Multimodal quantitative magnetic resonance imaging analysis with individualized postprocessing in patients with drug-resistant focal epilepsy and conventional visual inspection negative for epileptogenic lesions

OBJECTIVES: Approximately one-third of candidates for epilepsy surgery have no visible abnormalities on conventional magnetic resonance imaging. This is extremely discouraging, as these patients have a less favorable prognosis. We aimed to evaluate the utility of quantitative magnetic resonance imaging in patients with drug-resistant neocortical focal epilepsy and negative imaging. METHODS: A prospective study including 46 patients evaluated through individualized postprocessing of five quantitative measures: cortical thickness, white and gray matter junction signal, relaxation rate, magnetization transfer ratio, and mean diffusivity. Scalp video-electroencephalography was used to suggest the epileptogenic zone. A volumetric fluid-attenuated inversion recovery sequence was performed to aid visual inspection. A critical assessment of follow-up was also conducted throughout the study. RESULTS: In the subgroup classified as having an epileptogenic zone, individualized postprocessing detected abnormalities within the region of electroclinical origin in 9.7% to 31.0% of patients. Abnormalities outside the epileptogenic zone were more frequent, up to 51.7%. In five patients initially included with negative imaging, an epileptogenic structural abnormality was identified when a new visual magnetic resonance imaging inspection was guided by information gleaned from postprocessing. In three patients, epileptogenic lesions were detected after visual evaluation with volumetric fluid-attenuated sequence guided by video electroencephalography. CONCLUSION: Although quantitative magnetic resonance imaging analyses may suggest hidden structural lesions, caution is warranted because of the apparent low specificity of these findings for the epileptogenic zone. Conversely, these methods can be used to prevent visible lesions from being ignored, even in referral centers. In parallel, we need to highlight the positive contribution of the volumetric fluid-attenuated sequence.

Comportamento ingestivo de vacas alimentadas com torta de macaúba / Ingestive behavior of dairy cows fed with macauba meal

Avaliaram-se os efeitos de diferentes níveis de inclusão (0, 100, 200 e 300g kg-1 de MS) de torta de macaúba (TM) na produção leiteira e no comportamento ingestivo de oito vacas Holandesas, em dois quadrados latinos 4x4, sendo quatro tratamentos e quatro períodos experimentais. O comportamento ingestivo foi determinado mediante observações visuais, ocorridas durante 24 horas, a intervalos de 5 minutos, para determinação do tempo despendido em alimentação, ruminação e ócio. Embora tenha ocorrido redução quadrática no consumo de matéria seca e na produção de leite com a inclusão de TM nas dietas, a eficiência alimentar (gMS h-1 e gFDN h-1) e a eficiência de ruminação (gMS h-1 e gFDN h-1) foram semelhantes em todos os tratamentos. O tempo total de mastigações (min dia-1), o número de bolos ruminados (n° dia-1), o número de mastigações merícicas (n° dia-1 e n° bolo-1) e o tempo de mastigações merícicas por bolo (seg bolo-1) não apresentaram diferenças. Os resultados permitem concluir que a inclusão da torta de TM na dieta de vacas leiteiras não influencia no comportamento ingestivo dos animais, entretanto, compromete o seu desempenho.

The effects of the macauba meal (MM) inclusion (0, 100, 200 and 300g kg-1 of DM) upon daily milk production and ingestive behavior parameters were evaluated in eight Holstein cows. Animals were randomly allocated to treatments according to a replicated latin square design, with four treatments and four experimental periods. The ingestive behavior was determined by observation, during 24 hours with 5 minutes intervals to determine the time spent in feeding, rumination and idleness. There was a quadratic decrease in dry matter intake and daily milk production with MM inclusion. However, no effects were detected in MM inclusion on the feeding efficiency (gDM h-1 and gNDF h-1) and rumination efficiency (gDM h-1 and gNDF h-1). The total chewing time (min day-1), the number of ruminated (boli day-1), the ruminating chews (n. day-1 and n. boli-1) and the time of ruminating chews boli (sec boli-1) did not show any difference. The MM inclusion in the diet did not influence the ingestive behavior, but reduces the performance of animals.