Hippocampal but not amygdalar volume loss in narcolepsy with cataplexy.

OBJECTIVE: Narcolepsy with cataplexy (NC) and narcolepsy without cataplexy (NwoC) are lifelong neurological disorders characterized primarily by excessive daytime sleepiness. Emotional events such as laughter are a trigger of cataplexy in NC. METHODS: We compared the volumes of key limbic structures, the amygdala and hippocampus, in 53 NC, 23 NwoC and 37 control subjects. MRI volumetry was performed in FreeSurfer (FS) and by manual delineation. RESULTS: We found no differences in amygdalar volume in the three groups, however, hippocampal volume was significantly smaller in the NC group than in other groups. Amygdalar and hippocampal volumes assessed by FS were significantly greater, but strong positive correlation between manual and FS results were observed. Thus, both methods are suitable for amygdalar and hippocampal volumetry.

Volume of the amygdala is reduced in patients with narcolepsy - a structural MRI study.

OBJECTIVE: Based on the clinical observation that patients suffering from narcolepsy with cataplexy (NC) have cataplectic attacks when they experience positive emotions, it is therefore hypothesised that the abnormal processing of external emotional input through the limbic system, or motor dysregulation induced by emotions, takes place during these episodes. To date, imaging studies have failed to reveal consistent brain abnormalities in NC patients. METHODS: Considering the discrepancies in reported structural or functional abnormalities of the hypothalamus, amygdala, and nucleus accumbens, we used the MRI volumetry to determine the volumes of the amygdala and nucleus accumbens in a group of eleven patients with NC (5 males and 6 females, mean age 41.7 years ± 17.7). This data was compared to an equal number of examinations in healthy volunteers matched for age and gender. RESULTS: We found a decrease in the amygdalar volume of NC patients in both raw (p<0.001) and relative (p<0.01) data sets. The difference in amygdalar volume between healthy volunteers and NC patients was about 17%. In contrast to the amygdala, we did not find any differences in the volumes of nucleus accumbens. CONCLUSION: In the present MRI volumetric study, we found bilateral gray matter loss in the amygdala only.

Volumetry of the human amygdala - an anatomical study.

A striking feature of the studies that have addressed the measurement of the amygdala is the wide range of volumes encountered, with reports of volumes ranging from 1 to almost 4 cm(3). Another striking feature is the number of discrepancies in the landmarks adopted for manual tracing in magnetic resonance imaging (MRI). The goal of our study was to assess the anatomical volume of the amygdala on the basis of its cytoarchitecture while comparing the differences in age and sex. This study was performed on 21 normal male brains (mean age of 56.8 years) and 9 normal female brains (mean age of 61.2 years). The volume of the amygdala was measured by planimetry of Nissl-stained serial sections using ImageJ software. To address the complexity of the amygdala, we elected to use two types of amygdalar measurement that differ mainly in the definition of anterior pole boundaries. The average size of the classic amygdala was 1.24 cm(3) (S.D.=0.14), while the average size of the amygdala with wider borders was 1.63 cm(3) (S.D.=0.2). No interhemispheric or intersexual differences were observed for either type of amygdalar measurement. Neither sex revealed any statistically important relationship between volume of the amygdala and age. Our study was concerned exclusively with the anatomical volume of the amygdala rather than the MRI volume. Nevertheless, our results may have important implications for MRI studies because as of yet there is no gold standard for manual volumetry of the amygdala.

Post-mortem magnetic resonance imaging and its irreplaceable role in determining CNS malformation (hydranencephaly)--case report.

Post-mortem magnetic resonance appears to be a method supplementary to classic pathological-anatomical autopsy in determining foetal abnormalities. Frequently, it plays a key role, primarily where autopsy options are in some way limited (developed autolysis, dilatation of the ventricular system). This case report demonstrates that post-mortem magnetic resonance imaging can precisely determine the type of congenital malformation (hydranencephaly), by contrast to ultrasound, with which alobar holoprosencephaly has been described, often presenting a differential diagnosis problem. Pathological-anatomical autopsy was significantly limited due to this diagnosis and this methodology was incapable of unequivocally determining the type of malformation. We would like to demonstrate by this case report the necessity of performing post-mortem magnetic resonance imaging so that we may precisely determine the diagnosis as requested by the parents and also be able to answer the question posed by risks for future pregnancies.

Validity of primary motor area localization with fMRI versus electric cortical stimulation: a comparative study.

BACKGROUND: Functional magnetic resonance imaging (fMRI) is a widely used method for research and visualization of the brain function. However, its clinical use is still limited. Our objective was to study fMRI reliability in localizing the primary hand motor cortex (M1) under pathological conditions caused by the proximity of a brain tumour. The results were then compared with standard technique of cortical function mapping-electric cortical stimulation (ECS). METHOD: We compared M1 areas localized with the fMRI and ECS in 18 patients with brain tumours in fronto-parietal regions. The 1.5 T blood oxygenation-level dependent (BOLD) fMRI was performed preoperatively using a motor task involving rhythmic touching of the thumb consecutively with other fingers on the same hand contralateral to the affected hemisphere. Each individual fMRI result was displayed at the P < 0.05 significance level corrected for family wise error (more conservative approach) or at the P < 0.001 level uncorrected (less conservative approach) and projected on the T1-weighted image used for neuronavigation. FINDINGS: In 12 patients (66.6%) we found full agreement between the fMRI and ECS. In 3 patients (16.6%) the overlap was only partial, with one ECS testing position on motor response found outside the BOLD signal cluster. In another 3 cases (16.6%) there was a discrepancy between the two methods. The fMRI sensitivity for localizing the ECS reactive M1 cortex was 71%. The fMRI/ECS consistency was within a 5-mm range in 77% of the testing positions used for ECS which complies with the inherent accuracy of the navigation system. CONCLUSIONS: Because the overlap between the two methods never exceeded 10-mm, we found that the fMRI method correctly guided the ECS to the M1 cortex in 83% of patients. Infiltrative growth of the tumour and collateral oedema were the reasons for the BOLD signal suppression in three patients. Our results support using ECS as a more reliable tool for M1 cortical mapping than fMRI.

Evaluation of biocompatibility of the copolymer of 2-hydroxyethyl methacrylate with 2-(methylsulfanyl)ethyl methacrylate.

This study compares subcutaneous and intracerebral biocompatibilty of two hydrogels: copolymer of 2-hydroxyethyl methacrylate with 2-(methylsulfanyl)ethyl methacrylate and poly(2-hydroxyethyl methacrylate) as reference polymer. The experimental copolymer was more biologically inert than poly(2-hydroxyethyl methacrylate) in both the studied parameters, hence the former material is a suitable candidate for biomedical application.