scholarly journals The utility of diffusion tractography for speech preservation in laser ablation of the dominant insula: illustrative case

2021 ◽  
Vol 1 (19) ◽  
Author(s):  
Timothy J. Kaufmann ◽  
Vance T. Lehman ◽  
Lily C. Wong-Kisiel ◽  
Panagiotis Kerezoudis ◽  
Kai J. Miller
Keyword(s):  
Laser Ablation ◽  
White Matter ◽  
Diffusion Tensor ◽  
Neurological Deficits ◽  
Illustrative Case ◽  
Dominant Hemisphere ◽  
White Matter Tracts ◽  
Dti Tractography ◽  
Magnetic Resonance Imaging Mri ◽  
Open Surgical Treatment

BACKGROUND Open surgical treatment of insular epilepsy holds particular risk of injury to middle cerebral artery branches, the operculum (through retraction), and adjacent language-related white matter tracts in the language-dominant hemisphere. Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (LITT) is a surgical alternative that allows precise lesioning with potentially less operative risk. The authors presented the case of a 13-year-old girl with intractable, MRI-negative, left (dominant hemisphere) insular epilepsy that was treated with LITT. Diffusion tensor imaging (DTI) tractography was used to aid full posterior insular lesioning in the region of stereo electroencephalography–determined seizure onset while avoiding thermal injury to the language-related superior longitudinal fasciculus (SLF)/arcuate fasciculus (AF) and inferior fronto-occipital fasciculus (IFOF). OBSERVATIONS DTI tractography was used successfully in planning insular LITT and facilitated a robust insular ablation with sharp margins at the interfaces with the SLF/AF and IFOF. These tracts were spared, and no neurological deficits were induced through LITT. LESSONS Although it is technically demanding and has important limitations that must be understood, clinically available DTI tractography adds precision and confidence to insular laser ablation when used to protect important language-related white matter tracts.

scholarly journals Paramedian transparietal approach to a dominant hemisphere intraventricular meningioma: illustrative case

2021 ◽  
Vol 2 (7) ◽  
Author(s):  
John P. Andrews ◽  
Tarun Arora ◽  
Philip Theodosopoulos ◽  
Mitchel S. Berger
Keyword(s):  
Lateral Ventricle ◽  
Diffusion Tensor ◽  
Three Dimensional ◽  
Neurological Deficits ◽  
Illustrative Case ◽  
Dominant Hemisphere ◽  
Fiber Tracts ◽  
Left Lateral Ventricle ◽  
Magnetic Resonance Imaging Mri ◽  
Oblique Approach

BACKGROUND Meningiomas of the atrium of the lateral ventricle present a unique operative challenge. Parietal transcortical approaches have been described with an oblique approach, but a strictly paramedian approach may offer advantages in a dominant hemisphere atrial meningioma. OBSERVATIONS The patient presented with several weeks of intermittent headaches. Magnetic resonance imaging (MRI) showed an enhancing intraventricular mass in the atrium of the left lateral ventricle. Three-dimensional reconstructions were created from a preoperative MRI, with 1-mm slices for neuronavigation. Diffusion tensor imaging (DTI) was obtained, and tracts were reconstructed in the patient’s three-dimensional brainspace. DTI tractography delineated a paramedian transparietal corridor devoid of functional white matter tracks. The patient was positioned supine, in a semislouch position. A left parietal craniotomy was performed. Neuronavigation identified a gyrus posterior to the sensory cortex, anterior to the optic radiations and medial to superior longitudinal and arcuate fasciculus fiber tracts. The tumor was debulked to allow mobilization to coagulate capsular blood supply. Gross total resection was achieved. The patient was discharged postoperatively on day 3 without neurological deficits. LESSONS A paramedian transparietal approach to a dominant hemisphere meningioma of the lateral ventricle can be a safe and effective way to resect tumors in this anatomically unique operative corridor.

White matter microstructural abnormalities in families multiply affected with bipolar I disorder: a diffusion tensor tractography study

2013 ◽  
Vol 44 (10) ◽  
pp. 2139-2150 ◽  
Author(s):  
L. Emsell ◽  
C. Chaddock ◽  
N. Forde ◽  
W. Van Hecke ◽  
G. J. Barker ◽  
...  
Keyword(s):  
White Matter ◽  
Diffusion Tensor ◽  
Internal Capsule ◽  
Type I ◽  
Genetic Liability ◽  
Inferior Longitudinal Fasciculus ◽  
Participant Group ◽  
Dti Tractography ◽  
Magnetic Resonance Imaging Mri ◽  
Diffusion Tensor Imaging Dti

BackgroundWhite matter (WM) abnormalities are proposed as potential endophenotypic markers of bipolar disorder (BD). In a diffusion tensor imaging (DTI) voxel-based analysis (VBA) study of families multiply affected with BD, we previously reported that widespread abnormalities of fractional anisotropy (FA) are associated with both BD and genetic liability for illness. In the present study, we further investigated the endophenotypic potential of WM abnormalities by applying DTI tractography to specifically investigate tracts implicated in the pathophysiology of BD.MethodDiffusion magnetic resonance imaging (MRI) data were acquired from 19 patients with BD type I from multiply affected families, 21 of their unaffected first-degree relatives and 18 healthy volunteers. DTI tractography was used to identify the cingulum, uncinate fasciculus (UF), arcuate portion of the superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF), corpus callosum, and the anterior limb of the internal capsule (ALIC). Regression analyses were conducted to investigate the effect of participant group and genetic liability on FA and radial diffusivity (RD) in each tract.ResultsWe detected a significant effect of group on both FA and RD in the cingulum, SLF, callosal splenium and ILF driven by reduced FA and increased RD in patients compared to controls and relatives. Increasing genetic liability was associated with decreased FA and increased RD in the UF, and decreased FA in the SLF, among patients.ConclusionsWM microstructural abnormalities in limbic, temporal and callosal pathways represent microstructural abnormalities associated with BD whereas alterations in the SLF and UF may represent potential markers of endophenotypic risk.

scholarly journals Acute disseminated encephalomyelitis following endonasal resection of a craniopharyngioma: illustrative case

2021 ◽  
Vol 2 (16) ◽  
Author(s):  
Konrad Gag ◽  
Jonas Müller ◽  
Marie Süße ◽  
Robert Fleischmann ◽  
Henry W. S. Schroeder
Keyword(s):  
White Matter ◽  
White Matter Lesions ◽  
Acute Disseminated Encephalomyelitis ◽  
Intravenous Immunoglobulins ◽  
Neurological Deficits ◽  
Illustrative Case ◽  
Sensorimotor Deficits ◽  
Fluid Analysis ◽  
Magnetic Resonance Imaging Mri

BACKGROUND Acute disseminated encephalomyelitis (ADEM) is a rare, acquired demyelination syndrome that causes cognitive impairment and focal neurological deficits and may be fatal. The potentially reversible disease mainly affects children, often after vaccination or viral infection, but may be seen rarely in adults. OBSERVATIONS A 50-year-old woman presented with loss of visual acuity of the left eye. Magnetic resonance imaging (MRI) revealed an intra- and suprasellar mass, which was removed successfully. On postoperative day 1, MRI showed gross total resection of the lesion and no surgery-related complications. On postoperative day 2, the patient presented with a progressive left-sided hemiparesis, hemineglect, and decline of cognitive performance. MRI showed white matter edema in both hemispheres. Cerebrospinal fluid analysis revealed mixed pleocytosis (355/µL) without further evidence of infection. In synopsis of the findings, ADEM was diagnosed and treated with intravenous immunoglobulins. Shortly thereafter, the patient recovered, and no sensorimotor deficits were detected in the follow-up examination. LESSONS Pituitary gland pathologies are commonly treated by transsphenoidal surgery, with only minor risks for complications. A case of ADEM after craniopharyngioma resection has not been published before and should be considered in case of progressive neurological deterioration with multiple white matter lesions.

Individual differences in white and grey matter structure associated with verbal habits of thought

2019 ◽  
Author(s):  
Justin C. Hayes ◽  
Katherine L Alfred ◽  
Rachel Pizzie ◽  
Joshua S. Cetron ◽  
David J. M. Kraemer
Keyword(s):  
Individual Differences ◽  
White Matter ◽  
Cognitive Processing ◽  
Grey Matter ◽  
Structural Changes ◽  
Structural Integrity ◽  
Diffusion Tensor ◽  
Self Report ◽  
White Matter Tracts

Modality specific encoding habits account for a significant portion of individual differences reflected in functional activation during cognitive processing. Yet, little is known about how these habits of thought influence long-term structural changes in the brain. Traditionally, habits of thought have been assessed using self-report questionnaires such as the visualizer-verbalizer questionnaire. Here, rather than relying on subjective reports, we measured habits of thought using a novel behavioral task assessing attentional biases toward picture and word stimuli. Hypothesizing that verbal habits of thought are reflected in the structural integrity of white matter tracts and cortical regions of interest, we used diffusion tensor imaging and volumetric analyses to assess this prediction. Using a whole-brain approach, we show that word bias is associated with increased volume in several bilateral language regions, in both white and grey matter parcels. Additionally, connectivity within white matter tracts within an a priori speech production network increased as a function of word bias. These results demonstrate long-term structural and morphological differences associated with verbal habits of thought.

scholarly journals White matter in prolonged glucocorticoid response to psychological stress in schizophrenia

2021 ◽  
Author(s):  
Eric L. Goldwaser ◽  
Joshua Chiappelli ◽  
Mark D. Kvarta ◽  
Xiaoming Du ◽  
Zachary B. Millman ◽  
...  
Keyword(s):  
White Matter ◽  
Psychological Stress ◽  
Stress Responses ◽  
Diffusion Tensor ◽  
Brain Network ◽  
White Matter Tracts ◽  
Cortisol Reactivity ◽  
Cortisol Responses ◽  
Psychological Stressor ◽  
Post Stress

AbstractStress is implicated in psychosis etiology and exacerbation, but pathogenesis toward brain network alterations in schizophrenia remain unclear. White matter connects limbic and prefrontal regions responsible for stress response regulation, and white matter tissues are also vulnerable to glucocorticoid aberrancies. Using a novel psychological stressor task, we studied cortisol stress responses over time and white matter microstructural deficits in schizophrenia spectrum disorder (SSD). Cortisol was measured at baseline, 0-, 20-, and 40-min after distress induction by a psychological stressor task in 121 SSD patients and 117 healthy controls (HC). White matter microstructural integrity was measured by 64-direction diffusion tensor imaging. Fractional anisotropy (FA) in white matter tracts were related to cortisol responses and then compared to general patterns of white matter tract deficits in SSD identified by mega-analysis. Differences between 40-min post-stress and baseline, but not acute reactivity post-stress, was significantly elevated in SSD vs HC, time × diagnosis interaction F2.3,499.9 = 4.1, p = 0.013. All SSD white matter tracts were negatively associated with prolonged cortisol reactivity but all tracts were positively associated with prolonged cortisol reactivity in HC. Individual tracts most strongly associated with prolonged cortisol reactivity were also most impacted in schizophrenia in general as established by the largest schizophrenia white matter study (r = −0.56, p = 0.006). Challenged with psychological stress, SSD and HC mount similar cortisol responses, and impairments arise in the resolution timeframe. Prolonged cortisol elevations are associated with the white matter deficits in SSD, in a pattern previously associated with schizophrenia in general.

scholarly journals Multiple sclerosis and depressive manifestations: can diffusion tensor MR imaging help in the detection of microstructural white matter changes?

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Talaat A. Hassan ◽  
Shaima Fattouh Elkholy ◽  
Bahaa Eldin Mahmoud ◽  
Mona ElSherbiny
Keyword(s):  
Multiple Sclerosis ◽  
Depressive Symptoms ◽  
White Matter ◽  
Limbic System ◽  
Diffusion Tensor ◽  
Control Group ◽  
Uncinate Fasciculus ◽  
White Matter Tracts ◽  
Significant Difference ◽  
The Right

Abstract Background Multiple sclerosis is one of the commonest causes of neurological disability in middle-aged and young adults. Depression in MS patients can compromise cognitive functions, lead to suicide attempts, impair relationships and reduce compliance with disease-modifying treatments. The aim of this study was to investigate and compare the microstructural changes in the white matter tracts of the limbic system in MS patients with and those without depressive manifestations using a diffusion tensor imaging (DTI) technique. Methods This study included 40 patients who were divided into three groups. Group 1 comprised of 20 patients with relapsing-remitting MS with depressive symptoms and group 2 comprised 10 MS patients without symptoms of depression. The third group is a control group that included 10 age-matched healthy individuals. All patients underwent conventional MRI examinations and DTI to compare the fractional anisotropy (FA) values in the white matter tracts of the limbic system. Results We compared the DTI findings in MS patients with and those without depressive symptoms. It was found that patients with depression and MS exhibited a significant reduction in the FA values of the cingulum (P < 0.0111 on the right and P < 0.0142 on the left), uncinate fasciculus (P < 0.0001 on the right and P < 0.0076 on the left) and the fornix (P < 0.0001 on both sides). No significant difference was found between the FA values of the anterior thalamic radiations in both groups. Conclusion Patients with depression and MS showed more pronounced microstructural damage in the major white matter connections of the limbic pathway, namely, the uncinate fasciculus, cingulum and fornix. These changes can be detected by DTI as decreased FA values in depressed MS patients compared to those in non-depressed patients.

Structural changes of central white matter tracts in Kennedy's disease - a diffusion tensor imaging and voxel-based morphometry study

2012 ◽  
Vol 127 (5) ◽  
pp. 323-328 ◽  
Author(s):  
C. C. Pieper ◽  
C. Konrad ◽  
J. Sommer ◽  
I. Teismann ◽  
H. Schiffbauer
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Structural Changes ◽  
Diffusion Tensor ◽  
Voxel Based Morphometry ◽  
White Matter Tracts ◽  
Kennedy’S Disease ◽  
Kennedy's Disease

scholarly journals Direct segmentation of the major white matter tracts in diffusion tensor images

NeuroImage ◽  
2011 ◽  
Vol 58 (2) ◽  
pp. 458-468 ◽  
Author(s):  
Pierre-Louis Bazin ◽  
Chuyang Ye ◽  
John A. Bogovic ◽  
Navid Shiee ◽  
Daniel S. Reich ◽  
...  
Keyword(s):  
White Matter ◽  
Diffusion Tensor ◽  
White Matter Tracts ◽  
Diffusion Tensor Images
Sign in / Sign up

Export Citation Format

Share Document