scholarly journals Infratentorial MRI Findings in Rasmussen Encephalitis Suggest Primary Cerebellar Involvement

2021 ◽  
Vol 8 (6) ◽  
pp. e1058
Author(s):  
Johannes T. Reiter ◽  
Bastian David ◽  
Selma Enders ◽  
Conrad C. Prillwitz ◽  
Tobias Bauer ◽  
...  
Keyword(s):  
Diffusion Tensor ◽  
Cerebellar Atrophy ◽  
Patient Specific ◽  
Strongly Correlated ◽  
Rasmussen Encephalitis ◽  
Voxel Based Morphometry ◽  
Mri Findings ◽  
Cerebral Involvement ◽  
Fluid Attenuated Inversion Recovery ◽  
Cerebellar Involvement

Background and ObjectiveRasmussen encephalitis (RE) is characterized by its unilateral cerebral involvement. However, both ipsi- and contralesional cerebellar atrophy have been anecdotally reported raising questions about the nature and extent of infratentorial findings. Using MRI, we morphometrically investigated the cerebellum and hypothesized abnormalities beyond the effects of secondary atrophy, implicating a primary involvement of the cerebellum by RE.MethodsVoxel-based morphometry of the cerebellum and brainstem was conducted in 57 patients with RE and in 57 matched controls. Furthermore, patient-specific asymmetry indices (AIs) of cerebellar morphometry and fluid-attenuated inversion recovery (FLAIR) intensity were calculated. Using diffusion tensor imaging, the integrity of the cortico-ponto-cerebellar (CPC) tract was assessed. Finally, a spatial independent component analysis (ICA) was used to compare atrophy patterns between groups.ResultsPatients with RE showed bilateral cerebellar and predominantly ipsilesional mesencephalic atrophy (p < 0.01). Morphometric AIs revealed ipsilesional < contralesional asymmetry in 27 and ipsilesional > contralesional asymmetry in 30 patients. In patients with predominant ipsilesional atrophy, morphometric AIs strongly correlated with FLAIR intensity AIs (r = 0.86, p < 0.0001). Fractional anisotropy was lower for ipsilesional-to-contralesional CPC tracts than opposite tracts (T = 2.30, p < 0.05). ICA revealed bilateral and strictly ipsi- and contralesional atrophy components in patients with RE (p < 0.05).DiscussionWe demonstrated atrophy of the ipsilesional-to-contralesional CPC pathway and, consequently, interpret the loss of contralesional gray matter as secondary crossed cerebellar atrophy. The ipsilesional cerebellar atrophy, however, defies this explanation. Based on FLAIR hyperintensities, we interpret ipsilesional atrophy to be due to inflammation in the scope of a primary involvement of the cerebellum by RE.

Cerebral involvement in celiac disease: A serial MRI study in a patient with brainstem and cerebellar symptoms

Neurology ◽  
1997 ◽  
Vol 49 (5) ◽  
pp. 1447-1450 ◽  
Author(s):  
Angelo Ghezzi ◽  
Massimo Filippi ◽  
Andrea Falini ◽  
Mauro Zaffaroni
Keyword(s):  
Celiac Disease ◽  
Neuronal Damage ◽  
Magnetization Transfer ◽  
Cerebellar Atrophy ◽  
Cerebral Involvement ◽  
Cerebellar Involvement ◽  
Mri Study ◽  
Serial Mri ◽  
Cerebellar Symptoms ◽  
Csf Findings

A patient with celiac disease and relapsing-progressive symptoms suggesting brainstem and cerebellar involvement underwent serial MRIs. The first examination revealed multiple enhancing and nonenhancing lesions. Thereafter, a large enhancing cerebellar lesion appeared, followed by severe cerebellar atrophy. The presence of structural neuronal damage was confirmed by proton MR spectroscopy and magnetization transfer imaging. MRI results and CSF findings suggested that neurologic complications were more likely due to an inflammatory process.

Diffusion and functional MRI findings and their relationship to behaviour in postconcussion syndrome: a scoping review

2021 ◽  
pp. jnnp-2021-326604
Author(s):  
Melisa Gumus ◽  
Alexandra Santos ◽  
Maria Carmela Tartaglia
Keyword(s):  
Functional Mri ◽  
Scoping Review ◽  
Diffusion Tensor ◽  
Neuropsychiatric Symptoms ◽  
Postconcussion Syndrome ◽  
Mri Findings ◽  
Functional Brain ◽  
Behavioural Changes ◽  
Brain Changes ◽  
The Relationship

Postconcussion syndrome (PCS) is a term attributed to the constellation of symptoms that fail to recover after a concussion. PCS is associated with a variety of symptoms such as headaches, concentration deficits, fatigue, depression and anxiety that have an enormous impact on patients’ lives. There is currently no diagnostic biomarker for PCS. There have been attempts at identifying structural and functional brain changes in patients with PCS, using diffusion tensor imaging (DTI) and functional MRI (fMRI), respectively, and relate them to specific PCS symptoms. In this scoping review, we appraised, synthesised and summarised all empirical studies that (1) investigated structural or functional brain changes in PCS using DTI or fMRI, respectively, and (2) assessed behavioural alterations in patients with PCS. We performed a literature search in MEDLINE (Ovid), Embase (Ovid) and PsycINFO (Ovid) for primary research articles published up to February 2020. We identified 8306 articles and included 45 articles that investigated the relationship between DTI and fMRI parameters and behavioural changes in patients with PCS: 20 diffusion, 20 fMRI studies and 5 papers with both modalities. Most frequently studied structures were the corpus callosum, superior longitudinal fasciculus in diffusion and the dorsolateral prefrontal cortex and default mode network in the fMRI literature. Although some white matter and fMRI changes were correlated with cognitive or neuropsychiatric symptoms, there were no consistent, converging findings on the relationship between neuroimaging abnormalities and behavioural changes which could be largely due to the complex and heterogeneous presentation of PCS. Furthermore, the heterogeneity of symptoms in PCS may preclude discovery of one biomarker for all patients. Further research should take advantage of multimodal neuroimaging to better understand the brain–behaviour relationship, with a focus on individual differences rather than on group comparisons.

scholarly journals Relationship between the Corticospinal and Corticocerebellar Tracts and Their Role in Upper Extremity Motor Recovery in Stroke Patients

2021 ◽  
Vol 11 (11) ◽  
pp. 1162
Author(s):  
Jungsoo Lee ◽  
Won Hyuk Chang ◽  
Yun-Hee Kim
Keyword(s):  
Upper Extremity ◽  
Predictive Accuracy ◽  
Diffusion Tensor ◽  
Stroke Onset ◽  
Patient Specific ◽  
Stroke Patients ◽  
Predictive Values ◽  
The Relationship ◽  
Diffusion Tensor Imaging Dti

The corticospinal tract (CST) and corticocerebellar tract (CCT) are both involved in the upper extremity (UE) function after stroke. Understanding the relationship between the tracts and their functions can contribute to developing patient-specific rehabilitative strategies. Seventy ischemic stroke patients who underwent diffusion tensor imaging (DTI) two weeks after the stroke onset and motor function assessments two weeks and three months after the stroke onset were included in this study. To obtain the CST and CCT integrity, the functional anisotropy (FA) values of both tracts were extracted from the DTI data. Linear regression was used to identify the relationship and predictive accuracy. The CST FA data had predictive values, but CCT FA did not. There were interaction effects between the CST and CCT FA values (p = 0.011). The CCT was significantly associated with high CST FA but not low CST FA. When the CST or CCT FA were applied to patients depending on the CST status, the stratified model showed higher predictive accuracy (R2 = 0.380) than that of the CST-only model (R2 = 0.320). In this study, the conditional role of CCT depending on CST status was identified in terms of UE recovery in stroke patients. This result could provide useful information about individualized rehabilitative strategies in stroke patients.

scholarly journals White matter and schizophrenia: A meta-analysis of voxel-based morphometry and diffusion tensor imaging studies

2017 ◽  
Vol 270 ◽  
pp. 8-21 ◽  
Author(s):  
Enrico Vitolo ◽  
Mona Karina Tatu ◽  
Claudia Pignolo ◽  
Franco Cauda ◽  
Tommaso Costa ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Diffusion Tensor ◽  
Meta Analysis ◽  
Voxel Based Morphometry ◽  
Imaging Studies ◽  
And Diffusion

Diffusion tensor imaging and tractography of Rasmussen encephalitis

2009 ◽  
Vol 39 (7) ◽  
pp. 727-730 ◽  
Author(s):  
Keith A. Cauley ◽  
Heather N. Burbank ◽  
Christopher G. Filippi
Keyword(s):  
Diffusion Tensor Imaging ◽  
Diffusion Tensor ◽  
Rasmussen Encephalitis

Cortical involvement and leptomeningeal inflammation in myelin oligodendrocyte glycoprotein antibody disease: A three-dimensional fluid-attenuated inversion recovery MRI study

2021 ◽  
pp. 135245852110343
Author(s):  
Dimitrios Tzanetakos ◽  
John S Tzartos ◽  
Aigli G Vakrakou ◽  
Marianthi Breza ◽  
Georgios Velonakis ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Median Number ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Inversion Recovery ◽  
Cortical Lesion ◽  
Mri Findings ◽  
Meningeal Inflammation ◽  
Fluid Attenuated Inversion Recovery ◽  
3D Flair

Background: Cortical demyelination and meningeal inflammation have been detected neuropathologically in multiple sclerosis (MS) and recently in myelin oligodendrocyte glycoprotein antibody disease (MOGAD). Objectives: To assess in vivo cortical and leptomeningeal involvement in MOGAD. Methods: We prospectively evaluated 11 MOGAD and 12 relapsing-remitting MS (RRMS) patients combining three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and 3D-T1-weighted (3D-T1w) sequences at 3-Tesla magnetic resonance imaging (MRI). Leptomeningeal contrast enhancement (LMCE) was assessed on 3D-FLAIR post-gadolinium (3D-FLAIRGd). Cerebral cortical lesions (CCLs) were classified as either intracortical–subpial (IC–SP) or leukocortical (LC). Results: CCLs were present in 8/11 MOGAD and 12/12 RRMS patients, with the number of CCLs being significantly lower in MOGAD (median (interquartile range (IQR)) 3 (0.5–4) vs 12 (4.75–19), p = 0.0032). In MOGAD, IC–SP lesions were slightly more prevalent than LC lesions (2 (0–2.5) vs 1 (0–2), p = 0.6579); whereas in RRMS, IC–SP lesions were less prevalent than LC lesions (3.5 (2.75–5.5) vs 9 (2–12.75), p = 0.27). LMCE was observed in 3/11 MOGAD and 1/12 RRMS patients; MOGAD with LMCE showed an increased median number of CCLs compared with MOGAD without LMCE (8 (4–9) vs 2.5 (0.75–3.25), p = 0.34). No correlation was observed between MOGAD MRI findings and (a) MOGAD duration, (b) serum MOG-immunoglobulin G1 titers, and (c) oligoclonal band presence. Conclusion: We described cortical lesion topography and detected for the first time LMCE using 3D-FLAIRGd sequences in MOGAD patients.

Noninvasive Localization of Language Cortex in an Awake 4-Year-Old Child with Rasmussen Encephalitis: A Case Report

2019 ◽  
Vol 18 (5) ◽  
pp. E175-E180
Author(s):  
Shalini Narayana ◽  
Luke M Embury ◽  
Namrata Shah ◽  
Sarah Weatherspoon ◽  
Asim F Choudhri ◽  
...  
Keyword(s):  
Young Children ◽  
Young Patients ◽  
Definitive Treatment ◽  
Rasmussen Encephalitis ◽  
Mri Findings ◽  
Left Frontal Lobe ◽  
Epilepsia Partialis Continua ◽  
Language Functions ◽  
Mapping Tool ◽  
The Right

Abstract BACKGROUND AND IMPORTANCE Presurgical mapping of eloquent cortex in young patients undergoing neurosurgery is critical for timely intervention, surgical planning, and minimizing postoperative deficits. However, invasive direct cortical stimulation has limited success in young children and noninvasive modalities, such as magnetoencephalography and functional MRI, require sedation, often precluding localization of critical language cortices. Transcranial magnetic stimulation (TMS), a noninvasive brain stimulation technique, is well suited to evaluate language areas in young children because it does not require the patient to remain still during mapping. CLINICAL PRESENTATION A 4-yr and 11-mo-old female patient diagnosed with epilepsia partialis continua of the right arm and face and right-sided weakness was evaluated at our institution. MRI findings and clinical examination led to the diagnosis of Rasmussen encephalitis involving left frontal lobe and insula. Language cortices were successfully identified in both hemispheres using TMS. The TMS findings aided in discussing with the family the risks of postsurgical deficits of left functional hemispherectomy, the definitive treatment for Rasmussen encephalitis. Postoperatively, the patient had intact speech and was seizure free. CONCLUSION We illustrate the feasibility and utility of TMS as a noninvasive functional mapping tool in this young child. The preoperative demonstration of bilateral language organization indicated a greater likelihood of preserved language functions postsurgery. We demonstrate that TMS is a safe and noninvasive tool to map language cortices in young children with serious epilepsy syndromes.

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