Magnetic resonance imaging of the pulsing brain: a systematic review.

OBJECTIVE: To perform a systematic review of the literature exploring magnetic resonance imaging (MRI) methods for measuring natural brain tissue pulsations (BTPs) in humans. METHODS: A prospective systematic search of MEDLINE, SCOPUS and OpenGrey databases was conducted by two independent reviewers using a pre-determined strategy. The search focused on identifying reported measurements of naturally occurring BTP motion in humans. Studies involving non-human participants, MRI in combination with other modalities, MRI during invasive procedures and MRI studies involving externally applied tests were excluded. Data from the retrieved records were combined to create Forest plots comparing brain tissue displacement between Chiari-malformation type 1 (CM-I) patients and healthy controls using an independent samples t-test. RESULTS: The search retrieved 22 eligible articles. Articles described 5 main MRI techniques for visualisation or quantification of intrinsic brain motion. MRI techniques generally agreed that the amplitude of BTPs varies regionally from 0.04 mm to ~ 0.80 mm, with larger tissue displacements occurring closer to the centre and base of the brain compared to peripheral regions. Studies of brain pathology using MRI BTP measurements are currently limited to tumour characterisation, idiopathic intracranial hypertension (IIH), and CM-I. A pooled analysis confirmed that displacement of tissue in the cerebellar tonsillar region of CM-I patients was + 0.31 mm [95% CI 0.23, 0.38, p < 0.0001] higher than in healthy controls. DISCUSSION: MRI techniques used for measurements of brain motion are at an early stage of development with high heterogeneity across the methods used. Further work is required to provide normative data to support systematic BTPs characterisation in health and disease.

Neural changes associated with cerebellar tDCS studied using MR spectroscopy.

Anodal cerebellar transcranial direct current stimulation (tDCS) is known to enhance motor learning, and therefore, has been suggested to hold promise as a therapeutic intervention. However, the neural mechanisms underpinning the effects of cerebellar tDCS are currently unknown. We investigated the neural changes associated with cerebellar tDCS using magnetic resonance spectroscopy (MRS). 34 healthy participants were divided into two groups which received either concurrent anodal or sham cerebellar tDCS during a visuomotor adaptation task. The anodal group underwent an additional session involving MRS in which the main inhibitory and excitatory neurotransmitters: GABA and glutamate (Glu) were measured pre-, during, and post anodal cerebellar tDCS, but without the behavioural task. We found no significant group-level changes in GABA or glutamate during- or post-tDCS compared to pre-tDCS levels, however, there was large degree of variability across participants. Although cerebellar tDCS did not affect visuomotor adaptation, surprisingly cerebellar tDCS increased motor memory retention with this being strongly correlated with a decrease in cerebellar glutamate levels during tDCS across participants. This work provides novel insights regarding the neural mechanisms which may underlie cerebellar tDCS, but also reveals limitations in the ability to produce robust effects across participants and between studies.

White Matter Microstructure in Youths With Conduct Disorder: Effects of Sex and Variation in Callous Traits.

OBJECTIVE: Studies using diffusion tensor imaging (DTI) to investigate white matter (WM) microstructure in youths with conduct disorder (CD) have reported disparate findings. We investigated WM alterations in a large sample of youths with CD, and examined the influence of sex and callous-unemotional (CU) traits. METHOD: DTI data were acquired from 124 youths with CD (59 female) and 174 typically developing (TD) youths (103 female) 9 to 18 years of age. Tract-based spatial statistics tested for effects of diagnosis and sex-by-diagnosis interactions. Associations with CD symptoms, CU traits, a task measuring impulsivity, and the impact of comorbidity, and age- and puberty-related effects were examined. RESULTS: Youths with CD exhibited higher axial diffusivity in the corpus callosum and lower radial diffusivity and mean diffusivity in the anterior thalamic radiation relative to TD youths. Female and male youths with CD exhibited opposite changes in the left hemisphere within the internal capsule, fornix, posterior thalamic radiation, and uncinate fasciculus. Within the CD group, CD symptoms and callous traits exerted opposing influences on corpus callosum axial diffusivity, with callous traits identified as the unique clinical feature predicting higher axial diffusivity and lower radial diffusivity within the corpus callosum and anterior thalamic radiation, respectively. In an exploratory analysis, corpus callosum axial diffusivity partially mediated the association between callous traits and impulsive responses to emotional faces. Results were not influenced by symptoms of comorbid disorders, and no age- or puberty-related interactions were observed. CONCLUSION: WM alterations within the corpus callosum represent a reliable neuroimaging marker of CD. Sex and callous traits are important factors to consider when examining WM in CD.

A pilot study to assess the effect of acute exercise on brain glutathione.

The brain is highly susceptible to oxidative stress due to its high metabolic demand. Increased oxidative stress and depletion of glutathione (GSH) are observed with aging and many neurological diseases. Exercise training has the potential to reduce oxidative stress in the brain. In this study, nine healthy sedentary males (aged 25 ± 4 years) undertook a bout of continuous moderate intensity exercise and a high-intensity interval (HII) exercise bout on separate days. GSH concentration in the anterior cingulate was assessed by magnetic resonance spectroscopy (MRS) in four participants, before and after exercise. This was a pilot study to evaluate the ability of the MRS method to detect exercise-induced changes in brain GSH in humans for the first time. MRS is a non-invasive method based on nuclear magnetic resonance, which enables the quantification of metabolites, such as GSH, in the human brain in vivo. To add context to brain GSH data, other markers of oxidative stress were also assessed in the periphery (in blood) at three time points [pre-, immediately post-, and post (∼1 hour)-exercise]. Moderate exercise caused a significant decrease in brain GSH from 2.12 ± 0.64 mM/kg to 1.26 ± 0.36 mM/kg (p = .04). Blood GSH levels increased immediately post-HII exercise, 580 ± 101 µM to 692 ± 102 µM (n = 9, p = .006). The findings from this study show that brain GSH is altered in response to acute moderate exercise, suggesting that exercise may stimulate an adaptive response in the brain. Due to the challenges in MRS methodology, this pilot study should be followed up with a larger exercise intervention trial.