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Biomedical subjects

A Connelly

Publications and source records attributed to A Connelly.

At least 37 records · Page 2Linked to original sources
PubMed2000

Sampling and reconstruction effects due to motion in diffusion-weighted interleaved echo planar imaging.

Subject motion during diffusion-weighted interleaved echo-planar imaging causes k-space offsets which lead to irregular sampling in the phase-encode direction. For each image, the k-space shifts are monitored using 2D navigator echoes, and are shown to lead to a frequent violation of the Nyquist condition when an ungated sequence is used on seven subjects. Combining data from four repeat acquisitions allows the Nyquist condition to be satisfied in all but 1% of images. Reconstruction of the irregularly-sampled data can be performed using a matrix inversion technique. The repeated acquisitions make the inversion more stable and additionally improve the signal-to-noise ratio. The resultant isotropic diffusion-weighted images and average apparent diffusion coefficient (ADC) maps show high resolution and enable clear localization of a stroke lesion. Residual ADC artifacts with a slow spatial variation are observed and assumed to originate from non-rigid pulsatile brain motion. Magn Reson Med 44:101-109, 2000.

Artifacts↗
PubMed2000

Delay and dispersion effects in dynamic susceptibility contrast MRI: simulations using singular value decomposition.

Dynamic susceptibility contrast (DSC) MRI is now increasingly used for measuring perfusion in many different applications. The quantification of DSC data requires the measurement of the arterial input function (AIF) and the deconvolution of the tissue concentration time curve. One of the most accepted deconvolution methods is the use of singular value decomposition (SVD). Simulations were performed to evaluate the effects on DSC quantification of the presence of delay and dispersion in the estimated AIF. Both delay and dispersion were found to introduce significant underestimation of cerebral blood flow (CBF) and overestimation of mean transit time (MTT). While the error introduced by the delay can be corrected by using the information of the arrival time of the bolus, the correction for the dispersion is less straightforward and requires a model for the vasculature.

Adult↗
PubMed2000

The reorganization of sensorimotor function in children after hemispherectomy. A functional MRI and somatosensory evoked potential study.

Children who have suffered extensive unilateral brain injury early in life may show a remarkable degree of residual sensorimotor function. It is generally believed that this reflects the high capacity of the immature brain for cerebral reorganization. In this study, we investigated 17 patients who had undergone hemispherectomy for relief from seizures; eight of the patients had congenital brain damage and nine had sustained their initial insult at the age of 1 year or older. Sensorimotor functions of the hand were investigated using functional MRI (fMRI) during a passive movement task, somatosensory evoked potentials (SEPs) arising from electrical and vibration stimulation, and behavioural tests including grip strength, double simultaneous stimulation and joint position sense. On fMRI, two of the eight patients studied with this technique (one with congenital damage and one with damage acquired at the age of 3 years) showed activation in the sensorimotor cortex of the remaining hemisphere with passive movement of the hemiplegic hand. The location of the ipsilateral brain activation was similar to that found on movement of the normal contralateral hand, although the latter was greater in spatial extent. In one of these patients, a greater role was demonstrated for the ipsilateral secondary sensorimotor area (compared with the ipsilateral primary sensorimotor area) for movement of the hemiplegic hand than for movement of the normal hand. Median nerve stimulation of the hemiplegic hand showed reproducible early-latency ipsilateral SEP components in the remaining sensorimotor cortex in 10 of the 17 patients (five with congenital and five with acquired disease). Five of the patients who demonstrated ipsilateral electrical SEPs also showed ipsilateral vibration SEPs (two with congenital and three with acquired disease). The behavioural tests revealed residual sensorimotor function in 14 of the patients; however, not all of the patients who exhibited ipsilateral SEP or fMRI responses had residual sensorimotor function in the hemiplegic hand. Ipsilateral sensorimotor responses were demonstrated both in patients with congenital disease and those with acquired disease, suggesting that factors additional to aetiology and age at injury may influence the degree of residual sensorimotor function and cerebral reorganization.

Adolescent↗
PubMed2000

Diffusion and perfusion magnetic resonance imaging in childhood stroke.

Two magnetic resonance imaging techniques, diffusion and perfusion imaging, are being used increasingly for evaluation of pathophysiology of stroke. This article introduces these techniques and reports some initial studies using these approaches, together with conventional T2-weighted magnetic resonance imaging, for investigation of childhood stroke. It is shown that the combination of T2-weighted and diffusion images can provide information about the timing of stroke events in childhood, and perfusion imaging can detect abnormalities not visible by other magnetic resonance imaging techniques. These magnetic resonance methods therefore should play an important role in investigation of children with stroke and could be of particular value in studies of at-risk populations of children such as those with sickle cell disease.

Adolescent↗
PubMed1999

Correction for eddy current induced Bo shifts in diffusion-weighted echo-planar imaging.

The importance of diffusion-weighted MRI in the assessment of acute stroke is well-recognized, and quantitative maps of the apparent diffusion coefficient (ADC) are now widely used. Echoplanar imaging provides a robust method of acquiring diffusion-weighted images free of motion artifact. However, initial experience with clinical MRI systems indicates that calculation of artifact-free ADC maps from a series of echo-planar diffusion-weighted images is not necessarily straight-forward. One of the problems is that frequency shifts resulting from eddy currents can cause misregistration of base diffusion-weighted images. In this study, an on-line correction method that overcomes this problem is described, and phantom and human images that demonstrate the validity of the technique are presented. The method uses a non-phase-encoded reference scan to correct the phase of each echo in the echo train, and can provide ADC maps that are free of misregistration artifacts, without the need for off-line postprocessing.

Anisotropy↗
PubMed1999

The effect of residual Nyquist ghost in quantitative echo-planar diffusion imaging.

Single-shot diffusion-weighted echo-planar imaging (EPI) is typically used for most clinical diffusion studies due to its low sensitivity to patient motion. Although the Nyquist ghost artifact in EPI can be substantially reduced, there is frequently a residual ghost with low signal intensity. As reported in this study, this residual ghost can produce severe artifacts when maps of the apparent diffusion coefficient (ADC) are calculated from single-shot echo-planar images. The artifacts presented in this paper appear as regions of apparently low ADC which simulate regions of reduced diffusion, but are in fact generated by b-value dependent Nyquist ghosts of the orbits. Data acquired in vivo were used to demonstrate that these artifacts can be avoided by including standard methods of spatial presaturation or fluid-suppression in the diffusion-weighted EPI protocol. In addition, phantom studies were used to illustrate how phase and amplitude variations in the ghost generate the artifacts and theoretical expressions, derived elsewhere, were used to provide a detailed understanding of the artifacts observed in vivo. The level of Nyquist ghost reported for the current generation of commercial scanners suggests that this is a general phenomenon which should be a consideration in all EPI-based diffusion studies. Magn Reson Med 42:385-392, 1999.

Artifacts↗
PubMed1999

Somatomotor fMRI in the pre-surgical evaluation of a case of focal epilepsy.

A child with intractable partial epilepsy who was found to have a focal lesion in the motor cortex underwent detailed pre-surgical and intraoperative investigations which enabled curative surgery without morbidity by minimizing a targeted resection. The pre-surgical assessment included mapping motor cortical function with functional magnetic resonance imaging (fMRI). This was subsequently correlated with the results of pre-surgical and intraoperative invasive corticography.

Adolescent↗
PubMed1999

Lesion volume, lesion location, and outcome after middle cerebral artery territory stroke.

AIM: To investigate the relation between lesion volume, lesion location, and clinical outcome in children with infarction in the territory of the middle cerebral artery (MCA). PATIENTS AND METHODS: Children with MCA territory infarcts were selected retrospectively from a database of children with ischaemic stroke. Lesion volumes were expressed as a percentage of the supratentorial intracranial volume and were categorised as "small", "moderate", or "large". Lesion location was categorised as cortical or purely subcortical. Outcome was ascertained by parental questionnaire and was categorised as "good" or "poor". RESULTS: 38 patients were identified (median age 6 years); 21 patients had lesions that involved cortical tissue. Outcome was good in 12 cases and poor in 26 cases (including 2 children who died). Although there was no significant effect of lesion size or lesion location on outcome for the group as a whole, all children who had infarcted more than 10% of intracranial volume had a poor outcome. Of note, some children with small subcortical lesions had pronounced residual deficits. CONCLUSIONS: Although the outcome after a small infarct in the MCA territory is variable and unpredictable, infarction of more than 10% of intracranial volume is universally associated with a poor outcome. Characterisation of lesion volume and topography might be helpful in identification of such children for participation in future trials of treatments for acute stroke.

Adolescent↗
PubMed1999

Quantitative MR diffusion mapping and cyclosporine-induced neurotoxicity.

Apparent diffusion coefficient maps of two patients with cyclosporine-induced neurotoxicity showed areas of increased diffusion that corresponded to the characteristic regions of signal change on routine T2-weighted sequences. The majority of lesions subsequently resolved without residual T2 or diffusion signal alteration. These findings suggest that, in our patients, the neurotoxic effects of cyclosporine resulted in a partially reversible extravasation of fluid into the cerebral interstitium and were not associated with acute ischemia.

Anemia, Sickle Cell↗
PubMed1998

Neural basis of an inherited speech and language disorder.

Investigation of the three-generation KE family, half of whose members are affected by a pronounced verbal dyspraxia, has led to identification of their core deficit as one involving sequential articulation and orofacial praxis. A positron emission tomography activation study revealed functional abnormalities in both cortical and subcortical motor-related areas of the frontal lobe, while quantitative analyses of magnetic resonance imaging scans revealed structural abnormalities in several of these same areas, particularly the caudate nucleus, which was found to be abnormally small bilaterally. A recent linkage study [Fisher, S., Vargha-Khadem, F., Watkins, K. E., Monaco, A. P. & Pembry, M. E. (1998) Nat. Genet. 18, 168-170] localized the abnormal gene (SPCH1) to a 5. 6-centiMorgan interval in the chromosomal band 7q31. The genetic mutation or deletion in this region has resulted in the abnormal development of several brain areas that appear to be critical for both orofacial movements and sequential articulation, leading to marked disruption of speech and expressive language.

Brain↗
PubMed1998

A comparison of the neuropathological effects of vigabatrin and carbamazepine in patients with newly diagnosed localization-related epilepsy using MR-based cerebral T2 relaxation time measurements.

BACKGROUND: Magnetic resonance (MR)-based T2 relaxation time measurement is a sensitive technique to detect neuropathological changes such as intramyelinic edema in vivo. OBJECTIVE: To determine whether vigabatrin (VGB) causes an increase in T2 relaxation time in patients with newly diagnosed localization-related epilepsy over 1 year. METHODS: Patients with newly diagnosed localization-related epilepsy who participated in a VGB-carbamazepine (CBZ) monotherapy trial were included. All were scanned on a 1.5 T Siemens SP63 Magnetom scanner. T2 maps of the brain were obtained at baseline and at follow-up 1 year later. Nine control subjects had repeated hippocampal T2 maps with a median interval of approximately 2 years. RESULTS: 23 patients (12 on VGB and 11 on CBZ) were included. There were no increased T2 relaxation times in the VGB treated group at follow-up and no significant differences between the two antiepileptic drug groups. There was a trend for the temporal and frontal white matter T2 relaxation times to be lower on follow-up in the patients compared to the control subjects. CONCLUSION: The findings do not suggest that intramyelinic edema occurs in patients taking monotherapy VGB for 1 year.

Adolescent↗
PubMed1998

Cognitive deficits associated with frontal-lobe infarction in children with sickle cell disease.

This study examined the cognitive manifestations of frontal-lobe infarction in a population of children with sickle cell disease (SCD). Forty-one patients with SCD underwent MRI. Five patients with stroke symptoms had large infarcts encroaching on the tissue of the frontal lobes. Four patients without symptoms had smaller frontal-lobe infarcts. The patients with stroke were significantly impaired on measures of intelligence, memory, and frontal-lobe function (Wisconsin Card Sorting Test, WCST) compared with both the patients with normal MRI scans (N=30) and a group of sibling controls (N=15), who did not differ from each other. Patients with covert infarction obtained scores on the intelligence tests and the WCST that fell in between those of the stroke patients and the other two groups. This trend toward impairment suggests that patients with covert infarction are at similar risk for cognitive deficits to those with stroke.

Adolescent↗
PubMed1998

The relationship between quantitative MRI and neuropsychological functioning in temporal lobe epilepsy.

PURPOSE: Quantitative MRI techniques provide an unparalleled opportunity to examine in vivo the relationship between the extent and laterality of hippocampal pathology and associated neuropsychological deficits. The purpose of this study was to examine the nature of the relationship between quantitative measures of hippocampal pathology and neuropsychological measures, using a multivariate approach. METHODS: We examined the relationship between two MRI measures of hippocampal structure; hippocampal volumes (HCvol) and T2 relaxation times (HCT2), and memory performance, in 80 presurgical temporal lobe epilepsy patients. RESULTS: As a group, patients with left hippocampal sclerosis (LHS) performed more poorly that those with right hippocampal sclerosis (RHS) on immediate and delayed prose recall. In the group as a whole, right hippocampal volume was significantly correlated with the delayed recall of a complex figure. None of the verbal memory test scores were significantly correlated with the right or left HCvol or HCT2 measures. However, stepwise multiple regression analyses indicated that up to a third of the variation in specific test scores could be explained by the quantitative MRI hippocampal measures in conjunction with chronological age, and age at onset of habitual epilepsy. Left hippocampal measures explained 24% of the variance in the story-recall tasks, while right hippocampal measures explained 18% of the variance in a design-learning task and 32% of the variance in a figure-recall task. CONCLUSIONS: Our results provide some support for the lateralised model of material specific memory deficits, but suggest that a number of demographic and epilepsy-related factors may interact with the extent and laterality of hippocampal pathology in shaping the nature of the associated neuropsychological deficit.

Adult↗
PubMed1998

Longitudinal quantitative hippocampal magnetic resonance imaging study of adults with newly diagnosed partial seizures: one-year follow-up results.

PURPOSE: We wished to establish whether hippocampal changes occur in 1 year in adults with newly diagnosed partial seizures and, if so, to identify possible causes and mechanisms. METHODS: Thirty-six adult patients with newly diagnosed partial seizures underwent a magnetic resonance imaging (MRI) scan of the brain including hippocampal volume and T2 relaxation time (HCT2) measurement and had a follow-up quantitative MRI scan approximately 1 year after the baseline MRI scan. RESULTS: At baseline, 4 patients (11%) had hippocampal sclerosis (HS), 4 (11%) had abnormalities other than HS, and 28 had a normal MRI scan (78%). Twenty-three patients (64%) had recurrent seizures in the period between the two MRI scans. One of the 4 patients with HS, who had daily seizures, had significantly increased HCT2 values on follow-up, possibly reflecting progressive hippocampal damage. None of the 32 patients with MRI findings other than HS at baseline progressed to HS on follow-up. However, 2 of the 32 patients had significant hippocampal changes, probably related to resolution of inflammatory swelling or edema after seizures were controlled. CONCLUSIONS: Subtle changes in hippocampi can occur in 1 year in adults with newly diagnosed partial seizures, which could be due to resolution of edema after seizure control or to hippocampal changes associated with frequent and daily seizures. Follow-up of the studied cohort for several years will be required to settle the question of whether progressive hippocampal damage occurs in temporal lobe epilepsy (TLE).

Adolescent↗
PubMed1998

Proton magnetic resonance spectroscopy in MRI-negative temporal lobe epilepsy.

OBJECTIVE: To determine the 1H MRS findings in patients with intractable temporal lobe epilepsy (TLE) who had no detectable abnormality on either qualitative or quantitative MRI. BACKGROUND: Previous work has indicated that approximately 20% of patients with TLE remain MRI negative after extensive qualitative and quantitative investigation. Single-voxel 1H MRS provides a means of identifying potentially diffuse disease. METHODS: Seven patients with intractable TLE, normal routine MRI, normal hippocampal volumes, and normal hippocampal and amygdala quantitative T2 values underwent single-voxel 1H MRS of the medial temporal lobes. The results are compared with those from 13 control subjects and 15 patients with evidence of hippocampal sclerosis (HS). RESULTS: The ratio N-acetylaspartate/(choline-creatine + phosphocreatine) was abnormally low in five of the seven MRI-negative patients. In two of these patients, the ratios were low bilaterally. The observed MRS ratios in the MRI-negative group with abnormal EEG were similar to those from temporal lobes ipsilateral to HS, suggesting the presence of widespread or diffuse disease of a similar degree in both groups. CONCLUSIONS: These results demonstrate that MRS can provide evidence of temporal lobe abnormalities in TLE patients who show no abnormality on extensive MRI investigation.

Adult↗
PubMed1997

Differential effects of early hippocampal pathology on episodic and semantic memory.

Global anterograde amnesia is described in three patients with brain injuries that occurred in one case at birth, in another by age 4, and in the third at age 9. Magnetic resonance techniques revealed bilateral hippocampal pathology in all three cases. Remarkably, despite their pronounced amnesia for the episodes of everyday life, all three patients attended mainstream schools and attained levels of speech and language competence, literacy, and factual knowledge that are within the low average to average range. The findings provide support for the view that the episodic and semantic components of cognitive memory are partly dissociable, with only the episodic component being fully dependent on the hippocampus.

Adolescent↗