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1.
Neuroimage ; 221: 117122, 2020 11 01.
Article in English | MEDLINE | ID: mdl-32634596

ABSTRACT

Structural neural network architecture patterns in the human brain could be related to individual differences in phenotype, behavior, genetic determinants, and clinical outcomes from neuropsychiatric disorders. Recent studies have indicated that a personalized neural (brain) fingerprint can be identified from structural brain connectomes. However, the accuracy, reproducibility and translational potential of personalized fingerprints in terms of cognition is not yet fully determined. In this study, we introduce a dynamic connectome modeling approach to identify a critical set of white matter subnetworks that can be used as a personalized fingerprint. Several individual variable assessments were performed that demonstrate the accuracy and practicality of personalized fingerprint, specifically predicting the identity and IQ of middle age adults, and the developmental quotient in toddlers. Our findings suggest the fingerprint found by our dynamic modeling approach is sufficient for differentiation between individuals, and is also capable of predicting general intellectual ability across human development.


Subject(s)
Cognition/physiology , Human Development/physiology , Intelligence/physiology , Learning/physiology , Machine Learning , Nerve Net/anatomy & histology , Neuroimaging , White Matter/anatomy & histology , Adult , Aged , Child, Preschool , Female , Humans , Infant , Magnetic Resonance Imaging , Male , Middle Aged , Nerve Net/diagnostic imaging , White Matter/diagnostic imaging , Young Adult
2.
Brain Lang ; 193: 31-44, 2019 06.
Article in English | MEDLINE | ID: mdl-27393391

ABSTRACT

Advanced, noninvasive imaging has revolutionized our understanding of language networks in the brain and is reshaping our approach to the presurgical evaluation of patients with epilepsy. Functional magnetic resonance imaging (fMRI) has had the greatest impact, unveiling the complexity of language organization and reorganization in patients with epilepsy both pre- and postoperatively, while volumetric MRI and diffusion tensor imaging have led to a greater appreciation of structural and microstructural correlates of language dysfunction in different epilepsy syndromes. In this article, we review recent literature describing how unimodal and multimodal imaging has advanced our knowledge of language networks and their plasticity in epilepsy, with a focus on the most frequently studied epilepsy syndrome in adults, temporal lobe epilepsy (TLE). We also describe how new analytic techniques (i.e., graph theory) are leading to a refined characterization of abnormal brain connectivity, and how subject-specific imaging profiles combined with clinical data may enhance the prediction of both seizure and language outcomes following surgical interventions.


Subject(s)
Epilepsy, Temporal Lobe/diagnostic imaging , Language Disorders/diagnostic imaging , Language , Nerve Net/diagnostic imaging , Neuroimaging/methods , Adult , Brain/physiopathology , Brain Mapping/methods , Diffusion Tensor Imaging/methods , Epilepsy, Temporal Lobe/physiopathology , Female , Humans , Language Disorders/physiopathology , Magnetic Resonance Imaging/methods , Male , Nerve Net/physiopathology
3.
AJNR Am J Neuroradiol ; 39(6): 1017-1024, 2018 06.
Article in English | MEDLINE | ID: mdl-29622553

ABSTRACT

BACKGROUND AND PURPOSE: Treatment with bevacizumab is standard of care for recurrent high-grade gliomas; however, monitoring response to treatment following bevacizumab remains a challenge. The purpose of this study was to determine whether quantifying the sharpness of the fluid-attenuated inversion recovery hyperintense border using a measure derived from texture analysis-edge contrast-improves the evaluation of response to bevacizumab in patients with high-grade gliomas. MATERIALS AND METHODS: MRIs were evaluated in 33 patients with high-grade gliomas before and after the initiation of bevacizumab. Volumes of interest within the FLAIR hyperintense region were segmented. Edge contrast magnitude for each VOI was extracted using gradients of the 3D FLAIR images. Cox proportional hazards models were generated to determine the relationship between edge contrast and progression-free survival/overall survival using age and the extent of surgical resection as covariates. RESULTS: After bevacizumab, lower edge contrast of the FLAIR hyperintense region was associated with poorer progression-free survival (P = .009) and overall survival (P = .022) among patients with high-grade gliomas. Kaplan-Meier curves revealed that edge contrast cutoff significantly stratified patients for both progression-free survival (log-rank χ2 = 8.3, P = .003) and overall survival (log-rank χ2 = 5.5, P = .019). CONCLUSIONS: Texture analysis using edge contrast of the FLAIR hyperintense region may be an important predictive indicator in patients with high-grade gliomas following treatment with bevacizumab. Specifically, low FLAIR edge contrast may partially reflect areas of early tumor infiltration. This study adds to a growing body of literature proposing that quantifying features may be important for determining outcomes in patients with high-grade gliomas.


Subject(s)
Antineoplastic Agents/therapeutic use , Bevacizumab/therapeutic use , Brain Neoplasms/diagnostic imaging , Glioma/diagnostic imaging , Image Interpretation, Computer-Assisted/methods , Adult , Aged , Brain Neoplasms/drug therapy , Brain Neoplasms/mortality , Female , Glioma/drug therapy , Glioma/mortality , Humans , Imaging, Three-Dimensional/methods , Kaplan-Meier Estimate , Magnetic Resonance Imaging/methods , Male , Middle Aged
4.
Opt Express ; 26(6): 7646-7654, 2018 Mar 19.
Article in English | MEDLINE | ID: mdl-29609317

ABSTRACT

Whereas the Kerr nonlinearity is well understood in the perturbative limit of nonlinear optics, there is considerable discussion about its functional form and magnitude at extreme intensities, at which point matter starts to ionize. Here, we introduce a concept to answer this question and theoretically analyze its feasibility. We demonstrate that seeded Kerr instability amplification provides clear signatures from which functional form and magnitude of the Kerr nonlinearity can be extracted in the non-perturbative limit of nonlinear optics.

5.
Phys Rev Lett ; 119(18): 183902, 2017 Nov 03.
Article in English | MEDLINE | ID: mdl-29219570

ABSTRACT

We investigate theoretically the effect of quantum confinement on high harmonic generation (HHG) in semiconductors by systematically varying the width of a model quantum nanowire. Our analysis reveals a reduction in ionization and a concurrent growth in HHG efficiency with increasing confinement. The drop in ionization results from an increase in the band gap due to stronger confinement. The increase in harmonic efficiency comes as a result of the confinement restricting the spreading of the transverse wave packet. As a result, intense laser driven 1D and 2D nanosystems present a potential pathway to increasing yield and photon energy of HHG in solids.

6.
Phys Rev Lett ; 118(17): 173601, 2017 Apr 28.
Article in English | MEDLINE | ID: mdl-28498686

ABSTRACT

Experiments on intense laser driven dielectrics have revealed population transfer to the conduction band to be oscillatory in time. This is in stark contrast to ionization in semiconductors and is currently unexplained. Current ionization theories neglect coupling between the valence and conduction band and therewith, the dynamic Stark shift. Our single-particle analysis identifies this as a potential reason for the different ionization behavior. The dynamic Stark shift increases the band gap with increasing laser intensities, thus suppressing ionization to an extent where virtual population oscillations become dominant. The dynamic Stark shift plays a role dominantly in dielectrics which, due to the larger band gap, can be exposed to significantly higher laser intensities.

7.
AJNR Am J Neuroradiol ; 38(5): 882-889, 2017 May.
Article in English | MEDLINE | ID: mdl-28279985

ABSTRACT

BACKGROUND AND PURPOSE: ADC as a marker of tumor cellularity has been promising for evaluating the response to therapy in patients with glioblastoma but does not successfully stratify patients according to outcomes, especially in the upfront setting. Here we investigate whether restriction spectrum imaging, an advanced diffusion imaging model, performed after an operation but before radiation therapy, could improve risk stratification in patients with newly diagnosed glioblastoma relative to ADC. MATERIALS AND METHODS: Pre-radiation therapy diffusion-weighted and structural imaging of 40 patients with glioblastoma were examined retrospectively. Restriction spectrum imaging and ADC-based hypercellularity volume fraction (restriction spectrum imaging-FLAIR volume fraction, restriction spectrum imaging-contrast-enhanced volume fraction, ADC-FLAIR volume fraction, ADC-contrast-enhanced volume fraction) and intensities (restriction spectrum imaging-FLAIR 90th percentile, restriction spectrum imaging-contrast-enhanced 90th percentile, ADC-FLAIR 10th percentile, ADC-contrast-enhanced 10th percentile) within the contrast-enhanced and FLAIR hyperintensity VOIs were calculated. The association of diffusion imaging metrics, contrast-enhanced volume, and FLAIR hyperintensity volume with progression-free survival and overall survival was evaluated by using Cox proportional hazards models. RESULTS: Among the diffusion metrics, restriction spectrum imaging-FLAIR volume fraction was the strongest prognostic metric of progression-free survival (P = .036) and overall survival (P = .007) in a multivariate Cox proportional hazards analysis, with higher values indicating earlier progression and shorter survival. Restriction spectrum imaging-FLAIR 90th percentile was also associated with overall survival (P = .043), with higher intensities, indicating shorter survival. None of the ADC metrics were associated with progression-free survival/overall survival. Contrast-enhanced volume exhibited a trend toward significance for overall survival (P = .063). CONCLUSIONS: Restriction spectrum imaging-derived cellularity in FLAIR hyperintensity regions may be a more robust prognostic marker than ADC and conventional imaging for early progression and poorer survival in patients with glioblastoma. However, future studies with larger samples are needed to explore its predictive ability.


Subject(s)
Brain Neoplasms/diagnostic imaging , Diffusion Magnetic Resonance Imaging/methods , Glioblastoma/diagnostic imaging , Adult , Brain Neoplasms/classification , Brain Neoplasms/pathology , Disease Progression , Disease-Free Survival , Female , Glioblastoma/classification , Glioblastoma/pathology , Humans , Male , Middle Aged , Prognosis , Proportional Hazards Models , Retrospective Studies
9.
Phys Rev Lett ; 115(19): 193603, 2015 Nov 06.
Article in English | MEDLINE | ID: mdl-26588381

ABSTRACT

The band structure of matter determines its properties. In solids, it is typically mapped with angle-resolved photoemission spectroscopy, in which the momentum and the energy of incoherent electrons are independently measured. Sometimes, however, photoelectrons are difficult or impossible to detect. Here we demonstrate an all-optical technique to reconstruct momentum-dependent band gaps by exploiting the coherent motion of electron-hole pairs driven by intense midinfrared femtosecond laser pulses. Applying the method to experimental data for a semiconductor ZnO crystal, we identify the split-off valence band as making the greatest contribution to tunneling to the conduction band. Our new band structure measurement technique is intrinsically bulk sensitive, does not require a vacuum, and has high temporal resolution, making it suitable to study reactions at ambient conditions, matter under extreme pressures, and ultrafast transient modifications to band structures.

10.
Nature ; 522(7557): 462-4, 2015 Jun 25.
Article in English | MEDLINE | ID: mdl-26108855

ABSTRACT

When intense light interacts with an atomic gas, recollision between an ionizing electron and its parent ion creates high-order harmonics of the fundamental laser frequency. This sub-cycle effect generates coherent soft X-rays and attosecond pulses, and provides a means to image molecular orbitals. Recently, high harmonics have been generated from bulk crystals, but what mechanism dominates the emission remains uncertain. To resolve this issue, we adapt measurement methods from gas-phase research to solid zinc oxide driven by mid-infrared laser fields of 0.25 volts per ångström. We find that when we alter the generation process with a second-harmonic beam, the modified harmonic spectrum bears the signature of a generalized recollision between an electron and its associated hole. In addition, we find that solid-state high harmonics are perturbed by fields so weak that they are present in conventional electronic circuits, thus opening a route to integrate electronics with attosecond and high-harmonic technology. Future experiments will permit the band structure of a solid to be tomographically reconstructed.

11.
Phys Rev Lett ; 113(7): 073901, 2014 Aug 15.
Article in English | MEDLINE | ID: mdl-25170708

ABSTRACT

We investigate theoretically high-harmonic generation (HHG) in bulk crystals exposed to intense midinfrared lasers with photon energies smaller than the band gap. The two main mechanisms, interband and intraband HHG, are explored. Our analysis indicates that the interband current neglected so far is the dominant mechanism for HHG. Saddle point analysis in the Keldysh limit yields an intuitive picture of interband HHG in solids similar to atomic HHG. Interband and intraband HHG exhibit a fundamentally different wavelength dependence. This signature can be used to experimentally distinguish between the two mechanisms in order to verify their importance.

12.
Neuroimage Clin ; 5: 197-207, 2014.
Article in English | MEDLINE | ID: mdl-25068109

ABSTRACT

OBJECTIVE/METHODS: Neuroimaging research has predominantly focused on exploring how cortical or subcortical brain abnormalities are related to language dysfunction in patients with neurological disease through the use of single modality imaging. Still, limited knowledge exists on how various MRI measures relate to each other and to patients' language performance. In this study, we explored the relationship between measures of regional cortical thickness, gray-white matter contrast (GWMC), white matter diffusivity [mean diffusivity (MD) and fractional anisotropy (FA)] and the relative contributions of these MRI measures to predicting language function across patients with temporal lobe epilepsy (TLE) and healthy controls. T1- and diffusion-weighted MRI data were collected from 56 healthy controls and 52 patients with TLE. By focusing on frontotemporal regions implicated in language function, we reduced each domain of MRI data to its principal component (PC) and quantified the correlations among these PCs and the ability of these PCs to explain the variation in vocabulary, naming and fluency. We followed up our significant findings by assessing the predictive power of the implicated PCs with respect to language impairment in our sample. RESULTS: We found significant positive associations between PCs representing cortical thickness, GWMC and FA that appeared to be partially mediated by changes in total brain volume. We also found a significant association between reduced FA and increased MD after controlling for confounding factors (e.g., age, field strength, total brain volume). Reduced FA was significantly associated with reductions in visual naming while increased MD was associated with reductions in auditory naming scores, even after controlling for the variability explained by reductions in hippocampal volumes. Inclusion of FA and MD PCs in predictive models of language impairment resulted in significant improvements in sensitivity and specificity of the predictions. CONCLUSIONS: Quantitative MRI measures from T1 and diffusion-weighted scans are unlikely to represent perfectly orthogonal vectors of disease in individuals with epilepsy. On the contrary, they exhibit highly intercorrelated PCs in their factor structures, which is consistent with an underlying pathological process that affects both the cortical and the subcortical structures simultaneously. In addition to hippocampal volume, the PCs of diffusion weighted measures (FA and MD) increase the sensitivity and specificity for determining naming impairment in patients with TLE. These findings underline the importance of combining multimodal imaging measures to better predict language performance in TLE that could extend to other patients with prominent language impairments.


Subject(s)
Brain/pathology , Epilepsy, Temporal Lobe/pathology , Language , Adolescent , Adult , Anisotropy , Brain/physiopathology , Diffusion Tensor Imaging , Epilepsy, Temporal Lobe/physiopathology , Female , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Middle Aged , Multimodal Imaging , Neuroimaging , Neuropsychological Tests , Young Adult
13.
Phys Rev Lett ; 111(9): 090405, 2013 Aug 30.
Article in English | MEDLINE | ID: mdl-24033008

ABSTRACT

A numerical method is developed by which the tunnel ionization dynamics of bound systems in laser fields can be isolated from the total wave function, as given by the time-dependent Schrödinger equation. The analysis of the numerical data for a step function field reveals the following definition for the tunnel time. It is the time it takes the ground state to develop the underbarrier wave function components necessary for reaching the static field ionization rate. This definition is generalized to time varying laser fields. The tunnel time is found to scale with the Keldysh tunnel time. Our Letter establishes the physical meaning of the tunnel time, its relation to the Keldysh tunnel time, and suggests how it can be measured.

14.
AJNR Am J Neuroradiol ; 34(6): 1157-63, 2013.
Article in English | MEDLINE | ID: mdl-23275591

ABSTRACT

BACKGROUND AND PURPOSE: DTI is being increasingly used to visualize critical white matter tracts adjacent to brain tumors before neurosurgical resection. However, brain tumors, particularly high-grade gliomas, are typically surrounded by regions of FLAIR hyperintensity that include edema, which increase isotropic diffusion, degrading the ability of standard DTI to uncover orientation estimates within these regions. We introduce a new technique, RSI, which overcomes this limitation by removing the spherical, fast diffusion component introduced by edema, providing better analysis of white matter architecture. MATERIALS AND METHODS: A total of 10 patients with high-grade gliomas surrounded by FLAIR-HI that at least partially resolved on follow-up imaging were included. All patients underwent RSI and DTI at baseline (FLAIR-HI present) and at follow-up (FLAIR-HI partially resolved). FA values obtained with RSI and DTI were compared within regions of FLAIR-HI and NAWM at both time points. RESULTS: RSI showed higher FA in regions of FLAIR-HI and NAWM relative to DTI, reflecting the ability of RSI to specifically measure the slow, restricted volume fraction in regions of edema and NAWM. Furthermore, a method by time interaction revealed that FA estimates increased when the FLAIR-HI resolved by use of standard DTI but remained stable with RSI. Tractography performed within the region of FLAIR-HI revealed the superior ability of RSI to track fibers through severe edema relative to standard DTI. CONCLUSIONS: RSI improves the quantification and visualization of white matter tracts in regions of peritumoral FLAIR-HI associated with edema relative to standard DTI and may provide a valuable tool for neurosurgical planning.


Subject(s)
Brain Edema/pathology , Brain Neoplasms/pathology , Diffusion Tensor Imaging/methods , Glioma/pathology , Nerve Fibers, Myelinated/pathology , Adult , Aged , Astrocytoma/pathology , Astrocytoma/surgery , Brain Edema/surgery , Brain Neoplasms/surgery , Female , Follow-Up Studies , Glioblastoma/pathology , Glioblastoma/surgery , Glioma/surgery , Humans , Longitudinal Studies , Male , Middle Aged , Preoperative Care
15.
AJNR Am J Neuroradiol ; 34(5): 958-64, S1, 2013 May.
Article in English | MEDLINE | ID: mdl-23139079

ABSTRACT

BACKGROUND AND PURPOSE: Restriction spectrum imaging is a sensitive DWI technique for probing separable water diffusion compartments in tissues. Here, we evaluate RSI-CMs derived from the spherically-restricted water compartment for improved tumor conspicuity and delineation from nontumor tissue and reduced sensitivity to edema compared with high-b-value DWI and ADC. MATERIALS AND METHODS: RSI was performed in 10 presurgical patients: 4 with glioblastoma, 3 with primary CNS lymphoma, and 3 with metastatic brain tumors. Multidirectional DWI data were collected at b = 500, 1500, and 4000 s/mm(2). Quantification of tumor conspicuity, edema conspicuity, and relative sensitivity to edema for RSI-CMs; DWI at b = 4000 (DWI-4000); and ADC were compared in manually drawn VOIs. Receiver operating characteristic curves were used to evaluate the sensitivity and specificity of each method for delineating tumor from normal-appearing WM. RESULTS: Significant TC was seen with both RSI-CMs and DWI-4000, but not ADC. Significant EC was seen with ADC, but not RSI-CMs or DWI-4000. Significantly greater TC was seen with RSI-CMs compared with DWI-4000. Significantly reduced RSE was seen with RSI-CMs compared with both DWI-4000 and ADC. Greater sensitivity and specificity for delineating tumor from normal-appearing WM were seen with RSI-CMs (AUC = 0.91) compared with both DWI-4000 (AUC = 0.77) and ADC (AUC = 0.66). CONCLUSIONS: RSI-CMs offer improved conspicuity and delineation of high-grade primary and metastatic brain tumors and reduced sensitivity to edema compared with high-b-value DWI and ADC.


Subject(s)
Brain Edema/etiology , Brain Edema/pathology , Brain Neoplasms/pathology , Brain Neoplasms/secondary , Diffusion Magnetic Resonance Imaging/methods , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Aged , Aged, 80 and over , Algorithms , Brain Neoplasms/complications , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
16.
Phys Rev Lett ; 111(25): 256801, 2013 Dec 20.
Article in English | MEDLINE | ID: mdl-24483751

ABSTRACT

An analytical expression for the quantum breathing frequency ωb of harmonically trapped quantum particles with inverse power-law repulsion is derived. It is verified by ab initio numerical calculations for electrons confined in a lateral (2D) quantum dot. We show how this relation can be used to express the ground state properties of harmonically trapped quantum particles as functions of the breathing frequency by presenting analytical results for the kinetic, trap, and repulsive energy and for the linear entropy. Measurement of ωb together with these analytical relations represents a tool to characterize the state of harmonically trapped interacting particles--from the Fermi gas to the Wigner crystal regime.

17.
J Int Neuropsychol Soc ; 18(1): 57-67, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22014246

ABSTRACT

The objective of this study is to investigate the relationships among frontotemporal fiber tract compromise and task-switching performance in healthy controls and patients with temporal lobe epilepsy (TLE). We performed diffusion tensor imaging (DTI) on 30 controls and 32 patients with TLE (15 left TLE). Fractional anisotropy (FA) was calculated for four fiber tracts [uncinate fasciculus (UncF), arcuate fasciculus (ArcF), dorsal cingulum (CING), and inferior fronto-occipital fasciculus (IFOF)]. Participants completed the Trail Making Test-B (TMT-B) and Verbal Fluency Category Switching (VFCS) test. Multivariate analyses of variances (MANOVAs) were performed to investigate group differences in fiber FA and set-shifting performances. Canonical correlations were used to examine the overall patterns of structural-cognitive relationships and were followed by within-group bivariate correlations. We found a significant canonical correlation between fiber FA and task-switching performance. In controls, TMT-B correlated with left IFOF, whereas VFCS correlated with FA of left ArcF and left UncF. These correlations were not significant in patients with TLE. We report significant correlations between frontotemporal fiber tract integrity and set-shifting performance in healthy controls that appear to be absent or attenuated in patients with TLE. These findings suggest a breakdown of typical structure-function relationships in TLE that may reflect aberrant developmental or degenerative processes.


Subject(s)
Attention Deficit Disorder with Hyperactivity/etiology , Epilepsy, Temporal Lobe/complications , Epilepsy, Temporal Lobe/pathology , Frontal Lobe/pathology , Temporal Lobe/pathology , Adult , Analysis of Variance , Anisotropy , Diffusion Tensor Imaging , Female , Humans , Image Processing, Computer-Assisted , Male , Nerve Fibers/pathology , Neuropsychological Tests , Trail Making Test , Young Adult
18.
Neurology ; 75(18): 1631-8, 2010 Nov 02.
Article in English | MEDLINE | ID: mdl-20881271

ABSTRACT

OBJECTIVE: To investigate postoperative changes in fiber tract integrity in patients with temporal lobe epilepsy (TLE) following anterior temporal lobectomy (ATL) and to determine whether postoperative changes are 1) stable vs progressive and 2) related to visual field defects. METHODS: Diffusion tensor imaging (DTI) was obtained in 7 patients with TLE before, 2 months after, and 1 year after ATL. Changes in fractional anisotropy (FA) were evaluated in a whole-brain voxel-wise analysis, as well within specific fiber tracts. Repeated-measures analysis of variance was performed to examine the time course of FA changes within ipsilateral and contralateral fiber tracts. Quantitative visual field analysis was performed to determine whether decreases in regional FA were related to the extent or location of visual field defects. RESULTS: Patients showed decreased FA 2 months post-ATL in ipsilateral fiber tracts transected during surgery (parahippocampal cingulum, uncinate fasciculus, inferior longitudinal fasciculus, and fornix), as well as in fiber tracts not directly transected (inferior fronto-occipital fasciculus and corpus callosum). Additional decreases in FA were not observed from 2 months to 1 year post-ATL. Visual field defects in most patients were characterized by incomplete quadrantanopsias. However, FA reductions in one patient extended into temporo-occipital cortex and the splenium of the corpus callosum and were associated with a complete hemianopia. CONCLUSIONS: Wallerian degeneration is apparent 2 months following unilateral ATLs in ipsilateral fibers directly and indirectly affected during surgery. These changes do not appear to progress over the course of a year, but may correlate with the nature and extent of postoperative visual field defects.


Subject(s)
Anterior Temporal Lobectomy/methods , Epilepsy, Temporal Lobe/surgery , Nerve Fibers, Myelinated/pathology , Visual Fields/physiology , Adult , Anisotropy , Brain Mapping , Diffusion Magnetic Resonance Imaging/methods , Electronic Data Processing , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging/methods , Male , Time Factors , Young Adult
19.
Neurology ; 73(6): 457-65, 2009 Aug 11.
Article in English | MEDLINE | ID: mdl-19667321

ABSTRACT

OBJECTIVE: To evaluate the spatial pattern and regional rates of neocortical atrophy from normal aging to early Alzheimer disease (AD). METHODS: Longitudinal MRI data were analyzed using high-throughput image analysis procedures for 472 individuals diagnosed as normal, mild cognitive impairment (MCI), or AD. Participants were divided into 4 groups based on Clinical Dementia Rating Sum of Boxes score (CDR-SB). Annual atrophy rates were derived by calculating percent cortical volume loss between baseline and 12-month scans. Repeated-measures analyses of covariance were used to evaluate group differences in atrophy rates across regions as a function of impairment. Planned comparisons were used to evaluate the change in atrophy rates across levels of disease severity. RESULTS: In patients with MCI-CDR-SB 0.5-1, annual atrophy rates were greatest in medial temporal, middle and inferior lateral temporal, inferior parietal, and posterior cingulate. With increased impairment (MCI-CDR-SB 1.5-2.5), atrophy spread to parietal, frontal, and lateral occipital cortex, followed by anterior cingulate cortex. Analysis of regional trajectories revealed increasing rates of atrophy across all neocortical regions with clinical impairment. However, increases in atrophy rates were greater in early disease within medial temporal cortex, whereas increases in atrophy rates were greater at later stages in prefrontal, parietal, posterior temporal, parietal, and cingulate cortex. CONCLUSIONS: Atrophy is not uniform across regions, nor does it follow a linear trajectory. Knowledge of the spatial pattern and rate of decline across the spectrum from normal aging to Alzheimer disease can provide valuable information for detecting early disease and monitoring treatment effects at different stages of disease progression.


Subject(s)
Aging/pathology , Alzheimer Disease/pathology , Neocortex/pathology , Aged , Aged, 80 and over , Alzheimer Disease/diagnosis , Alzheimer Disease/physiopathology , Atrophy/pathology , Cross-Sectional Studies , Disease Progression , Early Diagnosis , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Neocortex/physiology
20.
AJNR Am J Neuroradiol ; 30(9): 1740-7, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19509072

ABSTRACT

BACKGROUND AND PURPOSE: Noninvasive imaging plays a pivotal role in lateralization of the seizure focus in presurgical patients with temporal lobe epilepsy (TLE). Our goal was to evaluate the utility of diffusion tensor imaging (DTI) tractography in TLE. MATERIALS AND METHODS: Twenty-one patients with TLE (11 right, 10 left TLE) and 21 controls were enrolled. A 1.5T MR imaging scanner was used to obtain 51 diffusion-gradient-direction images per subject. Eight pairs of white matter fiber tracts were traced, and fiber tract fractional anisotropy (FA) was calculated and compared with controls. Fiber tract FA asymmetry and discriminant function analysis were evaluated in all subjects and fiber tracts respectively. RESULTS: Compared with controls, patients with TLE demonstrated decreased FA in 5 ipsilateral fiber tracts. Patients with left TLE had 6 ipsilateral and 4 contralateral fiber tracts with decreased FA. Patients with right TLE had 4 ipsilateral but no contralateral tracts with decreased FA compared with controls. Right-sided FA asymmetry was demonstrated in patients with right TLE for 5 fiber tracts, and left-sided asymmetry, for patients with left TLE for 1 fiber tract. Discriminant function analysis correctly categorized patients into left-versus-right TLE in 90% of all cases (100% correct in all patients without hippocampal sclerosis) by using uncinate fasciculus and parahippocampal fiber tracts. CONCLUSIONS: We found widespread reductions in fiber tract FA in patients with TLE, which were most pronounced ipsilateral to the seizure focus. Patients with left TLE had greater, more diffuse changes, whereas patients with right TLE showed changes that were primarily ipsilateral. Disease was lateralized to a high degree independent of identifiable hippocampal pathology noted on conventional MR imaging.


Subject(s)
Diffusion Tensor Imaging/methods , Temporal Lobe/pathology , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
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