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1.
Int J Surg Case Rep ; 116: 109421, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38430895

RESUMO

INTRODUCTION ET IMPORTANCE: The iliac origin Ewing's sarcoma is a highly malignant primitive bone tumor. Its occurrence in adults is very rare. The prognosis for this tumor in adult patients is unfavorable and has a high rate of local recurrence. The main treatment goals include preventing local recurrences and distant metastases. A secondary objective is to maintain the quality of life by avoiding major amputative surgery. The primary aim of this report is to underscore the rarity and significance of the combination of surgery with neoadjuvant chemotherapy for better outcomes. CASE PRESENTATION: We present a rare case of Ewing's sarcoma of the right ilium without metastasis in a 50-year-old woman, treated with initial chemotherapy followed by extensive local marginal resection of the pelvic lesion, complemented by perimeter radiotherapy, and concluded with additional chemotherapy. The patient's progress has been satisfactory, with no recurrence observed during a 6-month follow-up period. CLINICAL DISCUSSION: The Ewing's sarcoma of the pelvis, being more aggressive than in other locations, presents an unfavorable prognosis, especially in cases of delayed diagnosis associated with large tumors and micrometastases. Therapeutic advancements, such as neoadjuvant chemotherapy, precise radiotherapy, and sophisticated preoperative planning, contribute to improving survival rates. Early diagnosis of Ewing's sarcoma of the ilium remains a challenge due to subtle changes difficult to detect on radiographs and nonspecific clinical symptoms. Ewing's sarcoma of the pelvis has an unfavorable prognosis due to the lack of a major anatomical barrier to tumor spread in this region. The treatment of this disease requires a multidisciplinary approach involving oncologists, radiation oncologists, surgeons, and radiologists. The effectiveness of surgery depends on the possibility of complete resection without excessive morbidity. The clarity of surgical margins influences the prognosis, although the presence of distant metastases remains the worst prognostic factor, with a limited long-term survival of 20 % despite aggressive treatment. Histological grades do not determine the prognosis, and long-term survival is generally reported between 60 % and 70 %, emphasizing the crucial importance of early detection and appropriate therapeutic intervention. CONCLUSION: In summary, the case of Ewing's sarcoma in the right ilium highlights the rarity and challenges associated with this highly malignant bone tumor. Despite the unfavorable prognosis often linked to delayed diagnosis in the pelvic region, a multidisciplinary approach, including surgical resection along with neoadjuvant chemotherapy and precise radiotherapy, shows promise in improving outcomes. The satisfactory progress of the patient over 6 months underscores the potential effectiveness of this treatment plan.

2.
Am J Gastroenterol ; 113(2): 265-272, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28809388

RESUMO

OBJECTIVES: Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period. METHODS: Pediatric-onset IBD (<17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification. RESULTS: 1,350 incident cases were recorded (8.3% of all IBD) including 990 Crohn's disease (CD), 326 ulcerative colitis (UC) and 34 IBD unclassified (IBDU). Median age at diagnosis was similar in CD (14.4 years (Q1=11.8-Q3=16.0)) and UC (14.0 years (11.0-16.0)) and did not change over time. There were significantly more males with CD (females/males=0.82) than UC (females/males=1.25) (P=0.0042). Median time between onset of symptoms and IBD diagnosis was consistently 3 months (1-6). Mean incidence was 4.4/105 for IBD overall (3.2 for CD, 1.1 for UC and 0.1 for IBDU). From 1988-1990 to 2009-2011, a dramatic increase in incidences of both CD and UC were observed in adolescents (10-16 years): for CD from 4.2 to 9.5/105 (+126%; P<0.001) and for UC, from 1.6 to 4.1/105 (+156%; P<0.001). No modification in age or location at diagnosis was observed in either CD or UC. CONCLUSIONS: In this population-based study, CD and UC incidences increased dramatically in adolescents across a 24-year span, suggesting that one or more strong environmental factors may predispose this population to IBD.


Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Adolescente , Criança , Feminino , França/epidemiologia , Humanos , Incidência , Doenças Inflamatórias Intestinais/epidemiologia , Masculino
3.
Eur J Neurol ; 24(8): 1040-1046, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28586096

RESUMO

BACKGROUND AND PURPOSE: Assessing survival is a critical issue in patients with amyotrophic lateral sclerosis (ALS). Neuroimaging seems to be promising in the assessment of disease severity and several studies also suggest a strong relationship between spinal cord (SC) atrophy described by magnetic resonance imaging (MRI) and disease progression. The aim of the study was to determine the predictive added value of multimodal SC MRI on survival. METHODS: Forty-nine ALS patients were recruited and clinical data were collected. Patients were scored on the Revised ALS Functional Rating Scale and manual muscle testing. They were followed longitudinally to assess survival. The cervical SC was imaged using the 3 T MRI system. Cord volume and cross-sectional area (CSA) at each vertebral level were computed. Diffusion tensor imaging metrics were measured. Imaging metrics and clinical variables were used as inputs for a multivariate Cox regression survival model. RESULTS: On building a multivariate Cox regression model with clinical and MRI parameters, fractional anisotropy, magnetization transfer ratio and CSA at C2-C3, C4-C5, C5-C6 and C6-C7 vertebral levels were significant. Moreover, the hazard ratio calculated for CSA at the C3-C4 and C5-C6 levels indicated an increased risk for patients with SC atrophy (respectively 0.66 and 0.68). In our cohort, MRI parameters seem to be more predictive than clinical variables, which had a hazard ratio very close to 1. CONCLUSIONS: It is suggested that multimodal SC MRI could be a useful tool in survival prediction especially if used at the beginning of the disease and when combined with clinical variables. To validate it as a biomarker, confirmation of the results in bigger independent cohorts of patients is warranted.


Assuntos
Esclerose Lateral Amiotrófica/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Medula Espinal/diagnóstico por imagem , Adulto , Idoso , Esclerose Lateral Amiotrófica/mortalidade , Esclerose Lateral Amiotrófica/patologia , Anisotropia , Estudos Transversais , Imagem de Tensor de Difusão/métodos , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Prognóstico , Medula Espinal/patologia , Taxa de Sobrevida
4.
Neuroimage Clin ; 8: 180-92, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26106542

RESUMO

Sensorimotor representations of movements are created in the sensorimotor network through repeated practice to support successful and effortless performance. Writer's cramp (WC) is a disorder acquired through extensive practice of finger movements, and it is likely associated with the abnormal acquisition of sensorimotor representations. We investigated (i) the activation and connectivity changes in the brain network supporting the acquisition of sensorimotor representations of finger sequences in patients with WC and (ii) the link between these changes and consolidation of motor performance 24 h after the initial practice. Twenty-two patients with WC and 22 age-matched healthy volunteers practiced a complex sequence with the right (pathological) hand during functional MRI recording. Speed and accuracy were measured immediately before and after practice (day 1) and 24 h after practice (day 2). The two groups reached equivalent motor performance on day 1 and day 2. During motor practice, patients with WC had (i) reduced hippocampal activation and hippocampal-striatal functional connectivity; and (ii) overactivation of premotor-striatal areas, whose connectivity correlated with motor performance after consolidation. These results suggest that patients with WC use alternative networks to reach equiperformance in the acquisition of new motor memories.


Assuntos
Distúrbios Distônicos/fisiopatologia , Hipocampo/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Córtex Motor/fisiopatologia , Neostriado/fisiopatologia , Prática Psicológica , Desempenho Psicomotor/fisiologia , Adulto , Feminino , Dedos/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade
5.
J Psychiatr Res ; 68: 285-92, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26037888

RESUMO

A continuum of phenotypes makes up the autism spectrum (AS). In particular, individuals show large differences in language acquisition, ranging from precocious speech to severe speech onset delay. However, the neurological origin of this heterogeneity remains unknown. Here, we sought to determine whether AS individuals differing in speech acquisition show different cortical responses to auditory stimulation and morphometric brain differences. Whole-brain activity following exposure to non-social sounds was investigated. Individuals in the AS were classified according to the presence or absence of Speech Onset Delay (AS-SOD and AS-NoSOD, respectively) and were compared with IQ-matched typically developing individuals (TYP). AS-NoSOD participants displayed greater task-related activity than TYP in the inferior frontal gyrus and peri-auditory middle and superior temporal gyri, which are associated with language processing. Conversely, the AS-SOD group only showed enhanced activity in the vicinity of the auditory cortex. We detected no differences in brain structure between groups. This is the first study to demonstrate the existence of differences in functional brain activity between AS individuals divided according to their pattern of speech development. These findings support the Trigger-threshold-target model and indicate that the occurrence of speech onset delay in AS individuals depends on the location of cortical functional reallocation, which favors perception in AS-SOD and language in AS-NoSOD.


Assuntos
Percepção Auditiva/fisiologia , Transtorno do Espectro Autista/fisiopatologia , Transtornos do Desenvolvimento da Linguagem/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Lobo Temporal/fisiopatologia , Estimulação Acústica , Adolescente , Adulto , Córtex Auditivo/fisiopatologia , Feminino , Humanos , Masculino , Plasticidade Neuronal/fisiologia , Adulto Jovem
6.
J Neuroradiol ; 42(4): 202-11, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24997478

RESUMO

PURPOSE: Severe traumatic brain injury (TBI) is characterized mainly by diffuse axonal injuries (DAI). The cortico-subcortical disconnections induced by such fiber disruption play a central role in consciousness recovery. We hypothesized that these cortico-subcortical deafferentations inferred from diffusion MRI data could differentiate between TBI patients with favorable or unfavorable (death, vegetative state, or minimally conscious state) outcome one year after injury. METHODS: Cortico-subcortical fiber density maps were derived by using probabilistic tractography from diffusion tensor imaging data acquired in 24 severe TBI patients and 9 healthy controls. These maps were compared between patients and controls as well as between patients with favorable (FO) and unfavorable (UFO) 1-year outcome to identify the thalamo-cortical and ponto-thalamo-cortical pathways involved in the maintenance of consciousness. RESULTS: Thalamo-cortical and ponto-thalamo-cortical fiber density was significantly lower in TBI patients than in healthy controls. Comparing FO and UFO TBI patients showed thalamo-cortical deafferentation associated with unfavorable outcome for projections from ventral posterior and intermediate thalamic nuclei to the associative frontal, sensorimotor and associative temporal cortices. Specific ponto-thalamic deafferentation in projections from the upper dorsal pons (including the reticular formation) was also associated with unfavorable outcome. CONCLUSION: Fiber density of cortico-subcortical pathways as measured from diffusion MRI tractography is a relevant candidate biomarker for early prediction of one-year favorable outcome in severe TBI.


Assuntos
Lesão Axonal Difusa/patologia , Imagem de Tensor de Difusão/métodos , Ponte/lesões , Ponte/patologia , Tálamo/lesões , Tálamo/patologia , Adulto , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Substância Branca/lesões , Substância Branca/patologia
7.
Neuroimage ; 102 Pt 2: 817-27, 2014 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-25204864

RESUMO

The field of spinal cord MRI is lacking a common template, as existing for the brain, which would allow extraction of multi-parametric data (diffusion-weighted, magnetization transfer, etc.) without user bias, thereby facilitating group analysis and multi-center studies. This paper describes a framework to produce an unbiased average anatomical template of the human spinal cord. The template was created by co-registering T2-weighted images (N = 16 healthy volunteers) using a series of pre-processing steps followed by non-linear registration. A white and gray matter probabilistic template was then merged to the average anatomical template, yielding the MNI-Poly-AMU template, which currently covers vertebral levels C1 to T6. New subjects can be registered to the template using a dedicated image processing pipeline. Validation was conducted on 16 additional subjects by comparing an automatic template-based segmentation and manual segmentation, yielding a median Dice coefficient of 0.89. The registration pipeline is rapid (~15 min), automatic after one C2/C3 landmark manual identification, and robust, thereby reducing subjective variability and bias associated with manual segmentation. The template can notably be used for measurements of spinal cord cross-sectional area, voxel-based morphometry, identification of anatomical features (e.g., vertebral levels, white and gray matter location) and unbiased extraction of multi-parametric data.


Assuntos
Substância Cinzenta/anatomia & histologia , Imageamento por Ressonância Magnética , Substância Branca/anatomia & histologia , Adulto , Feminino , Humanos , Masculino , Medula Espinal/anatomia & histologia
8.
Chir Main ; 32(3): 121-8, 2013 Jun.
Artigo em Francês | MEDLINE | ID: mdl-23731670

RESUMO

Functional MRI (fMRI) allowed considerable advances upon understanding of cerebral functioning. Cortical plasticity, which allows the voluntary command of a restored function by a transferred muscle remains to be investigated in its intimacy. The authors present here the round table held at the 48th annual meeting of the French Society for Surgery of the Hand on December 22nd, 2012. It tries to review the analysis of the phenomenon observed during multiple tendinous transfers for restoration of proximal radial nerve palsy. Were successively approached: 1) Methods of acquisition and analysis of the signals (C. D-M.); 2) Movement reorganization (O.M.); 3) Motor plasticity after hand allograft (A. S.); 4) The potential interest of the fMRI in hand rehabilitation (F. D.); 5) The analysis of cerebral plasticity in general (H. B.). A rather philosophical conclusion opens other fields to f MRI (A.M.).


Assuntos
Mãos/cirurgia , Imageamento por Ressonância Magnética , Neuropatia Radial/cirurgia , Tendões/transplante , Aloenxertos , França , Mãos/inervação , Humanos , Plasticidade Neuronal , Neuropatia Radial/diagnóstico , Neuropatia Radial/reabilitação , Recuperação de Função Fisiológica
9.
Neuroimage ; 63(1): 245-52, 2012 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-22776463

RESUMO

The evaluation of spinal cord neuronal activity in humans with functional magnetic resonance imaging (fMRI) is technically challenging. Major difficulties arise from cardiac and respiratory movement artifacts that constitute significant sources of noise. In this paper we assessed the Correction of Structured noise using spatial Independent Component Analysis (CORSICA). FMRI data of the cervical spinal cord were acquired in 14 healthy subjects using gradient-echo EPI. Nociceptive electrical stimuli were applied to the thumb. Additional data with short TR (250 ms, to prevent aliasing) were acquired to generate a spatial map of physiological noise derived from Independent Component Analysis (ICA). Physiological noise was subsequently removed from the long-TR data after selecting independent components based on the generated noise map. Stimulus-evoked responses were analyzed using the general linear model, with and without CORSICA and with a regressor generated from the cerebrospinal fluid region. Results showed higher sensitivity to detect stimulus-related activation in the targeted dorsal segment of the cord after CORSICA. Furthermore, fewer voxels showed stimulus-related signal changes in the CSF and outside the spinal region, suggesting an increase in specificity. ICA can be used to effectively reduce physiological noise in spinal cord fMRI time series.


Assuntos
Algoritmos , Potenciais Somatossensoriais Evocados/fisiologia , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Nociceptividade/fisiologia , Medula Espinal/fisiologia , Humanos , Análise de Componente Principal , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Razão Sinal-Ruído
10.
Neuroimage ; 57(3): 1068-76, 2011 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-21596140

RESUMO

One goal of in vivo neuroimaging is the detection of neurodegenerative processes and anatomical reorganizations after spinal cord (SC) injury. Non-invasive examination of white matter fibers in the living SC can be conducted using magnetic resonance diffusion-weighted imaging. However, this technique is challenging at the spinal level due to the small cross-sectional size of the cord and the presence of physiological motion and susceptibility artifacts. In this study, we acquired in vivo high angular resolution diffusion imaging (HARDI) data at 3T in cats submitted to partial SC injury. Cats were imaged before, 3 and 21 days after injury. Spatial resolution was enhanced to 1.5 × 1.5 × 1 mm(3) using super-resolution technique and distortions were corrected using the reversed gradient method. Tractography-derived regions of interest were generated in the dorsal, ventral, right and left quadrants, to evaluate diffusion tensor imaging (DTI) and Q-Ball imaging metrics with regards to their sensitivity in detecting primary and secondary lesions. A three-way ANOVA tested the effect of session (intact, D3, D21), cross-sectional region (left, right, dorsal and ventral) and rostrocaudal location. Significant effect of session was found for FA (P<0.001), GFA (P<0.05) and radial diffusivity (P<0.001). Post-hoc paired T-test corrected for multiple comparisons showed significant changes at the lesion epicenter (P<0.005). More interestingly, significant changes were also found several centimeters from the lesion epicenter at both 3 and 21 days. This decrease was specific to the type of fibers, i.e., rostrally to the lesion on the dorsal aspect of the cord and caudally to the lesion ipsilaterally, suggesting the detection of Wallerian degeneration.


Assuntos
Imagem de Tensor de Difusão , Interpretação de Imagem Assistida por Computador/métodos , Traumatismos da Medula Espinal/patologia , Degeneração Walleriana/patologia , Animais , Gatos , Medula Espinal/patologia
11.
Neuroscience ; 179: 94-103, 2011 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-21277942

RESUMO

A broad range of motor skills, such as speech and writing, evolves with the ability to articulate elementary motor movements into novel sequences that come to be performed smoothly through practice. Neuroimaging studies in humans have demonstrated the involvement of the cerebello-cortical and striato-cortical motor loops in the course of motor sequence learning. Nonetheless, the nature of the improvement and brain mechanisms underlying different parameters of movement kinematics are not yet fully ascertained. We aimed at dissociating the cerebral substrates related to the increase in performance on two kinematic indices: velocity, that is the speed with which each single movement in the sequence is produced, and transitions, that is the duration of the gap between these individual movements. In this event-related fMRI experiment, participants practiced an eight-element sequence of finger presses on a keypad which allowed to record those kinematic movement parameters. Velocity was associated with activations in the ipsilateral spinocerebellum (lobules 4-5, 8 and medial lobule 6) and in the contralateral primary motor cortex. Transitions were associated with increased activity in the neocerebellum (lobules 6 bilaterally and lobule 4-5 ipsilaterally), as well as with activations within the right and left putamen and a broader bilateral network of motor cortical areas. These findings indicate that, rather than being the product of a single mechanism, the general improvement in motor performance associated with early motor sequence learning arises from at least two distinct kinematic processes, whose behavioral expressions are supported by partially overlapping and segregated brain networks.


Assuntos
Mapeamento Encefálico , Encéfalo/anatomia & histologia , Aprendizagem/fisiologia , Destreza Motora/fisiologia , Movimento/fisiologia , Adulto , Fenômenos Biomecânicos , Encéfalo/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino
12.
Neuroimage ; 55(3): 1024-33, 2011 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-21232610

RESUMO

Characterizing demyelination/degeneration of spinal pathways in traumatic spinal cord injured (SCI) patients is crucial for assessing the prognosis of functional rehabilitation. Novel techniques based on diffusion-weighted (DW) magnetic resonance imaging (MRI) and magnetization transfer (MT) imaging provide sensitive and specific markers of white matter pathology. In this paper we combined for the first time high angular resolution diffusion-weighted imaging (HARDI), MT imaging and atrophy measurements to evaluate the cervical spinal cord of fourteen SCI patients and age-matched controls. We used high in-plane resolution to delineate dorsal and ventrolateral pathways. Significant differences were detected between patients and controls in the normal-appearing white matter for fractional anisotropy (FA, p<0.0001), axial diffusivity (p<0.05), radial diffusivity (p<0.05), generalized fractional anisotropy (GFA, p<0.0001), magnetization transfer ratio (MTR, p<0.0001) and cord area (p<0.05). No significant difference was detected in mean diffusivity (p=0.41), T1-weighted (p=0.76) and T2-weighted (p=0.09) signals. MRI metrics were remarkably well correlated with clinical disability (Pearson's correlations, FA: p<0.01, GFA: p<0.01, radial diffusivity: p=0.01, MTR: p=0.04 and atrophy: p<0.01). Stepwise linear regressions showed that measures of MTR in the dorsal spinal cord predicted the sensory disability whereas measures of MTR in the ventro-lateral spinal cord predicted the motor disability (ASIA score). However, diffusion metrics were not specific to the sensorimotor scores. Due to the specificity of axial and radial diffusivity and MT measurements, results suggest the detection of demyelination and degeneration in SCI patients. Combining HARDI with MT imaging is a promising approach to gain specificity in characterizing spinal cord pathways in traumatic injury.


Assuntos
Doenças Desmielinizantes/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/métodos , Doenças Neurodegenerativas/patologia , Traumatismos da Medula Espinal/patologia , Adulto , Idoso , Artefatos , Atrofia , Avaliação da Deficiência , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Medula Espinal/patologia , Adulto Jovem
13.
Behav Brain Res ; 217(1): 117-21, 2011 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-20974183

RESUMO

This study aimed to determine the distinct contribution of slow (11-13 Hz) and fast (13-15 Hz) spindles in the consolidation process of a motor sequence learning task (MSL). Young subjects (n = 12) were trained on both a finger MSL task and a control (CTRL) condition, which were administered one week apart in a counterbalanced order. Subjects were asked to practice the MSL or CTRL task in the evening (approximately 9:00 p.m.) and their performance was retested on the same task 12h later (approximately 9:00 a.m.). Polysomnographic (PSG) recordings were performed during the night following training on either task, and an automatic algorithm was used to detect fast and slow spindles and to quantify their characteristics (i.e., density, amplitude, and duration). Statistical analyses revealed higher fast (but not slow) spindle density after training on the MSL than after practice of the CTRL task. The increase in fast spindle density on the MSL task correlated positively with overnight performance gains on the MSL task and with difference in performance gain between the MSL and CTRL tasks. Together, these results suggest that fast sleep spindles help activate the cerebral network involved in overnight MSL consolidation, while slow spindles do not appear to play a role in this mnemonic process.


Assuntos
Ondas Encefálicas/fisiologia , Memória/fisiologia , Desempenho Psicomotor/fisiologia , Adulto , Feminino , Humanos , Aprendizagem/fisiologia , Masculino , Polissonografia/métodos , Sono/fisiologia
14.
Neuroimage ; 44(2): 328-39, 2009 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-18938251

RESUMO

Functional magnetic resonance imaging (fMRI) of the spinal cord has been the subject of intense research for the last ten years. An important motivation for this technique is its ability to detect non-invasively neuronal activity in the spinal cord related to sensorimotor functions in various conditions, such as after spinal cord lesions. Although promising results of spinal cord fMRI have arisen from previous studies, the poor reproducibility of BOLD activations and their characteristics remain a major drawback. In the present study we investigated the reproducibility of BOLD fMRI in the spinal cord of cats (N=9) by repeating the same stimulation protocol over a long period (approximately 2 h). Cats were anaesthetized with ketamine, and spinal cord activity was induced by electrical stimulation of cutaneous nerves of the hind limbs. As a result, task-related signals were detected in most cats with relatively good spatial specificity. However, BOLD response significantly varied within and between cats. This variability was notably attributed to the moderate intensity of the stimulus producing a low amplitude haemodynamic response, variation in end-tidal CO(2) during the session, low signal-to-noise ratio (SNR) in spinal fMRI time series and animal-specific vascular anatomy. Original contributions of the present study are: (i) first spinal fMRI experiment in ketamine-anaesthetized animals, (ii) extensive study of intra- and inter-subject variability of activation, (iii) characterisation of static and temporal SNR in the spinal cord and (iv) investigation on the impact of CO(2) end-tidal level on the amplitude of BOLD response.


Assuntos
Estimulação Elétrica , Potenciais Evocados/fisiologia , Membro Posterior/inervação , Membro Posterior/fisiologia , Imageamento por Ressonância Magnética/métodos , Medula Espinal/fisiologia , Anestésicos/administração & dosagem , Animais , Gatos , Membro Posterior/efeitos dos fármacos , Ketamina/administração & dosagem , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Medula Espinal/efeitos dos fármacos
15.
Neuroimage ; 42(2): 739-49, 2008 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-18562214

RESUMO

Magnetic resonance diffusion tensor imaging (DTI) has been extensively applied to the spinal cord for depicting its architecture and for assessing its integrity following spinal lesions. However, DTI is limited in representing complex white matter architecture, notably in the presence of crossing fibres. Recently, q-ball imaging (QBI) has been proposed as a new method for recovering complex white matter architecture. We applied this technique to both ex vivo and in vivo spinal cords of cats using a 3T scanner. For the purpose of comparison, gradients have been applied in 55 and 100 encoding directions and b-values varied from 800 to 3000 s/mm(2). As a result, QBI was able to retrieve crossing fibre information, where the DTI approach was constrained in a unique diffusion direction. To our knowledge, this is the first study demonstrating the benefits of QBI for detecting the presence of longitudinal, commissural and dorso-ventral fibres in the spinal cord. It is a first step towards in vivo characterization of the healthy and injured human spinal cord using high angular resolution diffusion imaging and QBI.


Assuntos
Inteligência Artificial , Imagem de Difusão por Ressonância Magnética/métodos , Interpretação de Imagem Assistida por Computador/métodos , Fibras Nervosas Mielinizadas/ultraestrutura , Vias Neurais/anatomia & histologia , Reconhecimento Automatizado de Padrão/métodos , Medula Espinal/anatomia & histologia , Algoritmos , Animais , Gatos , Aumento da Imagem/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
16.
Int J Biomed Imaging ; 2008: 320195, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18299703

RESUMO

Using geodesics for inferring white matter fibre tracts from diffusion-weighted MR data is an attractive method for at least two reasons: (i) the method optimises a global criterion, and hence is less sensitive to local perturbations such as noise or partial volume effects, and (ii) the method is fast, allowing to infer on a large number of connexions in a reasonable computational time. Here, we propose an improved fast marching algorithm to infer on geodesic paths. Specifically, this procedure is designed to achieve accurate front propagation in an anisotropic elliptic medium, such as DTI data. We evaluate the numerical performance of this approach on simulated datasets, as well as its robustness to local perturbation induced by fiber crossing. On real data, we demonstrate the feasibility of extracting geodesics to connect an extended set of brain regions.

17.
Neuroimage ; 40(2): 685-697, 2008 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-18201909

RESUMO

Spinal cord diffusion tensor imaging (DTI) is challenging in many ways: the small size of the cord, physiological motion and susceptibility artifacts pose daunting obstacles to the acquisition of high-quality data. Here, we present DTI results computed from in vivo studies of the healthy and injured spinal cord of five cats. Both high spatial (1.1 mm3) and angular (55 directions) resolutions were used to optimise modelling of the diffusion process. Also, particular effort was directed towards a strategy that limits susceptibility artifacts. For validation purposes, acquisitions were repeated in two cats before and after making a spinal lesion. As a result, various axonal trajectories were identified by tractography including dorsal and ventral columns as well as lateral tracts. Also, fibre bundles showed robust disruption at the site of spinal cord injuries (partial and complete) via tractography, accompanied with significantly lower fractional anisotropy values at the site of lesions. Important outcomes of this work are (i) tractography-based localisation of anatomical tracts in the thoraco-lumbar spinal cord and (ii) in vivo assessment of axonal integrity following experimental spinal cord injury.


Assuntos
Imageamento por Ressonância Magnética , Traumatismos da Medula Espinal/patologia , Medula Espinal/anatomia & histologia , Animais , Gatos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética/métodos
18.
Artigo em Inglês | MEDLINE | ID: mdl-18001955

RESUMO

Magnetic resonance diffusion tensor imaging (DTI) of the spinal cord is challenging because of the cord's thin structure and the presence of physiological and susceptibility artifacts. To circumvent these issues, we developed a methodology for imaging the thoraco-lumbar spinal cord of cats at 3T using single-shot spin-echo echo planar imaging (ss-SE-EPI). The proposed method could potentially be applied to humans since it was developed on a clinical scanner with a standard spine coil. Results provide (i) suggestions for optimal slice orientation and phase encoding direction; (ii) an assessment of the benefits of parallel imaging to reduce geometric distortions; (iii) feasibility of acquiring quality diffusion weighted data in 13 minutes at a resolution of 1.1 mm(3) and (iv) determination of axonal disruption, in two cats with complete spinal cord transection, using tractography.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Traumatismos da Medula Espinal/patologia , Medula Espinal/anatomia & histologia , Animais , Axônios , Gatos , Processamento de Imagem Assistida por Computador/métodos , Nervos Espinhais/anatomia & histologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-18002408

RESUMO

Functional magnetic resonance imaging (fMRI) of the spinal cord produces dataset that are particularly noisy because of cardiac-related motions. Realignment methods allowing subject motion correction might be sensitive to such noisy dataset. By realigning and quantifying cardiac variance on spinal dataset, we showed that such procedures decrease cardiac noise within the volumes. This has a direct and positive impact on functional imaging when estimating the T-score by means of the general linear model.


Assuntos
Processamento de Imagem Assistida por Computador/instrumentação , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Movimento , Coluna Vertebral/anatomia & histologia , Coluna Vertebral/patologia , Algoritmos , Desenho de Equipamento , Análise de Fourier , Humanos , Modelos Estatísticos , Movimento (Física) , Miocárdio/patologia , Reprodutibilidade dos Testes , Medula Espinal/patologia , Técnica de Subtração , Resultado do Tratamento
20.
Med Image Anal ; 11(6): 616-29, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17643341

RESUMO

Due to its non-invasive nature and low cost, diffuse optical imaging (DOI) is becoming a commonly used technique to assess functional activation in the brain. When imaging with DOI, two major issues arise in the data analysis: (i) the separation of noise of physiological origin and the recovery of the functional response; (ii) the tomographic image reconstruction problem. This paper focuses on the first issue. Although the general linear model (GLM) has been extensively used in functional magnetic resonance imaging (fMRI), DOI has mostly relied on filtering and averaging of raw data to recover brain functional activation. This is mainly due to the high temporal resolution of DOI which implies a new design of the drift basis modelling physiology. In this paper, we provide (i) a filtering method based on cosine functions that is more adapted than standard averaging techniques for DOI specifically; (ii) a new mode-locking technique to recover small signals and locate them temporally with high precision (shift method). Results on real data show the capability of the shift method to retrieve HbR and HbO(2) peak locations.


Assuntos
Mapeamento Encefálico/métodos , Aumento da Imagem/métodos , Processamento de Imagem Assistida por Computador/métodos , Modelos Lineares , Imageamento por Ressonância Magnética , Teorema de Bayes , Simulação por Computador , Humanos
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