Biomedical subjects

G Bruce Pike

Publications and source records attributed to G Bruce Pike.

25 records · Page 2Linked to original sources

PubMed2004

Quantitative analysis of temporal lobe white matter T2 relaxation time in temporal lobe epilepsy.

The objective of this study was to assess temporal lobe white matter (WM) quantitatively using T2 relaxometry in patients with pharmacologically intractable temporal lobe epilepsy (TLE). T2 relaxometry was performed using a dual-echo sequence with 23 contiguous oblique coronal slices in 56 consecutive TLE patients and in 30 healthy subjects. Averages of six slices were chosen to calculate T2 relaxation time in the temporal lobe WM (WM-T2) and the hippocampus (Hippo-T2). Twenty-seven patients had unilateral hippocampal atrophy (HA), and twenty-nine patients had normal hippocampal volumes (NV) on volumetric MRI. Mean WM-T2 was increased ipsilateral to the seizure focus in TLE patients with HA and those with NV (P < 0.001). Contralateral mean WM-T2 was increased in left and right TLE with HA (P < 0.001) and in right TLE with NV (P = 0.001). There was a positive correlation between WM-T2 and Hippo-T2. Individual analysis showed a prolongation of WM-T2 in about 70% of TLE patients with HA and NV. In half of the patients, WM-T2 increase was bilateral and symmetric. However, in 33% of patients with NV and bilateral symmetric increase in Hippo-T2, WM-T2 provided a correct lateralization of the seizure focus. Regardless of the pattern of T2 abnormalities, that is, bilateral symmetric or ipsilateral, the majority of patients with HA became seizure-free after surgery, while those with NV did not have a favorable outcome. In patients with NV, WM-T2 measurement may provide additional lateralizing information compared to Hippo-T2.

Adolescent↗

PubMed2004

The role of the anterior cingulate cortex in pitch variation during sad affect.

We examined neural activity, in the frontal lobes, associated with speech production during affective states. Using functional magnetic resonance imaging (fMRI), the blood oxygen level-dependent (BOLD) response to the overt reading of emotionally neutral sentences was measured before and after a happy or sad mood induction. There was no explicit demand to produce affect-congruent speech and a cover story was used to de-emphasize the significance of the speech task in light of our experimental aims. Each fMRI measurement was acquired 6 s after the onset of sentence presentation so that speech could be recorded while the scanner noise was minimal; speech parameters (e.g. pitch variation) were extracted from the sentences and regressed against fMRI data. In the sad group we found the predicted changes in affect and pitch variation. Further, the fMRI data confirmed our hypothesis in that the 'reading effect' (i.e. the BOLD response to reading minus the BOLD response to baseline stimuli) in the supracallosal anterior cingulate cortex covaried negatively with both pitch variation and affect. Our results suggest that the anterior cingulate cortex modulates paralinguistic features of speech during affective states, thus placing this neural structure at the interface between action and emotions.

Adult↗

PubMed2003

Quantitative T2 in the occipital lobe: the role of the CPMG refocusing rate.

PURPOSE: To investigate the dependence of occipital gray and white matter T(2) on the Carr-Purcell-Meiboom-Gill (CPMG) refocusing interval, thereby testing the basis of a novel functional magnetic resonance imaging (fMRI) method for blood volume quantification, and addressing recent questions surrounding T(2) contrast in the occipital lobe. MATERIALS AND METHODS: A CPMG sequence with 1 x 1 x 5 mm(3) resolution was used to quantify T(2) in a single axial slice at the midlevel of the occipital lobe in 23 healthy adult volunteers. Refocusing intervals of 8, 11, and 22 msec were compared. A Bayesian classifier was used to classify a 1 x 1 x 1 mm(3) T(1)-weighted three-dimensional data set into gray matter, white matter, and cerebrospinal fluid, with an average 95% a posteriori probability used as the threshold for inclusion into a tissue-specific region of interest (ROI). RESULTS: The usual T(2) contrast between the gray and white matter (i.e., T(2GM) > T(2WM)) was observed, with a highly significant effect of tissue type on the estimated T(2) (P < 10(-5)). The observed T(2) gradually decreased with increasing refocusing interval, for a decrease of 3.3 +/- 1.5 msec in gray matter and 3.0 +/- 1.5 msec in white matter between the 8 and 22 msec refocusing interval acquisitions. CONCLUSION: The observed T(2) shortening is consistent with the effect of the dramatic decrease in T(2) of partly deoxygenated blood on this range of refocusing rates.

Adult↗

PubMed2003

Using patient-specific hemodynamic response functions in combined EEG-fMRI studies in epilepsy.

Combining electroencephalogram (EEG) and functional MRI (fMRI) allows localization of brain regions activated as a result of epileptic spikes. The statistical analysis of fMRI data usually includes a standard model of the hemodynamic response function (HRF) but it is not known how well this fits the actual HRF of epileptic spikes. The objective of this exploratory study was to compare the activated areas and t-statistical scores obtained with a standard HRF to those obtained with a patient-specific HRF. Eight patients with focal epilepsy were studied. We obtained an estimate of the patient-specific HRFs for each patient at the local maximum of activation in the standard HRF analysis. The activated areas obtained with the patient-specific HRFs were larger or similar to the originally activated areas. Additional activated areas were seen in five patients, and most were compatible with the EEG and anatomical MRI localization of epileptogenic and lesional regions. Using patient-specific HRFs brings increased sensitivity to the analysis of epileptic spikes by EEG-fMRI.

Cerebrovascular Circulation↗

PubMed2002

Magnetization transfer can predict clinical evolution in patients with multiple sclerosis.

The clinical course of multiple sclerosis (MS) is highly variable ranging from benign to aggressive, and is difficult to predict. Since magnetization transfer (MT) imaging can detect focal abnormalities in normal-appearing white matter (NAWM) before the appearance of lesions on conventional MRI, we hypothesized that changes in MT might be able to predict the clinical evolution of MS. We assessed MR data from MS patients who were subsequently followed clinically for 5 years. We computed the mean MT ratio (MTr) in gray matter, in lesions identified on T2-weighted MRI, and in NAWM, as well as in a thick central brain slice for each patient. Patients were divided into stable and worsening groups according to their change in Expanded Disability Status Scale (EDSS) scores over 5 years. We calculated the sensitivity, specificity, predictive value, and odds ratio of the baseline MTr measures in order to assess their prognostic utility. We found significant differences in baseline MTr values in NAWM (p = 0.005) and brain slice (p = 0.03) between clinically stable and worsening MS patients. When these MTr values were compared with changes in EDSS over 5 years, a strong correlation was found between the EDSS changes and MTr values in both NAWM (SRCC = -0.76, p < 0.001) and in the brain slice (SRCC = 0.59, p = 0.01). Baseline NAWM MTr correctly predicted clinical evolution in 15/18 patients (1 false positive and 2 false negatives), yielding a positive predictive value of 77.78 %, a negative predictive value of 88.89 %, and an odds ratio of 28. The relationship between 5-year changes in EDSS and MTr values in T2 weighted MRI lesions was weaker (SRCC = -0.43, p = 0.07). Our data support the notion that the quantification of MTr in the NAWM can predict the clinical evolution of MS. Lower MTr values predict poorer long-term clinical outcome. Abnormalities of MTr values in the NAWM are more relevant to the development of future patient disability than those in the T2-weighted MRI lesions.

Adult↗

PubMed2002

Optimal location of thalamotomy lesions for tremor associated with Parkinson disease: a probabilistic analysis based on postoperative magnetic resonance imaging and an integrated digital atlas.

OBJECT: Renewed interest in stereotactic neurosurgery for movement disorders has led to numerous reports of clinical outcomes associated with different treatment strategies. Nevertheless, there is a paucity of autopsy and imaging data that can be used to describe the optimal size and location of lesions or the location of implantable stimulators. In this study the authors correlated the clinical efficacy of stereotactic thalamotomy for tremor with precise anatomical localization by using postoperative magnetic resonance (MR) imaging and an integrated deformable digital atlas of subcortical structures. METHODS: Thirty-one lesions were created by stereotactic thalamotomy in 25 patients with tremor-dominant Parkinson disease. Lesion volume and configuration were evaluated by reviewing early postoperative MR images and were correlated with excellent, good, or fair tremor outcome categories. To allow valid comparisons of configurations of lesions with respect to cytoarchitectonic thalamic boundaries, the MR image obtained in each patient was nonlinearly deformed into a standardized MR imaging space, which included an integrated atlas of the basal ganglia and thalamus. The volume and precise location of lesions associated with different clinical outcomes were compared using nonparametric statistical methods. Probabilistic maps of lesions in each tremor outcome category were generated and compared. Statistically significant differences in lesion location between excellent and good. and excellent and fair outcome categories were demonstrated. On average, lesions associated with excellent outcomes involved thalamic areas located more posteriorly than sites affected by lesions in the other two outcome groups. Subtraction analysis revealed that lesions correlated with excellent outcomes necessarily involved the interface of the nucleus ventralis intermedius (Vim; also known as the ventral lateral posterior nucleus [VLp]) and the nucleus ventrocaudalis (Vc; also known as the ventral posterior [VP] nucleus). Differences in lesion volume among outcome groups did not achieve statistical significance. CONCLUSIONS: Anatomical evaluation of lesions within a standardized MR image-atlas integrated reference space is a useful method for determining optimal lesion localization. The results of an analysis of probabilistic maps indicates that optimal relief of tremor is associated with lesions involving the Vim (VLp) and the anterior Vc (VP).

Aged↗

PubMed2000

A new anatomical landmark for reliable identification of human area V5/MT: a quantitative analysis of sulcal patterning.

The location of human area V5 (or MT) has been correlated with the intersection of the ascending limb of the inferior temporal sulcus (ALITS) and the lateral occipital sulcus (LO). This study was undertaken to attempt a replication and quantification of these observations using functional magnetic resonance imaging. V5 was significantly activated in 19 hemispheres with alternating, low contrast, random checkerboard patterns. We confirmed the stereotaxic location of V5 and were able to describe a fairly consistent sulcal pattern in the parieto-temporo-occipital cortex. V5 was usually (95%) buried within a sulcus, most commonly within the inferior temporal sulcus (ITS) (11%), the ascending limb of the ITS (ALITS) (53%) and the posterior continuation of the ITS (26%). The average distance from V5 of two identified anatomical landmarks of V5, the junctions of the LO and the ALITS, and the ITS and ALITS, were both 1 cm. However, the LO-ALITS junction often had to be determined by interpolation (47%), and was not always present even with interpolation (21%). In contrast, the ITS-ALITS junction was always present and V5 was usually (90%) located in a sulcus intersecting with this junction, making it a more reliable landmark for localizing V5 with respect to gross morphological features on individual cortical surfaces.

Adult↗