Magnetic Susceptibility from Quantitative Susceptibility Mapping Can Differentiate New Enhancing from Nonenhancing Multiple Sclerosis Lesions without Gadolinium Injection.

BACKGROUND AND PURPOSE: Magnetic susceptibility values of multiple sclerosis lesions increase as they change from gadolinium-enhancing to nonenhancing. Can susceptibility values measured on quantitative susceptibility mapping without gadolinium injection be used to identify the status of lesion enhancement in surveillance MR imaging used to monitor patients with MS? MATERIALS AND METHODS: In patients who had prior MR imaging and quantitative susceptibility mapping in a current MR imaging, new T2-weighted lesions were evaluated for enhancement on conventional T1-weighted imaging with gadolinium, and their susceptibility values were measured on quantitative susceptibility mapping. Receiver operating characteristic analysis was used to assess the diagnostic accuracy of using quantitative susceptibility mapping in distinguishing new gadolinium-enhancing from new nonenhancing lesions. A generalized estimating equation was used to assess differences in susceptibility values among lesion types. RESULTS: In 54 patients, we identified 86 of 133 new lesions that were gadolinium-enhancing and had relative susceptibility values significantly lower than those of nonenhancing lesions (ß = -17.2; 95% CI, -20.2 to -14.2; P < .0001). Using susceptibility values to discriminate enhancing from nonenhancing lesions, we performed receiver operating characteristic analysis and found that the area under the curve was 0.95 (95% CI, 0.92-0.99). Sensitivity was measured at 88.4%, and specificity, at 91.5%, with a cutoff value of 11.2 parts per billion for quantitative susceptibility mapping-measured susceptibility. CONCLUSIONS: During routine MR imaging monitoring to detect new MS lesion activity, quantitative susceptibility mapping can be used without gadolinium injection for accurate identification of the BBB leakage status in new T2WI lesions.

Sensorimotor Cortex Reorganization in Alzheimer's Disease and Metal Dysfunction: A MEG Study.

Objective. To verify whether systemic biometals dysfunctions affect neurotransmission in living Alzheimer's disease (AD) patients. Methods. We performed a case-control study using magnetoencephalography to detect sensorimotor fields of AD patients, at rest and during median nerve stimulation. We analyzed position and amount of neurons synchronously activated by the stimulation in both hemispheres to investigate the capability of the primary somatosensory cortex to reorganize its circuitry disrupted by the disease. We also assessed systemic levels of copper, ceruloplasmin, non-Cp copper (i.e., copper not bound to ceruloplasmin), peroxides, transferrin, and total antioxidant capacity. Results. Patients' sensorimotor generators appeared spatially shifted, despite no change of latency and strength, while spontaneous activity sources appeared unchanged. Neuronal reorganization was greater in moderately ill patients, while delta activity increased in severe patients. Non-Cp copper was the only biological variable appearing to be associated with patient sensorimotor transmission. Conclusions. Our data strengthen the notion that non-Cp copper, not copper in general, affects neuronal activity in AD. Significance. High plasticity in the disease early stages in regions controlling more commonly used body parts strengthens the notion that physical and cognitive activities are protective factors against progression of dementia.

Conscious and preconscious adaptation to rhythmic auditory stimuli: a magnetoencephalographic study of human brain responses.

This study was triggered by the experimental evidence that subjects required to tap in synchrony with a heard rhythm spontaneously time their tapping to variations in rhythm frequency even when these variations are so small that they are not consciously detectable. We performed a series of magnetoencephalographic (MEG) measurements, aimed at investigating whether the response of the auditory cortex discriminates randomly administered series of brief tones differing from each other only by their interstimulus intervals (ISI). Moreover, by combining psychophysical measurements, conscious and preconscious adjustments of tapping to rhythm variations were compared with brain cortical responses. The ISIs were varied by 2% or 20% from a "central" value of 500 ms. Subjects always consciously detected the 20% ISI changes and easily adjusted their tapping accordingly, whereas they never consciously detected the 2% ISI changes, even though they always correctly adjusted their tapping to them. Analysis of the auditory evoked fields (AEFs) showed that the intensity of the M100 component decreased with decreasing ISI both for 20% and 2% variations in a statistically significant manner, despite the fact that the 2% variation was not consciously perceived. The M100 behavior indicated that connections between auditory and motor cortexes may exist that are able to use the information on rhythm variations in the stimuli even when these are not consciously identified by the subject. The ability of the auditory cortex to discriminate different time characteristics of the incoming rhythmic stimuli is discussed in this paper in relation to the theories regarding the physiology of time perception and discrimination.

Simple but reliable solutions for spiral MRI gradient design.

The efficiency of gradient design in MRI is limited by the simple fact that the gradient coil current and slew rate cannot exceed hardware threshold values. In spiral MRI, which requires gradients to be very rapidly switched between positive and negative values, minimization of the acquisition time is achieved by maintaining the current and slew rate as high as possible during the entire measurement. Since the current and slew rate compete against each other, an efficient gradient design consists of two parts in which current and slew rate are pushed alternatively to their limits. Values for these types of gradients can be obtained by solving numerically the equation of motion for the spiral trajectory. This paper shows that simple but reasonable mathematical approximations deliver reliable analytical solutions. Images obtained using these analytical solutions do not show evident distortions when compared with images obtained with numerical solutions.

Word meaningfulness and event-related potentials during phrase processing.

Evoked Potentials (EP) were recorded to visual presentation of words in phrases. Three EP components, P250, N400, P560, and their dependence on the role that each word plays in the phrase were studied. Subjects were requested to perform a congruity/incongruity task after the presentation of short phrases of two-types that differed in the position of meaningful keywords. We show how these keywords contribute substantially to N400 and possibly to P560 but do not reliably affect P250.

Modulation of Spontaneous Brain Activity during Mental Imagery.

Magnetic measurements of average power of human alpha and beta activity over the occipital and parietal areas of the scalp reveal spatially selective suppression of the activity of the occipital cortex when abstract figures are briefly presented visually and subjects simply indicate that they saw the figure. However, the duration of the suppression increases markedly when subjects must indicate whether or not they had previously seen the figure. The reaction time is similarly prolonged during the search of visual memory, and is commensurate with the duration of selective suppression of brain activity. It is also demonstrated that alpha activity is not replaced by beta activity during this suppression, but that power in the beta band is also diminished during memory search. Low correlations between the scalp distributions of power in the beta and alpha bands indicate that partly different neuronal populations give rise to activity of these different frequency bands. Since magnetic fields are negligibly affected by intervening bone tissues, dramatic asymmetries in the distribution of alpha activity across the scalps of individuals and the differences in distribution between individuals cannot be ascribed to differences in skull thickness but are due instead to differences in underlying brain anatomy or function. Nevertheless, a common pattern of suppression of alpha activity is observed across subjects during well-controlled cognitive tasks. This implies that the visual system is involved in mental imagery.

A simple method for 3-dimensional localization of epileptic activity recorded by simultaneous EEG and MEG.

A simple method is presented to average target patterns in the magnetoencephalographic trace of epileptic activity by finding markers in an EEG channel. This method proves to be useful even in cases of low magnetic signal-to-noise ratio. After simultaneously recording electric and magnetic activity the user chooses in the electric trace a template of interest and determines within the same trace all the time points at which the EEG pattern is highly correlated with the chosen template. The magnetic trace portions recorded at those times are averaged together, extracting in this way the magnetic signal from the noise. The MEG results are applied to localize in the brain the active sources that contribute to the recorded signals.

Study of focal epilepsy by multichannel neuromagnetic measurements.

A systematic investigation of several cases of focal epilepsy has been performed in an unshielded environment using a 4-channel neuromagnetic sensor. The localizations provided by the magnetic measurements have been compared with clinical evidence and confirmed by X-ray findings, and in one case also by intracranial surgery. The results show the importance of simultaneous detection of magnetic fields at different sites of the scalp in order to get a dynamic view of the epileptic activity and to detect multifocal activity unsuspected on the basis of the EEG investigation.

Neuromagnetic evidence of synchronized spontaneous activity in the brain following repetitive sensory stimulation.

Neuromagnetic measurements in the visual and somatosensory modalities reveal that, following repetitive stimulation, the brain persists in emitting synchronized after-discharges in the form of oscillations with highly specific spectral composition. In the visual modality, this rhythmic activity is centered at the frequency of the resting alpha rhythm and it is most readily induced by stimulation of the same frequency. This suggests that the phenomenon is due to synchronization of the generators responsible for the natural rhythms by the steady-state stimulation and that these generators behave as resonant oscillators. The phenomenon could then be referred to as Synchronized Spontaneous Activity (SSA). The discovery of this phenomenon has important implications for modelling the dynamics of normal evoked and spontaneous cerebral activity as well as for the understanding of pathological conditions such as photically induced epilepsies.

Neuromagnetic characterization of the cortical response to median nerve stimulation in the steady state paradigm.

Magnetic methods for localizing evoked neural activity in the human brain have been used to search for evidence of a functional organization in primary somatosensory cortex. We have found that in response to median nerve stimulation the deduced source for the evoked component with a latency of 45 ms lies at a depth in the central sulcus that depends on stimulus repetition rate, whereas the sources of the 20 ms and 24 ms components lie at a fixed depth. Moreover we have identified this 45 ms component with the dominant sinusoidal feature characteristic of steady state response.

Novel data analysis for synchronised spontaneous neuromagnetic activity.

A novel approach to neuromagnetic data analysis is presented. This technique is aimed at studying synchronised spontaneous activity (SSA) and has been used to resolve two different signals from one single evoked response, providing evidence for two possibly distinct sources. The data presented are consistent with a model that permits the generators of spontaneous activity to be synchronised by sensory stimuli.