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Functional MRI and the Wada test provide complementary information for predicting post-operative seizure control.

Prediction of post-surgical seizure relief and potential cognitive deficits secondary to anterior temporal lobectomy (ATL) are important to pre-surgical planning. Although the intracarotid amobarbital test (IAT) is predictive of post-ATL seizure outcome, development of non-invasive and more precise means for determining post-ATL seizure relief are needed. We previously reported on a technique utilizing functional MRI (fMRI) to evaluate the relative functional adequacy of mesial temporal lobe structures in preparation for ATL. In the present study, we report follow-up outcome data on eight temporal lobe epilepsy (TLE) patients 1-year post-ATL who were evaluated pre-surgically using IAT and fMRI. Functional memory lateralization using fMRI predicted post-ATL seizure outcome as effectively as the IAT. In general, asymmetry of functional mTL activation favouring the non-epileptic hemisphere was associated with seizure-free status at 1-year follow-up. Moreover, when combined, fMRI and IAT provided complementary data that resulted in improved prediction of post-operative seizure control compared with either procedure alone.

Adolescent↗

Spatial independent component analysis of functional MRI time-series: to what extent do results depend on the algorithm used?

Independent component analysis (ICA) has been successfully employed to decompose functional MRI (fMRI) time-series into sets of activation maps and associated time-courses. Several ICA algorithms have been proposed in the neural network literature. Applied to fMRI, these algorithms might lead to different spatial or temporal readouts of brain activation. We compared the two ICA algorithms that have been used so far for spatial ICA (sICA) of fMRI time-series: the Infomax (Bell and Sejnowski [1995]: Neural Comput 7:1004-1034) and the Fixed-Point (Hyvärinen [1999]: Adv Neural Inf Proc Syst 10:273-279) algorithms. We evaluated the Infomax- and Fixed Point-based sICA decompositions of simulated motor, and real motor and visual activation fMRI time-series using an ensemble of measures. Log-likelihood (McKeown et al. [1998]: Hum Brain Mapp 6:160-188) was used as a measure of how significantly the estimated independent sources fit the statistical structure of the data; receiver operating characteristics (ROC) and linear correlation analyses were used to evaluate the algorithms' accuracy of estimating the spatial layout and the temporal dynamics of simulated and real activations; cluster sizing calculations and an estimation of a residual gaussian noise term within the components were used to examine the anatomic structure of ICA components and for the assessment of noise reduction capabilities. Whereas both algorithms produced highly accurate results, the Fixed-Point outperformed the Infomax in terms of spatial and temporal accuracy as long as inferential statistics were employed as benchmarks. Conversely, the Infomax sICA was superior in terms of global estimation of the ICA model and noise reduction capabilities. Because of its adaptive nature, the Infomax approach appears to be better suited to investigate activation phenomena that are not predictable or adequately modelled by inferential techniques.

Adult↗

Functional MRI of the human brain: predominance of signals from extracerebral veins.

This study demonstrates the predominance of extracerebral vascular signals in gradient-echo functional magnetic resonance imaging of motor activity at 1.5 Tesla. The demonstration is based upon a novel experimental approach. Maximum intensity projection images are derived from a large set of contiguous 2D functional MR images, and compared with MR angiograms obtained from the volume covered by the set of functional MR images. The comparison shows that the hyperintensities in the functional MR images cover extensive areas, which can be superimposed with a number of veins in the MR angiograms. These results should trigger a general caution in interpretation of the observations in 1.5 Tesla functional MRI.

Brain↗

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↗

Motor recovery mechanism of diffuse axonal injury: a combined study of transcranial magnetic stimulation and functional MRI.

PURPOSE: The purpose of this study was to investigate the motor recovery mechanism following diffuse axonal injury (DAI) using transcranial magnetic stimulation (TMS) and functional MRI (fMRI). METHODS: Twenty-six hands of 13 control subjects and 14 affected hands of 8 patients (two hemiparetics and six quadriparetics) were evaluated. All the patients were initially diagnosed with DAI and were evaluated after they had reached their maximal motor recovery. fMRI was performed at 1.5 T using a hand grasp-release movement paradigm and TMS was applied with a round coil over the vertex. RESULTS: fMRI revealed that both normal subjects and patients with DAI showed increased contralateral primary sensori-motor cortex activation during affected hand movement. The motor evoked potentials (MEPs) of the patient group was slightly delayed in latency and significantly increased in duration and turns. The relative MEP amplitude, phase, and excitatory threshold were not significantly different between the groups. CONCLUSIONS: These findings may indicate the heterogeneity of the axons in the recovery process of the corticospinal tract. It seems that the motor recovery in patients who had suffered DAI was attributable to the recovery of the corticospinal tract.

Adult↗

Determination of the dominant language hemisphere by functional MRI in patients with temporal lobe epilepsy.

OBJECTIVE: To determine the dominant language hemisphere in patients with intractable temporal lobe epilepsy before surgical treatment by using functional MRI (fMRI). METHODS: Twelve patients underwent fMRI. Among them, 4 patients also underwent the Wada test. Anterior temporal lobectomy was performed on patients with epileptic focus on the non-dominant hemisphere, and selective amygdalo-hippocampectomy on patients with epileptic focus on the dominant hemisphere. RESULTS: Ten patients had left dominance, and 2 right dominance. The fMRI results were concordant with Wada test results in the 4 patients who accepted the Wada test. Seven patients underwent anterior temporal lobectomy, and 5 underwent selective amygdalo-hippocampectomy. There was no post-operative dysphasia. CONCLUSION: fMRI is an alternative method of noninvasive functional mapping for language dominance in patients with temporal lobe epilepsy.

Adult↗

Functional MRI comparison between reading ideographic and phonographic scripts of one language.

Brain activation during reading of phonographic (Hangul) and ideographic (Hanja) words is compared using functional MRI by taking advantage of the bi-scriptal system of the Korean language. To examine the psycholinguistic difference, i.e., phonographic vs. ideographic, separately from other differences due to Hanja being a secondary script, we made a control comparison between Hangul and the English alphabet, another phonographic and secondary script. Interaction analysis between the two comparisons revealed that the right fusiform gyrus and adjacent temporo-occipital region, among others, seem more specifically involved in processing ideographic scripts. On the other hand, regions in bilateral inferior parietal lobules were more active with Hangul reading than Hanja. This is consistent with the notion that reading the phonographic script may involve the assembled phonology route in addition to the addressed lexical route, whereas reading the ideographic script may not involve the former.

Adult↗

An approach to probe some neural systems interaction by functional MRI at neural time scale down to milliseconds.

In this paper, we demonstrate an approach by which some evoked neuronal events can be probed by functional MRI (fMRI) signal with temporal resolution at the time scale of tens of milliseconds. The approach is based on the close relationship between neuronal electrical events and fMRI signal that is experimentally demonstrated in concurrent fMRI and electroencephalographic (EEG) studies conducted in a rat model with forepaw electrical stimulation. We observed a refractory period of neuronal origin in a two-stimuli paradigm: the first stimulation pulse suppressed the evoked activity in both EEG and fMRI signal responding to the subsequent stimulus for a period of several hundred milliseconds. When there was an apparent site-site interaction detected in the evoked EEG signal induced by two stimuli that were primarily targeted to activate two different sites in the brain, fMRI also displayed signal amplitude modulation because of the interactive event. With visual stimulation using two short pulses in the human brain, a similar refractory phenomenon was observed in activated fMRI signals in the primary visual cortex. In addition, for interstimulus intervals shorter than the known latency time of the evoked potential induced by the first stimulus ( approximately 100 ms) in the primary visual cortex of the human brain, the suppression was not present. Thus, by controlling the temporal relation of input tasks, it is possible to study temporal evolution of certain neural events at the time scale of their evoked electrical activity by noninvasive fMRI methodology.

Animals↗

Imaging how attention modulates pain in humans using functional MRI.

Current clinical and experimental literature strongly supports the phenomenon of reduced pain perception whilst attention is distracted away from noxious stimuli. This study used functional MRI to elucidate the underlying neural systems and mechanisms involved. An analogue of the Stroop task, the counting Stroop, was used as a cognitive distraction task whilst subjects received intermittent painful thermal stimuli. Pain intensity scores were significantly reduced when subjects took part in the more cognitively demanding interference task of the counting Stroop than in the less demanding neutral task. When subjects were distracted during painful stimulation, brain areas associated with the affective division of the anterior cingulate cortex (ACC) and orbitofrontal regions showed increased activation. In contrast, many areas of the pain matrix (i.e. thalamus, insula, cognitive division of the ACC) displayed reduced activation, supporting the behavioural results of reduced pain perception.

Adult↗

[Cortical response to age-related macular degeneration (Part II). Functional MRI study].

UNLABELLED: PURPOSE AND MATERIALS: To evaluate the cortical response to visual stimulation in patients with age-related macular degeneration (ARMD), we conducted a functional MRI study in ten patients presenting unilateral or bilateral ARMD and five age-matched controls, using white flashes during activation phases (see Part I). RESULTS: After anatomical conformation, eight patients and four controls showed significant cortical hemodynamic response to monocular stimulations. Individual analysis was preferred to group evaluation, because of the differences in visual loss in a small number of patients. In controls, we observed cortical response in the primary visual cortex, especially at occipital poles corresponding to the macula. Patients showed a qualitative and quantitative restriction in cortical response and exclusion of occipital poles after stimulation of the affected eye, whereas activation was found in the peripheral striate and peristriate cortex. Cortical response showed hemispheric asymmetry in some patients. DISCUSSION: Our study demonstrated an activation defect in the macular projected striate cortex, corresponding to visual impairment in ARMD patients. Nevertheless, at a given visual acuity, cortical response may vary among subjects. Patients' subjective apprehension may account for such variations, as well as objective visual capacity stemming from residual functional retinal areas within the affected macula. The hemispheric asymmetry in cortical activation may result from gaze deviation onto the new fixation area in the perimacular retina, thus altering the global visual field. Enhancement in the peripheral striate and peristriate areas suggests changes in cortical interactions, possibly by a lowering of the feedback from macular projected V1. Finally, cortical evaluations must take into account degenerative phenomena delaying the hemodynamic response in the elderly. CONCLUSION: Aiming at a specific population of weakened patients with a serious visual impairment, we obtained significant results concerning cortical plasticity for visual perception in central vision deletion. Our preliminary findings must be confirmed in a larger population and correlated with other techniques exploring vision, in particular with multifocal electroretinography for retinal evaluation.

Age Factors↗

Resting functional MRI with temporal clustering analysis for localization of epileptic activity without EEG.

We report on the methods and initial findings of a novel noninvasive technique, resting functional magnetic resonance imaging (fMRI) with temporal clustering analysis (TCA), for localizing interictal epileptic activity. Nine subjects were studied including six temporal lobe epilepsy (TLE) patients with confirmed localization indicated by successful seizure control after resection. The remaining three subjects had standard presurgical evaluations with inconsistent results or suspected extratemporal lobe foci. Peaks of activity, presumably epileptic, were detected in all nine subjects, using the resting functional MRI with temporal clustering analysis. In all six patients who underwent resective surgery, the fMRI with temporal clustering analysis accurately determined the epileptogenic hippocampal hemisphere (P = 0.005). In the three subjects without confirmed localization, the technique determined regions of activity consistent with those determined by the presurgical assessments. Though more studies are required to validate this technique, the results demonstrate the potential of the resting fMRI with temporal clustering technique to detect and localize epileptic activity without the need for simultaneous electroencephalography (EEG). The greatest potential benefit of this technique will be in the evaluation of patients with suspected extratemporal lobe epilepsy and patients whose standard assessments are discordant.

Adolescent↗

Determination of cognitive hemispheric lateralization by "functional" transcranial Doppler cross-validated by functional MRI.

BACKGROUND AND PURPOSE: Changes of blood flow velocity in the right and left middle cerebral artery (MCA) induced by cognitive demands are detectable by means of "functional" transcranial Doppler sonography (fTCD). Functional MRI (fMRI) is an alternative method for mapping brain activity. The purpose of this study was to determine whether fTCD can detect hemispheric lateralization and to cross-validate fTCD with fMRI. METHODS: Bilateral continuous MCA monitoring of 14 healthy, right-handed subjects with TCD was performed while the subjects underwent a visuospatial task, and the hemispheric blood flow velocity shift was calculated. Identical stimulus and response patterns were used in fMRI. Blood oxygenation level-dependent fMRI was performed with the use of a gradient-echo echo-planar sequence on a 1.5-T scanner. Statistical maps were computed on a voxel-by-voxel basis, hemispheric ratios for activated pixels were computed, and a group study was performed separately for the male and female subgroups. RESULTS: Statistical analyses (t test) showed a significantly higher mean peak blood flow velocity increase (P<0.05) of the right MCA (111.3+/-7.0%) compared with the left MCA (107.1+/-6.1%). fMRI demonstrated bilateral activation in the superior parietal lobulus (Brodmann area 7) with a right/left ratio of 1.95. Concordant differences between the female and male subgroups could be visualized with both methods. CONCLUSIONS: Both methods succeeded in discriminating a blood flow shift to the right hemisphere induced by a complex cognitive visuospatial task. fMRI cross-validates the findings of fTCD. Our study suggests that fTCD can investigate the close relationship between brain activity and blood flow and lateralize higher cognitive functions reliably.

Adult↗

Critical period for cross-modal plasticity in blind humans: a functional MRI study.

The primary visual cortex (V1) in congenitally blind humans has been shown to be involved in tactile discrimination tasks, indicating that there is a shift in function of this area of cortex, but the age dependency of the reorganization is not fully known. To investigate the reorganized network, we measured the change of regional cerebral blood flow using 3.0 Tesla functional MRI during passive tactile tasks performed by 15 blind and 8 sighted subjects. There was increased activity in the postcentral gyrus to posterior parietal cortex and decreased activity in the secondary somatosensory area in blind compared with sighted subjects during a tactile discrimination task. This suggests that there is a greater demand for shape discrimination processing in blind subjects. Blind subjects, irrespective of the age at onset of blindness, exhibited higher activity in the visual association cortex than did sighted subjects. V1 was activated in blind subjects who lost their sight before 16 years of age, whereas it was suppressed in blind subjects who lost their sight after 16 years of age during a tactile discrimination task. This suggests that the first 16 years of life represent a critical period for a functional shift of V1 from processing visual stimuli to processing tactile stimuli. Because of the age-dependency, V1 is unlikely to be the "entry node" of the cortex for the redirection of tactile signals into visual cortices after blinding. Instead, the visual association cortex may mediate the circuitry by which V1 is activated during tactile stimulation.

Adult↗

[Functional MRI of human brain in musicians and non-musicians].

OBJECTIVE: To explore the differences in brain activation between musicians and non-musicians by use of functional MRI. METHODS: Twelve right-handed musicians and twelve right-handed non-musicians were recruited in the study. During a listening task, they were scanned on the Sigma 1.5T scanner (GE) while they were passively listening to several segments of music of "the Butterfly Love" and the white noise with same physical energy. RESULT: Both musicians and non-musicians demonstrated bilateral transverse gyrus weak activated while listening to the white noise. But when listening to music, they showed bilateral temporal areas strongly activated including superior temporal gyrus, transverse gyrus and some middle temporal areas. Moreover, musicians showed relative left dominance (10/12), whereas non-musicians demonstrated right dominance(11/12). Furthermore,besides bilateral temporal areas, more and stronger activated areas were found in musicians such as cuneus, precuneus,medial frontal and left middle occipital gyrus. CONCLUSION: There are different neuro-patterns between musicians and non-musicians.

Adult↗

Functional MRI correlates of real and imagined tool-use pantomimes.

OBJECTIVE: To study the pattern of cerebral activation related to the performance of tool-use pantomimes with functional MRI (fMRI) using a task-subtraction design. BACKGROUND: Tool use comprises a particular category of transitive actions. Inability to pantomime the use of tools has been classically associated with retrorolandic dominant hemisphere damage. However, where in the left hemisphere these transitive representations are generated is unclear. METHODS: Echoplanar images were acquired in eight alternating task and control periods. Sixteen right-handed normal adults pantomimed the use of common tools and utensils with each hand. The control condition consisted of a sequence of nonsymbolic complex movements of forearm, hand, and fingers at a self-paced rate. Eight individuals also imagined the execution of the real task and control actions. A repeated measures ANOVA compared activations in five regions of interest in each hemisphere. RESULTS: Regardless of which hand was used, the left hemisphere was more active than the right in both real (p < 0.02) and imagined (p < 0.04) tasks. Activations clustered in the left intraparietal cortex and posterior dorsolateral frontal cortex. CONCLUSIONS: Pantomiming the use of tools is associated with activation of the left intraparietal cortex and dorsolateral frontal cortex. The left intraparietal cortex may store the representations of tool-use formulae, whereas the dorsolateral frontal cortex activation may reflect the switching between innervatory motor programs.

Adolescent↗

Separating processes within a trial in event-related functional MRI II. Analysis.

Many cognitive processes occur on time scales that can significantly affect the shape of the blood oxygenation level-dependent (BOLD) response in event-related functional MRI. This shape can be estimated from event related designs, even if these processes occur in a fixed temporal sequence (J. M. Ollinger, G. L. Shulman, and M. Corbetta. 2001. NeuroImage 13: 210-217). Several important considerations come into play when interpreting these time courses. First, in single subjects, correlations among neighboring time points give the noise a smooth appearance that can be confused with changes in the BOLD response. Second, the variance and degree of correlation among estimated time courses are strongly influenced by the timing of the experimental design. Simulations show that optimal results are obtained if the intertrial intervals are as short as possible, if they follow an exponential distribution with at least three distinct values, and if 40% of the trials are partial trials. These results are not particularly sensitive to the fraction of partial trials, so accurate estimation of time courses can be obtained with lower percentages of partial trials (20-25%). Third, statistical maps can be formed from F statistics computed with the extra sum of square principle or by t statistics computed from the cross-correlation of the time courses with a model for the hemodynamic response. The latter method relies on an accurate model for the hemodynamic response. The most robust model among those tested was a single gamma function. Finally, the power spectrum of the measured BOLD signal in rapid event-related paradigms is similar to that of the noise. Nevertheless, high-pass filtering is desirable if the appropriate model for the hemodynamic response is used.

Algorithms↗

Corticobasal degeneration: structural and functional MRI and single-photon emission computed tomography.

We studied seven patients with corticobasal degeneration (CBD) from a clinical and imaging perspective. We describe the main morphological features of CBD and, using functional MRI, try to define the possible role of the parietal lobe in simple and complex learned motor sequences. We showed decreased activation of the parietal lobe contralateral to the more affected arm, when movements, simple or complex, are performed with that hand. Moreover we found that functional imaging can demonstrate parietal and motor cortex dysfunction before structural, and even single-photon emission computed tomography changes become evident.

Aged↗

Medial reorganization of motor function demonstrated by functional MRI and diffusion tensor tractography.

PURPOSE: Peri-lesional reorganization is a motor recovery mechanism after brain injury. The object of this study was to demonstrate the peri-lesional reorganization, using functional MRI (fMRI) and diffusion tensor tractography (DTT). METHODS: Six control subjects and a 53 year-old woman with left primary sensori-motor cortex (SM1) and underlying deep white matter injury were evaluated. The patient presented with complete paralysis of the right hand after the resection of a meningioma on the left SM1. The motor function of the affected hand had recovered slowly the extent of her being able to overcome some resistance for 6 months. At 2 years after the operation, fMRI was performed at 1.5 T in parallel with timed finger flexion-extension movements in all subjects and DTT was performed only in the patient. RESULTS: The contralateral SM1 centered on the precentral knob was activated during hand movements of unaffected (left) side or control subjects. However, the medial area of the injured SM1 was activated during affected (right) hand movements. DTT of the affected (left) hemisphere originated from the medial area of the injured SM1 and descended along the medial side of injured deep white matter. CONCLUSIONS: It seems that the motor function of the affected hand was reorganized into the medial area of the injured SM1 and deep white matter in this patient.

Aged↗