Association of peripheral blood pressure with gray matter volume in 19- to 40-year-old adults.

OBJECTIVE: To test whether elevated blood pressure (BP) relates to gray matter (GM) volume (GMV) changes in young adults who had not previously been diagnosed with hypertension (systolic BP [SBP]/diastolic BP [DBP] ≥140/90 mm Hg). METHODS: We associated BP with GMV from structural 3T T1-weighted MRI of 423 healthy adults between 19 and 40 years of age (mean age 27.7 ± 5.3 years, 177 women, SBP/DBP 123.2/73.4 ± 12.2/8.5 mm Hg). Data originated from 4 previously unpublished cross-sectional studies conducted in Leipzig, Germany. We performed voxel-based morphometry on each study separately and combined results in image-based meta-analyses (IBMA) to assess cumulative effects across studies. Resting BP was assigned to 1 of 4 categories: (1) SBP <120 and DBP <80 mm Hg, (2) SBP 120-129 or DBP 80-84 mm Hg, (3) SBP 130-139 or DBP 85-89 mm Hg, (4) SBP ≥140 or DBP ≥90 mm Hg. RESULTS: IBMA yielded the following results: (1) lower regional GMV was correlated with higher peripheral BP; (2) lower GMV was found with higher BP when comparing individuals in subhypertensive categories 3 and 2, respectively, to those in category 1; (3) lower BP-related GMV was found in regions including hippocampus, amygdala, thalamus, frontal, and parietal structures (e.g., precuneus). CONCLUSION: BP ≥120/80 mm Hg was associated with lower GMV in regions that have previously been related to GM decline in older individuals with manifest hypertension. Our study shows that BP-associated GM alterations emerge continuously across the range of BP and earlier in adulthood than previously assumed. This suggests that treating hypertension or maintaining lower BP in early adulthood might be essential for preventing the pathophysiologic cascade of asymptomatic cerebrovascular disease to symptomatic end-organ damage, such as stroke or dementia.

Quantitative Susceptibility Mapping of Amyloid-ß Aggregates in Alzheimer's Disease with 7T MR.

BACKGROUND: PET imaging is an established technique to detect cerebral amyloid-ß (Aß) plaques in vivo. Some preclinical and postmortem data report an accumulation of redox-active iron near Aß plaques. Quantitative susceptibility mapping (QSM) at high-field MRI enables iron deposits to be depicted with high spatial resolution. OBJECTIVE: Aim of this study was to examine whether iron and Aß plaque accumulation is related and thus, whether 7T MRI might be an additive diagnostic tool to Aß PET imaging. METHODS: Postmortem human Alzheimer's disease (AD) and healthy control (HC) frontal gray matter (GM) was imaged with 7T MRI which resulted in T1 maps and QSM. Aß plaque load was determined by histopathology. In vivo, 10 Aß PET-positive AD patients (74.1±6.0a) and 10 Aß PET-negative HCs (67.1±4.4a) underwent 7T MR examination and QSM maps were analyzed. Severity of cognitive deficits was determined by MMSE. RESULTS: Postmortem, the susceptibility of Aß plaque-containing GM were higher than those of Aß plaque-free GM (0.011±0.002 versus - 0.008±0.003 ppm, p < 0.001). In vivo, only the bilateral globus pallidus showed significantly higher susceptibility in AD patients compared to HCs (right: 0.277±0.018 versus - 0.009±0.009 ppm; left: 0.293±0.014 versus - 0.007±0.012 ppm, p < 0.0001). The pallidal QSM values were negatively correlated with those of the MMSE (r = - 0.69, p = 0.001). CONCLUSION: The postmortem study revealed significant susceptibility differences between the Aß plaque-containing and Aß plaque-free GM, whereas in vivo only the QSM values of the globus pallidus differed significantly between AD and HC group. The pallidal QSM values correlated with the severity of cognitive deficits. These findings encourage efforts to optimize the 7T-QSM methodology.

Investigating the dynamics of the brain response to music: A central role of the ventral striatum/nucleus accumbens.

Ventral striatal activity has been previously shown to correspond well to reward value mediated by music. Here, we investigate the dynamic brain response to music and manipulated counterparts using functional magnetic resonance imaging (fMRI). Counterparts of musical excerpts were produced by either manipulating the consonance/dissonance of the musical fragments or playing them backwards (or both). Results show a greater involvement of the ventral striatum/nucleus accumbens both when contrasting listening to music that is perceived as pleasant and listening to a manipulated version perceived as unpleasant (backward dissonant), as well as in a parametric analysis for increasing pleasantness. Notably, both analyses yielded a ventral striatal response that was strongest during an early phase of stimulus presentation. A hippocampal response to the musical stimuli was also observed, and was largely mediated by processing differences between listening to forward and backward music. This hippocampal involvement was again strongest during the early response to the music. Auditory cortex activity was more strongly evoked by the original (pleasant) music compared to its manipulated counterparts, but did not display a similar decline of activation over time as subcortical activity. These findings rather suggest that the ventral striatal/nucleus accumbens response during music listening is strongest in the first seconds and then declines.

Investigating brain response to music: a comparison of different fMRI acquisition schemes.

Functional magnetic resonance imaging (fMRI) in auditory experiments is a challenge, because the scanning procedure produces considerable noise that can interfere with the auditory paradigm. The noise might either mask the auditory material presented, or interfere with stimuli designed to evoke emotions because it sounds loud and rather unpleasant. Therefore, scanning paradigms that allow interleaved auditory stimulation and image acquisition appear to be advantageous. The sparse temporal sampling (STS) technique uses a very long repetition time in order to achieve a stimulus presentation in the absence of scanner noise. Although only relatively few volumes are acquired for the resulting data sets, there have been recent studies where this method has furthered remarkable results. A new development is the interleaved silent steady state (ISSS) technique. Compared with STS, this method is capable of acquiring several volumes in the time frame between the auditory trials (while the magnetization is kept in a steady state during stimulus presentation). In order to draw conclusions about the optimum fMRI procedure with auditory stimulation, different echo-planar imaging (EPI) acquisition schemes were compared: Continuous scanning, STS, and ISSS. The total acquisition time of each sequence was adjusted to about 12.5 min. The results indicate that the ISSS approach exhibits the highest sensitivity in detecting subtle activity in sub-cortical brain regions.

Cognitive dysfunction, urinary retention, and a lesion in the thalamus--beware of possible toxocariasis of the central nervous system.

Toxocariasis of the central nervous system is usually characterized by an eosinophilic meningitis, encephalitis or myelitis. We here report a patient with an at least 7 years history of unexplained neurologic signs and symptoms. MRI showed a cystic lesion in the left thalamus, compatible with a parasitic infection. Blood and CSF analyses were positive for Toxocara canis IgG Western-blot, but were otherwise unremarkable. The case report raises the question whether there are chronic or late variants of this disease.