Migraine improvement correlates with posterior cingulate cortical thickness reduction / Variação da espessura cortical no cíngulo posterior em pacientes com enxaqueca. Correlação com a melhora pós-tratamento profilático

ABSTRACT Objective The main goal of this study was to correlate migraine improvement, after prophylactic therapy, with cortical thickness changes. Methods Cortical thickness maps were obtained with magnetic resonance imaging (MRI) from 19 patients with migraine before (first scan) and after (second scan) prophylactic treatment, and these were compared with controls using the FreeSurfer MRI tool. Cortical changes were correlated with the headache index (HI). Results Anincrease incortical thickness was found in the right cuneus and precuneus, somatosensory and superior parietal cortices in both patient scans, compared with the controls. No changes were observed in the left hemisphere. Following correction for multiple comparisons, no areas changed from the first to the second scan. Regression analysis showed a significant negative correlation between the HI improvement and cortical thickness changes in the left posterior cingulate, a region involved with nociception and, possibly, the development of chronic pain. Conclusion There were changes in cortical thickness in patients with migraine relative to controls in areas involved with vision and pain processing. Left posterior cingulate cortical changes correlated with headache frequency and intensity.

RESUMO Objetivos Correlacionar a melhora de pacientes enxaquecosos após tratamento preventivo com alterações na espessura do córtex cerebral. Métodos Espessura cortical foi determinada a partir de imagens de ressonância magnética (RM)em 19 pacientes com enxaqueca, antes (1ᵃ RM) e após (2ᵃ RM) o tratamento profilático, e comparada com controles, usando o programa FreeSurfer. Mudanças corticais foram correlacionadas com o índice de cefaleia (HI). Resultados O hemisfério direito apresentou aumento da espessura no córtex do cúneus e pré-cúneus, parietal superior e somatossensitivo na primeira RM e na segunda RM, em comparação aos controles. Após correção para comparações múltiplas, nenhuma região cortical se mostrou estatisticamente diferente entre a primeira e a segunda RM. A regressão mostrou correlação (negativa) significativa entre melhora do HI e mudanças na espessura cortical do cíngulo posterior esquerdo. Conclusão Existem alterações de espessura cortical em pacientes com enxaqueca em relação a controles em áreas envolvidas com processamento visual e com a dor. As alterações corticais no cíngulo posterior esquerdo variaram de acordo com a frequência e intensidade das crises.

A magnetic resonance imaging study on brain surface morphology change in patients with first-episode obsessive compulsive disorder / 中华行为医学与脑科学杂志

Objective To analyze the brain structure changes of the first-episode obsessive compulsive disorder (OCD) patients who were scanned by three-dimensional structure magnetic resonance imaging.Methods According to the diagnostic criteria of OCD in American Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-Ⅳ),the fist-episode obsessive compulsive disorder patients as case group(OCD,n=26) and the adult healthy volunteers as control group (control group,n=25) were selected.All subjects were assessed with Yale-Brown obsessive-compulsive scale(Y-BOCS),Hamilton Anxiety rating Scale (HAMA) and Hamilton Depression Rating Scale(HAMD),and then,they received 3D-MRI scanning runs.All the data was processed with freesurfer software and analyzed about cerebral cortical volume,cortical thickness,cortical surface area,the local gyrification index and subcortical nuclei volume.Results Compared with control group,the cerebral cortical thickness of OCD group increased at the left postcentral gyrus ((2.223±0.118)mm),left supramarginal gyrus ((2.486 ± 0.027) mm) and left parahippocampal gyrus ((2.399±0.164)mm).The cerebral cortical surface area larged at the right inferior frontal gyrus((1.036±0.079) mm2),right paracentral lobule ((0.827 ± 0.048) mm2) and medial orbitofrontal ((0.990 ± 0.083)mm2),and decreased at right superior parietal lobule ((0.779 ± 0.040) mm2),right inferior parietal lobule ((0.767±0.093) mm2) and right inferior temporal gyrus ((0.888±0.070) mm2).The cerebral cortical volume increased at the right inferior frontal gyrus((2.330±0.223) mm3).The cerebral cortical local gyrification index decreased at right middle temporal gyrus(2.893±0.288)and left inferior temporal gyrus(2.589±0.100).Conclusion The first-episode OCD patients have multiple changes of brain structures,and this changes were priority for the frontal lobes,orbital frontal,parietal lobe,temporal lobe and hippocampus.The changes in these regions maybe have close relationship with symptoms of OCD.

Cortical Thickness of Resting State Networks in the Brain of Male Patients with Alcohol Dependence

OBJECTIVES: It is well known that problem drinking is associated with alterations of brain structures and functions. Brain functions related to alcohol consumption can be determined by the resting state functional connectivity in various resting state networks (RSNs). This study aims to ascertain the alcohol effect on the structures forming predetermined RSNs by assessing their cortical thickness. METHODS: Twenty-six abstinent male patients with alcohol dependence and the same number of age-matched healthy control were recruited from an inpatient mental hospital and community. All participants underwent a 3T MRI scan. Averaged cortical thickness of areas constituting 7 RSNs were determined by using FreeSurfer with Yeo atlas derived from cortical parcellation estimated by intrinsic functional connectivity. RESULTS: There were significant group differences of mean cortical thicknesses (Cohen's d, corrected p) in ventral attention (1.01, < 0.01), dorsal attention (0.93, 0.01), somatomotor (0.90, 0.01), and visual (0.88, 0.02) networks. We could not find significant group differences in the default mode network. There were also significant group differences of gray matter volumes corrected by head size across the all networks. However, there were no group differences of surface area in each network. CONCLUSIONS: There are differences in degree and pattern of structural recovery after abstinence across areas forming RSNs. Considering the previous observation that group differences of functional connectivity were significant only in networks related to taskpositive networks such as dorsal attention and cognitive control networks, we can explain recovery pattern of cognition and emotion related to the default mode network and the mechanisms for craving and relapse associated with task-positive networks.

Frontoparietal Cortical Thinning in Respiratory-Type Panic Disorder: A Preliminary Report

OBJECTIVE: Many evidences raise the possibility that the panic disorder (PD) patients with respiratory subtype (RS) may have characteristic structural abnormalities. We aimed to explore the structural differences between PD patients with and without the respiratory symptoms. METHODS: Patients with PD were recruited from the Department of Psychiatry at Korea University Anam Hospital. Respiratory subtype (RS) was diagnosed when at least 4 out of 5 of the following respiratory symptoms were present during the panic attack: fear of dying, chest pain/discomfort, shortness of breath, paresthesias, and a choking sensation. We acquired high-resolution MRI scans and used FreeSurfer to obtain a measure of cortical thickness for each patient. RESULTS: Cluster based analysis revealed significantly decreased cortical thickness in the left hemisphere in the caudal-middle-frontal, superior frontal, and posterior parietal areas in the RS group. No significant difference was observed in any of the limbic areas. CONCLUSION: Respiratory symptoms of panic disorder were associated with a reduction in cortical thickness in the left frontal and parietal areas. This finding leads to the assumption that the frontoparietal network is the crucial component in a larger cortical network underlying the perception of dyspnea in RS.

Surface-Based Parameters of Brain Imaging in Male Patients with Alcohol Use Disorder

OBJECTIVE: The structural alteration of brain shown in patients with alcohol use disorder (AUD) can originate from both alcohol effects and genetic or developmental processes. We compared surface-based parameters of patients with AUD with healthy controls to prove the applicability of surface-based morphometry with head size correction and to determine the areas that were sensitive to brain alteration related to AUD. METHODS: Twenty-six abstinent male patients with AUD (alcohol group, mean abstinence=13.2 months) and twenty-eight age-matched healthy participants (control group) were recruited from an inpatient mental hospital and community. All participants underwent a 3T MRI scan. Surface-based parameters were determined by using FreeSurfer. RESULTS: Every surface-based parameter of the alcohol group was lower than the corresponding control group parameter. There were large group differences in the whole brain, grey and white matter volume, and the differences were more prominent after head size correction. Significant group differences were shown in cortical thicknesses in entire brain regions, especially in parietal, temporal and frontal areas. There were no significant group differences in surface areas, but group difference trends in surface areas of the frontal and parietal cortices were shown after head size correction. CONCLUSION: Most of the surface-based parameters in alcohol group were altered because of incomplete recovery from chronic alcohol exposure and possibly genetic or developmental factors underlying the risk of AUD. Surface-based morphometry with controlling for head size is useful in comparing the volumetric parameters and the surface area to a lesser extent in alcohol-related brain alteration.

Evaluation of Hippocampal Volume Based on Various Inversion Time in Normal Adults by Manual Tracing and Automated Segmentation Methods

PURPOSE: To investigate the value of image post-processing software (FreeSurfer, IBASPM [individual brain atlases using statistical parametric mapping software]) and inversion time (TI) in volumetric analyses of the hippocampus and to identify differences in comparison with manual tracing. MATERIALS AND METHODS: Brain images from 12 normal adults were acquired using magnetization prepared rapid acquisition gradient echo (MPRAGE) with a slice thickness of 1.3 mm and TI of 800, 900, 1000, and 1100 ms. Hippocampal volumes were measured using FreeSurfer, IBASPM and manual tracing. Statistical differences were examined using correlation analyses accounting for spatial interpretations percent volume overlap and percent volume difference. RESULTS: FreeSurfer revealed a maximum percent volume overlap and maximum percent volume difference at TI = 800 ms (77.1 +/- 2.9%) and TI = 1100 ms (13.1 +/- 2.1%), respectively. The respective values for IBASPM were TI = 1100 ms (55.3 +/- 9.1%) and TI = 800 ms (43.1 +/- 10.7%). FreeSurfer presented a higher correlation than IBASPM but it was not statistically significant. CONCLUSIONS: FreeSurfer performed better in volumetric determination than IBASPM. Given the subjective nature of manual tracing, automated image acquisition and analysis image is accurate and preferable.

The Effects of Age, Gender and Head Size on the Cortical Thickness of Brain

OBJECTIVES: Standardization of head size is essential for the volume study. Cortical thickness analyses are increasingly being used in many fields of neuroscience. However, it is not established whether head size correction should be done for thickness study. METHODS: Using the Open Access Series of Imaging Studies data, we determined cortical thickness of 316 cognitively normal participants aged 18-94 with FreeSurfer. The association between head size and cortical thickness of whole cortical mantle and in each lobe among age tertile groups was assessed. Estimated total intracranial volume (eTIV) was calculated for determining head size. RESULTS: Across all participants, cortical thickness in whole brain except some areas in cingulate and insula decreased with aging. eTIV had positive correlation with the thickness of frontal, parietal, occipital and whole brain areas. However, the age effect was not shown in whole brain of the first tertile group and in cingulate areas of the third tertile group. eTIV had negative correlation with the thickness of cingulate in the third tertile group. Gender effects were shown in some areas in third tertile group, but it would be due to difference of head size. CONCLUSIONS: These findings suggest that head size standardization might be done especially in older population and in studies of paralimbic areas.

Total Intracranial Volume Measurement for Children by Using an Automatized Program

OBJECTIVES: Total intracranial volume (TIV) is a major nuisance of neuroimaging research for interindividual differences of brain structure and function. Authors intended to prove the reliability of the atlas scaling factor (ASF) method for TIV estimation in FreeSurfer by comparing it with the results of manual tracing as reference method. METHODS: The TIVs of 26 normal children and 26 children with attention-deficit hyperactivity disorder (ADHD) were obtained by using FreeSurfer reconstruction and manual tracing with T1-weighted images. Manual tracing performed in every 10th slice of MRI dataset from midline of sagittal plane by one researcher who was blinded from clinical data. Another reseacher performed manual tracing independently for randomly selected 20 dataset to verify interrater reliability. RESULTS: The interrater reliability was excellent (intraclass coefficient = 0.91, p < 7.1e-07). There were no significant differences of age and gender distribution between normal and ADHD groups. No significant differences were found between TIVs from ASF method and manual tracing. Strong correlation between TIVs from 2 different methods were shown (r = 0.90, p < 2.2e-16). CONCLUSIONS: The ASF method for TIV estimation by using FreeSurfer showed good agreement with the reference method. We can use the TIV from ASF method for correction in analysis of structural and functional neuroimaging studies with not only elderly subjects but also children, even with ADHD.

A Study of Changes of Inversion Time Effect on Brain Volume of Normal Volunteers

PURPOSE: The objective of this study was to analyze the brain volume according to the brain image of healthy adults in the 20s taken with different inversion time (TI). MATERIALS AND METHODS: Brain images of healthy adults in the 20 s were acquired using magnetization prepared rapid acquisition gradient echo (MPRAGE) pulse sequence with 1.5 mm thickness of pieces and four inversion times (1100 ms, 1000 ms, 900 ms, 800 ms). The acquired brain images were analyzed to measure the volume of white matter (WM), gray matter (GM), intracranial volume (ICV). The statistical difference according to brain volume and gender was analyzed for each TI. RESULTS: The brain volume calculated using Freesurfer was WM=486.52+/-48.64 cm3 and GM=646.86+/-57.12 cm3 in mean when adjusted by mean ICV=1278.94+/-154.92 cm3. Men's brain volume(WM, GM, ICV) was larger than women's brain volume. In the intrarater reliability test, all of the intraclass correlation coefficients were high (0.992 for WM, 0.988 for GM, and 0.997 for ICV). In the repeated measures analysis of variance, GM and ICV did not show a significant difference at each TI (GM p=0.143, ICV p=0.052), but WM showed a significant (p=0.001). In the linear structure relation analysis, all of the Pearson correlation coefficients were high. CONCLUSION: WM, GM, and ICV indicated high reliability and solid linear structure relations, but WM showed significant differences at each TI. The brain volume of healthy adults in the 20s could be used in comparison with that of patients for reference purposes and to predict the structural change of brain. It would be needed to conduct additional studies to examine the contract, SNR, and lesion detection ability according to variable TI.

Uso de volumetría y carga lesional en el seguimiento de pacientes con esclerosis múltiple: experiencia local y revisión de la literatura / Use of lesion volumes and loads for monitoring patients with multiple sclerosis: local experience and literature review

Multiple sclerosis (MS) is a common demyelinating disease that involves the central nervous system causing focal lesions in the brain and spinal cord causing diverse neurological development deficits, many of them severe and irreversible, affecting and invaliding a large percentage of young productive-aged patients. MRI exams have improved diagnostic capability compared to computed tomography, but in this decade the development of new magnets, coils and software have allowed the development of quantitative neuroradiology which achieves the evaluation of parameters such as total brain volume, of each of its structures, as well as semi-automated or automated counting of the lesion load, allowing better monitoring of each individual patient in relation to a particular event such as a new neurological deficit in an outbreak of the disease, a previously undetected cognitive impairment or in related to a given treatment. We will show our local experience using the FreeSurfer software in our habitual practice, as well as other post-processing software, this being the first experience of its use in multiple sclerosis published in our country.

La esclerosis múltiple (EM) es una frecuente enfermedad desmielinizante que afecta el sistema nervioso central produciendo lesiones focales a nivel cerebral y medular que condicionan diversos déficit neurológicos evolutivos, muchos de ellos severos e irreversibles, afectando e invalidando un gran porcentaje de pacientes jóvenes en edad productiva. El estudio con resonancia magnética mejoró la capacidad diagnóstica respecto a la tomografía computada, pero en esta década el desarrollo de nuevos magnetos, bobinas y software han permitido desarrollar la neurorradiología cuantitativa que logra evaluar parámetros como el volumen cerebral global, de cada una de sus estructuras así como el recuento semi o automatizado de la carga lesional, lo que permite el mejor seguimiento de cada paciente individual en relación a un evento determinado como un nuevo déficit neurológico dentro de un brote de la enfermedad, un deterioro cognitivo no detectado previamente o en relación a un tratamiento determinado. Mostraremos nuestra experiencia local utilizando el software freesurfer en nuestra práctica habitual, así como otro software de postproceso, siendo la primera experiencia de su uso en esclerosis múltiple publicada en nuestro país.