Effects of baclofen on the functional anatomy of the oesophago-gastric junction and proximal stomach in healthy volunteers and patients with GERD assessed by magnetic resonance imaging and high-resolution manometry: a randomised controlled double-blind study.

BACKGROUND: The mechanism of reflux protection may involve a 'flap valve' at the oesophago-gastric junction (OGJ). AIM: To assess the effects of baclofen, a gamma-aminobutyric acid receptor type-B (GABA-B) agonist known to suppress reflux events, on the 'functional anatomy' of the OGJ and proximal stomach after a large test meal. METHODS: Twelve healthy volunteers (HVs) and 12 patients with gastro-oesophageal reflux disease (GERD); with erosive oesophagitis or pathological oesophageal acid exposure completed a randomised, double-blind, cross-over study. On 2 test days participants received 40-mg baclofen or placebo before ingestion of a large test meal. OGJ structure and function were assessed by high-resolution manometry (HRM) and magnetic resonance imaging (MRI) using validated methods. Measurements of the oesophago-gastric angle were derived from three-dimensional models reconstructed from anatomic MRI images. Cine-MRI and HRM identified postprandial reflux events. Mixed model analysis and Wilcoxon rank signed tests assessed differences between participant groups and treatment conditions. RESULTS: In both HVs and GERD patients, baclofen reduced the frequency of postprandial reflux events. The oesophago-gastric insertion angle in GERD patients was reduced (-4.1 ± 1.8, P = 0.025), but was unchanged in healthy controls. In both study groups, baclofen augmented lower oesophageal sphincter (LES) pressure (HVs: +7.3 ± 1.8 mmHg, P < 0.0001, GERD: +4.50 ± 1.49 mmHg, P < 0.003) and increased LES length (HVs: +0.48 ± 0.11 cm, P < 0.0003, GERD: +0.35 ± 0.06 cm, P < 0.0001). CONCLUSIONS: Baclofen inhibits transient LES relaxations and augments LES pressure and length. Additionally, baclofen has effects on the 'functional anatomy' of the OGJ and proximal stomach in GERD patients, which may suppress reflux by means of a 'flap valve' mechanism.

Navigator based respiratory gating during acquisition and preparation phases for proton liver spectroscopy at 3 T.

Proton magnetic resonance spectroscopy ((1)H MRS) enables the non-invasive investigation of the human liver; however, because of technical difficulties it is not regularly used for diagnosis of liver diseases in clinical routine. Breathing motion is one of the major challenges, as it decreases spectral quality and leads to misplacement of the spectroscopic voxel. To overcome this problem, real-time navigator gating for spectral acquisition and preparation steps (B0 shimming, water frequency determination, receiver gain optimization, and water suppression) combined with short TE , optimized first order projection based B0 shimming, water suppression, and inner-volume saturated point resolved spectroscopy (PRESS) at 3 T is suggested. Simultaneous lipid and trimethylamine quantification is demonstrated by means of phantom, volunteer, and representative patient measurements. Precise localization of the voxel despite respiratory motion, increased spectral quality (higher signal-to-noise ratio and reduced linewidth) compared with measurements without respiratory gating, and the possibility of acquiring data without additional subject instructions regarding breathing enable robust and accurate liver (1)H MRS measurements with this novel acquisition protocol.

J-refocused 1H PRESS DEPT for localized 13C MR spectroscopy.

Proton point-resolved spectroscopy (PRESS) localization has been combined with distortionless enhanced polarization transfer (DEPT) in multinuclear MRS to overcome the signal contamination problem in image-selected in vivo spectroscopy (ISIS)-combined DEPT, especially for lipid detection. However, homonuclear proton scalar couplings reduce the DEPT enhancement by modifying the spin coherence distribution under J modulation during proton PRESS localization. Herein, a J-refocused proton PRESS-localized DEPT sequence is presented to obtain simultaneously enhanced and localized signals from a large number of metabolites by in vivo (13) C MRS. The suppression of J modulation during PRESS and the substantial recovery of signal enhancement by J-refocused PRESS-localized DEPT were demonstrated theoretically by product operator formalism, numerically by the spin density matrix simulations for different scalar coupling conditions, and experimentally with a glutamate phantom at various TEs, as well as a colza oil phantom. The application of the sequence for localized detection of saturated and unsaturated fatty acids in the calf bone marrow and skeletal muscle of healthy subjects yielded high signal enhancements simultaneously obtained for all components.

(1)H-MR spectroscopy in the human spinal cord.

SUMMARY: MR spectroscopy allows insight into the chemical composition of human tissue noninvasively. Thereby it can help to better characterize pathologic processes affecting the spinal cord and may provide important clinical markers for differential diagnosis. However, due to technical challenges, it has been rarely applied to the spinal cord. The aim of this review was to summarize the technical development and clinical studies using MR spectroscopy in the spinal cord. Main challenges of applying MR spectroscopy in the spinal cord are discussed, and a description of a state-of-the-art scan protocol is given. In conclusion, MR spectroscopy is a promising tool for research and diagnosis of the spinal cord because it can provide additional information complementary to other noninvasive imaging methods. However, the application of MR spectroscopy in the spinal cord is not straightforward, and great care is required to attain optimal spectral quality.

Gastric secretion does not affect the reliability of the 13C-acetate breath test: A validation of the 13C-acetate breath test by magnetic resonance imaging.

BACKGROUND: (13)C-Acetate labeled meals are widely used to determine meal emptying by means of analyzing resulting (13)CO(2) exhalation dynamics. In contrast to the underlying metabolic processes, only few (13)C breath test meal emptying studies have focused on intragastric processes that may alter (13)CO(2) exhalation. This work assessed the effect of enhanced gastric secretion on the reliability of half emptying time (t50) measurements by (13)C-acetate breath test. METHODS: (13)CO(2) exhalation data were acquired in a double-blind, randomized, cross-over gastric emptying study in 12 healthy volunteers receiving either pentagastrin or placebo intravenously. The standard method proposed by Ghoos et al. was applied to calculate t50 (t50_Ghoos) from (13)CO(2) exhalation data, which were compared and tested for agreement to meal half emptying times (t50_MV) from concurrent recorded MRI (magnetic resonance imaging) volume data. In addition, the accumulated gastric secretion volumes during infusion as detected by MRI (AUC_SV(60)) were correlated with the corresponding cumulative percent (13)C doses recovered (cPDR(60)). KEY RESULTS: t50_Ghoos and t50_MV showed a linear correlation with a slope of 1.1 ± 0.3 (r(2) = 0.67), however, a positive offset of 136 min for t50_Ghoos. No correlation was detected between AUC_SV(60) and cPDR(60) (r(2) = 0.11). Both, breath test and MRI, revealed a prolonged t50 under pentagastrin infusion with median differences in t50_Ghoos of 45[28-84] min (P = 0.002) and t50_MV of 39[28-52] min (P = 0.002). CONCLUSIONS & INFERENCES: This study suggests that (13)CO(2) exhalation after ingestion of a (13) C-labeled liquid test meal is not affected by stimulated gastric secretion, but is rather reflecting the dynamics of meal or caloric emptying from the stomach.

A genome-wide survey and functional brain imaging study identify CTNNBL1 as a memory-related gene.

Unbiased genome-wide screens combined with imaging data on brain function may identify novel molecular pathways related to human cognition. Here we performed a dense genome-wide screen to identify episodic memory-related gene variants. A genomic locus encoding the brain-expressed beta-catenin-like protein 1 (CTNNBL1) was significantly (P=7 × 10(-8)) associated with verbal memory performance in a cognitively healthy cohort from Switzerland (n=1073) and was replicated in a second cohort from Serbia (n=524; P=0.003). Gene expression studies showed CTNNBL1 genotype-dependent differences in beta-catenin-like protein 1 mRNA levels in the human cortex. Functional magnetic resonance imaging in 322 subjects detected CTNNBL1 genotype-dependent differences in memory-related brain activations. Converging evidence from independent experiments and different methodological approaches suggests a role for CTNNBL1 in human memory.

Aversive stimuli lead to differential amygdala activation and connectivity patterns depending on catechol-O-methyltransferase Val158Met genotype.

The functional Val158Met polymorphism in the gene coding for the catechol-O-methyltransferase (COMT), the major enzyme degrading the catecholaminergic neurotransmitters dopamine, norepinephrine, and epinephrine, has been associated with differential reactivity in limbic and prefrontal brain areas in response to aversive stimuli. However, studies on COMT-genotype effects on activity of the amygdala, a brain region centrally involved in affective processing, have yielded inconsistent results. Here we investigated the impact of the COMT Val158Met polymorphism on amygdala activity and connectivity during processing of emotional and neutral pictures using functional magnetic resonance imaging (fMRI) in 56 healthy participants. Homozygosity for the low-activity Met allele was positively correlated with increased activation in the right amygdala in response to unpleasant, but not pleasant pictures. In addition, the Met allele exerted an additive effect on the positive connectivity between the right amygdala and orbitofrontal regions. Our results support previous reports of a COMT-genotype-dependent difference in amygdala responsivity as well as connectivity, and highlight the importance of naturally occurring genetic variations in the catecholaminergic system for neural activity underlying affective processing.

In-vivo assessment of tissue metabolite levels using 1H MRS and the Electric REference To access In vivo Concentrations (ERETIC) method.

Quantitative values of metabolite concentrations in (1)H magnetic resonance spectroscopy have been obtained using the Electric REference To access In vivo Concentrations (ERETIC) method, whereby a synthetic reference signal is injected during the acquisition of spectra. The method has been improved to enable quantification of metabolite concentrations in vivo. Optical signal transmission was used to eliminate random fluctuations in ERETIC signal coupling to the receiver coil due to changes in position of cables and highly dielectric human tissue. Stability and reliability of the signal were tested in vitro, achieving stability with a mean error of 2.83%. Scaling of the signal in variable loading conditions was demonstrated and in-vivo measurements of brain were acquired on a 3T Philips system using a transmit/receive coil. The quantitative brain water and metabolite concentration values are in good agreement with those in the literature.

Analysing the protective potential of padded soccer goalkeeper shorts.

OBJECTIVE: In this study, the potential of currently available padded soccer goalkeeper shorts to prevent hip injuries sustained in side jumps was investigated. DESIGN: Within the scope of this study, a survey among professional and amateur goalkeepers, trainers and the medical staff was performed. In addition, commercially available shorts were impact-tested using an artificial hip model. The results were compared with requirements established for hip protectors for elderly. RESULTS: The results of the survey found that contusions and abrasions were observed most often for all players. Fractures and arthritis were only reported by amateur players, whereas bursitis was more frequently observed by professional players. Amateurs have a significantly higher risk of injury than professional players, and the higher injury risk during training is significantly higher compared with the injury risk during a match. No difference of the injury risk was found between goalkeepers wearing padded shorts and those who did not. Impact tests indicated a wide range of performance of the currently available products. The padded shorts generally reduce impact forces, but mostly perform poorly. Only shorts that were made of visco-elastic foam fulfilled the basic requirements requested for hip protectors for elderly. CONCLUSIONS: The quality of most of the currently available goalkeeper shorts needs to be improved to effectively prevent hip injury sustained in side jumps.

Good practices in EEG-MRI: the utility of retrospective synchronization and PCA for the removal of MRI gradient artefacts.

The electroencephalogram (EEG) recorded during magnetic resonance imaging (MRI) inside the scanner is obstructed by the MRI gradient artefact (MGA) originating from the electromagnetic interference of the MRI with the sensitive measurement of electrical scalp potentials. Post-processing algorithms based on average artefact subtraction (AAS) have proven to be efficient in removing the MGA. However, the residual MGA after AAS still limits the quality and usable bandwidth of the EEG data despite further reduction through re-sampling, principal component analysis (PCA), and regressive filtering. We recently demonstrated that the residual MGA can largely be avoided by means of hardware synchronization. Here we present a new software synchronization method, which substitutes hardware synchronization and facilitates the removal of motion artefacts by PCA. The effectiveness of the retrospective synchronization algorithm (Resync) is demonstrated by comparison to the aforementioned techniques. For this purpose, we also developed a method for simulating the MGA and we propose new concepts for quantifying and comparing the performance of post-processing algorithms for EEG-MRI data. Results indicate that the benefits of (retrospective) synchronization and PCA depend largely on the relative contribution of timing errors and motion artefacts to the residual MGA as well as the frequency range of interest.

A genetic variation of the noradrenergic system is related to differential amygdala activation during encoding of emotional memories.

Emotionally arousing events are typically well remembered, but there is a large interindividual variability for this phenomenon. We have recently shown that a functional deletion variant of ADRA2B, the gene encoding the alpha2b-adrenergic receptor, is related to enhanced emotional memory in healthy humans and enhanced traumatic memory in war victims. Here, we investigated the neural mechanisms of this effect in healthy participants by using fMRI. Carriers of the ADRA2B deletion variant exhibited increased activation of the amygdala during encoding of photographs with negative emotional valence compared with noncarriers of the deletion. Additionally, functional connectivity between amygdala and insula was significantly stronger in deletion carriers. The present findings indicate that the ADRA2B deletion variant is related to increased responsivity and connectivity of brain regions implicated in emotional memory.

Effects of clonidine and sumatriptan on postprandial gastric volume response, antral contraction waves and emptying: an MRI study.

Gastric emptying (GE) may be driven by tonic contraction of the stomach ('pressure pump') or antral contraction waves (ACW) ('peristaltic pump'). The mechanism underlying GE was studied by contrasting the effects of clonidine (alpha(2)-adrenergic agonist) and sumatriptan (5-HT(1) agonist) on gastric function. Magnetic resonance imaging provided non-invasive assessment of gastric volume responses, ACW and GE in nine healthy volunteers. Investigations were performed in the right decubitus position after ingestion of 500 mL of 10% glucose (200 kcal) under placebo [0.9% NaCl intravenous (IV) and subcutaneous (SC)], clonidine [0.01 mg min(-1) IV, max 0.1 mg (placebo SC)] or sumatriptan [6 mg SC (placebo IV)]. Total gastric volume (TGV) and gastric content volume (GCV) were assessed every 5 min for 90 min, interspersed with dynamic scan sequences to measure ACW activity. During gastric filling, TGV increased with GCV indicating that meal volume dictates initial relaxation. Gastric contents volume continued to increase over the early postprandial period due to gastric secretion surpassing initial gastric emptying. Clonidine diminished this early increase in GCV, reduced gastric relaxation, decreased ACW frequency compared with placebo. Gastric emptying (GE) rate increased. Sumatriptan had no effect on initial GCV, but prolonged gastric relaxation and disrupted ACW activity. Gastric emptying was delayed. There was a negative correlation between gastric relaxation and GE rate (r(2 )=49%, P < 0.001), whereas the association between ACW frequency and GE rate was inconsistent and weak (r2=15%, P = 0.05). These findings support the hypothesis that nutrient liquid emptying is primarily driven by the 'pressure pump' mechanism.

Characterization of gastric volume responses and liquid emptying in functional dyspepsia and health by MRI or barostat and simultaneous C-acetate breath test.

The assessment of gastric accommodation and emptying by different methodologies provides inconsistent results. We aimed to compare magnetic resonance imaging (MRI), barostat and 13C-acetate breath test (BT) for the assessment of gastric volume responses and emptying in healthy controls (HC) and patients with functional dyspepsia (FD). Eight HC and eight FD patients underwent: (i) continuous BT with simultaneous MRI in the upright position after ingestion of isocaloric, 300 kcal, 200 and 800 mL meals, both labelled with 100 mg of (13)C-acetate; and (ii) BT with gastric barostat after ingestion of the 200 mL meal. MRI measured total gastric volume and gastric content volume (GCV) at baseline, after filling and during emptying. Meal emptying half-times (T(1/2)) for MRI and BT were calculated (mean +/- SD). We found: (i) Initial GCV was lower in FD than in HC (762 +/- 22 vs 810 +/- 52 mL, P < 0.04) after the 800 mL meal but not the 200 mL meal. T(1/2)(MRI) was shorter for the 800 mL than the 200 mL meal (P < 0.001), but similar in HC and FD (200 mL: HC 117 +/- 30 min vs FD 138 +/- 42 min, ns; 800 mL: HC 71 +/- 16 min vs FD 78 +/- 27 min, ns). In contrast, T(1/2)(BT) was similar between meals and groups (200 mL: HC 111 +/- 11 min vs FD 116 +/- 19 min; 800 mL: HC 114 +/- 14 min vs FD: 113 +/- 17 min). (ii) Barostat measurements showed similar postprandial volume increases between groups. We conclude that direct measurements by MRI provide a sensitive, non-invasive assessment of gastric accommodation and emptying after a meal. In contrast to MRI, BT did not detect faster emptying of high-volume compared to low-volume liquid nutrient meals in HC or FD.

The effect of gastric secretion on gastric physiology and emptying in the fasted and fed state assessed by magnetic resonance imaging.

Conventional measurement of gastric secretion is invasive and cannot assess the intra-gastric distribution of gastric contents or the effects of secretion on gastric function. This study assessed the effect of gastric secretion on gastric volume responses and emptying (GE) using a validated fast T(1) mapping magnetic resonance imaging (MRI) technique. Twelve healthy participants were studied in the fasted state and after 200 kcal Gadolinium-DOTA labelled glucose meal during intravenous infusion of pentagastrin or placebo in double-blind, randomized order. Total gastric volume (TGV) and gastric content volume (GCV) was assessed by MRI volume scans and secretion by fast T(1) mapping. Data was described by the kappa-coefficient (volume change after meal ingestion), by GE half time (T(50)) and maximal GE rate (GER(max)) derived all from a GE model. Pentagastrin increased GCV and TGV compared to placebo [kappa(GCV):1.6 +/- 0.1 vs 0.6 +/- 0.1; kappa(TGV): 1.6 +/- 0.1 vs 0.7 +/- 0.1; P < 0.001]. T(1) maps revealed a secretion layer above the meal, the volume of which was associated with kappa (R(2) = 83%, P < 0.001). TGV and GCV change were similar in both conditions (kappa; P = ns). T(50) was higher for pentagastrin than for placebo (84 +/- 7 vs 56 +/- 4min, P < 0.001); however, GER(max) was similar (5.9 +/- 0.6 vs 4.9 +/- 0.4 mL min(-1), P = ns). This study shows volume and distribution of gastric secretion can be quantified in-vivo by non-invasive MRI T(1) mapping. Increased GCV drove TGV accommodation without evidence of a direct effect of pentagastrin or excess acid on gastric function. Secretion increases GCV thus prolongs GE as assessed by T(50); however, GE rate is unchanged.

The role of the carotid sinus in the reduction of arterial wall stresses due to head movements--potential implications for cervical artery dissection.

Spontaneous dissection of the cervical internal carotid artery (sICAD) is a major cause of stroke in young adults. A tear in the inner part of the vessel wall triggers sICAD as it allows the blood to enter the wall and develop a transmural hematoma. The etiology of the tear is unknown but many patients with sICAD report an initiating trivial trauma. We thus hypothesised that the site of the tear might correspond with the location of maximal stress in the carotid wall. Carotid artery geometries segmented from magnetic resonance images of a healthy subject at different static head positions were used to define a path of motion and deformation of the right cervical internal carotid artery (ICA). Maximum head rotation to the left and rotation to the left combined with hyperextension of the neck were investigated using a structural finite element model. A role of the carotid sinus as a geometrically compliant feature accommodating extension of the artery is shown. At the extreme range of the movements, the geometrical compliance of the carotid sinus is limited and significant stress concentrations appear just distal to the sinus with peak stresses at the internal wall on the posterior side of the vessel following maximum head rotation and on the anteromedial portion of the vessel wall following rotation and hyperextension. Clinically, the location of sICAD initiation is 10-30 mm distal to the origin of the cervical ICA, which corresponds with the peak stress locations observed in the model, thus supporting trivial trauma from natural head movements as a possible initiating factor in sICAD.

Diffusion-weighted imaging of the entire spinal cord.

In spite of their diagnostic potential, the poor quality of available diffusion-weighted spinal cord images often restricts clinical application to cervical regions, and improved spatial resolution is highly desirable. To address these needs, a novel technique based on the combination of two recently presented reduced field-of-view approaches is proposed, enabling high-resolution acquisition over the entire spinal cord. Field-of-view reduction is achieved by the application of non-coplanar excitation and refocusing pulses combined with outer volume suppression for removal of unwanted transition zones. The non-coplanar excitation is performed such that a gap-less volume is acquired in a dedicated interleaved slice order within two repetition times. The resulting inner volume selectivity was evaluated in vitro. In vivo diffusion tensor imaging data on the cervical, thoracic and lumbar spinal cord were acquired in transverse orientation in each of four healthy subjects. An in-plane resolution of 0.7 x 0.7 mm(2) was achieved without notable aliasing, motion or susceptibility artifacts. The measured mean +/- SD fractional anisotropy was 0.69 +/- 0.11 in the thoracic spinal cord and 0.75 +/- 0.07 and 0.63 +/- 0.08 in cervical and lumbar white matter, respectively.

[Hip injuries in professional and amateur soccer goalkeepers]. / Hüftverletzungen bei Fussballtorhütern unterschiedlicher Leistungsstufen.

Soccer goalkeeper often dive to the side loading their hip. Different hip injuries might result. Within the scope of this study the hip injury rate of professional and amateur soccer goalkeepers was investigated. Most often players suffer from contusions and abrasions. Bursitis is reported from professional players, but hardly from amateur players. Generally amateur players are injured more often than professional players. For all players the injury risk during exercise is significantly higher than during a match. The exercise frequency showed a weak link to incidence rate only. For age, gender and exercise intensity no influence of the injury rate was found. Artificial playground resulted in a higher injury rate than natural grass, although the difference was not statistically significant. It was noted that team coachs and players indicated a different perception of the injury rate. The use of protective sports wear (hip protectors) did not significantly influence the injury rate.

Wall shear rate in supra-aortic vessels: a factor for different atherosclerotic pattern?

BACKGROUND: Atherosclerotic lesions of the upper extremity arise three to five times more often at the origin of the left subclavian artery than on the right side. The aim of this study was to investigate, whether the hemodynamic forces (peak wall shear rate) in the large supra-aortic branches measured by MRI differ in healthy subjects. PATIENTS AND METHODS: Peak wall shear rate (WSR) and blood flow was assessed in the left carotid, left subclavian and innominate artery in ten healthy volunteers (5 females, mean age of 35.2 +/- 9 years) using high resolution (pixel size 0.6 mm 2) magnetic resonance imaging (MRI) flow velocity measurements. RESULTS: There is no difference between the maximum WSR of the three large supra-aortic vessels. Only within the proximal (327 +/- 132s-1) and distal wall (458 +/- 154s-1) of the innominate artery a significant difference (p = 0.011) of the WSR was found. CONCLUSION: The results from this study indicate that WSR is not different in the supra-aortic vessels. Therefore the atherosclerotic pattern in the subclavian and innominate arteries may not be explained by differences in these hemodynamic forces.

Preliminary experience with visualization of intracortical fibers by focused high-resolution diffusion tensor imaging.

BACKGROUND AND PURPOSE: The inherent low anisotropy of gray matter and the lack of adequate imaging sensitivity and resolution has, so far, impeded depiction of axonal fibers to their intracortical origin or termination. We tested the hypothesis that an experimental approach with high-resolution diffusion tensor imaging (DTI) provides anisotropic data for fiber tractography with sufficient sensitivity to visualize in vivo the fine distribution of white matter bundles at the intracortical level. MATERIALS AND METHODS: We conducted phantom measurements of signal-to-noise ratio (SNR) and obtained diffusion tensor maps of the occipital lobe in 6 healthy volunteers using a dedicated miniature phased array detector at 3T. We reconstructed virtual fibers using a standard tracking algorithm. RESULTS: The coil array provided a SNR of 8.0 times higher at the head surface compared with a standard quadrature whole head coil. Diffusion tensor maps could be obtained with an in-plane resolution of 0.58 x 0.58 mm(2). The axonal trajectories reconstructed from the diffusion data penetrate into the cortical ribbon perpendicular to the pial surface. This is the expected pattern for the terminations of thalamocortical afferent fibers to the middle layers of the occipital cortex and is consistent with the known microstructural organization of the mammalian cerebral cortex. CONCLUSION: High-resolution DTI reveals intracortical anisotropy with a distinct parallel geometrical order, perpendicular to the pial surface, consistent with structures that may be identified as the terminal afferents in cortical gray matter.

Combining fMRI and DTI: a framework for exploring the limits of fMRI-guided DTI fiber tracking and for verifying DTI-based fiber tractography results.

A powerful, non-invasive technique for estimating and visualizing white matter tracts in the human brain in vivo is white matter fiber tractography that uses magnetic resonance diffusion tensor imaging. The success of this method depends strongly on the capability of the applied tracking algorithm and the quality of the underlying data set. However, DTI-based fiber tractography still lacks standardized validation. In the present work, a combined fMRI/DTI study was performed, both to develop a setup for verifying fiber tracking results using fMRI-derived functional connections and to explore the limitations of fMRI based DTI fiber tracking. Therefore, a minor fiber bundle that features several fiber crossings and intersections was examined: The striatum and its connections to the primary motor cortex were examined by using two approaches to derive the somatotopic organization of the striatum. First, an fMRI-based somatotopic map of the striatum was reconstructed, based on fMRI activations that were provoked by unilateral motor tasks. Second, fMRI-guided DTI fiber tracking was performed to generate DTI-based somatotopic maps, using a standard line propagation and an advanced fast marching algorithm. The results show that the fiber connections reconstructed by the advanced fast marching algorithm are in good agreement with known anatomy, and that the DTI-revealed somatotopy is similar to the fMRI somatotopy. Furthermore, the study illustrates that the combination of fMRI with DTI can supply additional information in order to choose reasonable seed regions for generating functionally relevant networks and to validate reconstructed fibers.