Biomedical subjects

Christoph Preul

Publications and source records attributed to Christoph Preul.

6 recordsLinked to original sources

PubMed2005

Morphometry demonstrates loss of cortical thickness in cerebral microangiopathy.

OBJECTIVE: To evaluate the role of MR morphometry in the characterization of cerebral microangiopathy (CMA) in relation to clinical and neuropsychological impairment. SUBJECTS AND METHODS: 3D MR images of 27 patients and 27 age-matched controls were morphometrically analysed for regional thickness. The normalized values were related to the patients' clinical and neuropsychological scores. The patients were categorised according to the amount of structural MR signal changes. A ventricle index reflecting internal atrophy was related to MR morphology and cortical thickness as an indicator for external atrophy. RESULTS: Cortical thickness was significantly reduced in the patients group (3.03 mm +/- 0.26 vs. 3.22 mm +/-0.13 in controls, p=0.001). The severest loss of cortical thickness occurred in severe CMA. Internal and external atrophy evolved in parallel and both showed a significant relationship with structural MR-abnormalities (p<0.05; r=-0.7; r=0.67; r=-0.74, respectively). Neuropsychological performance correlated strongly with the loss of cortical thickness. CONCLUSIONS: Cortical thickness was identified as the most sensitive parameter to characterize CMA. A strong correlation was found of morphometric parameters to the severity of CMA based on a score derived from T2-weighted MRI. The degree of cortical atrophy was directly related to the degree of neuropsychological impairment. Our findings suggest that the cortical thickness is a valid marker in the structural and clinical characterization of CMA.

Analysis of Variance↗

PubMed2005

Spontaneous slow hemodynamic oscillations are impaired in cerebral microangiopathy.

Small-vessel disease or cerebral microangiopathy (CMA) is a common finding in elderly people. It is related to a variety of vascular risk factors and may finally lead to subcortical ischemic vascular dementia. Because vessel stiffness is increased, we hypothesized that slow spontaneous oscillations are reduced in cerebral hemodynamics. Accordingly, we examined spontaneous oscillations in the visual cortex of 13 patients suffering from CMA, and compared them with 14 age-matched controls. As an imaging method we applied functional near-infrared spectroscopy, because it is particularly sensitive to the microvasculature. Spontaneous low-frequency oscillations (LFOs) (0.07 to 0.12 Hz) were specifically impaired in CMA in contrast to spontaneous very-low-frequency oscillations (0.01 to 0.05 Hz), which remained unaltered. Vascular reagibility was reduced during visual stimulation. Interestingly, changes were tightly related to neuropsychological deficits, namely executive dysfunction. Vascular alterations had to be attributed mainly to the vascular risk factor arterial hypertension. Further, results suggest that the impairments might be, at least partly, reversed by medical treatment such as angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers. Results indicate that functional near-infrared spectroscopy may detect changes in the microvasculature due to CMA, namely an impairment of spontaneous LFOs, and of vascular reagibility. Hence, CMA accelerates microvascular changes due to aging, leading to impairments of autoregulation.

Aged↗

PubMed2004

Quantitative assessment of parenchymal and ventricular readjustment to intracranial pressure relief.

A 26-year-old patient underwent endoscopic third ventriculostomy for the treatment of obstructive hydrocephalus. 3D volume data sets were obtained at 3 T before surgery and three times after surgery. Off-line analysis of individual imaging data (initial linear registration, intensity adjustment, and final nonlinear registration of pre- to postoperative MR images) yielded 3D displacement fields representing the postoperative structural brain change. In principle, such an analysis technique can be used in any clinical follow-up for which careful observation of tissue readjustment is of particular importance.

Adult↗

PubMed2003

Morphology-based cortical thickness estimation.

We describe a new approach to estimating the cortical thickness of human brains using magnetic resonance imaging data. Our algorithm is part of a processing chain consisting of a brain segmentation (skull stripping), as well as white and grey matter segmentation procedures. In this paper, only the grey matter segmentation together with the cortical thickness estimation is described. In contrast to many existing methods, our estimation method is voxel-based and does not use any surface meshes. While this fact poses a principal limit on the accuracy that can be achieved by our method, it offers tremendous advantages with respect to practical applicability. In particular, it is applicable to data sets showing severe cortical atrophies that involve areas of high curvature and extremely thin gyral stalks. In contrast to many other methods, it is entirely automatic and very fast with computation times of a few minutes. Our method has been used in two clinical studies involving a total of 27 patients and 23 healthy subjects.

Algorithms↗

PubMed2003

Differentiation of cerebral tumors using multi-section echo planar MR perfusion imaging.

OBJECTIVE: We have investigated the performance of magnetic resonance (MR) perfusion imaging to differentiate between astrocytomas grade II, grade III and glioblastomas in a prospective study. MATERIALS AND METHODS: In 33 patients with suspected supratentorial primary cerebral tumors we performed multi-section Echo Planar MR perfusion imaging. Regional cerebral blood volume (rCBV) maps were calculated and the maximum rCBV was determined from the entire lesion. This value was divided by the mean rCBV value from the contralateral side, which provided the rCBV index used in this study. The rCBV index was correlated with the histological tumor classification after stereotactic biopsy (n=7) or open resection (n=26). RESULTS: The maximum rCBV index was 1.2+/-0.8 for grade II astrocytomas (n=3), 4.0+/-1.2 for grade III astrocytomas (n=13), and 10.3+/-3.3 for glioblastomas (n=17). The difference between grade III astrocytomas and glioblastomas was highly significant (P<0.001). DISCUSSION AND CONCLUSION: The rCBV index measured with multi-section Echo Planar MR perfusion is capable of differentiating grade III astrocytomas from glioblastomas. It serves as an additional parameter to establish a diagnosis in cases where it is not possible to clearly differentiate between these types of tumors on the basis of conventional MR imaging. MR perfusion imaging also provides information about spatial heterogeneities within a tumor which might improve diagnostic performance. This technology may also be of interest for follow-up examinations after histological diagnosis and further treatment.

Adult↗

PubMed2002

Do quiescent arachnoid cysts alter CNS functional organization?: A fMRI and morphometric study.

OBJECTIVE: To investigate whether congenital and clinically quiescent arachnoid cysts (AC) in the left temporal fossa alter the functional organization of adjacent cortices. METHODS: fMRI mapping was applied in five right-handed asymptomatic patients to determine the functional organization of language. Moreover, morphometry was performed in each patient to gain the size of cortical surface areas and cortical thickness values in the neighboring brain adjacent to the AC and explicitly in the left opercular region. RESULTS: Four patients showed a clear left hemisphere language dominance regardless of the cyst size; a mixed laterality of language organization was found in the remaining patient. An interesting dissociation of morphometric data was assessed when comparing strongly language-related cortices in the inferior frontal gyrus with the entire neighboring cortices. Morphometry in the neighboring brain regions of the AC showed 1) overall reduced cortical surface areas and 2) a decrease in cortical thickness compared to the homologous right side. However, the surface area of the fronto-opercular region in the left inferior frontal gyrus-i.e., the pars triangularis and the pars opercularis-was larger on the left as compared to the right side. Both structures have earlier been identified to represent the morphologic substrate of language dominance in the left hemisphere. CONCLUSION: Arachnoid cysts do not disturb the normal asymmetry of hemisphere language organization despite delicate locations adjacent to the left inferior frontal gyrus.

Adult↗