Selective Diffusion Changes of The Visual Pathways in Patients with Migraine: A 3-T Tractography Study

Cephalalgia ◽  
2008 ◽  
Vol 28 (10) ◽  
pp. 1061-1068 ◽  
Author(s):  
MA Rocca ◽  
E Pagani ◽  
B Colombo ◽  
P Tortorella ◽  
A Falini ◽  
...  
Keyword(s):  
Structural Changes ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Clinical Manifestations ◽  
Mean Diffusivity ◽  
Structural Mri ◽  
Visual Aura ◽  
Selective Diffusion ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Using diffusion tensor (DT) tractography, we quantified optic radiation (OR) structural changes in seven migraine patients with (MA) and eight without visual aura (MoA) and their relation to clinical manifestations and T2-visible burden. The corticospinal tract and the corpus callosum were studied as ‘control’ white matter (WM). No difference was found for any of the WM fibre bundles metrics between controls and MoA patients. MA patients had reduced average fractional anisotropy (FA) of both OR compared with controls and reduced average FA of the right OR compared with MoA patients. They also showed higher right OR mean diffusivity than controls. OR metrics were not correlated with clinical and magnetic resonance imaging (MRI) metrics. DT tractography reveals OR changes in MA patients that might represent a phenotypic biomarker of the disease given the lack of correlation with clinical and structural MRI metrics.

Migraine affects white-matter tract integrity: A diffusion-tensor imaging study

Cephalalgia ◽  
2015 ◽  
Vol 35 (13) ◽  
pp. 1162-1171 ◽  
Author(s):  
Catherine D Chong ◽  
Todd J Schwedt
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Imaging Study ◽  
White Matter Tract ◽  
Inferior Longitudinal Fasciculus ◽  
Left And Right ◽  
The Right

Background Specific white-matter tract alterations in migraine remain to be elucidated. Using diffusion tensor imaging (DTI), this study investigated whether the integrity of white-matter tracts that underlie regions of the “pain matrix” is altered in migraine and interrogated whether the number of years lived with migraine modifies fibertract structure. Methods Global probabilistic tractography was used to assess the anterior thalamic radiations, the corticospinal tracts and the inferior longitudinal fasciculi in 23 adults with migraine and 18 healthy controls. Results Migraine patients show greater mean diffusivity (MD) in the left and right anterior thalamic radiations, the left corticospinal tract, and the right inferior longitudinal fasciculus tract. Migraine patients also show greater radial diffusivity (RD) in the left anterior thalamic radiations, the left corticospinal tract as well as the left and right inferior longitudinal fasciculus tracts. No group fractional anisotropy (FA) differences were identified for any tracts. Migraineurs showed a positive correlation between years lived with migraine and MD in the right anterior thalamic radiations ( r = 0.517; p = 0.012) and the left corticospinal tract ( r = 0.468; p = 0.024). Conclusion Results indicate that white-matter integrity is altered in migraine and that longer migraine history is positively correlated with greater alterations in tract integrity.

Posterior fossa syndrome and increased mean diffusivity in the olivary bodies

2019 ◽  
Vol 24 (4) ◽  
pp. 376-381
Author(s):  
Derek Yecies ◽  
Rashad Jabarkheel ◽  
Michelle Han ◽  
Yong-Hun Kim ◽  
Lisa Bruckert ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Diffusion Tensor ◽  
Statistical Significance ◽  
Mean Diffusivity ◽  
Pediatric Brain Tumor ◽  
Structural Mri ◽  
Early Imaging ◽  
T2 Hyperintensity ◽  
The Right ◽  
Inferior Olivary

OBJECTIVEPosterior fossa syndrome (PFS) is a common postoperative complication following resection of posterior fossa tumors in children. It typically presents 1 to 2 days after surgery with mutism, ataxia, emotional lability, and other behavioral symptoms. Recent structural MRI studies have found an association between PFS and hypertrophic olivary degeneration, which is detectable as T2 hyperintensity in the inferior olivary nuclei (IONs) months after surgery. In this study, the authors investigated whether immediate postoperative diffusion tensor imaging (DTI) of the ION can serve as an early imaging marker of PFS.METHODSThe authors retrospectively reviewed pediatric brain tumor patients treated at their institution, Lucile Packard Children’s Hospital at Stanford, from 2004 to 2016. They compared the immediate postoperative DTI studies obtained in 6 medulloblastoma patients who developed PFS to those of 6 age-matched controls.RESULTSPatients with PFS had statistically significant increased mean diffusivity (MD) in the left ION (1085.17 ± 215.51 vs 860.17 ± 102.64, p = 0.044) and variably increased MD in the right ION (923.17 ± 119.2 vs 873.67 ± 60.16, p = 0.385) compared with age-matched controls. Patients with PFS had downward trending fractional anisotropy (FA) in both the left (0.28 ± 0.06 vs 0.23 ± 0.03, p = 0.085) and right (0.29 ± 0.06 vs 0.25 ± 0.02, p = 0.164) IONs compared with age-matched controls, although neither of these values reached statistical significance.CONCLUSIONSIncreased MD in the ION is associated with development of PFS. ION MD changes may represent an early imaging marker of PFS.

scholarly journals Injury of Corticospinal Tract in a Patient with Subarachnoid Hemorrhage as Determined by Diffusion Tensor Tractography: A Case Report

2020 ◽  
Vol 10 (3) ◽  
pp. 177 ◽  
Author(s):  
Chan-Hyuk Park ◽  
Hyeong Ryu ◽  
Chang-Hwan Kim ◽  
Kyung-Lim Joa ◽  
Myeong-Ok Kim ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Diffusion Tensor Tractography ◽  
Lower Limbs ◽  
Anterior Communicating Artery ◽  
Motor Weakness ◽  
Corona Radiata ◽  
The Right

We report diffusion tensor tractography (DTT) of the corticospinal tract (CST) in a patient with paresis of all four limbs following subarachnoid hemorrhage (SAH) with intraventricular hemorrhage (IVH) after the rupture of an anterior communicating artery (ACoA) aneurysm rupture. The 73-year-old female was admitted to our emergency room in a semi-comatose mental state. After coil embolization—an acute SAH treatment—she was transferred to our rehabilitation department with motor weakness development, two weeks after SAH. Upon admission, she was alert but she complained of motor weakness (upper limbs: MRC 3/5, and lower limbs: MRC 1/5). Four weeks after onset, DTT showed that the bilateral CSTs failed to reach the cerebral cortex. The left CST demonstrated a wide spread of fibers within the corona radiata as well as significantly lower tract volume (TV) and higher fractional anisotropy (FA) as well as mean diffusivity (MD) compared to the controls. On the other hand, the right CST shifted to the posterior region at the corona radiata, and MD values of the right CST were significantly higher when compared to the controls. Changes in both CSTs were attributed to vasogenic edema and compression caused by untreated hydrocephalus. We demonstrate in this case, two different pathophysiological entitles, contributing to this patient’s motor weakness after SAH.

Structural brain changes after 4 wk of unilateral strength training of the lower limb

2013 ◽  
Vol 115 (2) ◽  
pp. 167-175 ◽  
Author(s):  
H. S. Palmer ◽  
A. K. Håberg ◽  
M. S. Fimland ◽  
G. M. Solstad ◽  
V. Moe Iversen ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Strength Training ◽  
Isometric Contraction ◽  
Healthy Adult ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Cortical Activation ◽  
Maximum Voluntary Isometric Contraction ◽  
The Right ◽  
Unilateral Strength Training

Strength training enhances muscular strength and neural drive, but the underlying neuronal mechanisms remain unclear. This study used magnetic resonance imaging (MRI) to identify possible changes in corticospinal tract (CST) microstructure, cortical activation, and subcortical structure volumes following unilateral strength training of the plantar flexors. Mechanisms underlying cross-education of strength in the untrained leg were also investigated. Young, healthy adult volunteers were assigned to training ( n = 12) or control ( n = 9) groups. The 4 wk of training consisted of 16 sessions of 36 unilateral isometric plantar flexions. Maximum voluntary isometric contraction torque was tested pre- and posttraining. MRI investigation included a T1-weighted scan, diffusion tensor imaging and functional MRI. Probabilistic fiber tracking of the CST was performed on the diffusion tensor imaging images using a two-regions-of-interest approach. Fractional anisotropy and mean diffusivity were calculated for the left and right CST in each individual before and after training. Standard functional MRI analyses and volumetric analyses of subcortical structures were also performed. Maximum voluntary isometric contraction significantly increased in both the trained and untrained legs of the training group, but not the control group. A significant decrease in mean diffusivity was found in the left CST following strength training of the right leg. No significant changes were detected in the right CST. No significant changes in cortical activation were observed following training. A significant reduction in left putamen volume was found after training. This study provides the first evidence for strength training-related changes in white matter and putamen in the healthy adult brain.

Lateral Medullary Infarction with Contralateral Segmental Dysesthesia and Ipsilateral Headache: A Case Report

2021 ◽  
Vol 17 ◽  
Author(s):  
Renjie Wang ◽  
Yankun Shao ◽  
Lei Xu
Keyword(s):  
Medulla Oblongata ◽  
Clinical Manifestations ◽  
Lateral Medullary Infarction ◽  
Case Presentation ◽  
Specific Sign ◽  
Temperature Sense ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
The Brain ◽  
Medullary Infarction

Introduction: The medulla oblongata is the lowest segment of the brain stem, located adjacent to the spinal cord, with a complex anatomical structure. Thus, a small injury to the medulla oblongata can show complex clinical manifestations. Case Presentation: A patient experienced dysesthesia, which manifested as numbness in her right lower limb and decreased temperature sense, and dizziness 20 days before admission. The numbness worsened 1 week before admission, reaching the right thoracic (T) 12 dermatomes. Her thermoception below the T12 dermatomes decreased, and the degree of dizziness increased, accompanied by nausea and vomiting. Magnetic resonance imaging (MRI) of the neck, chest, and abdomen performed at a local hospital showed no abnormalities. MRI of the brain was performed after admission. One week after admission, she experienced a severe headache in the upper left periorbital area. The numbness extended to T4, and thermoception decreased below T4. Diagnosis: Lateral medullary infarction. Interventions: Anti-platelet aggregation and mitochondrial nutritional therapies were performed along with treatments for improving circulation and establishing collateral circulation. Outcomes: The intensity of limb numbness decreased, and the symptoms of headache and dizziness resolved. Conclusion: Lesions leading to segmental sensory disorders can occur in the medulla oblongata. Ipsilateral headaches with contralateral segmental paresthesia can be a specific sign of lateral medullary infarction.

scholarly journals Diffusion Tensor Imaging Evaluation of Corticospinal Tract Hyperintensity in Upper Motor Neuron-Predominant ALS Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Venkateswaran Rajagopalan ◽  
Didier Allexandre ◽  
Guang H. Yue ◽  
Erik P. Pioro
Keyword(s):  
Diffusion Tensor Imaging ◽  
Motor Neuron ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Internal Capsule ◽  
Proton Density ◽  
Imaging Evaluation ◽  
Axonal Pathology ◽  
Als Patients

Amyotrophic lateral sclerosis (ALS) patients with predominant upper motor neuron (UMN) signs occasionally have hyperintensity of corticospinal tract (CST) on T2- and proton-density-(PD-) weighted brain images. Diffusion tensor imaging (DTI) was used to assess whether diffusion parameters along intracranial CST differ in presence or absence of hyperintensity and correspond to UMN dysfunction. DTI brain scans were acquired in 47 UMN-predominant ALS patients with (n=21) or without (n=26) CST hyperintensity and in 10 control subjects. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured in four regions of interests (ROIs) along CST. Abnormalities (P<0.05) were observed in FA, AD, or RD in CST primarily at internal capsule (IC) level in ALS patients, especially those with CST hyperintensity. Clinical measures corresponded well with DTI changes at IC level. The IC abnormalities suggest a prominent axonopathy in UMN-predominant ALS and that tissue changes underlying CST hyperintensity have specific DTI changes, suggestive of unique axonal pathology.

scholarly journals Thalamic and thalamic projection abnormalities on DTI and NODDI analysis following acute concussion

Neurology ◽  
2019 ◽  
Vol 93 (14 Supplement 1) ◽  
pp. S4.2-S5
Author(s):  
James Houston ◽  
Frank Skidmore ◽  
William Monroe ◽  
Jon Amburgy ◽  
Mitchell Self
Keyword(s):  
White Matter ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Oculomotor System ◽  
White Matter Injury ◽  
Football Players ◽  
Cortical Regions ◽  
The Right ◽  
Collegiate Football ◽  
Concussive Injury

ObjectiveTo compare preseason and post-concussive MRI in a cohort of collegiate football players utilizing Diffusion Tensor Imaging (DTI) and Neurite Orientation Dispersion and Density Imaging (NODDI) post processing.BackgroundAcute post-concussive symptoms can vary in clinical characteristics and severity. However, vestibular and ocular dysfunction in particular, has been associated with poor clinical outcomes. The vestibular system comprises a complex network of projections from peripheral vestibular organs to thalamic relay systems and numerous cortical regions. The visual/oculomotor system is also complex, involving brainstem, subcortical-cortical and thalamo-cortical connections. Oculomotor deficits are thought to involve the midbrain and the visual and parietal association cortices, both of which have thalamic projections.Design/MethodsWe gathered pre-season MR diffusion weighted imaging on a cohort of 30 collegiate football players. We performed repeat imaging within 36 hours of any diagnosed concussion in the same subject cohort. DTI metrics: mean diffusivity (MD), axial diffusivity (AD), fractional anisotropy (FA), and radial diffusivity (RD) along with NODDI metric: orientation dispersion index (ODI), were analyzed for statistical comparisons between groups.Results4 subjects with pre-season MRI underwent repeat MRI within 36 hours of concussive injury. A paired t-test between these two groups using DTI and NODDI metrics showed significant (p < 0.05) decreases in: AD and MD in the left posterior thalamic radiations, FA in the column and body of the fornix, and MD in the right anterior corona radiata and superior fronto-occipital fasciculus, and a significant decrease in ODI in the anterior thalamus.ConclusionsDisruptions in the thalamus and its white matter projections may play a role in the vestibular/ocular dysfunction associated with acute concussive injury. While our numbers are small, the findings suggest that DTI and NODDI processing techniques have the capability to locate and measure grey and white matter injury patterns after concussive injury.

scholarly journals Loss of corticospinal tract integrity in early MS disease stages

2017 ◽  
Vol 4 (6) ◽  
pp. e399 ◽  
Author(s):  
Marc Pawlitzki ◽  
Jens Neumann ◽  
Jörn Kaufmann ◽  
Jan Heidel ◽  
Erhard Stadler ◽  
...  
Keyword(s):  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Group Differences ◽  
Disability Score ◽  
Brain Volumes ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Disease Stages ◽  
Diffusion Tensor Imaging Dti

Objective:We investigated corticospinal tract (CST) integrity in the absence of white matter (WM) lesions using diffusion tensor imaging (DTI) in early MS disease stages.Methods:Our study comprised 19 patients with clinically isolated syndrome (CIS), 11 patients with relapsing-remitting MS (RRMS), and 32 age- and sex-matched healthy controls, for whom MRI measures of CST integrity (fractional anisotropy [FA], mean diffusivity [MD]), T1- and T2-based lesion load, and brain volumes were available. The mean (SD) disease duration was 3.5 (2.1) months, and disability score was low (median Expanded Disability Status Scale 1.5) at the time of the study.Results:Patients with CIS and RRMS had significantly lower CST FA and higher CST MD values compared with controls. These findings were present, irrespective of whether WM lesions affected the CST. However, no group differences in the overall gray or WM volume were identified.Conclusions:In early MS disease stages, CST integrity is already affected in the absence of WM lesions or brain atrophy.

scholarly journals Primary Hepatic Choriocarcinoma in a Male Patient: A Case Report and Literature Review

2021 ◽  
Author(s):  
Ke Zhao ◽  
Ke Rao ◽  
Xin Chen ◽  
Si Chen ◽  
Haifeng Xu
Keyword(s):  
Male Patient ◽  
Malignant Tumor ◽  
Poor Prognosis ◽  
Clinical Manifestations ◽  
Deep Understanding ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Fdg Pet Ct

Abstract BackgroundChoriocarcinoma is a rare malignant tumor and rarely occurs outside the gonads. Primary hepatic choriocarcinoma is more infrequent, with hidden clinical manifestations, rapid progress, and extremely poor prognosis. Only more than 10 cases were publicly reported in the world. Therefore, there is still a lack of deep understanding of the diagnosis and treatment of the disease.Case presentationWe report a case of primary hepatic choriocarcinoma in a man diagnosed by pathology. A 65-year-old male patient presented with fever and anorexia, nothing but mild jaundice of the skin and sclera was found on physical examination. Abdominal enhanced magnetic resonance imaging (MRI) showed a huge mass in the right hepatic lobe. Fludeoxyglucose-positron emission tomography-computed tomography (FDG-PET/CT) scan showed increased uptake in the liver and sigmoid colon and no uptake in the testes. The patient underwent the right hepatectomy, and postoperative pathology showed that the tumor was primary hepatic choriocarcinoma. Then he received one course of adjuvant chemotherapy. Then he developed severe myelosuppression and was transferred to the intensive care unit for further treatment. He eventually died of severe liver failure about 100 days after surgery. Primary hepatic choriocarcinoma is extremely rare, and its diagnosis is challenging.ConclusionsPrimary hepatic choriocarcinoma is a rare and highly malignant tumor with a poor prognosis. We believe that this differential diagnosis should be considered in liver tumor patients. The effective treatment for this disease is still to be explored.

scholarly journals Accessory and Cavitated Uterine Mass (ACUM) in an 18-Year-Old Woman: A Case Report and Literature Review

2022 ◽  
Author(s):  
HaiJing He ◽  
XuZhi Liang ◽  
Jiangtao Fan
Keyword(s):  
Laparoscopic Surgery ◽  
Medical Therapy ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Mullerian Anomaly ◽  
Gynecological Disease ◽  
Inflammatory Drugs ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Benign Gynecological Disease

Abstract Background Accessory and cavitated uterine mass (ACUM) is a rare uterine anomaly newly recognized as a form of developmental Mullerian anomaly, which represents a non-communicating uterus-like mass within an otherwise normal uterus. It is a benign gynecological disease associated with severe dysmenorrhea and chronic pelvic pain, which is most common in young nullipara women, and sometimes develops in parous women. Clinical manifestations combined with imaging examinations including ultrasonography (USG), magnetic resonance imaging (MRI), and hysterosalpingography (HSG) are the means to establish a correct diagnosis. Medical therapy is only marginally effective, but laparoscopic surgery for complete mass excision is a feasible technique to relieve patient’s symptoms. Our article is aimed to report a case of ACUM in an 18-year-old woman and summarize the diagnostic criteria of ACUM. Case presentation : An 18-year-old woman was admitted for severe pain in the right lower abdomen during menstruation, which lasted more than 1 year. The patient was misdiagnosed with focal adenomyosis at our hospital on March 4, 2021. After 4 months, she was diagnosed with ACUM. Once diagnosis as focal adenomyosis, nonsteroidal anti-inflammatory drugs (NSAIDs) and gestrinone were administered to the patient. Following the diagnosis of ACUM, she received laparoscopic surgery. Our follow-up indicated that the symptom was significantly relief without drug therapy after sixty days postoperatively. Conclusions Clinical manifestations and imaging examinations are used to establish the diagnosis of ACUM. Medical therapy is only marginally effective, but laparoscopic surgery for complete mass excision is a feasible technique to solve the pain symptom. The prevalence and pathogenesis of ACUM and its reproductive outcomes on patients remain unclear, which calls for more and deeper research to study.

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