Diffusion- and perfusion-weighted magnetic resonance imaging of focal cerebral ischemia and cortical spreading depression under conditions of mild hypothermia.

In a model of experimental stroke, we characterize the effects of mild hypothermia, an effective neuroprotectant, on fluid shifts, cerebral perfusion and spreading depression (SD) using diffusion- (DWI) and perfusion-weighted MRI (PWI). Twenty-two rats underwent 2 h of middle cerebral artery (MCA) occlusion and were either kept normothermic or rendered mildly hypothermic shortly after MCA occlusion for 2 h. DWI images were obtained 0.5, 2 and 24 h after MCA occlusion, and maps of the apparent diffusion coefficient (ADC) were generated. SD-like transient ADC decreases were also detected using DWI in animals subjected to topical KCl application (n=4) and ischemia (n=6). Mild hypothermia significantly inhibited DWI lesion growth early after the onset of ischemia as well as 24 h later, and improved recovery of striatal ADC by 24 h. Mild hypothermia prolonged SD-like ADC transients and further decreased the ADC following KCl application and immediately after MCA occlusion. Cerebral perfusion, however, was not affected by temperature changes. We conclude that mild hypothermia is neuroprotective and suppresses infarct growth early after the onset of ischemia, with better ADC recovery. The ADC decrease during SD was greater during mild hypothermia, and suggests that the source of the ADC is more complex than previously believed.

Clinical utility of diffusion-weighted magnetic resonance imaging in the assessment of ischemic stroke.

Diffusion-weighted imaging (DWI) detects small changes in water diffusion that occur in ischemic brain. This study evaluated the clinical usefulness of a phase-navigated spin-echo DWI sequence compared with T2-weighted magnetic resonance imaging (T2W MRI) in patients with cerebral ischemia and assessed apparent diffusion coefficient (ADC) and T2-weighted imaging (T2WI) changes over time. ADC values and T2 ratios of image intensity were measured from the region of ischemia and from the corresponding contralateral brain region. The clinical histories of patients with DWI scans obtained over the course of 1 year were reviewed to ascertain whether DWI aided in clinical diagnosis or management. Of 103 scans obtained a mean of 10.4 days after symptom onset, DWI detected six lesions not seen on T2WI and discriminated two new infarcts from old lesions. DWI was most useful within 48 hours of the ictus. The evolution of ADC values and T2 ratios was evaluated in 26 cases with known symptom onset times. ADC values were low at less than 1 week after stroke onset and became elevated at chronic time points. T2 ratios were near normal acutely, increasing thereafter. DWI was superior to T2W MRI in detecting acute stroke, whereas both techniques assisted in determining lesion age.

Magnetic resonance imaging of human brain function.

BACKGROUND: Previously the exclusive domain of the technology of positron emission tomography, functional MRI is now proving capable of mapping functional regions of the human cortex in near real time during specific task activations or in response to any hemodynamic stress. Of particular interest is the opportunity to observe secondary cortical responses, activation due to imagined tasks, memory function, time-resolved pathways through cortical regions, and activation in sub-cortical structures. METHODS AND RESULTS: One method of functional MRI uses blood oxygenation changes, which can be imaged continuously while functional centers are being stimulated. Image intensity can become darker if there is more deoxygenated blood and brighter if more oxygenated blood enters the brain. This concepts works in all perfused tissues in the body, and allows use of the blood oxygenation mechanism to image neuronal activation. A second method takes advantage of the fact that the protons within the MRI slice are always partially saturated by the rapid rate of imaging. As blood flow delivers unsaturated blood water protons into an imaged slice, these arterially-delivered protons will appear very bright in the image. Visualization of this effect is accomplished by simple image subtraction or by comparison of intensity changes as a function of the paradigm application frequency. Using either approach leads directly to a functional map. CONCLUSIONS: At present, clinical applications are rapidly moving toward routine non-invasive mapping of distortions of the functional motor and somatosensory cortex and other cortical regions as a result of brain tumors. Other clinical applications include the observation of the effect of degenerative diseases such as multiple sclerosis. Alzheimer's disease, stroke, migraine, epilepsy, and other diseases causing neuronal loss and Parkinsonism. Functional MRI and its applications will continue to grow exponentially throughout the decade.

Effect of maturation on 31P magnetic resonance spectroscopy of the rabbit masseter muscle.

This work studies the dynamic metabolic changes of the rabbit masseter muscle during post-natal development. The composition and proportion of oxidative and glycolytic muscle fibers alter during maturation. The masseter muscle, as most muscles of the craniofacial region, exhibits unusual development in composition of isoforms of myosin. The effect of this unusual composition on the dynamic metabolic properties of the masseter muscle have not been assessed. The metabolism of the rabbit masseter muscle was studied by means of 31P-nuclear magnetic resonance (NMR) spectroscopy. Contraction was elicited by electrical stimulation of the muscle in the anesthetized animal. Five animals were studied at 8 weeks and 24 weeks so that both the juvenile and adult stages could be evaluated. The dynamic biochemical changes in the masseter muscle were studied by the analysis of NMR spectra. A single-turn surface coil (copper) was used, and the original signal was treated with Fourier transforms to obtain 31P spectra. The low signal-to-noise ratio required averaging 16 acquisitions (acquisition time = 400 msec, repetition rate = 1.8 sec) in 30 sec and then obtaining continuous spectra for 27 min. Each averaged spectrum demonstrated five peaks: inorganic phosphate (Pi), creatine phosphate (PCr), and three peaks related to adenosine triphosphate (ATP). The protocol involved recording an initial three-minute rest period, stimulating the muscle at 5 Hz for 3 min twice, separated by three-minute rest periods, and stimulating the muscle at 50 Hz twice for 3 min separated by rest periods. The Pi/PCr ratio increased significantly in the adult masseter during both 5-Hz stimulations, evoking twitching, and the first 50-Hz stimulation, evoking tetany (repeated ANOVA, P < 0.05). The resting pH (6.96 +/- 0.13) was significantly lowered during both twitching (6.85 +/- 0.10; P < 0.0038) and tetany (6.55 +/- 0.13; P < 0.0001), but only in the adult masseter muscle. These finding suggest that the adult masseter muscle possesses more glycolytic fibers as it modifies its metabolism during postnatal development.

Plasticity of craniomandibular muscle function: 31P magnetic resonance spectroscopy of the rabbit masseter muscle.

The masseter muscle was studied during postnatal development of the rabbit from the juvenile to adult stage in which the oral function was altered during maturation by modifying the diet to soft food. The muscle was assessed using phosphate magnetic resonance (31P NMR) spectroscopy with a single-turn copper surface coil to study potential changes in phosphate metabolism. The 31P NMR spectra consisted of five peaks related to unbound forms of inorganic phosphate (Pi), creatine phosphate (PCr), and three peaks related to the adenosine triphosphate (ATP). The masseter was assessed in one group of five rabbits at 8 weeks postnatally (juvenile) and after 4 months of this experimental group masticating on soft food. They were compared with a control group of five rabbits raised on a normal hard diet. The Pi/PCr ratio increased in the adult masseter much higher during twitching, tetany, and periodic contraction than in the juvenile regardless as to whether the adult animal had been raised from the juvenile period on soft or hard diet. There were relatively few differences between the experimental adult animals raised on a soft diet and the normal adult animals despite the soft diet animals demonstrating a significantly lower weight and smaller muscle mass. These findings suggest that chronic underuse of the masseter muscle by decreasing the masticatory loads has a minimal effect on the phosphate metabolism of the maturing masseter.

31P-magnetic resonance spectroscopy of the rabbit masseter muscle.

Dynamic biochemical changes in the masseter muscle were studied in 14 New Zealand adult male rabbits by 31P-nuclear magnetic resonance (NMR) spectroscopy. NMR spectra were obtained during rest and electrical stimulation of the muscle in the anaesthetized animal at 33 recording sessions. Electrical stimulation was applied by a pair of copper wires placed separately with hypodermic needles into the muscle. NMR spectra were acquired with a 2 x 3 cm, double-turn, copper transmit/receive coil. Sixteen spectra were averaged over 30 s to obtain averaged spectra continuously during a 30-min recording. The spectra were processed automatically using a non-linear 'least-squares' fitting program on the spectrometer. A Lorentzian line shape was assumed for the peaks, and values of peak height, area and chemical shifts were generated. Each averaged spectrum consisted of five peaks: inorganic phosphate (Pi), creatine phosphate (PCr), and three peaks related to ATP. Data were analysed as to absolute changes in Pi and PCr, in the ratio of Pi/PCr, and the shift of Pi to PCr to estimate pH. Several protocols were used in which ranges of frequency, intensity and duration of electrical stimulation were tested. The protocol for detailed studies involved stimulating the muscle twice at 5 Hz for 3 min separated by a 3-min rest period, then stimulating twice at 50 Hz for 3 min separated by a rest period. During contraction of the muscle, there was a significant increase in the Pi/PCr ratio (p < 0.05) as compared to the resting level. The ratio reached a plateau over a 3-min contraction using 5-Hz stimulation, then increased significantly more with the 50-Hz stimulation but decayed during the 3 min. Sustained stimulation with 50 Hz for 15-45 min evoked an initial sharp change in Pi/PCr, which then reached a steady plateau that remained over the entire stimulation. These findings indicate that the rabbit masseter muscle is relatively fatigue resistant in maintaining a steady-state equilibrium in the relation of Pi to PCr.