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Takashi Yoshiura

Publications and source records attributed to Takashi Yoshiura.

At least 19 recordsLinked to original sources

Functional network of the basal ganglia and cerebellar motor loops in vivo: different activation patterns between self-initiated and externally triggered movements.

The basal ganglia and cerebellar loops are known to participate differently in self-initiated (SI) and externally triggered (ET) movements. However, no previous neuroimaging studies have illustrated functional organization of these loops in vivo. Here, we aimed to functionally visualize these loops during motor execution using functional magnetic resonance imaging (fMRI) with structural equation modeling (SEM). Twelve normal subjects (24-29 years old) were scanned while performing five different frequencies of sequential left finger movements using either SI or ET movements. Random effect analysis combined with a parametric approach revealed a significant positive linear dependence of cerebral activation upon movement rate in the right Put, GPi, VL, SMC and SMA during SI tasks. During ET tasks, significant positive linear relationships were found in the right SMC, VPL, left CB and DN, whereas tendency for linear relationships was seen in the right PMv. SEM further showed significant interactions within the right basal ganglia-thalamo-motor loop during SI tasks. In contrast, there were significant interactions within the entire right cerebral hemisphere-left cerebellar loop involving CB, DN, VPL, PMv and SMC during ET tasks. Therefore, our modeling approach enabled identification of different contributions of the motor loops of basal ganglia and cerebellum to SI and ET tasks during motor execution.

Adult↗

Cerebral white matter degeneration in frontotemporal dementia detected by diffusion-weighted magnetic resonance imaging.

RATIONALE AND OBJECTIVE: Brain tissue damage in frontotemporal dementia (FTD) has never been systematically studied using diffusion-weighted imaging (DWI). We studied FTD patients using DWI to determine whether microstructural changes in white matter can be detected in vivo. MATERIALS AND METHODS: Thirteen FTD patients and 15 aged healthy subjects were studied. Mean diffusivity (MD) abnormalities in 28 white matter regions were visually evaluated. In addition, MD values in 10 white matter regions relative to that in the ipsilateral postcentral gyrus were measured. The results were compared between healthy subjects and FTD patients. RESULTS: The visual rating resulted in a significant MD elevation in FTD patients in the bilateral high superior frontal gyri, right orbitofrontal gyrus, bilateral anterior temporal lobes, and left middle temporal lobe (P < .01, respectively). Relative MD comparison revealed a significant MD elevation in FTD patients in the bilateral high superior frontal gyri, bilateral orbitofrontal gyri, and bilateral anterior temporal lobes (P < .05 after Bonferroni correction, respectively). CONCLUSION: Our results demonstrated white matter MD abnormalities in FTD patients. It was suggested that the observed white matter MD abnormalities are secondary to damage in the overlying cortex.

Aged↗

Mapping of subcortical white matter abnormality in Alzheimer's disease using diffusion-weighted magnetic resonance imaging.

RATIONALE AND OBJECTIVES: White matter (WM) abnormality in Alzheimer's disease (AD) has been less well characterized than cortical damage. We studied the spatial distribution of the subcortical WM abnormality using diffusion-weighted magnetic resonance imaging (DWI). MATERIALS AND METHODS: Twenty-one AD patients and seven healthy, elderly subjects were included. DWIs were obtained using a cerebrospinal fluid (CSF)-nulled pulse sequence to reduce the partial volume contamination of CSF signal. Diffusivity in the subcortical WM voxels was mapped onto the cortical surface using original software so that the spatial distribution of subcortical WM damage, which was visualized as an area of increased diffusivity, could be viewed in a three-dimensional map. The damages in the lateral surface of the bilateral cerebral hemispheres were visually evaluated, and severities of the damages in five brain regions were compared with each other. In addition, the severity of the damage in each region was correlated with patient's mini-mental state examination (MMSE) score. RESULTS: In both hemispheres, clear sparing of the pericentral regions and predominant involvement of the parietal and temporal regions were revealed with statistical significance (P < .05, respectively). Marginal correlation (P < .05 uncorrected for multiple comparisons) was observed between the damage severity in the bilateral frontal and right temporal regions and patient's MMSE score. CONCLUSION: We demonstrated a subcortical WM abnormality over the parietal and temporal regions with clear sparing of the pericentral region using our mapping method, which supported the hypothesis that the subcortical WM abnormality in AD originates in Wallerian degeneration.

Aged↗

Pre-surgical identification of epileptogenic areas in temporal lobe epilepsy by 123I-iomazenil SPECT: a comparison with IMP SPECT and FDG PET.

OBJECTIVES: The aim of this study was to evaluate the usefulness of (123)I-iomazenil (IMZ) single photon emission computed tomography (SPECT) for the pre-surgical identification of epileptogenic areas in patients with temporal lobe epilepsy and to compare the results with those of (123)I-IMP SPECT and (18)Fluorodeoxyglucose positron emission tomography (FDG PET). METHODS: We examined seven patients with medically refractory temporal lobe epilepsy (five men and two women; mean age, 28 years) with no remarkable findings on magnetic resonance imaging. Before surgery, IMZ SPECT, IMP SPECT and FDG PET were all performed in the interictal state. Then, visual assessment and region-of-interest (ROI) analysis were performed on each image. Final definitions of the epileptogenic areas were made by electrocorticography and histopathology. RESULTS: By IMZ SPECT, a decreased IMZ uptake in the ipsilateral temporal lobe was found in all patients, while a similar decrease in the contralateral temporal lobe was also found in one patient. In comparison to IMP SPECT, the extent of the abnormal area on IMZ SPECT was equal to that on IMP SPECT in one patient while it was more restricted to the epileptogenic area in five patients. In comparison to FDG PET, the extent of the abnormal area on IMZ SPECT was equal to that on FDG PET in three patients while it was more restricted in the epileptogenic area in four patients. In ROI analysis, decreases of IMZ, IMP and FDG uptake were observed in the epileptogenic area, although they were not statistically significant. CONCLUSIONS: IMZ SPECT was considered to be useful for pre-surgical determination of the epileptogenic areas in temporal lobe epilepsy with no remarkable MRI findings, and it was also found to be superior to IMP SPECT and FDG PET for this purpose.

Adolescent↗

Moyamoya syndrome in a splenectomized patient with beta-thalassemia intermedia.

We describe a 14-year-old Japanese girl with beta-thalassemia intermedia who developed moyamoya syndrome after splenectomy. This patient had compound heterozygous mutations of the beta-globin gene and received occasional transfusions. After splenectomy at 12 years of age, she transiently required partial exchange transfusions for leukoerythroblastosis but attained transfusion independence. Two years after the splenectomy, transient ischemic attacks occurred repeatedly with right hemiparesis or left paresthesia. Magnetic resonance imaging revealed bilateral stenosis of the internal carotid arteries and dilatation of the perforating branches with the formation of moyamoya vessels but not infarctions. The strict adherence to aspirin and dipyridamole has led to no stroke or progression of the vasculopathy for 8 years. Moyamoya disease has been reported in a patient with beta-thalassemia major. Cerebral vasculopathy can be a rare but grave consequence of the thromboembolic complications in beta-thalassemia major/intermedia. (J Child Neurol 2006;21:75-77).

Adolescent↗

A functional MRI comparison of patients with obsessive-compulsive disorder and normal controls during a Chinese character Stroop task.

Recent functional neuroimaging and neuropsychological studies have suggested that abnormal activity in the anterior cingulate cortex (ACC) might cause an action-monitoring dysfunction in obsessive-compulsive disorder (OCD). To identify the relationship between brain dysfunction and cognitive dysfunction, we examined regional brain changes in OCD with functional magnetic resonance imaging (fMRI) during the performance of a cognitive task. Participants comprised 24 patients with OCD and 14 normal controls. First, we compared the cognitive function in the two groups as assessed by several neuropsychological tests. Then we used fMRI to explore brain correlates of their performance during the Chinese character version of the Stroop test, a task that is strongly related to action-monitoring function. The two groups did not differ on the neuropsychological tests. Both groups also showed similar activation pattern on fMRI. The patients, however, showed weaker activation than the normal controls in the ACC and the right caudate nucleus.

Adult↗

Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement: a functional magnetic resonance imaging study.

BACKGROUND: Functional neuroimaging studies have implicated hyperactivity of the frontal cortex in obsessive-compulsive disorder (OCD); however, relationships between abnormal brain activity, clinical improvement, and neuropsychological function have not been clarified in OCD. To clarify the pathophysiology of this disorder, regional changes in brain function were examined during administration of cognitive and symptom provocation tasks in patients with OCD before and after treatment. METHODS: Ten outpatients with OCD participated in the study. Functional magnetic resonance imaging (fMRI) was performed before and after treatment. Stroop and symptom provocation tasks were administered during fMRI. Each patient was randomly allocated to receive either pharmacotherapy with fluvoxamine 200 mg/day (n = 4) or behavior therapy (n = 6) for 12 weeks. RESULTS: After 12-week treatment, mean (+/- SD) total score on the Yale-Brown Obsessive-Compulsive Scale decreased from 29.00 +/- 3.59 to 14.60 +/- 9.22, representing symptomatic improvement from moderate to mild. After symptom improvement, symptom provocation-related activation in the orbitofrontal, dorsolateral-prefrontal, and anterior cingulate cortices decreased. Conversely, Stroop task-related activation in the parietal cortex and cerebellum increased. CONCLUSIONS: After improvement of OCD with either fluvoxamine or behavioral therapy, hyperactivation of the frontal lobe related to a symptom-provocative state decreases, and posterior brain activity related to action-monitoring function increases.

Antidepressive Agents, Second-Generation↗

Novel method to estimate and display cerebral cortical degeneration using diffusion-weighted magnetic resonance imaging.

Previous studies have shown that diffusion-weighted imaging (DWI) is useful for detecting microstructural degradation of neuronal tissue in neurodegenerative diseases. Mapping of cortical degeneration by DWI is potentially useful, but is extremely difficult, mainly because of the partial volume effect resulting from the surrounding cerebrospinal fluid (CSF). In this study a novel method to map and display the cortical damage in neurodegenerative diseases using DWI is proposed. Instead of measuring the cortical diffusivity, the diffusivity of white matter directly beneath the cortex, where neuronal fibers enter or exit the overlying cortex, was measured and mapped onto the cortical surface. The map was viewed in a form of three-dimensional (3D) rendering. Patients with Alzheimer's disease (AD) showed cortical damage in the temporal and parietal cortices, and a patient with frontotemporal dementia showed damage in the frontal lobe, consistent with the typical topographical distribution of histopathological cortical damage in each of these diseases. The results suggest that subcortical diffusivity closely reflects cortical damage, and that the current mapping technique is a promising tool for evaluating neurodegenerative diseases.

Adult↗

Age-related structural changes in the young adult brain shown by magnetic resonance diffusion tensor imaging.

RATIONALE AND OBJECTIVE: Structure of the brain is generally thought to remain stationary over the course of young adulthood. However, there is some evidence that microstructural changes of the brain do occur during this period. Magnetic resonance diffusion tensor imaging (DTI) provides quantitative measures of structural changes in the brain. We used DTI to detect possible age-related structural changes in the brains of young adults. MATERIALS AND METHODS: Twenty-five healthy adults in their 20s and 30s were studied using DTI. Maps of mean diffusivity and fractional anisotropy (FA) were created for subsequent histogram and region-of-interest analyses, and the results were correlated with the respective ages of the subjects. RESULTS: The histogram analysis revealed a significant increase in the mean FA value (r = 0.407, P < .05) and a significant decrease in FA peak height (r = -0.578, P < .002) with increasing age. No age-related changes were observed in indices derived from mean diffusivity maps. Region-of-interest analysis showed no focal white matter regions with significant FA change. CONCLUSION: Quantitative DTI revealed age-related structural changes in the brains of young adults. Changes on FA histograms observed in this study were considered to be related to changes in the relative volumes of gray and white matter and may represent maturational changes.

Adult↗

Usefulness of constructive interference in steady-state magnetic resonance imaging in the presurgical examination for lumbosacral lipoma.

OBJECT: The aim of this study was to evaluate three-dimensional Fourier transformation constructive interference in steady-state (CISS) imaging as a preoperative investigation of anatomical structures around the lumbosacral lipoma for surgical untethering of the spinal cord and debulking of the lipoma. METHODS: The CISS imaging was used to visualize neural structures around the lumbosacral lipoma in 13 cases and was compared with conventional magnetic resonance imaging. In all cases, CISS images demonstrated the fine structure of the spinal cord and nerve roots, with good contrast between subarachnoid spaces and lipomas. The CISS findings were closely correlated with microscopic observation and electrophysiological investigation during surgery. In three of eight patients whose CISS images demonstrated abundant nerve roots embedded in the lipoma, untethering of the conus medullaris was not satisfactorily achieved. These three cases had obliteration of the subarachnoid space by the lipomas at the bilateral sides of the cord. In two cases with the vertebral misalignments scoliosis and lordosis, curvilinear reconstruction of CISS images along the spinal cord clearly demonstrated a neuroanatomy around the complicated lipomas. CONCLUSIONS: Using CISS imaging is useful for establishing precise neuroanatomical information around lumbosacral lipomas and for predicting the level of surgical difficulty.

Child↗

[A patient with focal dystonia induced by golf and presenting a decrease in activity of cerebral motor cortex on task].

We here report a 45-year-old man with left arm focal dystonia induced by golf. He was a swimming instructor. From 35 years of age, he swung a golf club for 4 hours everyday. At 37 years of age, he noted difficulties in moving left arm when swinging, and developed involuntary movement of left arm toward his back thereafter. His involuntary movement was exacerbated even in several years after stopping both golf and swimming. Neurologically, simultaneous contraction was observed in left triceps and biceps muscles and his left arm dropped when raising arm to front. A 'sensory trick' was also observed. Thus, he was diagnosed as having a rare focal dystonia, and its clinical characteristics and course were basically different from those of 'yips', a focal dystonia that is characterized by anxiety and distal dominant dystonia presenting only on golf. Magnetic resonance imaging (MRI), FDG-positron emission CT (FDG-PET), C11-Raclopride PET and 99mTc-single photon emission CT (SPECT) revealed no abnormality in cerebral cortex and basal ganglias. However, motor evoked potentials (MEPs) were not evoked bilaterally when magnetic stimulation was applied on primary motor cortex. On functional MRI (fMRI), 40 seconds raising left arm task-induced activation in the right primary motor, supplementary motor, and premotor areas was apparently decreased, while left motor areas, the normal side, were reasonably activated. Motor-associated areas are generally overactivated by task in focal dystonia patients whereas excitability in primary motor area is decreased in idiopathic generalized dystonia. Therefore, dystonia of the present case appears to be similar to focal dystonia clinically but may partly have a mechanism similar to idiopathic generalized dystonia as shown in the fMRI studies.

Arm↗

Percutaneous vertebroplasty in the treatment of pain caused by metastatic tumor.

Percutaneous vertebroplasty is a radiologically guided therapeutic procedure that consists of percutaneous injection of polymethylmetacrylate (PMMA) into pathologic vertebral bodies. It is a minimally invasive procedure that is effective in the treatment of pain resulting from bone metastasis. This procedure has the advantage of providing rapid pain relief and spinal stabilization. A patient with severe, aggressive pain from metastatic lumbar spinal tumor of thyroid follicular carcinoma is presented herein. Despite treatment with analgesic agents, external beam radiation therapy, radioiodine therapy, and posterior fusion surgery, the pain reemerged and progressed. After percutaneous vertebroplasty, definite pain relief was achieved. Vertebroplasty would be useful as an additional or alternative pain relief method in patients with metastatic vertebral tumors.

Adenocarcinoma, Follicular↗

A method to reduce saline and heparin in intraoperative cerebral angiography: a preliminary report.

PURPOSE: To reduce saline and heparin in continuous catheter perfusion in intraoperative cerebral angiography, a method using a syringe pump was tried. MATERIALS AND METHODS: Ten patients with brain arteriovenous malformation (AVM) underwent intraoperative cerebral angiography. Seven internal carotid arteries (ICAs) and six vertebral arteries (VAs) were catheterized in these patients. Continuous catheter perfusion was performed at a low rate of 3 mL/hr with saline containing 8,000 units of heparin per liter using a syringepump. RESULTS: Mean duration of catheter perfusion was 8.3 +/- 4.0 hrs (range, 3.0 to 15.7 hrs). Mean volume of saline was 25.0 +/- 11.9 mL (range, 9 to 47 mL) per catheter. Mean dosage of heparin was 200.0 +/- 94.9 units (range, 72 to 376 units) per catheter. No complications due to intraoperative angiography were observed in this trial. CONCLUSION: Reduction of the saline volume and heparin dosage was possible in intraoperative cerebral angiography by the continuous perfusion of a small amount of high-concentration heparinized saline using a syringe pump.

Adolescent↗

Validation of the CBF, CBV, and MTT values by perfusion MRI in chronic occlusive cerebrovascular disease: a comparison with 15O-PET.

RATIONALE AND OBJECTIVES: To evaluate the reliability of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) values obtained by deconvolution algorithm perfusion-weighted MR imaging (D-PWI), we compared these values with those obtained by first-moment algorithm perfusion-weighted MR imaging (F-PWI) and 15O-PET. SUBJECTS AND METHODS: Six healthy volunteers and eleven patients with chronic occlusive cerebrovascular disease were studied with both perfusion-weighted MR imaging and 15O-PET, and region-of-interest analyses were performed. Normalization factors for CBF and CBV values obtained by D-PWI were determined as the mean values of 15O-PET divided by those of D-PWI in healthy volunteers. Then these values were used in analyzing the data of the patients. RESULTS: The MTT value obtained by D-PWI was 6.1 +/- 0.5 seconds on the non-occluded side, 6.4 +/- 0.7 seconds on the minimally to moderately stenosed side, and 6.7 +/- 1.2 seconds on the severely stenosed to occluded side. These values were significantly correlated with those obtained by F-PWI (r = 0.83; P < .001), and with those obtained by 15O-PET (r = 0.78; P < .05). However, the CBF and CBV values obtained by D-PWI did not correlate with those obtained by 15O-PET. CONCLUSION: MTT values obtained by D-PWI were reliable parameters of cerebral hemodynamics, but the CBF and CBV values obtained by D-PWI were not always reliable.

Adult↗

Prevalence of stenoocclusive lesions in the renal and abdominal arteries in moyamoya disease.

OBJECTIVE: The extracranial involvement of moyamoya disease has been reported in several studies. The main purpose of this study was to determine the prevalence of stenoocclusive lesions in the renal and major abdominal arteries in moyamoya disease. MATERIALS AND METHODS: Abdominal angiography was performed in 73 patients with idiopathic moyamoya disease. The findings of abdominal angiography were retrospectively reviewed for the presence and appearance of stenosis in the renal and other major abdominal arteries. RESULTS: Four (5%) of 73 patients presented with unilateral renal artery stenosis. Three patients had moderate stenosis, and one patient had mild stenosis. In the three patients with moderate stenosis, the renal artery stenosis was located in the proximal region of the main branch. Two patients (3%) with moderate stenosis of the unilateral renal artery had renovascular hypertension. No statistically significant differences were observed in age, sex, and the cerebral angiographic stage between patients with and without renal artery stenosis. No stenosis was found in the abdominal aorta or celiac, superior mesenteric, common hepatic, splenic, and proximal common iliac arteries. No occlusions were found in any abdominal arteries. CONCLUSION: The prevalence of renal artery stenosis in patients with moyamoya disease was 5% (4/73). Involvement of the proximal region of the renal artery was dominant. No stenosis was found in other abdominal arteries.

Abdomen↗

Differentiation of cavernous hemangioma from schwannoma of the orbit: a dynamic MRI study.

OBJECTIVE: The purpose of this study was to determine the capability of dynamic contrast MRI to differentiate hemangioma from schwannoma of the orbit. MATERIALS AND METHODS: Sixteen patients (three males and 13 females; mean age, 39 +/- 17.3 [SD] years; age range, 10-71 years) with unilateral orbital tumors, including eight cavernous hemangiomas and eight schwannomas, were examined. In addition to conventional MRI, we performed a dynamic contrast study (fast spin-echo sequence, 20-sec interval) after bolus administration of the contrast material (gadopentetate dimeglumine, 0.1 mmol/kg). We evaluated the features of the contrast enhancement spread pattern and the tumors' time-intensity curves. RESULTS: In the early phase, all the hemangiomas started the enhancement from one point or portion, although all the schwannomas started the enhancement from a wide area. The difference in the contrast-enhancement spread pattern features between the two types of tumors was statistically significant (p < 0.0001). The gradient of the time-intensity curve did not show a significant difference. CONCLUSION: Hemangioma and schwannoma of the orbit can be differentiated by the contrast-enhancement spread pattern on dynamic MRI.

Adolescent↗

[A family with autosomal dominant temporal lobe epilepsy accompanied by motor and sensory neuropathy].

We report a 20-year-old man with temporal lobe epilepsy (TLE) accompanied by hereditary motor and sensory neuropathy (HMSN). He had experienced complex partial seizures (CPS), which started with a nausea-like feeling, followed by loss of consciousness and automatism, since he was 6 years old. The frequency of attacks was at first decreased by phenytoin. However, attacks increased again when he was 18 years old. On admission, neurological examination showed mild weakness of the toes, pes cavus, hammer toe and mildly impaired vibratory sensation in his legs. Ten people in four generations of his family showed a history of epilepsy in the autosomal dominant inheritance form. His younger sister and mother had a history of epilepsy accompanied with pes cavus, hammer toe, weakness of toe and finger extension and mildly impaired vibratory sensation as well. Direct sequencing of the glioma-inactivated leucine-rich gene (LGI1), in which several mutations were reported in patients with familial lateral temporal lobe epilepsy, showed no specific mutation in this family. On consecutive video-EEG monitoring, paroxysmal rhythmic activity was confirmed in his left fronto-temporal region when he showed automatism, and then a generalized slow burst activity was detected when he lost consciousness. For his seizures, TLE with secondary generalization was diagnosed. In the nerve conduction study, delayed nerve conduction, distal motor latency and decreased amplitudes of the compound muscle action potentials (CMAP) of bilateral peroneal nerves were observed, indicating the existence of mild axonal degeneration. Based on these data, we consider that this family to be a new phenotype of autosomal dominant TLE accompanied by motor and sensory neuropathy.

Adult↗