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PubMed1998

Association between regional brain volumes and clozapine response in schizophrenia.

BACKGROUND: Clozapine has shown considerable therapeutic promise in the treatment of schizophrenia; however, the clinical risks and initial high treatment costs associated with its administration motivate the search to identify patients who will best respond. Neuroimaging studies have suggested that prefrontal sulcal prominence may be a predictor of nonresponsiveness. METHODS: We used magnetic resonance imaging (MRI) to test whether volumes in any cortical regions of the brain were associated with symptom improvement with clozapine treatment. The 21 schizophrenic men studied were clinically evaluated during treatment with typical neuroleptics (baseline) and after a mean of 6.2 months treatment with clozapine (final dose 300-900, median = 562 mg/day). At least a 20% improvement on total Brief Psychiatric Rating Scale (BPRS) was seen in 47.6% of the schizophrenics. Clinical improvement was regressed on baseline differences in clinical severity, and the residual scores were related to MRI values. RESULTS: Patients with larger anterior superior temporal lobe cerebrospinal fluid volumes (primarily sylvian fissure) showed greater improvement on total BPRS and withdrawal/retardation symptoms. CONCLUSIONS: Even schizophrenics with significant brain dysmorphology can have a positive clinical response to clozapine.

Adult↗
PubMed1984

A procedure for small-volume brain grafting; vasopressin cells in neonatal and adult Brattleboro rats.

A simple and reliable technique is described for the transplantation of fetal vasopressin (VP) neurons in the third ventricle of the brain of homozygous Brattleboro neonates. Small-volume grafting is introduced by microdissection of paraventricular and supraoptic areas and by pelleting the minced tissue for insertion into the transplantation cannula. Morphological and immunocytochemical evaluation yielded results in both neonatal and adult host brain that were similar to those described for anterior hypothalamic grafts in adult Brattleboro brain. The present protocol circumvents some of the general problems encountered when the use of small grafts is imperative, and is also applicable to the implantation of pelleted cell suspensions.

Animals↗
PubMed2004

Reliability of brain volumes from multicenter MRI acquisition: a calibration study.

Multicenter studies can provide additional information over single center studies because of their increased statistical power. Because similar acquisition protocols are being used internationally for structural magnetic resonance imaging (MRI) studies of the human brain, volumetric MRI data studies seem suitable for this purpose. Possible systematic differences between sites should be avoided, however, particularly when subtle differences in tissue volume are being searched for, such as in neuropsychiatric diseases. In this calibration study, the brains of six healthy volunteers were (re)scanned with MR scanners from four different manufacturers at five different sites, using the local acquisition protocols. The images were segmented at a central reference site. The intraclass correlation coefficient (ICC) was determined for the whole brain, gray and white matter, cerebellum, and lateral and third ventricle volumes. When required, the processing algorithms were calibrated for each site. Calibration of the histogram analysis was needed for segmentation of total brain volume at one site and for gray and white matter volume at all sites. No (additional) calibration was needed for cerebellum and ventricle volumes. The ICCs were > or = 0.96 for total brain, > or = 0.92 for cerebellum, > or = 0.96 for lateral ventricle, > or = 0.21 for third ventricle, > or = 0.84 for gray matter, and > or = 0.78 for white matter volume. Calibration of segmentation procedures allows morphologic MRI data acquired at different research sites to be combined reliably in multicenter studies.

Adult↗
PubMedDate not supplied

Brain region and sex differences in age association with brain volume: a quantitative MRI study of healthy young adults.

There is evidence that some brain regions show age-associated volume decline and that men undergo more accelerated cerebral aging than women. However, limited information is available on age-associated changes during young adulthood. The authors performed quantitative magnetic resonance imaging in 116 healthy young adults (57 men, 59 women; age range: 18-49 years) to evaluate the relationship of age and sex with volumes of frontal and temporal regions, including selected limbic structures and the basal ganglia. Regardless of sex, increasing age was moderately associated with decrease in total gray matter (GM) and mildly with increase in sulcal cerebrospinal fluid (CSF). Associations of age with reduced GM volume were observed in all frontal and temporal cortical regions and some basal ganglia structures, but were generally less prominent in subcortical regions. The associations were stronger for men than women in the dorsolateral prefrontal cortex. Thus, in young, healthy adults, age-associated changes are selective as well as sex-specific, with men experiencing greater volume decrement across age-groups than women, particularly in the dorsolateral prefrontal regions. Reduced GM and increased CSF in this age range suggests that the aging process is a continuum, with changes evident before senescence. Thus, the biological changes commonly attributed to "aging" do, in fact, begin much earlier in the life-cycle.

Adult↗
PubMed2000

Automatic measurement of changes in brain volume on consecutive 3D MR images by segmentation propagation.

This article presents a technique to automatically measure changes in the volume of a structure of interest in successive 3D magnetic resonance (MR) images and its application in the study of the brain and lateral cerebral ventricles. The only manual step is a segmentation of the structure of interest in the first image. The analysis comprises, first, precise rigid co-registration of the time series of images; second, computation of residual deformations between pairs of images; third, automatic quantification of the volume change, obtained by propagation of the segmentation of the structure of interest through the series of MR images. This approach has been applied to monitor changes in the volume of the brain and lateral cerebral ventricles in a healthy subject and a patient with primary progressive aphasia (PPA). Results are consistent with those obtained by application of the boundary shift integral (BSI) and by stereology in the same subjects.

Aged↗
PubMed2005

Parkinson disease, brain volumes, and subthalamic nucleus stimulation.

BACKGROUND: High-frequency stimulation of the subthalamic nucleus (STN) is an effective treatment for advanced Parkinson disease (PD). The clinical and preoperative predictive factors of the best postoperative outcome have been identified. Radiologic predictive factors were investigated. METHODS: Forty patients with PD underwent surgery for bilateral STN stimulation. MRI was performed in stereotactic conditions before surgery. Brain parenchyma, caudate nucleus, putamen, pallidum, and red nucleus volumes and the surface of the mesencephalon were measured and normalized as percentages of the intracranial volume. Clinical evaluation was performed 1 month before and 6 months after surgery. RESULTS: The normalized brain parenchyma volume was lower in patients who were older and had a longer disease duration or a lower frontal score and was not predictive of the postoperative outcome. The residual scores for activities of daily living and parkinsonian motor disability were higher in patients with a smaller normalized mesencephalon. The normalized caudate nucleus volume was predictive of the pre- and postoperative levodopa-equivalent dosage. CONCLUSIONS: Brain atrophy is not an exclusion criterion for neurosurgery, indicating that patients' neurologic, psychiatric, and neuropsychological characteristics are the best predictive factors for neurosurgery. The fact that a smaller normalized mesencephalon surface was associated with a lower beneficial effect of the subthalamic nucleus stimulation on the parkinsonian motor disability suggests that the normalized mesencephalon surface is a predictive factor of the postoperative outcome.

Activities of Daily Living↗
PubMed2006

Automated ROI-based brain parcellation analysis of frontal and temporal brain volumes in schizophrenia.

Structural MRI studies of schizophrenia have yielded a diversity of findings. To help characterize regional gray matter changes in schizophrenia, we used an automated region of interest (ROI)-based approach that targeted frontal and temporal regions in schizophrenia patients. The sample compromised 43 schizophrenia patients (21 chronic patients, 22 unmedicated first episode patients), 20 first episode non-schizophrenia psychosis patients and 47 comparison subjects. Automated regional volume measurement was performed in 22 ROIs, including frontal and temporal cortical subregions and hippocampus. Correlations between volume measures, duration of illness and clinical scores were evaluated. Chronic schizophrenia patients showed gray matter volume differences in left dorsolateral prefrontal cortex (DLPFC) and right supplementary motor area (SMA). First episode psychosis patients presented smaller right anterior cingulate cortex (ACC) and left DLPFC than comparison subjects. Disorganization scores and duration of illness correlated negatively with gray matter volume of DLPFC and SMA in chronic schizophrenia patients. Using an automated ROI-based method, we found volume reductions in lateral and medial frontal regions in both first episode and chronic schizophrenia. The automated ROI-based method can be used as a valid and efficient tool for quantification of regional gray matter volume in schizophrenia in multiple ROIs across the brains of large numbers of subjects.

Adult↗
PubMed2006

Regional brain volumes distinguish PSP, MSA-P, and PD: MRI-based clinico-radiological correlations.

Progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are neurodegenerative disorders, each with a prevalence of around 5 per 100,000. Regional brain atrophy patterns differ in the two disorders, however, and magnetic resonance imaging is sometimes helpful in distinguishing them in the later stages. We measured whole brain and regional volumes, including cerebellum, pons, midbrain, superior cerebellar peduncle (SCP), and ventricular volumes as well as frontal and posterior-inferior cerebral regions in 18 subjects with PSP, 9 with MSA-P (parkinsonian phenotype), 9 with Parkinson's disease (PD), and 18 healthy controls. Associations between these volumes, cognitive profiles, and clinical measures of disease severity and motor disability were assessed. Mean midbrain volume was 30% smaller in PSP than in PD or controls (P < 0.001) and 15% smaller than in MSA-P (P = 0.009). The mean SCP volume in PSP was 30% smaller than in MSA-P, PD, or controls (P < 0.001). Mean cerebellar volumes in MSA-P were 20% smaller than in controls and PD and 18% smaller than in PSP (P = 0.01). Mean pontine volume in MSA-P was 30% smaller than in PD or controls (P < 0.001) and 25% smaller than in PSP (P = 0.01). Motor disability was most strongly associated with midbrain volume, and more severe executive dysfunction was associated with reduced frontal volume. These distinct patterns of cortical and subcortical atrophy, when considered together rather than independently, better differentiate PSP and MSA-P from each other and also from healthy controls.

Aged↗
PubMed2002

Brain volumes in familial and non-familial schizophrenic probands and their unaffected relatives.

Structural brain abnormalities are consistently reported in schizophrenic subjects but the etiology of these abnormalities remains unclear. We tested the contribution of genetic predisposition and obstetric complications to the structural brain abnormalities found in schizophrenic probands and their relatives. MRI scans were carried out on 35 schizophrenic probands from families multiply affected with the disorder, and 63 of their unaffected relatives, including 10 parents who appeared to transmit genetic risk to their children; as well as 31 schizophrenic probands from families with no other affected members, 33 of their unaffected relatives; and finally 68 controls. Volumetric measurements of whole brain, lateral ventricles, third ventricle, cerebellum, and temporal lobes were completed for each subject. The impact of obstetric complications on brain structure was assessed across the gradient of presumed genetic predisposition. Both groups of schizophrenic probands displayed enlargement of the lateral and third ventricles, and there was a gradient of ventricular enlargement amongst the unaffected relatives in proportion to their likelihood of carrying schizophrenic genes. Ventricular enlargement was largely confined to males in both probands and unaffected relatives. Obstetric complications were associated with ventricular enlargement only in the familial probands. Non-familial probands displayed reduced volume of the temporal lobes bilaterally. In families with several schizophrenic members, ventricular enlargement is a marker for genetic liability, particularly in males. Individuals inheriting the susceptibility to schizophrenia appear particularly prone to develop ventricular enlargement in response to obstetric complications.

Adolescent↗
PubMed2003

CSF monoamine metabolites and MRI brain volumes in alcohol dependence.

Correlations between cerebrospinal fluid (CSF) concentrations of monoamine metabolites (MAM) and brain structure have been described in schizophrenia, but not in alcoholism. To investigate the relationship between monoaminergic transmission and brain structure in alcoholism, the metabolites of dopamine (homovanillic acid, HVA), norepinephrenine (3-methoxy-4-hydroxyphenylethyleneglycol, MHPG) and serotonin (5-hydroxyindoleacetic acid, 5-HIAA) were measured in lumbar CSF in 54 alcohol-dependent patients and 20 healthy subjects. The volumes of the cerebrum, total grey and white matter, total and ventricular CSF, left and right hippocampus, and corpus callosum area were measured with MRI. MHPG and age were positively correlated in alcoholic women. The MAM concentrations were not significantly correlated with the MRI volumes in the subject categories. There were no differences in MAM across subjects defined by diagnosis and gender, age of onset of alcoholism or comorbidity of psychiatric disorders. Total CSF, cerebrum, and white and grey matter tissue volumes differed between patients and healthy subjects. The greatest difference was the white matter reduction in alcoholic women. In alcoholic women and men, monoaminergic neurotransmission measured by the CSF MAM HVA, MHPG, and 5-HIAA is not significantly correlated with the size of different brain structures.

Adult↗
PubMed1990

The effect of skull and dura on brain volume regulation after hypo- and hyperosmolar fluid treatment.

This study was performed to determine the response of brain water and electrolytes to acute hypo-osmolality and hyperosmolality in animals with intact skulls and dura, in comparison with those subjected to extensive bilateral or unilateral craniectomy and opening of the dura. In rats, 4 to 5 weeks after extensive unilateral or bilateral craniectomy and opening of the dura, a 50-mOsm/kg decrease in plasma osmolality was produced by systemic administration of distilled water ("water intoxication"), or a 28-mOsm/kg increase in plasma osmolality was produced by systemic administration of either 1 M NaCl or 1 M mannitol in 0.34 M NaCl. Tissue water, Na. and K contents were determined after 120 minutes. Tissue water accumulation or water loss was proportional to the decrease or increase in plasma osmolality. The tissue water accumulation after "water intoxication," however, was less (40% of the predicted value) than that predicted for ideal osmotic behavior. The brain tissue was also found to shrink less than predicted on the basis of ideal osmotic behavior (40% of the predicted value after mannitol treatment, and 60% after NaCl administration). This nonideal osmotic response of the brain tissue is consistent with the finding in other studies and indicated a significant degree of volume regulation. Water and electrolyte changes did not differ between animals operated on and those not operated on, a fact which demonstrates that there are no effects of extensive skull and dura defects on tissue volume regulation under hypo- and hyperosmolar conditions encountered under clinical circumstances.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

Brain volumes characterisation using hierarchical neural networks.

Objective knowledge of tissue density distribution in CT/MRI brain datasets can be related to anatomical or neuro-functional regions for assessing pathologic conditions characterised by slight differences. The process of monitoring illness and its treatment could be then improved by a suitable detection of these variations. In this paper, we present an approach for three-dimensional (3D) classification of brain tissue densities based on a hierarchical artificial neural network (ANN) able to classify the single voxels of the examined datasets. The method developed was tested on case studies selected by an expert neuro-radiologist and consisting of both normal and pathological conditions. The results obtained were submitted for validation to a group of physicians and they judged the system to be really effective in practical applications.

Aged↗