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1.
Proc Natl Acad Sci U S A ; 117(18): 10035-10044, 2020 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-32312804

RESUMO

One factor that contributes to the high prevalence of fetal alcohol spectrum disorder (FASD) is binge-like consumption of alcohol before pregnancy awareness. It is known that treatments are more effective with early recognition of FASD. Recent advances in retrospective motion correction for the reconstruction of three-dimensional (3D) fetal brain MRI have led to significant improvements in the quality and resolution of anatomical and diffusion MRI of the fetal brain. Here, a rhesus macaque model of FASD, involving oral self-administration of 1.5 g/kg ethanol per day beginning prior to pregnancy and extending through the first 60 d of a 168-d gestational term, was utilized to determine whether fetal MRI could detect alcohol-induced abnormalities in brain development. This approach revealed differences between ethanol-exposed and control fetuses at gestation day 135 (G135), but not G110 or G85. At G135, ethanol-exposed fetuses had reduced brainstem and cerebellum volume and water diffusion anisotropy in several white matter tracts, compared to controls. Ex vivo electrophysiological recordings performed on fetal brain tissue obtained immediately following MRI demonstrated that the structural abnormalities observed at G135 are of functional significance. Specifically, spontaneous excitatory postsynaptic current amplitudes measured from individual neurons in the primary somatosensory cortex and putamen strongly correlated with diffusion anisotropy in the white matter tracts that connect these structures. These findings demonstrate that exposure to ethanol early in gestation perturbs development of brain regions associated with motor control in a manner that is detectable with fetal MRI.


Assuntos
Consumo de Bebidas Alcoólicas/fisiopatologia , Encéfalo/fisiopatologia , Transtornos do Espectro Alcoólico Fetal/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Animais , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Imagem de Difusão por Ressonância Magnética , Modelos Animais de Doenças , Etanol/toxicidade , Feminino , Transtornos do Espectro Alcoólico Fetal/diagnóstico por imagem , Desenvolvimento Fetal/efeitos dos fármacos , Feto/diagnóstico por imagem , Feto/efeitos dos fármacos , Humanos , Macaca mulatta , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/diagnóstico por imagem , Estudos Retrospectivos
2.
Neuroimage ; 206: 116310, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31669303

RESUMO

Recent advances in image reconstruction techniques have enabled high resolution MRI studies of fetal brain development in human subjects. Rhesus macaques (Macaca mulatta) are valuable animal models for use in studies of fetal brain development due to the similarities between this species and humans in brain development and anatomy. There is a need to develop fetal brain templates for the rhesus macaque to facilitate the characterization of the normal brain growth trajectory and departures from this trajectory in rhesus models of neurodevelopmental disorders. Here we have developed unbiased population-based anatomical T2-weighted, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) templates for fetal brain from MR images scanned at 3 time points over the second and third trimesters of the 168 day gestational term. Specifically, atlas images are constructed for brains at gestational ages of 85 days (G85, N = 18, 9 females), 110 days (G110, N = 10, 7 females) and 135 days (G135, N = 16, 7 females). We utilized this atlas to perform segmentation of fetal brain MR images and fetal brain volumetric and microstructure analysis. The T2-weighted template images facilitated characterization of the growth within six fetal brain regions. The template images of diffusion tensor indices provided information related to the maturation of white matter tracts. These growth trajectories are referenced to human studies of fetal brain development. Similarities in the temporal and regional patterns of brain growth over the corresponding periods of central nervous system development are identified between the two species. Atlas images are available online as a reference for registration, reconstruction, segmentation, and for longitudinal analysis of early fetal brain growth over this unique time window.


Assuntos
Atlas como Assunto , Encéfalo , Feto/diagnóstico por imagem , Idade Gestacional , Macaca mulatta/anatomia & histologia , Imageamento por Ressonância Magnética/métodos , Neuroimagem/métodos , Animais , Encéfalo/anatomia & histologia , Encéfalo/diagnóstico por imagem , Encéfalo/crescimento & desenvolvimento , Imagem de Difusão por Ressonância Magnética/métodos , Feminino , Masculino , Gravidez
3.
Pediatr Res ; 85(3): 299-304, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30635642

RESUMO

BACKGROUND: To assess whether postnatal plasma cholesterol levels are associated with microstructural and macrostructural regional brain development in preterm newborns. METHODS: Sixty preterm newborns (born 24-32 weeks gestational age) were assessed using MRI studies soon after birth and again at term-equivalent age. Blood samples were obtained within 7 days of each MRI scan to analyze for plasma cholesterol and lathosterol (a marker of endogenous cholesterol synthesis) levels. Outcomes were assessed at 3 years using the Bayley Scales of Infant Development, Third Edition. RESULTS: Early plasma lathosterol levels were associated with increased axial and radial diffusivities and increased volume of the subcortical white matter. Early plasma cholesterol levels were associated with increased volume of the cerebellum. Early plasma lathosterol levels were associated with a 2-point decrease in motor scores at 3 years. CONCLUSIONS: Higher early endogenous cholesterol synthesis is associated with worse microstructural measures and larger volumes in the subcortical white matter that may signify regional edema and worse motor outcomes. Higher early cholesterol is associated with improved cerebellar volumes. Further work is needed to better understand how the balance of cholesterol supply and endogenous synthesis impacts preterm brain development, especially if these may be modifiable factors to improve outcomes.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/crescimento & desenvolvimento , Colesterol/sangue , Recém-Nascido Prematuro/sangue , Anisotropia , Encéfalo/metabolismo , Pré-Escolar , Imagem de Tensor de Difusão , Feminino , Seguimentos , Idade Gestacional , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Imageamento por Ressonância Magnética , Masculino , Destreza Motora , Estudos Prospectivos , Substância Branca/diagnóstico por imagem
4.
J Neurosci ; 37(8): 1971-1983, 2017 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-28069920

RESUMO

Altered macroscopic anatomical characteristics of the cerebral cortex have been identified in individuals affected by various neurodevelopmental disorders. However, the cellular developmental mechanisms that give rise to these abnormalities are not understood. Previously, advances in image reconstruction of diffusion magnetic resonance imaging (MRI) have made possible high-resolution in utero measurements of water diffusion anisotropy in the fetal brain. Here, diffusion anisotropy within the developing fetal cerebral cortex is longitudinally characterized in the rhesus macaque, focusing on gestation day (G85) through G135 of the 165 d term. Additionally, for subsets of animals characterized at G90 and G135, immunohistochemical staining was performed, and 3D structure tensor analyses were used to identify the cellular processes that most closely parallel changes in water diffusion anisotropy with cerebral cortical maturation. Strong correlations were found between maturation of dendritic arbors on the cellular level and the loss of diffusion anisotropy with cortical development. In turn, diffusion anisotropy changes were strongly associated both regionally and temporally with cortical folding. Notably, the regional and temporal dependence of diffusion anisotropy and folding were distinct from the patterns observed for cerebral cortical surface area expansion. These findings strengthen the link proposed in previous studies between cellular-level changes in dendrite morphology and noninvasive diffusion MRI measurements of the developing cerebral cortex and support the possibility that, in gyroencephalic species, structural differentiation within the cortex is coupled to the formation of gyri and sulci.SIGNIFICANCE STATEMENT Abnormal brain morphology has been found in populations with neurodevelopmental disorders. However, the mechanisms linking cellular level and macroscopic maturation are poorly understood, even in normal brains. This study contributes new understanding to this subject using serial in utero MRI measurements of rhesus macaque fetuses, from which macroscopic and cellular information can be derived. We found that morphological differentiation of dendrites was strongly associated both regionally and temporally with folding of the cerebral cortex. Interestingly, parallel associations were not observed with cortical surface area expansion. These findings support the possibility that perturbed morphological differentiation of cells within the cortex may underlie abnormal macroscopic characteristics of individuals affected by neurodevelopmental disorders.


Assuntos
Córtex Cerebral/citologia , Córtex Cerebral/embriologia , Embrião de Mamíferos/citologia , Fatores Etários , Animais , Anisotropia , Mapeamento Encefálico , Córtex Cerebral/diagnóstico por imagem , Imagem de Tensor de Difusão , Embrião de Mamíferos/diagnóstico por imagem , Desenvolvimento Embrionário/fisiologia , Feminino , Idade Gestacional , Processamento de Imagem Assistida por Computador , Macaca mulatta , Imageamento por Ressonância Magnética , Masculino , Proteínas Associadas aos Microtúbulos/metabolismo , Vias Neurais/embriologia , Vias Neurais/fisiologia , Organogênese , Gravidez , Estatística como Assunto , Vimentina/metabolismo
5.
Pediatr Res ; 83(1-1): 93-101, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28915231

RESUMO

BackgroundHuman studies investigating the link between postnatal polyunsaturated fatty acids and preterm brain growth are limited, despite emerging evidence of potential effects on outcomes.MethodsSixty preterm neonates <32 weeks gestational age with magnetic resonance imaging (MRI) scanning at near-birth and near-term age were assessed for brain tissue volumes, including cortical gray matter, white matter, deep gray matter, cerebellum, brainstem, and ventricular cerebrospinal fluid. Red blood cell fatty acid content was evaluated within 1 week of each MRI scan. Neurodevelopmental outcome at 30-36 months corrected age was assessed.ResultsAdjusting for potential confounders, higher near-birth docosahexaenoic acid levels are associated with larger cortical gray matter, deep gray matter, and brainstem volumes and higher near-term levels with larger deep gray matter, cerebellar, and brainstem volumes at near-term age; lower near-birth linoleic acid levels are correlated with larger white matter volume at near-term age. By 30-36 months corrected age, larger cortical and deep gray matter, cerebellar, and brainstem volumes by term age are associated with improved language scores and larger cerebellar and brainstem volumes with improved motor scores.ConclusionSpecific polyunsaturated fatty acid levels have differential and time-dependent associations with brain region growth. Larger brain volumes are associated with improved outcomes at preschool age.


Assuntos
Encéfalo/anatomia & histologia , Encéfalo/diagnóstico por imagem , Sistema Nervoso Central/crescimento & desenvolvimento , Ácidos Graxos Insaturados/química , Recém-Nascido Prematuro/crescimento & desenvolvimento , Encéfalo/crescimento & desenvolvimento , Desenvolvimento Infantil/fisiologia , Pré-Escolar , Estudos de Coortes , Ácidos Docosa-Hexaenoicos/sangue , Eritrócitos/metabolismo , Ácidos Graxos/sangue , Idade Gestacional , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Transtornos do Neurodesenvolvimento , Resultado do Tratamento
6.
Hum Brain Mapp ; 38(9): 4322-4336, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28608653

RESUMO

Preterm birth is associated with brain injury and altered cognitive development. However, the consequences of extrauterine development are not clearly distinguished from perinatal brain injury. Therefore, we characterized cortical growth patterns from 30 to 46 postmenstrual weeks (PMW) in 27 preterm neonates (25-32 PMW at birth) without detectable brain injury on magnetic resonance imaging. We introduce surface-based morphometric descriptors that quantify radial (thickness) and tangential (area) change rates. Within a tensor-based morphometry framework, we use a temporally weighted formulation of regression to simultaneously model local age-related changes in cortical gray matter (GM) and underlying white matter (WM) mapped onto the cortical surface. The spatiotemporal pattern of GM and WM development corresponded to the expected gyrification time course of primary sulcal deepening and branching. In primary gyri, surface area and thickness rates were below average along sulcal pits and above average on gyral banks and crests in both GM and WM. Above average surface area rates in GM corresponded to emergence of secondary and tertiary folds. These findings map the development of neonatal cortical morphometry in the context of extrauterine brain development using a novel approach. Future studies may compare this developmental trajectory to preterm populations with brain injury. Hum Brain Mapp 38:4322-4336, 2017. © 2017 Wiley Periodicals, Inc.


Assuntos
Encéfalo/crescimento & desenvolvimento , Substância Cinzenta/crescimento & desenvolvimento , Recém-Nascido Prematuro/crescimento & desenvolvimento , Substância Branca/crescimento & desenvolvimento , Encéfalo/diagnóstico por imagem , Feminino , Substância Cinzenta/diagnóstico por imagem , Humanos , Imageamento Tridimensional/métodos , Recém-Nascido , Imageamento por Ressonância Magnética/métodos , Masculino , Tamanho do Órgão , Estudos Prospectivos , Substância Branca/diagnóstico por imagem
7.
Magn Reson Med ; 78(3): 909-916, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-27699879

RESUMO

PURPOSE: Maximization of the blood oxygen level-dependent (BOLD) functional MRI (fMRI) contrast requires the echo time of the MR sequence to match the T2* value of the tissue of interest, which is expected to be higher in the fetal brain compared with the brain of a child or an adult. METHODS: T2* values of the cortical plate/cortical gray matter tissue in utero in healthy fetuses from mid-gestation onward (20-36 gestational weeks) were measured using 3D T2* maps calculated from 2D dual-echo T2*-weighted data corrected for between-slice motion and reconstructed in 1.0 mm3 isotropic resolution from a sequence of multiple time points, together with 1.0 mm3 isotropic resolution T2-weighted structural data. RESULTS: Mean T2* relaxation times of the cortical tissue were about twice as high as those reported previously in adults. In a supporting experiment applying single seed analysis, default mode and auditory networks appeared better localized and less noisy while using an echo time of 100 ms versus 43 ms. The results of the previous study reporting a trend for T2* values to decrease with fetal age were reproduced and extended to include cortical tissues and subjects in earlier gestation (20-26 gestational weeks). CONCLUSION: The first measurement of T2* values in fetal cortical tissues suggested the appropriate echo time range for fetal BOLD fMRI protocol optimization to be 130-190 ms. Magn Reson Med 78:909-916, 2017. © 2016 International Society for Magnetic Resonance in Medicine.


Assuntos
Encéfalo/diagnóstico por imagem , Feto/diagnóstico por imagem , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Diagnóstico Pré-Natal/métodos , Adulto , Feminino , Humanos , Masculino , Gravidez
8.
Neuroimage ; 127: 387-408, 2016 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-26702777

RESUMO

Accurate automated tissue segmentation of premature neonatal magnetic resonance images is a crucial task for quantification of brain injury and its impact on early postnatal growth and later cognitive development. In such studies it is common for scans to be acquired shortly after birth or later during the hospital stay and therefore occur at arbitrary gestational ages during a period of rapid developmental change. It is important to be able to segment any of these scans with comparable accuracy. Previous work on brain tissue segmentation in premature neonates has focused on segmentation at specific ages. Here we look at solving the more general problem using adaptations of age specific atlas based methods and evaluate this using a unique manually traced database of high resolution images spanning 20 gestational weeks of development. We examine the complimentary strengths of age specific atlas-based Expectation-Maximization approaches and patch-based methods for this problem and explore the development of two new hybrid techniques, patch-based augmentation of Expectation-Maximization with weighted fusion and a spatial variability constrained patch search. The former approach seeks to combine the advantages of both atlas- and patch-based methods by learning from the performance of the two techniques across the brain anatomy at different developmental ages, while the latter technique aims to use anatomical variability maps learnt from atlas training data to locally constrain the patch-based search range. The proposed approaches were evaluated using leave-one-out cross-validation. Compared with the conventional age specific atlas-based segmentation and direct patch based segmentation, both new approaches demonstrate improved accuracy in the automated labeling of cortical gray matter, white matter, ventricles and sulcal cortical-spinal fluid regions, while maintaining comparable results in deep gray matter.


Assuntos
Encéfalo/anatomia & histologia , Processamento de Imagem Assistida por Computador/métodos , Recém-Nascido Prematuro , Imageamento por Ressonância Magnética/métodos , Neuroimagem/métodos , Algoritmos , Feminino , Humanos , Recém-Nascido , Masculino
9.
Hum Brain Mapp ; 37(11): 4158-4178, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27510837

RESUMO

Recently, there has been considerable interest, especially for in utero imaging, in the detection of functional connectivity in subjects whose motion cannot be controlled while in the MRI scanner. These cases require two advances over current studies: (1) multiecho acquisitions and (2) post processing and reconstruction that can deal with significant between slice motion during multislice protocols to allow for the ability to detect temporal correlations introduced by spatial scattering of slices into account. This article focuses on the estimation of a spatially and temporally regular time series from motion scattered slices of multiecho fMRI datasets using a full four-dimensional (4D) iterative image reconstruction framework. The framework which includes quantitative MRI methods for artifact correction is evaluated using adult studies with and without motion to both refine parameter settings and evaluate the analysis pipeline. ICA analysis is then applied to the 4D image reconstruction of both adult and in utero fetal studies where resting state activity is perturbed by motion. Results indicate quantitative improvements in reconstruction quality when compared to the conventional 3D reconstruction approach (using simulated adult data) and demonstrate the ability to detect the default mode network in moving adults and fetuses with single-subject and group analysis. Hum Brain Mapp 37:4158-4178, 2016. © 2016 Wiley Periodicals, Inc.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Diagnóstico Pré-Natal , Adulto , Algoritmos , Encéfalo/embriologia , Simulação por Computador , Feminino , Humanos , Modelos Lineares , Masculino , Modelos Neurológicos , Movimento (Física) , Vias Neurais/diagnóstico por imagem , Vias Neurais/embriologia , Vias Neurais/fisiologia , Gravidez , Terceiro Trimestre da Gravidez , Descanso
10.
J Pediatr ; 172: 81-87.e2, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26763312

RESUMO

OBJECTIVE: To examine the relationship between morphine exposure and growth of the cerebellum and cerebrum in very preterm neonates from early in life to term-equivalent age, as well as to examine morphine exposure and brain volumes in relation to neurodevelopmental outcomes at 18 months corrected age (CA). STUDY DESIGN: A prospective cohort of 136 very preterm neonates (24-32 weeks gestational age) was serially scanned with magnetic resonance imaging near birth and at term-equivalent age for volumetric measurements of the cerebellum and cerebrum. Motor outcomes were assessed with the Peabody Developmental Motor Scales, Second Edition and cognitive outcomes with the Bayley Scales of Infant and Toddler Development, Third Edition at 18 months CA. Generalized least squares models and linear regression models were used to assess relationships between morphine exposure, brain volumes, and neurodevelopmental outcomes. RESULTS: A 10-fold increase in morphine exposure was associated with a 5.5% decrease in cerebellar volume, after adjustment for multiple clinical confounders and total brain volume (P = .04). When infants exposed to glucocorticoids were excluded, the association of morphine was more pronounced, with an 8.1% decrease in cerebellar volume. Morphine exposure was not associated with cerebral volume (P = .30). Greater morphine exposure also predicted poorer motor (P < .001) and cognitive outcomes (P = .006) at 18 months CA, an association mediated, in part, by slower brain growth. CONCLUSIONS: Morphine exposure in very preterm neonates is independently associated with impaired cerebellar growth in the neonatal period and poorer neurodevelopmental outcomes in early childhood. Alternatives to better manage pain in preterm neonates that optimize brain development and functional outcomes are urgently needed.


Assuntos
Analgésicos Opioides/efeitos adversos , Cerebelo/anormalidades , Cerebelo/efeitos dos fármacos , Cérebro/crescimento & desenvolvimento , Deficiências do Desenvolvimento/induzido quimicamente , Morfina/efeitos adversos , Malformações do Sistema Nervoso/induzido quimicamente , Cerebelo/crescimento & desenvolvimento , Cérebro/efeitos dos fármacos , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Imageamento por Ressonância Magnética , Masculino , Estudos Prospectivos
11.
Pediatr Res ; 75(3): 389-94, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24346111

RESUMO

BACKGROUND: Cerebellar hypoplasia is a common problem in preterm infants and infants suffering from intraventricular hemorrhage (IVH). To evaluate the effects of IVH on cerebellar growth and development, we used a neonatal rabbit model of systemic glycerol to produce IVH. METHODS: New Zealand White rabbit kits were surgically delivered 2 d preterm and treated with intraperitoneal glycerol (3.25-6.5 g/kg). Controls were born at term. IVH was documented by ultrasonography. Brain volumes determined by magnetic resonance imaging, cerebellar foliation, proliferation (Ki-67), and Purkinje cell density were assessed at 2 wk of life. Tissue glycerol and glutathione concentrations were measured. RESULTS: Glycerol increased IVH, subarachnoid hemorrhages, and mortality in a dose-dependent manner. Total cerebellar volumes, cerebellar foliation, and cerebellar proliferation were decreased in a dose-dependent manner. Glycerol accumulated rapidly in blood, brain, and liver and was associated with increased glutathione concentration. All of these results were independent of IVH status. CONCLUSION: Cerebellar hypoplasia was induced after glycerol administration in a dose-dependent manner. Given the rapid tissue accumulation of glycerol, dose-dependent decrease in brain growth, and lack of IVH effect on measured outcomes, we question the validity of this model because glycerol toxicity cannot be ruled out. A better physiological model of IVH is needed.


Assuntos
Animais Recém-Nascidos/crescimento & desenvolvimento , Cerebelo/anormalidades , Glicerol/farmacologia , Ventrículos do Coração/patologia , Hemorragia/complicações , Malformações do Sistema Nervoso/etiologia , Coelhos/crescimento & desenvolvimento , Animais , Animais Recém-Nascidos/sangue , Estudos de Casos e Controles , Cerebelo/patologia , Deficiências do Desenvolvimento/etiologia , Deficiências do Desenvolvimento/patologia , Relação Dose-Resposta a Droga , Glicerol/administração & dosagem , Glicerol/sangue , Hemorragia/induzido quimicamente , Hemorragia/diagnóstico por imagem , Hemorragia/patologia , Injeções Intraperitoneais , Imageamento por Ressonância Magnética , Malformações do Sistema Nervoso/patologia , Coelhos/sangue , Fatores de Tempo , Ultrassonografia
12.
Epilepsia ; 54(2): 341-50, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23030361

RESUMO

PURPOSE: Interictal positron emission tomography (PET) and ictal subtraction single photon emission computed tomography (SPECT) of the brain have been shown to be valuable tests in the presurgical evaluation of epilepsy. To determine the relative utility of these methods in the localization of seizure foci, we compared interictal PET and ictal subtraction SPECT to subdural and depth electrode recordings in patients with medically intractable epilepsy. METHODS: Between 2003 and 2009, clinical information on all patients at our institution undergoing intracranial electroencephalography (EEG) monitoring was charted in a prospectively recorded database. Patients who underwent preoperative interictal PET and ictal subtraction SPECT were selected from this database. Patient characteristics and the findings on preoperative interictal PET and ictal subtraction SPECT were analyzed. Sensitivity of detection of seizure foci for each modality, as compared to intracranial EEG monitoring, was calculated. KEY FINDINGS: Fifty-three patients underwent intracranial EEG monitoring with preoperative interictal PET and ictal subtraction SPECT scans. The average patient age was 32.7 years (median 32 years, range 1-60 years). Twenty-seven patients had findings of reduced metabolism on interictal PET scan, whereas all 53 patients studied demonstrated a region of relative hyperperfusion on ictal subtraction SPECT suggestive of an epileptogenic zone. Intracranial EEG monitoring identified a single seizure focus in 45 patients, with 39 eventually undergoing resective surgery. Of the 45 patients in whom a seizure focus was localized, PET scan identified the same region in 25 cases (56% sensitivity) and SPECT in 39 cases (87% sensitivity). Intracranial EEG was concordant with at least one study in 41 cases (91%) and both studies in 23 cases (51%). In 16 (80%) of 20 cases where PET did not correlate with intracranial EEG, the SPECT study was concordant. Conversely, PET and intracranial EEG were concordant in two (33%) of the six cases where the SPECT did not demonstrate the seizure focus outlined by intracranial EEG. Thirty-three patients had surgical resection and >2 years of follow-up, and 21 of these (64%) had Engel class 1 outcome. No significant effect of imaging concordance on seizure outcome was seen. SIGNIFICANCE: Interictal PET and ictal subtraction SPECT studies can provide important information in the preoperative evaluation of medically intractable epilepsy. Of the two studies, ictal subtraction SPECT appears to be the more sensitive. When both studies are used together, however, they can provide complementary information.


Assuntos
Epilepsia/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Convulsões/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adolescente , Adulto , Anticonvulsivantes/uso terapêutico , Criança , Pré-Escolar , Resistência a Medicamentos , Eletroencefalografia , Epilepsia/patologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Convulsões/patologia , Resultado do Tratamento , Adulto Jovem
13.
Cereb Cortex ; 22(1): 13-25, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21571694

RESUMO

Early cortical folding and the emergence of structural brain asymmetries have been previously analyzed by neuropathology as well as qualitative analysis of magnetic resonance imaging (MRI) of fetuses and preterm neonates. In this study, we present a dedicated image analysis framework and its application for the detection of folding patterns during the critical period for the formation of many primary sulci (20-28 gestational weeks). Using structural information from in utero MRI, we perform morphometric analysis of cortical plate surface development and modeling of early folding in the normal fetal brain. First, we identify regions of the fetal brain surface that undergo significant folding changes during this developmental period and provide precise temporal staging of these changes for each region of interest. Then, we highlight the emergence of interhemispheric structural asymmetries that may be related to future functional specialization of cortical areas. Our findings complement previous descriptions of early sulcogenesis based on neuropathology and qualitative evaluation of 2D in utero MRI by accurate spatial and temporal mapping of the emergence of individual sulci as well as structural brain asymmetries. The study provides the missing starting point for their developmental trajectories and extends our understanding of normal cortical folding.


Assuntos
Mapeamento Encefálico , Encéfalo/anatomia & histologia , Encéfalo/embriologia , Feto/embriologia , Lateralidade Funcional , Imageamento por Ressonância Magnética , Feminino , Idade Gestacional , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Modelos Estatísticos , Gravidez
14.
J Neurosci ; 31(8): 2878-87, 2011 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-21414909

RESUMO

Existing knowledge of growth patterns in the living fetal human brain is based upon in utero imaging studies by magnetic resonance imaging (MRI) and ultrasound, which describe overall growth and provide mainly qualitative findings. However, formation of the complex folded cortical structure of the adult brain requires, in part, differential rates of regional tissue growth. To better understand these local tissue growth patterns, we applied recent advances in fetal MRI motion correction and computational image analysis techniques to 40 normal fetal human brains covering a period of primary sulcal formation (20-28 gestational weeks). Growth patterns were mapped by quantifying tissue locations that were expanding more or less quickly than the overall cerebral growth rate, which reveal increasing structural complexity. We detected increased local relative growth rates in the formation of the precentral and postcentral gyri, right superior temporal gyrus, and opercula, which differentiated between the constant growth rate in underlying cerebral mantle and the accelerating rate in the cortical plate undergoing folding. Analysis focused on the cortical plate revealed greater volume increases in parietal and occipital regions compared to the frontal lobe. Cortical plate growth patterns constrained to narrower age ranges showed that gyrification, reflected by greater growth rates, was more pronounced after 24 gestational weeks. Local hemispheric volume asymmetry was located in the posterior peri-Sylvian area associated with structural lateralization in the mature brain. These maps of fetal brain growth patterns construct a spatially specific baseline of developmental biomarkers with which to correlate abnormal development in the human.


Assuntos
Padronização Corporal/fisiologia , Córtex Cerebral/embriologia , Feto/embriologia , Imageamento por Ressonância Magnética/métodos , Neurogênese/fisiologia , Organogênese/fisiologia , Córtex Cerebral/fisiologia , Feminino , Feto/fisiologia , Humanos , Gravidez
15.
Neuroimage ; 63(2): 947-58, 2012 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-22503938

RESUMO

Tensor based morphometry (TBM) is a powerful approach to analyze local structural changes in brain anatomy. However, conventional scalar TBM methods do not completely capture all direction specific volume changes required to model complex changes such as those during brain growth. In this paper, we describe novel TBM descriptors for studying direction-specific changes in a subject population which can be used in conjunction with scalar TBM to analyze local patterns in directionality of volume change during brain development. We also extend the methodology to provide a new approach to mapping directional asymmetry in deformation tensors associated with the emergence of structural asymmetry in the developing brain. We illustrate the use of these methods by studying developmental patterns in the human fetal brain, in vivo. Results show that fetal brain development exhibits a distinct spatial pattern of anisotropic growth. The most significant changes in the directionality of growth occur in the cortical plate at major sulci. Our analysis also detected directional growth asymmetry in the peri-Sylvian region and the medial frontal lobe of the fetal brain.


Assuntos
Mapeamento Encefálico/métodos , Encéfalo/crescimento & desenvolvimento , Imagem de Tensor de Difusão/métodos , Lateralidade Funcional/fisiologia , Interpretação de Imagem Assistida por Computador/métodos , Feto , Humanos
16.
Annu Rev Biomed Eng ; 13: 345-68, 2011 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-21568716

RESUMO

The development of tools to construct and investigate probabilistic maps of the adult human brain from magnetic resonance imaging (MRI) has led to advances in both basic neuroscience and clinical diagnosis. These tools are increasingly being applied to brain development in adolescence and childhood, and even to neonatal and premature neonatal imaging. Even earlier in development, parallel advances in clinical fetal MRI have led to its growing use as a tool in challenging medical conditions. This has motivated new engineering developments encompassing optimal fast MRI scans and techniques derived from computer vision, the combination of which allows full 3D imaging of the moving fetal brain in utero without sedation. These promise to provide a new and unprecedented window into early human brain growth. This article reviews the developments that have led us to this point, examines the current state of the art in the fields of fast fetal imaging and motion correction, and describes the tools to analyze dynamically changing fetal brain structure. New methods to deal with developmental tissue segmentation and the construction of spatiotemporal atlases are examined, together with techniques to map fetal brain growth patterns.


Assuntos
Mapeamento Encefálico/instrumentação , Encéfalo/embriologia , Feto/embriologia , Interpretação de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/instrumentação , Imageamento por Ressonância Magnética/instrumentação , Adolescente , Adulto , Algoritmos , Encéfalo/crescimento & desenvolvimento , Mapeamento Encefálico/métodos , Criança , Pré-Escolar , Feminino , Desenvolvimento Fetal/fisiologia , Feto/fisiologia , Humanos , Aumento da Imagem/métodos , Imageamento Tridimensional/métodos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética/métodos , Masculino , Gravidez , Diagnóstico Pré-Natal/métodos
17.
Cerebellum ; 11(3): 761-70, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22198870

RESUMO

To date, growth of the human fetal cerebellum has been estimated primarily from linear measurements from ultrasound and 2D magnetic resonance imaging (MRI). In this study, we use 3D analytical methods to develop normative growth trajectories for the cerebellum in utero. We measured cerebellar volume, linear dimensions, and local surface curvature from 3D reconstructed MRI of the human fetal brain (N = 46). We found that cerebellar volume increased approximately 7-fold from 20 to 31 gestational weeks. The better fit of the exponential curve (R (2) = 0.96) compared to the linear curve (R (2) = 0.92) indicated acceleration in growth. Within-subject cerebellar and cerebral volumes were highly correlated (R (2) = 0.94), though the cerebellar percentage of total brain volume increased from approximately 2.4% to 3.7% (R (2) = 0.63). Right and left hemispheric volumes did not significantly differ. Transcerebellar diameter, vermal height, and vermal anterior to posterior diameter increased significantly at constant rates. From the local curvature analysis, we found that expansion along the inferior and superior aspects of the hemispheres resulted in decreased convexity, which is likely due to the physical constraints of the dura surrounding the cerebellum and the adjacent brainstem. The paired decrease in convexity along the inferior vermis and increased convexity of the medial hemisphere represents development of the paravermian fissure, which becomes more visible during this period. In this 3D morphometric analysis of the human fetal cerebellum, we have shown that cerebellar growth is accelerating at a greater pace than the cerebrum and described how cerebellar growth impacts the shape of the structure.


Assuntos
Cerebelo/anatomia & histologia , Cerebelo/embriologia , Adulto , Feminino , Desenvolvimento Fetal/fisiologia , Idade Gestacional , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Idade Materna , Gravidez , Ultrassonografia Pré-Natal/métodos , Adulto Jovem
18.
Science ; 375(6579): eabk2346, 2022 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-35084970

RESUMO

The human cortex contains inhibitory interneurons derived from the medial ganglionic eminence (MGE), a germinal zone in the embryonic ventral forebrain. How this germinal zone generates sufficient interneurons for the human brain remains unclear. We found that the human MGE (hMGE) contains nests of proliferative neuroblasts with ultrastructural and transcriptomic features that distinguish them from other progenitors in the hMGE. When dissociated hMGE cells are transplanted into the neonatal mouse brain, they reform into nests containing proliferating neuroblasts that generate young neurons that migrate extensively into the mouse forebrain and mature into different subtypes of functional interneurons. Together, these results indicate that the nest organization and sustained proliferation of neuroblasts in the hMGE provide a mechanism for the extended production of interneurons for the human forebrain.


Assuntos
Interneurônios/fisiologia , Eminência Mediana/embriologia , Células-Tronco Neurais/fisiologia , Neurogênese , Prosencéfalo/citologia , Animais , Animais Recém-Nascidos , Movimento Celular , Proliferação de Células , Córtex Cerebral/citologia , Córtex Cerebral/embriologia , Córtex Cerebral/crescimento & desenvolvimento , Neurônios GABAérgicos/citologia , Neurônios GABAérgicos/fisiologia , Perfilação da Expressão Gênica , Idade Gestacional , Humanos , Interneurônios/citologia , Eminência Mediana/citologia , Eminência Mediana/crescimento & desenvolvimento , Camundongos , Células-Tronco Neurais/transplante , Prosencéfalo/embriologia , Prosencéfalo/crescimento & desenvolvimento , Transplante Heterólogo
19.
J Pediatr ; 158(3): 366-71, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20961562

RESUMO

OBJECTIVE: To hypothesize that detailed examination of early cerebellar volumes in time would distinguish differences in cerebellar growth associated with intraventricular hemorrhage (IVH) and white matter injury in preterm infants. STUDY DESIGN: Preterm newborns at the University of California San Francisco (n = 57) and the University of British Columbia (n = 115) were studied with serial magnetic resonance imaging scans near birth and again at near term-equivalent age. Interactive semi-automated tools were used to determine volumes of the cerebellar hemispheres. RESULTS: Adjusting for supratentorial brain injury, cerebellar hemorrhage, and study site, cerebellar volume increased 1.7 cm(3)/week postmenstrual age (95% CI, 1.6-1.7; P < .001). More severe supratentorial IVH was associated with slower growth of cerebellar volumes (P < .001). Volumes by 40 weeks were 1.4 cm(3) lower in premature infants with grade 1 to 2 IVH and 5.4 cm(3) lower in infants with grade 3 to 4 IVH. The same magnitude of decrease was found between ipsilateral and contralateral IVH. No association was found with severity of white matter injury (P = .3). CONCLUSIONS: Early effects of decreased cerebellar volume associated with supratentorial IVH in either hemisphere may be a result of concurrent cerebellar injury or direct effects of subarachnoid blood on cerebellar development.


Assuntos
Lesões Encefálicas/patologia , Cerebelo/crescimento & desenvolvimento , Ventrículos Cerebrais , Recém-Nascido Prematuro , Hemorragias Intracranianas/patologia , Leucoencefalopatias/patologia , Cerebelo/irrigação sanguínea , Cerebelo/lesões , Feminino , Humanos , Imageamento Tridimensional , Recém-Nascido , Estudos Longitudinais , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão , Análise de Regressão
20.
Pediatr Res ; 69(5 Pt 1): 425-9, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21270675

RESUMO

The hippocampal formation plays an important role in learning and memory; however, data on its development in utero in humans are limited. This study was performed to evaluate hippocampal development in healthy fetuses using 3D reconstructed MRI. A cohort of 20 healthy pregnant women underwent prenatal MRI at a median GA of 24.9 wk (range, 21.3-31.9 wk); six of the women also had a second fetal MRI performed at a 6-wk interval. Routine 2D ultrafast T2-weighted images were used to reconstruct a 3D volume image, which was then used to manually segment the right and left hippocampi. Total hippocampal volume was calculated for each subject and compared against GA. There was a linear increase in total hippocampal volume with increasing GA (p < 0.001). For subjects scanned twice, there was an increase in hippocampal size on the second fetal MRI (p = 0.0004). This represents the first volumetric study of fetal hippocampal development in vivo. This normative volumetric data will be helpful for future comparison studies of suspected developmental abnormalities of hippocampal structure and function.


Assuntos
Hipocampo/embriologia , Imageamento por Ressonância Magnética , Diagnóstico Pré-Natal/métodos , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Modelos Lineares , Masculino , Tamanho do Órgão , Gravidez , Valores de Referência , São Francisco
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