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A functional MRI study of subjects recovered from hemiparetic stroke.

BACKGROUND AND PURPOSE: Stroke recovery mechanisms remain incompletely understood, particularly for subjects with cortical stroke, in whom limited data are available. We used functional magnetic resonance imaging to compare brain activations in normal controls and subjects who recovered from hemiparetic stroke. METHODS: Functional magnetic resonance imaging was performed in ten stroke subjects with good recovery, five with deep, and five with cortical infarcts. Brain activation was achieved by index finger-tapping. Statistical parametric activation maps were obtained using a t test and a threshold of P < .001. In five bilateral motor regions, the volume of activated brain for each stroke subject was compared with the distribution of activation volumes among nine controls. RESULTS: Control subjects activated several motor regions. During recovered hand finger-tapping, stroke subjects activated the same regions as controls, often in a larger brain volume. In the unaffected hemisphere, sensorimotor cortex activation was increased in six of nine stroke subjects compared with controls. Cerebellar hemisphere contralateral and premotor cortex ipsilateral to this region, as well as supplementary motor areas, also had increased activation. In the stroke hemisphere, activation exceeding controls was uncommon, except that three of five cortical strokes showed peri-infarct activation foci. During unaffected hand finger-tapping, increased activation by stroke subjects compared with controls was uncommon; however, decreased activation was seen in unaffected sensorimotor cortex, suggesting that this region's responsiveness increased to the ipsilateral hand and decreased to contralateral hand movements. Use of a different threshold for defining activation (P < .01) did not change the overall findings (kappa = .75). CONCLUSIONS: Recovered finger-tapping by stroke subjects activated the same motor regions as controls but to a larger extent, particularly in the unaffected hemisphere. Increased reliance on these motor areas may represent an important component of motor recovery. Functional magnetic resonance imaging studies of subjects who recovered from stroke provide evidence for several processes that may be related to restoration of neurologic function.

Aged↗

Functional MRI involving painful stimulation of the ankle and the effect of physiotherapy joint mobilization.

We examined whether cerebral activation due to secondary hyperalgesia resulting from intrajoint capsaicin injection could be detected using functional magnetic resonance imaging (fMRI) in alpha-chloralose anesthetized rats. We also examined whether we could detect analgesic changes in the central nervous system response to pain as a result of physiotherapy joint manipulation. Robust activation of areas of the brain known to be associated with the processing of pain, namely the anterior cingulate (bilateral), frontal cortex (bilateral) and sensory motor cortex (contralateral), was found in all animals following injection of 25 microl of capsaicin (128 microg/ml in 7.5% DMSO) into the plantar surface of the rat hindpaw (n = 7) and 75 microL into the ankle joint (n = 13). Significantly greater activation was observed when capsaicin was injected into the plantar surface of the hindpaw compared to the ankle joint. Mechanical allodynia and secondary hyperalgesia following capsaicin injection into the ankle joint also resulted in activation of the same brain regions. Trends toward decreased areas of activation in brain regions associated with pain in animals following physiotherapy joint mobilization were observed.

Animals↗

Functional MRI of language-related activation in left frontal schizencephaly.

Brain activation associated with covert verb generation was studied in a right-handed patient with an asymptomatic left frontal schizencephaly by functional magnetic resonance imaging. Activation of the dysplastic neuronal tissue lining the cleft and the adjacent cortex was found, indicating participation of the malformed region in physiologic cerebral functions. This finding may have clinical impact in patients with medically intractable seizures due to malformations of the cortical development prior to epilepsy surgery.

Adult↗

Estimation of the Hemodynamic Response Function in event-related functional MRI: directed acyclic graphs for a general Bayesian inference framework.

A convenient way to analyze BOLD fMRI data consists of modeling the whole brain as a stationary, linear system characterized by its transfer function: the Hemodynamic Response Function (HRF). HRF estimation, though of the greatest interest, is still under investigation, for the problem is ill-conditioned. In this paper, we recall the most general Bayesian model for HRF estimation and show how it can beneficially be translated in terms of graphical models, leading to (i) a clear and efficient representation of all structural and functional relationships entailed by the model, and (ii) a straightforward numerical scheme to approximate the joint posterior distribution, allowing for estimation of the HRF, as well as all other model parameters. We finally apply this novel technique on both simulations and real data.

Adolescent↗

Contextual clustering for analysis of functional MRI data.

We present a contextual clustering procedure for statistical parametric maps (SPM) calculated from time varying three-dimensional images. The algorithm can be used for the detection of neural activations from functional magnetic resonance images (fMRI). An important characteristic of SPM is that the intensity distribution of background (nonactive area) is known whereas the distributions of activation areas are not. The developed contextual clustering algorithm divides an SPM into background and activation areas so that the probability of detecting false activations by chance is controlled, i.e., hypothesis testing is performed. Unlike the much used voxel-by-voxel testing, neighborhood information is utilized, an important difference. This is achieved by using a Markov random field prior and iterated conditional modes (ICM) algorithm. However, unlike in the conventional use of ICM algorithm, the classification is based only on the distribution of background. The results from our simulations and human fMRI experiments using visual stimulation demonstrate that a better sensitivity is achieved with a given specificity in comparison to the voxel-by-voxel thresholding technique. The algorithm is computationally efficient and can be used to detect and delineate objects from a noisy background in other applications.

Algorithms↗

Recovery of the rodent brain after cardiac arrest: a functional MRI study.

Recovery of the cerebral cortex after 10 min of cardiac arrest was studied in rat using noninvasive MRI techniques. The apparent diffusion coefficient (ADC) of brain water was imaged to document reversal of the metabolic impairment. Perfusion-weighted imaging and blood oxygen level dependent (BOLD) imaging were performed to assess functional recovery. To this purpose, rats were anesthetized with alpha-chloralose, and somatosensory cortex was activated by electrical stimulation of the contralateral forepaw. In sham-operated controls, cortical ADC was 862 +/- 10 microm2/s, and stimulation of forepaw led to a focal increase of signal intensity in somatosensory cortex by 71 +/- 22% in perfusion-weighted images and by 6 +/- 1% in BOLD images. One hour after successful resuscitation following 10 min of cardiac arrest, ADC did not differ from control but functional activation was completely suppressed. After 3 hours of reperfusion, functional activity began to reappear but the recovery of the BOLD signal progressed faster than that of the perfusion-weighted signal. The differences in the recovery of ADC, BOLD, and perfusion imaging are related to differences between metabolic and functional recovery on one hand and between blood flow and oxygen extraction on the other. The combination of these MRI methods thus provides detailed qualitative information about the progression of brain recovery after transient circulatory arrest.

Animals↗

Functional MRI at 4.7 tesla of the rat brain during electric stimulation of forepaw, hindpaw, or tail in single- and multislice experiments.

Stimulation of peripheral nerves activates corresponding regions in sensorimotor cortex. We have applied functional magnetic resonance imaging (fMRI) techniques to monitor activated brain regions by means of measuring changes of blood oxygenation level-dependent contrast during electric stimulation of the forepaw, hindpaw, or tail in rats. During alpha-chloralose anesthesia, artificial respiration, and complete muscle relaxation, stimulations were delivered at 3 Hz via subcutaneous bipolar electrodes with 500-microseconds-current pulses of 0.2-2.0 mA. Single- or multislice gradient echo images were collected during recording sessions consisting of five alternating rest and stimulation periods. Stimulation of the right and left forepaws and hindpaws repeatedly led to robust activation of the contralateral sensorimotor cortex. There was a significant correlation (P < 0.05) between current pulse strength and amount of activation of the sensory cortex during forepaw stimulation. The center of the main cortical representation of the forepaw was situated 3.4 mm lateral to the midline and 5 mm posterior to the rhinal fissure. The main representation of the hindpaw was 2.0 mm lateral to the midline and 6 mm posterior to the rhinal fissure. Tail stimulation gave rise to a strikingly extended bilateral cortical activation, localized along the midline in medial parietal and frontal cortex 4 and 5 mm posterior to the rhinal fissure. In conclusion, the experiments provide evidence that peripheral nerve stimulation induces a fMRI signal in the respective division of the somatosensory cortex in a stimulus-related manner. The marked cortical activation elicited by tail stimulation underlines the key importance of the tail.

Afferent Pathways↗

Functional MRI study of a serial reaction time task in Huntington's disease.

The aim of this study was to investigate pathophysiological changes at an early stage of clinical Huntington's disease (HD) using a functional magnetic resonance imaging (fMRI) study and a serial reaction time task paradigm. Mildly affected and presymptomatic HD subjects (n = 8) and healthy normal controls (NC, n = 12) were studied. A group behavioral effect of implicit learning was seen only in the control population. Individual statistical parametric mapping (SPM) analysis showed more consistent activation of the caudate nucleus and putamen in the NC group. In the HD group, the group average SPM showed significant activation in the right head of caudate nucleus, as well as bilateral thalami, left middle temporal, right superior temporal, right superior frontal, right middle and inferior frontal and right postcentral gyri. In the comparison of between-group differences (NC-HD), reduced activation in the HD group relative to NC was observed in the right middle frontal, left middle occipital, left precuneus, and left middle frontal gyri. The variable striatal activity in the Huntington's group suggests early functional loss possibly associated with previously demonstrated early atrophy of these same neural structures.

Adult↗

EEG-related functional MRI in benign childhood epilepsy with centrotemporal spikes.

The localization of epileptic foci is an important issue in children with extratemporal epilepsies. However, the value of noninvasive methods such as the EEG-assisted functional magnetic resonance imaging (fMRI) has not been sufficiently investigated in children. As a model of extratemporal epilepsies, we studied 7 patients aged 5 to 12 (median 10) years with benign childhood epilepsy and centrotemporal (rolandic) spikes. Interictal spikes were recorded during the fMRI acquisition on a MR-compatible battery-powered digital EEG system with 16 channels. The fMRI sequences were correlated off-line with the EEG spikes and analyzed with the software Statistical Parametrical Mapping SPM99. The fMRI results demonstrated the spike-related activation in the perisylvian central region in three patients; we could not demonstrate fMRI activation despite active spiking in 2 patients, and 2 patients did not produce sufficient spikes for fMRI analysis. We currently consider the spike-related fMRI as a research tool that localizes epileptic activity in selected patients. Further improvements of the technique are necessary to allow a clinical application of this method.

Brain Mapping↗

Face-sensitive regions in human extrastriate cortex studied by functional MRI.

1. We have previously identified face-selective areas in the mid-fusiform and inferior temporal gyri in electrophysiological recordings made from chronically implanted subdural electrodes in epilepsy patients. In this study, functional magnetic resonance imaging (fMRI) was used to study the anatomic extent of face-sensitive brain regions and to assess hemispheric laterality. 2. A time series of 128 gradient echo echoplanar images was acquired while subjects continuously viewed an alternating series of 10 unfamiliar faces followed by 10 equiluminant scrambled faces. Each cycle of this alternating sequence lasted 12 s and each experimental run consisted of 14 cycles. The time series of each voxel was transformed into the frequency domain using Fourier analysis. Activated voxels were defined by significant peaks in their power spectra at the frequency of stimulus alternation and by a 180 degrees phase shift that followed changes in stimulus alternation order. 3. Activated voxels to faces were obtained in the fusiform and inferior temporal gyri in 9 of 12 subjects and were approximately coextensive with previously identified face-selective regions. Nine subjects also showed activation in the left or right middle occipital gyri, or in the superior temporal or lateral occipital sulci. Cortical volumes activated in the left and right hemispheres were not significantly different. Activated voxels to scrambled faces were observed in six subjects at locations mainly in the lingual gyri and collateral sulci, medial to the regions activated by faces. 4. Face stimuli activated portions of the midfusiform and inferior temporal gyri, including adjacent cortex within occipitotemporal sulci.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Visualizing cortical activation during mental calculation with functional MRI.

Cortical activation during arithmetic calculation (silent subtraction by sevens) was compared to that observed during a control condition for which subjects were required to count forward by ones. Nine normal subjects underwent 1.5-T functional magnetic resonance imaging while performing these tasks. All subjects showed bilateral premotor, posterior parietal, and prefrontal cortex activation during serial calculation. There was a large degree of individual variation in activation outside of these areas. These results confirm the role of posterior parietal cortex in arithmetic calculation and implicate other regions, including prefrontal cortex.

Adult↗

Functional MRI of the spine: different patterns of positions of the forward flexed lumbar spine in healthy subjects.

Since the introduction of the technique of vertical open-configuration systems, efforts have been made to obtain functional lumbar spinal magnetic resonance (MR) images. The purpose of this study was to determine the relation between facet joint orientation and flexion patterns in the lower lumbar spine. Thirty-four normal subjects (18 women, 16 men) were examined in a vertical open 0.5-T MR scanner with T1-weighted gradient echo (GE) sequences. Flexion angles were digitally measured in the sagittal plane and facet joint orientation in the axial plane. The population showed three different functional flexion patterns: 17.6% (n=6) had kyphotic angles in all three lower lumbar levels during forward flexion (type 1), 50% (n= 17) had a lordotic angle at L5/S1 but kyphotic angles at L4/L5 and L3/L4 (type 2), and 32.4% (n=11) showed lordotic angles at L5/S1 and L4/L5 but a kyphotic angle at L3/L4 (type 3). There were statistically significant differences between flexion patterns and mean facet joint orientation: at 4/15 33.3 degrees for type 1, 33.5 degrees for type 2 and 46.2 degrees for type 3; at L5/S1 27.2 degrees for type 1, 46.4 degrees for type 2 and 48.1 degrees for type 3. There were no significant differences between the three groups at L3/L4. The three different flexion patterns in normal subjects and their relation to facet joint orientation have not been described previously. Knowledge of these patterns may lead to a better understanding of physiological spinal movement as a base for future investigations in low back pain patients.

Adult↗

Linking hemodynamic and electrophysiological measures of brain activity: evidence from functional MRI and intracranial field potentials.

We investigated the relation between electrophysiological and hemodynamic measures of brain activity through comparison of intracranially recorded event-related local field potentials (ERPs) and blood-oxygenation level dependent functional magnetic resonance imaging (BOLD fMRI). We manipulated the duration of visual checkerboard stimuli across trials and measured stimulus-duration-related changes in ERP and BOLD activity in three brain regions: peri-calcarine cortex, the fusiform gyrus and lateral temporal-occipital (LTO) cortex. ERPs were recorded from patients who had indwelling subdural electrodes as part of presurgical testing, while BOLD responses were measured in similar brain regions in a second set of subjects. Similar BOLD responses were measured in peri-calcarine and fusiform regions, with both showing monotonic but non-linear increases in hemodynamic amplitude with stimulus duration. In sharp contrast, very different ERP responses were observed in these same regions, such that calcarine electrodes exhibited onset potentials, sustained activity over the course of stimulus duration and prominent offset potentials, while fusiform electrodes only exhibited onset potentials that did not vary with stimulus duration. No duration-related ERP or BOLD changes were observed in LTO. Additional analyses revealed no consistent changes in the EEG spectrum across different brain sites that correlated with duration-related changes in the BOLD response. We conclude that the relation between ERPs and fMRI differs across brain regions.

Adult↗

Functional MRI evidence for motor cortex reorganization adjacent to a lesion in a primary motor cortex.

OBJECTIVE: The object of this study was to verify motor cortex reorganization in patients with primary motor cortex injury using functional magnetic resonance imaging. DESIGN: Ten control subjects and two patients with primary motor cortex injury, caused by a traumatic brain injury in patient 1 and meningioma in patient 2, were evaluated. Functional magnetic resonance imaging was performed using the blood oxygenation level-dependent technique at 1.5 T with hand movements. RESULTS: The contralateral primary sensorimotor cortex was activated by unaffected hand movements. However, only the contralateral primary sensory cortex in patient 1 and the premotor area in patient 2 were activated by affected hand movements, which were totally absent in control subjects. CONCLUSION: We believe that the hand motor function of injured primary motor cortex was shifted into the primary sensory cortex in patient 1 and premotor area in patient 2. In conclusion, this finding may reflect a functional reorganization of the motor area in patients with a primary motor cortex injury.

Adult↗

Functional MRI of the human brain with GRASE-based BOLD contrast.

The application of T2*-weighted gradient and spin-echo (GRASE) imaging was investigated as a method for blood oxygenation level-dependent (BOLD)-based functional magnetic resonance imaging (fMRI). The displaced-echo method was implemented to produce single-shot T2*-weighted GRASE images. This technique removes the requirement that the Carr-Purcell Meiboom-Gill (CPMG) condition be fulfilled. T2*-weighted GRASE images that are free from interference artifacts can thus be obtained, hence allowing the possibility of using single-shot GRASE for BOLD-based functional imaging. The method was demonstrated at 3 T and gave robust and reproducible activation-induced signal changes.

Artifacts↗

Effects of blood estrogen level on cortical activation patterns during cognitive activation as measured by functional MRI.

Modulation of the blood estrogen level as it occurs during the menstrual cycle has a strong influence on both neuropsychological and neurophysiological parameters. One of currently preferred hypotheses is that the menstrual cycle hormones modulate functional hemispheric lateralization. We examined six male and six female subjects by functional magnetic resonance imaging (fMRI) to image cortical activation patterns associated with cognitive and motor activation to determine whether these changes during the menstrual cycle can be visualized. Female subjects, who did not use oral contraceptives, were scanned twice, once during the menses and once on the 11/12 day of the menstrual cycle. A word-stem-completion task, a mental rotation task and a simple motor task were performed by all subjects. Our data provide evidence that the menstrual cycle hormones influence the overall level of cerebral hemodynamics to a much stronger degree than they influence the activation pattern itself. No differences were seen between male subjects and female subjects during the low estrogen phase. During both neuropsychological tasks blood estrogen level had a profound effect on the size but not on the lateralization or the localization of cortical activation patterns. The female brain under estrogen showed a marked increase in perfusion in cortical areas involved in both cognitive tasks, whereas the hemodynamic effects during the motor tasks were less pronounced. This might be due to differences in neuronal or endothelian receptor concentration, differences in synaptic function, or, most likely, changes in the cerebrovascular anatomy in different cortical regions.

Adult↗

Gender differences in regional cerebral activity during the perception of emotion: a functional MRI study.

Whether men activate different brain regions during various emotions compared to women or whether gender differences exist in transient emotional states has been the subject of only few studies. We used event-related functional magnetic resonance imaging (fMRI) to investigate gender differences during the perception of positive or negative emotions. The experiment comprised two emotional conditions (pleasant/unpleasant visual stimuli) during which fMRI data were acquired. Altogether, 38 healthy volunteers (19 males, 19 females) were investigated. When subtracting the activation values of men from those of women, suprathreshold positive signal changes were detected in the right posterior cingulate, the left putamen and the left cerebellum during positive mood induction, and in bilateral superior temporal gyri and cerebellar vermis during negative mood induction. The subtraction of activation values of women from those of men yielded no significant differences. Our findings suggest gender-related neural responses to emotional stimuli and could contribute to the understanding of mechanisms underlying gender-related vulnerability of the prevalence and severity of neuropsychiatric disorders.

Adult↗

Enhanced interictal responsiveness of the migraineous visual cortex to incongruent bar stimulation: a functional MRI visual activation study.

Since visual aura is usually described as expanding zigzag lines, neurones involved with the perception of line orientation may initiate this phenomenon. A visual incongruent line stimulation protocol was developed to obtain functional magnetic resonance images (fMRI) interictally in 5 female migraine patients with typical fortification spectra and in 5 normal matched controls. Activation in the visual cortex was present contralateral to the side of stimulation in 4 of 5 patients, notably in the extrastriate visual cortex. In 4 of 5 controls activation was observed in the medial and anterior orbitofrontal cortex. In one of them additional activation at the right nucleus accumbens/ventral striatum and right ventral pallidum was present. In the remaining control subject activation was present in the left primary visual cortex. The enhanced interictal reactivity of the visual cortex in migraineurs supports the hypothesis of abnormal cortical excitability as an important pathophysiological mechanism in migraine aura, though the role of specific regions of the visual cortex remains to be explored.

Adult↗