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BACKGROUND AND PURPOSE: The evaluation of a suspected malfunction of a ventricular shunt is a common procedure in neurosurgery. The evaluation relies on either the interpretation of the ventricular width using cranial imaging or invasive techniques. Several attempts have been made to measure the flow velocity of cerebrospinal fluid (CSF) utilizing different phase-contrast magnet resonance imaging (PC MRI) techniques. In the present study, we evaluated 3 T (Tesla) MRI scanners for their effectiveness in determining of flow in the parenchymal portion of ventricular shunt systems with adjustable valves containing magnets. METHODS: At first, an MRI phantom was used to measure the phase-contrasts at different constant low flow rates. The next step was to measure the CSF flow in patients treated with ventricular shunts without suspected malfunction of the shunt under observation. RESULTS: The measurements of the phantom showed a linear correlation between the CSF flow and corresponding phase values. Despite many artifacts resulting from the magnetic valves, the ventricular catheter within the parenchymal portion of shunt was not superimposed by artifacts at each PC MRI plane and clearly distinguishable in 9 of 12 patients. Three patients suffering from obstructive hydrocephalus showed a clear flow signal. CONCLUSION: CSF flow detected within the parenchymal portion of the shunt by PC MRI may reliably provide information about the functional status of a ventricular shunt. Even in patients whose hydrocephalus was treated with magnetic adjustable valves, the CSF flow was detectable using PC MRI sequences at 3 T field strength.
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Ventrículos Cerebrales/diagnóstico por imagen , Derivaciones del Líquido Cefalorraquídeo/efectos adversos , Hidrocefalia/diagnóstico por imagen , Adulto , Anciano , Ventrículos Cerebrales/cirugía , Femenino , Humanos , Hidrocefalia/cirugía , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVES: We assessed the use of high-resolution ultra-high-field diffusion magnetic resonance imaging (dMRI) to determine neuronal fiber orientation density functions (fODFs) throughout the human brain, including gray matter (GM), white matter (WM), and small intertwined structures in the cerebellopontine region. MATERIALS AND METHODS: We acquired 7-T whole-brain dMRI data of 23 volunteers with 1.4-mm isotropic resolution; fODFs were estimated using constrained spherical deconvolution. RESULTS: High-resolution fODFs enabled a detailed view of the intravoxel distributions of fiber populations in the whole brain. In the brainstem region, the fODF of the extra- and intrapontine parts of the trigeminus could be resolved. Intrapontine trigeminal fiber populations were crossed in a network-like fashion by fiber populations of the surrounding cerebellopontine tracts. In cortical GM, additional evidence was found that in parts of primary somatosensory cortex, fODFs seem to be oriented less perpendicular to the cortical surface than in GM of motor, premotor, and secondary somatosensory cortices. CONCLUSION: With 7-T MRI being introduced into clinical routine, high-resolution dMRI and derived measures such as fODFs can serve to characterize fine-scale anatomic structures as a prerequisite to detecting pathologies in GM and small or intertwined WM tracts.
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Imagen de Difusión por Resonancia Magnética , Sustancia Gris/diagnóstico por imagen , Procesamiento de Imagen Asistido por Computador/métodos , Sustancia Blanca/diagnóstico por imagen , Adulto , Mapeo Encefálico/métodos , Tronco Encefálico/diagnóstico por imagen , Ángulo Pontocerebeloso/diagnóstico por imagen , Femenino , Humanos , Inflamación , Masculino , Programas Informáticos , Nervio Trigémino/diagnóstico por imagen , Adulto JovenRESUMEN
People around the world suffer chronic lower back pain. Because spine imaging often does not explain the degree of perceived pain reported by patients, the role of the processing of nociceptor signals in the brain as the basis of pain perception is gaining increased attention. Modern neuroimaging techniques (including functional and morphometric methods) have produced results that suggest which brain areas may play a crucial role in the perception of acute and chronic pain. In this study, we examined 12 patients with chronic low back pain and sciatica, both resulting from lumbar disc herniation. Structural magnetic resonance imaging (MRI) of the brain was performed 1 day prior to and about 4 weeks after microsurgical lumbar discectomy. The subsequent MRI revealed an increase in gray matter volume in the basal ganglia but a decrease in volume in the hippocampus, which suggests the complexity of the network that involves movement, pain processing, and aspects of memory. Interestingly, volume changes in the hippocampus were significantly correlated to preoperative pain intensity but not to the duration of chronic pain. Mapping structural changes of the brain that result from lumbar disc herniation has the potential to enhance our understanding of the neuropathology of chronic low back pain and sciatica and therefore may help to optimize the decisions we make about conservative and surgical treatments in the future. The possibility of illuminating more of the details of central pain processing in lumbar disc herniation, as well as the accompanying personal and economic impact of pain relief worldwide, calls for future large-scale clinical studies.
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Real-time functional Magnetic Resonance Imaging (rtfMRI) is used mainly for neurofeedback or for brain-computer interfaces (BCI). But multi-site rtfMRI could in fact help in the application of new interactive paradigms such as the monitoring of mutual information flow or the controlling of objects in shared virtual environments. For that reason, a previously developed framework that provided an integrated control and data analysis of rtfMRI experiments was extended to enable multi-site rtfMRI. Important new components included a data exchange platform for analyzing the data of both MR scanners independently and/or jointly. Information related to brain activation can be displayed separately or in a shared view. However, a signal calibration procedure had to be developed and integrated in order to permit the connecting of sites that had different hardware and to account for different inter-individual brain activation levels. The framework was successfully validated in a proof-of-principle study with twelve volunteers. Thus the overall concept, the calibration of grossly differing signals, and BCI functionality on each site proved to work as required. To model interactions between brains in real-time, more complex rules utilizing mutual activation patterns could easily be implemented to allow for new kinds of social fMRI experiments.
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Mapeo Encefálico/métodos , Interfaces Cerebro-Computador , Encéfalo/fisiología , Imagen por Resonancia Magnética/métodos , Adulto , Humanos , Imagen por Resonancia Magnética/normas , Masculino , Adulto JovenRESUMEN
A recent paper by Eklund et al. (2012) showed that up to 70% false positive results may occur when analyzing functional magnetic resonance imaging (fMRI) data using the statistical parametric mapping (SPM) software, which may mainly be caused by insufficient compensation for the temporal correlation between successive scans. Here, we show that a blockwise permutation method can be an effective alternative to the standard correction method for the correlated residuals in the general linear model, assuming an AR(1)-model as used in SPM for analyzing fMRI data. The blockwise permutation approach including a random shift developed by our group (Adolf et al., 2011) accounts for the temporal correlation structure of the data without having to provide a specific definition of the underlying autocorrelation model. 1465 publicly accessible resting-state data sets were re-analyzed, and the results were compared with those of Eklund et al. (2012). It was found that with the new permutation method the nominal familywise error rate for the detection of activated voxels could be maintained approximately under even the most critical conditions in which Eklund et al. found the largest deviations from the nominal error level. Thus, the method presented here can serve as a tool to ameliorate the quality and reliability of fMRI data analyses.
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Chronic pain is one of the most common health complaints in industrial nations. For example, chronic low back pain (cLBP) disables millions of people across the world and generates a tremendous economic burden. While previous studies provided evidence of widespread functional as well as structural brain alterations in chronic pain, little is known about cortical changes in patients suffering from lumbar disc herniation. We investigated morphometric alterations of the gray and white matter of the brain in patients suffering from LDH. The volumes of the gray and white matter of 12 LDH patients were determined in a prospective study and compared to the volumes of healthy controls to distinguish local differences. High-resolution MRI brain images of all participants were performed using a 3 Tesla MRI scanner. Voxel-based morphometry was used to investigate local differences in gray and white matter volume between patients suffering from LDH and healthy controls. LDH patients showed significantly reduced gray matter volume in the right anterolateral prefrontal cortex, the right temporal lobe, the left premotor cortex, the right caudate nucleus, and the right cerebellum as compared to healthy controls. Increased gray matter volume, however, was found in the right dorsal anterior cingulate cortex, the left precuneal cortex, the left fusiform gyrus, and the right brainstem. Additionally, small subcortical decreases of the white matter were found adjacent to the left prefrontal cortex, the right premotor cortex and in the anterior limb of the left internal capsule. We conclude that the lumbar disk herniation can lead to specific local alterations of the gray and white matter in the human brain. The investigation of LDH-induced brain alterations could provide further insight into the underlying nature of the chronification processes and could possibly identify prognostic factors that may improve the conservative as well as the operative treatment of the LDH.
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Encéfalo/patología , Dolor Crónico/patología , Degeneración del Disco Intervertebral/complicaciones , Desplazamiento del Disco Intervertebral/complicaciones , Adulto , Dolor Crónico/etiología , Femenino , Humanos , Degeneración del Disco Intervertebral/patología , Desplazamiento del Disco Intervertebral/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Estudios ProspectivosRESUMEN
Functional magnetic resonance imaging (fMRI) allows observing cerebral activity not only in separated cortical regions but also in functionally coupled cortical networks. Although moderate doses of ethanol slowdown the neurovascular coupling, the functions of the primary sensorimotor and the visual system remain intact. Yet little is known about how more complex interactions between cortical regions are affected even at moderate doses of alcohol. Therefore the method of psychophysiological interaction (PPI) was applied to analyze ethanol-induced effects on the effective connectivity in the visuomotor system. Fourteen healthy social drinkers with no personal history of neurological disorders or substance abuse were examined. In a test/re-test design they served as their own controls by participating in both the sober and the ethanol condition. All participants were scanned in a 3 T MR scanner before and after ingestion of a body-weight-dependent amount of ethanol calculated to achieve a blood alcohol concentration of 1.0. PPIs were calculated for the primary visual cortex, the supplementary motor area, and the left and right primary motor cortex using the statistical software package SPM. The PPI analysis showed selective disturbance of the effective connectivity between different cortical areas. The regression analysis revealed the influence of the supplementary motor area on connected regions like the primary motor cortex to be decreased yet preserved. However, the connection between the primary visual cortex and the posterior parietal cortex was more severely impaired by the influence of ethanol, leading to an uncoupled regression between these regions. The decreased effective connectivity in the visuomotor system suggests that complex tasks requiring interaction or synchronization between different brain areas are affected even at moderate levels of alcohol. This finding may have important consequences for determining which components of demanding tasks such as driving a car might be compromised earlier than the functions of the main cortical motor and visual areas.
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Consumo de Bebidas Alcohólicas/metabolismo , Corteza Motora/metabolismo , Desempeño Psicomotor/fisiología , Corteza Visual/metabolismo , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Etanol/administración & dosificación , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Corteza Motora/efectos de los fármacos , Vías Nerviosas/efectos de los fármacos , Vías Nerviosas/metabolismo , Estimulación Luminosa/métodos , Desempeño Psicomotor/efectos de los fármacos , Corteza Visual/efectos de los fármacos , Adulto JovenRESUMEN
Despite some evidence of the underlying molecular mechanisms the neuronal basis of ethanol-induced effects on the neurovascular coupling that forms the BOLD (blood oxygenation level dependent) signal is poorly understood. In a recent fMRI (functional magnetic resonance imaging) study monitoring ethanol-induced changes of the BOLD signal a reduction of the amplitude and a prolongation of the BOLD signal were observed. However, the BOLD signal is assumed to consist of a complex superposition of different underlying signals. To gain insight how ethanol influences stimulus efficacy, oxygen extraction, transit time and vessel-related parameters the fMRI time series from the sensori-motor and the visual cortex were analyzed using the balloon model. The results show a region-dependent decrease of the stimulus efficacy to trigger a post-stimulus neurovascular response as well as a prolongation of the transit time through the venous compartment. Oxygen extraction, feedback mechanisms and other vessel-related parameters were not affected. The results may be interpreted as follows: the overall mechanisms of the neurovascular coupling are still acting well at the moderate ethanol level of about 0.8 (in particular the vessel-related parts), but the potency to evoke a neurovascular response is already compromised most obviously in the supplementary motor area responsible for complex synchronizing and planning processes.
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Depresores del Sistema Nervioso Central/efectos adversos , Circulación Cerebrovascular/efectos de los fármacos , Etanol/efectos adversos , Corteza Motora/irrigación sanguínea , Corteza Motora/efectos de los fármacos , Neuronas/efectos de los fármacos , Corteza Visual/irrigación sanguínea , Corteza Visual/efectos de los fármacos , Adulto , Velocidad del Flujo Sanguíneo/efectos de los fármacos , Mapeo Encefálico/métodos , Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/sangre , Simulación por Computador , Etanol/administración & dosificación , Etanol/sangre , Femenino , Humanos , Modelos Lineales , Imagen por Resonancia Magnética , Masculino , Modelos Cardiovasculares , Modelos Neurológicos , Actividad Motora , Corteza Motora/metabolismo , Neuronas/metabolismo , Oxígeno/sangre , Consumo de Oxígeno , Estimulación Luminosa , Factores de Tiempo , Corteza Visual/metabolismo , Adulto JovenRESUMEN
The advantage of using a virtual reality (VR) paradigm in fMRI is the possibility to interact with highly realistic environments. This extends the functions of standard fMRI paradigms, where the volunteer usually has a passive role, for example, watching a simple movie paradigm without any stimulus interactions. From that point of view the combined usage of VR and real-time fMRI offers great potential to identify underlying cognitive mechanisms such as spatial navigation, attention, semantic and episodic memory, as well as neurofeedback paradigms. However, the design and the implementation of a VR stimulus paradigm as well as the integration into an existing MR scanner framework are very complex processes. To support the modeling and usage of VR stimuli we developed and implemented a VR stimulus application based on C++. This software allows the fast and easy presentation of VR environments for fMRI studies without any additional expert knowledge. Furthermore, it provides for the reception of real-time data analysis values a bidirectional communication interface. In addition, the internal plugin interface enables users to extend the functionality of the software with custom programmed C++ plugins. The VR stimulus framework was tested in several performance tests and a spatial navigation study. According to the post-experimental interview, all subjects described immersive experiences and a high attentional load inside the artifical environment. Results from other VR spatial memory studies confirm the neuronal activation that was detected in parahippocampal areas, cuneus, and occipital regions.
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Encéfalo/irrigación sanguínea , Ambiente , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Interfaz Usuario-Computador , Adulto , Simulación por Computador , Femenino , Humanos , Masculino , Oxígeno/sangre , Reconocimiento Visual de Modelos , Estimulación Luminosa , Adulto JovenRESUMEN
Negotiation and trade typically require a mutual interaction while simultaneously resting in uncertainty which decision the partner ultimately will make at the end of the process. Assessing already during the negotiation in which direction one's counterpart tends would provide a tremendous advantage. Recently, neuroimaging techniques combined with multivariate pattern classification of the acquired data have made it possible to discriminate subjective states of mind on the basis of their neuronal activation signature. However, to enable an online-assessment of the participant's mind state both approaches need to be extended to a real-time technique. By combining real-time functional magnetic resonance imaging (fMRI) and online pattern classification techniques, we show that it is possible to predict human behavior during social interaction before the interacting partner communicates a specific decision. Average accuracy reached approximately 70% when we predicted online the decisions of volunteers playing the ultimatum game, a well-known paradigm in economic game theory. Our results demonstrate the successful online analysis of complex emotional and cognitive states using real-time fMRI, which will enable a major breakthrough for social fMRI by providing information about mental states of partners already during the mutual interaction. Interestingly, an additional whole brain classification across subjects confirmed the online results: anterior insula, ventral striatum, and lateral orbitofrontal cortex, known to act in emotional self-regulation and reward processing for adjustment of behavior, appeared to be strong determinants of later overt behavior in the ultimatum game. Using whole brain classification we were also able to discriminate between brain processes related to subjective emotional and motivational states and brain processes related to the evaluation of objective financial incentives.
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Toma de Decisiones , Relaciones Interpersonales , Imagen por Resonancia Magnética , Máquina de Vectores de Soporte , Adulto , Conducta/fisiología , Encéfalo/irrigación sanguínea , Encéfalo/fisiología , Toma de Decisiones/fisiología , Emociones/fisiología , Humanos , Masculino , Motivación/fisiología , Análisis Multivariante , Oxígeno/sangre , Factores de TiempoRESUMEN
In natural environments depth-related information has to be extracted very fast from binocular disparity even if cues are presented shortly. However, few studies used efMRI to study depth perception. We therefore analyzed extension and localization of activation evoked by depth-by-disparity stimuli that were displayed for 1 s. As some clinical as well as neuroimaging studies had found a right-hemispheric lateralization of depth perception the sample size was increased to 26 subjects to gain higher statistical significance. All individuals reported a stable depth perception. In the random effects analysis the maximum activation of the disparity versus no disparity condition was highly significant and located in the extra-striate cortex, presumably in V3A (P < 0.05, family wise error). The activation was more pronounced in the right hemisphere. However, in the single-subject analysis depth-related right-hemispheric lateralization was observed only in 65% of the subjects. Lateralization of depth-by-disparity may therefore be obscured in smaller groups.