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A pilot study of somatotopic mapping after cortical infarct.

BACKGROUND AND PURPOSE: Animal studies have described remodeling of sensory and motor representational maps after cortical infarct. These changes may contribute to return of function after stroke. METHODS: Functional MRI was used to compare sensory and motor maps obtained in 35 normal control subjects with results from 2 patients with good recovery 6 months after a cortical stroke. RESULTS: During finger tapping in controls, precentral gyrus activation exceeded or matched postcentral gyrus activation in 40 of 42 cases. Patient 1 had a small infarct limited to precentral gyrus. Finger tapping activated only postcentral gyrus, a pattern not seen in any control subject. During tactile stimulation of a finger or hand in controls, postcentral gyrus activation exceeded or matched precentral gyrus activation in 11 of 14 cases. Patient 2 had a small infarct limited to postcentral gyrus and superior parietal lobule. Tactile stimulation of the finger activated only precentral gyrus, a pattern not seen in any control. In both patients, activation during pectoralis contraction was medial to the site activated during finger tapping. CONCLUSIONS: Results during finger tapping (patient 1) and finger stimulation (patient 2) may reflect amplification of a preserved component of normal sensorimotor function, a shift in the cortical site of finger representation, or both. Cortical map reorganization along the infarct rim may be an important contributor to recovery of motor and sensory function after stroke. Functional MRI is useful for assessing motor and sensory representational maps.

Adult↗

Motor cortex activation is related to force of squeezing.

Primate studies have demonstrated that motor cortex neurons show increased activity with increased force of movement. In humans, this relationship has received little study during a power grip such as squeezing, and has previously only been evaluated across a narrow range of forces. Functional MRI was performed in eight healthy subjects who alternated between rest and right hand squeezing at one of three force levels. During scanning, motor performances were recorded using a dynamometer. At each force level, activation volume was measured within left sensorimotor cortex, right sensorimotor cortex, and a midline supplementary motor area. In left sensorimotor cortex, % signal change was also assessed. The range of force generated across the three force levels varied from 4.9 N to 276 N. In left sensorimotor cortex, activation volume increased significantly with greater force. The % signal change also increased with greater force and correlated closely with activation volume. In supplementary motor area, activation volume increased significantly with increasing force, but with greater intersubject variability. In right sensorimotor cortex, a trend for larger activation volumes with greater force did not reach significance. The laterality index, an expression of the relative degree of contralateral vs. ipsilateral sensorimotor cortex activation, did not change across the three force levels. Increased force of squeezing is associated with increased contralateral sensorimotor cortex and supplementary motor area activation. This relationship was found across the full spectrum of forces that the human hand is capable of generating. Use of a valid, reliable method for assessing motor behavior during functional MRI may be important to clinical applications.

Adult↗

Event-related functional MR imaging of visual cortex stimulation at high temporal resolution using a standard 1.5 T imager.

The authors report the technical feasibility of measuring event-related changes in blood oxygenation for studying brain function in humans at high temporal resolution. Measurements were performed on a conventional whole-body 1.5 T clinical scanner with a nonactive-shielded standard gradient system of 1 ms rise time for a maximum gradient strength of 10 mT/m. The radiofrequency (RF) transmitting and receiving MR unit consists of a commercially available circular polarized head coil. Magnet shimming with all first-order coils was performed to the volunteer's head resulting in a magnetic field homogeneity of about 0.1-0.2 ppm. The measuring sequence used was a modified 3D, first-order flow rephased, FLASH sequence with reduced bandwidth = 40 Hz/pixel, TR = 80 ms, TE = 56 ms, flip angle = 40-50 degrees, matrix = 64 x 128, field-of-view = 200-250 mm2, slice thickness = 4 mm, NEX = 1,128 partitions, and a total single scan time of about 10 min. In this sequence the 3D gradient table was removed and the 3D partition-loop acts as a time-loop for sequential measurement of 128 or 32 consecutive images at the same slice position. This means that event-related functional MRI could be performed with an interscan delay of 80 ms for a series of 128 sequential images or with an interscan delay of 320 ms for a simultaneous measurement of four slices with a series of 32 sequential images for each slice. We used a TTL signal given by the gradient board at the beginning of every line-loop in the measuring sequence and a self-made "TTL-Divider-Box" for the event triggering. This box was used to count and scale down the TTL signals by a factor of 128 and to trigger after every 128th TTL signal a single white flash-light, which was seen by the volunteer in the dark room of the scanner with a period of 10.24 s. As a consequence, the resulting event-related scan data coincide at each line of the series of 128 sequential images, which were repeated in 128 x 80 ms or 32 x 320 ms for the single- or four-slice experiment, respectively. Visual cortex response magnitude measured was about 5-7% with an approximate Gaussian shape and a rise time from stimulus onset to maximum of about 3-4 s, and a fall time to the baseline of about 5-6 s after end of stimulus. The reported data demonstrate the feasibility of functional MRI studies at high temporal resolution (up to 80 ms) using conventional MR equipment and measuring sequence.

Brain↗

[Visualization of central auditory processes with functional magnetic resonance tomography].

BACKGROUND: Central auditory processes can be visualized using functional MRI in a non-invasive manner and at high spatial resolution. Acoustic stimulation leads to an increase of blood flow of activated areas in the plane of the superior temporal gyrus. Radiologically, this may be visualized based on the long T2-relaxation time of oxyhemoglobin. PATIENTS: Ten normal-hearing subjects with ages between 28 and 38 years took part in the investigations. They received binaural, monaural right, and monaural left stimulation with pulsed sine tones of 1000 Hz at a pulse rate of 6 Hz and a sound pressure level of 100 dB SPL. Tonotopic organization of the auditory cortex was visualized using stimulation by pulsed sine tones of 500 Hz and 4000 Hz. RESULTS: Following monaural acoustic stimulation, increased activity of the contralateral auditory cortex could be demonstrated in 9 subjects. In one subject, bilateral activity was noted. Concerning the tonotopic organization of the auditory cortex, we could show that the higher frequencies were localized more medially and anteriorly; the lower frequencies were localized more laterally and posteriorly in the superior temporal gyrus. However, considerable overlap was noted. CONCLUSIONS: The overlap of the different frequencies could explain the controversial discussion of the tonotopic organization of the auditory cortex. The results of the monaural acoustic stimulation show clearly the predominant signal increase of contralateral areas in the primary auditory cortex. These results confirm the opinion of the current textbooks that the fiber of the auditory pathways mostly cross. Further investigations using functional MRI are necessary for better understanding of physiological and pathophysiological central-auditory processes.

Acoustic Stimulation↗

The effect of small rotations on R2* measured with echo planar imaging.

Several modern MRI techniques, such as functional MRI (fMRI), rely on the detection of microscopic changes in magnetic susceptibility. However, differences in magnetic susceptibility between brain tissue, bone, and air also produce local magnetic field gradients that may interfere with the contrast of interest, particularly at high field strengths. Since the magnetic field distribution depends on the orientation of the human head in the MRI scanner, head rotations can change the effective transverse relaxation rate (R(2)*) and confound fMRI studies. The size of the R(2)* changes produced by small head rotations was estimated from a brain-shaped gel-phantom at 4 T, by measuring the signal decay at 96 different echo times. Similar measurements were carried out in a human study. Rotations larger than 2 degrees changed R(2)* more than 1.5 Hz in the phantom, and indicate that even small rotations may compromise fMRI results.

Adult↗

Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls.

Visceral pain processing is abnormal in a majority of irritable bowel syndrome (IBS) patients. Aberrant endogenous nociceptive modulation and anticipation are possible underlying mechanisms investigated in the current study. Twelve IBS patients and 12 matched healthy controls underwent brain fMRI scanning during the following randomised stimuli: sham and painful rectal distensions by barostat without and with simultaneous activation of endogenous descending nociceptive inhibition using ice water immersion of the foot for heterotopic stimulation. Heterotopic stimulation decreased rectal pain scores from 3.7+/-0.2 to 3.1+/-0.3 (mean+/-SE, scale 0-5) in controls (p<0.01), but not significantly in IBS. Controls differed from IBS patients in showing significantly greater activation bilaterally in the anterior insula, SII and putamen during rectal stimulation alone compared to rectal plus heterotopic stimulation. Greater activation during rectal plus heterotopic versus rectal stimulation was seen bilaterally in SI and the right superior temporal gyrus in controls and in the right inferior lobule and bilaterally in the superior temporal gyrus in IBS. Rectal pain scores were similarly low during sham stimulation in both groups, but brain activation patterns differed. In conclusion, IBS patients showed dysfunctional endogenous inhibition of pain and concomitant aberrant activation of brain areas involved in pain processing and integration. Anticipation of rectal pain was associated with different brain activation patterns in IBS involving multiple interoceptive, homeostatic, associative and emotional areas, even though pain scores were similar during sham distension. The aberrant activation of endogenous pain inhibition appears to involve circuitry relating to anticipation as well as pain processing itself.

Adult↗

MRI for physiology and function: technical advances in MRI of congenital heart disease.

Cardiovascular MRI is an active area of research, and the techniques and application are continuing to evolve. We have presented the basic categories of MRI techniques used to image the heart and have shown some examples of advanced techniques applied to the evaluation of congenital heart disease. The reader is referred to other articles for examples of these techniques in clinical practice.

Equipment Design↗

A functional study of auditory verbal imagery.

BACKGROUND: We used functional MRI to examine the functional anatomy of inner speech and different forms of auditory verbal imagery (imagining speech) in normal volunteers. We hypothesized that generating inner speech and auditory verbal imagery would be associated with left inferior frontal activation, and that generating auditory verbal imagery would involve additional activation in the lateral temporal cortices. METHODS: Subjects were scanned, while performing inner speech and auditory verbal imagery tasks, using a 1.5 Tesla magnet. RESULTS: The generation of inner speech was associated with activation in the left inferior frontal/insula region, the left temporo-parietal cortex, right cerebellum and the supplementary motor area. Auditory verbal imagery in general, as indexed by the three imagery tasks combined, was associated with activation in the areas engaged during the inner speech task, plus the left precentral and superior temporal gyri (STG), and the right homologues of all these areas. CONCLUSIONS: These results are consistent with the use of the 'articulatory loop' during both inner speech and auditory verbal imagery, and the greater engagement of verbal self-monitoring during auditory verbal imagery.

Adult↗

Functional neuroanatomy of executive processes involved in dual-task performance.

The subjective experience of allocating one's attentional resources among competing tasks is nearly universal, and most current models of cognition include a mechanism that performs this allocation; examples include the central executive system and the supervisory attentional system. Yet, the exact form that an executive system might take and even its necessity for cognition are controversial. Dual-task paradigms have commonly been used to investigate executive function. The few neuroimaging studies of these paradigms have yielded contradictory findings. Using functional MRI, we imaged brain function during two dual-task paradigms, each with a common auditory component task (NOUN task) but varying with respect to a visual component task (SPACE or FACE tasks). In each of the two dual-task paradigms, the results showed that the activated areas varied with the component tasks, that all of the areas activated during dual task performance were also activated during the component tasks, and that surplus activation within activated areas during DUAL conditions was parsimoniously accounted for by the addition of the second task. These findings suggest that executive processes may be mediated by interactions between anatomically and functionally distinct systems engaged in performance of component tasks, as opposed to an area or areas dedicated to a generic executive system.

Brain↗

Highly functional ipsilateral motor control after extensive left hemispheric damage during gestation.

In large early cortical lesions, one of the most devastating consequences is the impaired motor dexterity of the contralateral limb. We present the case of an 8-year-old girl with a large left hemispherical porencephaly. Unlike previous reports, the girl exhibited high dexterity of the contralateral hand with preserved independent finger movements. We performed functional MRI of hand motor functions and diffusion tensor imaging, which revealed activation of the ipsilateral motor cortex and absence of a contralateral corticospinal tract. These observations suggest that by intensive training in early life, a complete transhemispheric shift of motor control with high skills can be achieved.

Brain Injuries↗

Functional properties of brain areas associated with motor execution and imagery.

Imagining motor acts is a cognitive task that engages parts of the executive motor system. While motor imagery has been intensively studied using neuroimaging techniques, most studies lack behavioral observations. Here, we used functional MRI to compare the functional neuroanatomy of motor execution and imagery using a task that objectively assesses imagery performance. With surface electromyographic monitoring within a scanner, 10 healthy subjects performed sequential finger-tapping movements according to visually presented number stimuli in either a movement or an imagery mode of performance. We also examined effects of varied and fixed stimulus types that differ in stimulus dependency of the task. Statistical parametric mapping revealed movement-predominant activity, imagery-predominant activity, and activity common to both movement and imagery modes of performance (movement-and-imagery activity). The movement-predominant activity included the primary sensory and motor areas, parietal operculum, and anterior cerebellum that had little imagery-related activity (-0.1 ~ 0.1%), and the caudal premotor areas and area 5 that had mild-to-moderate imagery-related activity (0.2 ~ 0.7%). Many frontoparietal areas and posterior cerebellum demonstrated movement-and-imagery activity. Imagery-predominant areas included the precentral sulcus at the level of middle frontal gyrus and the posterior superior parietal cortex/precuneus. Moreover, activity of the superior precentral sulcus and intraparietal sulcus areas, predominantly on the left, was associated with accuracy of the imagery task performance. Activity of the inferior precentral sulcus (area 6/44) showed stimulus-type effect particularly for the imagery mode. A time-course analysis of activity suggested a functional gradient, which was characterized by a more "executive" or more "imaginative" property in many areas related to movement and/or imagery. The results from the present study provide new insights into the functional neuroanatomy of motor imagery, including the effects of imagery performance and stimulus-dependency on brain activity.

Adult↗

Ipsilateral hemiparesis after putaminal hemorrhage due to uncrossed pyramidal tract.

OBJECTIVE: Previous case reports supported the presence of the uncrossed pyramidal tract in exceptional patients. However, most of these case reports have not fully discussed involvement of the motor cortex controlling the ipsilateral limbs. DESIGN AND METHOD: The authors investigated a 62-year-old man who developed right hemiparesis after right putaminal hemorrhage by using MRI, transcranial magnetic stimulation, functional MRI (fMRI), and sensory evoked potentials. He had moderate weakness including the face, spasticity with brisk deep tendon reflexes and Babinski sign, and impaired vibration and position sense, all on the right side. RESULT: A MRI study showed hemorrhage in the right putamen and the wedge-shaped medulla. A fMRI study during a sequential finger opposition task showed activation in the motor cortex ipsilateral to the finger movements, but not on the contralateral side. Sensory evoked potentials showed cortical response ipsilateral to the side of stimulation. CONCLUSION: The pyramidal tract and the dorsal column-medial lemniscus pathway did not cross in the medulla in this patient. In view of the presence of the abnormal shape in the medulla and congenital scoliosis, a congenital factor might be responsible for the uncrossed pyramidal tract and dorsal column-medial lemniscus in this patient.

Brain Mapping↗

Functional MRI-BOLD of brainstem structures during visually triggered migraine.

BACKGROUND: Previously, hyperoxia and blood volume increase were reported in the red nucleus and substantia nigra during spontaneous migraine with aura. OBJECTIVE: To further understand the pathophysiologic role of these centers, activation of brainstem structures was investigated in patients with visually triggered migraine. METHODS: Twenty-six patients with migraine (23 with aura and 3 without aura), and 10 normal control subjects were studied with blood oxygen level-dependent (BOLD) fMRI during repeated checkerboard visual stimulation. Three axial image sections, which covered the occipital cortex and brainstem, were acquired 224 times with a temporal resolution of 3.5 seconds. RESULTS: Repetitive visual stimulation triggered symptoms in 12 patients; four who had migraine with aura developed both visual symptoms and headaches, and six who had migraine with aura and two who had migraine without aura had headaches only. Four patients who had migraine with aura experienced the onset of their usual aura or onset of their typical headache either during the experiment or immediately after. In the remaining 10 patients with migraine, and all control subjects, visual stimulation failed to trigger symptoms at any time. In 75% of the patients who developed symptoms during stimulation, baseline T2*-weighted MR signal intensities increased in the red nucleus and substantia nigra before occipital cortex signal elevation or the onset of visually triggered symptoms. CONCLUSION: Activation (hyperoxia and blood volume increase) of the red nucleus and substantia nigra in association with visually triggered symptoms of migraine suggest that these brainstem structures are a part of a neuronal network activated during an attack.

Adult↗

[Three dimensional MRI].

Three-dimensional(3D) MRI is discussed in the present and future clinical application. The newly reconstructed 3D MRI have been widely utilized as a routine examination, and 3D MRA have been substituted for cerebral angiograms in some diseases. The parallel image with multiple phased-array coils can improve time resolution and reduce MRI artifacts. Fusion of 3D anatomical MRI with CT, various functional MRI, SPECT, and PET results in precise diagnosis and improves the accuracy in navigational neurosurgery and stereotactic radiosurgery. High-field 3-tesla MRI can be clinically used, but its role on 3D MRI is not clear. As the data of 3D MRI and multi detector-row CT increases, it becomes the major problem how to restore and protect these data.

Brain Neoplasms↗