Abstract W P158: Permeability as a Biomarker of Cavernous Malformations

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Abdul Ghani Mikati ◽  
Luying Li ◽  
Robert Shenkar ◽  
Lingjao Zhang ◽  
Xiaodong Guo ◽  
...  
Keyword(s):  
White Matter ◽  
Disease Activity ◽  
Grey Matter ◽  
Response To Treatment ◽  
Cavernous Malformations ◽  
Familial Cases ◽  
Coefficients Of Variation ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Over Time

Introduction: Vascular hyperpermeability in lesions and nonlesional brain is a cardinal feature of cerebral cavernous malformation (CCM) pathogenesis. Thus we implemented a novel magnetic resonance imaging (MRI) technique in order to quantitate vascular permeability in CCMs and non-CCM brain tissue in humans. We hypothesize that permeability of lesions and background brain will differ between familial and sporadic patients and measurements will be consistent between observers and over time. Method: We used a T 1 -weighted dynamic contrast-enhanced quantitative perfusion (DCEQP) protocol in 30 patients (13 sporadic, 12 familial, and 5 non-CCM cases) in conjunction with routine MRI scans. Regions of interest (ROIs) for permeability measurement included the entire lesion and areas of 12.9 mm 2 (16 pixels) of grey and white matter near and far from the lesion. Measurements were repeated by two observers and at two time points on a subset of patients. Results: For each ROI category except white matter near lesions, the mean permeability was higher in the familial than in the sporadic patients with p-values of 0.04, 0.005, 0.05, and 0.007 for CCM lesions, grey matter near, grey matter far (GMF), and white matter far (WMF) from lesions respectively. No difference was seen between sporadic and non-CCM cases, however familial WMF had higher permeability than both those groups (p0.05) except GMF with p=0.04. The intrapatient coefficients of variation between measurements were 0.74 and 0.63 and interpatient coefficients of variation were 1.36 and 1.56 for sporadic and familial cases respectively. Lastly, it was found that 3 of 4 patients with two scans had stable background (WMF) brain permeability over time. Conclusion: Results show the higher lesional and background brain permeability of familial cases, corroborating previous findings in mice. We also demonstrate the feasibility of DCEQP in CCM disease and the potential of permeability as a biomarker of disease activity or response to treatment. It also highlights the need for further investigation into clinical factors that may impact disease activity and permeability measures.

Are there structural brain changes following 10 days of SSRI administration investigated by voxel-based morphometry?

2011 ◽  
Vol 26 (S2) ◽  
pp. 913-913
Author(s):  
P. Baldinger ◽  
M. Savli ◽  
G.S. Kranz ◽  
A. Höflich ◽  
C. Kraus ◽  
...  
Keyword(s):  
White Matter ◽  
Psychotropic Drugs ◽  
Grey Matter ◽  
Structural Changes ◽  
Double Blind Study ◽  
Voxel Based Morphometry ◽  
Double Blind ◽  
Structural Alterations ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

IntroductionThere is evidence that psychiatric diseases are accompanied by structural alterations in the human brain, partly reversible by pharmacological treatments. Several studies including Tost et al. (Nat.Neurosci.2010;13(8):920-2) investigated the effect of psychotropic drugs on neuronal plasticity pointing towards rapid pharmacologically induced brain grey matter variations, apart from already presumed slow structural changes within weeks. Here, we investigated the short-term (days) structural effects of SSRIs.ObjectiveTo identify structural changes of grey and white matter following 10d of oral administration (citalopram/escitalopram vs. placebo) in 18 healthy subjects investigated by magnetic resonance imaging (MRI) using voxel-based morphometry (VBM).MethodsStudy design: Randomized, cross-over, placebo-controlled, double-blind study.Subjects: 18 healthy caucasian subjects (6 female 24.8 ± 2.5 years, 12 males 28.9 ± 6.7 years) MRI: 3 MRI scans/subject (3 Tesla scanner)Treatment: 10d of oral medication intake of either 20 mg citalopram/d, 10 mg escitalopram/d or placebo in alternating order of administrationData analysis: VBM, as implemented in SPM8.Statistical analysis: analysis of variance (ANOVA, FWE corrected), post-hoc pair-wise comparisons.ResultsANOVA (grey matter: F(2,48) = 18.85, p < 0.05; white matter: F(2,48) = 17.79, p < 0.05) did not reveal suprathreshold clusters in grey or white matter.ConclusionThis VBM-study does not support previous short-time (days) MR findings of pharmacologically-induced structural alterations in the brain, considering the lack of significant changes in grey and white matter volumes following 10d of SSRI administration. This divergence may be caused by dissent pharmacological effects of SSRIs compared to other psychotropic drugs.

scholarly journals White Matter Hyperintensities Predict Cognitive Decline: A Community-Based Study

2019 ◽  
Vol 46 (04) ◽  
pp. 383-388 ◽  
Author(s):  
Xuemei Qi ◽  
Huidong Tang ◽  
Qi Luo ◽  
Bei Ding ◽  
Jie Chen ◽  
...  
Keyword(s):  
White Matter ◽  
Cognitive Decline ◽  
White Matter Hyperintensities ◽  
Smoking Status ◽  
Brain Magnetic Resonance Imaging ◽  
The Elderly ◽  
Brain Regions ◽  
Cholinergic Pathways ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri

ABSTRACT:Introduction: White matter hyperintensities (WMHs) were commonly seen in brain magnetic resonance imaging (MRI) of the elderly. Many studies found that WMHs were associated with cognitive decline and dementia. However, the association between WMHs in different brain regions and cognitive decline remains debated. Methods: We explored the association of the severity of WMHs and cognitive decline in 115 non-demented elderly (≥50 years old) sampled from the Wuliqiao Community located in urban area of Shanghai. MRI scans were done during 2009–2011 at the beginning of the study. Severity of WMHs in different brain regions was scored by Improved Scheltens Scale and Cholinergic Pathways Hyperintensities Scale (CHIPS). Cognitive function was evaluated by Mini-Mental State Examination (MMSE) every 2 to 4 years during 2009–2018. Results: After adjusting for confounding factors including age, gender, education level, smoking status, alcohol consumption, depression, hypertension, diabetes, hyperlipidemia, brain infarcts, brain atrophy, apoE4 status, and baseline MMSE score, periventricular and subcortical WMH lesions as well as WMHs in cholinergic pathways were significantly associated with annual MMSE decline ( p &lt; 0.05), in which the severity of periventricular WMHs predicted a faster MMSE decline (–0.187 points/year, 95% confidence interval: –0.349, –0.026, p = 0.024). Conclusions: The severity of WMHs at baseline was associated with cognitive decline in the non-demented elderly over time. Interventions on WMH lesions may offer some benefits for cognitive deterioration.

scholarly journals In vivo detection of connectivity between cortical and white matter lesions in early MS

2016 ◽  
Vol 23 (7) ◽  
pp. 973-981 ◽  
Author(s):  
Jan-Mendelt Tillema ◽  
Stephen D Weigand ◽  
Jay Mandrekar ◽  
Yunhong Shu ◽  
Claudia F Lucchinetti ◽  
...  
Keyword(s):  
White Matter ◽  
Diffusion Tensor ◽  
White Matter Lesions ◽  
Cortical Lesion ◽  
In Vivo Detection ◽  
Relapsing Remitting ◽  
Mri Scans ◽  
Healthy Control ◽  
Magnetic Resonance Imaging Mri

Background: The relationship between cortical lesions (CLs) and white matter lesions (WMLs) in multiple sclerosis (MS) is poorly understood. Pathological studies support a topographical association between CLs and underlying subcortical WMLs and suggest CLs may play a role in both disease initiation and progression. We hypothesized that cortical MS lesions are physically connected to white matter MS lesions via axonal connections. Objective: To assess the presence of CL-WML connectivity utilizing novel magnetic resonance imaging (MRI) methodology. Methods: In all, 28 relapsing-remitting MS patients and 25 controls received 3 T MRI scans, including double inversion recovery (DIR) for CL detection coupled with diffusion tensor imaging (DTI). CL and WML maps were created, and DTI was used to calculate inter-lesional connectivity and volumetric connectivity indices. Results: All patients showed inter-lesional WML connectivity (median 76% of WMLs connected to another WML; interquartile range (IQR), 58%–88%). On average, 52% of detected CLs per patient were connected to at least one WML (IQR, 42%–71%). Volumetric connectivity analysis showed significantly elevated cortical lesion ratios in MS patients (median, 2.3; IQR, 1.6–3.3) compared to null MS and healthy control datasets ( p < 0.001). Conclusion: These findings provide strong evidence of inter-lesional connectivity between CLs and WMLs, supporting our hypothesis of intrinsic CL-WML connectivity.

scholarly journals White matter volume changes in people who develop psychosis

2008 ◽  
Vol 193 (3) ◽  
pp. 210-215 ◽  
Author(s):  
Mark Walterfang ◽  
Philip K. McGuire ◽  
Alison R. Yung ◽  
Lisa J. Phillips ◽  
Dennis Velakoulis ◽  
...  
Keyword(s):  
White Matter ◽  
Grey Matter ◽  
White Matter Volume ◽  
Volume Changes ◽  
Matter Volume ◽  
Original Group ◽  
Magnetic Resonance Imaging Mri ◽  
Longitudinal Comparison ◽  
The Right

BackgroundGrey matter changes have been described in individuals who are pre- and peri-psychotic, but it is unclear if these changes are accompanied by changes in white matter structures.AimsTo determine whether changes in white matter occur prior to and with the transition to psychosis in individuals who are pre-psychotic who had previously demonstrated grey matter reductions in frontotemporal regions.MethodWe used magnetic resonance imaging (MRI) to examine regional white matter volume in 75 people with prodromal symptoms. A subset of the original group (n=21) were rescanned at 12–18 months to determine white matter volume changes. Participants were retrospectively categorised according to whether they had or had not developed psychosis at follow-up.ResultsComparison of the baseline MRI data from these two subgroups revealed that individuals who later developed psychosis had larger volumes of white matter in the frontal lobe, particularly in the left hemisphere. Longitudinal comparison of data in individuals who developed psychosis revealed a reduction in white matter volume in the region of the left fronto-occipital fasciculus. Participants who had not developed psychosis showed no reductions in white matter volume but increases in a region subjacent to the right inferior parietal lobule.DiscussionThe reduction in volume of white matter near the left fronto-occipital fasciculus may reflect a change in this tract in association with the onset of frank psychosis.

The Nature and Fate of Punctate (Type IV) Cavernous Malformations

Neurosurgery ◽  
2001 ◽  
Vol 49 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Richard E. Clatterbuck ◽  
Ilhan Elmaci ◽  
Daniele Rigamonti
Keyword(s):  
Cavernous Malformation ◽  
Proton Density ◽  
Type I ◽  
Gradient Echo ◽  
Cavernous Malformations ◽  
Type Iv ◽  
Mri Scans ◽  
T1 And T2 ◽  
Over Time ◽  
T2 Weighted Images

Abstract OBJECTIVE Four types of cavernous malformations (Types I–IV) have been described on the basis of their magnetic resonance imaging (MRI) appearance. The nature of the Type IV cavernous malformation is unclear. It has been suggested that these small lesions, which are well observed only on gradient echo MRI scans, are capillary telangiectasias. We sought to understand the relationship of Type IV cavernous malformations to the other cavernous malformation subtypes. METHODS We examined serial MRI scans obtained between 1987 and 2000 from 68 patients with more than 228 cavernous malformations. Sixteen patients harbored Type IV cavernous malformations (total, &gt;114 Type IV lesions). Spin echo T1-weighted, T2-weighted, proton density, and (when available) gradient echo MRI scans were reviewed. Cavernous malformations that met the Zabramski criteria for Type IV (poorly observed on T1- and T2-weighted images) were reviewed in serial scans from individual patients to characterize their radiographic behavior over time. RESULTS Type IV cavernous malformations were best observed on gradient echo images and have an MRI appearance distinct from capillary telangiectasias. Proton density images demonstrate more Type IV lesions than T1- and T2-weighted images, but far fewer Type IV lesions than gradient echo images. When observed on T1- and T2-weighted images, Type IV cavernous malformations are generally punctate and hypointense. These lesions rarely enhance with gadolinium. Four of the Type IV cavernous malformations observed serially evolved into Type I and Type II cavernous malformations, for an approximate rate of progression of 0.05 per patient year. CONCLUSION Although most Type IV cavernous malformations remain stable over time, a small subset of these lesions progress into Types I and II cavernous malformations.

scholarly journals Idiopathic Normal Pressure Hydrocephalus: Cerebral Perfusion Measured with pCASL before and Repeatedly after CSF Removal

2014 ◽  
Vol 34 (11) ◽  
pp. 1771-1778 ◽  
Author(s):  
Johan Virhammar ◽  
Katarina Laurell ◽  
André Ahlgren ◽  
Kristina Giuliana Cesarini ◽  
Elna-Marie Larsson
Keyword(s):  
White Matter ◽  
Normal Pressure Hydrocephalus ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Regional Variability ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Gait Function

Pseudo-continuous arterial spin labeling (pCASL) measurements were performed in 20 patients with idiopathic normal pressure hydrocephalus (iNPH) to investigate whether cerebral blood flow (CBF) increases during the first 24 hours after a cerebrospinal fluid tap test (CSF TT). Five pCASL magnetic resonance imaging (MRI) scans were performed. Two scans were performed before removal of 40 mL CSF, and the other three at 30 minutes, 4 hours, and 24 hours, respectively after the CSF TT. Thirteen different regions of interest (ROIs) were manually drawn on coregistered MR images. In patients with increased CBF in lateral and frontal white matter after the CSF TT, gait function improved more than it did in patients with decreased CBF in these regions. However, in the whole sample, there was no significant increase in CBF after CSF removal compared with baseline investigations. The repeatability of CBF measurements at baseline was high, with intraclass correlation coefficients of 0.60 to 0.90 for different ROIs, but the median regional variability was in the range of 5% to 17%. Our results indicate that CBF in white matter close to the lateral ventricles plays a role in the reversibility of symptoms after CSF removal in patients with iNPH.

scholarly journals Synthesis of High-Resolution Research-Quality MRI Data from Clinical MRI Data in Patients with COVID-19

2021 ◽  
Author(s):  
Ryan J Cali ◽  
Holly J Freeman ◽  
Benjamin Billot ◽  
Megan E Barra ◽  
David Fischer ◽  
...  
Keyword(s):  
White Matter ◽  
High Resolution ◽  
Neurological Disorders ◽  
Grey Matter ◽  
Brain Lesion ◽  
Research Quality ◽  
Quality Data ◽  
Focal Lesions ◽  
Mri Scans ◽  
Clinical Mri

Pathophysiological mechanisms of neurological disorders in patients with coronavirus disease 2019 (COVID-19) are poorly understood, partly because of a lack of high-resolution neuroimaging data. We applied SynthSR, a convolutional neural network that synthesizes high-resolution isotropic research-quality data from thick-slice clinical MRI data, to a cohort of 11 patients with severe COVID-19. SynthSR successfully synthesized T1-weighted MPRAGE data at 1 mm spatial resolution for all 11 patients, each of whom had at least one brain lesion. Correlations between volumetric measures derived from synthesized and acquired MPRAGE data were strong for the cortical grey matter, subcortical grey matter, brainstem, hippocampus, and hemispheric white matter (r=0.84 to 0.96, p≤0.001), but absent for the cerebellar white matter and corpus callosum (r=0.04 to 0.17, p>0.61). SynthSR creates an opportunity to quantitatively study clinical MRI scans and elucidate the pathophysiology of neurological disorders in patients with COVID-19, including those with focal lesions.

scholarly journals P269 Longitudinal patterns of pain distribution in axSpA patients: a retrospective cohort study

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Revathi Nishtala ◽  
Rosie Barnett ◽  
Teyuan Chyou ◽  
Anushka Soni ◽  
Raj Sengupta
Keyword(s):  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Age At Diagnosis ◽  
Response To Treatment ◽  
Future Research ◽  
Widespread Pain ◽  
Using Data ◽  
Over Time ◽  
Pain Distribution

Abstract Background Chronic pain is an important and debilitating symptom experienced by patients with axial Spondyloarthritis (axSpA). The patterns of pain and their associations in this patient group is poorly understood. The overall aim of the study is to investigate patterns of pain distribution in patients with axSpA using Margolis Pain Diagrams, and any associations with clinical and demographic measures. Methods We analysed data collected from individuals attending the axSpA outpatient clinic at the Royal National Hospital for Rheumatic Diseases in Bath. All participants were asked to record their pain on a pre-printed Margolis Pain diagram at each clinical visit. The number and distribution of painful areas were assessed and then categorised into regional or widespread pain, using pre-defined anatomical criteria. Descriptive analyses and any associations between pain distribution and demographic and clinical variables were assessed. Changes in pain distribution over time, using data from up to four clinic visits, were further investigated using a Sankey diagram. Results Of the 187 participants who had a baseline pain assessment, their mean age at diagnosis was 31.6 (11.9) years and 31.6% were female. 89.3% of patients reported pain at baseline, and of these 21.4%, 29.4 % and 38.5% reported pain in 1-2, 3-4, and 5-6 regions respectively. The most common sites of pain are in the Trunk (68.4%), followed by Head and Cervical (65.8%) and Left lower limb regions (58.8%). Univariate analyses did not reveal any significant associations between the presence of widespread pain and age at diagnosis, sex, smoking or HLA-B27 status. Disease activity, measured using Bath Ankylosing Spondylitis Disease Activity Index, was significantly higher in participants with widespread pain compared to those with regional pain OR 1.60 (1.30-1.96), and a trend towards higher sleep disturbance, was demonstrated OR 1.05 (1.00-1.10). Longitudinal analyses demonstrated considerable flux over time in the number and distribution of pain reported. Conclusion The Margolis Pain diagram is a practical instrument for assessing pain in axSpA patients. Several pain patterns were noted in patients with axSpA, and future research should focus on the potential impact on quality of life measures, response to treatment, and radiological findings. Disclosures R. Nishtala None. R. Barnett None. T. Chyou None. A. Soni None. R. Sengupta None.

White-matter markers for psychosis in a prospective ultra-high-risk cohort

2009 ◽  
Vol 40 (8) ◽  
pp. 1297-1304 ◽  
Author(s):  
O. J. N. Bloemen ◽  
M. B. de Koning ◽  
N. Schmitz ◽  
D. H. Nieman ◽  
H. E. Becker ◽  
...  
Keyword(s):  
White Matter ◽  
High Risk ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Healthy Controls ◽  
Syndrome Scale ◽  
Ultra High Risk ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

BackgroundSubjects at ‘ultra high risk’ (UHR) for developing psychosis have differences in white matter (WM) compared with healthy controls. WM integrity has not yet been investigated in UHR subjects in relation to the development of subsequent psychosis. Hence, we investigated a prospective cohort of UHR subjects comparing whole brain fractional anisotropy (FA) of those later developing psychosis (UHR-P) to those who did not (UHR-NP).MethodWe recruited 37 subjects fulfilling UHR criteria and 10 healthy controls. Baseline 3 Tesla magnetic resonance imaging (MRI) scans and Positive and Negative Syndrome Scale (PANSS) ratings were obtained. UHR subjects were assessed at 9, 18 and 24 months for development of frank psychosis. We compared baseline FA of UHR-P to controls and UHR-NP subjects. Furthermore, we related clinical data to MRI outcome in the patient population.ResultsOf the 37 UHR subjects, 10 had transition to psychosis. UHR-P subjects showed significantly lower FA values than control subjects in medial frontal lobes bilaterally. UHR-P subjects had lower FA values than UHR-NP subjects, lateral to the right putamen and in the left superior temporal lobe. UHR-P subjects showed higher FA values, compared with UHR-NP, in the left medial temporal lobe. In UHR-P, positive PANSS negatively correlated to FA in the left middle temporal lobe. In the total UHR group positive PANSS negatively correlated to FA in the right superior temporal lobe.ConclusionsUHR subjects who later develop psychosis have differences in WM integrity, compared with UHR subjects who do not develop psychosis and to healthy controls, in brain areas associated with schizophrenia.

scholarly journals The Impact of Magnetic Resonance Imaging-Detected White Matter Hyperintensities on Longitudinal Changes in Regional Cerebral Blood Flow

2007 ◽  
Vol 28 (1) ◽  
pp. 190-197 ◽  
Author(s):  
Michael A Kraut ◽  
Lori L Beason-Held ◽  
Wendy D Elkins ◽  
Susan M Resnick
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
White Matter Disease ◽  
Resonance Imaging ◽  
Regional Cerebral Blood ◽  
Longitudinal Changes ◽  
Mri Scans ◽  
The Right ◽  
Over Time

White matter hyperintensities are frequently detected on cranial magnetic resonance imaging (MRI) scans of older adults. Given the presumed ischemic contribution to the etiology of these lesions and the posited import of resting brain activity on cognitive function, we hypothesized that longitudinal changes in MRI-detected white matter disease, and its severity at a given time point, would be associated with changes in regional cerebral blood flow (rCBF) over time. We evaluated MRI scans and resting H215O positron emission tomographic rCBF at baseline and after an average of 7.7-year follow-up in Baltimore Longitudinal Study of Aging participants without dementia. Differences in patterns of rCBF were evident at baseline and at follow-up between the group of subjects showing increased white matter disease over the 8-year interval compared with the group with stable white matter ratings. Furthermore, longitudinal changes over time in rCBF also differed between the two groups. Specifically, the group with progressive white matter abnormalities showed greater increase in the right inferior temporal gyrus/fusiform gyrus, right anterior cingulate, and the rostral aspect of the left superior temporal gyrus. Regions of greater longitudinal decrease in this group were evident in the right inferior parietal lobule and at the right occipital pole. Changes in white matter disease over time and its severity at any given time are associated significantly with both cross-sectional and longitudinal patterns of rCBF. The longitudinal increases may reflect cortical compensation mechanisms for reduced efficacy of interregional neural communications that result from white matter deterioration.

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