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1.
Neuroimage ; 234: 117999, 2021 07 01.
Article in English | MEDLINE | ID: mdl-33789133

ABSTRACT

Dopamine has direct and complex vasoactive effects on cerebral circulation. Catechol-O-methyltransferase (COMT) regulates cortical dopamine, and its activity can be influenced both genetically and pharmacologically. COMT activity influences the functional connectivity of the PFC at rest, as well as its activity during task performance, determined using blood oxygen level-dependent (BOLD) fMRI. However, its effects on cerebral perfusion have been relatively unexplored. Here, 76 healthy males, homozygous for the functional COMT Val158Met polymorphism, were administered either the COMT inhibitor tolcapone or placebo in a double-blind, randomised design. We then assessed regional cerebral blood flow at rest using pulsed arterial spin labelling. Perfusion was affected by both genotype and drug. COMT genotype affected frontal regions (Val158 > Met158), whilst tolcapone influenced parietal and temporal regions (placebo > tolcapone). There was no genotype by drug interaction. Our data demonstrate that lower COMT activity is associated with lower cerebral blood flow, although the regions affected differ between those affected by genotype compared with those altered by acute pharmacological inhibition. The results extend the evidence for dopaminergic modulation of cerebral blood flow. Our findings also highlight the importance of considering vascular effects in functional neuroimaging studies, and of exercising caution in ascribing group differences in BOLD signal solely to altered neuronal activity if information about regional perfusion is not available.


Subject(s)
Catechol O-Methyltransferase Inhibitors/pharmacology , Catechol O-Methyltransferase/metabolism , Cerebrovascular Circulation/physiology , Magnetic Resonance Imaging/methods , Perfusion Imaging/methods , Spin Labels , Adolescent , Adult , Cerebrovascular Circulation/drug effects , Dopamine/metabolism , Humans , Male , Tolcapone/pharmacology , Young Adult
2.
Mol Psychiatry ; 21(12): 1710-1716, 2016 12.
Article in English | MEDLINE | ID: mdl-26857596

ABSTRACT

Considerable uncertainty exists about the defining brain changes associated with bipolar disorder (BD). Understanding and quantifying the sources of uncertainty can help generate novel clinical hypotheses about etiology and assist in the development of biomarkers for indexing disease progression and prognosis. Here we were interested in quantifying case-control differences in intracranial volume (ICV) and each of eight subcortical brain measures: nucleus accumbens, amygdala, caudate, hippocampus, globus pallidus, putamen, thalamus, lateral ventricles. In a large study of 1710 BD patients and 2594 healthy controls, we found consistent volumetric reductions in BD patients for mean hippocampus (Cohen's d=-0.232; P=3.50 × 10-7) and thalamus (d=-0.148; P=4.27 × 10-3) and enlarged lateral ventricles (d=-0.260; P=3.93 × 10-5) in patients. No significant effect of age at illness onset was detected. Stratifying patients based on clinical subtype (BD type I or type II) revealed that BDI patients had significantly larger lateral ventricles and smaller hippocampus and amygdala than controls. However, when comparing BDI and BDII patients directly, we did not detect any significant differences in brain volume. This likely represents similar etiology between BD subtype classifications. Exploratory analyses revealed significantly larger thalamic volumes in patients taking lithium compared with patients not taking lithium. We detected no significant differences between BDII patients and controls in the largest such comparison to date. Findings in this study should be interpreted with caution and with careful consideration of the limitations inherent to meta-analyzed neuroimaging comparisons.


Subject(s)
Bipolar Disorder/physiopathology , Brain/physiopathology , Adult , Brain/anatomy & histology , Case-Control Studies , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Organ Size/physiology , Retrospective Studies
3.
Psychol Med ; 46(3): 505-18, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26647849

ABSTRACT

BACKGROUND: A hallmark symptom after psychological trauma is the presence of intrusive memories. It is unclear why only some moments of trauma become intrusive, and how these memories involuntarily return to mind. Understanding the neural mechanisms involved in the encoding and involuntary recall of intrusive memories may elucidate these questions. METHOD: Participants (n = 35) underwent functional magnetic resonance imaging (fMRI) while being exposed to traumatic film footage. After film viewing, participants indicated within the scanner, while undergoing fMRI, if they experienced an intrusive memory of the film. Further intrusive memories in daily life were recorded for 7 days. After 7 days, participants completed a recognition memory test. Intrusive memory encoding was captured by comparing activity at the time of viewing 'Intrusive scenes' (scenes recalled involuntarily), 'Control scenes' (scenes never recalled involuntarily) and 'Potential scenes' (scenes recalled involuntarily by others but not that individual). Signal change associated with intrusive memory involuntary recall was modelled using finite impulse response basis functions. RESULTS: We found a widespread pattern of increased activation for Intrusive v. both Potential and Control scenes at encoding. The left inferior frontal gyrus and middle temporal gyrus showed increased activity in Intrusive scenes compared with Potential scenes, but not in Intrusive scenes compared with Control scenes. This pattern of activation persisted when taking recognition memory performance into account. Intrusive memory involuntary recall was characterized by activity in frontal regions, notably the left inferior frontal gyrus. CONCLUSIONS: The left inferior frontal gyrus may be implicated in both the encoding and involuntary recall of intrusive memories.


Subject(s)
Memory, Episodic , Mental Recall , Prefrontal Cortex/physiopathology , Psychological Trauma/physiopathology , Temporal Lobe/physiopathology , Adolescent , Adult , Brain Mapping , Female , Humans , Magnetic Resonance Imaging , Male , Stress Disorders, Post-Traumatic/psychology , United Kingdom , Young Adult
4.
Psychol Med ; 44(14): 2939-48, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25066547

ABSTRACT

BACKGROUND: Major depression is associated with abnormalities in the function and structure of the hippocampus. However, it is unclear whether these abnormalities might also be present in people 'at risk' of illness. METHOD: We studied 62 young people (mean age 18.8 years) at familial risk of depression (FH+) but who had never been depressed themselves. Participants underwent magnetic resonance imaging to assess hippocampal structure and neural responses to a task designed to activate hippocampal memory networks. Magnetic resonance spectroscopy was used to measure levels of a combination of glutamine and glutamate (Glx) in the right hippocampus. A total of 59 matched controls with no history of mood disorder in a first-degree relative underwent the same investigations. RESULTS: Hippocampal volume did not differ between FH+ participants and controls; however, relative to controls, during the memory task, FH+ participants showed increased activation in brain regions encompassing the insular cortices, putamen and pallidum as well as the dorsal anterior cingulate cortex (ACC). FH+ participants also had increased hippocampal levels of Glx. CONCLUSIONS: Euthymic individuals with a parental history of depression demonstrate increased activation of hippocampal-related neural networks during a memory task, particularly in brain regions involved in processing the salience of stimuli. Changes in the activity of the ACC replicate previous findings in FH+ participants using different psychological tasks; this suggests that task-related abnormalities in the ACC may be a marker of vulnerability to depression. Increased levels of Glx in the hippocampus might also represent a risk biomarker but follow-up studies will be required to test these various possibilities.


Subject(s)
Depressive Disorder/physiopathology , Genetic Predisposition to Disease , Hippocampus/physiopathology , Magnetic Resonance Imaging , Adolescent , Adult , Brain Mapping , Depressive Disorder/metabolism , Depressive Disorder/pathology , Female , Hippocampus/metabolism , Hippocampus/pathology , Humans , Magnetic Resonance Spectroscopy , Male , Risk , Young Adult
5.
Psychol Med ; 43(7): 1521-32, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23171530

ABSTRACT

BACKGROUND: Psychological traumatic events, such as war or road traffic accidents, are widespread. A small but significant proportion of survivors develop post-traumatic stress disorder (PTSD). Distressing, sensory-based involuntary memories of trauma (henceforth 'flashbacks') are the hallmark symptom of PTSD. Understanding the development of flashbacks may aid their prevention. This work is the first to combine the trauma film paradigm (as an experimental analogue for flashback development) with neuroimaging to investigate the neural basis of flashback aetiology. We investigated the hypothesis that involuntary recall of trauma (flashback) is determined during the original event encoding. Method A total of 22 healthy volunteers viewed a traumatic film whilst undergoing functional magnetic resonance imaging (fMRI). They kept a 1-week diary to record flashbacks to specific film scenes. Using a novel prospective fMRI design, we compared brain activation for those film scenes that subsequently induced flashbacks with both non-traumatic control scenes and scenes with traumatic content that did not elicit flashbacks ('potentials'). RESULTS: Encoding of scenes that later caused flashbacks was associated with widespread increases in activation, including in the amygdala, striatum, rostral anterior cingulate cortex, thalamus and ventral occipital cortex. The left inferior frontal gyrus and bilateral middle temporal gyrus also exhibited increased activation but only relative to 'potentials'. Thus, these latter regions appeared to distinguish between traumatic content that subsequently flashed back and comparable content that did not. CONCLUSIONS: Results provide the first prospective evidence that the brain behaves differently whilst experiencing emotional events that will subsequently become involuntary memories - flashbacks. Understanding the neural basis of analogue flashback memory formation may aid the development of treatment interventions for this PTSD feature.


Subject(s)
Brain/physiology , Mental Recall/physiology , Stress Disorders, Post-Traumatic/physiopathology , Stress, Psychological/physiopathology , Adult , Amygdala/physiology , Amygdala/physiopathology , Brain/physiopathology , Corpus Striatum/physiology , Corpus Striatum/physiopathology , Female , Functional Neuroimaging , Gyrus Cinguli/physiology , Gyrus Cinguli/physiopathology , Humans , Magnetic Resonance Imaging , Male , Occipital Lobe/physiology , Occipital Lobe/physiopathology , Prospective Studies , Stress Disorders, Post-Traumatic/psychology , Temporal Lobe/physiology , Temporal Lobe/physiopathology , Thalamus/physiology , Thalamus/physiopathology , Young Adult
6.
Psychol Med ; 42(6): 1195-202, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22030013

ABSTRACT

BACKGROUND: Neuropsychological impairment is a key feature of late-life depression, with deficits observed across multiple domains. However, it is unclear whether deficits in multiple domains represent relatively independent processes with specific neural correlates or whether they can be explained by cognitive deficits in executive function or processing speed. METHOD: We examined group differences across five domains (episodic memory; executive function; language skills; processing speed; visuospatial skills) in a sample of 36 depressed participants and 25 control participants, all aged ≥ 60 years. The influence of executive function and processing speed deficits on other neuropsychological domains was also investigated. Magnetic resonance imaging correlates of executive function, processing speed and episodic memory were explored in the late-life depression group. RESULTS: Relative to controls, the late-life depression group performed significantly worse in the domains of executive function, processing speed, episodic memory and language skills. Impairments in executive function or processing speed were sufficient to explain differences in episodic memory and language skills. Executive function was correlated with anisotropy of the anterior thalamic radiation and uncinate fasciculus; processing speed was correlated with anisotropy of genu of the corpus callosum. Episodic memory was correlated with anisotropy of the anterior thalamic radiation, the genu and body of the corpus callosum and the fornix. CONCLUSIONS: Executive function and processing speed appear to represent important cognitive deficits in late-life depression, which contribute to deficits in other domains, and are related to reductions in anisotropy in frontal tracts.


Subject(s)
Brain/physiopathology , Cognition Disorders/physiopathology , Depressive Disorder/physiopathology , Neuropsychology , Age Factors , Aged , Anisotropy , Brain Mapping , Case-Control Studies , Executive Function/physiology , Female , Humans , Magnetic Resonance Imaging , Male , Memory, Episodic , Middle Aged , Neuropsychological Tests/statistics & numerical data , Reaction Time/physiology , Severity of Illness Index
7.
Neuroimage ; 59(4): 3821-8, 2012 Feb 15.
Article in English | MEDLINE | ID: mdl-22155375

ABSTRACT

Several studies have demonstrated age-related regional differences in the magnitude of the BOLD signal using task-based fMRI. It has been suggested that functional changes reflect either compensatory or de-differentiation mechanisms, both of which assume response to a specific stimulus. Here, we have tested whether ageing affects both task-based and resting brain function, and the extent to which functional changes are mediated by reductions in grey matter (GM) volume. Two groups, of 22 healthy younger and 22 older volunteers, underwent an imaging protocol involving structural and functional MRI, both during a memory task and at rest. The two groups had similar socio-demographical characteristics and cognitive performance. Image analysis revealed both structural and functional differences. Increased BOLD signal in older relative to younger volunteers was mainly observed in the frontal lobes, both during the task and at rest. Functional changes in the frontal lobes were largely located in brain regions spared from GM loss, and adding GM covariates to the fMRI analysis did not significantly alter the group differences. Our results are consistent with the suggestion that, during normal ageing, the brain responds to neuronal loss by fine-tuning connections between spared neurons. Longitudinal studies will be necessary to fully test this hypothesis.


Subject(s)
Brain/physiology , Magnetic Resonance Imaging , Memory/physiology , Rest/physiology , Adult , Age Factors , Aged , Female , Humans , Male , Middle Aged , Young Adult
8.
Schizophr Res ; 134(2-3): 125-30, 2012 Feb.
Article in English | MEDLINE | ID: mdl-22138046

ABSTRACT

BACKGROUND: Are anomalies of cerebral asymmetry integral to the disease process? Here, we examined the influence of age, chronicity and age of onset of illness in 34 patients with early onset schizophrenia and 20 controls in relation to structural asymmetries of the temporal lobe and performance asymmetries on a semantic language lexical decision task. METHODS: Volumetric MRI and a novel divided visual field probe of lateralised lexico-semantic language were assessed in patients with early onset schizophrenia (EOS) and controls. Novel ratios of age-illness overlap and directional asymmetry were developed in order to examine the association of chronicity factors to asymmetry. RESULTS: Loss of laterality on the lexical decision task and discordant structural asymmetry were correlated with duration of illness but were not seen in younger, less chronic patients. Reduced lateral processing speed, and discordant structural asymmetry were associated with greater proportion of lifetime schizophrenia. CONCLUSION: Although the conclusions are limited by the cross sectional nature of the study, anomalies of cerebral asymmetry in early onset patients may be an index of disease progression, and reflect directly on the disease process.


Subject(s)
Functional Laterality/physiology , Schizophrenia/physiopathology , Semantics , Temporal Lobe/pathology , Adolescent , Disease Progression , Female , Humans , Magnetic Resonance Imaging , Male , Psychiatric Status Rating Scales , Schizophrenia/pathology , Visual Fields/physiology , Vocabulary , Young Adult
9.
Neuroimage ; 54(1): 602-10, 2011 Jan 01.
Article in English | MEDLINE | ID: mdl-20705142

ABSTRACT

Increasing age and carrying an APOE ε4 allele are well established risk factors for Alzheimer's disease (AD). The earlier age of onset of AD observed in ε4-carriers may reflect an accelerated aging process. We recently reported that APOE genotype modulates brain function decades before the appearance of any cognitive or clinical symptoms. Here we test the hypothesis that APOE influences brain aging by comparing healthy ε4-carriers and non-carriers, using the same imaging protocol in distinct groups of younger and older healthy volunteers. A cross-sectional factorial design was used to examine the effects of age and APOE genotype, and their interaction, on fMRI activation during an encoding memory task. The younger (N=36; age range 20-35; 18 ε4-carriers) and older (35 middle-age/elderly; age range 50-78 years; 15 ε4-carriers) healthy volunteers taking part in the study were cognitively normal. We found a significant interaction between age and ε4-status in the hippocampi, frontal pole, subcortical nuclei, middle temporal gyri and cerebellum, such that aging was associated with decreased activity in e4-carriers and increased activity in non-carriers. Reduced cerebral blood flow was found in the older ε4-carriers relative to older non-carriers despite preserved grey matter volume. Overactivity of brain function in young ε4-carriers is disproportionately reduced with advancing age even before the onset of measurable memory impairment. The APOE genotype determines age-related changes in brain function that may reflect the increased vulnerability of ε4-carriers to late-life pathology or cognitive decline.


Subject(s)
Apolipoproteins E/genetics , Brain/physiology , Cognition/physiology , Life Expectancy , Magnetic Resonance Imaging/methods , Memory/physiology , Aged , Alzheimer Disease/blood , Alzheimer Disease/epidemiology , Apolipoprotein E4/blood , Brain/growth & development , Carrier State/epidemiology , Cerebrovascular Circulation/physiology , Cognition Disorders/epidemiology , Cognition Disorders/genetics , Female , Genotype , Humans , Male , Middle Aged , Neuropsychological Tests , Reaction Time , Reference Values , Risk Factors
10.
Mol Psychiatry ; 16(9): 908-16, 2011 Sep.
Article in English | MEDLINE | ID: mdl-20820167

ABSTRACT

The Apolipoprotein E (APOE) ɛ4 allele is the best-established genetic risk factor for sporadic Alzheimer's disease, and is also associated with structural gray matter and functional brain changes in healthy young, middle-aged and elderly subjects. Because APOE is implicated in brain mechanisms associated with white matter (WM) development and repair, we investigated the potential role played by the APOE polymorphism on WM structure in healthy younger (aged 20-35 years) and older (aged 50-78 years) adults using diffusion tensor imaging. General reduction of fractional anisotropy and increase in mean diffusivity values was found in carriers of the APOE ɛ4 allele relative to non-carriers. No significant interactions between genotype and age were observed, suggesting that differences in WM structure between APOE ɛ4-carriers and non-carriers do not undergo significant differential changes with age. This result was not explained by differences in brain morphology or cognitive measures. The APOE ɛ4 allele modulates brain WM structure before any clinical or neurophysiological expression of impending disease.


Subject(s)
Apolipoprotein E4/physiology , Brain/anatomy & histology , Nerve Fibers, Myelinated/physiology , Adult , Age Factors , Aged , Alleles , Anisotropy , Apolipoprotein E4/genetics , Diffusion Tensor Imaging/methods , Diffusion Tensor Imaging/statistics & numerical data , Female , Genotype , Humans , Male , Middle Aged , Nerve Fibers, Unmyelinated/physiology
11.
Neurology ; 75(18): 1645-52, 2010 Nov 02.
Article in English | MEDLINE | ID: mdl-21041787

ABSTRACT

OBJECTIVE: While the hallmark of amyotrophic lateral sclerosis (ALS) is corticospinal tract in combination with lower motor neuron degeneration, the clinical involvement of both compartments is characteristically variable and the site of onset debated. We sought to establish whether there is a consistent signature of cerebral white matter abnormalities in heterogeneous ALS cases. METHODS: In this observational study, diffusion tensor imaging was applied in a whole-brain analysis of 24 heterogeneous patients with ALS and well-matched healthy controls. Tract-based spatial statistics were used, with optimized voxel-based morphometry of T1 images to determine any associated gray matter involvement. RESULTS: A consistent reduction in fractional anisotropy was demonstrated in the corpus callosum of the ALS group, extending rostrally and bilaterally to the region of the primary motor cortices, independent of the degree of clinical upper motor neuron involvement. Matched regional radial diffusivity increase supported the concept of anterograde degeneration of callosal fibers observed pathologically. Gray matter reductions were observed bilaterally in primary motor and supplementary motor regions, and also in the anterior cingulate and temporal lobe regions. A post hoc group comparison model incorporating significant values for fractional anisotropy, radial diffusivity, and gray matter was 92% sensitive, 88% specific, with an accuracy of 90%. CONCLUSION: Callosal involvement is a consistent feature of ALS, independent of clinical upper motor neuron involvement, and may reflect independent bilateral cortical involvement or interhemispheric spread of pathology. The predominantly rostral corticospinal tract involvement further supports the concept of independent cortical degeneration even in those patients with ALS with predominantly lower motor neuron involvement clinically.


Subject(s)
Amyotrophic Lateral Sclerosis/pathology , Corpus Callosum/physiopathology , Adult , Aged , Aged, 80 and over , Amyotrophic Lateral Sclerosis/physiopathology , Anisotropy , Brain Mapping , Case-Control Studies , Diffusion Tensor Imaging/methods , Discriminant Analysis , Female , Humans , Male , Middle Aged , Motor Cortex/pathology , Obsessive Behavior , Severity of Illness Index
12.
Neuroimage ; 41(3): 1067-74, 2008 Jul 01.
Article in English | MEDLINE | ID: mdl-18424082

ABSTRACT

Heavy marijuana use has well established long term consequences for cognition and mental health, but the effect on brain structure is less well understood. We used an MRI technique that is sensitive to the structural integrity of brain tissue combined with a white matter mapping tractography technique to investigate structural changes in the corpus callosum (CC). Diffusion tensor imaging (DTI) was obtained in eleven heavy marijuana users who started using marijuana in early adolescence and eleven age matched controls. Mean diffusivity (MD) and fractional anisotropy (FA) (which measure structural integrity and tract coherence, respectively) were analysed within the corpus callosum which was spatially defined using tractography and tract-based spatial statistics (TBSS). MD was significantly increased in marijuana users relative to controls in the region of the CC where white matter passes between the prefrontal lobes. This observation suggests impaired structural integrity affecting the fibre tracts of the CC and is in keeping with previous reports of altered and diversified activation patterns in marijuana users. There was a trend towards a positive correlation between MD and length of use suggesting the possibility of a cumulative effect of marijuana over time and that a younger age at onset of use may predispose individuals to structural white matter damage. Structural abnormalities revealed in the CC may underlie cognitive and behavioural consequences of long term heavy marijuana use.


Subject(s)
Cannabis/adverse effects , Corpus Callosum/drug effects , Corpus Callosum/pathology , Diffusion Magnetic Resonance Imaging , Adult , Humans , Image Processing, Computer-Assisted , Male
13.
Mol Psychiatry ; 13(11): 1011-20, 2008 Nov.
Article in English | MEDLINE | ID: mdl-17955021

ABSTRACT

Recent neuropsychological studies in healthy volunteers suggest that antidepressants enhance the processing of positive emotional information. However, the neural substrates underpinning these changes have not been fully elucidated. The current study, therefore, used functional magnetic resonance imaging (fMRI) to map brain systems activated during successful categorization and subsequent recognition of self-referent positive and negative personality characteristics in healthy volunteers following short-term (7 days) repeated administration of the selective noradrenergic reuptake inhibitor reboxetine. Twenty-four healthy volunteers were randomly assigned to 7-day double-blind intervention with reboxetine or placebo. On day 7, neural responses during the categorization and subsequent recognition of positive and negative characteristics were assessed using fMRI. Questionnaires monitoring mood, hostility and anxiety were given before and during this intervention. During categorization, reboxetine was associated with greater activation to positive words, relative to negative words, in left precuneus and right inferior frontal gyrus. By contrast, at subsequent recognition reboxetine was associated with reduced response to positive words, relative to negative words, in left precuneus, anterior cingulate and medial frontal gyrus. These changes in the neural processing of positive and negative words occurred in the absence of significant differences in ratings of mood and anxiety. Such adaptations in the neural processing of emotional information support the hypothesis that antidepressants have early effects on emotional processing in a manner which would be expected to reverse negative biases in depression.


Subject(s)
Antidepressive Agents/pharmacology , Brain/blood supply , Brain/drug effects , Emotions/drug effects , Magnetic Resonance Imaging , Morpholines/pharmacology , Adolescent , Adult , Analysis of Variance , Brain Mapping , Double-Blind Method , Female , Humans , Image Processing, Computer-Assisted/methods , Male , Oxygen/blood , Photic Stimulation/methods , Reaction Time/drug effects , Reboxetine , Young Adult
14.
Neuroimage ; 33(3): 867-77, 2006 Nov 15.
Article in English | MEDLINE | ID: mdl-17000119

ABSTRACT

As diffusion tractography is increasingly used to generate quantitative measures to address clinical questions, it is important to characterise the inter-session reproducibility and inter-subject variability of these measures. Here, we assess the reproducibility and variability of diffusion tractography measures using diffusion data from 8 subjects scanned 3 times. We used probabilistic tractography to define the cingulum bundle, pyramidal tracts, optic radiations and genu of the corpus callosum in each individual data set using three different methods of seed definition. Measures of mean fractional anisotropy (FA) and mean diffusivity (MD) along the tracts were more reproducible than measures of tract volume. Further, tracts defined using a two region of interest (ROI) approach were more reproducible than those defined using manually placed seed masks alone. For mean FA taken from tracts defined using the two ROI approach, inter-session coefficients of variation (CV) were all below 5% and inter-subject CVs were below 10%; for mean MD inter-session, CVs were all below 3% and inter-subject CVs were below 8%. We use the variability measures found here to calculate the sample sizes required to detect changes in FA, MD or tract volume of a given size, either between groups of subjects or within subjects over time. Finally, we compare tractography results using 60 diffusion encoding directions to those found using a subset of 12 directions; the number of diffusion directions did not have a significant effect on reproducibility, but tracts derived using fewer directions were consistently smaller than those derived using 60 direction data. We suggest that 12 direction data are sufficient for reproducibly defining the core of large bundles but may be less sensitive to smaller pathways.


Subject(s)
Brain/anatomy & histology , Diffusion Magnetic Resonance Imaging/statistics & numerical data , Adult , Brain/pathology , Female , Humans , Image Processing, Computer-Assisted , Male , Mesencephalon/anatomy & histology , Pyramidal Tracts/anatomy & histology , Reproducibility of Results , Sample Size
15.
Eur Neurol ; 49(1): 3-7, 2003.
Article in English | MEDLINE | ID: mdl-12464711

ABSTRACT

The aim of our study was to determine when foramen ovale recordings add useful information to scalp EEG recordings and magnetic resonance imaging (MRI) with hippocampal measurements. We evaluated the outcome of 79 patients with non-lesional partial epilepsy with presumed temporal seizure onset. Ictal foramen ovale recordings were performed in 16 patients with normal MRI ('MRI-negative group') and 41 patients with lateralizing MRI but non-lateralizing scalp EEG ('discordant group'). 22 patients with concordant MRI and scalp EEG were not investigated with foramen ovale recordings ('concordant group'). The seizure-free rate was higher in concordant than discordant patients despite additional investigation with foramen ovale electrodes (71 and 55% seizure free, respectively). No useful localizing information was added with foramen ovale recordings in MRI-negative patients.


Subject(s)
Electroencephalography/methods , Epilepsies, Partial/surgery , Epilepsy, Temporal Lobe/surgery , Magnetic Resonance Imaging , Adult , Brain Mapping , Dominance, Cerebral/physiology , Electrodes , Epilepsies, Partial/physiopathology , Epilepsy, Temporal Lobe/physiopathology , Female , Hippocampus/pathology , Hippocampus/physiopathology , Hippocampus/surgery , Humans , Male , Middle Aged , Predictive Value of Tests , Psychosurgery , Sclerosis/pathology , Sclerosis/physiopathology , Sclerosis/surgery , Subarachnoid Space , Temporal Lobe/pathology , Temporal Lobe/physiopathology , Temporal Lobe/surgery , Treatment Outcome
16.
J Neurol Neurosurg Psychiatry ; 73(6): 648-55, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12438464

ABSTRACT

OBJECTIVES: To investigate the use of whole brain voxel based morphometry (VBM) and stereological analysis to study brain morphology in patients with medically intractable temporal lobe epilepsy; and to determine the relation between side, duration, and age of onset of temporal lobe epilepsy, history of childhood febrile convulsions, and grey matter structure. METHODS: Three dimensional magnetic resonance images were obtained from 58 patients with left sided seizure onset (LSSO) and 58 patients with right sided seizure onset (RSSO), defined using EEG and foramen ovale recordings in the course of presurgical evaluation for temporal lobectomy. Fifty eight normal controls formed a comparison group. VBM was used to characterise whole brain grey matter concentration, while the Cavalieri method of modern design stereology in conjunction with point counting was used to estimate hippocampal and amygdala volume. Age and sex were used as confounding covariates in analyses. RESULTS: LSSO and RSSO patients showed significant reductions in volume (using stereology) and grey matter concentration (using VBM) of the hippocampus, but not of the amygdala, in the presumed epileptogenic zone when compared with controls, but hippocampal (and amygdala) volume and grey matter concentration were not related to duration or age of onset of epilepsy. LSSO and RSSO patients with a history of childhood febrile convulsions had reduced hippocampal volumes in the presumed epileptogenic zone compared with patients without such a history. Left amygdala volume was also reduced in LSSO patients with a history of childhood convulsions. VBM results indicated bilateral thalamic, prefrontal, and cerebellar GMC reduction in patients, which correlated with duration and age of onset of epilepsy. CONCLUSIONS: Hippocampal sclerosis is not necessarily the consequence of recurrent temporal lobe seizures. A major cause of hippocampal sclerosis appears to be an early aberrant neurological insult, such as childhood febrile seizures. Secondary brain abnormalities exist in regions outside the presumed epileptogenic zone and may result from recurrent seizures.


Subject(s)
Brain/pathology , Dominance, Cerebral/physiology , Epilepsy, Temporal Lobe/diagnosis , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional/methods , Magnetic Resonance Imaging/methods , Seizures, Febrile/diagnosis , Adolescent , Adult , Amygdala/pathology , Atrophy , Brain Mapping/methods , Child , Child, Preschool , Epilepsy, Temporal Lobe/etiology , Female , Hippocampus/pathology , Humans , Infant , Male , Middle Aged , Recurrence , Risk Factors , Seizures, Febrile/etiology , Temporal Lobe/pathology
17.
Magn Reson Imaging ; 18(10): 1187-99, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11167039

ABSTRACT

We present the results of quantitative Magnetic Resonance Imaging (MRI) in 55 consecutively referred patients with clinical evidence of temporal lobe epilepsy (TLE). The Cavalieri method was used in combination with point counting to provide unbiased estimates of the volume of the left and right hippocampus, amygdala, temporal lobe, lateral ventricles and cerebral hemisphere, and pixel by pixel maps of the T2 relaxation time were computed for both central and anterior sections of the hippocampus. The 99th centiles of hippocampal volume, hippocampal volume asymmetry and T2 relaxation times in 20 control subjects provided limits which identified the presence of MTS. The results of the quantitative MRI were compared with the results of conventional diagnostic MRI, foramen ovale (FO) recording and the WADA test. Thirty-one patients were found to have unilateral MTS (17 left and 14 right) and 7 bilateral MTS. No evidence of MTS was detected in 16 patients. Of the 31 patients diagnosed with unilateral MTS on the basis of hippocampal volume and T2 measurement, 74% and 77% would respectively have received the same diagnosis on the basis of hippocampal volume and T2 measurements alone. In comparison to FO recording, quantitative MRI has a sensitivity of 55% and a specificity of 86%, while conventional diagnostic MRI has a sensitivity of 42% and a specificity of 80% for detection of MTS. Unilateral abnormalities were detected by FO recording in 30% cent of patients who appeared normal on quantitative MRI. WADA test results were available for 40 patients. The findings were consistent with quantitative MRI showing reduced memory function ipsilateral to unilateral MTS in 18 patients, but reduced memory function contralateral to unilateral MTS in two patients, and reduced memory function without MR abnormality in seven patients. WADA testing revealed unilateral memory impairments where MRI found bilateral pathology in 4 patients and in 4 patients in whom quantitative MRI detected unilateral MTS there was no evidence of reduced memory during WADA testing of the corresponding cerebral hemisphere. In the patients with unilateral right MTS a highly significant negative correlation (p = 0.0003) was observed between age of onset and the volume of the contralateral temporal lobe. Quantitative MR imaging of the hippocampus (i.e. volume and T2 measurement) is preferable to conventional radiological reporting for providing objective evidence of the presence of MTS on which to base the referral of patients for surgery, and since it has associated morbidity FO recording is now only being used in selected patients. Furthermore, stereology provides a convenient method for estimating the volume of other brain structures, which is relevant to obtaining a better understanding of the effects of laterality and age of onset of TLE.


Subject(s)
Epilepsy, Temporal Lobe/pathology , Hippocampus/pathology , Magnetic Resonance Imaging , Adolescent , Adult , Brain Mapping , Case-Control Studies , Epilepsy, Temporal Lobe/surgery , Female , Humans , Male , Middle Aged , Preoperative Care , Sensitivity and Specificity
18.
Fundam Appl Toxicol ; 30(1): 23-30, 1996 Mar.
Article in English | MEDLINE | ID: mdl-8812209

ABSTRACT

A method is presented for the isolation of a 155-kDa protein that possesses phenyl valerate hydrolysis activity in the presence of paraoxon but is inhibited by mipafox; the functional definition of neuropathy target esterase (neurotoxic esterase; NTE). Microsomes, isolated from 18-day-old chicken embryos were treated with phospholipase A2 to solubilize the NTE activity. The extract was then combined with polyoxyethylene W1 detergent and resolved by gel filtration chromatography to yield an active fraction with an approximate mass of 200 kDa. This fraction was further purified by preparative isoelectric focusing and native electrophoresis to yield two separate bands possessing NTE activity. The slower migrating band was highly enriched in a 155-kDa protein that was identified as a source of the NTE activity by affinity chromatography using 3-(9'-mercaptononylthio)-1,1,1-trifluoro-propan-2-one bound to Sepharose CL6B. This represents the first report of the isolation of NTE in its active form and aids in the confirmation of the 155-kDa protein as the most likely candidate for NTE.


Subject(s)
Carboxylic Ester Hydrolases/analysis , Carboxylic Ester Hydrolases/isolation & purification , Proteins/isolation & purification , Proteins/physiology , Animals , Chick Embryo , Chromatography, Affinity , Chromatography, Gel , Electrophoresis, Polyacrylamide Gel , Isoelectric Focusing , Isoflurophate/analogs & derivatives , Isoflurophate/antagonists & inhibitors , Proteins/analysis
19.
Microsc Res Tech ; 26(6): 473-88, 1993 Dec 15.
Article in English | MEDLINE | ID: mdl-8305725

ABSTRACT

We used intravital microscopy of small intestine and pancreas in order to show dynamic interactions between vascular wall and undiluted Mercox, because previous studies of ours have shown that Mercox diluted with monomeric methylmethacrylate penetrates cells in the vascular wall. Scanning and transmission electron microscopy were used to show three-dimensional pathways and correlating tissue structures, which cannot be identified in vivo. The microvascular diameters were not altered when the vasculature was flushed with saline/dextran solution using perfusion pressures between 70 and 140 mm Hg, but, in circumscribed areas, contraction of vascular wall was observed immediately after Mercox injection. This phenomenon was carried out by endothelial cells; pericytes were never present at the site of constrictions. Extravasation, i.e., leakage of the resin into the surrounding tissue, occurred in circumscribed areas regardless of the applied perfusion pressure. The resin also filled routes, which were not perfused with blood before casting. Scanning microscopy of corresponding specimens showed flattened cast channels, with impressions of valves and endothelial cell nuclear imprints characteristic of lymphatics. These results show that undiluted Mercox is a stimulus for vascular cellular components and that it changes the vascular wall permeability, resulting in extravasation and filling of lymphatics. Transmission electron microscopy showed that large vessels were homogeneously filled with resin and that cellular structures were not infiltrated with Mercox. Cut sections of the gold-coated surface of casts showed grooves up to 20 nm wide, suggestive of minimal deformation, while the abluminal surface of the metal film was almost smooth. Another proof of minimal deformation of undiluted Mercox casts is that the diameter of vessels was not altered during and after polymerization. Obtained casts are not fragile, as are casts of diluted Mercox, and phase separation does not occur, which would result in penetration of the cells in the vascular wall. For these reasons, the use of undiluted Mercox is recommended. Mixing 10 ml Mercox with 1 g catalyst resulted in complete polymerization within 5.5-7 min. This mixture can be used for casting biological specimens.


Subject(s)
Corrosion Casting , Microcirculation/ultrastructure , Microscopy, Electron/methods , Animals , Female , Intestine, Small/blood supply , Intestine, Small/ultrastructure , Lymphatic System/ultrastructure , Male , Microscopy, Electron, Scanning/methods , Pancreas/blood supply , Pancreas/ultrastructure , Rats , Rats, Sprague-Dawley
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