3D motion strategy for online volumetric thermometry using simultaneous multi-slice EPI at 1.5T: an evaluation study.

PURPOSE: In presence of respiratory motion, temperature mapping is altered by in-plane and through-plane displacements between successive acquisitions together with periodic phase variations. Fast 2D Echo Planar Imaging (EPI) sequence can accommodate intra-scan motion, but limited volume coverage and inter-scan motion remain a challenge during free-breathing acquisition since position offsets can arise between the different slices. METHOD: To address this limitation, we evaluated a 2D simultaneous multi-slice EPI sequence with multiband (MB) acceleration during radiofrequency ablation on a mobile gel and in the liver of a volunteer (no heating). The sequence was evaluated in terms of resulting inter-scan motion, temperature uncertainty and elevation, potential false-positive heating and repeatability. Lastly, to account for potential through-plane motion, a 3D motion compensation pipeline was implemented and evaluated. RESULTS: In-plane motion was compensated whatever the MB factor and temperature distribution was found in agreement during both the heating and cooling periods. No obvious false-positive temperature was observed under the conditions being investigated. Repeatability of measurements results in a 95% uncertainty below 2 °C for MB1 and MB2. Uncertainty up to 4.5 °C was reported with MB3 together with the presence of aliasing artifacts. Lastly, fast simultaneous multi-slice EPI combined with 3D motion compensation reduce residual out-of-plane motion. CONCLUSION: Volumetric temperature imaging (12 slices/700 ms) could be performed with 2 °C accuracy or less, and offer tradeoffs in acquisition time or volume coverage. Such a strategy is expected to increase procedure safety by monitoring large volumes more rapidly for MR-guided thermotherapy on mobile organs.

Practical challenges of continuous real-time functional magnetic resonance imaging neurofeedback with multiband accelerated echo-planar imaging and short repetition times.

Continuous real-time functional magnetic resonance imaging (fMRI) neurofeedback is gaining increasing scientific attention in clinical neuroscience and may benefit from the short repetition times of modern multiband echoplanar imaging sequences. However, minimizing feedback delay can result in technical challenges. Here, we report a technical problem we experienced during continuous fMRI neurofeedback with multiband echoplanar imaging and short repetition times. We identify the possible origins of this problem, describe our current interim solution and provide openly available workflows and code to other researchers in case they wish to use a similar approach.

STEAM-DWI as a robust alternative to EPI-DWI: Evaluation in pediatric brain MRI.

PURPOSE: Diffusion-weighted imaging (DWI) is an essential element of almost every brain MRI examination. The most widely applied DWI technique, a single-shot echo-planar imaging DWI (EPI-DWI) sequence, suffers from a high sensitivity to magnetic field inhomogeneities. As an alternative, a single-shot stimulated echo acquisition mode diffusion-weighted MRI (STEAM-DWI) has recently been re-introduced after it became significantly faster. The aim of the study was to investigate the applicability of STEAM-DWI as a substitute to EPI-DWI in a daily routine of pediatric radiology. METHODS: Retrospectively, brain MRI examinations of 208 children with both EPI-DWI and STEAM-DWI were assessed. Visual resolution and diagnostic confidence were evaluated, the extent of susceptibility artifacts was quantified, and contrast-to-noise ratio was calculated in case of diffusion restriction. Furthermore, the correlation of apparent diffusion coefficient values between STEAM-DWI and EPI-DWI was tested. RESULTS: STEAM-DWI was inferior to EPI-DWI in visual resolution but with higher diagnostic confidence and lower artifact size. The apparent diffusion coefficient values of both sequences demonstrated excellent correlation. The contrast-to-noise ratio of STEAM-DWI was only half of that of EPI-DWI (58% resp. 112%). CONCLUSION: STEAM-DWI is a robust alternative to EPI-DWI when increased susceptibility artifacts are to be expected. Drawbacks are a lower contrast-to-noise ratio and poorer visual resolution.

Distinct neural-behavioral correspondence within face processing and attention networks for the composite face effect.

The composite face effect (CFE) is recognized as a hallmark for holistic face processing, but our knowledge remains sparse about its cognitive and neural loci. Using functional magnetic resonance imaging with independent localizer and complete composite face task, we here investigated its neural-behavioral correspondence within face processing and attention networks. Complementing classical comparisons, we adopted a dimensional reduction approach to explore the core cognitive constructs of the behavioral CFE measurement. Our univariate analyses found an alignment effect in regions associated with both the extended face processing network and attention networks. Further representational similarity analyses based on Euclidian distances among all experimental conditions were used to identify cortical regions with reliable neural-behavioral correspondences. Multidimensional scaling and hierarchical clustering analyses for neural-behavioral correspondence data revealed two principal components underlying the behavioral CFE effect, which fit best to the neural responses in the bilateral insula and medial frontal gyrus. These findings highlight the distinct neurocognitive contributions of both face processing and attentional networks to the behavioral CFE outcome, which bridge the gaps between face recognition and attentional control models.

Mapping the subcortical connectivity of the human default mode network.

The default mode network (DMN) mediates self-awareness and introspection, core components of human consciousness. Therapies to restore consciousness in patients with severe brain injuries have historically targeted subcortical sites in the brainstem, thalamus, hypothalamus, basal forebrain, and basal ganglia, with the goal of reactivating cortical DMN nodes. However, the subcortical connectivity of the DMN has not been fully mapped, and optimal subcortical targets for therapeutic neuromodulation of consciousness have not been identified. In this work, we created a comprehensive map of DMN subcortical connectivity by combining high-resolution functional and structural datasets with advanced signal processing methods. We analyzed 7 Tesla resting-state functional MRI (rs-fMRI) data from 168 healthy volunteers acquired in the Human Connectome Project. The rs-fMRI blood-oxygen-level-dependent (BOLD) data were temporally synchronized across subjects using the BrainSync algorithm. Cortical and subcortical DMN nodes were jointly analyzed and identified at the group level by applying a novel Nadam-Accelerated SCAlable and Robust (NASCAR) tensor decomposition method to the synchronized dataset. The subcortical connectivity map was then overlaid on a 7 Tesla 100 µm ex vivo MRI dataset for neuroanatomic analysis using automated segmentation of nuclei within the brainstem, thalamus, hypothalamus, basal forebrain, and basal ganglia. We further compared the NASCAR subcortical connectivity map with its counterpart generated from canonical seed-based correlation analyses. The NASCAR method revealed that BOLD signal in the central lateral nucleus of the thalamus and ventral tegmental area of the midbrain is strongly correlated with that of the DMN. In an exploratory analysis, additional subcortical sites in the median and dorsal raphe, lateral hypothalamus, and caudate nuclei were correlated with the cortical DMN. We also found that the putamen and globus pallidus are negatively correlated (i.e., anti-correlated) with the DMN, providing rs-fMRI evidence for the mesocircuit hypothesis of human consciousness, whereby a striatopallidal feedback system modulates anterior forebrain function via disinhibition of the central thalamus. Seed-based analyses yielded similar subcortical DMN connectivity, but the NASCAR result showed stronger contrast and better spatial alignment with dopamine immunostaining data. The DMN subcortical connectivity map identified here advances understanding of the subcortical regions that contribute to human consciousness and can be used to inform the selection of therapeutic targets in clinical trials for patients with disorders of consciousness.

Tracking spatial dynamics of functional connectivity during a task.

Functional connectivity (FC) measured from functional magnetic resonance imaging (fMRI) provides a powerful tool to explore brain organization. Studies of the temporal dynamics of brain organization have shown a large temporal variability of the functional connectome, which may be associated with mental status transitions and/or adaptive process. Most dynamic studies, e.g. functional connectome and functional network connectivity (FNC), have focused on the macroscopic FC changes, i.e. the changes of temporal coherence across various brain network sources, nodes and/or regions of interest, where it is assumed within the network or node that the FC is static. In this paper, we develop a novel method to examine the spatial dynamics of FC, without the assumption of its intra-network stationarity. We applied our approach to fMRI data during an auditory oddball task (AOD) from twenty-two subjects, in an attempt to capture/validate the approach by evaluating whether spatial connectivity varies with task condition. The results showed that connectivity networks exhibit spatial variability over time, in addition to participating in conventional temporal dynamics, i.e. cross-network variability or dynamic functional network connectivity (dFNC). Furthermore, we studied the relationship of spatial dynamic in FC to cognitive processes, by performing a cluster analysis to evaluate an individual's functional correspondence towards the 'target' (oddball) detection from AOD task, and extracting cognitive task correspondence states as well as their dynamic FC spatial maps segregated by such states. We found a clear trend in different task-guided states, particularly, a prominent reduction of task stimulus synchrony state along with strong anticorrelation between default mode network (DMN) and cognitive attentional networks. We also observed an increasing occurrence of the task desynchrony state which showed an absence of DMN anticorrelation. The results highlight the impact of a well-studied cognitive task on the observed spatial dynamic structure. We also showed that the FC spatial dynamic pattern from our method largely corresponds to macroscopic dFNC patterns, but with more details and specifications over space, meanwhile the connectivity within the source itself provides novel information and varies over time. Overall, we demonstrate clear evidence of the presence of the (usually ignored) spatial dynamics of connectivity, its links to the task and implications of cognition/mental status.

Fiber Bragg Grating Sensors for Performance Evaluation of Fast Magnetic Resonance Thermometry on Synthetic Phantom.

The increasing recognition of minimally invasive thermal treatment of tumors motivate the development of accurate thermometry approaches for guaranteeing the therapeutic efficacy and safety. Magnetic Resonance Thermometry Imaging (MRTI) is nowadays considered the gold-standard in thermometry for tumor thermal therapy, and assessment of its performances is required for clinical applications. This study evaluates the accuracy of fast MRTI on a synthetic phantom, using dense ultra-short Fiber Bragg Grating (FBG) array, as a reference. Fast MRTI is achieved with a multi-slice gradient-echo echo-planar imaging (GRE-EPI) sequence, allowing monitoring the temperature increase induced with a 980 nm laser source. The temperature distributions measured with 1 mm-spatial resolution with both FBGs and MRTI were compared. The root mean squared error (RMSE) value obtained by comparing temperature profiles showed a maximum error of 1.2 °C. The Bland-Altman analysis revealed a mean of difference of 0.1 °C and limits of agreement 1.5/-1.3 °C. FBG sensors allowed to extensively assess the performances of the GRE-EPI sequence, in addition to the information on the MRTI precision estimated by considering the signal-to-noise ratio of the images (0.4 °C). Overall, the results obtained for the GRE-EPI fully satisfy the accuracy (~2 °C) required for proper temperature monitoring during thermal therapies.

Impact of bowel preparation with Fleet's™ enema on prostate MRI quality.

AIM: To investigate the effects of cleansing Fleet's™ enema (FE) on rectal distention and image quality of diffusion-weighted imaging (DWI) in prostate magnetic resonance imaging (MRI). METHODS: This study included 117 prospectively accrued active surveillance patients who underwent prostate MRI both without (prep-) and with bowel preparation consisting of FE (prep+) obtained within 12 months of each other. The anterior-posterior (AP) diameter of the rectum, degree of perceived distention in the rectum and image quality scores were assessed by two independent readers for both (prep- and prep+) scans. DWI distortion was assessed quantitatively using the degree of anatomic mismatches between images obtained at different b values and the T2-weighted MRI. DWI artifact was qualitatively scored based on the presence of blurring, poor signal-to-noise, and artifact lines. The difference in rectal AP diameters between the two methods was tested by the paired Wilcoxon rank test. Stuart Maxell test was used in comparing rectal distention, DWI distortion, and artifact. Reader agreement was estimated by kappa statistics. p values < 0.05 were considered statistically significant. RESULTS: Mean rectal AP diameter was significantly larger in prep- compared with prep+ scans (p = 0.002). Subjective scores demonstrated inter-reader variability. For instance, the rectal distention score was significantly lower in prep+ for reader 2 (p < 0.001) whereas it was not significant for reader 1 (p = 0.09). Reader 2 also found significant improvement in DWI distortion (p = 0.02) in prep+ scans. There was no significant difference between prep- and prep+ in DWI distortion and artifacts for reader 1 (p = 0.17 and p = 0.49, respectively), or DWI artifacts for reader 2 (p = 0.55). Kappa scores were moderate for rectal distension, but weak for DWI distortion, and artifacts. CONCLUSION: Bowel preparation with enema prior to prostate MRI may diminish rectal gas but has modest effects on DWI distortion and overall image quality. The value of bowel prep is not conclusively validated in this study.

Look-Locker FAIR TrueFISP for arterial spin labelling on mouse at 9.4 T.

Pulsed arterial spin labelling remains a non-invasive and highly used method for the study of rodent cerebral blood flow (CBF). Flow-sensitive alternating inversion recovery (FAIR) is one of the most commonly used MR-sequences for this purpose and exists with many different strategies to record the images. This study investigates Look-Locker (LL) TrueFISP readout for FAIR as an alternative to the standard EPI readout, which is provided by the manufacturer. The aim was to show the improved image quality using TrueFISP and to verify the reproducibility of the determination of the cerebral blood flow values. The measurement of many inversion points also allowed to investigate the influence of the correct blood relaxation rate on the fit of the CBF data. For the LL-FAIR TrueFISP an in-house written method was created. The method was tested on a group of C57BL/6 mice at the field strength of 9.4 T. The results show CBF maps with less distortion than for EPI and the values found are in good agreement with the literature. A comparison of the CBF values found with EPI and LL-TrueFISP shows very small differences, most being not significant. In conclusion, the method presented gives equivalent CBF maps in comparison to standard FAIR-EPI. Both methods have the same measurement time. TrueFISP has the advantage to EPI of producing undistorted images over larger areas of the mouse brain. It is advisable to check the value of the blood relaxation rate by measurement or to estimate it as a fitting parameter.

Effects of sound therapy on resting-state functional brain networks in patients with tinnitus: A graph-theoretical-based study.

BACKGROUND: Tinnitus is considered to be triggered by aberrant neural activity in the brain. Sound therapy is regarded as a reasonable management option for tinnitus treatment and has been applied in the clinical setting for decades. HYPOTHESIS: We hypothesized that sound therapy, a commonly used tinnitus treatment method, would alter the functional connectivity (FC) of brain regions in tinnitus models. STUDY TYPE: Longitudinal. POPULATION: Resting-state functional MRI data were collected from 27 tinnitus patients before and after 12 weeks of sound therapy. Twenty-seven age- and sex-matched healthy controls were also longitudinally scanned at the 12-week timepoint. FIELD STRENGTH: 3.0T MRI system and echo planar imaging (EPI) sequence, 3D brain volume imaging (BRAVO) sequence. ASSESSMENT: Functional connectivity strength (FCS), a graph-theoretical-based analytic method, was applied to analyze the FC features in the whole brain. STATISTICAL TESTS: Student's t-test and chi-square test were used for analyses between two groups. A two-way analysis of covariance (ANCOVA) followed by post-hoc analyses was performed to determine differences of FC. RESULTS: The interaction effect between the two groups and two scans on FCS was observed in the bilateral thalami and left anterior cingulate cortex (ACC). The fitted FCS values in the bilateral thalami were significantly higher in tinnitus patients at baseline and decreased to a relatively normal range after sound therapy compared with healthy controls. Conversely, the fitted FCS values in the left ACC were within the normal range, but increased after treatment (1.08 ± 0.29, P < 0.02); however, there was no change in the control group. Importantly, significant correlations were observed between the FCS changes in the right thalamus (P = 0.028), the FC of the right thalamus-right inferior frontal gyrus (P = 0.015), and symptomatic improvement. DATA CONCLUSION: Sound therapy may modulate the brain network by altering the gating function of the thalamus as well as enhancing the tinnitus-canceling system. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 4 J. Magn. Reson. Imaging 2019;50:1731-1741.

Improved MR thermometry for laser interstitial thermotherapy.

OBJECTIVES: To develop, test and evaluate improved 2D and 3D protocols for proton resonance frequency shift magnetic resonance temperature imaging (MRTI) of laser interstitial thermal therapy (LITT). The objective was to develop improved MRTI protocols in terms of temperature measurement precision and volume coverage compared to the 2D MRTI protocol currently used with a commercially available LITT system. METHODS: Four different 2D protocols and four different 3D protocols were investigated. The 2D protocols used multi-echo readouts to prolong the total MR sampling time and hence the MRTI precision, without prolonging the total acquisition time. The 3D protocols provided volumetric thermometry by acquiring a slab of 12 contiguous slices in the same acquisition time as the 2D protocols. The study only considered readily available pulse sequences (Cartesian 2D and 3D gradient recalled echo and echo planar imaging [EPI]) and methods (partial Fourier and parallel imaging) to ensure wide availability and rapid clinical implementation across vendors and field strengths. In vivo volunteer studies were performed to investigate and compare MRTI precision and image quality. Phantom experiments with LITT heating were performed to investigate and compare MRTI precision and accuracy. Different coil setups were used in the in vivo studies to assess precision differences between using local (such as flex and head coils) and non-local (i.e., body coil) receive coils. Studies were performed at both 1.5 T and 3 T. RESULTS: The improved 2D protocols provide up to a factor of two improvement in the MRTI precision in the same acquisition time, compared to the currently used clinical protocol. The 3D echo planar imaging protocols provide comparable precision as the currently used 2D clinical protocol, but over a substantially larger field of view, without increasing the acquisition time. As expected, local receive coils perform substantially better than the body coil, and 3 T provides better MRTI accuracy and precision than 1.5 T. 3D data can be zero-filled interpolated in all three dimensions (as opposed to just two dimensions for 2D data), reducing partial volume effects and measuring higher maximum temperature rises. CONCLUSIONS: With the presented protocols substantially improved MRTI precision (for 2D imaging) or greatly improved field of view coverage (for 3D imaging) can be achieved in the same acquisition time as the currently used protocol. Only widely available pulse sequences and acquisition methods were investigated, which should ensure quick translation to the clinic. Lasers Surg. Med. 51:286-300, 2019. © 2019 Wiley Periodicals, Inc.

Encoding of 3D head direction information in the human brain.

Head direction cells are critical for navigation because they convey information about which direction an animal is facing within an environment. To date, most studies on head direction encoding have been conducted on a horizontal two-dimensional (2D) plane, and little is known about how three-dimensional (3D) direction information is encoded in the brain despite humans and other animals living in a 3D world. Here, we investigated head direction encoding in the human brain while participants moved within a virtual 3D "spaceship" environment. Movement was not constrained to planes and instead participants could move along all three axes in volumetric space as if in zero gravity. Using functional magnetic resonance imaging (fMRI) multivoxel pattern similarity analysis, we found evidence that the thalamus, particularly the anterior portion, and the subiculum encoded the horizontal component of 3D head direction (azimuth). In contrast, the retrosplenial cortex was significantly more sensitive to the vertical direction (pitch) than to the azimuth. Our results also indicated that vertical direction information in the retrosplenial cortex was significantly correlated with behavioral performance during a direction judgment task. Our findings represent the first evidence showing that the "classic" head direction system that has been identified on a horizontal 2D plane also seems to encode vertical and horizontal heading in 3D space in the human brain.

Primary Interoceptive Cortex Activity during Simulated Experiences of the Body.

Studies of the classic exteroceptive sensory systems (e.g., vision, touch) consistently demonstrate that vividly imagining a sensory experience of the world-simulating it-is associated with increased activity in the corresponding primary sensory cortex. We hypothesized, analogously, that simulating internal bodily sensations would be associated with increased neural activity in primary interoceptive cortex. An immersive, language-based mental imagery paradigm was used to test this hypothesis (e.g., imagine your heart pounding during a roller coaster ride, your face drenched in sweat during a workout). During two neuroimaging experiments, participants listened to vividly described situations and imagined "being there" in each scenario. In Study 1, we observed significantly heightened activity in primary interoceptive cortex (of dorsal posterior insula) during imagined experiences involving vivid internal sensations. This effect was specific to interoceptive simulation: It was not observed during a separate affect focus condition in Study 1 nor during an independent Study 2 that did not involve detailed simulation of internal sensations (instead involving simulation of other sensory experiences). These findings underscore the large-scale predictive architecture of the brain and reveal that words can be powerful drivers of bodily experiences.

Neuroplasticity in the cerebello-thalamo-basal ganglia pathway: A longitudinal in vivo MRI study in male songbirds.

Similar to human speech, bird song is controlled by several pathways including a cortico-basal ganglia-thalamo-cortical (C-BG-T-C) loop. Neurotoxic disengagement of the basal ganglia component, i.e. Area X, induces long-term changes in song performance, while most of the lesioned area regenerates within the first months. Importantly however, the timing and spatial extent of structural neuroplastic events potentially affecting other constituents of the C-BG-T-C loop is not clear. We designed a longitudinal MRI study where changes in brain structure were evaluated relative to the time after neurotoxic lesioning or to vocal performance. By acquiring both Diffusion Tensor Imaging and 3-dimensional anatomical scans, we were able to track alterations in respectively intrinsic tissue properties and local volume. Voxel-based statistical analyses revealed structural remodeling remote to the lesion, i.e. in the thalamus and, surprisingly, the cerebellum, both peaking within the first two months after lesioning Area X. Voxel-wise correlations between song performance and MRI parameters uncovered intriguing brain-behavior relationships in several brain areas pertaining to the C-BG-T-C loop supervising vocal motor control. Our results clearly point to structural neuroplasticity in the cerebellum induced by basal ganglia (striatal) damage and might point to the existence of a human-like cerebello-thalamic-basal ganglia pathway capable of modifying vocal motor output.

Frequency-dependent functional connectivity of the nucleus accumbens during continuous transcutaneous vagus nerve stimulation in major depressive disorder.

Transcutaneous vagus nerve stimulation (tVNS) may be a promising treatment for major depressive disorder (MDD). In this exploratory study, fMRI scans were acquired during continuous real or sham tVNS from 41 MDD patients. Then, all patients received real or sham tVNS treatment for four weeks. We investigated the functional connectivity (FC) of the nucleus accumbens (NAc) at different frequency bands during real and sham tVNS and explored their associations with depressive symptom changes after one month of treatment. The results revealed: 1) significant positive FCs between the NAc and surrounding areas including the putamen, caudate, and distinct areas of the medial prefrontal cortex (MPFC) and the anterior cingulate cortex (ACC) during continuous real and sham tVNS; 2) compared with sham tVNS, real tVNS increased the FC between the left NAc and bilateral MPFC/rACC in the slow-5 band (0.008-0.027) and between the right NAc and left insula, occipital gyrus, and right lingual/fusiform gyrum in the typical low band (0.008-0.09); and 3) the FC of the NAc-MPFC/rACC during real tVNS showed a negative association with Hamilton Depression Rating Scale (HAMD) score changes in the real tVNS group after one month of treatment, but not in the sham group. Our findings demonstrate that tVNS can modulate low frequency intrinsic FC among key brain regions involved in reward and motivation processing and provide insights into the brain mechanism underlying tVNS treatment of MDD.

Phosphorus magnetic resonance spectroscopic imaging using flyback echo planar readout trajectories.

OBJECT: To present and evaluate a fast phosphorus magnetic resonance spectroscopic imaging (MRSI) sequence using echo planar spectroscopic imaging with flyback readout gradient trajectories. MATERIALS AND METHODS: Waveforms were designed and implemented using a 3 Tesla MRI system. 31P spectra were acquired with 2 × 2 cm2 and 3 × 3 cm2 resolution over a 20- and 21-cm field of view and spectral bandwidths up to 1923 Hz. The sequence was first tested using a 20-cm-diameter phosphate phantom, and subsequent in vivo tests were performed on healthy human calf muscles and brains from five volunteers. RESULTS: Flyback EPSI achieved 10× and 7× reductions in acquisition time, with 68.0 ± 1.2 and 69.8 ± 2.2% signal-to-noise ratio (SNR) per unit of time efficiency (theoretical SNR efficiency was 74.5 and 76.4%) for the in vivo experiments, compared to conventional phase-encoded MRSI for the 2 × 2 cm2 and 3 × 3 cm2 resolution waveforms, respectively. Statistical analysis showed no difference in the quantification of most metabolites. Time savings and SNR comparisons were consistent across phantom, leg and brain experiments. CONCLUSION: EPSI using flyback readout trajectories was found to be a reliable alternative for acquiring 31P-MRSI data in a shorter acquisition time.

Gas-induced susceptibility artefacts on diffusion-weighted MRI of the rectum at 1.5 T - Effect of applying a micro-enema to improve image quality.

PURPOSE: Assess whether application of a micro-enema can reduce gas-induced susceptibility artefacts in Single-shot Echo Planar Imaging (EPI) Diffusion-weighted imaging of the rectum at 1.5 T. MATERIALS AND METHODS: Retrospective analysis of n = 50 rectal cancer patients who each underwent multiple DWI-MRIs (1.5 T) from 2012 to 2016 as part of routine follow-up during a watch-and-wait approach after chemoradiotherapy. From March 2014 DWI-MRIs were routinely acquired after application of a preparatory micro-enema (Microlax®; 5 ml; self-administered shortly before acquisition); before March 2014 no bowel preparation was given. In total, 335 scans were scored by an experienced reader for the presence/severity of gas-artefacts (on b1000 DWI), ranging from 0 (no artefact) to 5 (severe artefact). A score ≥3 (moderate-severe) was considered a clinically relevant artefact. A random sample of 100 scans was re-assessed by a second independent reader to study inter-observer effects. Scores were compared between the scans performed without and with a preparatory micro-enema using univariable and multivariable logistic regression taking into account potential confounding factors (age/gender, acquisition parameters, MRI-hardware, rectoscopy prior to MRI). RESULTS: Clinically relevant gas-artefacts were seen in 24.3% (no micro-enema) vs. 3.7% (micro-enema), odds ratios were 0.118 in univariable and 0.230 in multivariable regression (P = 0.0005 and 0.0291). Mean severity score (±SD) was 1.19 ±â€¯1.71 (no-enema) vs 0.32 ±â€¯0.77 (micro-enema), odds ratios were 0.321 (P < 0.0001) and 0.489 (P = 0.0461) in uni- and multivariable regression, respectively. Inter-observer agreement was excellent (κ0.85). CONCLUSION: Use of a preparatory micro-enema shortly before rectal EPI-DWI examinations performed at 1.5 T MRI significantly reduces both the incidence and severity of gas-induced artefacts, compared to examinations performed without bowel preparation.

Abnormal structural and functional hypothalamic connectivity in mild traumatic brain injury.

PURPOSE: To investigate whether there is imaging evidence of hypothalamic injury in patients with mild traumatic brain injury (MTBI), which is a major public health problem due to the high prevalence and difficulty in diagnosis and treatment. MATERIALS AND METHODS: Twenty-four patients (mean age 34.2, range, 18-56 years) with symptomatic MTBI and 22 age-matched healthy controls (mean age 37.0, range 20-61 years) participated in the study. Diffusion kurtosis imaging was performed with diffusion-weighted images acquired along 30 gradient directions and three b-values (b = 0, 1000, 2000 s/mm2 ) based on a twice-refocused spin-echo sequence with a 3T magnetic resonance imaging (MRI) scanner. Resting-state functional (f)MRI with standard echo planar imaging (EPI) were performed to localize the resting-state networks (RSN) and hypothalamic functional connectivity. RESULTS: There were significantly reduced mean kurtosis (P = 0.0092) and radial kurtosis (P = 0.0078) in patients as compared to controls in the hypothalamus. Furthermore, there was a significant negative correlation (r = -0.675, P = 0.0007) between radial kurtosis in the hypothalamus and fatigue severity scale in patients. The MTBI group also showed disrupted hypothalamic RSNs, with significantly decreased positive connectivity in medial prefrontal cortex, inferior posterior parietal, and cingulate regions but increased connectivity in the peri-hypothalamic regions and cerebellum, together with significantly decreased negative RSNs in visual and bilateral premotor areas (cluster corrected P < 0.05). CONCLUSION: Our results show disruption of functional and structural hypothalamic connectivity in patients with MTBI, and might further the understanding of an array of clinical symptoms in MTBI such as sleep disturbance and fatigue. LEVEL OF EVIDENCE: 2 J. Magn. Reson. Imaging 2017;45:1105-1112.

The real-time fMRI neurofeedback based stratification of Default Network Regulation Neuroimaging data repository.

This data descriptor describes a repository of openly shared data from an experiment to assess inter-individual differences in default mode network (DMN) activity. This repository includes cross-sectional functional magnetic resonance imaging (fMRI) data from the Multi Source Interference Task, to assess DMN deactivation, the Moral Dilemma Task, to assess DMN activation, a resting state fMRI scan, and a DMN neurofeedback paradigm, to assess DMN modulation, along with accompanying behavioral and cognitive measures. We report technical validation from n=125 participants of the final targeted sample of 180 participants. Each session includes acquisition of one whole-brain anatomical scan and whole-brain echo-planar imaging (EPI) scans, acquired during the aforementioned tasks and resting state. The data includes several self-report measures related to perseverative thinking, emotion regulation, and imaginative processes, along with a behavioral measure of rapid visual information processing. Technical validation of the data confirms that the tasks deactivate and activate the DMN as expected. Group level analysis of the neurofeedback data indicates that the participants are able to modulate their DMN with considerable inter-subject variability. Preliminary analysis of behavioral responses and specifically self-reported sleep indicate that as many as 73 participants may need to be excluded from an analysis depending on the hypothesis being tested. The present data are linked to the enhanced Nathan Kline Institute, Rockland Sample and builds on the comprehensive neuroimaging and deep phenotyping available therein. As limited information is presently available about individual differences in the capacity to directly modulate the default mode network, these data provide a unique opportunity to examine DMN modulation ability in relation to numerous phenotypic characteristics.

Accelerated Echo Planer J-resolved Spectroscopic Imaging of Putamen and Thalamus in Obstructive Sleep Apnea.

UNLABELLED: Obstructive sleep apnea syndrome (OSAS) leads to neurocognitive and autonomic deficits that are partially mediated by thalamic and putamen pathology. We examined the underlying neurochemistry of those structures using compressed sensing-based 4D echo-planar J-resolved spectroscopic imaging (JRESI), and quantified values with prior knowledge fitting. Bilaterally increased thalamic mI/Cr, putamen Glx/Cr, and Glu/Cr, and bilaterally decreased thalamic and putamen tCho/Cr and GABA/Cr occurred in OSAS vs healthy subjects (p < 0.05). Increased right thalamic Glx/Cr, Glu/Cr, Gln/Cr, Asc/Cr, and decreased GPC/Cr and decreased left thalamic tNAA/Cr, NAA/Cr were detected. The right putamen showed increased mI/Cr and decreased tCho/Cr, and the left, decreased PE/Cr ratio. ROC curve analyses demonstrated 60-100% sensitivity and specificity for the metabolite ratios in differentiating OSAS vs. CONTROLS: Positive correlations were found between: left thalamus mI/Cr and baseline oxygen saturation (SaO2); right putamen tCho/Cr and apnea hypopnea index; right putamen GABA/Cr and baseline SaO2; left putamen PE/Cr and baseline SaO2; and left putamen NAA/Cr and SaO2 nadir (all p < 0.05). Negative correlations were found between left putamen PE/Cr and SaO2 nadir. These findings suggest underlying inflammation or glial activation, with greater alterations accompanying lower oxygen saturation. These metabolite levels may provide biomarkers for future neurochemical interventions by pharmacologic or other means.