Late measures of microstructural alterations in severe neonatal hypoxic-ischemic encephalopathy by MR diffusion tensor imaging.

Neonatal hypoxic-ischemic encephalopathy is a major cause of brain damage in infants, and is associated with periventricular white matter injury and chronic neurological dysfunctions. However, the mechanisms of the chronic white matter injury and reorganization are still unclear. In this study, in vivo diffusion tensor imaging (DTI) was employed to evaluate the late changes of white matter microstructural integrity in the rat brains at 10 weeks after severe neonatal hypoxic-ischemic insults at postnatal day 7. In the fractional anisotropy directionality map, qualitative evaluation showed that a dorsoventrally oriented fiber bundle extended from the corpus callosum into the cyst in the anterior brain, whilst the posterior peri-infarct areas had similar fiber orientations as the contralateral internal capsule, optic tract and fimbria of hippocampus. Compared to the contralateral hemisphere, significantly higher fractional anisotropy, axial diffusivity and diffusion trace value were observed quantitatively in the distal end of the extended fiber bundle connecting the anterior and posterior white matters rostrocaudally. A significantly lower fractional anisotropy but higher axial and radial diffusivities and trace were also found in the ipsilateral corpus callosum, proximal external capsule and anterior commissure, while slightly lower fractional anisotropy and axial diffusivity were noticed in the ipsilateral internal capsule and optic nerve. It was suggested that increased fractional anisotropy, axial diffusivity and trace characterize white matter reorganization in chronic neonatal hypoxic-ischemic insults, whereas reduction in fractional anisotropy appears to characterize two types of white matter lesions, with significantly higher axial and radial diffusivities and trace being primary and slightly lower axial diffusivity being secondary. Combined with fractional anisotropy directionality map, in vivo DTI provides important indices to differentiate the chronic effects of severe neonatal hypoxic-ischemic injury and recovery globally, quantitatively and non-invasively.

Longitudinal diffusion tensor magnetic resonance imaging study of radiation-induced white matter damage in a rat model.

Radiation-induced white matter (WM) damage is a major side effect of whole brain irradiation among childhood cancer survivors. We evaluate longitudinally the diffusion characteristics of the late radiation-induced WM damage in a rat model after 25 and 30 Gy irradiation to the hemibrain at 8 time points from 2 to 48 weeks postradiation. We hypothesize that diffusion tensor magnetic resonance imaging (DTI) indices including fractional anisotropy (FA), trace, axial diffusivity (lambda(//)), and radial diffusivity (lambda( perpendicular)) can accurately detect and monitor the histopathologic changes of radiation-induced WM damage, measured at the EC, and that these changes are dose and time dependent. Results showed a progressive reduction of FA, which was driven by reduction in lambda(//) from 4 to 40 weeks postradiation, and an increase in lambda( perpendicular) with return to baseline in lambda(//) at 48 weeks postradiation. Histologic evaluation of irradiated WM showed reactive astrogliosis from 4 weeks postradiation with reversal at 36 weeks, and demyelination, axonal degeneration, and necrosis at 48 weeks postradiation. Moreover, changes in lambda(//) correlated with reactive astrogliosis (P < 0.01) and lambda( perpendicular) correlated with demyelination (P < 0.01). Higher radiation dose (30 Gy) induced earlier and more severe histologic changes than lower radiation dose (25 Gy), and these differences were reflected by the magnitude of changes in lambda(//) and lambda( perpendicular). DTI indices reflected the histopathologic changes of WM damage and our results support the use of DTI as a biomarker to noninvasively monitor radiation-induced WM damage.

Characterization of white matter injury in a hypoxic-ischemic neonatal rat model by diffusion tensor MRI.

BACKGROUND AND PURPOSE: We evaluate white matter (WM) injury after hypoxic-ischemic (HI) insult in a neonatal rat model using diffusion tensor imaging (DTI) to determine whether lambda(parallel) and lambda(perpendicular) are able to characterize type and severity of brain damage. METHODS: Eighteen 7-day-old Sprague-Dawley rats underwent unilateral ligation of left common carotid artery followed by 50 minutes (n=9) or 90 minutes (n=9) of hypoxia at 37 degrees C. Rats were divided into 2 groups, according to absence (group A, n=11) or presence (group B, n=7) of cystic lesions on D7 post-HI T2-weighted imaging. DTI was performed for all rats at D1 and for group A rats at D7 post-HI. Signal intensity of ipsilateral and contralateral external capsule (EC) on D1 was compared by paired t test, with histological correlation. RESULTS: Group A rats had significantly reduced FA, elevated trace, elevated lambda(perpendicular), and similar lambda(parallel) on D1 in the ipsilateral compared to contralateral EC, whereas group B rats had significant reduction in all parameters in the ipsilateral EC. Elevated trace normalized on D7 in group A rats. Histopathologic results demonstrated reduced myelination in group A noncystic HI and severe necrosis in group B cystic HI. CONCLUSIONS: Increased lambda(perpendicular) with no significant change in lambda(parallel) appears to characterize noncystic WM injury with reduced myelination, whereas reduction in both lambda(parallel) and lambda(perpendicular) characterize severe damage with loss of structural integrity and necrosis. Combining with FA and trace, lambda(parallel) and lambda(perpendicular) provide additional information which reflects type and severity of HI injury.

Cervical spinal cord BOLD fMRI study: modulation of functional activation by dexterity of dominant and non-dominant hands.

The objective of this study was to investigate the effect of dexterity on the magnitude of signal changes in functional magnetic resonance imaging (fMRI) in the cervical spinal cord with unilateral finger-tapping. Right-handed healthy volunteers were investigated with blood oxygenation level-dependent (BOLD) fMRI. Spinal cord BOLD functional MR images were acquired from 10 healthy right-handed volunteers who performed four sessions of unilateral finger-tapping tasks: left sequential (LS), right sequential (RS), left interleaved (LI), and right interleaved (RI) tasks. Our results from the difficulty measurement test showed that finger-tapping in interleaved order was more difficult than in sequential order. For the functional activation, seven out of 10 subjects had activation in all four fMRI sessions (two of the subjects who showed no detectable activation had problems in volume registration). The mean contrast value of the activation area inside the entire cervical spinal cord was significantly higher in performing LS than RS tasks. The increase in the mean contrast value was because the less skilled and competent right hemisphere required additional processing power for doing the left hand task than the left hemisphere required in doing the right hand task. The analysis of the interleaved finger-tapping tasks did not show any significant difference in the results. This was probably because the interleaved task was similarly challenging for both hands, and required high dexterity. Therefore, differences in activity between the left and right hands were less apparent. Our results showed the modulation of activation intensity in the spinal cord by the dexterity.