with a large right thoracic SFTP, who underwent preoperative angiography and embolization and developed diffuse embolic brain infarcts immediately after the administration of polyvinyl alcohol particles.

  13. Auditory extinction and dichotic listening cv task in cerebral infarction preliminary report

    Directory of Open Access Journals (Sweden)

    Mauro Muszkat

    1990-06-01

    Full Text Available Six stroke patients were studied using a dichotic listening¹ CV task, 4 with left hemisphere infarction, 2 with right hemisphere infarction. It was observed a «lesion--effect», a shift of hemisphere prevalence to the side opposite a brain lesion. The authors suggest that the lesion-effect can be explained by the auditory extinction phenomenon at the linguistic level.

  14. Fetal growth, cognitive function, and brain volumes in childhood and adolescence.

    Science.gov (United States)

    Rogne, Tormod; Engstrøm, Andreas Aass; Jacobsen, Geir Wenberg; Skranes, Jon; Østgård, Heidi Furre; Martinussen, Marit

    2015-03-01

    To evaluate the association between fetal growth pattern and cognitive function at 5 and 9 years and regional brain volumes at 15 years. Eighty-three term-born small-for-gestational-age (SGA) neonates and 105 non-SGA neonates in a control group were available for follow-up. Based on serial fetal ultrasound measurements from gestational weeks 25-37, SGA neonates were classified with fetal growth restriction (n=13) or non-fetal growth restriction (n=36). Cognitive function was assessed at 5 and 9 years, and brain volumes were estimated with cerebral magnetic resonance imaging at 15 years. Small-for-gestational-age children had lower performance intelligence quotient at 5 years compared with those in a control group (107.3 compared with 112.5, Pgrowth restriction and control groups, the SGA fetal growth restriction group had significantly lower performance intelligence quotient at 5 years (103.5 compared with 112.5, Pgrowth restriction and control groups for thalamic (17.4 compared with 18.6 cm, Pintelligence quotient scores at 5 and 9 years and smaller brain volumes at 15 years compared with those in the control group, but these findings were only found in those with fetal growth restriction, indicating a possible relationship to decelerated fetal growth. II.

  15. Quantitative estimation of a ratio of intracranial cerebrospinal fluid volume to brain volume based on segmentation of CT images in patients with extra-axial hematoma.

    Science.gov (United States)

    Nguyen, Ha Son; Patel, Mohit; Li, Luyuan; Kurpad, Shekar; Mueller, Wade

    2017-02-01

    Background Diminishing volume of intracranial cerebrospinal fluid (CSF) in patients with space-occupying masses have been attributed to unfavorable outcome associated with reduction of cerebral perfusion pressure and subsequent brain ischemia. Objective The objective of this article is to employ a ratio of CSF volume to brain volume for longitudinal assessment of space-volume relationships in patients with extra-axial hematoma and to determine variability of the ratio among patients with different types and stages of hematoma. Patients and methods In our retrospective study, we reviewed 113 patients with surgical extra-axial hematomas. We included 28 patients (age 61.7 +/- 17.7 years; 19 males, nine females) with an acute epidural hematoma (EDH) ( n = 5) and subacute/chronic subdural hematoma (SDH) ( n = 23). We excluded 85 patients, in order, due to acute SDH ( n = 76), concurrent intraparenchymal pathology ( n = 6), and bilateral pathology ( n = 3). Noncontrast CT images of the head were obtained using a CT scanner (2004 GE LightSpeed VCT CT system, tube voltage 140 kVp, tube current 310 mA, 5 mm section thickness) preoperatively, postoperatively (3.8 ± 5.8 hours from surgery), and at follow-up clinic visit (48.2 ± 27.7 days after surgery). Each CT scan was loaded into an OsiriX (Pixmeo, Switzerland) workstation to segment pixels based on radiodensity properties measured in Hounsfield units (HU). Based on HU values from -30 to 100, brain, CSF spaces, vascular structures, hematoma, and/or postsurgical fluid were segregated from bony structures, and subsequently hematoma and/or postsurgical fluid were manually selected and removed from the images. The remaining images represented overall brain volume-containing only CSF spaces, vascular structures, and brain parenchyma. Thereafter, the ratio between the total number of voxels representing CSF volume (based on values between 0 and 15 HU) to the total number of voxels

  16. Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children.

    Science.gov (United States)

    Lind, Annika; Parkkola, Riitta; Lehtonen, Liisa; Munck, Petriina; Maunu, Jonna; Lapinleimu, Helena; Haataja, Leena

    2011-08-01

    Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children.

  17. Genetic correlations between brain volumes and the WAIS-III dimensions of verbal comprehension, working memory, perceptual organization, and processing speed.

    Science.gov (United States)

    Posthuma, Daniëlle; Baaré, Wim F C; Hulshoff Pol, Hilleke E; Kahn, René S; Boomsma, Dorret I; De Geus, Eco J C

    2003-04-01

    We recently showed that the correlation of gray and white matter volume with full scale IQ and the Working Memory dimension are completely mediated by common genetic factors (Posthuma et al., 2002). Here we examine whether the other WAIS III dimensions (Verbal Comprehension, Perceptual Organization, Processing Speed) are also related to gray and white matter volume, and whether any of the dimensions are related to cerebellar volume. Two overlapping samples provided 135 subjects from 60 extended twin families for whom both MRI scans and WAIS III data were available. All three brain volumes are related to Working Memory capacity (r = 0.27). This phenotypic correlation is completely due to a common underlying genetic factor. Processing Speed was genetically related to white matter volume (r(g) = 0.39). Perceptual Organization was both genetically (r(g) = 0.39) and environmentally (r(e) = -0.71) related to cerebellar volume. Verbal Comprehension was not related to any of the three brain volumes. It is concluded that brain volumes are genetically related to intelligence which suggests that genes that influence brain volume may also be important for intelligence. It is also noted however, that the direction of causation (i.e., do genes influence brain volume which in turn influences intelligence, or alternatively, do genes influence intelligence which in turn influences brain volume), or the presence or absence of pleiotropy has not been resolved yet.

  18. Dysglycemia, brain volume and vascular lesions on MRI in a memory clinic population

    NARCIS (Netherlands)

    Exalto, L.G.; van der Flier, W.M.; Scheltens, P.; Vrenken, H.; Biessels, G.J.

    2014-01-01

    Objective It is unclear, if the association between abnormalities in glucose metabolism (dysglycemia) and impaired cognitive functioning is primarily driven by degenerative or vascular brain damage. We therefore examined the relation between dysglycemia and brain volume and vascular lesions on MRI

  19. Prognostic significance of MR angiography in patients with cerebral infarction

    International Nuclear Information System (INIS)

    Moon, Woong Jae; Kim, Jun Ho; Seo, Jeong Jin; Cho, Ki Hyun; Kim, Yun Hyeon; Kim, Jae Kyu; Kang, Heoung Keun

    1994-01-01

    This study was designed to evaluate the prognostic significance of Magnetic resonance angiography(MRA) in patients with cerebral infarction. Magnetic Resonance Imaging(MRI) and 2 dimensional or 3 dimensional Time-of-Flight MRA were performed subsequently in 83 patients with cerebral infarction proven by brain CT and clinical manifestations, using GE Signa Advantage 1.5 T. We classified the size of infarction on MRI as Extent I( 6 cm) and classified the intracranial vascular occlusion according to visualizations of intracranial vascular branches on MRA as Grade 0, Grade I, Grade II, Grade III. And we evaluated clinical outcomes of these patients according to Rankin's disability scale, compared with MRI and MRA. In 72 cases(86.8%), the larger the size of infarction on MRI, the more severe vascular occlusion on MRA, the worse the clinical outcomes were noted(p < 0.01). However, in 7 cases(8.4%) who showed huge cerebral infarction on MRI with low grade intracranial vascular occlusion on MRA, the clinical outcomes were improved. In 4 cases(4.8%) who noted small sized cerebral infarction on MRI with high grade vascular occlusion on MRA, the clinical outcomes were worsened. MRA provides additional useful information to that provided by MRI in predicting the prognosis of patients with cerebral infarction

  20. The impact of glucose disorders on cognition and brain volumes in the elderly: the Sydney Memory and Ageing Study.

    Science.gov (United States)

    Samaras, Katherine; Lutgers, Helen L; Kochan, Nicole A; Crawford, John D; Campbell, Lesley V; Wen, Wei; Slavin, Melissa J; Baune, Bernard T; Lipnicki, Darren M; Brodaty, Henry; Trollor, Julian N; Sachdev, Perminder S

    2014-04-01

    Type 2 diabetes predicts accelerated cognitive decline and brain atrophy. We hypothesized that impaired fasting glucose (IFG) and incident glucose disorders have detrimental effects on global cognition and brain volume. We further hypothesized that metabolic and inflammatory derangements accompanying hyperglycaemia contribute to change in brain structure and function. This was a longitudinal study of a community-dwelling elderly cohort with neuropsychological testing (n = 880) and brain volumes by magnetic resonance imaging (n = 312) measured at baseline and 2 years. Primary outcomes were global cognition and total brain volume. Secondary outcomes were cognitive domains (processing speed, memory, language, visuospatial and executive function) and brain volumes (hippocampal, parahippocampal, precuneus and frontal lobe). Participants were categorised as normal, impaired fasting glucose at both assessments (stable IFG), baseline diabetes or incident glucose disorders (incident diabetes or IFG at 2 years). Measures included inflammatory cytokines and oxidative metabolites. Covariates were age, sex, education, non-English speaking background, smoking, blood pressure, lipid-lowering or antihypertensive medications, mood score, apolipoprotein E genotype and baseline cognition or brain volume. Participants with incident glucose disorders had greater decline in global cognition and visuospatial function compared to normal, similar to that observed in baseline diabetes. Homocysteine was independently associated with the observed effect of diabetes on executive function. Apolipoprotein E genotype did not influence the observed effects of diabetes on cognition. Incident glucose disorders and diabetes were also associated with greater 2-year decline in total brain volume, compared to normal (40.0 ± 4.2 vs. 46.7 ± 5.7 mm(3) vs. 18.1 ± 6.2, respectively, p cognition or brain volumes compared to normal. Incident glucose disorders, like diabetes, are

  1. SU-E-T-568: Improving Normal Brain Sparing with Increasing Number of Arc Beams for Volume Modulated Arc Beam Radiosurgery of Multiple Brain Metastases

    International Nuclear Information System (INIS)

    Hossain, S; Hildebrand, K; Ahmad, S; Larson, D; Ma, L; Sahgal, A

    2014-01-01

    Purpose: Intensity modulated arc beams have been newly reported for treating multiple brain metastases. The purpose of this study was to determine the variations in the normal brain doses with increasing number of arc beams for multiple brain metastases treatments via the TrueBeam Rapidarc system (Varian Oncology, Palo Alto, CA). Methods: A patient case with 12 metastatic brain lesions previously treated on the Leksell Gamma Knife Perfexion (GK) was used for the study. All lesions and organs at risk were contoured by a senior radiation oncologist and treatment plans for a subset of 3, 6, 9 and all 12 targets were developed for the TrueBeam Rapidarc system via 3 to 7 intensity modulated arc-beams with each target covered by at least 99% of the prescribed dose of 20 Gy. The peripheral normal brain isodose volumes as well as the total beam-on time were analyzed with increasing number of arc beams for these targets. Results: All intensisty modulated arc-beam plans produced efficient treatment delivery with the beam-on time averaging 0.6–1.5 min per lesion at an output of 1200 MU/min. With increasing number of arc beams, the peripheral normal brain isodose volumes such as the 12-Gy isodose line enclosed normal brain tissue volumes were on average decreased by 6%, 11%, 18%, and 28% for the 3-, 6-, 9-, 12-target treatment plans respectively. The lowest normal brain isodose volumes were consistently found for the 7-arc treatment plans for all the cases. Conclusion: With nearly identical beam-on times, the peripheral normal brain dose was notably decreased when the total number of intensity modulated arc beams was increased when treating multiple brain metastases. Dr Sahgal and Dr Ma are currently serving on the board of international society of stereotactic radiosurgery

  2. Bilateral cerebellar and brain stem infarction resulting from vertebral artery injury following cervical trauma without radiographic damage of the spinal column: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Mimata, Yoshikuni; Sato, Kotaro; Suzuki, Yoshiaki [Iwate Prefectural Chubu Hospital, Department of Orthopaedic Surgery, Kitakami (Japan); Murakami, Hideki [Iwate Medical University, Department of Orthopaedic Surgery, School of Medicine, Morioka (Japan)

    2014-01-15

    Vertebral artery injury can be a complication of cervical spine injury. Although most cases are asymptomatic, the rare case progresses to severe neurological impairment and fatal outcomes. We experienced a case of bilateral cerebellar and brain stem infarction with fatal outcome resulting from vertebral artery injury associated with cervical spine trauma. A 69-year-old male was admitted to our hospital because of tetraplegia after falling down the stairs and hitting his head on the floor. Marked bony damage of the cervical spine was not apparent on radiographs and CT scans, so the injury was initially considered to be a cervical cord injury without bony damage. However, an intensity change in the intervertebral disc at C5/C6, and a ventral epidural hematoma were observed on MRI. A CT angiogram of the neck showed the right vertebral artery was completely occluded at the C4 level of the spine. Forty-eight hours after injury, the patient lapsed into drowsy consciousness. The cranial CT scan showed a massive low-density area in the bilateral cerebellar hemispheres and brain stem. Anticoagulation was initiated after a diagnosis of the right vertebral artery injury, but the patient developed bilateral cerebellar and brain stem infarction. The patient's brain herniation progressed and the patient died 52 h after injury. We considered that not only anticoagulation but also treatment for thrombosis would have been needed to prevent cranial embolism. We fully realize that early and appropriate treatment are essential to improve the treatment results, and constructing a medical system with a team of orthopedists, radiologists, and neurosurgeons is also very important. (orig.)

  3. Deficiency of vasodilator-stimulated phosphoprotein (VASP increases blood-brain-barrier damage and edema formation after ischemic stroke in mice.

    Directory of Open Access Journals (Sweden)

    Peter Kraft

    2010-12-01

    Full Text Available Stroke-induced brain edema formation is a frequent cause of secondary infarct growth and deterioration of neurological function. The molecular mechanisms underlying edema formation after stroke are largely unknown. Vasodilator-stimulated phosphoprotein (VASP is an important regulator of actin dynamics and stabilizes endothelial barriers through interaction with cell-cell contacts and focal adhesion sites. Hypoxia has been shown to foster vascular leakage by downregulation of VASP in vitro but the significance of VASP for regulating vascular permeability in the hypoxic brain in vivo awaits clarification.Focal cerebral ischemia was induced in Vasp(-/- mice and wild-type (WT littermates by transient middle cerebral artery occlusion (tMCAO. Evan's Blue tracer was applied to visualize the extent of blood-brain-barrier (BBB damage. Brain edema formation and infarct volumes were calculated from 2,3,5-triphenyltetrazolium chloride (TTC-stained brain slices. Both mouse groups were carefully controlled for anatomical and physiological parameters relevant for edema formation and stroke outcome. BBB damage (p0.05 towards worse neurological outcomes.Our study identifies VASP as critical regulator of BBB maintenance during acute ischemic stroke. Therapeutic modulation of VASP or VASP-dependent signalling pathways could become a novel strategy to combat excessive edema formation in ischemic brain damage.

  4. Regional volumes and spatial volumetric distribution of gray matter in the gender dysphoric brain.

    Science.gov (United States)

    Hoekzema, Elseline; Schagen, Sebastian E E; Kreukels, Baudewijntje P C; Veltman, Dick J; Cohen-Kettenis, Peggy T; Delemarre-van de Waal, Henriette; Bakker, Julie

    2015-05-01

    The sexual differentiation of the brain is primarily driven by gonadal hormones during fetal development. Leading theories on the etiology of gender dysphoria (GD) involve deviations herein. To examine whether there are signs of a sex-atypical brain development in GD, we quantified regional neural gray matter (GM) volumes in 55 female-to-male and 38 male-to-female adolescents, 44 boys and 52 girls without GD and applied both univariate and multivariate analyses. In girls, more GM volume was observed in the left superior medial frontal cortex, while boys had more volume in the bilateral superior posterior hemispheres of the cerebellum and the hypothalamus. Regarding the GD groups, at whole-brain level they differed only from individuals sharing their gender identity but not from their natal sex. Accordingly, using multivariate pattern recognition analyses, the GD groups could more accurately be automatically discriminated from individuals sharing their gender identity than those sharing their natal sex based on spatially distributed GM patterns. However, region of interest analyses indicated less GM volume in the right cerebellum and more volume in the medial frontal cortex in female-to-males in comparison to girls without GD, while male-to-females had less volume in the bilateral cerebellum and hypothalamus than natal boys. Deviations from the natal sex within sexually dimorphic structures were also observed in the untreated subsamples. Our findings thus indicate that GM distribution and regional volumes in GD adolescents are largely in accordance with their respective natal sex. However, there are subtle deviations from the natal sex in sexually dimorphic structures, which can represent signs of a partial sex-atypical differentiation of the brain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Long-term global and regional brain volume changes following severe traumatic brain injury: A longitudinal study with clinical correlates

    DEFF Research Database (Denmark)

    Sidaros, Annette; Skimminge, Arnold Jesper Møller; Liptrot, Matthew George

    2009-01-01

    with percent brain volume change (%BVC) ranging between − 0.6% and − 9.4% (mean − 4.0%). %BVC correlated significantly with injury severity, functional status at both scans, and with 1-year outcome. Moreover, %BVC improved prediction of long-term functional status over and above what could be predicted using......Traumatic brain injury (TBI) results in neurodegenerative changes that progress for months, perhaps even years post-injury. However, there is little information on the spatial distribution and the clinical significance of this late atrophy. In 24 patients who had sustained severe TBI we acquired 3D...... scan time point using SIENAX. Regional distribution of atrophy was evaluated using tensor-based morphometry (TBM). At the first scan time point, brain parenchymal volume was reduced by mean 8.4% in patients as compared to controls. During the scan interval, patients exhibited continued atrophy...

  6. A new graphic method for evaluation of distribution volume on N-isopropyl-p-[123I]iodoamphetamine (IMP) SPECT

    International Nuclear Information System (INIS)

    Odano, Ikuo; Takahashi, Naoya; Ohtaki, Hiroh; Noguchi, Eikichi; Hatano, Masayoshi; Yamasaki, Yoshihiro; Nishihara, Mamiko; Ohkubo, Masaki; Yokoi, Takashi.

    1993-01-01

    We developed a new graphic method using N-isopropyl-p-[ 123 I]iodoamphetamine (IMP) and SPECT of the brain, the graph on which all three parameters, cerebral blood flow, distribution volume (V d ) and delayed count to early count ratio (Delayed/Early ratio), were able to be evaluated simultaneously. The kinetics of 123 I-IMP in the brain was analyzed by a 2-compartment model, and a standard input function was prepared by averaging the time activity curves of 123 I-IMP in arterial blood on 6 patients with small cerebral infarction etc. including 2 normal controls. Being applied this method to the differential diagnosis between Parkinson's disease and progressive supranuclear palsy, we were able to differentiate both with a glance, because the distribution volume of the frontal lobe significantly decreased in Parkinson's disease (Mean±SD; 26±6 ml/g). This method was clinically useful. We think that the distribution volume of 123 I-IMP may reflect its retention mechanism in the brain, and the values are related to amine, especially to dopamine receptors and its metabolism. (author)

  7. Measurement of extracellular volume and transit time heterogeneity using contrast-enhanced myocardial perfusion MRI in patients after acute myocardial infarction.

    Science.gov (United States)

    Kunze, Karl P; Rischpler, Christoph; Hayes, Carmel; Ibrahim, Tareq; Laugwitz, Karl-Ludwig; Haase, Axel; Schwaiger, Markus; Nekolla, Stephan G

    2017-06-01

    To assess the ability of dynamic contrast-enhanced myocardial perfusion MRI to measure extracellular volume (ECV) and to investigate the possibility of estimating capillary transit time heterogeneity (CTH) in patients after myocardial infarction and successful revascularization. Twenty-four perfusion data sets were acquired on a 3 Tesla positron emission tomography (PET)/MRI scanner. Three perfusion models of different complexity were implemented in a hierarchical fashion with an Akaike information criterion being used to determine the number of fit parameters supported by the data. Results were compared sector-wise to ECV from an equilibrium T 1 mapping method (modified look-locker inversion recovery (MOLLI)). ECV derived from the perfusion analysis correlated well with equilibrium measurements (R² = 0.76). Estimation of CTH was supported in 16% of sectors (mostly remote). Inclusion of a nonzero CTH parameter usually led to lower estimates of first-pass extraction and slightly higher estimates of blood volume and flow. Estimation of the capillary permeability-surface area product was feasible in 81% of sectors. Transit time heterogeneity has a measurable effect on the kinetic analysis of myocardial perfusion MRI data, and Gd-DTPA extravasation in the myocardium is usually not flow-limited in infarct-related pathology. Measurement of myocardial ECV using perfusion imaging could provide a scan-time efficient alternative to methods based on T 1 mapping. Magn Reson Med 77:2320-2330, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  8. Total and regional brain volumes in a population-based normative sample from 4 to 18 years: the NIH MRI Study of Normal Brain Development.

    Science.gov (United States)

    2012-01-01

    Using a population-based sampling strategy, the National Institutes of Health (NIH) Magnetic Resonance Imaging Study of Normal Brain Development compiled a longitudinal normative reference database of neuroimaging and correlated clinical/behavioral data from a demographically representative sample of healthy children and adolescents aged newborn through early adulthood. The present paper reports brain volume data for 325 children, ages 4.5-18 years, from the first cross-sectional time point. Measures included volumes of whole-brain gray matter (GM) and white matter (WM), left and right lateral ventricles, frontal, temporal, parietal and occipital lobe GM and WM, subcortical GM (thalamus, caudate, putamen, and globus pallidus), cerebellum, and brainstem. Associations with cross-sectional age, sex, family income, parental education, and body mass index (BMI) were evaluated. Key observations are: 1) age-related decreases in lobar GM most prominent in parietal and occipital cortex; 2) age-related increases in lobar WM, greatest in occipital, followed by the temporal lobe; 3) age-related trajectories predominantly curvilinear in females, but linear in males; and 4) small systematic associations of brain tissue volumes with BMI but not with IQ, family income, or parental education. These findings constitute a normative reference on regional brain volumes in children and adolescents.

  9. Anti neuroinflammatory effect of Vildagliptin in ischaemia-reperfusion induced cerebral infarction in normal and STZ induced type-II diabetic rats

    Directory of Open Access Journals (Sweden)

    Kaleru Purnachander

    2016-03-01

    Full Text Available Diabetes is one of the major risk factor for cerebral ischemic stroke. Increased base line levels of oxidative stress in diabetes will lead to cerebral ischemic damage. In pathological conditions such as cerebral ischemia/reperfusion injury, free radicals cause oxidative stress and inflammation leading to increased injury of brain. Inflammation is one of the major pathological mechanisms involved in cerebral ischemia and reperfusion injury. Vildagliptin newer anti-diabetic drug of the class DPP-4 inhibitors is reported to have anti-inflammatory properties apart from its antihyperglycemic activity. Therefore the aim of the present study is to evaluate the anti-inflammatory effect of Vildagliptin against cerebral infarction induced ischemia reperfusion injury in normal and STZ induced diabetic Wistar rats. Cerebral infarction was induced by bilateral common carotid artery occlusion followed by 4 hr reperfusion. Percent infarction, inflammatory markers such as MPO, TNF-α, IL-6 and IL-10 were analysed. Treatment with Vildagliptin for a period of four weeks produced significant reduction in percent cerebral infarct volume. Vildagliptin at 10 mg/kg dose, showed significant reduction in markers like MPO, TNF-α, IL-6 and IL-1β in diabetic group when compared to normal group and in contrast significant increase in anti-inflammatory marker like IL-10 levels. Vildagliptin showed significant cerebroprotective effect by antiinflammatory mechanisms.

  10. Assessment of brain perfusion with MRI: methodology and application to acute stroke

    International Nuclear Information System (INIS)

    Grandin, C.B.

    2003-01-01

    We review the methodology of brain perfusion measurements with MRI and their application to acute stroke, with particular emphasis on the work awarded by the 6th Lucien Appel Prize for Neuroradiology. The application of the indicator dilution theory to the dynamic susceptibility-weighted bolus-tracking method is explained, as is the approach to obtaining quantitative measurements of cerebral blood flow (CBF) and volume (CBV). Our contribution to methodological developments, such as CBV measurement with the frequency-shifted burst sequence, development of the PRESTO sequence, comparison of different deconvolution methods and of spin- and gradient-echo sequences, and the validation of MRI measurements against positron emission tomography is summarised. The pathophysiology of brain ischaemia and the role of neuroimaging in the setting of acute stroke are reviewed, with an introduction to the concepts of ischaemic penumbra and diffusion/perfusion mismatch. Our work on the determination of absolute CBF and CBV thresholds for predicting the area of infarct growth, identification of the best perfusion parameters (relative or absolute) for predicting the area of infarct growth and the role of MR angiography is also summarised. We conclude that MRI is a very powerful way to assess brain perfusion and that its use might help in selecting patients who will benefit most from treatment such as thrombolysis. (orig.)

  11. Measurement of infarct size and percentage myocardium infarcted in a dog preparation with single photon-emission computed tomography, thallium-201, and indium 111-monoclonal antimyosin Fab

    International Nuclear Information System (INIS)

    Johnson, L.L.; Lerrick, K.S.; Coromilas, J.

    1987-01-01

    Single photon-emission tomography (SPECT) and indium 111-labeled monoclonal antimyosin Fab fragments were used to measure myocardial infarct size in 12 dogs, six subjected to balloon catheter-induced coronary artery occlusion for 6 hr (late reperfusion) and six subjected to occlusion with reperfusion at 2 hr (early reperfusion). Tomographic imaging was performed 24 hr after the intravenous injection of labeled Fab fragments with the use of a dual-head SPECT camera with medium-energy collimators. Immediately after the first tomographic scan, thallium-201 was injected into nine of 12 dogs and imaging was repeated. Estimated infarct size in grams was calculated from transaxially reconstructed, normalized, and background-corrected indium SPECT images with the use of a threshold technique for edge detection. Estimated noninfarcted myocardium in grams was calculated from obliquely reconstructed thallium SPECT images by a similar method. The animals were killed and infarct size in grams and true infarct size as a percentage of total left ventricular myocardial volume were measured by triphenyl tetrazolium chloride staining. Estimated infarct size from indium SPECT images showed an excellent correlation with true infarct size (r = .95, SEE = 4.1 g). Estimated percentage myocardium infarcted was calculated by dividing estimated infarct size from indium images by the sum of estimated infarct size plus estimated noninfarcted myocardium obtained from thallium images. Correlation between the estimated percentage of myocardium infarcted and true percentage of myocardium infarcted was excellent

  12. Comparison of brain volume abnormalities between ADHD and conduct disorder in adolescence

    Science.gov (United States)

    Stevens, Michael C.; Haney-Caron, Emily

    2012-01-01

    Background Previous studies of brain structure abnormalities in conduct disorder and attention-deficit/hyperactivity disorder (ADHD) samples have been limited owing to cross-comorbidity, preventing clear understanding of which structural brain abnormalities might be specific to or shared by each disorder. To our knowledge, this study was the first direct comparison of grey and white matter volumes in diagnostically “pure” (i.e., no comorbidities) conduct disorder and ADHD samples. Methods Groups of adolescents with noncormobid conduct disorder and with noncomorbid, combined-subtype ADHD were compared with age- and sex-matched controls using DARTEL voxel-based analysis of T1-weighted brain structure images. Analysis of variance with post hoc analyses compared whole brain grey and white matter volumes among the groups. Results We included 24 adolescents in each study group. There was an overall 13% reduction in grey matter volume in adolescents with conduct disorder, reflecting numerous frontal, temporal, parietal and subcortical deficits. The same grey matter regions typically were not abnormal in those with ADHD. Deficits in frontal lobe regions previously identified in studies of patients with ADHD either were not detected, or group differences from controls were not as strong as those between the conduct disorder and control groups. White matter volume measurements did not differentiate conduct disorder and ADHD. Limitations Our modest sample sizes prevented meaningful examination of individual features of ADHD or conduct disorder, such as aggression, callousness, or hyperactive versus inattentive symptom subtypes. Conclusion The evidence supports theories of frontotemporal abnormalities in adolescents with conduct disorder, but raises questions about the prominence of frontal lobe and striatal structural abnormalities in those with noncomorbid, combined-subtype ADHD. The latter point is clinically important, given the widely held belief that ADHD is

  13. Brain extraction in partial volumes T2*@7T by using a quasi-anatomic segmentation with bias field correction.

    Science.gov (United States)

    Valente, João; Vieira, Pedro M; Couto, Carlos; Lima, Carlos S

    2018-02-01

    Poor brain extraction in Magnetic Resonance Imaging (MRI) has negative consequences in several types of brain post-extraction such as tissue segmentation and related statistical measures or pattern recognition algorithms. Current state of the art algorithms for brain extraction work on weighted T1 and T2, being not adequate for non-whole brain images such as the case of T2*FLASH@7T partial volumes. This paper proposes two new methods that work directly in T2*FLASH@7T partial volumes. The first is an improvement of the semi-automatic threshold-with-morphology approach adapted to incomplete volumes. The second method uses an improved version of a current implementation of the fuzzy c-means algorithm with bias correction for brain segmentation. Under high inhomogeneity conditions the performance of the first method degrades, requiring user intervention which is unacceptable. The second method performed well for all volumes, being entirely automatic. State of the art algorithms for brain extraction are mainly semi-automatic, requiring a correct initialization by the user and knowledge of the software. These methods can't deal with partial volumes and/or need information from atlas which is not available in T2*FLASH@7T. Also, combined volumes suffer from manipulations such as re-sampling which deteriorates significantly voxel intensity structures making segmentation tasks difficult. The proposed method can overcome all these difficulties, reaching good results for brain extraction using only T2*FLASH@7T volumes. The development of this work will lead to an improvement of automatic brain lesions segmentation in T2*FLASH@7T volumes, becoming more important when lesions such as cortical Multiple-Sclerosis need to be detected. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Reliability of infarct volumetry: Its relevance and the improvement by a software-assisted approach.

    Science.gov (United States)

    Friedländer, Felix; Bohmann, Ferdinand; Brunkhorst, Max; Chae, Ju-Hee; Devraj, Kavi; Köhler, Yvette; Kraft, Peter; Kuhn, Hannah; Lucaciu, Alexandra; Luger, Sebastian; Pfeilschifter, Waltraud; Sadler, Rebecca; Liesz, Arthur; Scholtyschik, Karolina; Stolz, Leonie; Vutukuri, Rajkumar; Brunkhorst, Robert

    2017-08-01

    Despite the efficacy of neuroprotective approaches in animal models of stroke, their translation has so far failed from bench to bedside. One reason is presumed to be a low quality of preclinical study design, leading to bias and a low a priori power. In this study, we propose that the key read-out of experimental stroke studies, the volume of the ischemic damage as commonly measured by free-handed planimetry of TTC-stained brain sections, is subject to an unrecognized low inter-rater and test-retest reliability with strong implications for statistical power and bias. As an alternative approach, we suggest a simple, open-source, software-assisted method, taking advantage of automatic-thresholding techniques. The validity and the improvement of reliability by an automated method to tMCAO infarct volumetry are demonstrated. In addition, we show the probable consequences of increased reliability for precision, p-values, effect inflation, and power calculation, exemplified by a systematic analysis of experimental stroke studies published in the year 2015. Our study reveals an underappreciated quality problem in translational stroke research and suggests that software-assisted infarct volumetry might help to improve reproducibility and therefore the robustness of bench to bedside translation.

  15. Migraine and brain changes

    NARCIS (Netherlands)

    Meinders, I.H.

    2018-01-01

    This thesis describes the longitudinal population-based CAMERA-study on the association between migraine and brain changes (e.g. white matter hyperintensities, infarct-like and other lesions) and possible causes and consequences of those brain changes. Women with migraine showed higher incidence of

  16. Surgical outcome after decompressive craniectomy in patients with extensive cerebral infarction

    International Nuclear Information System (INIS)

    Otani, Naoki; Takasato, Yoshio; Masaoka, Hiroyuki

    2008-01-01

    Extensive cerebral hemispheric infarction is a devastating condition leading to early death in nearly 80% of cases due to the rapid rise of intracranial pressure in spite of maximum medical treatment for brain edema and swelling. Recently, decompressive craniectomy has been reevaluated to prevent the brain herniation caused by extensive hemispheric cerebral infarction. We studied the surgical results after decompressive craniectomy for extensive cerebral infarction. Between December 1997 and August 2006, 13 consecutive patients (7 males and 6 females aged from 39 to 73 with a mean age of 59 years) with massive cerebral infarction of internal carotid (IC) (11 patients) and middle cerebral artery (MCA) (2 patients) territory were treated with decompressive craniectomy and dural plasty. Five patients had a left-sided stroke with severe aphasia. The cardioembolic source of stroke was seen in 5 patients. Surgery was performed at the point of neurological deterioration, anisocoria, and effacement of perimesencephalic cistern on CT findings. The mean time between stroke onset and surgery was 39.8 hr and ranged from 13 to 102 hr. Glasgow outcome scale (GOS) on discharge was moderately disabled (MD) 1, severe disabled (SD) 5, vegetative state (VS) 1, and dead (D) 3 (mortality rate 30.8%). Severe pneumoniae were the causes of death. All survivors underwent cranioplasty and were transferred with the aim of rehabilitation. In this study, we showed that the decompressive craniectomy reduced mortality after extensive cerebral infarction. However, the functional outcome and level of independence are poor. It seems that the early decompressive craniectomy should be aggressively performed for extensive cerebral infarction before neurological deterioration such as worsening of consciousness disturbance or pupil abnormalities. Further investigations will be needed to clarify the surgical indications, timing, and functional outcomes. (author)

  17. The use of MRI apparent diffusion coefficient (ADC) in monitoring the development of brain infarction

    International Nuclear Information System (INIS)

    Shen, Jian-Min; Xia, Xian-Wu; Kang, Wu-Gen; Yuan, Jian-Jun; Sheng, Liang

    2011-01-01

    To study the rules that apparent diffusion coefficient (ADC) changes with time and space in cerebral infarction, and to provide the evidence in defining the infarction stages. 117 work-ups in 98 patients with cerebral infarction (12 hyperacute, 43 acute, 29 subacute, 10 steady, and 23 chronic infarctions) were imaged with both conventional MRI and diffusion weighted imaging. The average ADC values, the relative ADC (rADC) values, and the ADC values or rADC values from the center to the periphery of the lesion were calculated. The average ADC values and the rADC values of hyperacute and acute infarction lesion depressed obviously. rADC values in hyperacute and acute stage was minimized, and increased progressively as time passed and appeared as 'pseudonormal' values in approximately 8 to 14 days. Thereafter, rADC values became greater than normal in chronic stage. There was positive correlation between rADC values and time (P < 0.01). The ADC values and the rADC values in hyperacute and acute lesions had gradient signs that these lesions increased from the center to the periphery. The ADC values and the rADC values in subacute lesions had adverse gradient signs that these lesions decreased from the center to the periphery. The ADC values of infarction lesions have evolution rules with time and space. The evolution rules with time and those in space can be helpful to decide the clinical stage, and to provide the evidence in guiding the treatment or judging the prognosis in infarction

  18. Early intervention with human albumin to reduce the tissue plasminogen activator-mediated blood-brain barrier permeability damaged by delayed reperfusion: an experimental study in rats

    International Nuclear Information System (INIS)

    Lu Haitao; Zhao Jungong; Li Minghua; Li Yongdong; Zhang Peilei

    2011-01-01

    Objective: To clarify whether early use of high-dose human albumin can reduce the permeability of blood-brain barrier (BBB) damaged by delayed thrombolysis or not, and, in tun, reduce the vasogenic brain edema. Methods: A total of 138 male SD rats weighing 320-380 grams were randomly divided into 4 groups: sham operation group (n=3), control group (n=45), albumin group (n=45) and albumin+rt-PA group (n=45). According to the reperfusion time after the onset of middle cerebral artery occlusion (MCAO), each group, except sham operation group, was divided into three subgroups of 2 h, 3 h and 4 h with 15 rats in each subgroup. Rats in albumin group and albumin+rt-PA group received an intravenous infusion of 20% human albumin (2.5 g/kg) 2 hours after the onset of MCAO, and rats in albumin+rt-PA group received an intravenous infusion of rt-PA (10 mg/kg) at all points of reperfusion time via the rat's femoral vein immediately after the reperfusion. All rats were sacrificed 24 hours after MCAO, the infarct volume of the brain was determined with TTC dye method, the leakage extent of BBB was quantitatively estimated by using Evans blue method, and the matrix metalloproteinase-9 (MMP-9) expression was assessed with immunohistochemistry technique. Results: Early intervention with the use of high-dose human albumin could significantly improve the neurological score at 24 h. In MCAO 3 h albumin group, MCAO 4 h albumin group and MCAO 3 h albumin+rt-PA group, neurological score was significantly better than that in the control group (P 0.05). The volume of the infarct tissue was also significantly smaller in all the treated groups with high-dose human albumin groups (P<0.05) when compared with the control group. The infarct volume of the MCAO 4 h in albumin group and albumin+rt-PA group was reduced by 23% and by 17.3%, respectively. Cerebral hemorrhage transformation occurred in two rats of MCAO 4 h control group, in one rat of MCAO 4 h albumin group and in one rat of MCAO 4 h

  19. Comparision between Brain Atrophy and Subdural Volume to Predict Chronic Subdural Hematoma: Volumetric CT Imaging Analysis.

    Science.gov (United States)

    Ju, Min-Wook; Kim, Seon-Hwan; Kwon, Hyon-Jo; Choi, Seung-Won; Koh, Hyeon-Song; Youm, Jin-Young; Song, Shi-Hun

    2015-10-01

    Brain atrophy and subdural hygroma were well known factors that enlarge the subdural space, which induced formation of chronic subdural hematoma (CSDH). Thus, we identified the subdural volume that could be used to predict the rate of future CSDH after head trauma using a computed tomography (CT) volumetric analysis. A single institution case-control study was conducted involving 1,186 patients who visited our hospital after head trauma from January 1, 2010 to December 31, 2014. Fifty-one patients with delayed CSDH were identified, and 50 patients with age and sex matched for control. Intracranial volume (ICV), the brain parenchyme, and the subdural space were segmented using CT image-based software. To adjust for variations in head size, volume ratios were assessed as a percentage of ICV [brain volume index (BVI), subdural volume index (SVI)]. The maximum depth of the subdural space on both sides was used to estimate the SVI. Before adjusting for cranium size, brain volume tended to be smaller, and subdural space volume was significantly larger in the CSDH group (p=0.138, p=0.021, respectively). The BVI and SVI were significantly different (p=0.003, p=0.001, respectively). SVI [area under the curve (AUC), 77.3%; p=0.008] was a more reliable technique for predicting CSDH than BVI (AUC, 68.1%; p=0.001). Bilateral subdural depth (sum of subdural depth on both sides) increased linearly with SVI (pSubdural space volume was significantly larger in CSDH groups. SVI was a more reliable technique for predicting CSDH. Bilateral subdural depth was useful to measure SVI.

  20. Differences between head CT and MRI for selecting patients for intravenous rt-PA during hyperacute brain infarction. Comparative study of intracranial bleeding complications and prognosis

    International Nuclear Information System (INIS)

    Deguchi, Ichiro; Takeda, Hidetaka; Furuya, Daisuke

    2010-01-01

    The objective of this study was to investigate the differences in usefulness between head CT and MRI for selecting patients for intravenous injection of recombinant tissue plasminogen activator (rt-PA) during hyperacute brain infarction. Of a total of 1280 brain infarction patients who were admitted from October 2005 to March 2009, 45 patients (33 men and 12 women with an average age of 69.2±11.6 years) received intravenous rt-PA. Of these, 16 patients in whom only head CT was performed (593 inpatients from October 2005 to March 2007, CT standard group, 11 men and 5 women, average age 67.4±15.4 years) and 29 patients in whom head CT and MRI were performed (687 inpatients from April 2007 to March 2009, MRI standard group, 21 men and 7 women, average age 70.1±9.0 years) were studied. The median National Institutes of Health Stroke Scale (NIHSS) scores immediately before intravenous rt-PA for the CT and MRI standard groups were 19 and 11, respectively; disease severity was lower for the MRI standard group. Three months later, the modified Rankin Scale (mRS) score for the MRI standard group (0-1: 31%, 2-3: 38%, 4-5: 24%, and 6: 12%) was better than for the CT standard group (0-1: 25%, 2-3: 25%, 4-5: 38%, and 6: 12%). The frequency of symptomatic intracranial hemorrhage was lower for the MRI standard group (6.9%) than for the CT standard group (18.8%). However, there was no statistical difference in the prognosis and incidence of intracranial hemorrhage between the 2 groups, due to the small number of cases. When selecting patients for intravenous rt-PA, brain infarction improved more, prognosis was better three months later, and the frequency of symptomatic intracranial hemorrhage was lower among patients selected based on MRI standards than among those selected based on CT standards. (author)

  1. Radiation Dose-Volume Effects in the Brain

    International Nuclear Information System (INIS)

    Lawrence, Yaacov Richard; Li, X. Allen; El Naqa, Issam; Hahn, Carol A.; Marks, Lawrence B.; Merchant, Thomas E.; Dicker, Adam P.

    2010-01-01

    We have reviewed the published data regarding radiotherapy (RT)-induced brain injury. Radiation necrosis appears a median of 1-2 years after RT; however, cognitive decline develops over many years. The incidence and severity is dose and volume dependent and can also be increased by chemotherapy, age, diabetes, and spatial factors. For fractionated RT with a fraction size of 80 Gy. For large fraction sizes (≥2.5 Gy), the incidence and severity of toxicity is unpredictable. For single fraction radiosurgery, a clear correlation has been demonstrated between the target size and the risk of adverse events. Substantial variation among different centers' reported outcomes have prevented us from making toxicity-risk predictions. Cognitive dysfunction in children is largely seen for whole brain doses of ≥18 Gy. No substantial evidence has shown that RT induces irreversible cognitive decline in adults within 4 years of RT.

  2. A new graphic method for evaluation of distribution volume on N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo; Takahashi, Naoya; Ohtaki, Hiroh; Noguchi, Eikichi; Hatano, Masayoshi; Yamasaki, Yoshihiro; Nishihara, Mamiko [Niigata Univ. (Japan). School of Medicine; Ohkubo, Masaki; Yokoi, Takashi

    1993-10-01

    We developed a new graphic method using N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) and SPECT of the brain, the graph on which all three parameters, cerebral blood flow, distribution volume (V[sub d]) and delayed count to early count ratio (Delayed/Early ratio), were able to be evaluated simultaneously. The kinetics of [sup 123]I-IMP in the brain was analyzed by a 2-compartment model, and a standard input function was prepared by averaging the time activity curves of [sup 123]I-IMP in arterial blood on 6 patients with small cerebral infarction etc. including 2 normal controls. Being applied this method to the differential diagnosis between Parkinson's disease and progressive supranuclear palsy, we were able to differentiate both with a glance, because the distribution volume of the frontal lobe significantly decreased in Parkinson's disease (Mean[+-]SD; 26[+-]6 ml/g). This method was clinically useful. We think that the distribution volume of [sup 123]I-IMP may reflect its retention mechanism in the brain, and the values are related to amine, especially to dopamine receptors and its metabolism. (author).

  3. Prediction of language and neurologic recovery after cerebral infarction with SPECT imaging using N-isopropyl-p-(I-123) iodoamphetamine

    International Nuclear Information System (INIS)

    Bushnell, D.L.; Gupta, S.; Mlcoch, A.G.; Barnes, W.E.

    1989-01-01

    Fourteen patients (10 with left-sided and 4 with right-sided cerebral infarction) were prospectively studied with single-photon emission computed tomography (SPECT) using N-isopropyl-p-(I-123) iodoamphetamine (IMP, SPECTamine) to determine its usefulness in predicting neurologic/language recovery after cerebral infarction. All neuro-SPECT imaging was performed within 30 days after infarction. Detailed assessment of neurologic and/or language recovery (after 3 months) was carried out prospectively in each patient. Patients with smaller volume IMP defects in the region of infarction demonstrated significantly better neurologic and language recovery than patients with large IMP defects. Analysis of the IMP ''redistribution'' phenomenon failed to demonstrate definitively a relationship with clinical recovery. It was concluded that the volume of the IMP defect can aid in predicting recovery potential after cerebral infarction

  4. Delayed brain ischemia tolerance induced by electroacupuncture pretreatment is mediated via MCP-induced protein 1

    Science.gov (United States)

    2013-01-01

    Background Emerging studies have demonstrated that pretreatment with electroacupuncture (EA) induces significant tolerance to focal cerebral ischemia. The present study seeks to determine the involvement of monocyte chemotactic protein-induced protein 1 (MCPIP1), a recently identified novel modulator of inflammatory reactions, in the cerebral neuroprotection conferred by EA pretreatment in the animal model of focal cerebral ischemia and to elucidate the mechanisms of EA pretreatment-induced ischemic brain tolerance. Methods Twenty-four hours after the end of the last EA pretreatment, focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 90 minutes in male C57BL/6 mice and MCPIP1 knockout mice. Transcription and expression of MCPIP1 gene was monitored by qRT-PCR, Western blot and immunohistochemistry. The neurobehavioral scores, infarction volumes, proinflammatory cytokines and leukocyte infiltration in brain and NF-κB signaling were evaluated after ischemia/reperfusion. Results MCPIP1 protein and mRNA levels significantly increased specifically in mouse brain undergoing EA pretreatment. EA pretreatment significantly attenuated the infarct volume, neurological deficits, upregulation of proinflammatory cytokines and leukocyte infiltration in the brain of wild-type mice after MCAO compared with that of the non-EA group. MCPIP1-deficient mice failed to evoke EA pretreatment-induced tolerance compared with that of the control MCPIP1 knockout group without EA treatment. Furthermore, the activation of NF-κB signaling was significantly reduced in EA-pretreated wild-type mice after MCAO compared to that of the non-EA control group and MCPIP1-deficient mice failed to confer the EA pretreatment-induced inhibition of NF-κB signaling after MCAO. Conclusions Our data demonstrated that MCPIP1 deficiency caused significant lack of EA pretreatment-induced cerebral protective effects after MCAO compared with the control group and that MCPIP1 is

  5. Reliability and Accuracy of Brain Volume Measurement on MR Imaging

    DEFF Research Database (Denmark)

    Yamagchii, Kechiro; Lassen, Anders; Ring, Poul

    1998-01-01

    Yamaguchi, K., Lassen, A. And Ring, P. Reliability and Accuracy of Brain Volume Measurement on MR Imaging. Abstract at ESMRMB98 European Society for Magnetic Resonance in Medicine and Biology, Geneva, Sept 17-20, 1998 Danish Research Center for Magnetic Resonance, Hvidovre University Hospital...

  6. Regional volumes and spatial volumetric distribution of gray matter in the gender dysphoric brain.

    OpenAIRE

    Hoekzema, Elseline; Schagen, Sebastian E. E.; Kreukels, Baudewijntje P. C.; Veltman, Dick J.; Cohen-Kettenis, Peggy T.; Delemarre-van de Waal, Henriette; Bakker, Julie

    2015-01-01

    The sexual differentiation of the brain is primarily driven by gonadal hormones during fetal development. Leading theories on the etiology of gender dysphoria (GD) involve deviations herein. To examine whether there are signs of a sex-atypical brain development in GD, we quantified regional neural gray matter (GM) volumes in 55 female-to-male and 38 male-to-female adolescents, 44 boys and 52 girls without GD and applied both univariate and multivariate analyses. In girls, more GM volume was o...

  7. Time course of infarct healing and left ventricular remodelling in patients with reperfused ST segment elevation myocardial infarction using comprehensive magnetic resonance imaging

    International Nuclear Information System (INIS)

    Ganame, Javier; Messalli, Giancarlo; Dymarkowski, Steven; Abbasi, Kayvan; Bogaert, Jan; Masci, Pier Giorgio; Werf, Frans van de; Janssens, Stefan

    2011-01-01

    To describe the time course of myocardial infarct (MI) healing and left ventricular (LV) remodelling and to assess factors predicting LV remodelling using cardiac MRI. In 58 successfully reperfused MI patients, MRI was performed at baseline, 4 months (4M), and 1 year (1Y) post MI Infarct size decreased between baseline and 4M (p < 0.001), but not at 1Y; i.e. 18 ± 11%, 12 ± 8%, 11 ± 6% of LV mass respectively; this was associated with LV mass reduction. Infarct and adjacent wall thinning was found at 4M, whereas significant remote wall thinning was measured at 1Y. LV end-diastolic and end-systolic volumes significantly increased at 1Y, p < 0.05 at 1Y vs. baseline and vs. 4M; this was associated with increased LV sphericity index. No regional or global LV functional improvement was found at follow-up. Baseline infarct size was the strongest predictor of adverse LV remodelling. Infarct healing, with shrinkage of infarcted myocardium and wall thinning, occurs early post-MI as reflected by loss in LV mass and adjacent myocardial remodelling. Longer follow-up demonstrates ongoing remote myocardial and ventricular remodelling. Infarct size at baseline predicts long-term LV remodelling and represents an important parameter for tailoring future post-MI pharmacological therapies designed to prevent heart failure. (orig.)

  8. Socialization of prosocial behavior: Gender differences in the mediating role of child brain volume

    NARCIS (Netherlands)

    R. Kok (Renske); P.J. Prinzie (Peter); M.J. Bakermans-Kranenburg (Marian); F.C. Verhulst (Frank); T.J.H. White (Tonya); H.W. Tiemeier (Henning); M.H. van IJzendoorn (Rien)

    2017-01-01

    textabstractEvidence has been accumulating for the impact of normal variation in caregiving quality on brain morphology in children, but the question remains whether differences in brain volume related to early caregiving translate to behavioral implications. In this longitudinal population-based

  9. Breakfast staple types affect brain gray matter volume and cognitive function in healthy children.

    Directory of Open Access Journals (Sweden)

    Yasuyuki Taki

    Full Text Available Childhood diet is important for brain development. Furthermore, the quality of breakfast is thought to affect the cognitive functioning of well-nourished children. To analyze the relationship among breakfast staple type, gray matter volume, and intelligence quotient (IQ in 290 healthy children, we used magnetic resonance images and applied voxel-based morphometry. We divided subjects into rice, bread, and both groups according to their breakfast staple. We showed that the rice group had a significantly larger gray matter ratio (gray matter volume percentage divided by intracranial volume and significantly larger regional gray matter volumes of several regions, including the left superior temporal gyrus. The bread group had significantly larger regional gray and white matter volumes of several regions, including the right frontoparietal region. The perceptual organization index (POI; IQ subcomponent of the rice group was significantly higher than that of the bread group. All analyses were adjusted for age, gender, intracranial volume, socioeconomic status, average weekly frequency of having breakfast, and number of side dishes eaten for breakfast. Although several factors may have affected the results, one possible mechanism underlying the difference between the bread and the rice groups may be the difference in the glycemic index (GI of these two substances; foods with a low GI are associated with less blood-glucose fluctuation than are those with a high GI. Our study suggests that breakfast staple type affects brain gray and white matter volumes and cognitive function in healthy children; therefore, a diet of optimal nutrition is important for brain maturation during childhood and adolescence.

  10. Breakfast staple types affect brain gray matter volume and cognitive function in healthy children.

    Science.gov (United States)

    Taki, Yasuyuki; Hashizume, Hiroshi; Sassa, Yuko; Takeuchi, Hikaru; Asano, Michiko; Asano, Kohei; Kawashima, Ryuta

    2010-12-08

    Childhood diet is important for brain development. Furthermore, the quality of breakfast is thought to affect the cognitive functioning of well-nourished children. To analyze the relationship among breakfast staple type, gray matter volume, and intelligence quotient (IQ) in 290 healthy children, we used magnetic resonance images and applied voxel-based morphometry. We divided subjects into rice, bread, and both groups according to their breakfast staple. We showed that the rice group had a significantly larger gray matter ratio (gray matter volume percentage divided by intracranial volume) and significantly larger regional gray matter volumes of several regions, including the left superior temporal gyrus. The bread group had significantly larger regional gray and white matter volumes of several regions, including the right frontoparietal region. The perceptual organization index (POI; IQ subcomponent) of the rice group was significantly higher than that of the bread group. All analyses were adjusted for age, gender, intracranial volume, socioeconomic status, average weekly frequency of having breakfast, and number of side dishes eaten for breakfast. Although several factors may have affected the results, one possible mechanism underlying the difference between the bread and the rice groups may be the difference in the glycemic index (GI) of these two substances; foods with a low GI are associated with less blood-glucose fluctuation than are those with a high GI. Our study suggests that breakfast staple type affects brain gray and white matter volumes and cognitive function in healthy children; therefore, a diet of optimal nutrition is important for brain maturation during childhood and adolescence.

  11. Effect of Donepezil on Wernicke Aphasia After Bilateral Middle Cerebral Artery Infarction: Subtraction Analysis of Brain F-18 Fluorodeoxyglucose Positron Emission Tomographic Images.

    Science.gov (United States)

    Yoon, Seo Yeon; Kim, Je-Kyung; An, Young-Sil; Kim, Yong Wook

    2015-01-01

    Aphasia is one of the most common neurologic deficits occurring after stroke. Although the speech-language therapy is a mainstream option for poststroke aphasia, pharmacotherapy is recently being tried to modulate different neurotransmitter systems. However, the efficacy of those treatments is still controversial. We present a case of a 53-year-old female patient with Wernicke aphasia, after the old infarction in the territory of left middle cerebral artery for 8 years and the recent infarction in the right middle cerebral artery for 4 months. On the initial evaluation, the Aphasia Quotient in Korean version of the Western Aphasia Battery was 25.6 of 100. Baseline brain F-18 fluorodeoxyglucose positron emission tomographic images demonstrated a decreased cerebral metabolism in the left temporoparietal area and right temporal lobe. Donepezil hydrochloride, a reversible acetylcholinesterase inhibitor, was orally administered 5 mg/d for 6 weeks after the initial evaluation and was increased to 10 mg/d for the following 6 weeks. After the donepezil treatment, the patient showed improvement in language function, scoring 51.0 of 100 on Aphasia Quotient. A subtraction analysis of the brain F-18 fluorodeoxyglucose positron emission tomographic images after donepezil medication demonstrated increased uptake in both middle temporal gyri, extended to the occipital area and the left cerebellum. Thus, we suggest that donepezil can be an effective therapeutic choice for the treatment of Wernicke aphasia.

  12. Slice-to-Volume Nonrigid Registration of Histological Sections to MR Images of the Human Brain

    Science.gov (United States)

    Osechinskiy, Sergey; Kruggel, Frithjof

    2011-01-01

    Registration of histological images to three-dimensional imaging modalities is an important step in quantitative analysis of brain structure, in architectonic mapping of the brain, and in investigation of the pathology of a brain disease. Reconstruction of histology volume from serial sections is a well-established procedure, but it does not address registration of individual slices from sparse sections, which is the aim of the slice-to-volume approach. This study presents a flexible framework for intensity-based slice-to-volume nonrigid registration algorithms with a geometric transformation deformation field parametrized by various classes of spline functions: thin-plate splines (TPS), Gaussian elastic body splines (GEBS), or cubic B-splines. Algorithms are applied to cross-modality registration of histological and magnetic resonance images of the human brain. Registration performance is evaluated across a range of optimization algorithms and intensity-based cost functions. For a particular case of histological data, best results are obtained with a TPS three-dimensional (3D) warp, a new unconstrained optimization algorithm (NEWUOA), and a correlation-coefficient-based cost function. PMID:22567290

  13. Slice-to-Volume Nonrigid Registration of Histological Sections to MR Images of the Human Brain

    Directory of Open Access Journals (Sweden)

    Sergey Osechinskiy

    2011-01-01

    Full Text Available Registration of histological images to three-dimensional imaging modalities is an important step in quantitative analysis of brain structure, in architectonic mapping of the brain, and in investigation of the pathology of a brain disease. Reconstruction of histology volume from serial sections is a well-established procedure, but it does not address registration of individual slices from sparse sections, which is the aim of the slice-to-volume approach. This study presents a flexible framework for intensity-based slice-to-volume nonrigid registration algorithms with a geometric transformation deformation field parametrized by various classes of spline functions: thin-plate splines (TPS, Gaussian elastic body splines (GEBS, or cubic B-splines. Algorithms are applied to cross-modality registration of histological and magnetic resonance images of the human brain. Registration performance is evaluated across a range of optimization algorithms and intensity-based cost functions. For a particular case of histological data, best results are obtained with a TPS three-dimensional (3D warp, a new unconstrained optimization algorithm (NEWUOA, and a correlation-coefficient-based cost function.

  14. Brain-volume changes in young and middle-aged smokers: a DARTEL-based voxel-based morphometry study.

    Science.gov (United States)

    Peng, Peng; Wang, Zhenchang; Jiang, Tao; Chu, Shuilian; Wang, Shuangkun; Xiao, Dan

    2017-09-01

    Many studies have reported brain volume changes in smokers. However, the volume differences of grey matter (GM) and white matter (WM) in young and middle-aged male smokers with different lifetime tobacco consumption (pack-years) remain uncertain. To examine the brain volume change, especially whether more pack-years smoking would be associated with smaller gray matter and white matter volume in young and middle-aged male smokers. We used a 3T MR scanner and performed Diffeomorphic anatomical registration through exponentiated lie algebra (DARTEL)-based voxel-based morphometry on 53 long-term male smokers (30.72 ± 4.19 years) and 53 male healthy non-smokers (30.83 ± 5.18 years). We separated smokers to light and heavy smokers by pack-years and compared brain volume between different smoker groups and non-smokers. And then we did analysis of covariance (ANCOVA) between smokers and non-smokers by setting pack-years as covariates. Light and heavy smokers all displayed smaller GM and WM volume than non-smokers and more obviously in heavy smokers. The main smaller areas in light and heavy smokers were superior temporal gyrus, insula, middle occipital gyrus, posterior cingulate, precuneus in GM and posterior cingulate, thalamus and midbrain in WM, in addition, we also observed more pack-years smoking was associated with some certain smaller GM and WM volumes by ANCOVA. Young and middle-aged male smokers had many smaller brain areas than non-smokers. Some of these areas' volume had negative correlation with pack-years, while some had not. These may due to different pathophysiological role of smokings. © 2015 John Wiley & Sons Ltd.

  15. Longitudinal genetic analysis of brain volumes in normal elderly male twins

    OpenAIRE

    Lessov-Schlaggar, Christina N.; Hardin, Jill; DeCarli, Charles; Krasnow, Ruth E.; Reed, Terry; Wolf, Philip A.; Swan, Gary E.; Carmelli, Dorit

    2010-01-01

    This study investigated the role of genetic and environmental influences on individual differences in brain volumes measured at two time points in normal elderly males from the National Heart, Lung, and Blood Institute Twin Study. The MRI scans were conducted four years apart on 33 monozygotic and 33 dizygotic male twin pairs, aged 68 to 77 years when first scanned. Volumetric measures of total brain and total cerebrospinal fluid were significantly heritable at baseline (over 70%). For both v...

  16. Assessment of in vivo MR imaging compared to physical sections in vitro-A quantitative study of brain volumes using stereology

    DEFF Research Database (Denmark)

    Jelsing, Jacob; Rostrup, Egill; Markenroth, Karin

    2005-01-01

    The object of the present study was to compare stereological estimates of brain volumes obtained in vivo by magnetic resonance imaging (MRI) to corresponding volumes from physical sections in vitro. Brains of ten domestic pigs were imaged using a 3-T scanner. The volumes of different brain....... However, although intraobserver difference of MRI estimates was acceptable, the interobserver difference was not. A statistical highly significant difference of 11-41% was observed between observers for volume estimates of all compartments considered. The study demonstrates that quantitative MRI...

  17. Predictors and prognostic value of left atrial remodelling after acute myocardial infarction

    DEFF Research Database (Denmark)

    Kyhl, Kasper; Vejlstrup, Niels; Lønborg, Jacob

    2015-01-01

    PURPOSE: Left atrial (LA) volume is a strong prognostic predictor in patients following ST-segment elevation myocardial infarction (STEMI). However, the change in LA volume over time (LA remodelling) following STEMI has been scarcely studied. We sought to identify predictors for LA remodelling an...

  18. Female adolescents with severe substance and conduct problems have substantially less brain gray matter volume.

    Directory of Open Access Journals (Sweden)

    Manish S Dalwani

    Full Text Available Structural neuroimaging studies have demonstrated lower regional gray matter volume in adolescents with severe substance and conduct problems. These research studies, including ours, have generally focused on male-only or mixed-sex samples of adolescents with conduct and/or substance problems. Here we compare gray matter volume between female adolescents with severe substance and conduct problems and female healthy controls of similar ages.Female adolescents with severe substance and conduct problems will show significantly less gray matter volume in frontal regions critical to inhibition (i.e. dorsolateral prefrontal cortex and ventrolateral prefrontal cortex, conflict processing (i.e., anterior cingulate, valuation of expected outcomes (i.e., medial orbitofrontal cortex and the dopamine reward system (i.e. striatum.We conducted whole-brain voxel-based morphometric comparison of structural MR images of 22 patients (14-18 years with severe substance and conduct problems and 21 controls of similar age using statistical parametric mapping (SPM and voxel-based morphometric (VBM8 toolbox. We tested group differences in regional gray matter volume with analyses of covariance, adjusting for age and IQ at p<0.05, corrected for multiple comparisons at whole-brain cluster-level threshold.Female adolescents with severe substance and conduct problems compared to controls showed significantly less gray matter volume in right dorsolateral prefrontal cortex, left ventrolateral prefrontal cortex, medial orbitofrontal cortex, anterior cingulate, bilateral somatosensory cortex, left supramarginal gyrus, and bilateral angular gyrus. Considering the entire brain, patients had 9.5% less overall gray matter volume compared to controls.Female adolescents with severe substance and conduct problems in comparison to similarly aged female healthy controls showed substantially lower gray matter volume in brain regions involved in inhibition, conflict processing, valuation

  19. Early developmental gene enhancers affect subcortical volumes in the adult human brain.

    Science.gov (United States)

    Becker, Martin; Guadalupe, Tulio; Franke, Barbara; Hibar, Derrek P; Renteria, Miguel E; Stein, Jason L; Thompson, Paul M; Francks, Clyde; Vernes, Sonja C; Fisher, Simon E

    2016-05-01

    Genome-wide association screens aim to identify common genetic variants contributing to the phenotypic variability of complex traits, such as human height or brain morphology. The identified genetic variants are mostly within noncoding genomic regions and the biology of the genotype-phenotype association typically remains unclear. In this article, we propose a complementary targeted strategy to reveal the genetic underpinnings of variability in subcortical brain volumes, by specifically selecting genomic loci that are experimentally validated forebrain enhancers, active in early embryonic development. We hypothesized that genetic variation within these enhancers may affect the development and ultimately the structure of subcortical brain regions in adults. We tested whether variants in forebrain enhancer regions showed an overall enrichment of association with volumetric variation in subcortical structures of >13,000 healthy adults. We observed significant enrichment of genomic loci that affect the volume of the hippocampus within forebrain enhancers (empirical P = 0.0015), a finding which robustly passed the adjusted threshold for testing of multiple brain phenotypes (cutoff of P < 0.0083 at an alpha of 0.05). In analyses of individual single nucleotide polymorphisms (SNPs), we identified an association upstream of the ID2 gene with rs7588305 and variation in hippocampal volume. This SNP-based association survived multiple-testing correction for the number of SNPs analyzed but not for the number of subcortical structures. Targeting known regulatory regions offers a way to understand the underlying biology that connects genotypes to phenotypes, particularly in the context of neuroimaging genetics. This biology-driven approach generates testable hypotheses regarding the functional biology of identified associations. Hum Brain Mapp 37:1788-1800, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. Volume of the crocodilian brain and endocast during ontogeny

    Czech Academy of Sciences Publication Activity Database

    Jirák, D.; Janáček, Jiří

    2017-01-01

    Roč. 12, č. 6 (2017), č. článku e0178491. E-ISSN 1932-6203 R&D Projects: GA ČR(CZ) GAP302/12/1207; GA ČR(CZ) GA13-12412S Institutional support: RVO:67985823 Keywords : brain volume * endoneurocranium * crocodilians * magnetic resonance imaging Subject RIV: EA - Cell Biology OBOR OECD: Developmental biology Impact factor: 2.806, year: 2016

  1. Childhood adversity is linked to differential brain volumes in adolescents with alcohol use disorder: a voxel-based morphometry study.

    Science.gov (United States)

    Brooks, Samantha J; Dalvie, Shareefa; Cuzen, Natalie L; Cardenas, Valerie; Fein, George; Stein, Dan J

    2014-06-01

    Previous neuroimaging studies link both alcohol use disorder (AUD) and early adversity to neurobiological differences in the adult brain. However, the association between AUD and childhood adversity and effects on the developing adolescent brain are less clear, due in part to the confound of psychiatric comorbidity. Here we examine early life adversity and its association with brain volume in a unique sample of 116 South African adolescents (aged 12-16) with AUD but without psychiatric comorbidity. Participants were 58 adolescents with DSM-IV alcohol dependence and with no other psychiatric comorbidities, and 58 age-, gender- and protocol-matched light/non-drinking controls (HC). Assessments included the Childhood Trauma Questionnaire (CTQ). MR images were acquired on a 3T Siemens Magnetom Allegra scanner. Volumes of global and regional structures were estimated using SPM8 Voxel Based Morphometry (VBM), with analysis of covariance (ANCOVA) and regression analyses. In whole brain ANCOVA analyses, a main effect of group when examining the AUD effect after covarying out CTQ was observed on brain volume in bilateral superior temporal gyrus. Subsequent regression analyses to examine how childhood trauma scores are linked to brain volumes in the total cohort revealed a negative correlation in the left hippocampus and right precentral gyrus. Furthermore, bilateral (but most significantly left) hippocampal volume was negatively associated with sub-scores on the CTQ in the total cohort. These findings support our view that some alterations found in brain volumes in studies of adolescent AUD may reflect the impact of confounding factors such as psychiatric comorbidity rather than the effects of alcohol per se. In particular, early life adversity may influence the developing adolescent brain in specific brain regions, such as the hippocampus.

  2. Regional Differences in Brain Volume Predict the Acquisition of Skill in a Complex Real-Time Strategy Videogame

    Science.gov (United States)

    Basak, Chandramallika; Voss, Michelle W.; Erickson, Kirk I.; Boot, Walter R.; Kramer, Arthur F.

    2011-01-01

    Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also…

  3. Correlation between MRI findings, blood pressure and mental ability in patients with multiple lacunar infarcts

    International Nuclear Information System (INIS)

    Fukuda, Hitoshi; Kobayashi, Shotai; Okada, Kazunori; Tsunematsu, Tokugoro

    1991-01-01

    We studied the association between mental ability as rated by Hasegawa's scale, the severity of hypertension, the severity of brain atrophy, and the severity of lesions in the cerebral white matter on magnetic resonance imaging in 34 patients with multiple cerebral infarcts but without obvious cortical lesions. Data were analyzed using multiple regression analysis. The patients having both marked brain atrophy and severe white matter lesions showed an impairment of mental ability. Brain atrophy was correlated with aging and the severity of white matter lesions. There was a significant positive correlation between the diastolic blood pressure and the severity of white matter lesions. These findings suggest that the white matter lesions in patients with multiple cerebral infarcts are correlated with brain atrophy and mental deterioration, and that uncontrolled hypertension is an important risk factor in exacerbating the lesions in the cerebral white matter. (author)

  4. Diagnostic value of dynamic CT in early cerebral infarct

    International Nuclear Information System (INIS)

    Huang, K.-M.; Shih, T.T.F.

    1989-01-01

    The authors have tried to demonstrate early cerebral infarct by dynamic CT scanning without any CT change. They also have tried to find a correlation between the clinical outcome and the hemodynamic change of the damaged brain tissue supplied by the occluded vessels. (author) 14 refs.; 3 figs

  5. The association of insular stroke with lesion volume

    Directory of Open Access Journals (Sweden)

    Nishanth Kodumuri

    2016-01-01

    Full Text Available The insula has been implicated in many sequelae of stroke. It is the area most commonly infarcted in people with post-stroke arrhythmias, loss of thermal sensation, hospital acquired pneumonia, and apraxia of speech. We hypothesized that some of these results reflect the fact that: (1 ischemic strokes that involve the insula are larger than strokes that exclude the insula (and therefore are associated with more common and persistent deficits; and (2 insular involvement is a marker of middle cerebral artery (MCA occlusion. We analyzed MRI scans of 861 patients with acute ischemic hemispheric strokes unselected for functional deficits, and compared infarcts involving the insula to infarcts not involving the insula using t-tests for continuous variables and chi square tests for dichotomous variables. Mean infarct volume was larger for infarcts including the insula (n = 232 versus excluding the insula (n = 629: 65.8 ± 78.8 versus 10.2 ± 15.9 cm3 (p < 0.00001. Even when we removed lacunar infarcts, mean volume of non-lacunar infarcts that included insula (n = 775 were larger than non-lacunar infarcts (n = 227 that excluded insula: 67.0 cm3 ± 79.2 versus 11.5 cm3 ± 16.7 (p < 0.00001. Of infarcts in the 90th percentile for volume, 87% included the insula (χ2 = 181.8; p < 0.00001. Furthermore, 79.0% infarcts due to MCA occlusion included the insula; 78.5% of infarcts without MCA occlusion excluded the insula (χ2 = 93.1; p < 0.0001. The association between insular damage and acute or chronic sequelae likely often reflects the fact that insular infarct is a marker of large infarcts caused by occlusion of the MCA more than a specific role of the insula in a range of functions. Particularly in acute stroke, some deficits may also be due to ischemia of the MCA or ICA territory caused by large vessel occlusion.

  6. Benefits of lifelong exercise training on left ventricular function after myocardial infarction.

    Science.gov (United States)

    Maessen, Martijn Fh; Eijsvogels, Thijs Mh; Stevens, Guus; van Dijk, Arie Pj; Hopman, Maria Te

    2017-11-01

    Background Endurance exercise training induces cardio-protective effects, but athletes are not exempted from a myocardial infarction. Evidence from animal studies suggests that exercise training attenuates pathological left ventricular remodelling following myocardial infarction. We tested the hypothesis that lifelong exercise training is related to attenuated pathological left ventricular remodelling after myocardial infarction as evidenced by better left ventricular systolic function in veteran athletes compared to sedentary peers. Design This was a cross-sectional study. Methods Sixty-five males (60 ± 6 years) were included and allocated to four groups based on lifelong exercise training volumes: (a) athletes ( n = 18), (b) post-myocardial infarction athletes (athletes + myocardial infarction, n = 20), (c) sedentary controls ( n = 13), and (d) post-myocardial infarction controls (sedentary controls + myocardial infarction, n = 14). Athletes were lifelong (≥20 years) highly physically active (≥30 metabolic equivalent of task (MET)-h/week), whereas sedentary controls did not meet the exercise guidelines (creatine-kinase, creatinine, aspartate transaminase and lactate dehydrogenase) following myocardial infarction and infarct location did not differ between athletes + myocardial infarction and sedentary controls + myocardial infarction. Left ventricular ejection fraction was significantly higher in athletes (61% ± 4), athletes + myocardial infarction (58% ± 4) and sedentary controls (57% ± 6) compared to sedentary controls + myocardial infarction (51% ± 7; p athletes (-19% (-21% to -17%), athletes + myocardial infarction (-16% (-20% to -12%)), and sedentary controls (-15% (-18% to -14%) compared to sedentary controls + myocardial infarction (-13% (-15% to -8%), p athletes.

  7. Multicenter Study of Brain Volume Abnormalities in Children and Adolescent-Onset Psychosis

    Science.gov (United States)

    Reig, Santiago; Parellada, Mara; Castro-Fornieles, Josefina; Janssen, Joost; Moreno, Dolores; Baeza, Inmaculada; Bargalló, Nuria; González-Pinto, Ana; Graell, Montserrat; Ortuño, Felipe; Otero, Soraya; Arango, Celso; Desco, Manuel

    2011-01-01

    The goal of the study is to determine the extent of structural brain abnormalities in a multicenter sample of children and adolescents with a recent-onset first episode of psychosis (FEP), compared with a sample of healthy controls. Total brain and lobar volumes and those of gray matter (GM), white matter, and cerebrospinal fluid (CSF) were measured in 92 patients with a FEP and in 94 controls, matched for age, gender, and years of education. Male patients (n = 64) showed several significant differences when compared with controls (n = 61). GM volume in male patients was reduced in the whole brain and in frontal and parietal lobes compared with controls. Total CSF volume and frontal, temporal, and right parietal CSF volumes were also increased in male patients. Within patients, those with a further diagnosis of “schizophrenia” or “other psychosis” showed a pattern similar to the group of all patients relative to controls. However, bipolar patients showed fewer differences relative to controls. In female patients, only the schizophrenia group showed differences relative to controls, in frontal CSF. GM deficit in male patients with a first episode correlated with negative symptoms. Our study suggests that at least part of the GM deficit in children and adolescent-onset schizophrenia and in other psychosis occurs before onset of the first positive symptoms and that, contrary to what has been shown in children-onset schizophrenia, frontal GM deficits are probably present from the first appearance of positive symptoms in children and adolescents. PMID:20478821

  8. Application of cell sheet technology to bone marrow stromal cell transplantation for rat brain infarct.

    Science.gov (United States)

    Ito, Masaki; Shichinohe, Hideo; Houkin, Kiyohiro; Kuroda, Satoshi

    2017-02-01

    Bone marrow stromal cells (BMSC) transplantation enhances functional recovery after cerebral infarct, but the optimal delivery route is undetermined. This study was aimed to assess whether a novel cell-sheet technology non-invasively serves therapeutic benefits to ischemic stroke. First, the monolayered cell sheet was engineered by culturing rat BMSCs on a temperature-responsive dish. The cell sheet was analysed histologically and then transplanted onto the ipsilateral neocortex of rats subjected to permanent middle cerebral artery occlusion at 7 days after the insult. Their behaviours and histology were compared with those in the animals treated with direct injection of BMSCs or vehicle over 4 weeks post-transplantation. The cell sheet was 27.9 ± 8.0 μm thick and was composed of 9.8 ± 2.4 × 10 5 cells. Cell sheet transplantation significantly improved motor function when compared with the vehicle-injected animals. Histological analysis revealed that the BMSCs were densely distributed to the neocortex adjacent to the cerebral infarct and expressed neuronal phenotype in the cell sheet-transplanted animals. These findings were almost equal to those for the animals treated with direct BMSC injection. The attachment of the BMSC sheet to the brain surface did not induce reactive astrocytes in the adjacent neocortex, although direct injection of BMSCs profoundly induced reactive astrocytes around the injection site. These findings suggest that the BMSCs in cell sheets preserve their biological capacity of migration and neural differentiation. Cell-sheet technology may enhance functional recovery after ischaemic stroke, using a less invasive method. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

  9. Brain tissues volume measurements from 2D MRI using parametric approach

    Science.gov (United States)

    L'vov, A. A.; Toropova, O. A.; Litovka, Yu. V.

    2018-04-01

    The purpose of the paper is to propose a fully automated method of volume assessment of structures within human brain. Our statistical approach uses maximum interdependency principle for decision making process of measurements consistency and unequal observations. Detecting outliers performed using maximum normalized residual test. We propose a statistical model which utilizes knowledge of tissues distribution in human brain and applies partial data restoration for precision improvement. The approach proposes completed computationally efficient and independent from segmentation algorithm used in the application.

  10. Regional differences in brain volume predict the acquisition of skill in a complex real-time strategy videogame.

    Science.gov (United States)

    Basak, Chandramallika; Voss, Michelle W; Erickson, Kirk I; Boot, Walter R; Kramer, Arthur F

    2011-08-01

    Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also be useful in predicting the acquisition of skill in complex tasks, such as strategy-based video games. Twenty older adults were trained for over 20 h to play Rise of Nations, a complex real-time strategy game. These adults showed substantial improvements over the training period in game performance. MRI scans obtained prior to training revealed that the volume of a number of brain regions, which have been previously associated with subsets of the trained skills, predicted a substantial amount of variance in learning on the complex game. Thus, regional differences in brain volume can predict learning in complex tasks that entail the use of a variety of perceptual, cognitive and motor processes. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Protein Synthesis Inhibition in the Peri-Infarct Cortex Slows Motor Recovery in Rats.

    OpenAIRE

    Schubring-Giese Maximilian; Leemburg Susan; Luft Andreas Rüdiger; Hosp Jonas Aurel

    2016-01-01

    Neuroplasticity and reorganization of brain motor networks are thought to enable recovery of motor function after ischemic stroke. Especially in the cortex surrounding the ischemic scar (i.e., peri-infarct cortex), evidence for lasting reorganization has been found at the level of neurons and networks. This reorganization depends on expression of specific genes and subsequent protein synthesis. To test the functional relevance of the peri-infarct cortex for recovery we assessed the effect of ...

  12. Adipose-Derived Cell Construct Stabilizes Heart Function and Increases Microvascular Perfusion in an Established Infarct

    Science.gov (United States)

    Nguyen, Quang T.; Touroo, Jeremy S.; Aird, Allison L.; Chang, Raymond C.; Ng, Chin K.; Hoying, James B.; Williams, Stuart K.

    2013-01-01

    We have previously shown that myocardial infarction (MI) immediately treated with an epicardial construct containing stromal vascular fraction (SVF) from adipose tissue preserved microvascular function and left ventricle contractile mechanisms. In order to evaluate a more clinically relevant condition, we investigated the cardiac recovery potential of an SVF construct implanted onto an established infarct. SVF cells were isolated from rat adipose tissue, plated on Vicryl, and cultured for 14 days. Fischer-344 rats were separated into MI groups: (a) 6-week MI (MI), (b) 6-week MI treated with an SVF construct at 2 weeks (MI SVF), (c) 6-week MI with Vicryl construct at 2 weeks (MI Vicryl), and (d) MI 2wk (time point of intervention). Emax, an indicator of systolic performance and contractile function, was lower in the MI and MI Vicryl versus MI SVF. Positron emission tomography imaging (18F-fluorodeoxyglucose) revealed a decreased percentage of relative infarct volume in the MI SVF versus MI and MI Vicryl. Total vessel count and percentage of perfusion assessed via immunohistochemistry were both increased in the infarct region of MI SVF versus MI and MI Vicryl. Overall cardiac function, percentage of relative infarct, and percentage of perfusion were similar between MI SVF and MI 2wk; however, total vessel count increased after SVF treatment. These data suggest that SVF treatment of an established infarct stabilizes the heart at the time point of intervention by preventing a worsening of cardiac performance and infarcted volume, and is associated with increased microvessel perfusion in the area of established infarct. PMID:24106337

  13. Patterns of damage in the mature neonatal brain

    International Nuclear Information System (INIS)

    Triulzi, Fabio; Parazzini, Cecilia; Righini, Andrea

    2006-01-01

    Patterns of damage in the mature neonatal brain can be subdivided into focal, multifocal and diffuse. The main cause of diffuse brain damage in the term newborn is hypoxic-ischaemic encephalopathy (HIE). HIE is still the major recognized perinatal cause of neurological morbidity in full-term newborns. MRI offers today the highest sensitivity in detecting acute anoxic injury of the neonatal brain. Conventional acquisition techniques together with modern diffusion techniques can identify typical patterns of HIE injury, even in the early course of the disease. However, even though highly suggestive, these patterns cannot be considered as pathognomonic. Perinatal metabolic disease such as kernicterus and severe hypoglycaemia should be differentiated from classic HIE. Other conditions, such as infections, non-accidental injury and rarer metabolic diseases can be misinterpreted as HIE in their early course when diffuse brain swelling is still the predominant MRI feature. Diffusion techniques can help to differentiate different types of diffuse brain oedema. Typical examples of focal injuries are arterial or venous infarctions. In arterial infarction, diffusion techniques can define more precisely than conventional imaging the extent of focal infarction, even in the hyperacute phase. Moreover, diffusion techniques provide quantitative data of acute corticospinal tract injury, especially at the level of the cerebral peduncles. Venous infarction should be suspected in every case of unexplained cerebral haematoma in the full-term newborn. In the presence of spontaneous bleeding, venous structures should always be evaluated by MR angiography. (orig.)

  14. Patterns of damage in the mature neonatal brain

    Energy Technology Data Exchange (ETDEWEB)

    Triulzi, Fabio; Parazzini, Cecilia; Righini, Andrea [Children' s Hospital ' ' Vittore Buzzi' ' , Departments of Radiology and Neuroradiology, Milan (Italy)

    2006-07-15

    Patterns of damage in the mature neonatal brain can be subdivided into focal, multifocal and diffuse. The main cause of diffuse brain damage in the term newborn is hypoxic-ischaemic encephalopathy (HIE). HIE is still the major recognized perinatal cause of neurological morbidity in full-term newborns. MRI offers today the highest sensitivity in detecting acute anoxic injury of the neonatal brain. Conventional acquisition techniques together with modern diffusion techniques can identify typical patterns of HIE injury, even in the early course of the disease. However, even though highly suggestive, these patterns cannot be considered as pathognomonic. Perinatal metabolic disease such as kernicterus and severe hypoglycaemia should be differentiated from classic HIE. Other conditions, such as infections, non-accidental injury and rarer metabolic diseases can be misinterpreted as HIE in their early course when diffuse brain swelling is still the predominant MRI feature. Diffusion techniques can help to differentiate different types of diffuse brain oedema. Typical examples of focal injuries are arterial or venous infarctions. In arterial infarction, diffusion techniques can define more precisely than conventional imaging the extent of focal infarction, even in the hyperacute phase. Moreover, diffusion techniques provide quantitative data of acute corticospinal tract injury, especially at the level of the cerebral peduncles. Venous infarction should be suspected in every case of unexplained cerebral haematoma in the full-term newborn. In the presence of spontaneous bleeding, venous structures should always be evaluated by MR angiography. (orig.)

  15. Time Is Brain: The Stroke Theory of Relativity.

    Science.gov (United States)

    Gomez, Camilo R

    2018-04-25

    Since the introduction of the philosophical tenet "Time is Brain!," multiple lines of research have demonstrated that other factors contribute to the degree of ischemic injury at any one point in time, and it is now clear that the therapeutic window of acute ischemic stroke is more protracted than it was first suspected. To define a more realistic relationship between time and the ischemic process, we used computational modeling to assess how these 2 variables are affected by collateral circulatory competence. Starting from the premise that the expression "Time=Brain" is mathematically false, we reviewed the existing literature on the attributes of cerebral ischemia over time, with particular attention to relevant clinical parameters, and the effect of different variables, particularly collateral circulation, on the time-ischemia relationship. We used this information to construct a theoretical computational model and applied it to categorically different yet abnormal cerebral perfusion scenarios, allowing comparison of their behavior both overall (i.e., final infarct volume) and in real-time (i.e., instantaneous infarct growth rate). Optimal collateral circulatory competence was predictably associated with slower infarct growth rates and prolongation of therapeutic window. Modeling of identifiable specific types of perfusion maps allows forecasting of the fate of the ischemic process over time. Distinct cerebral perfusion map patterns can be readily identified in patients with acute ischemic stroke. These patterns have inherently different behaviors relative to the time-ischemia construct, allowing the possibility of improving parsing and treatment allocation. It is clearly evident that the effect of time on the ischemic process is relative. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  16. Genetic influences on individual differences in longitudinal changes in global and subcortical brain volumes: Results of the ENIGMA plasticity working group.

    Science.gov (United States)

    Brouwer, Rachel M; Panizzon, Matthew S; Glahn, David C; Hibar, Derrek P; Hua, Xue; Jahanshad, Neda; Abramovic, Lucija; de Zubicaray, Greig I; Franz, Carol E; Hansell, Narelle K; Hickie, Ian B; Koenis, Marinka M G; Martin, Nicholas G; Mather, Karen A; McMahon, Katie L; Schnack, Hugo G; Strike, Lachlan T; Swagerman, Suzanne C; Thalamuthu, Anbupalam; Wen, Wei; Gilmore, John H; Gogtay, Nitin; Kahn, René S; Sachdev, Perminder S; Wright, Margaret J; Boomsma, Dorret I; Kremen, William S; Thompson, Paul M; Hulshoff Pol, Hilleke E

    2017-09-01

    Structural brain changes that occur during development and ageing are related to mental health and general cognitive functioning. Individuals differ in the extent to which their brain volumes change over time, but whether these differences can be attributed to differences in their genotypes has not been widely studied. Here we estimate heritability (h 2 ) of changes in global and subcortical brain volumes in five longitudinal twin cohorts from across the world and in different stages of the lifespan (N = 861). Heritability estimates of brain changes were significant and ranged from 16% (caudate) to 42% (cerebellar gray matter) for all global and most subcortical volumes (with the exception of thalamus and pallidum). Heritability estimates of change rates were generally higher in adults than in children suggesting an increasing influence of genetic factors explaining individual differences in brain structural changes with age. In children, environmental influences in part explained individual differences in developmental changes in brain structure. Multivariate genetic modeling showed that genetic influences of change rates and baseline volume significantly overlapped for many structures. The genetic influences explaining individual differences in the change rate for cerebellum, cerebellar gray matter and lateral ventricles were independent of the genetic influences explaining differences in their baseline volumes. These results imply the existence of genetic variants that are specific for brain plasticity, rather than brain volume itself. Identifying these genes may increase our understanding of brain development and ageing and possibly have implications for diseases that are characterized by deviant developmental trajectories of brain structure. Hum Brain Mapp 38:4444-4458, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  17. Trajectories of cortical surface area and cortical volume maturation in normal brain development

    Directory of Open Access Journals (Sweden)

    Simon Ducharme

    2015-12-01

    Full Text Available This is a report of developmental trajectories of cortical surface area and cortical volume in the NIH MRI Study of Normal Brain Development. The quality-controlled sample included 384 individual typically-developing subjects with repeated scanning (1–3 per subject, total scans n=753 from 4.9 to 22.3 years of age. The best-fit model (cubic, quadratic, or first-order linear was identified at each vertex using mixed-effects models, with statistical correction for multiple comparisons using random field theory. Analyses were performed with and without controlling for total brain volume. These data are provided for reference and comparison with other databases. Further discussion and interpretation on cortical developmental trajectories can be found in the associated Ducharme et al.׳s article “Trajectories of cortical thickness maturation in normal brain development – the importance of quality control procedures” (Ducharme et al., 2015 [1].

  18. Computed Tomography-Based Imaging of Voxel-Wise Lesion Water Uptake in Ischemic Brain: Relationship Between Density and Direct Volumetry.

    Science.gov (United States)

    Broocks, Gabriel; Flottmann, Fabian; Ernst, Marielle; Faizy, Tobias Djamsched; Minnerup, Jens; Siemonsen, Susanne; Fiehler, Jens; Kemmling, Andre

    2018-04-01

    Net water uptake per volume of brain tissue may be calculated by computed tomography (CT) density, and this imaging biomarker has recently been investigated as a predictor of lesion age in acute stroke. However, the hypothesis that measurements of CT density may be used to quantify net water uptake per volume of infarct lesion has not been validated by direct volumetric measurements so far. The purpose of this study was to (1) develop a theoretical relationship between CT density reduction and net water uptake per volume of ischemic lesions and (2) confirm this relationship by quantitative in vitro and in vivo CT image analysis using direct volumetric measurements. We developed a theoretical rationale for a linear relationship between net water uptake per volume of ischemic lesions and CT attenuation. The derived relationship between water uptake and CT density was tested in vitro in a set of increasingly diluted iodine solutions with successive CT measurements. Furthermore, the consistency of this relationship was evaluated using human in vivo CT images in a retrospective multicentric cohort. In 50 edematous infarct lesions, net water uptake was determined by direct measurement of the volumetric difference between the ischemic and normal hemisphere and was correlated with net water uptake calculated by ischemic density measurements. With regard to in vitro data, water uptake by density measurement was equivalent to direct volumetric measurement (r = 0.99, P volumetry was 44.7 ± 26.8 mL and the mean percent water uptake per lesion volume was 22.7% ± 7.4%. This was equivalent to percent water uptake obtained from density measurements: 21.4% ± 6.4%. The mean difference between percent water uptake by direct volumetry and percent water uptake by CT density was -1.79% ± 3.40%, which was not significantly different from 0 (P < 0.0001). Volume of water uptake in infarct lesions can be calculated quantitatively by relative CT density measurements. Voxel-wise imaging

  19. Magnetic resonance imaging of human cerebral infarction: Enhancement with Gd-DTPA

    Energy Technology Data Exchange (ETDEWEB)

    Imakita, S.; Nishimura, T.; Naito, H.; Yamada, N.; Yamamoto, K.; Takamiya, M.; Yamada, Y.; Sakashita, Y.; Minamikawa, J.; Kikuchi, H.

    1987-09-01

    Five patients (1 female and 4 males) with cerebral infarction of 4 h to 27 months duration were studied 9 times with magnetic resonance (MR) using Gd-DTPA. Spinecho (SE) MR images (MRI) were obtained before and after the administration of Gd-DTPA, and correlative CT scans were performed on the same day. In 2 cases, 4 h and 27 months after the ictus, there was no enhancement with Gd-DTPA. There was faint enhancement in 2 cases with cerebral infarction of about 24 h duration and obvious enhancement in all cases in the subacute stage. Compared with enhanced CT, MR using Gd-DTPA demonstrated more obvious enhancement of infarcted areas. MR enhancement using Gd-DTPA showed a gradual increase and the accumulated Gd-DTPA in infarcted areas slowly diffused to the periphery. MR enhancement with Gd-DTPA is similar to that of enhanced CT, but may be more sensitive in the detection of blood brain barrier breakdown.

  20. Performance of computer-aided diagnosis for detection of lacunar infarcts on brain MR images: ROC analysis of radiologists' detection

    International Nuclear Information System (INIS)

    Uchiyama, Y.; Yokoyama, R.; Hara, T.; Fujita, H.; Asano, T.; Kato, H.; Hoshi, H.; Yamakawa, H.; Iwama, T.; Ando, H.; Yamakawa, H.

    2007-01-01

    The detection and management of asymptomatic lacunar infarcts on magnetic resonance (MR) images are important tasks for radiologists to ensure the prevention of sever cerebral infarctions. However, accurate identification of lacunar infarcts is a difficult. Therefore, we developed a computer-aided diagnosis (CAD) scheme for detection of lacunar infarcts. The purpose of this study was to evaluate radiologists' performance in detection of lacunar infarcts without and with use of CAD scheme. 30 T1- and 30 T2- weighted images obtained from 30 patients were used for an observer study, which were consisted of 15 cases with a single lacunar infarct and 15 cases without any lacunar infarct. Six radiologists participated in the observer study. They interpreted lacunar infarcts first without and then with use of the scheme. For all six observers, average area under the receiver operating characteristic curve value was increased from 0.920 to 0.965 when they used the computer output. This CAD scheme might have the potential to improve the accuracy of radiologists' performance in the detection of lacunar infarcts on MR images. (orig.)

  1. Emission computed tomography with technetium-99m pyrophosphate for delineating location and size of acute myocardial infarction in man

    Energy Technology Data Exchange (ETDEWEB)

    Tamaki, S; Kadota, K; Kambara, H; Suzuki, Y; Nohara, R; Murakami, T; Kawai, C; Tamaki, N; Torizuka, K [Kyoto Univ. (Japan). Faculty of Medicine

    1984-07-01

    Emission computed tomography with technetium-99m pyrophosphate was used to delineate the location and estimate the size of myocardial infarcts in 20 patients with documented acute myocardial infarction. Tomography was performed after planar imaging within 2-5 days after the onset of infarction. Infarct volume was measured from the tomographic images by computerised planimetry and compared with the cumulative release of creatine kinase MB isoenzyme. The planar images showed discrete myocardial uptake in 13 of the 20 patients and diffuse uptake throughout the cardiac region in the remaining seven. In contrast, the tomographic images clearly delineated myocardial uptake by avoiding confusion of myocardial activity with that of surrounding structures, particularly bones, in all patients. For the 10 patients whose infarct size was assessed by analysis of the creatine kinase MB curve there was a close correlation between infarct volume estimated by tomography and by cumulative creatine kinase MB release. Thus emission computed tomography can provide a three dimensional map of technetium-99m pyrophosphate distribution within the heart and is thus able accurately to localise and estimate the size of myocardial infarcts in man.

  2. Emission computed tomography with technetium-99m pyrophosphate for delineating location and size of acute myocardial infarction in man

    International Nuclear Information System (INIS)

    Tamaki, S.; Kadota, K.; Kambara, H.; Suzuki, Y.; Nohara, R.; Murakami, T.; Kawai, C.; Tamaki, N.; Torizuka, K.

    1984-01-01

    Emission computed tomography with technetium-99m pyrophosphate was used to delineate the location and estimate the size of myocardial infarcts in 20 patients with documented acute myocardial infarction. Tomography was performed after planar imaging within 2-5 days after the onset of infarction. Infarct volume was measured from the tomographic images by computerised planimetry and compared with the cumulative release of creatine kinase MB isoenzyme. The planar images showed discrete myocardial uptake in 13 of the 20 patients and diffuse uptake throughout the cardiac region in the remaining seven. In contrast, the tomographic images clearly delineated myocardial uptake by avoiding confusion of myocardial activity with that of surrounding structures, particularly bones, in all patients. For the 10 patients whose infarct size was assessed by analysis of the creatine kinase MB curve there was a close correlation between infarct volume estimated by tomography and by cumulative creatine kinase MB release. Thus emission computed tomography can provide a three dimensional map of technetium-99m pyrophosphate distribution within the heart and is thus able accurately to localise and estimate the size of myocardial infarcts in man. (author)

  3. Structural imaging of the brain reveals decreased total brain and total gray matter volumes in obese but not in lean women with polycystic ovary syndrome compared to body mass index-matched counterparts.

    Science.gov (United States)

    Ozgen Saydam, Basak; Has, Arzu Ceylan; Bozdag, Gurkan; Oguz, Kader Karli; Yildiz, Bulent Okan

    2017-07-01

    To detect differences in global brain volumes and identify relations between brain volume and appetite-related hormones in women with polycystic ovary syndrome (PCOS) compared to body mass index-matched controls. Forty subjects participated in this study. Cranial magnetic resonance imaging and measurements of fasting ghrelin, leptin and glucagon-like peptide 1 (GLP-1), as well as GLP-1 levels during mixed-meal tolerance test (MTT), were performed. Total brain volume and total gray matter volume (GMV) were decreased in obese PCOS compared to obese controls (p lean PCOS and controls did not show a significant difference. Secondary analyses of regional brain volumes showed decreases in GMV of the caudate nucleus, ventral diencephalon and hippocampus in obese PCOS compared to obese controls (p lean patients with PCOS had lower GMV in the amygdala than lean controls (p PCOS, suggests volumetric reductions in global brain areas in obese women with PCOS. Functional studies with larger sample size are needed to determine physiopathological roles of these changes and potential effects of long-term medical management on brain structure of PCOS.

  4. A longitudinal analysis of regional brain volumes in macaques exposed to X-irradiation in early gestation.

    Directory of Open Access Journals (Sweden)

    Kristina Aldridge

    Full Text Available Early gestation represents a period of vulnerability to environmental insult that has been associated with adult psychiatric disease. However, little is known about how prenatal perturbation translates into adult brain dysfunction. Here, we use a longitudinal study design to examine the effects of disruption of early gestational neurogenesis on brain volume in the non-human primate.Five Rhesus macaques were exposed to x-irradiation in early gestation (E30-E41, and four control monkeys were sham-irradiated at comparable ages. Whole brain magnetic resonance imaging was performed at 6 months, 12 months, and 3 and 5 years of age. Volumes of whole cerebrum, cortical gray matter, caudate, putamen, and thalamus were estimated using semi-automated segmentation methods and high dimensional brain mapping. Volume reductions spanning all ages were observed in irradiated monkeys in the putamen (15-24%, p = 0.01 and in cortical gray matter (6-15%, p = 0.01. Upon covarying for whole cerebral volume, group differences were reduced to trend levels (putamen: p = 0.07; cortical gray matter: p = 0.08. No group-by-age effects were significant.Due to the small number of observations, the conclusions drawn from this study must be viewed as tentative. Early gestational irradiation may result in non-uniform reduction of gray matter, mainly affecting the putamen and cerebral cortex. This may be relevant to understanding how early prenatal environmental insult could lead to brain morphological differences in neurodevelopmental diseases.

  5. Isoflurane anesthesia initiated at the onset of reperfusion attenuates oxidative and hypoxic-ischemic brain injury.

    Directory of Open Access Journals (Sweden)

    Sergey A Sosunov

    Full Text Available This study demonstrates that in mice subjected to hypoxia-ischemia (HI brain injury isoflurane anesthesia initiated upon reperfusion limits a release of mitochondrial oxidative radicals by inhibiting a recovery of complex-I dependent mitochondrial respiration. This significantly attenuates an oxidative stress and reduces the extent of HI brain injury. Neonatal mice were subjected to HI, and at the initiation of reperfusion were exposed to isoflurane with or without mechanical ventilation. At the end of HI and isoflurane exposure cerebral mitochondrial respiration, H2O2 emission rates were measured followed by an assessment of cerebral oxidative damage and infarct volumes. At 8 weeks after HI navigational memory and brain atrophy were assessed. In vitro, direct effect of isoflurane on mitochondrial H2O2 emission was compared to that of complex-I inhibitor, rotenone. Compared to controls, 15 minutes of isoflurane anesthesia inhibited recovery of the compex I-dependent mitochondrial respiration and decreased H2O2 production in mitochondria supported with succinate. This was associated with reduced oxidative brain injury, superior navigational memory and decreased cerebral atrophy compared to the vehicle-treated HI-mice. Extended isoflurane anesthesia was associated with sluggish recovery of cerebral blood flow (CBF and the neuroprotection was lost. However, when isoflurane anesthesia was supported with mechanical ventilation the CBF recovery improved, the event associated with further reduction of infarct volume compared to HI-mice exposed to isoflurane without respiratory support. Thus, in neonatal mice brief isoflurane anesthesia initiated at the onset of reperfusion limits mitochondrial release of oxidative radicals and attenuates an oxidative stress. This novel mechanism contributes to neuroprotective action of isoflurane. The use of mechanical ventilation during isoflurane anesthesia counterbalances negative effect of isoflurane anesthesia on

  6. Caudal brain infarctions in a kitten – case reportInfartos em região encefálica caudal em gata filhote – relato de caso

    Directory of Open Access Journals (Sweden)

    Lucas Alécio Gomes

    2013-05-01

    Full Text Available Stroke is uncommon in animals compared with humans because of the lower incidence of atherosclerosis and primary hypertension. However with advanced imaging, vascular disease is being recognized with increasing frequency in veterinary medicine. Cerebrovascular disease can be subdivided into infarction and hemorrhage, although the two categories overlap in the case of hemorrhagic infarcts. The aim of thisarticle is to report the neurological manifestations associated with stroke (infarctions in at two-month old, domestic shorthair cat. Neurological evaluation revealed head tilt, tetraparesis, proprioceptive deficits in all four limbs, and decreased pupillary light reflex. Further, manifestations of neurological dysfunctions were acute and progressive. At the necropsy, grossly there were hemorrhage and necrosis at mid-brain and cerebellum. Histopathology confirmed liquefactive necrosis at the mid-brain and cerebellum. The neurological manifestations associated with the pathological findings are suggestive of an anoxic infarction probably due to vascular occlusion. Em animais é baixa a incidência de arterosclerose e hipertensão primária. Devido a tal característica, infarto cerebral é incomum nos mesmos. Entretanto, com o avanço das modalidades de imagem, doença vascular está sendo reconhecida com maio frequência na medicina veterinária. Doença cerebrovascular pode ser subdividida em infarto e hemorragia, embora as duas categorias se interponham no caso de infartos hemorrágicos. Assim sendo, o objetivo deste artigo é descrever as manifestações neurológicas associadas a acidente vascular (infartos em uma gata de dois meses de idade, sem raça definida e domiciliada. Na avaliação neurológica observou-se inclinação de cabeça, tetraparesia, déficits proprioceptivos nos quatro membros e diminuição do reflexo pupilar a luz. Além disso, os problemas neurológicos foram agudos e progressivos. Na necropsia macroscopicamente

  7. The association between brain volumes, delirium duration, and cognitive outcomes in intensive care unit survivors: the VISIONS cohort magnetic resonance imaging study*.

    Science.gov (United States)

    Gunther, Max L; Morandi, Alessandro; Krauskopf, Erin; Pandharipande, Pratik; Girard, Timothy D; Jackson, James C; Thompson, Jennifer; Shintani, Ayumi K; Geevarghese, Sunil; Miller, Russell R; Canonico, Angelo; Merkle, Kristen; Cannistraci, Christopher J; Rogers, Baxter P; Gatenby, J Chris; Heckers, Stephan; Gore, John C; Hopkins, Ramona O; Ely, E Wesley

    2012-07-01

    Delirium duration is predictive of long-term cognitive impairment in intensive care unit survivors. Hypothesizing that a neuroanatomical basis may exist for the relationship between delirium and long-term cognitive impairment, we conducted this exploratory investigation of the associations between delirium duration, brain volumes, and long-term cognitive impairment. A prospective cohort of medical and surgical intensive care unit survivors with respiratory failure or shock. Quantitative high resolution 3-Tesla brain magnetic resonance imaging was used to calculate brain volumes at discharge and 3-month follow-up. Delirium was evaluated using the confusion assessment method for the intensive care unit; cognitive outcomes were tested at 3- and 12-month follow-up. Linear regression was used to examine associations between delirium duration and brain volumes, and between brain volumes and cognitive outcomes. A total of 47 patients completed the magnetic resonance imaging protocol. Patients with longer duration of delirium displayed greater brain atrophy as measured by a larger ventricle-to-brain ratio at hospital discharge (0.76, 95% confidence intervals [0.10, 1.41]; p = .03) and at 3-month follow-up (0.62 [0.02, 1.21], p = .05). Longer duration of delirium was associated with smaller superior frontal lobe (-2.11 cm(3) [-3.89, -0.32]; p = .03) and hippocampal volumes at discharge (-0.58 cm(3) [-0.85, -0.31], p Battery for the Assessment of Neuropsychological Status score -11.17 [-21.12, -1.22], p = .04). Smaller superior frontal lobes, thalamus, and cerebellar volumes at 3 months were associated with worse executive functioning and visual attention at 12 months. These preliminary data show that longer duration of delirium is associated with smaller brain volumes up to 3 months after discharge, and that smaller brain volumes are associated with long-term cognitive impairment up to 12 months. We cannot, however, rule out that smaller preexisting brain volumes explain

  8. Stereological brain volume changes in post-weaned socially isolated rats

    DEFF Research Database (Denmark)

    Fabricius, Katrine; Helboe, Lone; Steiniger-Brach, Björn

    2010-01-01

    Rearing rats in isolation after weaning is an environmental manipulation that leads to behavioural and neurochemical alterations that resemble what is seen in schizophrenia. The model is neurodevelopmental in origin and has been used as an animal model of schizophrenia. However, only a few studies...... Lister Hooded rats isolated from postnatal day 25 for 15 weeks. We observed the expected gender differences in total brain volume with males having larger brains than females. Further, we found that isolated males had significantly smaller brains than group-housed controls and larger lateral ventricles...... than controls. However, this was not seen in female rats. Isolated males had a significant smaller hippocampus, dentate gyrus and CA2/3 where isolated females had a significant smaller CA1 compared to controls. Thus, our results indicate that long-term isolation of male rats leads to neuroanatomical...

  9. The role of testosterone and estradiol in brain volume changes across adolescence: a longitudinal structural MRI study.

    Science.gov (United States)

    Herting, Megan M; Gautam, Prapti; Spielberg, Jeffrey M; Kan, Eric; Dahl, Ronald E; Sowell, Elizabeth R

    2014-11-01

    It has been postulated that pubertal hormones may drive some neuroanatomical changes during adolescence, and may do so differently in girls and boys. Here, we use growth curve modeling to directly assess how sex hormones [testosterone (T) and estradiol (E₂)] relate to changes in subcortical brain volumes utilizing a longitudinal design. 126 adolescents (63 girls), ages 10 to 14, were imaged and restudied ∼2 years later. We show, for the first time, that best-fit growth models are distinctly different when using hormones as compared to a physical proxy of pubertal maturation (Tanner Stage) or age, to predict brain development. Like Tanner Stage, T and E₂ predicted white matter and right amygdala growth across adolescence in both sexes, independent of age. Tanner Stage also explained decreases in both gray matter and caudate volumes, whereas E₂ explained only gray matter decreases and T explained only caudate volume decreases. No pubertal measures were related to hippocampus development. Although specificity was seen, sex hormones had strikingly similar relationships with white matter, gray matter, right amygdala, and bilateral caudate volumes, with larger changes in brain volume seen at early pubertal maturation (as indexed by lower hormone levels), followed by less robust, or even reversals in growth, by late puberty. These novel longitudinal findings on the relationship between hormones and brain volume change represent crucial first steps toward understanding which aspects of puberty influence neurodevelopment. Copyright © 2014 Wiley Periodicals, Inc.

  10. Sleep Apnea, Sleep Duration and Brain MRI Markers of Cerebral Vascular Disease and Alzheimer's Disease: The Atherosclerosis Risk in Communities Study (ARIC.

    Directory of Open Access Journals (Sweden)

    Pamela L Lutsey

    Full Text Available A growing body of literature has suggested that obstructive sleep apnea (OSA and habitual short sleep duration are linked to poor cognitive function. Neuroimaging studies may provide insight into this relation.We tested the hypotheses that OSA and habitual short sleep duration, measured at ages 54-73 years, would be associated with adverse brain morphology at ages 67-89 years.Included in this analysis are 312 ARIC study participants who underwent in-home overnight polysomnography in 1996-1998 and brain MRI scans about 15 years later (2012-2013. Sleep apnea was quantified by the apnea-hypopnea index and categorized as moderate/severe (≥15.0 events/hour, mild (5.0-14.9 events/hour, or normal (<5.0 events/hour. Habitual sleep duration was categorized, in hours, as <7, 7 to <8, ≥8. MRI outcomes included number of infarcts (total, subcortical, and cortical and white matter hyperintensity (WMH and Alzheimer's disease signature region volumes. Multivariable adjusted logistic and linear regression models were used. All models incorporated inverse probability weighting, to adjust for potential selection bias.At the time of the sleep study participants were 61.7 (SD: 5.0 years old and 54% female; 19% had moderate/severe sleep apnea. MRI imaging took place 14.8 (SD: 1.0 years later, when participants were 76.5 (SD: 5.2 years old. In multivariable models which accounted for body mass index, neither OSA nor abnormal sleep duration were statistically significantly associated with odds of cerebral infarcts, WMH brain volumes or regional brain volumes.In this community-based sample, mid-life OSA and habitually short sleep duration were not associated with later-life cerebral markers of vascular dementia and Alzheimer's disease. However, selection bias may have influenced our results and the modest sample size led to relatively imprecise associations.

  11. Is lactate a volume transmitter of metabolic states of the brain?

    DEFF Research Database (Denmark)

    Bergersen, Linda H; Gjedde, Albert

    2012-01-01

    We present the perspective that lactate is a volume transmitter of cellular signals in brain that acutely and chronically regulate the energy metabolism of large neuronal ensembles. From this perspective, we interpret recent evidence to mean that lactate transmission serves the maintenance...... of network metabolism by two different mechanisms, one by regulating the formation of cAMP via the lactate receptor GPR81, the other by adjusting the NADH/NAD(+) redox ratios, both linked to the maintenance of brain energy turnover and possibly cerebral blood flow. The role of lactate as mediator...

  12. Partial volume correction and image segmentation for accurate measurement of standardized uptake value of grey matter in the brain.

    Science.gov (United States)

    Bural, Gonca; Torigian, Drew; Basu, Sandip; Houseni, Mohamed; Zhuge, Ying; Rubello, Domenico; Udupa, Jayaram; Alavi, Abass

    2015-12-01

    Our aim was to explore a novel quantitative method [based upon an MRI-based image segmentation that allows actual calculation of grey matter, white matter and cerebrospinal fluid (CSF) volumes] for overcoming the difficulties associated with conventional techniques for measuring actual metabolic activity of the grey matter. We included four patients with normal brain MRI and fluorine-18 fluorodeoxyglucose (F-FDG)-PET scans (two women and two men; mean age 46±14 years) in this analysis. The time interval between the two scans was 0-180 days. We calculated the volumes of grey matter, white matter and CSF by using a novel segmentation technique applied to the MRI images. We measured the mean standardized uptake value (SUV) representing the whole metabolic activity of the brain from the F-FDG-PET images. We also calculated the white matter SUV from the upper transaxial slices (centrum semiovale) of the F-FDG-PET images. The whole brain volume was calculated by summing up the volumes of the white matter, grey matter and CSF. The global cerebral metabolic activity was calculated by multiplying the mean SUV with total brain volume. The whole brain white matter metabolic activity was calculated by multiplying the mean SUV for the white matter by the white matter volume. The global cerebral metabolic activity only reflects those of the grey matter and the white matter, whereas that of the CSF is zero. We subtracted the global white matter metabolic activity from that of the whole brain, resulting in the global grey matter metabolism alone. We then divided the grey matter global metabolic activity by grey matter volume to accurately calculate the SUV for the grey matter alone. The brain volumes ranged between 1546 and 1924 ml. The mean SUV for total brain was 4.8-7. Total metabolic burden of the brain ranged from 5565 to 9617. The mean SUV for white matter was 2.8-4.1. On the basis of these measurements we generated the grey matter SUV, which ranged from 8.1 to 11.3. The

  13. A new graphic method for evaluation of distribution volume on N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo; Takahashi, Naoya; Ohtaki, Hiroh; Noguchi, Eikichi; Hatano, Masayoshi; Yamasaki, Yoshihiro; Nishihara, Mamiko (Niigata Univ. (Japan). School of Medicine); Ohkubo, Masaki; Yokoi, Takashi

    1993-10-01

    We developed a new graphic method using N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) and SPECT of the brain, the graph on which all three parameters, cerebral blood flow, distribution volume (V[sub d]) and delayed count to early count ratio (Delayed/Early ratio), were able to be evaluated simultaneously. The kinetics of [sup 123]I-IMP in the brain was analyzed by a 2-compartment model, and a standard input function was prepared by averaging the time activity curves of [sup 123]I-IMP in arterial blood on 6 patients with small cerebral infarction etc. including 2 normal controls. Being applied this method to the differential diagnosis between Parkinson's disease and progressive supranuclear palsy, we were able to differentiate both with a glance, because the distribution volume of the frontal lobe significantly decreased in Parkinson's disease (Mean[+-]SD; 26[+-]6 ml/g). This method was clinically useful. We think that the distribution volume of [sup 123]I-IMP may reflect its retention mechanism in the brain, and the values are related to amine, especially to dopamine receptors and its metabolism. (author).

  14. An improved approach to reduce partial volume errors in brain SPET

    International Nuclear Information System (INIS)

    Hatton, R.L.; Hatton, B.F.; Michael, G.; Barnden, L.; QUT, Brisbane, QLD; The Queen Elizabeth Hospital, Adelaide, SA

    1999-01-01

    Full text: Limitations in SPET resolution give rise to significant partial volume error (PVE) in small brain structures We have investigated a previously published method (Muller-Gartner et al., J Cereb Blood Flow Metab 1992;16: 650-658) to correct PVE in grey matter using MRI. An MRI is registered and segmented to obtain a grey matter tissue volume which is then smoothed to obtain resolution matched to the corresponding SPET. By dividing the original SPET with this correction map, structures can be corrected for PVE on a pixel-by-pixel basis. Since this approach is limited by space-invariant filtering, modification was made by estimating projections for the segmented MRI and reconstructing these using identical parameters to SPET. The methods were tested on simulated brain scans, reconstructed with the ordered subsets EM algorithm (8,16, 32, 64 equivalent EM iterations) The new method provided better recovery visually. For 32 EM iterations, recovery coefficients were calculated for grey matter regions. The effects of potential errors in the method were examined. Mean recovery was unchanged with one pixel registration error, the maximum error found in most registration programs. Errors in segmentation > 2 pixels results in loss of accuracy for small structures. The method promises to be useful for reducing PVE in brain SPET

  15. Role of cerebral blood volume changes in brain specific-gravity measurements

    International Nuclear Information System (INIS)

    Picozzi, P.; Todd, N.V.; Crockard, A.H.

    1985-01-01

    Cerebral blood volume (CBV) was calculated in gerbils from specific-gravity (SG) changes between normal and saline-perfused brains. Furthermore, changes in CBV were investigated during ischemia using carbon-14-labeled dextran (MW 70,000) as an intravascular marker. Both data were used to evaluate the possible error due to a change in CBV on the measurement of ischemic brain edema by the SG method. The methodological error found was 0.0004 for a 100% CBV change. This error is insignificant, being less than the standard deviation in the SG measured for the gerbil cortex. Thus, CBV changes are not responsible for the SG variations observed during the first phase of ischemia. These variations are better explained as an increase of brain water content during ischemia

  16. Protective effect of Kombucha tea on brain damage induced by transient cerebral ischemia and reperfusion in rat

    Directory of Open Access Journals (Sweden)

    Najmeh Kabiri

    2016-09-01

    Full Text Available The aim of study was to investigate the potential neuroprotective effects of Kombucha on cerebral damage induced by ischemia in rats (n=99. Cerebral infarct volume in the ischemic rats received Kombucha solution showed no significance alteration. However, the permeability of blood-brain barrier significantly decreased in both ischemic rats received 15 mg/kg Kombucha tea and Sham group. In addition, brain water content in the ischemic groups treated with Kombucha solution was significantly higher than the Sham group, although right hemispheres in all of the treated groups illustrated higher brain water content than the left ones. Brain anti-oxidant capacity elevated in the ischemic rats treated with Kombucha and in the Sham group. Brain and plasma malondialdehyde concentrations significantly decreased in both of the ischemic groups injected with Kombucha. The findings suggest that Kombucha tea could be useful for the prevention of cerebral damage.

  17. Clinical evaluation of dose-volume-effect relationship in radiation injury of the brain

    International Nuclear Information System (INIS)

    Saito, Mari

    1990-01-01

    Radiation brain injury, including functional disturbances or morphological changes (brain atrophy, periventricular lucencies or ventricular dilatation), were studied by CT in patients with primary intracranial neoplasms who were followed-up for at least 5 months after receiving radiotherapy. Each of 33 patients with medulloblastoma, pinealregion tumor or malignant lymphoma received a total dose of 40-61 Gy by conventional fractionation using a whole brain irradiation field boosted by a localized field. Of these patients, 19 (58%) developed radiation brain injury. It was concluded that the volume-dose was one of the most important factors influencing the development of radiation brain injury. Age at the time of radiotherapy and time of follow-up after the treatment were also considered to be important factors. (author)

  18. Developmentally Sensitive Interaction Effects of Genes and the Social Environment on Total and Subcortical Brain Volumes.

    Directory of Open Access Journals (Sweden)

    Jennifer S Richards

    Full Text Available Smaller total brain and subcortical volumes have been linked to psychopathology including attention-deficit/hyperactivity disorder (ADHD. Identifying mechanisms underlying these alterations, therefore, is of great importance. We investigated the role of gene-environment interactions (GxE in interindividual variability of total gray matter (GM, caudate, and putamen volumes. Brain volumes were derived from structural magnetic resonance imaging scans in participants with (N = 312 and without ADHD (N = 437 from N = 402 families (age M = 17.00, SD = 3.60. GxE effects between DAT1, 5-HTT, and DRD4 and social environments (maternal expressed warmth and criticism; positive and deviant peer affiliation as well as the possible moderating effect of age were examined using linear mixed modeling. We also tested whether findings depended on ADHD severity. Deviant peer affiliation was associated with lower caudate volume. Participants with low deviant peer affiliations had larger total GM volumes with increasing age. Likewise, developmentally sensitive GxE effects were found on total GM and putamen volume. For total GM, differential age effects were found for DAT1 9-repeat and HTTLPR L/L genotypes, depending on the amount of positive peer affiliation. For putamen volume, DRD4 7-repeat carriers and DAT1 10/10 homozygotes showed opposite age relations depending on positive peer affiliation and maternal criticism, respectively. All results were independent of ADHD severity. The presence of differential age-dependent GxE effects might explain the diverse and sometimes opposing results of environmental and genetic effects on brain volumes observed so far.

  19. Developmentally Sensitive Interaction Effects of Genes and the Social Environment on Total and Subcortical Brain Volumes.

    Science.gov (United States)

    Richards, Jennifer S; Arias Vásquez, Alejandro; Franke, Barbara; Hoekstra, Pieter J; Heslenfeld, Dirk J; Oosterlaan, Jaap; Faraone, Stephen V; Buitelaar, Jan K; Hartman, Catharina A

    2016-01-01

    Smaller total brain and subcortical volumes have been linked to psychopathology including attention-deficit/hyperactivity disorder (ADHD). Identifying mechanisms underlying these alterations, therefore, is of great importance. We investigated the role of gene-environment interactions (GxE) in interindividual variability of total gray matter (GM), caudate, and putamen volumes. Brain volumes were derived from structural magnetic resonance imaging scans in participants with (N = 312) and without ADHD (N = 437) from N = 402 families (age M = 17.00, SD = 3.60). GxE effects between DAT1, 5-HTT, and DRD4 and social environments (maternal expressed warmth and criticism; positive and deviant peer affiliation) as well as the possible moderating effect of age were examined using linear mixed modeling. We also tested whether findings depended on ADHD severity. Deviant peer affiliation was associated with lower caudate volume. Participants with low deviant peer affiliations had larger total GM volumes with increasing age. Likewise, developmentally sensitive GxE effects were found on total GM and putamen volume. For total GM, differential age effects were found for DAT1 9-repeat and HTTLPR L/L genotypes, depending on the amount of positive peer affiliation. For putamen volume, DRD4 7-repeat carriers and DAT1 10/10 homozygotes showed opposite age relations depending on positive peer affiliation and maternal criticism, respectively. All results were independent of ADHD severity. The presence of differential age-dependent GxE effects might explain the diverse and sometimes opposing results of environmental and genetic effects on brain volumes observed so far.

  20. Early Life Stress-Related Elevations in Reaction Time Variability Are Associated with Brain Volume Reductions in HIV+ Adults

    Directory of Open Access Journals (Sweden)

    Uraina S. Clark

    2018-01-01

    Full Text Available There is burgeoning evidence that, among HIV+ adults, exposure to high levels of early life stress (ELS is associated with increased cognitive impairment as well as brain volume abnormalities and elevated neuropsychiatric symptoms. Currently, we have a limited understanding of the degree to which cognitive difficulties observed in HIV+ High-ELS samples reflect underlying neural abnormalities rather than increases in neuropsychiatric symptoms. Here, we utilized a behavioral marker of cognitive function, reaction time intra-individual variability (RT-IIV, which is sensitive to both brain volume reductions and neuropsychiatric symptoms, to elucidate the unique contributions of brain volume abnormalities and neuropsychiatric symptoms to cognitive difficulties in HIV+ High-ELS adults. We assessed the relation of RT-IIV to neuropsychiatric symptom levels and total gray and white matter volumes in 44 HIV+ adults (26 with high ELS. RT-IIV was examined during a working memory task. Self-report measures assessed current neuropsychiatric symptoms (depression, stress, post-traumatic stress disorder. Magnetic resonance imaging was used to quantify total gray and white matter volumes. Compared to Low-ELS participants, High-ELS participants exhibited elevated RT-IIV, elevated neuropsychiatric symptoms, and reduced gray and white matter volumes. Across the entire sample, RT-IIV was significantly associated with gray and white matter volumes, whereas significant associations with neuropsychiatric symptoms were not observed. In the High-ELS group, despite the presence of elevated neuropsychiatric symptom levels, brain volume reductions explained more than 13% of the variance in RT-IIV, whereas neuropsychiatric symptoms explained less than 1%. Collectively, these data provide evidence that, in HIV+ High-ELS adults, ELS-related cognitive difficulties (as indexed by RT-IIV exhibit strong associations with global brain volumes, whereas ELS-related elevations in

  1. Patent foramen ovale closure with GORE HELEX or CARDIOFORM Septal Occluder vs. antiplatelet therapy for reduction of recurrent stroke or new brain infarct in patients with prior cryptogenic stroke: Design of the randomized Gore REDUCE Clinical Study.

    Science.gov (United States)

    Kasner, Scott E; Thomassen, Lars; Søndergaard, Lars; Rhodes, John F; Larsen, Coby C; Jacobson, Joth

    2017-12-01

    Rationale The utility of patent foramen ovale (PFO) closure for secondary prevention in patients with prior cryptogenic stroke is uncertain despite multiple randomized trials completed to date. Aims The Gore REDUCE Clinical Study (REDUCE) aims to establish superiority of patent foramen ovale closure in conjunction with antiplatelet therapy over antiplatelet therapy alone in reducing the risk of recurrent clinical ischemic stroke or new silent brain infarct in patients who have had a cryptogenic stroke. Methods and design This controlled, open-label trial randomized 664 subjects with cryptogenic stroke at 63 multinational sites in a 2:1 ratio to either antiplatelet therapy plus patent foramen ovale closure (with GORE® HELEX® Septal Occluder or GORE® CARDIOFORM Septal Occluder) or antiplatelet therapy alone. Subjects will be prospectively followed for up to five years. Neuroimaging is required for all subjects at baseline and at two years or study exit. Study outcomes The two co-primary endpoints for the study are freedom from recurrent clinical ischemic stroke through at least 24 months post-randomization and incidence of new brain infarct (defined as clinical ischemic stroke or silent brain infarct) through 24 months. The primary analyses are an unadjusted log-rank test and a binomial test of subject-based proportions, respectively, both on the intent-to-treat population, with adjustment for testing multiplicity. Discussion The REDUCE trial aims to target a patient population with truly cryptogenic strokes. Medical therapy is limited to antiplatelet agents in both arms thereby reducing confounding. The trial should determine whether patent foramen ovale closure with the Gore septal occluders is safe and more effective than medical therapy alone for the prevention of recurrent clinical ischemic stroke or new silent brain infarct; the neuroimaging data will provide an opportunity to further support the proof of concept. The main results are anticipated in 2017

  2. Vascular brain lesions, brain atrophy, and cognitive decline. The Second Manifestations of ARTerial diseased-Magnetic Resonance (SMART-MR) study

    NARCIS (Netherlands)

    Kooistra, M.; Geerlings, M.I.; van der Graaf, Y.; Mali, W.P.T.M.; Vincken, K.L.; Kappelle, L.J.; Muller, M.; Biessels, G.J.

    2014-01-01

    We examined the association between brain atrophy and vascular brain lesions (i.e., white matter lesions [WMLs] or brain infarcts), alone or in combination, with decline in memory and executive functioning over 4 years of follow-up in 448 patients (57 ± 9.5 years) with symptomatic atherosclerotic

  3. Global and regional associations of smaller cerebral gray and white matter volumes with gait in older people.

    Directory of Open Access Journals (Sweden)

    Michele L Callisaya

    Full Text Available BACKGROUND: Gait impairments increase with advancing age and can lead to falls and loss of independence. Brain atrophy also occurs in older age and may contribute to gait decline. We aimed to investigate global and regional relationships of cerebral gray and white matter volumes with gait speed, and its determinants step length and cadence, in older people. METHODS: In a population-based study, participants aged >60 years without Parkinson's disease or brain infarcts underwent magnetic resonance imaging and gait measurements using a computerized walkway. Linear regression was used to study associations of total gray and white matter volumes with gait, adjusting for each other, age, sex, height and white matter hyperintensity volume. Other covariates considered in analyses included weight and vascular disease history. Voxel-based morphometry was used to study regional relationships of gray and white matter with gait. RESULTS: There were 305 participants, mean age 71.4 (6.9 years, 54% male, mean gait speed 1.16 (0.22 m/s. Smaller total gray matter volume was independently associated with poorer gait speed (p = 0.001 and step length (p<0.001, but not cadence. Smaller volumes of cortical and subcortical gray matter in bilateral regions important for motor control, vision, perception and memory were independently associated with slower gait speed and shorter steps. No global or regional associations were observed between white matter volume and gait independent of gray matter volume, white matter hyperintensity volume and other covariates. CONCLUSION: Smaller gray matter volume in bilaterally distributed brain networks serving motor control was associated with slower gait speed and step length, but not cadence.

  4. Lysophosphatidic Acid Level and the Incidence of Silent Brain Infarction in Patients with Nonvalvular Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Li Zhou

    2010-10-01

    Full Text Available Lysophosphatidic acid (LPA, which is proposed to play an important role in normal physiological situations such as wound healing, vascular tone, vascular integrity and reproduction, may be involved in the etiology of some diseases such as atherosclerosis, cancer, obesity or myocardial infarction. Abnormal findings, including silent brain infarction (SBI, are frequently observed by magnetic resonance imaging (MRI in patients with nonvalvular atrial fibrillation (NVAF. However, whether there is a relationship between LPA level and the prevalence of SBI has not been extensively studied. In the present study, the association between them was investigated. 235 patients with NVAF, 116 cases of SBI without NVAF and 120 cases of healthy volunteers (control group, who did not receive any antithrombotic therapy, were enrolled in this study. Plasma LPA levels in the NVAF with SBI group were significantly higher than that in the control group (p < 0.01, NVAF without SBI group (p < 0.01 and SBI without NVAF group (p < 0.01. The LPA levels are lower in the control group than in the NVAF without SBI and SBI without NVAF groups (p < 0.01, however, the latter two groups did not significantly differ from each other for LPA levels (p > 0.05 There were significant differences in the positive rate of platelet activation between each of the groups (p < 0.01. The positive rate of platelet activation was significantly higher in the NVAF with SBI group. We suggest that LPA might be a novel marker for estimation of the status of platelet activation and the risk factor for SBI onset in NVAF patients. We expected that plasma LPA levels could predict the occurrence of SBI in NVAF patients.

  5. Performance of computer-aided diagnosis for detection of lacunar infarcts on brain MR images: ROC analysis of radiologists' detection

    Energy Technology Data Exchange (ETDEWEB)

    Uchiyama, Y.; Yokoyama, R.; Hara, T.; Fujita, H. [Dept. of Intelligent Image Information, Graduate Scholl of Medicine, Gifu Univ. (Japan); Asano, T.; Kato, H.; Hoshi, H. [Dept. of Radiology, Graduate Scholl of Medicine, Gifu Univ. (Japan); Yamakawa, H.; Iwama, T. [Dept. of Neurosurgery, Graduate Scholl of Medicine, Gifu Univ. (Japan); Ando, H. [Dept. of Neurosurgery, Gifu Municipal Hospital (Japan); Yamakawa, H. [Dept. of Emergency and Critical Care Medicine, Chuno-Kousei Hospital (Japan)

    2007-06-15

    The detection and management of asymptomatic lacunar infarcts on magnetic resonance (MR) images are important tasks for radiologists to ensure the prevention of sever cerebral infarctions. However, accurate identification of lacunar infarcts is a difficult. Therefore, we developed a computer-aided diagnosis (CAD) scheme for detection of lacunar infarcts. The purpose of this study was to evaluate radiologists' performance in detection of lacunar infarcts without and with use of CAD scheme. 30 T1- and 30 T2- weighted images obtained from 30 patients were used for an observer study, which were consisted of 15 cases with a single lacunar infarct and 15 cases without any lacunar infarct. Six radiologists participated in the observer study. They interpreted lacunar infarcts first without and then with use of the scheme. For all six observers, average area under the receiver operating characteristic curve value was increased from 0.920 to 0.965 when they used the computer output. This CAD scheme might have the potential to improve the accuracy of radiologists' performance in the detection of lacunar infarcts on MR images. (orig.)

  6. The assessment of changes in brain volume using combined linear measurements

    International Nuclear Information System (INIS)

    Gomori, J.M.; Steiner, I.; Melamed, E.; Cooper, G.

    1984-01-01

    All linear measurements employed for evaluation of brain atrophy, were performed on 148 computed tomograms of patients aged 28 to 84 without evidence of any nervous system disorder. These included size of lateral, third and fourth ventricles, width of the Sylvian and frontal interhemispheric fissures and cortical sulci and size of the pre-pontine cistern. Various parameters indicated decrease in brain mass with age. Since the atrophic process is a diffuse phenomenon, integration of several measurements evaluating separate brain regions was made. The bicaudate ratio and the Sylvian fissure ratio (representing both central and cortical atrophy) were combined arithmetically, resulting in a correlation of 0.6390 with age (p<0.0005). With a computed canonical correlation analysis: a formula was obtained which combined measurements of the lateral and third ventricles, the Sylvian fissure and the pre-pontine cistern. This formula yealded a correlation of 0.67795 (p<0.0005). These linear measurements will enable simple and reliable assessment of reduction in brain volume during the normal aging process and in disorders accompanied by brain atrophy. (orig.)

  7. Sex Differences in Brain Volume Are Related to Specific Skills, Not to General Intelligence

    Science.gov (United States)

    Burgaleta, Miguel; Head, Kevin; Alvarez-Linera, Juan; Martinez, Kenia; Escorial, Sergio; Haier, Richard; Colom, Roberto

    2012-01-01

    It has been proposed that males would show higher mean scores than females in general intelligence ("g") because (1) men have, on average, larger brains than women, and (2) brain volume correlates with "g." Here we report a failure to support the conclusion derived from these premises. High resolution MRIs were acquired in a sample of one hundred…

  8. SONOlysis in prevention of Brain InfaRctions During Internal carotid Endarterectomy (SONOBIRDIE) trial - study protocol for a randomized controlled trial.

    Science.gov (United States)

    Hrbáč, Tomáš; Netuka, David; Beneš, Vladimír; Nosáľ, Vladimír; Kešnerová, Petra; Tomek, Aleš; Fadrná, Táňa; Beneš, Vladimír; Fiedler, Jiří; Přibáň, Vladimír; Brozman, Miroslav; Langová, Kateřina; Herzig, Roman; Školoudík, David

    2017-01-17

    Carotid endarterectomy (CEA) is a beneficial procedure for selected patients with an internal carotid artery (ICA) stenosis. Surgical risk of CEA varies from between 2 and 15%. The aim of the study is to demonstrate the safety and effectiveness of sonolysis (continual transcranial Doppler monitoring, TCD) using a 2-MHz diagnostic probe with maximal diagnostic energy on the reduction of the incidence of stroke, transient ischemic attack (TIA) and brain infarction detected using magnetic resonance imaging (MRI) by the activation of the endogenous fibrinolytic system during CEA. Design: a multicenter, randomized, double-blind, sham-controlled trial. international, multicenter trial for patients with at least 70% symptomatic or asymptomatic ICA stenosis undergoing CEA. patients with symptomatic or asymptomatic ICA stenosis of at least 70% are candidates for CEA; a sufficient temporal bone window for TCD; aged 40-85 years, functionally independent; provision of signed informed consent. Randomization: consecutive patients will be assigned to the sonolysis or control (sham procedure) group by computer-generated 1:1 randomization. Prestudy calculations showed that a minimum of 704 patients in each group is needed to reach a significant difference with an alpha value of 0.05 (two-tailed) and a beta value of 0.8 assuming that 10% would be lost to follow-up or refuse to participate in the study (estimated 39 endpoints). the primary endpoint is the incidence of stroke or TIA during 30 days after CEA and the incidence of new ischemic lesions on brain MRI performed 24 h after CEA in the sonolysis and control groups. Secondary endpoints are occurrence of death, any stroke, or myocardial infarction within 30 days, changes in cognitive functions 1 year post procedure related to pretreatment scores, and number of new lesions and occurrence of new lesions ≥0.5 mL on post-procedural brain MRI. descriptive statistics and linear/logistic multiple regression models will be

  9. No effect of ablation of surfactant protein-D on acute cerebral infarction in mice

    DEFF Research Database (Denmark)

    Lambertsen, Kate Lykke; Østergaard, Kamilla; Clausen, Bettina Hjelm

    2014-01-01

    known to be involved in extrapulmonary modulation of inflammation in mice. We investigated whether SP-D affected cerebral ischemic infarction and ischemia-induced inflammatory responses in mice. METHODS: The effect of SP-D was studied by comparing the size of ischemic infarction and the inflammatory...... and astroglial responses in SP-D knock out (KO) and wild type (WT) mice subjected to permanent middle cerebral artery occlusion. SP-D mRNA production was assessed in isolated cerebral arteries and in the whole brain by PCR, and SP-D protein in normal appearing and ischemic human brain by immunohistochemistry......-induced increase in TNF mRNA production one day after induction of ischemia; however the TNF response to the ischemic insult was affected at five days. SP-D mRNA was not detected in parenchymal brain cells in either naïve mice or in mice subjected to focal cerebral ischemia. However, SP-D mRNA was detected...

  10. Fatal outcome after brain stem infarction related to bilateral vertebral artery occlusion - case report of a detrimental complication of cervical spine trauma

    Directory of Open Access Journals (Sweden)

    Beauchamp Kathryn M

    2011-07-01

    Full Text Available Abstract Background Vertebral artery injury (VAI after blunt cervical trauma occurs more frequently than historically believed. The symptoms due to vertebral artery (VA occlusion usually manifest within the first 24 hours after trauma. Misdiagnosed VAI or delay in diagnosis has been reported to cause acute deterioration of previously conscious and neurologically intact patients. Case presentation A 67 year-old male was involved in a motor vehicle crash (MVC sustaining multiple injuries. Initial evaluation by the emergency medical response team revealed that he was alert, oriented, and neurologically intact. He was transferred to the local hospital where cervical spine computed tomography (CT revealed several abnormalities. Distraction and subluxation was present at C5-C6 and a comminuted fracture of the left lateral mass of C6 with violation of the transverse foramen was noted. Unavailability of a spine specialist prompted the patient's transfer to an area medical center equipped with spine care capabilities. After arrival, the patient became unresponsive and neurological deficits were noted. His continued deterioration prompted yet another transfer to our Level 1 regional trauma center. A repeat cervical spine CT at our institution revealed significantly worsened subluxation at C5-C6. CT angiogram also revealed complete occlusion of bilateral VA. The following day, a repeat CT of the head revealed brain stem infarction due to bilateral VA occlusion. Shortly following, the patient was diagnosed with brain death and care was withdrawn. Conclusion Brain stem infarction secondary to bilateral VA occlusion following cervical spine trauma resulted in fatal outcome. Prompt imaging evaluation is necessary to assess for VAI in cervical trauma cases with facet joint subluxation/dislocation or transverse foramen fracture so that treatment is not delayed. Additionally, multiple transportation events are risk factors for worsening when unstable cervical

  11. Pretreatment with Shuanghe-Tang Extract Attenuates Postischemic Brain Injury and Edema in a Mouse Model of Stroke: An Analysis of Medicinal Herbs Listed in Dongui Bogam

    Directory of Open Access Journals (Sweden)

    Min Jae Kim

    2018-01-01

    Full Text Available Aim. Although stroke is among the leading causes of death and long-term disability, there are few effective treatments for limiting the severity of neurological sequelae. We evaluated the effects of 29 medicinal herbs listed in the Pung chapter of the 17th century Korean medical text Dongui Bogam on stroke symptoms in a mouse model of cerebral ischemia. Methods. Focal cerebral ischemia was induced via photothrombosis. Infarct volume, brain edema, and neurological deficits were evaluated. Immunofluorescence staining for tight junction proteins and aquaporin 4 (AQP4 was performed following ischemic injury. Results. Based on our initial findings, we examined the effects of two prescriptions in which the candidate herbs comprised more than 60% of the total formula: Shuanghe-tang and Zengsunsiwu-tang. Pretreatment with Shuanghe-tang significantly reduced infarct volume, decreased blood-brain barrier (BBB breakdown, attenuated edema, and improved neurological and motor functions in a dose-dependent manner (30, 100, and 300 mg/kg, while no such effects were observed in mice pretreated with Zengsunsiwu-tang. Immunohistochemical analysis revealed significant increases in ipsilateral occludin and zonula occludens 1 (ZO-1 expression in Shuanghe-tang-pretreated mice, as well as increased AQP4 immunofluorescence. Conclusions. These results indicate that Shuanghe-tang may protect against brain injury and promote recovery of neurological function following ischemia.

  12. Clinical study of acute cerebral infarction with a midline shift on the CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Takemae, T; Mizukami, M; Kin, H; Kawase, T; Araki, G [Mihara Memorial Hospital, Isezaki, Gunma (Japan)

    1978-12-01

    Twenty-one cases of acute cerebral infarction with a midline shift on the CT scan were studied with respect to the development of the midline shift, the angiographic findings, the clinical pictures and the outcome of these patients. The CT findings of hemorrhagic infarction were also studied. No cases showed a midline shift on a CT scan taken within 6 hours after the onset. A midline shift was, however, noted as early as 9 hours after the onset, and it reached its peak between the 2nd and 7th day of the onset. It gradually disappeared by the end of the third week. Hemorrhagic infarction was diagnosed in 6 patients by either spinal tap or autopsy. The CT findings of these hemorrhagic infarction were divided into two types, solid hemorrhages with an unequivocal high density within the low-density area, and small, scattered hemorrhagic of almost the same density as normal brain tissue within the low-density area. In 19 of 21 patients, an round-edged occlusion and/or embolus were observed on the initial angiograms. The recanalization of the occluded vessels was proved in 10 of 14 patients by subsequent angiographic studies. Twenty of 21 patients showed a sudden development of neurological symptoms, and 15 patients had a history of various kinds of heart disease, such as atrial fibrillation, valvular heart disease and myocardial infarction. The patients had atrial fibrillation on EKG on admission. These angiographic findings and clinical pictures strongly suggest that the infarction with a midline shift on the CT scan may be caused by a cerebral embolism of cardiac origin. Eight patients died of cerebral herniation between the 2nd and 6th day of the onset. Taking these poor outcomes into consideration, surgical as well as medical decompression of the brain would seem to be most important when the CT scan shows a midline shift.

  13. Exploratory Use of Decision Tree Analysis in Classification of Outcome in Hypoxic–Ischemic Brain Injury

    Directory of Open Access Journals (Sweden)

    Thanh G. Phan

    2018-03-01

    Full Text Available BackgroundPrognostication following hypoxic ischemic encephalopathy (brain injury is important for clinical management. The aim of this exploratory study is to use a decision tree model to find clinical and MRI associates of severe disability and death in this condition. We evaluate clinical model and then the added value of MRI data.MethodThe inclusion criteria were as follows: age ≥17 years, cardio-respiratory arrest, and coma on admission (2003–2011. Decision tree analysis was used to find clinical [Glasgow Coma Score (GCS, features about cardiac arrest, therapeutic hypothermia, age, and sex] and MRI (infarct volume associates of severe disability and death. We used the area under the ROC (auROC to determine accuracy of model. There were 41 (63.7% males patients having MRI imaging with the average age 51.5 ± 18.9 years old. The decision trees showed that infarct volume and age were important factors for discrimination between mild to moderate disability and severe disability and death at day 0 and day 2. The auROC for this model was 0.94 (95% CI 0.82–1.00. At day 7, GCS value was the only predictor; the auROC was 0.96 (95% CI 0.86–1.00.ConclusionOur findings provide proof of concept for further exploration of the role of MR imaging and decision tree analysis in the early prognostication of hypoxic ischemic brain injury.

  14. Exploratory Use of Decision Tree Analysis in Classification of Outcome in Hypoxic-Ischemic Brain Injury.

    Science.gov (United States)

    Phan, Thanh G; Chen, Jian; Singhal, Shaloo; Ma, Henry; Clissold, Benjamin B; Ly, John; Beare, Richard

    2018-01-01

    Prognostication following hypoxic ischemic encephalopathy (brain injury) is important for clinical management. The aim of this exploratory study is to use a decision tree model to find clinical and MRI associates of severe disability and death in this condition. We evaluate clinical model and then the added value of MRI data. The inclusion criteria were as follows: age ≥17 years, cardio-respiratory arrest, and coma on admission (2003-2011). Decision tree analysis was used to find clinical [Glasgow Coma Score (GCS), features about cardiac arrest, therapeutic hypothermia, age, and sex] and MRI (infarct volume) associates of severe disability and death. We used the area under the ROC (auROC) to determine accuracy of model. There were 41 (63.7% males) patients having MRI imaging with the average age 51.5 ± 18.9 years old. The decision trees showed that infarct volume and age were important factors for discrimination between mild to moderate disability and severe disability and death at day 0 and day 2. The auROC for this model was 0.94 (95% CI 0.82-1.00). At day 7, GCS value was the only predictor; the auROC was 0.96 (95% CI 0.86-1.00). Our findings provide proof of concept for further exploration of the role of MR imaging and decision tree analysis in the early prognostication of hypoxic ischemic brain injury.

  15. Age-Modulated Associations between KIBRA, Brain Volume, and Verbal Memory among Healthy Older Adults

    Directory of Open Access Journals (Sweden)

    Ariana Stickel

    2018-01-01

    Full Text Available The resource modulation hypothesis suggests that the influence of genes on cognitive functioning increases with age. The KIBRA single nucleotide polymorphism rs17070145, associated with episodic memory and working memory, has been suggested to follow such a pattern, but few studies have tested this assertion directly. The present study investigated the relationship between KIBRA alleles (T carriers vs. CC homozygotes, cognitive performance, and brain volumes in three groups of cognitively healthy adults—middle aged (ages 52–64, n = 38, young old (ages 65–72, n = 45, and older old (ages 73–92, n = 62—who were carefully matched on potentially confounding variables including apolipoprotein ε4 status and hypertension. Consistent with our prediction, T carriers maintained verbal memory performance with increasing age while CC homozygotes declined. Voxel-based morphometric analysis of magnetic resonance images showed an advantage for T carriers in frontal white matter volume that increased with age. Focusing on the older old group, this advantage for T carriers was also evident in left lingual gyrus gray matter and several additional frontal white matter regions. Contrary to expectations, neither KIBRA nor the interaction between KIBRA and age predicted hippocampal volumes. None of the brain regions investigated showed a CC homozygote advantage. Taken together, these data suggest that KIBRA results in decreased verbal memory performance and lower brain volumes in CC homozygotes compared to T carriers, particularly among the oldest old, consistent with the resource modulation hypothesis.

  16. Quantitative relationships between thallium-201 estimated myocardial infarct size and left ventricular function in the acute or convalescent phase of the first attack of myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Kataoka, Hajime (Kagoshima Univ. (Japan). Faculty of Medicine); Ueda, Keiji; Sakai, Makoto (and others)

    1983-07-01

    Correlations between left ventricular (LV) function and infarct size estimated by computer-assisted thallium (Tl)-201 scintigraphy were studied in 16 patients in the acute or convalescent phase of the first attack of transmural myocardial infarction (MI). Tl-201 estimation of the infarct size was done using a ''corrected'' circumferential profile method, by which the total defect score could be obtained. The LV function was evaluated by radionuclide angiography, echocardiography and cardiac catheterization study. The following results were obtained: 1) A close inverse relationship was found between the defect score and the ejection fraction (r = -0.649, p < 0.01). 2) The linear correlation coefficient was 0.540 (p < 0.05) between the defect score and the pulmonary arterial end-diastolic pressure and -0.616 (p < 0.02) between the defect score and the stroke volume index. There was no significant correlation between the defect score and the cardiac index. 3) There was a linear correlation between the defect score and the LV end-diastolic dimension (r = -0.852, p < 0.001). However, there was no relation between the defect score and the left atrial dimension. When the LV indices were compared between the small (S) and the large (L) defect score group, the L defect group had faster heart rate, larger LV chamber size and the smaller stroke volume index than the S defect group. However, there was no significant difference in the cardiac index between these 2 groups. These results suggest that the LV dilatation in acute or convalescent phase of the first attack of transmural MI is an ominous sign because it was usually accompanied by large infarct size. The present study also indicates that LV dilatation accompanying a large infarct does not satisfactorily compensate for LV dysfunction by Frank-Starling mechanism.

  17. Herniation despite Decompressive Hemicraniectomy in Large Hemispherical Ischemic Strokes.

    Science.gov (United States)

    Hinduja, Archana; Samant, Rohan; Feng, Dongxia; Hannawi, Yousef

    2018-02-01

    Despite decompressive hemicraniectomy (DHC), progressive herniation resulting in death has been reported following middle cerebral artery (MCA) strokes. We aimed to determine the surgical parameters measured on brain computed tomography (CT) scan that are associated with progressive herniation despite DHC in large MCA strokes. Retrospective chart review of medical records of patients with malignant hemispheric infarction who underwent DHC for cerebral edema was performed. Infarct volume was calculated on CT scans obtained within 24 hours of ictus. Radiological parameters of craniectomy bone flap size, brain volume protruding out of the skull, adequate centering of the craniectomy over the stroke bed, and the infarct volume outside the craniectomy bed (volume not centered [VNC]) were measured on the postoperative brain CT. Of 41 patients who underwent DHC, 7 had progressive herniation leading to death. Radiographic parameters significantly associated with progressive herniation included insufficient centering of craniectomy bed on the stroke bed (P = .03), VNC (P = .011), additional anterior cerebral artery infarction (P = .047), and smaller craniectomy length (P = .05). Multivariate logistic regression analysis for progressive herniation using craniectomy length and VNC as independent variables demonstrated that a higher VNC was significantly associated with progressive herniation despite surgery (P = .029). In large MCA strokes, identification of large infarct volume outside the craniectomy bed was associated with progressive herniation despite surgery. These results will need to be verified in larger prospective studies. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  18. Molecular Mechanisms Responsible for Neuron-Derived Conditioned Medium (NCM-Mediated Protection of Ischemic Brain.

    Directory of Open Access Journals (Sweden)

    Chi-Hsin Lin

    Full Text Available The protective value of neuron-derived conditioned medium (NCM in cerebral ischemia and the underlying mechanism(s responsible for NCM-mediated brain protection against cerebral ischemia were investigated in the study. NCM was first collected from the neuronal culture growing under the in vitro ischemic condition (glucose-, oxygen- and serum-deprivation or GOSD for 2, 4 or 6 h. Through the focal cerebral ischemia (bilateral CCAO/unilateral MCAO animal model, we discovered that ischemia/reperfusion (I/R-induced brain infarction was significantly reduced by NCM, given directly into the cistern magna at the end of 90 min of CCAO/MCAO. Immunoblocking and chemical blocking strategies were applied in the in vitro ischemic studies to show that NCM supplement could protect microglia, astrocytes and neurons from GOSD-induced cell death, in a growth factor (TGFβ1, NT-3 and GDNF and p-ERK dependent manner. Brain injection with TGFβ1, NT3, GDNF and ERK agonist (DADS alone or in combination, therefore also significantly decreased the infarct volume of ischemic brain. Moreover, NCM could inhibit ROS but stimulate IL-1β release from GOSD-treated microglia and limit the infiltration of IL-β-positive microglia into the core area of ischemic brain, revealing the anti-oxidant and anti-inflammatory activities of NCM. In overall, NCM-mediated brain protection against cerebral ischemia has been demonstrated for the first time in S.D. rats, due to its anti-apoptotic, anti-oxidant and potentially anti-glutamate activities (NCM-induced IL-1β can inhibit the glutamate-mediated neurotoxicity and restriction upon the infiltration of inflammatory microglia into the core area of ischemic brain. The therapeutic potentials of NCM, TGFβ1, GDNF, NT-3 and DADS in the control of cerebral ischemia in human therefore have been suggested and require further investigation.

  19. Autosomal dominant arteriopathy with sub cortical infarcts and leucoencephalopathy (CADASIL)

    International Nuclear Information System (INIS)

    Ojeda, Adriana; Tiezzi, Gerardo; Uriarte, Ana M.; Eguren, Leonor

    2002-01-01

    Cerebral autosomal dominant arteriopathy with sub cortical infarcts and leucoencephalopathy (CASADIL) is a systemic hereditary, vascular disease that involves small arteries. Recurrent ischemia, pseudo bulbar paralysis and dementia are characteristic. Other manifestations include migraine and depression. We report an Argentine family with VI generations with evidence of disease in IV. MR examinations were performed on 21 family members (both symptomatic and asymptomatic). The main findings on MR on symptomatic and asymptomatic patients were small lesions with high signal on T2 localised in periventricular white matter, brain stem, basal ganglia and thalamus, and confluent patches on white matter although with high signal on T2 images, usually symmetric. In conclusion we can assess that diffuse myelin loss and small infarcts occurring in cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy well demonstrated with MR. In addition, some of the abnormalities in pre symptomatic patients can be identified on MR images. (author)

  20. Pet imaging of peripheral benzodiazepine binding sites in brain tumors

    International Nuclear Information System (INIS)

    Junck, L.; Jewett, D.M.; Olsen, J.M.; Kilbourn, M.R.; Koeppe, R.A.; Young, A.B.; Greenberg, H.S.; Kuhl, D.E.

    1991-01-01

    Studies in vitro have shown that the peripheral-type benzodiazepine binding site (PBBS) is present in moderate to high density on malignant gliomas as well as in areas of reactive gliosis, but in low density in normal brain. PK 11195 is an isoquinoline derivative that binds selectively to the PBBS but not to the central benzodiazepine receptor. We have used [ 11 C]PK 11195 with positron emission tomography (PET) to study brain tumors and cerebral infarcts. Preliminary results showed that, in 13 of 18 patients with astrocytomas, [ 11 C]PK 11195 radioactivity was increased in tumor compared to remote brain and that the concentration ratios of tumor-to-remote brain were higher for high grade astrocytomas than for low grade astrocytomas. Pharmacokinetic analysis suggests that the increased activity in tumor probably does not result from alterations in blood flow or vascular permeability. Patients with lymphoma, meningioma, medulloblastoma, brain metastasis, and neurosarcoidosis have also shown increased radioactivity in tumor. Among eight patients with acute and subacute cerebral infarcts, activity in the infarct was increased in seven and was often greatest at the periphery. We conclude that [ 11 C]PK 11195 is a promising radiopharmaceutical for further investigation of brain tumors as well as diseases characterized by reactive gliosis

  1. 3D cardiac wall thickening assessment for acute myocardial infarction

    Science.gov (United States)

    Khalid, A.; Chan, B. T.; Lim, E.; Liew, Y. M.

    2017-06-01

    Acute myocardial infarction (AMI) is the most severe form of coronary artery disease leading to localized myocardial injury and therefore irregularities in the cardiac wall contractility. Studies have found very limited differences in global indices (such as ejection fraction, myocardial mass and volume) between healthy subjects and AMI patients, and therefore suggested regional assessment. Regional index, specifically cardiac wall thickness (WT) and thickening is closely related to cardiac function and could reveal regional abnormality due to AMI. In this study, we developed a 3D wall thickening assessment method to identify regional wall contractility dysfunction due to localized myocardial injury from infarction. Wall thickness and thickening were assessed from 3D personalized cardiac models reconstructed from cine MRI images by fitting inscribed sphere between endocardial and epicardial wall. The thickening analysis was performed in 5 patients and 3 healthy subjects and the results were compared against the gold standard 2D late-gadolinium-enhanced (LGE) images for infarct localization. The notable finding of this study is the highly accurate estimation and visual representation of the infarct size and location in 3D. This study provides clinicians with an intuitive way to visually and qualitatively assess regional cardiac wall dysfunction due to infarction in AMI patients.

  2. Protective Effect of Human Leukocyte Antigen (HLA Allele DRB1*13:02 on Age-Related Brain Gray Matter Volume Reduction in Healthy Women

    Directory of Open Access Journals (Sweden)

    Lisa M. James

    2018-03-01

    Full Text Available Background: Reduction of brain volume (brain atrophy during healthy brain aging is well documented and dependent on genetic, lifestyle and environmental factors. Here we investigated the possible dependence of brain gray matter volume reduction in the absence of the Human Leukocyte Antigen (HLA allele DRB1*13:02 which prevents brain atrophy in Gulf War Illness (James et al., 2017. Methods: Seventy-one cognitively healthy women (32–69 years old underwent a structural Magnetic Resonance Imaging (sMRI scan to measure the volumes of total gray matter, cerebrocortical gray matter, and subcortical gray matter. Participants were assigned to two groups, depending on whether they lacked the DRB1*13:02 allele (No DRB1*13:02 group, N = 60 or carried the DRB1*13:02 allele (N = 11. We assessed the change of brain gray matter volume with age in each group by performing a linear regression where the brain volume (adjusted for total intracranial volume was the dependent variable and age was the independent variable. Findings: In the No DRB1*13:02 group, the volumes of total gray matter, cerebrocortical gray matter, and subcortical gray matter were reduced highly significantly. In contrast, none of these volumes showed a statistically significant reduction with age in the DRB1*13:02 group. Interpretation: These findings document the protective effect of DRB1*13:02 on age-dependent reduction of brain gray matter in healthy individuals. Since the role of this allele is to connect to matching epitopes of external antigens for the subsequent production of antibodies and elimination of the offending antigen, we hypothesize that its protective effect may be due to the successful elimination of such antigens to which we are exposed during the lifespan, antigens that otherwise would persist causing gradual brain atrophy. In addition, we consider a possible beneficial role of DRB1*13:02 attributed to its binding to cathepsin S, a known harmful substance in brain

  3. Free radical scavenger, edaravone, reduces the lesion size of lacunar infarction in human brain ischemic stroke

    Science.gov (United States)

    2011-01-01

    Background Although free radicals have been reported to play a role in the expansion of ischemic brain lesions, the effect of free radical scavengers is still under debate. In this study, the temporal profile of ischemic stroke lesion sizes was assessed for more than one year to evaluate the effect of edaravone which might reduce ischemic damage. Methods We sequentially enrolled acute ischemic stroke patients, who admitted between April 2003 and March 2004, into the edaravone(-) group (n = 83) and, who admitted between April 2004 and March 2005, into the edaravone(+) group (n = 93). Because, edaravone has been used as the standard treatment after April 2004 in our hospital. To assess the temporal profile of the stroke lesion size, the ratio of the area [T2-weighted magnetic resonance images (T2WI)/iffusion-weighted magnetic resonance images (DWI)] were calculated. Observations on T2WI were continued beyond one year, and observational times were classified into subacute (1-2 months after the onset), early chronic (3-6 month), late chronic (7-12 months) and old (≥13 months) stages. Neurological deficits were assessed by the National Institutes of Health Stroke Scale upon admission and at discharge and by the modified Rankin Scale at 1 year following stroke onset. Results Stroke lesion size was significantly attenuated in the edaravone(+) group compared with the edaravone(-) group in the period of early and late chronic observational stages. However, this reduction in lesion size was significant within a year and only for the small-vessel occlusion stroke patients treated with edaravone. Moreover, patients with small-vessel occlusion strokes that were treated with edaravone showed significant neurological improvement during their hospital stay, although there were no significant differences in outcome one year after the stroke. Conclusion Edaravone treatment reduced the volume of the infarct and improved neurological deficits during the subacute period, especially

  4. Free radical scavenger, edaravone, reduces the lesion size of lacunar infarction in human brain ischemic stroke

    Directory of Open Access Journals (Sweden)

    Suzuki Akifumi

    2011-03-01

    Full Text Available Abstract Background Although free radicals have been reported to play a role in the expansion of ischemic brain lesions, the effect of free radical scavengers is still under debate. In this study, the temporal profile of ischemic stroke lesion sizes was assessed for more than one year to evaluate the effect of edaravone which might reduce ischemic damage. Methods We sequentially enrolled acute ischemic stroke patients, who admitted between April 2003 and March 2004, into the edaravone(- group (n = 83 and, who admitted between April 2004 and March 2005, into the edaravone(+ group (n = 93. Because, edaravone has been used as the standard treatment after April 2004 in our hospital. To assess the temporal profile of the stroke lesion size, the ratio of the area [T2-weighted magnetic resonance images (T2WI/iffusion-weighted magnetic resonance images (DWI] were calculated. Observations on T2WI were continued beyond one year, and observational times were classified into subacute (1-2 months after the onset, early chronic (3-6 month, late chronic (7-12 months and old (≥13 months stages. Neurological deficits were assessed by the National Institutes of Health Stroke Scale upon admission and at discharge and by the modified Rankin Scale at 1 year following stroke onset. Results Stroke lesion size was significantly attenuated in the edaravone(+ group compared with the edaravone(- group in the period of early and late chronic observational stages. However, this reduction in lesion size was significant within a year and only for the small-vessel occlusion stroke patients treated with edaravone. Moreover, patients with small-vessel occlusion strokes that were treated with edaravone showed significant neurological improvement during their hospital stay, although there were no significant differences in outcome one year after the stroke. Conclusion Edaravone treatment reduced the volume of the infarct and improved neurological deficits during the subacute

  5. Cerebral blood flow and brain atrophy correlated by xenon contrast CT scanning

    International Nuclear Information System (INIS)

    Kitagawa, Y.; Meyer, J.S.; Tanahashi, N.; Rogers, R.L.; Tachibana, H.; Kandula, P.; Dowell, R.E.; Mortel, K.F.

    1985-01-01

    Correlations between cerebral blood flow (CBF) measured during stable xenon contrast CT scanning and standard CT indices of brain atrophy were investigated in the patients with senile dementia of Alzheimer type, multi-infarct dementia and idiopathic Parkinson's disease. Compared to age-matched normal volunteers, significant correlations were found in patients with idiopathic Parkinson's disease between cortical and subcortical gray matter blood flow and brain atrophy estimated by the ventricular body ratio, and mild to moderate brain atrophy were correlated with stepwise CBF reductions. However, in patients with senile dementia of Alzheimer type and multi-infarct dementia, brain atrophy was not associated with stepwise CBF reductions. Overall correlations between brain atrophy and reduced CBF were weak. Mild degrees of brain atrophy are not always associated with reduced CBF

  6. NJP VOLUME 42 NO 2

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2015-01-07

    Jan 7, 2015 ... sciousness and subsequent right- ... 80/50mmHg (<50thcentile for gender, age and height), jugular venous pressure was ... Computerized Tomograph (CT) of the brain showed a large left hemispheric infarct. Subsequently,.

  7. Fingolimod's Impact on MRI Brain Volume Measures in Multiple Sclerosis: Results from MS-MRIUS.

    Science.gov (United States)

    Zivadinov, Robert; Medin, Jennie; Khan, Nasreen; Korn, Jonathan R; Bergsland, Niels; Dwyer, Michael G; Chitnis, Tanuja; Naismith, Robert T; Alvarez, Enrique; Kinkel, Peter; Cohan, Stanley; Hunter, Samuel F; Silva, Diego; Weinstock-Guttman, Bianca

    2018-05-11

    Evidence is needed to understand the effect of fingolimod on slowing down brain atrophy progression in multiple sclerosis (MS) patients in clinical practice. We investigated the effect of fingolimod on brain atrophy in MS patients with active disease (clinically and/or magnetic resonance imaging [MRI]) versus no evidence of active disease (NEAD). MS and clinical outcome and MRI in the United States (MS-MRIUS) is a multicenter, retrospective study that included 590 relapsing-remitting MS patients, who initiated fingolimod, and were followed for a median of 16 months. Patients with active disease at baseline (245, 41.5%) were defined as those who had one or more relapses in the year previous starting fingolimod, and/or displayed gadolinium enhancing lesions(s) at baseline MRI scan, whereas patients with NEAD at baseline (345, 58.5%) did not fulfill these criteria. Annualized percentage brain volume change (PBVC) and percentage lateral ventricle volume change (PLVVC) over the follow-up were analyzed in both groups. Over the follow-up, the rate of PBVC was -.38% in active disease and -.25% in NEAD patients (P = .076), whereas PLLVC was 1.76% in active disease and .28% in NEAD patients (P = .046). No changes in timed 25-foot walk (P = .619) and Expanded Disability Status Scale (P = .275) scores or MRI lesion accumulation (P > 0.08) were detected, although the active disease group had a higher proportion of relapses during the follow-up period (P = .02). The study provides real-world evidence that rate of brain atrophy in MS patients with underlying active disease and NEAD in fingolimod treated patients is below the established pathological cutoff for loss of whole brain volume (>-.4%) or expansion of lateral ventricles (> 3.5%). Copyright © 2018 by the American Society of Neuroimaging.

  8. Clinical implications of anterior S-T segment depression in patients with acute inferior myocardial infarction

    International Nuclear Information System (INIS)

    Croft, C.H.; Woodward, W.; Nicod, P.; Corbett, J.R.; Lewis, S.E.; Willerson, J.T.; Rude, R.E.

    1982-01-01

    To assess various factors associated with anterior S-T segment depression during acute inferior myocardial infarction, 47 consecutive patients with electrocardiographic evidence of a first transmural inferior infarction were studied prospectively with radionuclide ventriculography an average of 7.3 hours (range 2.9 to 15.3) after the onset of symptoms. Thirty-nine patients (Group I) had anterior S-T depression in the initial electrocardiogram and 8 (Group II) did not have such reciprocal changes. There was no difference between the two groups in left ventricular end-diastolic or end-diastolic volume index or left ventricular ejection fraction. Stroke volume index was greater in Group I than in Group II. There were no group differences in left ventricular total or regional wall motion scores. A weak correlation existed between the quantities (mV) or inferior S-T segment elevation and reciprocal S-T depression. No relation between anterior S-T segment depression and the left ventricular end-diastolic volume index could be demonstrated; the extent of left ventricular apical and right ventricular wall motion abnormalities, both frequently associated with inferior infarction, did not correlate with the quantity of anterior S-T depression. These data show that anterior S-T segment depression occurs commonly during the early evolution of transmural inferior infarction, is not generally a marker of functionally significant anterior ischemia and cannot be used to predict left ventricular function in individual patients. Anterior S-T segment depression may be determined by reciprocal mechanisms

  9. Acute Mountain Sickness: Relationship to Brain Volume and Effect of Oral Glycerol Prophylaxis

    National Research Council Canada - National Science Library

    Muza, Stephen

    1998-01-01

    ... development of cerebral edema. Furthermore, to assess whether AMS was associated with development of cerebral edema, we used MR imaging and post-processing to quantify changes in brain tissue volume, hypothesized to increase due to cerebral edema...

  10. Diagnosis of small posterior fossa stroke on brain CT: effect of iterative reconstruction designed for brain CT on detection performance

    International Nuclear Information System (INIS)

    Inoue, Taihei; Yoshida, Morikatsu; Yokoyama, Koichi; Nakaura, Takeshi; Hirata, Kenichiro; Kidoh, Masafumi; Oda, Seitaro; Utsunomiya, Daisuke; Yamashita, Yasuyuki; Harada, Kazunori

    2017-01-01

    In this study, we aimed to determine whether iterative model reconstruction designed for brain CT (IMR-neuro) would improve the accuracy of posterior fossa stroke diagnosis on brain CT. We enrolled 37 patients with ischaemic stroke in the posterior fossa and 37 patients without stroke (controls). Using axial images reconstructed using filtered back-projection (FBP) and IMR-neuro, we compared the CT numbers in infarcted areas, image noise in the pons, and contrast-to-noise ratios (CNRs) of infarcted and non-infarcted areas on scans subjected to IMR-neuro and FBP. To analyse the performance of hypo-attenuation detection, we used receiver-operating characteristic (ROC) curve techniques. The image noise was significantly lower (2.2 ± 0.5 vs. 5.1 ± 0.9 Hounsfield units, p < 0.01) and the difference in CNR between the infarcted and non-infarcted areas was significantly higher with IMR-neuro than with FBP (2.2 ± 1.7 vs. 4.0 ± 3.6, p < 0.01). Furthermore, the average area under the ROC curve was significantly higher with IMR-neuro (0.90 vs. 0.86 for FBP, p = 0.04). IMR-neuro yielded better image quality and improved hypo-attenuation detection in patients with ischaemic stroke. (orig.)

  11. Diagnosis of small posterior fossa stroke on brain CT: effect of iterative reconstruction designed for brain CT on detection performance

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Taihei; Yoshida, Morikatsu; Yokoyama, Koichi [Amakusa Medical Center, Department of Radiology, Amakusa, Kumamoto (Japan); Nakaura, Takeshi; Hirata, Kenichiro; Kidoh, Masafumi; Oda, Seitaro; Utsunomiya, Daisuke; Yamashita, Yasuyuki [Kumamoto University, Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto (Japan); Harada, Kazunori [Amakusa Medical Center, Department of Surgery, Kumamoto (Japan)

    2017-09-15

    In this study, we aimed to determine whether iterative model reconstruction designed for brain CT (IMR-neuro) would improve the accuracy of posterior fossa stroke diagnosis on brain CT. We enrolled 37 patients with ischaemic stroke in the posterior fossa and 37 patients without stroke (controls). Using axial images reconstructed using filtered back-projection (FBP) and IMR-neuro, we compared the CT numbers in infarcted areas, image noise in the pons, and contrast-to-noise ratios (CNRs) of infarcted and non-infarcted areas on scans subjected to IMR-neuro and FBP. To analyse the performance of hypo-attenuation detection, we used receiver-operating characteristic (ROC) curve techniques. The image noise was significantly lower (2.2 ± 0.5 vs. 5.1 ± 0.9 Hounsfield units, p < 0.01) and the difference in CNR between the infarcted and non-infarcted areas was significantly higher with IMR-neuro than with FBP (2.2 ± 1.7 vs. 4.0 ± 3.6, p < 0.01). Furthermore, the average area under the ROC curve was significantly higher with IMR-neuro (0.90 vs. 0.86 for FBP, p = 0.04). IMR-neuro yielded better image quality and improved hypo-attenuation detection in patients with ischaemic stroke. (orig.)

  12. Computed microtomography visualization and quantification of mouse ischemic brain lesion by nonionic radio contrast agents.

    Science.gov (United States)

    Dobrivojević, Marina; Bohaček, Ivan; Erjavec, Igor; Gorup, Dunja; Gajović, Srećko

    2013-02-01

    To explore the possibility of brain imaging by microcomputed tomography (microCT) using x-ray contrasting methods to visualize mouse brain ischemic lesions after middle cerebral artery occlusion (MCAO). Isolated brains were immersed in ionic or nonionic radio contrast agent (RCA) for 5 days and subsequently scanned using microCT scanner. To verify whether ex-vivo microCT brain images can be used to characterize ischemic lesions, they were compared to Nissl stained serial histological sections of the same brains. To verify if brains immersed in RCA may be used afterwards for other methods, subsequent immunofluorescent labeling with anti-NeuN was performed. Nonionic RCA showed better gray to white matter contrast in the brain, and therefore was selected for further studies. MicroCT measurement of ischemic lesion size and cerebral edema significantly correlated with the values determined by Nissl staining (ischemic lesion size: P=0.0005; cerebral edema: P=0.0002). Brain immersion in nonionic RCA did not affect subsequent immunofluorescent analysis and NeuN immunoreactivity. MicroCT method was proven to be suitable for delineation of the ischemic lesion from the non-infarcted tissue, and quantification of lesion volume and cerebral edema.

  13. [Digitalization for acute myocardial infarction: haemodynamic changes in patients with heart failure at rest (author's transl)].

    Science.gov (United States)

    Bachour, G; Hochrein, H

    1975-11-21

    Haemodynamic changes after intravenous administration of 0.4 mg beta-methyldigoxin or 0.4 mg digoxin daily were measured on the first to fourth day in 42 patients in heart failure after onset of transmural myocardial infarction. Regular reduction in filling pressure and increased stroke volume while arterial blood pressure remained unaltered pointed to improved contractility. Digitalization in the first few days after infarction achieved sustained tendency towards improved haemodynamics. It is concluded that early digitalization is indicated in patients with acute myocardial infarction if there are signs of heart failure.

  14. Exercise enhanced functional recovery and expression of GDNF after photochemically induced cerebral infarction in the rat.

    Science.gov (United States)

    Ohwatashi, Akihiko; Ikeda, Satoshi; Harada, Katsuhiro; Kamikawa, Yurie; Yoshida, Akira

    2013-01-01

    Exercise has been considered to affect the functional recovery from central nervous damage. Neurotrophic factors have various effects on brain damage. However, the effects of exercise for expression of GDNF on functional recovery with brain damage are not well known. We investigated the difference in functional recovery between non-exercise and beam-walking exercise groups, and the expression of GDNF in both groups after photochemical infarction. Adult male Wistar rats (N = 64) were used. Animals were divided into two groups: non-exercise (N = 35), and beam-walking exercise (N = 29). All rats underwent surgical photochemical infarction. The rats of the beam-walking group were trained every day to walk on a narrow beam after a one-day recovery period and those of the non-exercise group were left to follow a natural course. Animals were evaluated for hind limb function every day using a beam-walking task with an elevated narrow beam. The number of GDNF-like immunoreactive cells in the temporal cortex surrounding the lesion was counted 1, 3, 5, and 7 days after the infarction. Functional recovery of the beam-walking exercise group was significantly earlier than that of the non-exercise group. At 3 days after infarction, the number of GDNF-positive cells in the temporal cortex surrounding the infarction was significantly increased in the beam-walking exercise group compared with that in the non-exercise group. In the exercise group, motor function was remarkably recovered with the increased expression of GDNF-like immunoreactive cells. Our results suggested that a rehabilitative approach increased the expression of GDNF and facilitated functional recovery from cerebral infarction.

  15. Application of myocardial perfusion quantitative imaging for the evaluation of therapeutic effect in canine with myocardial infarction

    International Nuclear Information System (INIS)

    Liang Hong; Chen Ju; Liu Sheng; Zeng Shiquan

    2000-01-01

    Myocardial blood perfusion (MBP) ECT and quantitative analysis were performed in 10 canines with experimental acute myocardial infarct (AMI). The accuracy of main myocardial quantitative index, including defect volume (DV) and defect fraction (DF), was estimated and correlated with histochemical staining (HS) of infarcted area. Other 21/AMI canines were divided into Nd:YAG laser trans-myocardial revascularization treated group LTMR and control group. All canines were performed MBP ECT after experimental AMI. Results found that the infarcted volume (IV) measured by HS has well correlated (r 0.88) with DV estimated by myocardial quantitative analysis. But the DF values calculated by both methods was not significantly different (t = 1.28 P > 0.05). In LTMR group 27.5% +- 3.9%, the DF is smaller than control group 32.1% +- 4.6% (t = 2.49 P 99m Tc-MIBI myocardial perfusion SPECT and quantitative study can accurately predict the myocardial blood flow and magnitude of injured myocardium. Nd:YAG LTMR could improve myocardial blood perfusion of ischemic myocardium and decrease effectively the infarct areas

  16. Probucol plus cilostazol attenuate hypercholesterolemia‑induced exacerbation in ischemic brain injury via anti-inflammatory effects.

    Science.gov (United States)

    Kim, Ji Hyun; Hong, Ki Whan; Bae, Sun Sik; Shin, Yong-Il; Choi, Byung Tae; Shin, Hwa Kyoung

    2014-09-01

    Probucol, a lipid-lowering agent with anti-oxidant properties, is involved in protection against atherosclerosis, while cilostazol, an antiplatelet agent, has diverse neuroprotective properties. In this study, we investigated the anti-inflammatory effects of probucol and cilostazol on focal cerebral ischemia with hypercholesterolemia. Apolipoprotein E (ApoE) knockout (KO) mice were fed a high-fat diet (HFD) with or without 0.3% probucol and/or 0.2% cilostazol for 10 weeks. To assess the protective effects of the combined therapy of probucol and cilostazol on ischemic injury, the mice received 40 min of middle cerebral artery occlusion (MCAO). Infarct volumes, neurobehavioral deficits and neuroinflammatory mediators were subsequently evaluated 48 h after reperfusion. Probucol alone and probucol plus cilostazol significantly decreased total- and low-density lipoprotein (LDL)-cholesterol in ApoE KO with HFD. MCAO resulted in significantly larger infarct volumes in ApoE KO mice provided with HFD compared to those fed a regular diet, although these volumes were significantly reduced in the probucol plus cilostazol group. Consistent with a smaller infarct size, probucol alone and the combined treatment of probucol and cilostazol improved neurological and motor function. In addition, probucol alone and probucol plus cilostazol decreased MCP-1 expression and CD11b and GFAP immuno-reactivity in the ischemic cortex. These findings suggested that the inhibitory effects of probucol plus cilostazol in MCP-1 expression in the ischemic brain with hypercholesterolemia allowed the identification of one of the mechanisms responsible for anti-inflammatory action. Probucol plus cilostazol may therefore serve as a therapeutic strategy for reducing the impact of stroke in hypercholesterolemic subjects.

  17. A stereotaxic, population-averaged T1w ovine brain atlas including cerebral morphology and tissue volumes

    Directory of Open Access Journals (Sweden)

    Björn eNitzsche

    2015-06-01

    Full Text Available Standard stereotaxic reference systems play a key role in human brain studies. Stereotaxic coordinate systems have also been developed for experimental animals including non-human primates, dogs and rodents. However, they are lacking for other species being relevant in experimental neuroscience including sheep. Here, we present a spatial, unbiased ovine brain template with tissue probability maps (TPM that offer a detailed stereotaxic reference frame for anatomical features and localization of brain areas, thereby enabling inter-individual and cross-study comparability. Three-dimensional data sets from healthy adult Merino sheep (Ovis orientalis aries, 12 ewes and 26 neutered rams were acquired on a 1.5T Philips MRI using a T1w sequence. Data were averaged by linear and non-linear registration algorithms. Moreover, animals were subjected to detailed brain volume analysis including examinations with respect to body weight, age and sex. The created T1w brain template provides an appropriate population-averaged ovine brain anatomy in a spatial standard coordinate system. Additionally, TPM for gray (GM and white (WM matter as well as cerebrospinal fluid (CSF classification enabled automatic prior-based tissue segmentation using statistical parametric mapping (SPM. Overall, a positive correlation of GM volume and body weight explained about 15% of the variance of GM while a positive correlation between WM and age was found. Absolute tissue volume differences were not detected, indeed ewes showed significantly more GM per bodyweight as compared to neutered rams. The created framework including spatial brain template and TPM represent a useful tool for unbiased automatic image preprocessing and morphological characterization in sheep. Therefore, the reported results may serve as a starting point for further experimental and/or translational research aiming at in vivo analysis in this species.

  18. Quantification of brain tissue through incorporation of partial volume effects

    Science.gov (United States)

    Gage, Howard D.; Santago, Peter, II; Snyder, Wesley E.

    1992-06-01

    This research addresses the problem of automatically quantifying the various types of brain tissue, CSF, white matter, and gray matter, using T1-weighted magnetic resonance images. The method employs a statistical model of the noise and partial volume effect and fits the derived probability density function to that of the data. Following this fit, the optimal decision points can be found for the materials and thus they can be quantified. Emphasis is placed on repeatable results for which a confidence in the solution might be measured. Results are presented assuming a single Gaussian noise source and a uniform distribution of partial volume pixels for both simulated and actual data. Thus far results have been mixed, with no clear advantage being shown in taking into account partial volume effects. Due to the fitting problem being ill-conditioned, it is not yet clear whether these results are due to problems with the model or the method of solution.

  19. Reduced astrocyte density underlying brain volume reduction in activity-based anorexia rats

    Science.gov (United States)

    Frintrop, Linda; Liesbrock, Johanna; Paulukat, Lisa; Johann, Sonja; Kas, Martien J; Tolba, Rene; Heussen, Nicole; Neulen, Joseph; Konrad, Kerstin; Herpertz-Dahlmann, Beate; Beyer, Cordian; Seitz, Jochen

    2018-04-01

    Severe grey and white matter volume reductions were found in patients with anorexia nervosa (AN) that were linked to neuropsychological deficits while their underlying pathophysiology remains unclear. For the first time, we analysed the cellular basis of brain volume changes in an animal model (activity-based anorexia, ABA). Female rats had 24 h/day running wheel access and received reduced food intake until a 25% weight reduction was reached and maintained for 2 weeks. In ABA rats, the volumes of the cerebral cortex and corpus callosum were significantly reduced compared to controls by 6% and 9%, respectively. The number of GFAP-positive astrocytes in these regions decreased by 39% and 23%, total astrocyte-covered area by 83% and 63%. In neurons no changes were observed. The findings were complemented by a 60% and 49% reduction in astrocyte (GFAP) mRNA expression. Volumetric brain changes in ABA animals mirror those in human AN patients. These alterations are associated with a reduction of GFAP-positive astrocytes as well as GFAP expression. Reduced astrocyte functioning could help explain neuronal dysfunctions leading to symptoms of rigidity and impaired learning. Astrocyte loss could constitute a new research target for understanding and treating semi-starvation and AN.

  20. Global reduction of cerebral glucose metabolism in persons with symptomatic as well as asymptomatic lacunar infarction

    International Nuclear Information System (INIS)

    Takahashi, Wakoh; Takagi, Shigeharu; Shinohara, Yukito; Ide, Michiru; Shohtsu, Akira

    2000-01-01

    To clarify the hemodynamic changes in lacunar infarction, we evaluated cerebral glucose metabolism by using positron emission tomography with 18 F-fluorodeoxyglucose (FDG-PET) in patients with asymptomatic and symptomatic lacunar infarction and in persons without cerebral infarction on MRI. Subjects in this study were 27 patients with symptomatic lacunar infarction (SCI group), 73 subjects with asymptomatic lacunar infarction (ACI group), and 134 persons without infarction (NC group). CMRgI in the ACI group was significantly lower than that in the NC group in the cerebral cortex (P<0.05) and thalamus (P<0.05). CMRgI in the SCI group was significantly reduced from that in the NC group in the cerebral cortex (P<0.005), basal ganglia (P<0.001), thalamus (P<0.05) and white matter (P<0.005). The reduction in CMRgI in the SCI group was more severe than that in the ACI group in basal ganglia (P<0.05) and thalamus (P<0.05). Our results indicated that glucose metabolism in patients with asymptomatic lacunar infarction is reduced throughout the whole brain as compared with non-infarcted elderly persons. Follow-up and treatment of risk factors if present, may be necessary in such patients. (author)

  1. Early estimation of acute myocardial infarct size soon after coronary reperfusion using emission computed tomography with technetium-99m pyrophosphate

    International Nuclear Information System (INIS)

    Hashimoto, T.; Kambara, H.; Fudo, T.; Tamaki, S.; Nohara, R.; Takatsu, Y.; Hattori, R.; Tokunaga, S.; Kawai, C.

    1987-01-01

    Early appearance of positive findings on a technetium-99m pyrophosphate scan has been shown to be associated with the presence of a reperfused acute myocardial infarction (AMI). Early technetium-99m pyrophosphate imaging was performed by emission computed tomography to evaluate reperfusion and to test the feasibility of estimating infarct size soon after coronary reperfusion based on acute positive tomographic findings. Twenty-seven patients with transmural AMI who were treated with intracoronary urokinase infusion followed by percutaneous transluminal coronary angioplasty underwent pyrophosphate imaging 8.7 +/- 2.1 hours after the onset of AMI. None of the 8 patients in whom reperfusion was unsuccessful had acute positive findings. Of 19 patients in whom reperfusion was successful, 17 had acute positive findings (p less than 0.001). In these 17, tomographic infarct volumes were determined from reconstructed transaxial images. The threshold for areas of increased pyrophosphate uptake within the infarct was set at 60% of peak activity by the computerized edge-detection algorithm. The total number of pixels in all transaxial sections showing increased tracer uptake were added and multiplied by a size factor and 1.05 g/cm3 muscle to determine infarct volume. The correlations of tomographic infarct volumes with peak serum creatine kinase (CK) levels (r = 0.82) and with cumulative release of CK-MB isoenzyme (r = 0.89) were good. Moreover, the time to positive imaging was significantly shorter than that to peak CK level (8.5 +/- 2.3 vs 10.4 +/- 2.2 hours, p less than 0.005)

  2. Assessment of cardiac performance by radionuclide angiocardiography in the patient with myocardial infarction

    International Nuclear Information System (INIS)

    Kimura, Yutaka; Iwasaka, Toshiji; Onoyama, Hideki

    1987-01-01

    The relationship between regional ejection fraction (REF) and left ventricular end-diastolic volume (LVEDV) was examined in 75 patients with myocardial infarction (MI). The infarcted and non-infarcted areas were defined visually from left ventricular REF images obtained by RI angiocardiography. In patients with anterior MI (n = 51), neither left ventricular ejection fraction (LVEF) nor REF in non-infarcted areas (N-REF) was affected by the increase up to 140 ml of LVEDV; however, REF in infarcted areas (I-REF) had already decreased when LVEDV was 100 ml or more. In patients with inferior MI (n = 24), less than 140 ml of LVEDV did not affect any of the dynamic parameters, such as LVEF, 1-REF and N-REF, while 140 ml or more of LVEDV significantly decreased I-REF. When comparing anterior and inferior MIs, I-REF of the anterior MI was readily influenced by ventricular enlargement. In this respect, cardiac reserve of the anterior MI is considered to be limited, as compared with inferior MI. (Namekawa, K.)

  3. A comparative study of linear measurement of the brain and three-dimensional measurement of brain volume using CT scans

    International Nuclear Information System (INIS)

    Hamano, K.; Iwasaki, N.; Takeya, T.; Takita, H.

    1993-01-01

    Parameters of linear measurement were compared with actual brain volume to assess the significance of linear measurements as indices of atrophy in 31 neurologically normal children and 22 neurologically abnormal children. Brain volume was established by means of an image-analyzing system using contiguous CT scans. The parameters or indices estimated were: (1) the maximum transverse width of both hemispheres, (2) the maximum longitudinal length of both hemispheres, (3) the maximum frontal subarachnoid space, (4) the maximum width of the interhemispheric fissure, (5) the maximum width of the Sylvian fissure, (6) Evans' ratio, (7) the maximum width of the third ventricle, (8) the cella media index, (9) the maximum width of the fourth ventricle. In neurologically normal children, the maximum transverse width of both hemispheres, the maximum longitudinal length of both hemispheres, the maximum width of the interhemispheric fissure and the maximum width of the Sylvian fissure correlated significantly with the combined volume (CV) of both hemipheres and basal ganglia. In particular, the maximum transverse width of both hemispheres and the maximum longitudinal length of both hemispheres had a high correlation. In neurologically abnormal children the maximum transverse width of both hemispheres and the maximum width of the interhemispheric fissure were significantly correlated with the CV of both hemispheres and basal ganglia. (orig.)

  4. Amusia After Right Temporoparietal Lobe Infarction: A Case Report.

    Science.gov (United States)

    Yoo, Hyun-Joon; Moon, Hyun Im; Pyun, Sung-Bom

    2016-10-01

    Which brain regions participate in musical processing remains controversial. During singing and listening a familiar song, it is necessary to retrieve information from the long-term memory. However, the precise mechanism involved in musical processing is unclear. Amusia is impaired perception, understanding, or production of music not attributable to disease of the peripheral auditory pathways or motor system. We report a case of a 36-year-old right-handed man who lost the ability to discriminate or reproduce rhythms after a right temporoparietal lobe infarction. We diagnosed him as an amusic patient using the online version of Montreal Battery of Evaluation of Amusia (MBEA). This case report suggests that amusia could appear after right temporoparietal lobe infarction. Further research is needed to elucidate the dynamic musical processing mechanism and its associated neural structures.

  5. Monitoring stem cell transplantation in rat cerebral ischemic infarction model with 131I-FIAU/TK reporter gene system

    International Nuclear Information System (INIS)

    Wu Tao; An Rui; Zhang Binqing; Sun Xun; Lang Juntao

    2011-01-01

    Objective: To study the biodistribution of 131 I-2'-deoxy-1-β-D-arabinofuranosyl-5-iodouracil (FIAU) in the rat middle cerebral artery occlusion model and the expression of thymidine kinase (TK) gene in brain tissue after gene-modified stem cell transplantation, and thus evaluate the possibility of further noninvasive monitoring of stem cell transplantation therapy in cerebral infarction. Methods: Adenovirus recombinant Ad5-TK-internal ribosome entry site-brain derived heterotrophic factor-enhanced green florescent protein(IRES-BDNF-EGFP) carrying TK-IRES-BDNF gene was prepared. Cerebral infarction model was established in rats by intraluminal middle cerebral artery occlusion with nylon monofilament. Gene modified bone marrow mesenchymal stem cells were transplanted via intraparenchymal route, lateral ventricle, carotid artery and tail vein, respectively. The normal rats were used as controls. 131 I-FAU was prepared to be the tracer for biodistribution study and the % ID/g was calculated based on measurement of the tissue radioactivity counts. The expression of TK gene was evaluated by quantitative real-time PCR (QR-PCR) and Western blot analysis. Data were analyzed with independent-samples t-test, one-way analysis of variance (ANOVA) test, and Pearson linear correlation test. Results: The % ID/g of infarcted brain tissue in the intraparenchymal group was 0.124 ± 0.013, which was significantly higher than that in lateral ventricle group (0.052 ±0.004), carotid artery group (0.061 ±0.002), tail vein group (0.059 ±0.005) and control group (0.005 ±0.001) (t=2.913-5.652, all P<0.05), while there were no statistically significant differences among the other route transplanted groups (t=0.694-1.448, all P>0.05). The differences of % ID/g between the infarcted and contralateral sides of brain tissue in all transplanted groups were statistically significant (t=9.004-15.734, all P<0.05), while there was no statistically significant difference of this parameter

  6. Exposure to Severe Urban Air Pollution Influences Cognitive Outcomes, Brain Volume and Systemic Inflammation in Clinically Healthy Children

    Science.gov (United States)

    Calderon-Garciduenas, Lilian; Engle, Randall; Mora-Tiscareno, Antonieta; Styner, Martin; Gomez-Garza, Gilberto; Zhu, Hongtu; Jewells, Valerie; Torres-Jardon, Ricardo; Romero, Lina; Monroy-Acosta, Maria E.; Bryant, Christopher; Gonzalez-Gonzalez, Luis Oscar; Medina-Cortina, Humberto; D'Angiulli, Amedeo

    2011-01-01

    Exposure to severe air pollution produces neuroinflammation and structural brain alterations in children. We tested whether patterns of brain growth, cognitive deficits and white matter hyperintensities (WMH) are associated with exposures to severe air pollution. Baseline and 1 year follow-up measurements of global and regional brain MRI volumes,…

  7. Isolated Hand Palsy Due to Small Cortical Infarcts: A Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Meliha Tan

    2009-03-01

    Full Text Available The cortical motor hand area is a knob-like structure of the precentral gyrus, with an inverted omega or horizontal epsilon shape. Isolated hand weakness is infrequently observed and is usually due to small cortical infarcts of this hand knob structure. Isolated hand palsy is sometimes restricted to radial-sided fingers or ulnar sided-fingers. Uniform weakness in all fingers may also occur. We present 2 patients with small cortical infarcts of the cortical hand knob due to different etiologies. A 61-year-old male had right hand weakness restricted to his first and second digits. He had a small cortical infarct on the hand knob area due to emboli from ulcerative plaque of the ipsilateral internal carotid artery. The other patient, a 23-year-old female with sickle cell anemia, had uniform left hand weakness due to an epsilon-shaped infarct on the right precentral gyrus. An obstruction of the small cerebral artery supply to the hand knob area due to sickle cell anemia was the likely pathogenic mechanism. It is suggested that isolated hand weakness due to small cortical infarcts may have different etiologies, most commonly homodynamic or embolic processes. Conditions that rarely cause brain infarction, such as sickle cell anemia, deserve clinical attention. Investigations of strokes must include anemia tests. Patients with predominant weakness of the radial group of fingers due to cortical infarct must be checked for embolism

  8. MRI of 'brain death'

    International Nuclear Information System (INIS)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira; Sanou, Kazuo.

    1990-01-01

    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author)

  9. Spreading depolarizations have prolonged direct current shifts and are associated with poor outcome in brain trauma

    DEFF Research Database (Denmark)

    Hartings, Jed A; Watanabe, Tomas; Bullock, M Ross

    2011-01-01

    , although prolonged events have not been observed in animal models. To determine whether detrimental penumbral-type depolarizations occur in human brain trauma, we analysed electrocorticographic recordings obtained by subdural electrode-strip monitoring during intensive care. Of 53 patients studied, 10......Cortical spreading depolarizations occur spontaneously after ischaemic, haemorrhagic and traumatic brain injury. Their effects vary spatially and temporally as graded phenomena, from infarction to complete recovery, and are reflected in the duration of depolarization measured by the negative direct...... current shift of electrocorticographic recordings. In the focal ischaemic penumbra, peri-infarct depolarizations have prolonged direct current shifts and cause progressive recruitment of the penumbra into the core infarct. In traumatic brain injury, the effects of spreading depolarizations are unknown...

  10. Plasma bilirubin values on admission and ventricular remodeling after a first anterior ST-segment elevation acute myocardial infarction.

    Science.gov (United States)

    Miranda, Berta; Barrabés, José A; Figueras, Jaume; Pineda, Victor; Rodríguez-Palomares, José; Lidón, Rosa-Maria; Sambola, Antonia; Bañeras, Jordi; Otaegui, Imanol; García-Dorado, David

    2016-01-01

    Bilirubin may elicit cardiovascular protection and heme oxygenase-1 overexpression attenuated post-infarction ventricular remodeling in experimental animals, but the association between bilirubin levels and post-infarction remodeling is unknown. In 145 patients with a first anterior ST-segment elevation acute myocardial infarction (STEMI), we assessed whether plasma bilirubin on admission predicted adverse remodeling (left ventricular end-diastolic volume [LVEDV] increase ≥20% between discharge and 6 months, estimated by magnetic resonance imaging). Patients' baseline characteristics and management were comparable among bilirubin tertiles. LVEDV increased at 6 months (P bilirubin tertiles (10.8 [30.2], 10.1 [22.9], and 12.7 [24.3]%, P = 0.500). Median (25-75 percentile) bilirubin values in patients with and without adverse remodeling were 0.75 (0.60-0.93) and 0.73 (0.60-0.92) mg/dL (P = 0.693). Absence of final TIMI flow grade 3 (odds ratio 3.92, 95% CI 1.12-13.66) and a history of hypertension (2.04, 0.93-4.50), but not admission bilirubin, were independently associated with adverse remodeling. Bilirubin also did not predict the increase in ejection fraction at 6 months. Admission bilirubin values are not related to LVEDV or ejection fraction progression after a first anterior STEMI and do not predict adverse ventricular remodeling. Key messages Bilirubin levels are inversely related to cardiovascular disease, and overexpression of heme oxygenase-1 (the enzyme that determines bilirubin production) has prevented post-infarction ventricular remodeling in experimental animals, but the association between bilirubin levels and the progression of ventricular volumes and function in patients with acute myocardial infarction remained unexplored. In this cohort of patients with a first acute anterior ST-segment elevation myocardial infarction receiving contemporary management, bilirubin levels on admission were not predictive of the changes in left

  11. Flow dynamics and energy efficiency of flow in the left ventricle during myocardial infarction.

    Science.gov (United States)

    Vasudevan, Vivek; Low, Adriel Jia Jun; Annamalai, Sarayu Parimal; Sampath, Smita; Poh, Kian Keong; Totman, Teresa; Mazlan, Muhammad; Croft, Grace; Richards, A Mark; de Kleijn, Dominique P V; Chin, Chih-Liang; Yap, Choon Hwai

    2017-10-01

    Cardiovascular disease is a leading cause of death worldwide, where myocardial infarction (MI) is a major category. After infarction, the heart has difficulty providing sufficient energy for circulation, and thus, understanding the heart's energy efficiency is important. We induced MI in a porcine animal model via circumflex ligation and acquired multiple-slice cine magnetic resonance (MR) images in a longitudinal manner-before infarction, and 1 week (acute) and 4 weeks (chronic) after infarction. Computational fluid dynamic simulations were performed based on MR images to obtain detailed fluid dynamics and energy dynamics of the left ventricles. Results showed that energy efficiency flow through the heart decreased at the acute time point. Since the heart was observed to experience changes in heart rate, stroke volume and chamber size over the two post-infarction time points, simulations were performed to test the effect of each of the three parameters. Increasing heart rate and stroke volume were found to significantly decrease flow energy efficiency, but the effect of chamber size was inconsistent. Strong complex interplay was observed between the three parameters, necessitating the use of non-dimensional parameterization to characterize flow energy efficiency. The ratio of Reynolds to Strouhal number, which is a form of Womersley number, was found to be the most effective non-dimensional parameter to represent energy efficiency of flow in the heart. We believe that this non-dimensional number can be computed for clinical cases via ultrasound and hypothesize that it can serve as a biomarker for clinical evaluations.

  12. Protein Synthesis Inhibition in the Peri-Infarct Cortex Slows Motor Recovery in Rats.

    Science.gov (United States)

    Schubring-Giese, Maximilian; Leemburg, Susan; Luft, Andreas Rüdiger; Hosp, Jonas Aurel

    2016-01-01

    Neuroplasticity and reorganization of brain motor networks are thought to enable recovery of motor function after ischemic stroke. Especially in the cortex surrounding the ischemic scar (i.e., peri-infarct cortex), evidence for lasting reorganization has been found at the level of neurons and networks. This reorganization depends on expression of specific genes and subsequent protein synthesis. To test the functional relevance of the peri-infarct cortex for recovery we assessed the effect of protein synthesis inhibition within this region after experimental stroke. Long-Evans rats were trained to perform a skilled-reaching task (SRT) until they reached plateau performance. A photothrombotic stroke was induced in the forelimb representation of the primary motor cortex (M1) contralateral to the trained paw. The SRT was re-trained after stroke while the protein synthesis inhibitor anisomycin (ANI) or saline were injected into the peri-infarct cortex through implanted cannulas. ANI injections reduced protein synthesis within the peri-infarct cortex by 69% and significantly impaired recovery of reaching performance through re-training. Improvement of motor performance within a single training session remained intact, while improvement between training sessions was impaired. ANI injections did not affect infarct size. Thus, protein synthesis inhibition within the peri-infarct cortex impairs recovery of motor deficits after ischemic stroke by interfering with consolidation of motor memory between training sessions but not short-term improvements within one session.

  13. Lycium barbarum Extracts Protect the Brain from Blood-Brain Barrier Disruption and Cerebral Edema in Experimental Stroke

    Science.gov (United States)

    Yang, Di; Li, Suk-Yee; Yeung, Chung-Man; Chang, Raymond Chuen-Chung; So, Kwok-Fai; Wong, David; Lo, Amy C. Y.

    2012-01-01

    Background and Purpose Ischemic stroke is a destructive cerebrovascular disease and a leading cause of death. Yet, no ideal neuroprotective agents are available, leaving prevention an attractive alternative. The extracts from the fruits of Lycium barbarum (LBP), a Chinese anti-aging medicine and food supplement, showed neuroprotective function in the retina when given prophylactically. We aim to evaluate the protective effects of LBP pre-treatment in an experimental stroke model. Methods C57BL/6N male mice were first fed with either vehicle (PBS) or LBP (1 or 10 mg/kg) daily for 7 days. Mice were then subjected to 2-hour transient middle cerebral artery occlusion (MCAO) by the intraluminal method followed by 22-hour reperfusion upon filament removal. Mice were evaluated for neurological deficits just before sacrifice. Brains were harvested for infarct size estimation, water content measurement, immunohistochemical analysis, and Western blot experiments. Evans blue (EB) extravasation was determined to assess blood-brain barrier (BBB) disruption after MCAO. Results LBP pre-treatment significantly improved neurological deficits as well as decreased infarct size, hemispheric swelling, and water content. Fewer apoptotic cells were identified in LBP-treated brains by TUNEL assay. Reduced EB extravasation, fewer IgG-leaky vessels, and up-regulation of occludin expression were also observed in LBP-treated brains. Moreover, immunoreactivity for aquaporin-4 and glial fibrillary acidic protein were significantly decreased in LBP-treated brains. Conclusions Seven-day oral LBP pre-treatment effectively improved neurological deficits, decreased infarct size and cerebral edema as well as protected the brain from BBB disruption, aquaporin-4 up-regulation, and glial activation. The present study suggests that LBP may be used as a prophylactic neuroprotectant in patients at high risk for ischemic stroke. PMID:22438957

  14. MRI-based brain structure volumes in temporal lobe epilepsy patients and their unaffected siblings: a preliminary study.

    LENUS (Irish Health Repository)

    Scanlon, Cathy

    2013-01-01

    Investigating the heritability of brain structure may be useful in simplifying complicated genetic studies in temporal lobe epilepsy (TLE). A preliminary study is presented to determine if volume deficits of candidate brain structures present at a higher rate in unaffected siblings than controls subjects.

  15. Ischemic lesion volume determination on diffusion weighted images vs. apparent diffusion coefficient maps.

    Science.gov (United States)

    Bråtane, Bernt Tore; Bastan, Birgul; Fisher, Marc; Bouley, James; Henninger, Nils

    2009-07-07

    Though diffusion weighted imaging (DWI) is frequently used for identifying the ischemic lesion in focal cerebral ischemia, the understanding of spatiotemporal evolution patterns observed with different analysis methods remains imprecise. DWI and calculated apparent diffusion coefficient (ADC) maps were serially obtained in rat stroke models (MCAO): permanent, 90 min, and 180 min temporary MCAO. Lesion volumes were analyzed in a blinded and randomized manner by 2 investigators using (i) a previously validated ADC threshold, (ii) visual determination of hypointense regions on ADC maps, and (iii) visual determination of hyperintense regions on DWI. Lesion volumes were correlated with 24 hour 2,3,5-triphenyltetrazoliumchloride (TTC)-derived infarct volumes. TTC-derived infarct volumes were not significantly different from the ADC and DWI-derived lesion volumes at the last imaging time points except for significantly smaller DWI lesions in the pMCAO model (p=0.02). Volumetric calculation based on TTC-derived infarct also correlated significantly stronger to volumetric calculation based on last imaging time point derived lesions on ADC maps than DWI (pdetermined lesion volumes on ADC maps and DWI by both investigators correlated significantly with threshold-derived lesion volumes on ADC maps with the former method demonstrating a stronger correlation. There was also a better interrater agreement for ADC map analysis than for DWI analysis. Ischemic lesion determination by ADC was more accurate in final infarct prediction, rater independent, and provided exclusive information on ischemic lesion reversibility.

  16. Prospective longitudinal MRI study of brain volumes and diffusion changes during the first year after moderate to severe traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Veronika Brezova

    2014-01-01

    Higher ADC values were detected in the cortex in individuals with severe TBI, DAI and PTA > 2 weeks, from 3 months. There were no associations between ADC values and brain volumes, and ADC values did not predict outcome.

  17. Automated delineation of brain structures in patients undergoing radiotherapy for primary brain tumors: From atlas to dose–volume histograms

    International Nuclear Information System (INIS)

    Conson, Manuel; Cella, Laura; Pacelli, Roberto; Comerci, Marco; Liuzzi, Raffaele; Salvatore, Marco; Quarantelli, Mario

    2014-01-01

    Purpose: To implement and evaluate a magnetic resonance imaging atlas-based automated segmentation (MRI-ABAS) procedure for cortical and sub-cortical grey matter areas definition, suitable for dose-distribution analyses in brain tumor patients undergoing radiotherapy (RT). Patients and methods: 3T-MRI scans performed before RT in ten brain tumor patients were used. The MRI-ABAS procedure consists of grey matter classification and atlas-based regions of interest definition. The Simultaneous Truth and Performance Level Estimation (STAPLE) algorithm was applied to structures manually delineated by four experts to generate the standard reference. Performance was assessed comparing multiple geometrical metrics (including Dice Similarity Coefficient – DSC). Dosimetric parameters from dose–volume-histograms were also generated and compared. Results: Compared with manual delineation, MRI-ABAS showed excellent reproducibility [median DSC ABAS = 1 (95% CI, 0.97–1.0) vs. DSC MANUAL = 0.90 (0.73–0.98)], acceptable accuracy [DSC ABAS = 0.81 (0.68–0.94) vs. DSC MANUAL = 0.90 (0.76–0.98)], and an overall 90% reduction in delineation time. Dosimetric parameters obtained using MRI-ABAS were comparable with those obtained by manual contouring. Conclusions: The speed, reproducibility, and robustness of the process make MRI-ABAS a valuable tool for investigating radiation dose–volume effects in non-target brain structures providing additional standardized data without additional time-consuming procedures

  18. Impact of papillary muscle infarction on ischemic mitral regurgitation assessed by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bretschneider, Christiane [Klinikum Frankfurt Hochst GmbH, Frankfurt am Main (Germany). Radiology; Heinrich, Hannah-Klara; Kramer, Ulrich; Nikolaou, Konstantin; Klumpp, Bernhard [Universitaetsklinikum Tuebingen, Tuebingen (Germany). Diagnostic and Interventional Radiology; Seeger, Achim; Miller, Stephan [Radiologiepraxis Tuebingen, Tuebingen (Germany); Burgstahler, Christof [Universitaetsklinikum Tuebingen, Tuebingen (Germany). Sports Medicine; Gawaz, Meinrad [Universitaetsklinikum Tuebingen, Tuebingen (Germany). Cardiology

    2018-01-15

    Objective Ischemic mitral regurgitation is a predictor of heart failure resulting in increased mortality in patients with chronic myocardial infarction. It is uncertain whether the presence of papillary muscle (PM) infarction contributes to the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function. 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included. The location and extent of MI depicted by MRI were correlated with left ventricular function assessed by MRI and mitral regurgitation assessed by echocardiography. The presence, location and extent of PM infarction depicted by late gadolinium enhancement (LGE-) MRI were correlated with functional parameters and compared with patients with chronic MI but no PM involvement. PM infarction was found in 11 of 48 patients (23 %) using LGE-MRI. 8/11 patients (73 %) with PM infarction and 22/37 patients (59 %) without PM involvement in MI had ischemic mitral regurgitation. There was no significant difference between location, extent of MI and presence of mitral regurgitation between patients with and without PM involvement in myocardial infarction. In 4/4 patients with complete and in 4/7 patients with partial PM infarction, mitral regurgitation was present. The normalized mean left ventricular end-diastolic volume was increased in patients with ischemic mitral regurgitation. The presence of PM infarction does not correlate with ischemic mitral regurgitation. In patients with complete PM infarction and consequent discontinuity of viable tissue in the PM-chorda-mitral valve complex, the probability of developing ischemic mitral regurgitation seems to be increased. However, the severity of mitral regurgitation is not increased compared to patients with partial or no PM infarction.

  19. Clinical analysis of three cases of Percheron artery infarction

    Directory of Open Access Journals (Sweden)

    Zi-juan PENG

    2016-11-01

    Full Text Available The clinical features, imaging, treatment and prognosis of 3 cases of Percheron artery infarction were analyzed retrospectively. Risk factors for cerebrovascular diseases existed in all patients. They presented acute onset, with varying degrees of disturbance of consciousness, lags in response, dysgnosia and mental changes, but without movement disorders. Two cases also presented eye movement disorders. Brain MRI showed symmetrical long T1 and long T2 signal in bilateral thalami and midbrain. Diffusion-weighted imaging (DWI showed hyperintensity, and FLAIR of one case showed "V sign" in midbrain. Magnetic resonance angiography (MRA of one case demonstrated right posterior cerebral artery (PCA was mainly extended posterior communicating artery (PCoA, with dysplastic P1 segment, which was embryonal PCA. The clinical symptoms of 3 cases were improved significantly after cerebrovascular disease treatment. The classical clinical symptoms, symmetrical high signal in bilateral paramedian thalami on DWI and "V sign" in midbrain on FLAIR, can improve early diagnosis of Percheron artery infarction. Unilateral embryonal PCA may be underlying risk factor for Percheron artery infarction. DOI: 10.3969/j.issn.1672-6731.2016.11.011

  20. Incidence and prognostic significance of postoperative complications demonstrated on CT after brain tumor removal

    Energy Technology Data Exchange (ETDEWEB)

    Fukamachi, Akira; Koizumi, Hidehito; Kimura, Ryoichi; Nukui, Hideaki; Kunimine, Hideo

    1987-06-01

    We surveyed the computed tomographic (CT) findings in 273 patients who had undergone 301 craniotomies for brain tumors to determine the incidence and clinical outcome of the postoperative complications demonstrated on CT. The frequencies of medium-sized or large postoperative lesions were as follows: intracerebral hemorrhage, 11% of 301 operations; subdural fluid collection, 8%; brain edema, 6%; extradural hemorrhage, 4%; cerebral infarction, 3%; ventricular enlargement, 3%; intraventricular hemorrhage, 2%; chronic subdural hematoma, 1%; porencephalic cyst, 0.7%; tension pneumocephalus, 0.7%. In association with these complications, poor outcomes (deaths) developed with the following frequencies: intracerebral hemorrhage including an association with other types of hemorrhage, 4% (deaths, 2%) of 301 operations; cerebral infarction, 1% (deaths, 0.7%); brain edema, 0.7% (deaths, 0.7%); simple intraventricular hemorrhage, 0.3% (no deaths); tension pneumocephalus, 0.3% (no deaths). From these results, we conclude that medium-sized or large intracerebral hemorrhage, massive cerebral infarction and edema have a grave clinical significance in the postoperative course of patients with brain tumors.

  1. Brain arterial aging and its relationship to Alzheimer dementia.

    Science.gov (United States)

    Gutierrez, Jose; Honig, Lawrence; Elkind, Mitchell S V; Mohr, Jay P; Goldman, James; Dwork, Andrew J; Morgello, Susan; Marshall, Randolph S

    2016-04-19

    To test the hypothesis that brain arterial aging is associated with the pathologic diagnosis of Alzheimer disease (AD). Brain large arteries were assessed for diameter, gaps in the internal elastic lamina (IEL), luminal stenosis, atherosclerosis, and lumen-to-wall ratio. Elastin, collagen, and amyloid were assessed with Van Gieson, trichrome, and Congo red staining intensities, and quantified automatically. Brain infarcts and AD (defined pathologically) were assessed at autopsy. We created a brain arterial aging (BAA) score with arterial characteristics associated with aging after adjusting for demographic and clinical variables using cross-sectional generalized linear models. We studied 194 autopsied brains, 25 (13%) of which had autopsy evidence of AD. Brain arterial aging consisted of higher interadventitial and lumen diameters, thickening of the wall, increased prevalence of IEL gaps, concentric intima thickening, elastin loss, increased amyloid deposition, and a higher IEL proportion without changes in lumen-to-wall ratio. In multivariable analysis, a high IEL proportion (B = 1.96, p = 0.030), thick media (B = 3.50, p = 0.001), elastin loss (B = 6.16, p < 0.001), IEL gaps (B = 3.14, p = 0.023), and concentric intima thickening (B = 7.19, p < 0.001) were used to create the BAA score. Adjusting for demographics, vascular risk factors, atherosclerosis, and brain infarcts, the BAA score was associated with AD (B = 0.022, p = 0.002). Aging of brain large arteries is characterized by arterial dilation with a commensurate wall thickening, elastin loss, and IEL gaps. Greater intensity of arterial aging was associated with AD independently of atherosclerosis and brain infarcts. Understanding the drivers of arterial aging may advance the knowledge of the pathophysiology of AD. © 2016 American Academy of Neurology.

  2. CT features of renal infarction

    International Nuclear Information System (INIS)

    Suzer, Okan; Shirkhoda, Ali; Jafri, S. Zafar; Madrazo, Beatrice L.; Bis, Kostaki G.; Mastromatteo, James F.

    2002-01-01

    Purpose: To demonstrate the different patterns of renal infarction to avoid pitfalls. To present 'flip-flop enhancement' pattern in renal infarction. Materials and methods: Retrospective review of a total of 41 renal infarction in 37 patients were done. These patients underwent initial CT and the diagnosis of renal infarction was confirmed with either follow up CT or at surgery. Results: Twenty-three patients had wedge-shaped focal infarcts, nine patients had global and five patients had multifocal infarcts of the kidneys. Cortical rim sign was seen predominantly with global infarcts. In five patients, a 'flip-flop enhancement' pattern was observed. In two patients, planned renal biopsies due to tumefactive renal lesions were cancelled because of 'flip-flop enhancement' pattern on follow up CTs. Conclusion: Although most of our cases were straightforward for the diagnosis of renal infarction, cases with tumefactive lesions and global infarctions without the well-known cortical rim sign were particularly challenging. We describe a new sign, flip-flop enhancement pattern, which we believe solidified the diagnosis of renal infarction in five of our cases. The authors recommend further investigations for association of flip-flop enhancement and renal infarction

  3. Clinical study of the relationship between arteriosclerosis obliterans (ASO) and cerebral infarction

    International Nuclear Information System (INIS)

    Iwamoto, Toshihiko; Sasaki, Akinori; Yanagawa, Kiyotaka; Mitsugi, Yasushi

    1991-01-01

    To clarify the relationship between arteriosclerosis obliterans (ASO) and cerebral infarction (CI), brain CT was performed and the risk factors for atherosclerosis were assessed. Thirty-five male and 5 female patients with intermittent claudication and/or leg ulceration were angiographically diagnosed as having ASO. According to CT findings, these patients were divided into three groups [no low-density areas (NLDA), hemorrhage, and infarction (CI)]. CI was subdivided as lacunar, cortical, and watershed infarction. Thirteen patients were in the NLDA group and 26 in the CI group (17 lacunar, 3 cortical and 6 mixed infarcts), indicating a CI incidence of 65%. Comparing the risk factors of the CI group with those of the NLDA group, hypertension (53.8%), diabetes (34.6%), and cigarette smoking (69.2%) was often seen in the CI group, although hypercholesterolemia (53.8%) and ischemic heart disease (42.3%) was the same in both groups. Multivariate analysis revealed that smoking had the strongest effect on the occurrence of CI in ASO patients. Furthermore, the number of combined risk factors (hypertension, diabetes, smoking, hypercholesterolemia) had a significant positive correlation with cortical infarction. As to the chronological relationship between the onset of ASO and CI, CI was present in 14 of 27 ASO patients on CT when the ischemic leg symptoms appeared, while symptomatic cortical infarction preceded ASO in 5 patients. CI patients increased gradually over a decade to 26 out of 40, among whom 16 patients with lacunae had silent infarcts. These findings suggested that ASO is frequently associated with CI, not only due to atherosclerosis of the main trunks of the cerebral vessels, but also due to arteriolosclerosis of the perforating arteries. (author)

  4. A high-affinity, dimeric inhibitor of PSD-95 bivalently interacts with PDZ1-2 and protects against ischemic brain damage

    DEFF Research Database (Denmark)

    Bach, Anders*; Clausen, Bettina H; Møller, Magda

    2012-01-01

    Inhibition of the ternary protein complex of the synaptic scaffolding protein postsynaptic density protein-95 (PSD-95), neuronal nitric oxide synthase (nNOS), and the N-methyl-d-aspartate (NMDA) receptor is a potential strategy for treating ischemic brain damage, but high-affinity inhibitors are ...... of Tat-N-dimer (3 nmol/g) to mice subjected to focal cerebral ischemia reduces infarct volume with 40% and restores motor functions. Thus, Tat-N-dimer is a highly efficacious neuroprotective agent with therapeutic potential in stroke....

  5. In vivo relaxation of N-acetyl-aspartate, creatine plus phosphocreatine, and choline containing compounds during the course of brain infarction: a proton MRS study

    DEFF Research Database (Denmark)

    Gideon, P; Henriksen, O

    1992-01-01

    Localized water suppressed proton spectroscopy has opened up a new field of pathophysiological studies of severe brain ischemia. The signals obtained with the pulse sequences used so far are both T1 and T2 weighted. In order to evaluate the extent to which changes in metabolite signals during...... the course of infarction can be explained by changes in T1 and T2 relaxation times, eight patients with acute stroke were studied. STEAM sequences with varying echo delay times and repetition times were used to measure T1 and T2 of N-acetyl-aspartate (NAA), creatine plus phosphocreatine (Cr+PCr) and choline...... containing compounds (CHO) in a 27-ml voxel located in the affected area of the brain. Ten healthy volunteers served as controls. We found no difference in T1 or T2 of the metabolites between the patients and the normal controls. The T2 of CHO was longer than that of NAA and Cr+PCr. Our results indicate...

  6. Effect of decompressive hemicraniectomy on mortality of malignant middle cerebral artery infarction

    Directory of Open Access Journals (Sweden)

    Bahram Aminmansour

    2010-01-01

    Full Text Available Background: Increasing intracranial pressure (ICP is one of the leading causes of mortality in patients with malignant infarction of the middle cerebral artery (MCA. We prospectively evaluated patients with MCA infarction for one month survival after decompressive hemicraniectomy. Methods: This study was conducted at Alzahra University Hospital, Isfahan (Iran. Twenty patients with infarction in total MCA distribution area, resulting in midline shift of brain tissue for greater than 5mm, underwent decompressive hemicraniectomy. Mortality rate was estimated one month after surgery. Results: Patients were 8 (40% males and 12 (60% females with a mean age of 49.9 ± 3.8 (25 to 70 years. Left and right MCA were involved in 7 (35% and 13 (65% patients, respectively. Four (20% patients died within one month after surgery (3 females and one male, mean age of 59.0 ± 4.5 vs. 47.6 ± 3.4 in survived patients, p < 0.001. The mean of baseline Glasscow Coma Scale (GCS score estimated 8.60 ± 1.55 in survived patients and 6.75 ± 0.95 in patients who died (p < 0.05. Conclusions: The survival rate of malignant MCA infarction treated with decompressive hemicraniectomy was the same as previous reports. MCA infarction mortality increased with age and lower admission GCS score.

  7. Target volumes in radiation therapy of childhood brain tumours

    International Nuclear Information System (INIS)

    Habrand, J.L.; Abdulkarim, B.; Beaudre, A.; El Khouri, M.; Kalifa, C.

    2001-01-01

    Pediatric tumors have enjoyed considerable improvements for the past 30 years. This is mainly due to the extensive use of combined therapeutical modalities in which chemotherapy plays a prominent role. In many children, local treatment including radiotherapy, can nowadays be adapted in terms of target volume and dose to the 'response' to an initial course of chemotherapy almost on a case by case basis. This makes precise recommendation on local therapy highly difficult in this age group. We will concentrate in this paper on brain tumors in which chemotherapy is of limited value and radiotherapy still plays a key-role. (authors)

  8. Hemicraniectomy after middle cerebral artery infarction with life-threatening Edema trial (HAMLET). Protocol for a randomised controlled trial of decompressive surgery in space-occupying hemispheric infarction.

    Science.gov (United States)

    Hofmeijer, Jeannette; Amelink, G Johan; Algra, Ale; van Gijn, Jan; Macleod, Malcolm R; Kappelle, L Jaap; van der Worp, H Bart

    2006-09-11

    Patients with a hemispheric infarct and massive space-occupying brain oedema have a poor prognosis. Despite maximal conservative treatment, the case fatality rate may be as high as 80%, and most survivors are left severely disabled. Non-randomised studies suggest that decompressive surgery reduces mortality substantially and improves functional outcome of survivors. This study is designed to compare the efficacy of decompressive surgery to improve functional outcome with that of conservative treatment in patients with space-occupying supratentorial infarction The study design is that of a multi-centre, randomised clinical trial, which will include 112 patients aged between 18 and 60 years with a large hemispheric infarct with space-occupying oedema that leads to a decrease in consciousness. Patients will be randomised to receive either decompressive surgery in combination with medical treatment or best medical treatment alone. Randomisation will be stratified for the intended mode of conservative treatment (intensive care or stroke unit care). The primary outcome measure will be functional outcome, as determined by the score on the modified Rankin Scale, at one year.

  9. Correlation between special brain area and blood perfusion in patients with cerebral infarction at convalescent period Feasibility for quantitative determination and estimation of learning and memory function

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies,and the influence of difference in measurement condition of individuals exists.OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period,and to try to find out a method which can quantitatively evaluate learning ability.DESIGN: Case observation, and correlation analysis.SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College.PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Departtment of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3) years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives.METHODS: When the patients were at convalescent period, their learning and memory ability were measured with" clinic memory scale (set A)". The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale,temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis.MAIN OUTCOME MEASURES

  10. Training the brain to survive stroke.

    Directory of Open Access Journals (Sweden)

    Jeff F Dunn

    Full Text Available Presently, little can be done to repair brain tissue after stroke damage. We hypothesized that the mammalian brain has an intrinsic capacity to adapt to low oxygen which would improve outcome from a reversible hypoxic/ischemic episode. Acclimation to chronic hypoxia causes increased capillarity and tissue oxygen levels which may improve the capacity to survive ischemia. Identification of these adaptations will lead to protocols which high risk groups could use to improve recovery and reduce costs.Rats were exposed to hypoxia (3 weeks living at ½ an atmosphere. After acclimation, capillary density was measured morphometrically and was increased by 30% in the cortex. Novel implantable oxygen sensors showed that partial pressure of oxygen in the brain was increased by 40% in the normal cortex. Infarcts were induced in brain with 1 h reversible middle cerebral artery occlusions. After ischemia (48 h behavioural scores were improved and T2 weighted MRI lesion volumes were reduced by 52% in acclimated groups. There was a reduction in inflammation indicated by reduced lymphocytes (by 27-33%, and ED1 positive cells (by 35-45%.It is possible to stimulate a natural adaptive mechanism in the brain which will reduce damage and improve outcome for a given ischemic event. Since these adaptations occur after factors such as HIF-1α have returned to baseline, protection is likely related more to morphological changes such as angiogenesis. Such pre-conditioning, perhaps with exercise or pharmaceuticals, would not necessarily reduce the incidence of stroke, but the severity of damage could be reduced by 50%.

  11. A clinical study of acute cerebral infarction with a midline shift on the CT scan

    International Nuclear Information System (INIS)

    Takemae, Toshiki; Mizukami, Masahiro; Kin, Hiroshi; Kawase, Takeshi; Araki, Goro

    1978-01-01

    Twenty-one cases of acute cerebral infarction with a midline shift on the CT scan were studied with respect to the development of the midline shift, the angiographic findings, the clinical pictures and the outcome of these patients. The CT findings of hemorrhagic infarction were also studied. No cases showed a midline shift on a CT scan taken within 6 hours after the onset. A midline shift was, however, noted as early as 9 hours after the onset, and it reached its peak between the 2nd and 7th day of the onset. It gradually disappeared by the end of the third week. Hemorrhagic infarction was diagnosed in 6 patients by either spinal tap or autopsy. The CT findings of these hemorrhagic infarction were divided into two types, solid hemorrhages with an unequivocal high density within the low-density area, and small, scattered hemorrhagic of almost the same density as normal brain tissue within the low-density area. In 19 of 21 patients, an round-edged occlusion and/or embolus were observed on the initial angiograms. The recanalization of the occluded vessels was proved in 10 of 14 patients by subsequent angiographic studies. Twenty of 21 patients showed a sudden development of neurological symptoms, and 15 patients had a history of various kinds of heart disease, such as atrial fibrillation, valvular heart disease and myocardial infarction. The patients had atrial fibrillation on EKG on admission. These angiographic findings and clinical pictures strongly suggest that the infarction with a midline shift on the CT scan may be caused by a cerebral embolism of cardiac origin. Eight patients died of cerebral herniation between the 2nd and 6th day of the onset. Taking these poor outcomes into consideration, surgical as well as medical decompression of the brain would seem to be most important when the CT scan shows a midline shift. (author)

  12. Volume changes of whole brain gray matter in pediatric patients with Tourette syndrome: evidence from voxel-based morphometry

    International Nuclear Information System (INIS)

    Liu Yue; Peng Yun; Gao Peiyi; Nie Binbin; Lu Chuankai; Zhang Liping; Ji Zhiying; Yin Guangheng; Yu Tong; Shan Baoci

    2012-01-01

    Objectives: To identify the related abnormalities of gray matter in pediatric patients with Tourette syndrome (TS) by using the optimized voxel-based morphometry (VBM). Methods: Three dimensional T 1 WI was acquired in 31 TS children (28 boys, 3 girts, mean age 8 years, range 4-15 years) and 50 age- and sex-matched controls on a 1.5 Tesla Philips scanner. Images were pre-processed and analyzed using a version of VBM 2 in SPM 2. The whole brain gray matter volume was compared between the study and control group by using t-test. Multivariate linear regression analysis was used for analyzing the correlation between the change of grey matter volume within each brain region (mm 3 ) and YGTSS score and course of disease of TS patients. Statistical analyses were performed by using SPSS 13.0. Results: Using VBM, significant increases in gray matter volumes in left superior parietal lobule, right cerebellar hemisphere and left parahippocampal gyrus were detected in TS patients, and the volume changes were 4059, 2126 and 84 mm 3 (t=3.93, 3.71, 3.58, P<0.05) respectively. Compared to the control group, decreased grey matter volumes were found in medulla and left pons, and the volume changes were 213 and 117 mm 3 (t=3.53, 3.48, P<0.05)respectively. Tic severity was not correlated with any volume changes of gray matter in brain (P>0.05, a small volume correction, KE ≥ 10 voxel). Tic course was negatively correlated with the gray matter volume of left parahippocampal gyrus (Beta =-0.391, P=0.039). Conclusions: Using VBM technique, the gray matter abnormalities can be revealed in TS patients without obvious lesions on conventional MR imaging. The increasing volume of temporal and parietal lobes and cerebellar may be an adaptive anatomical change in response to experiential demand. The gray matter volume of the parahippocampal gyrus may be used as one potential objective index for evaluating the prognosis of TS. (authors)

  13. RESVERATROL PRECONDITIONING INDUCES A NOVEL EXTENDED WINDOW OF ISCHEMIC TOLERANCE IN THE MOUSE BRAIN

    Science.gov (United States)

    Koronowski, Kevin B.; Dave, Kunjan R.; Saul, Isabel; Camarena, Vladimir; Thompson, John W.; Neumann, Jake T.; Young, Juan I.; Perez-Pinzon, Miguel A.

    2015-01-01

    Background and Purpose Prophylactic treatments that afford neuroprotection against stroke may emerge from the field of preconditioning. Resveratrol mimics ischemic preconditioning, reducing ischemic brain injury when administered two days prior to global ischemia in rats. This protection is linked to Sirt1 and enhanced mitochondrial function possibly through its repression of UCP2. BDNF is another neuroprotective protein associated with Sirt1. In this study we sought to identify the conditions of resveratrol preconditioning (RPC) that most robustly induce neuroprotection against focal ischemia in mice. Methods We tested four different RPC paradigms against a middle cerebral artery occlusion (MCAo) model of stroke. Infarct volume and neurological score were calculated 24 hours following MCAo. Sirt1-chromatin binding was evaluated by ChIP-qPCR. Percoll gradients were used to isolate synaptic fractions and changes in protein expression were determined via Western blot analysis. BDNF concentration was measured using a BDNF-specific ELISA assay. Results While repetitive RPC induced neuroprotection from MCAo, strikingly one application of RPC 14 days prior to MCAo showed the most robust protection, reducing infarct volume by 33% and improving neurological score by 28%. Fourteen days following RPC, Sirt1 protein was increased 1.5 fold and differentially bound to the UCP2 and BDNF promoter regions. Accordingly, synaptic UCP2 protein decreased by 23% and cortical BDNF concentration increased 26%. Conclusions RPC induces a novel extended window of ischemic tolerance in the brain that lasts for at least 14 days. Our data suggest that this tolerance may be mediated by Sirt1, through upregulation of BDNF and downregulation of UCP2. PMID:26159789

  14. Anterior ST depression with acute transmural inferior infarction due to posterior infarction. A vectorcardiographic and scintigraphic study

    International Nuclear Information System (INIS)

    Mukharji, J.; Murray, S.; Lewis, S.E.; Croft, C.H.; Corbett, J.R.; Willerson, J.T.; Rude, R.E.

    1984-01-01

    The hypothesis that anterior ST segment depression represents concomitant posterior infarction was tested in 49 patients admitted with a first transmural inferior myocardial infarction. Anterior ST depression was defined as 0.1 mV or more ST depression in leads V1, V2 or V3 on an electrocardiogram recorded within 18 hours of infarction. Serial vectorcardiograms and technetium pyrophosphate scans were obtained. Eighty percent of the patients (39 of 49) had anterior ST depression. Of these 39 patients, 34% fulfilled vectorcardiographic criteria for posterior infarction, and 60% had pyrophosphate scanning evidence of posterior infarction. Early anterior ST depression was neither highly sensitive (84%) nor specific (20%) for the detection of posterior infarction as defined by pyrophosphate imaging. Of patients with persistent anterior ST depression (greater than 72 hours), 87% had posterior infarction detected by pyrophosphate scan. In patients with inferior myocardial infarction, vectorcardiographic evidence of posterior infarction correlated poorly with pyrophosphate imaging data. Right ventricular infarction was present on pyrophosphate imaging in 40% of patients with pyrophosphate changes of posterior infarction but without vectorcardiographic evidence of posterior infarction. It is concluded that: 1) the majority of patients with acute inferior myocardial infarction have anterior ST segment depression; 2) early anterior ST segment depression in such patients is not a specific marker for posterior infarction; and 3) standard vectorcardiographic criteria for transmural posterior infarction may be inaccurate in patients with concomitant transmural inferior myocardial infarction or right ventricular infarction, or both

  15. Fluctuating drowsiness following cardiac catheterisation: artery of Percheron ischaemic stroke causing bilateral thalamic infarcts.

    Science.gov (United States)

    Hammersley, Daniel; Arora, Ankur; Dissanayake, Madhava; Sengupta, Nabarun

    2017-01-02

    An 81-year-old man underwent cardiac catheterisation to investigate breathlessness and left ventricular impairment of unknown cause. He had unobstructed coronary arteries. Immediately following the procedure, he became suddenly unresponsive with vertical gaze palsy, anisocoria and bilateral upgoing plantar responses. He made a rapid recovery to his premorbid state 25 min later with no residual focal neurological signs. He then had multiple unresponsive episodes, interspaced with complete resolution of symptoms and neurological signs. MRI of the brain identified bilateral medial thalamic infarcts and midbrain infarcts, consistent with an artery of Percheron territory infarction. By the time the diagnosis was reached, the thrombolysis window had elapsed. The unresponsive episodes diminished with time and the patient was discharged to inpatient rehabilitation. At 6-month review after the episode, the patient has a degree of progressive cognitive impairment. 2017 BMJ Publishing Group Ltd.

  16. Serial CT and MRI of ischaemic cerebral infarcts: frequency and clinical impact of haemorrhagic transformation

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, T.E.; Brueckmann, H. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie; Schulte-Altedorneburg, G. [Dept. of Radiology/Neuroradiology, University Medical School of Luebeck (Germany); Droste, D.W. [Dept. of Neurology, University Medical School of Luebeck (Germany)

    2000-04-01

    The frequency, predisposing factors and clinical consequences of haemorrhagic infarcts and damaged blood-brain barrier as shown by contrast enhancement (CE) in ischaemic cerebral infarcts are controversial. We prospectively compared the sensitivity of CT and MRI to haemorrhagic transformation (HT) and CE. We also wished to investigate the clinical significance of HT and factors possibly associated with it. We studied 36 patients with acute ischaemic infarcts in the middle cerebral artery territory during the first 2 weeks after the ictus. After CT and rating of the neurological deficit on admission, serial examinations with clinical neuromonitoring, contrast-enhanced CT and MRI were done on the same day. The occurrence and severity of HT were correlated with CE, stroke mechanism, infarct size, development of neurological deficits and antithrombotic treatment. The frequency of HT detected by MRI was 80 %. CE usually preceded HT or was seen simultaneously. MRI had a higher sensitivity than CT to HT and CE. Severity of HT was positively correlated with infarct size (P < 0.01). HT had no influence on patient's neurological status. Neither the type of antithrombotic treatment nor the stroke mechanism was associated with the severity of HT. No parenchymal haemorrhage occurred. (orig.)

  17. IQ subgroups in relation to neurocognitive profiles, psychopathology and brain volume in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Jensen, Maria Høj; Glenthøj, Birte Yding; Rostrup, Egill

    . low) using the healthy controls as reference. The IQ subgroups were compared using psychopathology ratings (Positive and Negative Symptoms Scale), neuropsychological assessments (Brief Assessment of Cognition in schizophrenia and Cambridge Neuropsychological Test Automated Battery) and a combined 3T......Background and Aim: Approximately half of patients with schizophrenia experience a deterioration in IQ before or around illness onset and recent studies have found apositive association between IQ and brain volume in first episode schizophrenia. The aim of this study was to examine the combined...... impact of estimated IQ trajectory and IQ level at illness onset on psychopathology, neurocognitive profiles and brain volume. Materials and methods: The design is a cross-sectional, case-control study of 60 first-episode antipsychotic-naïve schizophrenia patients and 60 matched healthy controls...

  18. Surface and volume three-dimensional displays of Tc-99m HMPAO brain SPECT images in stroke patients with three-head gamma camera

    International Nuclear Information System (INIS)

    Shih, W.J.; Slevin, J.T.; Schleenbaker, R.E.; Mills, B.J.; Magoun, S.L.; Ryo, U.Y.

    1991-01-01

    This paper evaluates volume and surface 3D displays in Tc-99m HMPAO brain SPECT imaging in stroke patients. Using a triple-head gamma camera interfaced with a 64-bit supercomputer, 20 patients with stroke were studied. Each patient was imaged 30-60 minutes after an intravenous injection of 20 mCi of Tc-99m HMPAO. SPECT images as well as planar images were routinely obtained; volume and surface 3D display then proceeded, with the process requiring 5-10 minutes. Volume and surface 3D displays show the brain from all angles; thus the location and extension of lesion(s) in the brain are much easier to appreciate. While a cerebral lesion(s) was more clearly delineated by surface 3D imaging, crossed cerebellar diaschisis in seven patients was clearly exhibited with volume 3D but not with surface 3D imaging. Volume and surface 3D displays enhance continuity of structures and understanding of spatial relationships

  19. Significance and problems of the dynamic CT scan for the diagnosis and treatment of cerebral infarctions

    International Nuclear Information System (INIS)

    Morita, Akio; Teraoka, Akira

    1985-01-01

    Dynamic CT scan is a very useful method for the diagnosis of cerebral infarctions and other ischemic disorders. We have used this method for 1) the ultra-early stage diagnosis of major infarctions, 2) the detection of the recanalization and the disruption of the blood-brain barrier, and 3) the detection of latent ischemic lesions. In this report we discussed the clinical cases and the usual use of this dynamic CT scan. We used a GE CT/T8800 scanner for dynamic CT scanning. Manual bolus-contrast-medium injection was done simultaneously with the first scanning, and 6 sequential scannings (scan time: 4.8 s; scan interval: 1.4 s) were done on the same slice level. Especially in major infarctions (e.g., MCA occlusion), OM 40 was the most preferred slice. In cases of ultra-early stage infarctions (i.e., no abnormal lesions in non-enhanced CT), we used this dynamic CT scan immediately after the non-enhanced CT; we could thus obtain information on the ischemic lesions and the ischemic degree. After that we repeated this examination on Days 3, 7, and 14 for the evaluation of the recanalization and blood-brain-barrier disruption. In the cases of TIA and impending or progressing strokes, dynamic CT scan could disclose latent ischemic lesions; in there instances, we treated the patients with intensive to prevent the prognosis from worsening. These benefits and also some problems were discussed. (author)

  20. Direct and Indirect Effects of Brain Volume, Socioeconomic Status and Family Stress on Child IQ

    Science.gov (United States)

    Marcus Jenkins, Jade V; Woolley, Donald P; Hooper, Stephen R; De Bellis, Michael D

    2013-01-01

    1.1. Background A large literature documents the detrimental effects of socioeconomic disparities on intelligence and neuropsychological development. Researchers typically measure environmental factors such as socioeconomic status (SES), using income, parent's occupation and education. However, SES is more complex, and this complexity may influence neuropsychological outcomes. 1.2. Methods This studyused principal components analysis to reduce 14 SES and 28 family stress indicators into their core dimensions (e.g. community and educational capital, financial resources, marital conflict). Core dimensions were used in path analyses to examine their relationships with parent IQ and cerebral volume (white matter, grey matter and total brain volume), to predict child IQ in a sample of typically developing children. 1.3. Results Parent IQ affected child IQ directly and indirectly through community and educational capital, demonstrating how environmental factors interact with familial factors in neuro-development. There were no intervening effects of cerebral white matter, grey matter, or total brain volume. 1.4. Conclusions Findings may suggest that improving community resources can foster the intellectual development of children. PMID:24533427

  1. The correlation between changes of C-reactive protein (CRP level and size of infarct in stroke

    Directory of Open Access Journals (Sweden)

    Shahram Aboutalebi

    2006-09-01

    Full Text Available Background: The presence of C-reactive protein (CRP during different stages of stroke had been shown in several studies. There is still no definite document about the correlation of CRP level and size of infarct in stroke. We studied the correlation of the acute level of CRP with size of infarct in stroke. Methods: A total of 90 consecutive patients with acute stroke admitted in Fatemeh Zahra University Hospital in Bushehr city were studied. Levels of CRP were measured at admission time and 48 hours later. Sizes of infarct and types of stroke were determined with Computerized Tomography scanning. The excluded patients were those with infection, stroke in brain stem, a delay more than 24 hours after attack of stroke and Transient Ischemic Attacks. CRP level was measured quantitatively using ELISA method. Results: No correlation between the first CRP levels and variables of age, size of infarct and type of stroke was detected. Size of infarct was correlated with the second CRP (r=0.41, P<0.001 and the difference in CRP levels (r=0.45, P<0.001. The CRP difference was significant in ischemic, hemorrhagic and territory infarcts (P<0.01. But there was no difference between the first and the second CRP in lacunar infarcts. Conclusion: We found no correlation between the CRP levels of the 24 first hours after acute stroke with size of infarct in stroke. But the increase of CRP levels which were measured in 48 hours after the stroke had correlation with size of infarct irrespective of types of stroke. More studies could reveal the cause and effect of CRP in size of infarct in stroke.

  2. Application of radionuclide infarct scintigraphy to diagnose perioperative myocardial infarction following revascularization

    International Nuclear Information System (INIS)

    Klausner, S.C.; Botvinick, E.H.; Shames, D.; Ullyot, D.J.; Fishman, N.H.; Roe, B.B.; Ebert, P.A.; Chatterjee, K.; Parmley, W.W.

    1977-01-01

    To evaluate the application of radionuclide infarct scintigraphy to diagnose myocardial infarction after revascularization, we obtained postoperative technetium 99m pyrophosphate myocardial scintigrams, serial electrocardiograms and CPK-MB isoenzymes in ten control and 51 revascularized patients. All control patients had negative electrocardiograms and scintigrams, but eight had positive isoenzymes. Eight revascularized patients had positive electrocardiograms, images and enzymes and two had positive scintigrams and enzymes with negative electrocardiograms. Thirty-four patients with negative electrocardiograms and scintigrams had positive isoenzymes; in only seven patients were all tests negative. Our data suggest radionuclide infarct scintigraphy is a useful adjunct to the electrocardiogram in diagnosing perioperative infarction. The frequent presence of CPK-MB in postoperative patients without other evidence of infarction suggests that further studies are required to identify all factors responsible for its release

  3. Classification of myocardial infarction

    DEFF Research Database (Denmark)

    Saaby, Lotte; Poulsen, Tina Svenstrup; Hosbond, Susanne Elisabeth

    2013-01-01

    The classification of myocardial infarction into 5 types was introduced in 2007 as an important component of the universal definition. In contrast to the plaque rupture-related type 1 myocardial infarction, type 2 myocardial infarction is considered to be caused by an imbalance between demand...

  4. Does left ventricular function improve with L-carnitine after acute myocardial infarction?

    Directory of Open Access Journals (Sweden)

    Iyer R

    1999-04-01

    Full Text Available A double blind randomized placebo controlled clinical trial was carried out to assess the efficacy and safety of L-carnitine in patients suffering from acute anterior wall myocardial infarction with respect to left ventricular function. Sixty patients (34 men, 26 women, mean age 56+11 yr. with acute anterior wall myocardial infarction were randomized to placebo and L-carnitine. All the patients were given intravenous L-carnitine / placebo in the dose of 6gm/day for the first seven days followed by oral L-carnitine / placebo 3 gm/day in three divided doses for a period of three months. Echocardiography was performed for regional wall motion abnormality, left ventricular end systolic volume (ESV, end diastolic volume (EDV and ejection fraction (EF on admission, after seven days and after three months of the infarction. Forty-four patients completed the study. There were three deaths, two in the placebo and one in the L-carnitine group (p>0.05. Thirteen patients were lost to follow up. Echo parameters in both groups were comparable (p>0.05. The duration of chest pain prior to initiation of the I.V. L-carnitine was 7.5 + 5.2 hrs in the L-carnitine group and 7 + 4 hrs in the placebo group (p>0.05. There was no statistical difference in the EF, ESV and EDV on admission, at discharge and after three months in the L-carnitine and the placebo groups (p>0.05. No significant adverse effects were noted. L-carnitine, though a safe drug, does not affect the left ventricular function in patients with myocardial infarction.

  5. Dynamic glucose enhanced (DGE) MRI for combined imaging of blood-brain barrier break down and increased blood volume in brain cancer.

    Science.gov (United States)

    Xu, Xiang; Chan, Kannie W Y; Knutsson, Linda; Artemov, Dmitri; Xu, Jiadi; Liu, Guanshu; Kato, Yoshinori; Lal, Bachchu; Laterra, John; McMahon, Michael T; van Zijl, Peter C M

    2015-12-01

    Recently, natural d-glucose was suggested as a potential biodegradable contrast agent. The feasibility of using d-glucose for dynamic perfusion imaging was explored to detect malignant brain tumors based on blood brain barrier breakdown. Mice were inoculated orthotopically with human U87-EGFRvIII glioma cells. Time-resolved glucose signal changes were detected using chemical exchange saturation transfer (glucoCEST) MRI. Dynamic glucose enhanced (DGE) MRI was used to measure tissue response to an intravenous bolus of d-glucose. DGE images of mouse brains bearing human glioma showed two times higher and persistent changes in tumor compared with contralateral brain. Area-under-curve (AUC) analysis of DGE delineated blood vessels and tumor and had contrast comparable to the AUC determined using dynamic contrast enhanced (DCE) MRI with GdDTPA, both showing a significantly higher AUC in tumor than in brain (P blood volume and permeability with respect to normal brain. We expect DGE will provide a low-risk and less expensive alternative to DCE MRI for imaging cancer in vulnerable populations, such as children and patients with renal impairment. © 2015 Wiley Periodicals, Inc.

  6. Dynamic Glucose Enhanced (DGE) MRI for Combined Imaging of Blood Brain Barrier Break Down and Increased Blood Volume in Brain Cancer

    Science.gov (United States)

    Xu, Xiang; Chan, Kannie WY; Knutsson, Linda; Artemov, Dmitri; Xu, Jiadi; Liu, Guanshu; Kato, Yoshinori; Lal, Bachchu; Laterra, John; McMahon, Michael T.; van Zijl, Peter C.M.

    2015-01-01

    Purpose Recently, natural d-glucose was suggested as a potential biodegradable contrast agent. The feasibility of using d-glucose for dynamic perfusion imaging was explored to detect malignant brain tumors based on blood brain barrier breakdown. Methods Mice were inoculated orthotopically with human U87-EGFRvIII glioma cells. Time-resolved glucose signal changes were detected using chemical exchange saturation transfer (glucoCEST) MRI. Dynamic glucose enhanced (DGE) MRI was used to measure tissue response to an intravenous bolus of d-glucose. Results DGE images of mouse brains bearing human glioma showed two times higher and persistent changes in tumor compared to contralateral brain. Area-under-curve (AUC) analysis of DGE delineated blood vessels and tumor and had contrast comparable to the AUC determined using dynamic contrast enhanced (DCE) MRI with GdDTPA, both showing a significantly higher AUC in tumor than in brain (pblood volume and permeability with respect to normal brain. We expect DGE will provide a low-risk and less expensive alternative to DCE MRI for imaging cancer in vulnerable populations, such as children and patients with renal impairment. PMID:26404120

  7. Glucocorticoids Protect Neonatal Rat Brain in Model of Hypoxic-Ischemic Encephalopathy (HIE

    Directory of Open Access Journals (Sweden)

    Benjamin Harding

    2016-12-01

    Full Text Available Hypoxic-ischemic encephalopathy (HIE resulting from asphyxia in the peripartum period is the most common cause of neonatal brain damage and can result in significant neurologic sequelae, including cerebral palsy. Currently therapeutic hypothermia is the only accepted treatment in addition to supportive care for infants with HIE, however, many additional neuroprotective therapies have been investigated. Of these, glucocorticoids have previously been shown to have neuroprotective effects. HIE is also frequently compounded by infectious inflammatory processes (sepsis and as such, the infants may be more amenable to treatment with an anti-inflammatory agent. Thus, the present study investigated dexamethasone and hydrocortisone treatment given after hypoxic-ischemic (HI insult in neonatal rats via intracerebroventricular (ICV injection and intranasal administration. In addition, we examined the effects of hydrocortisone treatment in HIE after lipopolysaccharide (LPS sensitization in a model of HIE and sepsis. We found that dexamethasone significantly reduced rat brain infarction size when given after HI treatment via ICV injection; however it did not demonstrate any neuroprotective effects when given intranasally. Hydrocortisone after HI insult also significantly reduced brain infarction size when given via ICV injection; and the intranasal administration showed to be protective of brain injury in male rats at a dose of 300 µg. LPS sensitization did significantly increase the brain infarction size compared to controls, and hydrocortisone treatment after LPS sensitization showed a significant decrease in brain infarction size when given via ICV injection, as well as intranasal administration in both genders at a dose of 300 µg. To conclude, these results show that glucocorticoids have significant neuroprotective effects when given after HI injury and that these effects may be even more pronounced when given in circumstances of additional

  8. Lateral medullary infarction with cardiovascular autonomic dysfunction: an unusual presentation with review of the literature.

    Science.gov (United States)

    Huynh, Tridu R; Decker, Barbara; Fries, Timothy J; Tunguturi, Ajay

    2018-01-24

    We report an unusual case of lateral medullary infarction presenting with orthostatic hypotension with pre-syncope without vertigo or Horner's syndrome. Case report with review of the literature. A 67-year-old man presented with pre-syncope and ataxia without vertigo. Initial brain CT and MRI were normal. Neurological evaluation revealed right-beating nystagmus with left gaze, vertical binocular diplopia, right upper-extremity dysmetria, truncal ataxia with right axial lateropulsion, and right-facial and lower extremity hypoesthesia. Bedside blood pressure measurements disclosed orthostatic hypotension. He had normal sinus rhythm on telemetry and normal ejection fraction on echocardiogram. A repeat brain MRI disclosed an acute right dorsolateral medullary infarct. Autonomic testing showed reduced heart rate variability during paced deep breathing, attenuated late phase II and phase IV overshoot on Valsalva maneuver, and a fall of 25 mmHg of blood pressure at the end of a 10-min head-up tilt with no significant change in heart rate. These results were consistent with impaired sympathetic and parasympathetic cardiovascular reflexes. He was discharged to acute rehabilitation a week later with residual right dysmetria and ataxia. Lateral medullary infarctions are usually reported as partial presentations of classical lateral medullary syndrome with accompanying unusual symptoms ranging from trigeminal neuralgias to hiccups. Pre-syncope from orthostatic hypotension is a rare presentation. In the first 3-4 days, absence of early DWI MRI findings is possible in small, dorsolateral medullary infarcts with sensory disturbances. Physicians should be aware of this presentation, as early diagnosis and optimal therapy are associated with good prognosis.

  9. Correlating lesion size and location to deficits after ischemic stroke: the influence of accounting for altered peri-necrotic tissue and incidental silent infarcts

    Directory of Open Access Journals (Sweden)

    Black Sandra E

    2010-01-01

    Full Text Available Abstract Background Investigators frequently quantify and evaluate the location and size of stroke lesions to help uncover cerebral anatomical correlates of deficits observed after first-ever stroke. However, it is common to discover silent infarcts such as lacunes in patients identified clinically as 'first-ever' stroke, and it is unclear if including these incidental findings may impact lesion-based investigations of brain-behaviour relationships. There is also debate concerning how to best define the boundaries of necrotic stroke lesions that blend in an ill-defined way into surrounding tissue, as it is unclear whether including this altered peri-necrotic tissue region may influence studies of brain-behaviour relationships. Therefore, for patients with clinically overt stroke, we examined whether including altered peri-necrotic tissue and incidental silent strokes influenced either lesion volume correlations with a measure of sensorimotor impairment or the anatomical localization of this impairment established using subtraction lesion analysis. Methods Chronic stroke lesions of 41 patients were manually traced from digital T1-MRI to sequentially include the: necrotic lesion core, altered peri-necrotic tissue, silent lesions in the same hemisphere as the index lesion, and silent lesions in the opposite hemisphere. Lesion volumes for each region were examined for correlation with motor impairment scores, and subtraction analysis was used to highlight anatomical lesion loci associated with this deficit. Results For subtraction lesion analysis, including peri-necrotic tissue resulted in a larger region of more frequent damage being seen in the basal ganglia. For correlational analysis, only the volume of the lesion core was significantly associated with motor impairment scores (r = -0.35, p = 0.025. In a sub-analysis of patients with small subcortical index lesions, adding silent lesions in the opposite hemisphere to the volume of the index

  10. Incidence and prognostic significance of postoperative complications demonstrated on CT after brain tumor removal

    International Nuclear Information System (INIS)

    Fukamachi, Akira; Koizumi, Hidehito; Kimura, Ryoichi; Nukui, Hideaki; Kunimine, Hideo.

    1987-01-01

    We surveyed the computed tomographic (CT) findings in 273 patients who had undergone 301 craniotomies for brain tumors to determine the incidence and clinical outcome of the postoperative complications demonstrated on CT. The frequencies of medium-sized or large postoperative lesions were as follows: intracerebral hemorrhage, 11 % of 301 operations; subdural fluid collection, 8 %; brain edema, 6 %; extradural hemorrhage, 4 %; cerebral infarction, 3 %; ventricular enlargement, 3 %; intraventricular hemorrhage, 2 %; chronic subdural hematoma, 1 %; porencephalic cyst, 0.7 %; tension pneumocephalus, 0.7 %. In association with these complications, poor outcomes (deaths) developed with the following frequencies: intracerebral hemorrhage including an association with other types of hemorrhage, 4 % (deaths, 2 %) of 301 operations; cerebral infarction, 1 % (deaths, 0.7 %); brain edema, 0.7 % (deaths, 0.7 %); simple intraventricular hemorrhage, 0.3 % (no deaths); tension pneumocephalus, 0.3 % (no deaths). From these results, we conclude that medium-sized or large intracerebral hemorrhage, massive cerebral infarction and edema have a grave clinical significance in the postoperative course of patients with brain tumors. (author)

  11. Regional brain volumes, diffusivity, and metabolite changes after electroconvulsive therapy for severe depression

    DEFF Research Database (Denmark)

    Jørgensen, A.; Magnusson, P.; Hanson, Lars G.

    2016-01-01

    , and metabolite changes in 19 patients receiving ECT for severe depression. Other regions of interest included the amygdala, dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex, and hypothalamus. Patients received a 3T MR scan before ECT (TP1), 1 week (TP2), and 4 weeks (TP3) after ECT. Results......: Hippocampal and amygdala volume increased significantly at TP2 and continued to be increased at TP3. DLPFC exhibited a transient volume reduction at TP2. DTI revealed a reduced anisotropy and diffusivity of the hippocampus at TP2. We found no significant post-ECT changes in brain metabolite concentrations...

  12. Robust volume assessment of brain tissues for 3-dimensional fourier transformation MRI via a novel multispectral technique.

    Directory of Open Access Journals (Sweden)

    Jyh-Wen Chai

    Full Text Available A new TRIO algorithm method integrating three different algorithms is proposed to perform brain MRI segmentation in the native coordinate space, with no need of transformation to a standard coordinate space or the probability maps for segmentation. The method is a simple voxel-based algorithm, derived from multispectral remote sensing techniques, and only requires minimal operator input to depict GM, WM, and CSF tissue clusters to complete classification of a 3D high-resolution multislice-multispectral MRI data. Results showed very high accuracy and reproducibility in classification of GM, WM, and CSF in multislice-multispectral synthetic MRI data. The similarity indexes, expressing overlap between classification results and the ground truth, were 0.951, 0.962, and 0.956 for GM, WM, and CSF classifications in the image data with 3% noise level and 0% non-uniformity intensity. The method particularly allows for classification of CSF with 0.994, 0.961 and 0.996 of accuracy, sensitivity and specificity in images data with 3% noise level and 0% non-uniformity intensity, which had seldom performed well in previous studies. As for clinical MRI data, the quantitative data of brain tissue volumes aligned closely with the brain morphometrics in three different study groups of young adults, elderly volunteers, and dementia patients. The results also showed very low rates of the intra- and extra-operator variability in measurements of the absolute volumes and volume fractions of cerebral GM, WM, and CSF in three different study groups. The mean coefficients of variation of GM, WM, and CSF volume measurements were in the range of 0.03% to 0.30% of intra-operator measurements and 0.06% to 0.45% of inter-operator measurements. In conclusion, the TRIO algorithm exhibits a remarkable ability in robust classification of multislice-multispectral brain MR images, which would be potentially applicable for clinical brain volumetric analysis and explicitly promising

  13. Hyperacute stroke patients and catheter thrombolysis therapy. Correlation between computed tomography perfusion maps and final infarction

    International Nuclear Information System (INIS)

    Naito, Yukari; Tanaka, Shigeko; Inoue, Yuichi; Ota, Shinsuke; Sakaki, Saburo; Kitagaki, Hajime

    2008-01-01

    We investigated the correlation between abnormal perfusion areas by computed tomography perfusion (CTP) study of hyperacute stroke patients and the final infarction areas after intraarterial catheter thrombolysis. CTP study using the box-modulation transfer function (box-MTF) method based on the deconvolution analysis method was performed in 22 hyperacute stroke patients. Ischemic lesions were immediately treated with catheter thrombolysis after CTP study. Among them, nine patients with middle cerebral artery (MCA) occlusion were investigated regarding correlations of the size of the prolonged mean transit time (MTT) area, the decreased cerebral blood volume (CBV) area, and the final infarction area. Using the box-MTF method, the prolonged MTT area was almost identical to the final infarction area in the case of catheter thrombolysis failure. The decreased CBV areas resulted in infarction or hemorrhage, irrespective of the outcome of recanalization after catheter thrombolysis. The prolonged MTT areas, detected by the box-MTF method of CTP in hyperacute stroke patients, included the area of true prolonged MTT and the tracer delay. The prolonged MTT area was almost identical to the final infarction area when recanalization failed. We believe that a tracer delay area also indicates infarction in cases of thrombolysis failure. (author)

  14. Role of platelet parameters and haematological indices in myocardial infarction and unstable angina

    International Nuclear Information System (INIS)

    Yaghoubi, A.; Golmohamadi, Z.; Alizadehasi, A.; Azarfarin, R.

    2013-01-01

    Objective: To explore the significance of platelet parameters, including mean platelet volume, platelet count and other haematological indices, in patients of acute coronary syndrome. Methods: In this one-year retrospective cross-sectional study in 2010, a total of 631 patients were enrolled at the Cardiovascular Research Institute, Tabriz University of Medical Sciences, Iran, and classified into three groups: myocardial infarction, unstable angina, and Control. Cardiovascular risk factors such as smoking, diabetes mellitus, hyperlipidaemia and hypertension status were compared. Blood samples were collected for the measurement of platelet count, mean platelet volume and other haematological indices, including prothrombin time, partial thromoplastin time, blood group and Rh, haematocrit, haemoglobin, and erythrocyte sedimentation rate. SPSS 18 was used for statistical analysis. Results: Of the total, there were 210 (33.3%; 163 men, 47 women) with myocardial infarction whose mean age was 62.7+-14.2 years; 211 (33.3%; 110 men, 101 women) had unstable angina with a mean age of 63.5+-13.1 years and 210 (33.3%; 117 men, 90 women) health controls with a mean age of 60.6+-12.8 years. The mean platelet volume values of patients in the first two groups were significantly higher than the control group (10.14 +-1.05 fL, 9.82 +- 0.93 fL and 9.34+-1.14 fL, respectively; p< 0.001). The platelet count was detected to be significantly lower in the patients than the controls (207.92+-58.40*109/L, 220.18+-65.81*109/L, 238+-56.10*109/L, respectively, p<0.001). While blood cell count was significantly higher in those with myocardial infarction compared to the unstable angina patients and control group (P<0.001). Differences in mean values of mean platelet volume between the two patient groups was not significant, but mean values of platelet count was statistically significant between these two groups (p<0.04). Conclusion: Mean platelet volume and platelet count may be considered

  15. Myocardial infarction

    International Nuclear Information System (INIS)

    Ando, Jyoji; Yasuda, Hisakazu; Miyamoto, Atsushi; Kobayashi, Tsuyoshi

    1980-01-01

    sup(99m)Tc-pyrophosphate (PYP) scintigraphy and 201 Tl myocardial scintigraphy were utilized for the diagnoses of the presence, the region, and the extent of myocardial infarction. Exercise 201 Tl myocardial scintigrams and exercise radionuclide ventriculography were utilized for diagnosis of coronary artery lesions in angina pectoris. Radionuclide ventriculography was used to investigate effects of coronary artery lesions on cardiac function and hemodynamics. In order to select adequate treatments for myocardial infarction and estimate the prognosis, it was necessary to detect the presence, the region, and the extent of acute myocardial infarction and to investigate effects of partial infarction on hemodynamics by using radionuclide imaging. Exercise myocardial scintigraphy could be carried out noninvasively and repeatedly for diagnosis of coronal artery disease. Therefore, this method could be applied widely. It was possible to use this method as a screening test of coronary artery diseases for the diagnoses of asymptomatic patients who showed ST changes in ECG, the patients with cardiac neurosis and the patency after a reconstructive surgery of coronary artery. (Tsunoda, M.)

  16. A tensor-based morphometry analysis of regional differences in brain volume in relation to prenatal alcohol exposure.

    Science.gov (United States)

    Meintjes, E M; Narr, K L; van der Kouwe, A J W; Molteno, C D; Pirnia, T; Gutman, B; Woods, R P; Thompson, P M; Jacobson, J L; Jacobson, S W

    2014-01-01

    Reductions in brain volumes represent a neurobiological signature of fetal alcohol spectrum disorders (FASD). Less clear is how regional brain tissue reductions differ after normalizing for brain size differences linked with FASD and whether these profiles can predict the degree of prenatal exposure to alcohol. To examine associations of regional brain tissue excesses/deficits with degree of prenatal alcohol exposure and diagnosis with and without correction for overall brain volume, tensor-based morphometry (TBM) methods were applied to structural imaging data from a well-characterized, demographically homogeneous sample of children diagnosed with FASD (n = 39, 9.6-11.0 years) and controls (n = 16, 9.5-11.0 years). Degree of prenatal alcohol exposure was significantly associated with regionally pervasive brain tissue reductions in: (1) the thalamus, midbrain, and ventromedial frontal lobe, (2) the superior cerebellum and inferior occipital lobe, (3) the dorsolateral frontal cortex, and (4) the precuneus and superior parietal lobule. When overall brain size was factored out of the analysis on a subject-by-subject basis, no regions showed significant associations with alcohol exposure. FASD diagnosis was associated with a similar deformation pattern, but few of the regions survived FDR correction. In data-driven independent component analyses (ICA) regional brain tissue deformations successfully distinguished individuals based on extent of prenatal alcohol exposure and to a lesser degree, diagnosis. The greater sensitivity of the continuous measure of alcohol exposure compared with the categorical diagnosis across diverse brain regions underscores the dose dependence of these effects. The ICA results illustrate that profiles of brain tissue alterations may be a useful indicator of prenatal alcohol exposure when reliable historical data are not available and facial features are not apparent.

  17. A tensor-based morphometry analysis of regional differences in brain volume in relation to prenatal alcohol exposure

    Directory of Open Access Journals (Sweden)

    E.M. Meintjes

    2014-01-01

    Full Text Available Reductions in brain volumes represent a neurobiological signature of fetal alcohol spectrum disorders (FASD. Less clear is how regional brain tissue reductions differ after normalizing for brain size differences linked with FASD and whether these profiles can predict the degree of prenatal exposure to alcohol. To examine associations of regional brain tissue excesses/deficits with degree of prenatal alcohol exposure and diagnosis with and without correction for overall brain volume, tensor-based morphometry (TBM methods were applied to structural imaging data from a well-characterized, demographically homogeneous sample of children diagnosed with FASD (n = 39, 9.6–11.0 years and controls (n = 16, 9.5–11.0 years. Degree of prenatal alcohol exposure was significantly associated with regionally pervasive brain tissue reductions in: (1 the thalamus, midbrain, and ventromedial frontal lobe, (2 the superior cerebellum and inferior occipital lobe, (3 the dorsolateral frontal cortex, and (4 the precuneus and superior parietal lobule. When overall brain size was factored out of the analysis on a subject-by-subject basis, no regions showed significant associations with alcohol exposure. FASD diagnosis was associated with a similar deformation pattern, but few of the regions survived FDR correction. In data-driven independent component analyses (ICA regional brain tissue deformations successfully distinguished individuals based on extent of prenatal alcohol exposure and to a lesser degree, diagnosis. The greater sensitivity of the continuous measure of alcohol exposure compared with the categorical diagnosis across diverse brain regions underscores the dose dependence of these effects. The ICA results illustrate that profiles of brain tissue alterations may be a useful indicator of prenatal alcohol exposure when reliable historical data are not available and facial features are not apparent.

  18. Positron emission tomography in human hemispheric infarction: a study with 150 continuous inhalation technique

    International Nuclear Information System (INIS)

    Castaigne, Paul; Baron, J.C.; Bousser, M.G.; Comar, D.; Kellershohn, C.; CEA, 91 - Orsay

    1979-01-01

    Non-invasive tomographic imaging of cerebral blood flow and oxygen metabolism has now become possible with the 15 O continuous inhalation technique coupled with positron emission tomography (PET). We have for the first time applied this procedure in a large scale study of human hemispheric infarction. From this study, it may be concluded that: various hitherto undescribed patterns of disturbances in the perfusion/metabolism couple that occur in cerebral infarction have been documented by PET imaging of CBF and EO 2 . The EO 2 appears as an important physiological parameter in the study of recent cerebral infarction, and specific patterns of the CBF/EO 2 relationship are now emerging that may have important pathophysiologic, prognostic and therapeutic implications. Despite some limitations, the non invasive 15 O inhalation technique has a number of major specific advantages that make it particularly suited for the study of ischemic brain disorders

  19. Comparison of Usefulness of N-Terminal Pro-Brain Natriuretic Peptide as an Independent Predictor of Cardiac Function Among Admission Cardiac Serum Biomarkers in Patients With Anterior Wall Versus Nonanterior Wall ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

    NARCIS (Netherlands)

    Haeck, Joost D. E.; Verouden, Niels J. W.; Kuijt, Wichert J.; Koch, Karel T.; van Straalen, Jan P.; Fischer, Johan; Groenink, Maarten; Bilodeau, Luc; Tijssen, Jan G. P.; Krucoff, Mitchell W.; de Winter, Robbert J.

    2010-01-01

    The purpose of the present study was to determine the prognostic value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP), among other serum biomarkers, on cardiac magnetic resonance (CMR) imaging parameters of cardiac function and infarct size in patients with ST-segment elevation myocardial

  20. Infarcts presenting with a combination of medial medullary and posterior inferior cerebellar artery syndromes.

    Science.gov (United States)

    Lee, Hyung; Baik, Seung Kug

    2004-09-15

    Cerebellar and medial medullary infarctions are well-known vertebrobasilar stroke syndromes. However, their development in a patient with distal vertebral artery occlusion has not been previously reported. A 49-year-old man with longstanding hypertension suddenly developed vertigo, right-sided Horner syndrome, and left-sided weakness. An MRI of the brain showed acute infarcts in the right inferior cerebellum (posterior inferior cerebellar artery territory) and the right upper medial medulla (direct penetrating branches of vertebral artery). Magnetic resonance angiogram showed occlusion of the distal vertebral artery on the right side. Atherothrombotic occlusion of the distal vertebral artery may cause this unusual combination of vertebrobasilar stroke.

  1. Diagnosis of Alzheimer's disease and multiple infarct dementia by tomographic imaging of iodine-123 IMP

    International Nuclear Information System (INIS)

    Cohen, M.B.; Graham, L.S.; Lake, R.

    1986-01-01

    Tomographic imaging of the brain was performed using a rotating slant hole collimator and [ 123 I]N-isopropyl p-iodoamphetamine (IMP) in normal subjects (n = 6) and patients with either Alzheimer's disease (n = 5) or multiple infarct dementia (n = 3). Four blinded observers were asked to make a diagnosis from the images. Normal subjects and patients with multiple infarct dementia were correctly identified. Alzheimer's disease was diagnosed in three of the five patients with this disease. One patient with early Alzheimer's disease was classified as normal by two of the four observers. Another patient with Alzheimer's disease had an asymmetric distribution of IMP and was incorrectly diagnosed as multiple infarct dementia by all four observers. Limited angle tomography of the cerebral distribution of 123 I appears to be a useful technique for the evaluation of demented patients

  2. Imaging of acute myocardial infarction in pigs with Indium-111 monoclonal antimyosin scintigraphy and MRI

    International Nuclear Information System (INIS)

    Kate, C.I.; Kroonenburgh, M.J. van; Schipperheyn, J.J.; Doornbos, J.; Hoedemaeker, P.J.; Maes, A.; Nat, K.H. van der; Camps, J.A.; Huysmans, H.A.; Pauwels, E.K.

    1990-01-01

    Indium-111 antimyosin F(ab')2 was used in a series of scintigraphic studies on experimentally induced myocardial infarctions in pigs. Antimyosin distribution recorded by planar images of in vivo pigs and by single photon emission computed tomography (SPECT) of excised hearts delineated areas of myocardial necrosis if infarct volume exceeded 3.3 cm3. Scintigraphic images were compared with magnetic resonance images (MRI) obtained from excised hearts and with photographs of slices of the hearts. Infarct size and localization determined with antimyosin were compared. The MR images, with or without gadolinium-DTPA (Gd-DTPA), of the in vivo pigs were all false-negative; some myocardial wall thinning and high bloodpool signals were visible. Results show that both the antimyosin and the MR technique are specific methods for the visualization of induced myocardial necrosis in this animal model. However, the use of antimyosin is limited to a period ranging from 24 to 72 hours after infarction

  3. Protective effect of green tea polyphenol EGCG against neuronal damage and brain edema after unilateral cerebral ischemia in gerbils.

    Science.gov (United States)

    Lee, Hyung; Bae, Jae Hoon; Lee, Seong-Ryong

    2004-09-15

    Previous studies have demonstrated that a green tea polyphenol, (-)-epigallocatechine gallate (EGCG), has a potent free radical scavenging and antioxidant effect. Glutamate leads to excitotoxicity and oxidative stress, which are important pathophysiologic responses to cerebral ischemia resulting in brain edema and neuronal damage. We investigated the effect of EGCG on excitotoxic neuronal damage in a culture system and the effect on brain edema formation and lesion after unilateral cerebral ischemia in gerbils. In vitro, excitotoxicity was induced by 24-hr incubation with N-methyl-D-aspartate (NMDA; 10 microM), AMPA (10 microM), or kainate (20 microM). EGCG (5 microM) was added to the culture media alone or with excitotoxins. We examined malondialdehyde (MDA) level and neuronal viability to evaluate the effect of EGCG. In vivo, unilateral cerebral ischemia was induced by occlusion of the right common carotid artery for 30, 60, or 90 min and followed by reperfusion of 24 hr. Brain edema, MDA, and infarction were examined to evaluate the protective effect of EGCG. EGCG (25 or 50 mg/kg, intraperitoneally) was administered twice, at 30 min before and immediately after ischemia. EGCG reduced excitotoxin-induced MDA production and neuronal damage in the culture system. In the in vivo study, treatment of gerbils with the lower EGCG dose failed to show neuroprotective effects; however, the higher EGCG dose attenuated the increase in MDA level caused by cerebral ischemia. EGCG also reduced the formation of postischemic brain edema and infarct volume. These results demonstrate EGCG may have future possibilities as a neuroprotective agent against excitotoxicity-related neurologic disorders such as brain ischemia.

  4. Overestimation of myocardial infarct size on two-dimensional echocardiograms due to remodelling of the infarct zone.

    Science.gov (United States)

    Johnston, B J; Blinston, G E; Jugdutt, B I

    1994-01-01

    To assess the effect of early regional diastolic shape distortion or bulging of infarct zones due to infarct expansion on estimates of regional left ventricular dysfunction and infarct size by two-dimensional echocardiographic imaging. Quantitative two-dimensional echocardiograms from patients with a first Q wave myocardial infarction and creatine kinase infarct size data, and normal subjects, were subjected to detailed analysis of regional left ventricular dysfunction and shape distortion in short-axis images by established methods. Regional left ventricular asynergy (akinesis and dyskinesis) and shape distortion indices (eg, peak [Pk]/radius [ri]) were measured on endocardial diastolic outlines of short-axis images in 43 postinfarction patients (28 anterior and 15 inferior, 5.9 h after onset) and 11 normal subjects (controls). In the infarction group, endocardial surface area of asynergy was calculated by three-dimensional reconstruction of the images and infarct size from serial creatine kinase blood levels. Diastolic bulging of asynergic zones was found in all infarction patients. The regional shape distortion indices characterizing the area between the 'actual' bulging asynergic segment and the derived 'ideal' circular segment (excluding the bulge) on indexed sections were greater in infarct than control groups (Pk/ri 0.31 versus 0, P 0.001). Importantly, the degree of distortion correlated with overestimation of asynergy (r = 0.89, P < 0.001), and the relation between infarct size and total 'ideal' asynergy showed a leftward shift from that with 'actual' asynergy. Early regional diastolic bulging of the infarct zone results in overestimation of regional ventricular dysfunction, especially in patients with anterior infarction. This effect should be considered when assessing effects of therapy on infarct size, remodelling and dysfunction using tomographical imaging.

  5. MRI of 'brain death'

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira (Okayama Univ. (Japan). School of Medicine); Sanou, Kazuo

    1990-12-01

    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author).

  6. Duration of untreated psychosis/illness and brain volume changes in early psychosis.

    Science.gov (United States)

    Rapp, Charlotte; Canela, Carlos; Studerus, Erich; Walter, Anna; Aston, Jacqueline; Borgwardt, Stefan; Riecher-Rössler, Anita

    2017-09-01

    The time period during which patients manifest psychotic or unspecific symptoms prior to treatment (duration of untreated psychosis, DUP, and the duration of untreated illness, DUI) has been found to be moderately associated with poor clinical and social outcome. Equivocal evidence exists of an association between DUP/DUI and structural brain abnormalities, such as reduced hippocampus volume (HV), pituitary volume (PV) and grey matter volume (GMV). Thus, the goal of the present work was to examine if DUP and DUI are associated with abnormalities in HV, PV and GMV. Using a region of interest (ROI) based approach, we present data of 39 patients from the Basel FePsy (Früherkennung von Psychosen, early detection of psychosis) study for which information about DUP, DUI and HV, PV and GMV data could be obtained. Twenty-three of them were first episode psychosis (FEP) and 16 at-risk mental state (ARMS) patients who later made the transition to frank psychosis. In unadjusted analyses, we found a significant positive correlation between DUP and PV in FEP patients. However, when adjusted for covariates, we found no significant correlation between DUP or DUI and HV, PV or GMV anymore. There only was a trend for decreasing GMV with increasing DUI in FEP. Our results do not comprehensively support the hypothesis of a "toxic" effect of the pathogenic mechanism underlying untreated psychosis on brain structure. If there is any effect, it might rather occur very early in the disease process, during which patients experience only unspecific symptoms. Copyright © 2017. Published by Elsevier B.V.

  7. MR-based automatic delineation of volumes of interest in human brain PET images using probability maps

    DEFF Research Database (Denmark)

    Svarer, Claus; Madsen, Karina; Hasselbalch, Steen G.

    2005-01-01

    The purpose of this study was to develop and validate an observer-independent approach for automatic generation of volume-of-interest (VOI) brain templates to be used in emission tomography studies of the brain. The method utilizes a VOI probability map created on the basis of a database of several...... delineation of the VOI set. The approach was also shown to work equally well in individuals with pronounced cerebral atrophy. Probability-map-based automatic delineation of VOIs is a fast, objective, reproducible, and safe way to assess regional brain values from PET or SPECT scans. In addition, the method...

  8. Facial Emotion Recognition Impairments are Associated with Brain Volume Abnormalities in Individuals with HIV

    Science.gov (United States)

    Clark, Uraina S.; Walker, Keenan A.; Cohen, Ronald A.; Devlin, Kathryn N.; Folkers, Anna M.; Pina, Mathew M.; Tashima, Karen T.

    2015-01-01

    Impaired facial emotion recognition abilities in HIV+ patients are well documented, but little is known about the neural etiology of these difficulties. We examined the relation of facial emotion recognition abilities to regional brain volumes in 44 HIV-positive (HIV+) and 44 HIV-negative control (HC) adults. Volumes of structures implicated in HIV− associated neuropathology and emotion recognition were measured on MRI using an automated segmentation tool. Relative to HC, HIV+ patients demonstrated emotion recognition impairments for fearful expressions, reduced anterior cingulate cortex (ACC) volumes, and increased amygdala volumes. In the HIV+ group, fear recognition impairments correlated significantly with ACC, but not amygdala volumes. ACC reductions were also associated with lower nadir CD4 levels (i.e., greater HIV-disease severity). These findings extend our understanding of the neurobiological substrates underlying an essential social function, facial emotion recognition, in HIV+ individuals and implicate HIV-related ACC atrophy in the impairment of these abilities. PMID:25744868

  9. Optimization of stereotactically-guided conformal treatment planning of sellar and parasellar tumors, based on normal brain dose volume histograms

    International Nuclear Information System (INIS)

    Perks, Julian R.; Jalali, Rakesh; Cosgrove, Vivian P.; Adams, Elizabeth J.; Shepherd, Stephen F.; Warrington, Alan P.; Brada, Michael

    1999-01-01

    Purpose: To investigate the optimal treatment plan for stereo tactically-guided conformal radiotherapy (SCRT) of sellar and parasellar lesions, with respect to sparing normal brain tissue, in the context of routine treatment delivery, based on dose volume histogram analysis. Methods and Materials: Computed tomography (CT) data sets for 8 patients with sellar- and parasellar-based tumors (6 pituitary adenomas and 2 meningiomas) have been used in this study. Treatment plans were prepared for 3-coplanar and 3-, 4-, 6-, and 30-noncoplanar-field arrangements to obtain 95% isodose coverage of the planning target volume (PTV) for each plan. Conformal shaping was achieved by customized blocks generated with the beams eye view (BEV) facility. Dose volume histograms (DVH) were calculated for the normal brain (excluding the PTV), and comparisons made for normal tissue sparing for all treatment plans at ≥80%, ≥60%, and ≥40% of the prescribed dose. Results: The mean volume of normal brain receiving ≥80% and ≥60% of the prescribed dose decreased by 22.3% (range 14.8-35.1%, standard deviation σ = 7.5%) and 47.6% (range 25.8-69.1%, σ 13.2%), respectively, with a 4-field noncoplanar technique when compared with a conventional 3-field coplanar technique. Adding 2 further fields, from 4-noncoplanar to 6-noncoplanar fields reduced the mean normal brain volume receiving ≥80% of the prescribed dose by a further 4.1% (range -6.5-11.8%, σ = 6.4%), and the volume receiving ≥60% by 3.3% (range -5.5-12.2%, σ = 5.4%), neither of which were statistically significant. Each case must be considered individually however, as a wide range is seen in the volume spared when increasing the number of fields from 4 to 6. Comparing the 4- and 6-field noncoplanar techniques to a 30-field conformal field approach (simulating a dynamic arc plan) revealed near-equivalent normal tissue sparing. Conclusion: Four to six widely spaced, fixed-conformal fields provide the optimum class solution

  10. Meta-analysis of associations between human brain volume and intelligence differences: How strong are they and what do they mean?

    Science.gov (United States)

    Pietschnig, Jakob; Penke, Lars; Wicherts, Jelte M; Zeiler, Michael; Voracek, Martin

    2015-10-01

    Positive associations between human intelligence and brain size have been suspected for more than 150 years. Nowadays, modern non-invasive measures of in vivo brain volume (Magnetic Resonance Imaging) make it possible to reliably assess associations with IQ. By means of a systematic review of published studies and unpublished results obtained by personal communications with researchers, we identified 88 studies examining effect sizes of 148 healthy and clinical mixed-sex samples (>8000 individuals). Our results showed significant positive associations of brain volume and IQ (r=.24, R(2)=.06) that generalize over age (children vs. adults), IQ domain (full-scale, performance, and verbal IQ), and sex. Application of a number of methods for detection of publication bias indicates that strong and positive correlation coefficients have been reported frequently in the literature whilst small and non-significant associations appear to have been often omitted from reports. We show that the strength of the positive association of brain volume and IQ has been overestimated in the literature, but remains robust even when accounting for different types of dissemination bias, although reported effects have been declining over time. While it is tempting to interpret this association in the context of human cognitive evolution and species differences in brain size and cognitive ability, we show that it is not warranted to interpret brain size as an isomorphic proxy of human intelligence differences. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Quantifying brain tissue volume in multiple sclerosis with automated lesion segmentation and filling

    Directory of Open Access Journals (Sweden)

    Sergi Valverde

    2015-01-01

    Full Text Available Lesion filling has been successfully applied to reduce the effect of hypo-intense T1-w Multiple Sclerosis (MS lesions on automatic brain tissue segmentation. However, a study of fully automated pipelines incorporating lesion segmentation and lesion filling on tissue volume analysis has not yet been performed. Here, we analyzed the % of error introduced by automating the lesion segmentation and filling processes in the tissue segmentation of 70 clinically isolated syndrome patient images. First of all, images were processed using the LST and SLS toolkits with different pipeline combinations that differed in either automated or manual lesion segmentation, and lesion filling or masking out lesions. Then, images processed following each of the pipelines were segmented into gray matter (GM and white matter (WM using SPM8, and compared with the same images where expert lesion annotations were filled before segmentation. Our results showed that fully automated lesion segmentation and filling pipelines reduced significantly the % of error in GM and WM volume on images of MS patients, and performed similarly to the images where expert lesion annotations were masked before segmentation. In all the pipelines, the amount of misclassified lesion voxels was the main cause in the observed error in GM and WM volume. However, the % of error was significantly lower when automatically estimated lesions were filled and not masked before segmentation. These results are relevant and suggest that LST and SLS toolboxes allow the performance of accurate brain tissue volume measurements without any kind of manual intervention, which can be convenient not only in terms of time and economic costs, but also to avoid the inherent intra/inter variability between manual annotations.

  12. Vascular territories and watersheds: a zonal frequency analysis of the gyral and sulcal extent of cerebral infarcts. Part I: the anatomic template

    International Nuclear Information System (INIS)

    Naidich, T.P.; Brightbill, T.C.

    2003-01-01

    Our purpose was to establish a template of upper cerebral anatomy suitable for analysis of infarct distribution and for comparison among infarct types. We made a standard diagram of the key gyri and sulci of the supraventricular and occipital regions, partitioned the gray matter and white matter into specific zones useful for analyzing infarcts by CT and MRI, and numbered each zone uniquely in to establish a template suitable for tabulating the precise regions affected by each infarct and for analyzing differences among infarcts. The template provides a method for extracting a standardized set of data from CT or MRI performed at any angle, reconfiguring those data into a standard image, and characterizing the specific portions of infarcted brain in terms of unique numbers suitable for tabulation, collation and comparison. Standardization of the format provides for later computer analysis of increasing numbers of diverse infarcts. This method may be extended to any other type of pathology, although successful analysis of different lesions may require partitioning the gray and white matter zones in different ways. (orig.)

  13. Scintigraphic demonstration of acute myocardial infarcts

    International Nuclear Information System (INIS)

    Holman, B.L.; Lesch, M.

    1976-01-01

    The feasibility of acute infarct scintigraphy for the clinical evaluation of patients with known or suspected acute myocardial infarction is established. Further development of this methodologic approach may result in even better agents for the visualization of infarcts. Radiotracers with high affinity for the infarct, rapid blood clearance, and low concentrations in surrounding organs, such as liver and bone, would be more suitable than available radiopharmaceuticals for acute myocardial infarct scintigraphy. Ultimately, labeling these tracers and ultra-short-lived radionuclides will enable rapid sequential imaging to assess changes in the extent of infarction and to determine the efficacy of therapies aimed at limiting infarct size

  14. De-novo collateral formation following acute myocardial infarction: Dependence on CCR2⁺ bone marrow cells.

    Science.gov (United States)

    Zhang, Hua; Faber, James E

    2015-10-01

    Wide variation exists in the extent (number and diameter) of native pre-existing collaterals in tissues of different strains of mice, with supportive indirect evidence recently appearing for humans. This variation is a major determinant of the wide variation in severity of tissue injury in occlusive vascular disease. Whether such genetic-dependent variation also exists in the heart is unknown because no model exists for study of mouse coronary collaterals. Also owing to methodological limitations, it is not known if ischemia can induce new coronary collaterals to form ("neo-collaterals") versus remodeling of pre-existing ones. The present study sought to develop a model to study coronary collaterals in mice, determine whether neo-collateral formation occurs, and investigate the responsible mechanisms. Four strains with known rank-ordered differences in collateral extent in brain and skeletal muscle were studied: C57BLKS>C57BL/6>A/J>BALB/c. Unexpectedly, these and 5 additional strains lacked native coronary collaterals. However after ligation, neo-collaterals formed rapidly within 1-to-2 days, reaching their maximum extent in ≤7 days. Rank-order for neo-collateral formation differed from the above: C57BL/6>BALB/c>C57BLKS>A/J. Collateral network conductance, infarct volume(-1), and contractile function followed this same rank-order. Neo-collateral formation and collateral conductance were reduced and infarct volume increased in MCP1(-/-) and CCR2(-/-) mice. Bone-marrow transplant rescued collateral formation in CCR2(-/-) mice. Involvement of fractalkine➔CX3CR1 signaling and endothelial cell proliferation were also identified. This study introduces a model for investigating the coronary collateral circulation in mice, demonstrates that neo-collaterals form rapidly after coronary occlusion, and finds that MCP➔CCR2-mediated recruitment of myeloid cells is required for this process. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Cerebral volumes, neuronal integrity and brain inflammation measured by MRI in patients receiving PI monotherapy or triple therapy.

    Science.gov (United States)

    Valero, Ignacio Pérez; Baeza, Alicia Gonzalez; Hernandez-Tamames, Juan Antonio; Monge, Susana; Arnalich, Francisco; Arribas, Jose Ramon

    2014-01-01

    Penetration of protease inhibitors (PI) in the central nervous system (CNS) is limited. Therefore, there are concerns about the capacity of PI monotherapy (MT) to control HIV in CNS and preserve brain integrity. Exploratory case-control study designed to compare neuronal integrity and brain inflammation in HIV-suppressed patients (>2 years) with and without neurocognitive impairment (NI), treated with MT or triple therapy (TT), 3-Tesla cerebral magnetic resonance image (MRI) and spectroscopy (MRS) were used to evaluate neuronal integrity (volume of cerebral structures and MRS levels of N-acetyl-aspartate (NAA)) and brain inflammation (MRS levels of myo-inositol (MI) and choline (CHO)). MRS biomarkers were measured in 4 voxels located in basal ganglia, frontal (2) and parietal lobes. A comprehensive battery of tests (14 tests - 7 domains) was used to diagnose neurocognitive impairment (1). We included 18 neurocognitively impaired patients (MT: 10, TT: 8) and 21 without NI (MT: 9; TT: 12, Table 1). Subset of patients with NI: cerebral volumes and MRS biomarkers were mostly similar between MT and TT with exception of the right cingulate nucleolus volume (MT: 8854±1851 vs TT: 10482±1107 mm(3); p<0.04), CHO levels in basal ganglia (MT: 0.44±0.05 vs TT: 0.37±0.03 MMOL/L; p<0.01) and the NAA levels in parietal lobe (MT: 1.49±0.12 vs 1.70±0.13 MMOL/L; p<0.01). Subset of patients without NI: cerebral volumes and MRS biomarkers were mostly similar between MT and TT with exception of MI levels in frontal lobe (MT: 1.20±0.36 vs 0.81±0.25 MMOL/L; p=0.01). We did not find significant differences in cerebral volumes or MRS biomarkers in most areas of the brain. However, we found higher levels of inflammation and neuronal damage in some brain areas of patients who received MT. This observation has to be taken into caution while we could not adjust our results by potential confounders. Further investigation is needed to confirm these preliminary results.

  16. Global and focal brain volume in long-term breast cancer survivors exposed to adjuvant chemotherapy

    NARCIS (Netherlands)

    Koppelmans, Vincent; de Ruiter, Michiel B.; van der Lijn, Fedde; Boogerd, Willem; Seynaeve, Caroline; van der Lugt, Aad; Vrooman, Henri; Niessen, Wiro J.; Breteler, Monique M. B.; Schagen, Sanne B.

    2012-01-01

    A limited number of studies have associated adjuvant chemotherapy with structural brain changes. These studies had small sample sizes and were conducted shortly after cessation of chemotherapy. Results of these studies indicate local gray matter volume decrease and an increase in white matter

  17. The ischemic perinatal brain damage

    International Nuclear Information System (INIS)

    Crisi, G.; Mauri, C.; Canossi, G.; Della Giustina, E.

    1986-01-01

    The term ''hypoxic-ischemic encephalopathy'' covers a large part of neonatal neuropathology including the various forms of intracerebral haemorrhage. In the present work the term is confined to ischemic brain edema and actual infarction, be it diffuse or focal. Eighteen newborns with CT evidence of ischemic brain lesions and infarctual necrosis were selected. Emphasis is placed on current data on neuropathology of ischemic brain edema and its CT appearance. Particular entities such as periventricular leukomalacia and multicystic encephalopathy are discussed. Relationship between CT and temporal profile of cerebral damage is emphasized in order to predict the structural sequelae and the longterm prognosis

  18. Optimism and the brain: trait optimism mediates the protective role of the orbitofrontal cortex gray matter volume against anxiety.

    Science.gov (United States)

    Dolcos, Sanda; Hu, Yifan; Iordan, Alexandru D; Moore, Matthew; Dolcos, Florin

    2016-02-01

    Converging evidence identifies trait optimism and the orbitofrontal cortex (OFC) as personality and brain factors influencing anxiety, but the nature of their relationships remains unclear. Here, the mechanisms underlying the protective role of trait optimism and of increased OFC volume against symptoms of anxiety were investigated in 61 healthy subjects, who completed measures of trait optimism and anxiety, and underwent structural scanning using magnetic resonance imaging. First, the OFC gray matter volume (GMV) was associated with increased optimism, which in turn was associated with reduced anxiety. Second, trait optimism mediated the relation between the left OFC volume and anxiety, thus demonstrating that increased GMV in this brain region protects against symptoms of anxiety through increased optimism. These results provide novel evidence about the brain-personality mechanisms protecting against anxiety symptoms in healthy functioning, and identify potential targets for preventive and therapeutic interventions aimed at reducing susceptibility and increasing resilience against emotional disturbances. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  19. Effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury; a randomized double-blind placebo-controlled clinical trial.

    Science.gov (United States)

    Farzanegan, Gholam Reza; Derakhshan, Nima; Khalili, Hosseinali; Ghaffarpasand, Fariborz; Paydar, Shahram

    2017-10-01

    The aim of the current study was to investigate the effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury (TBI). The study was conducted as a randomized clinical trial during a 16-month period from May 2015 and August 2016 in a level I trauma center in Shiraz, Southern Iran. We included 65 patients with moderate (GCS: 9-13) to severe (GCS: 5-8) TBI who had brain contusions of less than 30cc volume. We excluded those who required surgical intervention. Patients were randomly assigned to receive daily 20mg atorvastatin for 10days (n=21) or placebo in the same dosage (n=23). The brain contusion volumetry was performed on days 0, 3 and 7 utilizing spiral thin-cut brain CT-Scan (1-mm thickness). The outcome measured included modified Rankin scale (MRS), Glasgow Outcome Scale (GOS) and Disability rating Scale (DRS) which were all evaluated 3months post-injury. There was no significant difference between two study group regarding the baseline, 3rd day and 7th day of the contusion volume and the rate of contusion expansion. However, functional outcome scales of GOS, MRS and DRS at 3-months post-injury were significantly better in atorvastatin arm of the study compared to placebo (p values of 0.043, 0.039 and 0.030 respectively). Even though atorvastatin was not found to be more effective than placebo in reducing contusion expansion rate, it was associated with improved functional outcomes at 3-months following moderate to severe TBI. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Glyceraldehyde-3-phosphate dehydrogenase versus toluidine blue as a marker for infarct volume estimation following permanent middle cerebral artery occlusion in mice

    DEFF Research Database (Denmark)

    Clausen, Bettina Hjelm; Lambertsen, Kate Lykke; Finsen, Bente

    2006-01-01

    Infarct size is a good predictor of the neurological outcome following stroke. Estimation of infarct size in the early phase following experimental stroke depends on the availability of reliable techniques that can distinguish ischemic from nonischemic tissue. The objective of this study was to p......Infarct size is a good predictor of the neurological outcome following stroke. Estimation of infarct size in the early phase following experimental stroke depends on the availability of reliable techniques that can distinguish ischemic from nonischemic tissue. The objective of this study...... was to provide a simple and robust method for reliable delineation of the ischemic infarct area in fresh frozen cryosections from mice subjected to focal cerebral ischemia. Mice were subjected to permanent middle cerebral artery (MCA) occlusion and euthanised after 30 min, 1, 2, 4, 6, 12 and 24 h. The size......RNA in areas prone to undergo degeneration 30 min to 1 h after MCA occlusion, thereby preceding visible pycnosis in TB-stained sections. The results showed that in situ hybridization for GAPDH mRNA was a reliable method and superior to TB staining for precise infarct delineation prior to 6 h of permanent MCA...