scholarly journals MRI evaluation of thalamic volume differentiates MS from common mimics

2017 ◽  
Vol 4 (5) ◽  
pp. e387 ◽  
Author(s):  
Andrew J. Solomon ◽  
Richard Watts ◽  
Blake E. Dewey ◽  
Daniel S. Reich
Keyword(s):  
White Matter ◽  
Three Dimensional ◽  
Assessment Tools ◽  
Class Iii ◽  
Mri Segmentation ◽  
White Matter Abnormalities ◽  
Volumetric Assessment ◽  
Study Participants ◽  
Mri Evaluation

Objective:To determine whether MRI evaluation of thalamic volume differentiates MS from other disorders that cause MRI white matter abnormalities.Methods:There were 40 study participants: 10 participants with MS without additional comorbidities for white matter abnormalities (MS − c); 10 participants with MS with additional comorbidities for white matter abnormalities (MS + c); 10 participants with migraine, MRI white matter abnormalities, and no additional comorbidities for white matter abnormalities (Mig − c); and 10 participants previously incorrectly diagnosed with MS (Misdx). T1-magnetization-prepared rapid gradient-echo and T2-weighted three-dimensional fluid attenuation inversion recovery sequences were acquired on a Phillips Achieva d-Stream 3T MRI, and scans were randomly ordered and de-identified for a blinded reviewer who performed MRI segmentation using LesionTOADS.Results:Mean normalized thalamic volume differed among the 4 cohorts (analysis of variance, p = 0.005) and was smaller in the 20 MS participants compared with the 20 non-MS participants (p < 0.001), smaller in MS − c compared with Mig − c (p = 0.03), and smaller in MS + c compared with Misdx (p = 0.006). The sensitivity and specificity were both 0.75 for diagnosis of MS with a thalamic volume <0.0077.Conclusions:MRI volumetric evaluation of the thalamus, but not other deep gray-matter structures, differentiated MS from other diseases that cause white matter abnormalities and are often mistaken for MS. Evaluation for thalamic atrophy may improve accuracy for diagnosis of MS as an adjunct to additional radiologic criteria. Thalamic volumetric assessment by MRI in larger cohorts of patients undergoing evaluation for MS is needed, along with the development of automated and easily applied volumetric assessment tools for future clinical application.Classification of evidence:This study provides Class III evidence that MRI evaluation of thalamic volume differentiates MS from other diseases that cause white matter abnormalities.

scholarly journals 3D MPRAGE improves classification of cortical lesions in multiple sclerosis

2008 ◽  
Vol 14 (9) ◽  
pp. 1214-1219 ◽  
Author(s):  
F Nelson ◽  
A Poonawalla ◽  
P Hou ◽  
JS Wolinsky ◽  
PA Narayana
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Signal To Noise Ratio ◽  
Three Dimensional ◽  
Inversion Recovery ◽  
High Signal ◽  
Cortical Lesions ◽  
Rapid Acquisition ◽  
Lesion Morphology

Background Gray matter lesions are known to be common in multiple sclerosis (MS) and are suspected to play an important role in disease progression and clinical disability. A combination of magnetic resonance imaging (MRI) techniques, double-inversion recovery (DIR), and phase-sensitive inversion recovery (PSIR), has been used for detection and classification of cortical lesions. This study shows that high-resolution three-dimensional (3D) magnetization-prepared rapid acquisition with gradient echo (MPRAGE) improves the classification of cortical lesions by allowing more accurate anatomic localization of lesion morphology. Methods 11 patients with MS with previously identified cortical lesions were scanned using DIR, PSIR, and 3D MPRAGE. Lesions were identified on DIR and PSIR and classified as purely intracortical or mixed. MPRAGE images were then examined, and lesions were re-classified based on the new information. Results The high signal-to-noise ratio, fine anatomic detail, and clear gray-white matter tissue contrast seen in the MPRAGE images provided superior delineation of lesion borders and surrounding gray-white matter junction, improving classification accuracy. 119 lesions were identified as either intracortical or mixed on DIR/PSIR. In 89 cases, MPRAGE confirmed the classification by DIR/PSIR. In 30 cases, MPRAGE overturned the original classification. Conclusion Improved classification of cortical lesions was realized by inclusion of high-spatial resolution 3D MPRAGE. This sequence provides unique detail on lesion morphology that is necessary for accurate classification.

Varenicline for the treatment of postural and gait dysfunction in Parkinson’s disease (PD)

2020 ◽  
pp. 10.1212/CPJ.0000000000000958 ◽  
Author(s):  
Deborah Hall ◽  
Sachin Kapur ◽  
Christina Vaughan ◽  
Jacob Hawkins ◽  
Glenn Stebbins
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Objective Measure ◽  
Berg Balance Scale ◽  
Controlled Study ◽  
Class Iii ◽  
Double Blind ◽  
Treatment Groups ◽  
Study Participants

ABSTRACTObjective:To determine if varenicline is effective for balance in Parkinson’s disease (PD).Methods:This was an investigator-initiated, double-blind, placebo-controlled study. Participants with a clinical diagnosis of PD were randomized to receive varenicline or placebo for eight weeks. After dose escalation, participants took 1mg of drug twice daily until end of study. Patients with severe tremor were excluded. Primary outcome was change on the Berg Balance Scale (BBS) from baseline to eight weeks. The BBS is a fourteen-item measure consisting of basic balance tasks. The study had a secondary, exploratory outcome of change in cognition, measured with the Frontal Assessment Battery (FAB) and the Mini Mental State Exam (MMSE) from baseline to eight weeks. The FAB is a six item measure of executive functioning.Results:Thirty-six participants were randomized (82% men, 100% Caucasian). Average age was 71.0 years (±8.1). Average baseline motor MDS-UPDRS was 34.7 (±11.6). There were no differences between treatment groups on the BBS (F[1,28]=2.85,p =0.10) or FAB (d=0.16,95% CI=[-1.39,1.53]), or MMSE (d=0.81,95%CI=[-0.40,1.40]).Conclusion:The results did not suggest varenicline had an effect on balance in patients with PD. Furthermore, varenicline did not appear to effect cognition. Perhaps if an objective measure of balance had been used in place of the BBS, analysis would show a difference between groups. However, the authors do not recommend further study.Classification of Evidence:This study provides Class III evidence that in PD patients with H&Y stages 2,3, or 4, varenicline does not improve balance as assessed by the BBS.

Holistic Communication Assessment for Young Children With Cleft Palate Using the International Classification of Functioning, Disability and Health:Children and Youth

2020 ◽  
Vol 51 (4) ◽  
pp. 914-938
Author(s):  
Anna Cronin ◽  
Sharynne McLeod ◽  
Sarah Verdon
Keyword(s):  
Young Children ◽  
Cleft Palate ◽  
Case History ◽  
Significant Others ◽  
International Classification ◽  
Assessment Tools ◽  
International Classification Of Functioning ◽  
Speech Language Pathologists ◽  
Holistic Assessment

Purpose Children with a cleft palate (± cleft lip; CP±L) can have difficulties communicating and participating in daily life, yet speech-language pathologists typically focus on speech production during routine assessments. The International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY; World Health Organization, 2007 ) provides a framework for holistic assessment. This tutorial describes holistic assessment of children with CP±L illustrated by data collected from a nonclinical sample of seven 2- to 3-year-old children, 13 parents, and 12 significant others (e.g., educators and grandparents). Method Data were collected during visits to participants' homes and early childhood education and care centers. Assessment tools applicable to domains of the ICF-CY were used to collect and analyze data. Child participants' Body Functions including speech, language, and cognitive development were assessed using screening and standardized assessments. Participants' Body Structures were assessed via oral motor examination, case history questionnaires, and observation. Participants' Activities and Participation as well as Environmental and Personal Factors were examined through case history questionnaires, interviews with significant others, parent report measures, and observations. Results Valuable insights can be gained from undertaking holistic speech-language pathology assessments with children with CP±L. Using multiple tools allowed for triangulation of data and privileging different viewpoints, to better understand the children and their contexts. Several children demonstrated speech error patterns outside of what are considered cleft speech characteristics, which underscores the importance of a broader assessment. Conclusion Speech-language pathologists can consider incorporating evaluation of all components and contextual factors of the ICF-CY when assessing and working with young children with CP±L to inform intervention and management practices.

Phonetic iconicity in the evaluative morphology of a sample of Indo-European, Niger-Congo and Austronesian languages

2010 ◽  
Vol 3 (2) ◽  
pp. 156-180 ◽  
Author(s):  
Renáta Gregová ◽  
Lívia Körtvélyessy ◽  
Július Zimmermann
Keyword(s):  
Three Dimensional ◽  
Sound Symbolism ◽  
Three Dimensional Model ◽  
Austronesian Languages ◽  
Place Of Articulation ◽  
European Languages ◽  
Phonetic Symbolism ◽  
The Individual ◽  
Core Vocabulary

Universals Archive (Universal #1926) indicates a universal tendency for sound symbolism in reference to the expression of diminutives and augmentatives. The research ( Štekauer et al. 2009 ) carried out on European languages has not proved the tendency at all. Therefore, our research was extended to cover three language families – Indo-European, Niger-Congo and Austronesian. A three-step analysis examining different aspects of phonetic symbolism was carried out on a core vocabulary of 35 lexical items. A research sample was selected out of 60 languages. The evaluative markers were analyzed according to both phonetic classification of vowels and consonants and Ultan's and Niewenhuis' conclusions on the dominance of palatal and post-alveolar consonants in diminutive markers. Finally, the data obtained in our sample languages was evaluated by means of a three-dimensional model illustrating the place of articulation of the individual segments.

scholarly journals Tractography Alterations in the Arcuate and Uncinate Fasciculi in Post-Stroke Aphasia

2021 ◽  
Vol 11 (1) ◽  
pp. 53
Author(s):  
Sara Kierońska ◽  
Milena Świtońska ◽  
Grzegorz Meder ◽  
Magdalena Piotrowska ◽  
Paweł Sokal
Keyword(s):  
White Matter ◽  
Brain Connectivity ◽  
Three Dimensional ◽  
Cerebral White Matter ◽  
Neural Pathways ◽  
Uncinate Fasciculus ◽  
Arcuate Fasciculus ◽  
Fiber Tractography ◽  
Post Stroke

Fiber tractography based on diffuse tensor imaging (DTI) can reveal three-dimensional white matter connectivity of the human brain. Tractography is a non-invasive method of visualizing cerebral white matter structures in vivo, including neural pathways surrounding the ischemic area. DTI may be useful for elucidating alterations in brain connectivity resulting from neuroplasticity after stroke. We present a case of a male patient who developed significant mixed aphasia following ischemic stroke. The patient had been treated by mechanical thrombectomy followed by an early rehabilitation, in conjunction with transcranial direct current stimulation (tDCS). DTI was used to examine the arcuate fasciculus and uncinate fasciculus upon admission and again at three months post-stroke. Results showed an improvement in the patient’s symptoms of aphasia, which was associated with changes in the volume and numbers of tracts in the uncinate fasciculus and the arcuate fasciculus.

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