Treadmill walking exercise training and brain function in multiple sclerosis: Preliminary evidence setting the stage for a network-based approach to rehabilitation

Exercise training has been identified as a highly promising approach for managing the cognitive consequences of multiple sclerosis (MS). This study represents a secondary analysis of resting-state functional connectivity (RSFC) magnetic resonance imaging data from a pilot treadmill walking exercise training intervention for improving cognitive processing speed (CPS) in MS. There were large intervention effects on RSFC between the thalamus and right superior frontal gyrus (d = 1.92) and left medial frontal gyrus (d = 1.70). There further were moderate-to-large intervention effects on CPS (d = 0.72). Such preliminary data highlight FC within thalamocortical circuitry as a potential target for rehabilitation interventions for improving CPS in cognitively impaired individuals with MS.

Mechanical properties of porcine brain tissue in vivo and ex vivo estimated by MR elastography

The mechanical properties of brain tissue in vivo determine the response of the brain to rapid skull acceleration. These properties are thus of great interest to the developers of mathematical models of traumatic brain injury (TBI) or neurosurgical simulations. Animal models provide valuable insight that can improve TBI modeling. In this study we compare estimates of mechanical properties of the Yucatan mini-pig brain in vivo and ex vivo using magnetic resonance elastography (MRE) at multiple frequencies. MRE allows estimations of properties in soft tissue, either in vivo or ex vivo, by imaging harmonic shear wave propagation. Most direct measurements of brain mechanical properties have been performed using samples of brain tissue ex vivo. It has been observed that direct estimates of brain mechanical properties depend on the frequency and amplitude of loading, as well as the time post-mortem and condition of the sample. Using MRE in the same animals at overlapping frequencies, we observe that porcine brain tissue in vivo appears stiffer than porcine brain tissue samples ex vivo at frequencies of 100 Hz and 125 Hz, but measurements show closer agreement at lower frequencies.

The Relationship of Three-Dimensional Human Skull Motion to Brain Tissue Deformation in Magnetic Resonance Elastography Studies

In traumatic brain injury (TBI), membranes such as the dura mater, arachnoid mater, and pia mater play a vital role in transmitting motion from the skull to brain tissue. Magnetic resonance elastography (MRE) is an imaging technique developed for noninvasive estimation of soft tissue material parameters. In MRE, dynamic deformation of brain tissue is induced by skull vibrations during magnetic resonance imaging (MRI); however, skull motion and its mode of transmission to the brain remain largely uncharacterized. In this study, displacements of points in the skull, reconstructed using data from an array of MRI-safe accelerometers, were compared to displacements of neighboring material points in brain tissue, estimated from MRE measurements. Comparison of the relative amplitudes, directions, and temporal phases of harmonic motion in the skulls and brains of six human subjects shows that the skull-brain interface significantly attenuates and delays transmission of motion from skull to brain. In contrast, in a cylindrical gelatin "phantom," displacements of the rigid case (reconstructed from accelerometer data) were transmitted to the gelatin inside (estimated from MRE data) with little attenuation or phase lag. This quantitative characterization of the skull-brain interface will be valuable in the parameterization and validation of computer models of TBI.

Use of antibiotics in paediatric long-term care facilities

BACKGROUND

Adult long-term care (LTC) facilities have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC facilities.

AIM

To describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use.

METHODS

A retrospective cohort study was conducted from September 2012 to December 2015 in three paediatric LTC facilities. Medical records were reviewed for demographics, healthcare-associated infections (HAIs), antimicrobial use and diagnostic testing. Logistic regression was used to identify predictors for antibiotic use. The association between susceptibility testing results and appropriate antibiotic coverage was determined using Chi-squared test.

FINDINGS

Fifty-eight percent (413/717) of residents had at least one HAI, and 79% (325/413) of these residents were treated with at least one antibiotic course, totalling 2.75 antibiotic courses per 1000 resident-days. Length of enrolment greater than one year, having a neurological disorder, having a tracheostomy, and being hospitalized at least once during the study period were significantly associated with receiving antibiotics when controlling for facility (all P < 0.001). Diagnostic testing was performed for 40% of antibiotic-treated HAIs. Eighty-six percent of antibiotic courses for identified bacterial pathogens (201/233) provided appropriate coverage. Access to susceptibility testing was not associated with appropriate antibiotic choice (P = 0.26).

CONCLUSION

Use of antibiotics in paediatric LTC facilities is widespread. There is further need to assess antibiotic use in paediatric LTC facilities. Evaluation of the adverse outcomes associated with inappropriate antibiotic use, including the prevalence of resistant organisms in paediatric LTC facilities, is critical.

Magnetic resonance elastography for examining developmental changes in the mechanical properties of the brain

Magnetic resonance elastography (MRE) is a quantitative imaging technique for noninvasively characterizing tissue mechanical properties, and has recently emerged as a valuable tool for neuroimaging. The measured mechanical properties reflect the microstructural composition and organization of neural tissue, and have shown significant effects in many neurological conditions and normal, healthy aging, and evidence has emerged supporting novel relationships between mechanical structure and cognitive function. The sensitivity of MRE to brain structure, function, and health make it an ideal technique for studying the developing brain; however, brain MRE studies on children and adolescents have only just begun. In this article, we review brain MRE and its findings, discuss its potential role in developmental neuroimaging, and provide suggestions for researchers interested in adopting this technique.

Quantitative Testing of fMRI-Compatibility of an Electrically Active Mechatronic Device for Robot-Assisted Sensorimotor Protocols

OBJECTIVE

To develop a quantitative set of methods for testing the functional magnetic resonance imaging (fMRI) compatibility of an electrically-active mechatronic device developed to support sensorimotor protocols during fMRI.

METHODS

The set of methods includes phantom and in vivo experiments to measure the effect of a progressively broader set of noise sources potentially introduced by the device. Phantom experiments measure the radio-frequency (RF) noise and temporal noise-to-signal ratio (tNSR) introduced by the device. The in vivo experiment assesses the effect of the device on measured brain activation for a human subject performing a representative sensorimotor task. The proposed protocol was validated via experiments using a 3T MRI scanner operated under nominal conditions and with the inclusion of an electrically-active mechatronic device - the MR-SoftWrist - as the equipment under test (EUT).

RESULTS

Quantitative analysis of RF noise data allows detection of active RF noise sources both in controlled RF noise conditions, and in conditions resembling improper filtering of the EUT's electrical signals. In conditions where no RF noise was detectable, the presence and operation of the EUT did not introduce any significant increase in tNSR. A quantitative analysis conducted on in vivo measurements of the number of active voxels in visual and motor areas further showed no significant difference between EUT and baseline conditions.

CONCLUSION AND SIGNIFICANCE

The proposed set of quantitative methods supports the development and troubleshooting of electrically-active mechatronic devices for use in sensorimotor protocols with fMRI, and may be used for future testing of such devices.

Aerobic fitness, hippocampal viscoelasticity, and relational memory performance

The positive relationship between hippocampal structure, aerobic fitness, and memory performance is often observed among children and older adults; but evidence of this relationship among young adults, for whom the hippocampus is neither developing nor atrophying, is less consistent. Studies have typically relied on hippocampal volumetry (a gross proxy of tissue composition) to assess individual differences in hippocampal structure. While volume is not specific to microstructural tissue characteristics, microstructural differences in hippocampal integrity may exist even among healthy young adults when volumetric differences are not diagnostic of tissue health or cognitive function. Magnetic resonance elastography (MRE) is an emerging noninvasive imaging technique for measuring viscoelastic tissue properties and provides quantitative measures of tissue integrity. We have previously demonstrated that individual differences in hippocampal viscoelasticity are related to performance on a relational memory task; however, little is known about health correlates to this novel measure. In the current study, we investigated the relationship between hippocampal viscoelasticity and cardiovascular health, and their mutual effect on relational memory in a group of healthy young adults (N=51). We replicated our previous finding that hippocampal viscoelasticity correlates with relational memory performance. We extend this work by demonstrating that better aerobic fitness, as measured by VO2max, was associated with hippocampal viscoelasticity that mediated the benefits of fitness on memory function. Hippocampal volume, however, did not account for individual differences in memory. Therefore, these data suggest that hippocampal viscoelasticity may provide a more sensitive measure to microstructural tissue organization and its consequences to cognition among healthy young adults.

MR elastography measurement of the effect of passive warmup prior to eccentric exercise on thigh muscle mechanical properties

Purpose

To investigate the effect of warmup by application of the thermal agent Deep Heat (DH) on muscle mechanical properties using magnetic resonance elastography (MRE) at 3T before and after exercise‐induced muscle damage (EIMD).

Materials and Methods

Twenty male participants performed an individualized protocol designed to induce EIMD in the quadriceps. DH was applied to the thigh in 50% of the participants before exercise. MRE, T₂‐weighted MRI, maximal voluntary contraction (MVC), creatine kinase (CK) concentration, and muscle soreness were measured before and after the protocol to assess EIMD effects. Five participants were excluded: four having not experienced EIMD and one due to incidental findings.

Results

Total workload performed during the EIMD protocol was greater in the DH group than the control group (P < 0.03), despite no significant differences in baseline MVC (P = 0.23). Shear stiffness |G*| increased in the rectus femoris (RF) muscle in both groups (P < 0.03); however, DH was not a significant between‐group factor (P =  0.15). MVC values returned to baseline faster in the DH group (5 days) than the control group (7 days). Participants who displayed hyperintensity on T₂‐weighted images had a greater stiffness increase following damage than those without: RF; 0.61 kPa vs. 0.15 kPa, P < 0.006, vastus intermedius; 0.34 kPa vs. 0.03 kPa, P = 0.06.

Conclusion

EIMD produces increased muscle stiffness as measured by MRE, with the change in |G*| significantly increased when T₂ hyperintensity was present. DH did not affect CK concentration or soreness; however, DH participants produced greater workload during the EIMD protocol and exhibited accelerated MVC recovery.

Level of Evidence: 1

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2017;46:1115–1127.

High-resolution 1 H-MRSI of the brain using short-TE SPICE

PURPOSE

To improve signal-to-noise ratio (SNR) for high-resolution spectroscopic imaging using a subspace-based technique known as SPectroscopic Imaging by exploiting spatiospectral CorrElation (SPICE).

METHODS

The proposed method is based on a union-of-subspaces model of MRSI signals, which exploits the partial separability properties of water, lipid, baseline and metabolite signals. Enabled by this model, a special scheme is used for accelerated data acquisition, which includes a double-echo CSI component used to collect a "training" dataset (for determination of the basis functions) and a short-TE EPSI component used to collect a sparse "imaging" dataset (for determination of the overall spatiospectral distributions). A set of signal processing algorithms are developed to remove the water and lipid signals and jointly reconstruct the metabolite and baseline signals.

RESULTS

In vivo 1 H-MRSI results show that the proposed method can effectively remove the remaining water and lipid signals from sparse MRSI data acquired at 20 ms TE. Spatiospectral distributions of metabolite signals at 2 mm in-plane resolution with good SNR were obtained in a 15.5 min scan.

CONCLUSIONS

The proposed method can effectively remove nuisance signals and reconstruct high-resolution spatiospectral functions from sparse data to make short-TE SPICE possible. The method should prove useful for high-resolution 1 H-MRSI of the brain. Magn Reson Med 77:467-479, 2017. © 2016 International Society for Magnetic Resonance in Medicine.

Viscoelasticity of subcortical gray matter structures

Viscoelastic mechanical properties of the brain assessed with magnetic resonance elastography (MRE) are sensitive measures of microstructural tissue health in neurodegenerative conditions. Recent efforts have targeted measurements localized to specific neuroanatomical regions differentially affected in disease. In this work, we present a method for measuring the viscoelasticity in subcortical gray matter (SGM) structures, including the amygdala, hippocampus, caudate, putamen, pallidum, and thalamus. The method is based on incorporating high spatial resolution MRE imaging (1.6 mm isotropic voxels) with a mechanical inversion scheme designed to improve local measures in pre-defined regions (soft prior regularization [SPR]). We find that in 21 healthy, young volunteers SGM structures differ from each other in viscoelasticity, quantified as the shear stiffness and damping ratio, but also differ from the global viscoelasticity of the cerebrum. Through repeated examinations on a single volunteer, we estimate the uncertainty to be between 3 and 7% for each SGM measure. Furthermore, we demonstrate that the use of specific methodological considerations-higher spatial resolution and SPR-both decrease uncertainty and increase sensitivity of the SGM measures. The proposed method allows for reliable MRE measures of SGM viscoelasticity for future studies of neurodegenerative conditions. Hum Brain Mapp 37:4221-4233, 2016. © 2016 Wiley Periodicals, Inc.

Aerobic fitness is associated with greater hippocampal cerebral blood flow in children

The present study is the first to investigate whether cerebral blood flow in the hippocampus relates to aerobic fitness in children. In particular, we used arterial spin labeling (ASL) perfusion MRI to provide a quantitative measure of blood flow in the hippocampus in 73 7- to 9-year-old preadolescent children. Indeed, aerobic fitness was found to relate to greater perfusion in the hippocampus, independent of age, sex, and hippocampal volume. Such results suggest improved microcirculation and cerebral vasculature in preadolescent children with higher levels of aerobic fitness. Further, aerobic fitness may influence how the brain regulates its metabolic demands via blood flow in a region of the brain important for learning and memory. To add specificity to the relationship of fitness to the hippocampus, we demonstrate no significant association between aerobic fitness and cerebral blood flow in the brainstem. Our results reinforce the importance of aerobic fitness during a critical period of child development.

Observation of direction-dependent mechanical properties in the human brain with multi-excitation MR elastography

Magnetic resonance elastography (MRE) has shown promise in noninvasively capturing changes in mechanical properties of the human brain caused by neurodegenerative conditions. MRE involves vibrating the brain to generate shear waves, imaging those waves with MRI, and solving an inverse problem to determine mechanical properties. Despite the known anisotropic nature of brain tissue, the inverse problem in brain MRE is based on an isotropic mechanical model. In this study, distinct wave patterns are generated in the brain through the use of multiple excitation directions in order to characterize the potential impact of anisotropic tissue mechanics on isotropic inversion methods. Isotropic inversions of two unique displacement fields result in mechanical property maps that vary locally in areas of highly aligned white matter. Investigation of the corpus callosum, corona radiata, and superior longitudinal fasciculus, three highly ordered white matter tracts, revealed differences in estimated properties between excitations of up to 33%. Using diffusion tensor imaging to identify dominant fiber orientation of bundles, relationships between estimated isotropic properties and shear asymmetry are revealed. This study has implications for future isotropic and anisotropic MRE studies of white matter tracts in the human brain.

Medial temporal lobe viscoelasticity and relational memory performance

Structural and functional imaging studies have been among converging lines of evidence demonstrating the importance of the hippocampus in successful memory performance. The advent of a novel neuroimaging technique - magnetic resonance elastography (MRE) - now makes it possible for us to investigate the relationship between the microstructural integrity of hippocampal tissue and successful memory processing. Mechanical properties of brain tissue estimated with MRE provide a measure of the integrity of the underlying tissue microstructure and have proven to be sensitive measures of tissue health in neurodegeneration. However, until recently, MRE methods lacked sufficient resolution necessary to accurately examine specific neuroanatomical structures in the brain, and thus could not contribute to examination of specific structure-function relationships. In this study, we took advantage of recent developments in MRE spatial resolution and mechanical inversion techniques to measure the viscoelastic properties of the human hippocampus in vivo, and investigated how these properties reflect hippocampal function. Our data reveal a strong relationship between relative elastic/viscous behavior of the hippocampus and relational memory performance (N=20). This is the first report linking the mechanical properties of brain tissue with functional performance.

3D multislab, multishot acquisition for fast, whole-brain MR elastography with high signal-to-noise efficiency

PURPOSE

To develop an acquisition scheme for generating MR elastography (MRE) displacement data with whole-brain coverage, high spatial resolution, and adequate signal-to-noise ratio (SNR) in a short scan time.

THEORY AND METHODS

A 3D multislab, multishot acquisition for whole-brain MRE with 2.0 mm isotropic spatial resolution is proposed. The multislab approach allowed for the use of short repetition time to achieve very high SNR efficiency. High SNR efficiency allowed for a reduced acquisition time of only 6 min while the minimum SNR needed for inversion was maintained.

RESULTS

The mechanical property maps estimated from whole-brain displacement data with nonlinear inversion (NLI) demonstrated excellent agreement with neuroanatomical features, including the cerebellum and brainstem. A comparison with an equivalent 2D acquisition illustrated the improvement in SNR efficiency of the 3D multislab acquisition. The flexibility afforded by the high SNR efficiency allowed for higher resolution with a 1.6 mm isotropic voxel size, which generated higher estimates of brainstem stiffness compared with the 2.0 mm isotropic acquisition.

CONCLUSION

The acquisition presented allows for the capture of whole-brain MRE displacement data in a short scan time, and may be used to generate local mechanical property estimates of neuroanatomical features throughout the brain.

Magnetic Resonance Elastography Demonstrating Low Brain Stiffness in a Patient with Low-Pressure Hydrocephalus: Case Report

The authors describe the case of a 19-year-old female with shunted aqueductal stenosis who presented with low-pressure hydrocephalus that responded to negative pressure drainage. A magnetic resonance elastography scan performed 3 weeks later demonstrated very low brain tissue stiffness (high brain tissue compliance). An analysis of the importance of this finding in understanding this rare condition is discussed.

Outcomes with multimodal therapy for elderly patients with rectal cancer

BACKGROUND

Treatment guidelines for stage II and III rectal cancer include neoadjuvant chemoradiotherapy, surgery and postoperative adjuvant chemotherapy. Although data support this recommendation in younger patients, it is unclear whether this benefit can be extrapolated to elderly patients (aged 75 years or older).

METHODS

This was a retrospective review of patients aged at least 75 years with stage II or III rectal cancer who underwent surgery with curative intent from 1996 to 2013 at the Mayo Clinic. Kaplan-Meier analysis and log rank test were used to compare overall survival between therapy groups. Cox proportional hazards model was used to estimate the independent effect of treatment group on survival.

RESULTS

A total of 160 elderly patients (median age 80 years) with stage II (66) and stage III (94) rectal cancer underwent surgical resection. Only 30·0 and 33·8 per cent received neoadjuvant or adjuvant therapy respectively. Among patients with stage II disease, there was no significant difference in 60-month survival between patients who received any additional therapy and those who had surgery alone (55 versus 38 per cent respectively; P = 0·184), whereas additional therapy improved survival in patients with stage III tumours (58 versus 30 per cent respectively; P = 0·007). Multivariable analysis found a survival benefit for additional therapy in elderly patients with stage III disease (hazard ratio 0·58, 95 per cent c.i. 0·34 to 0·98).

CONCLUSION

A multimodal approach in elderly patients with stage III rectal cancer improved oncological outcomes.

High-resolution (1) H-MRSI of the brain using SPICE: Data acquisition and image reconstruction

PURPOSE

To develop data acquisition and image reconstruction methods to enable high-resolution (1) H MR spectroscopic imaging (MRSI) of the brain, using the recently proposed subspace-based spectroscopic imaging framework called SPICE (SPectroscopic Imaging by exploiting spatiospectral CorrElation).

THEORY AND METHODS

SPICE is characterized by the use of a subspace model for both data acquisition and image reconstruction. For data acquisition, we propose a novel spatiospectral encoding scheme that provides hybrid data sets for determining the subspace structure and for image reconstruction using the subspace model. More specifically, we use a hybrid chemical shift imaging /echo-planar spectroscopic imaging sequence for two-dimensional (2D) MRSI and a dual-density, dual-speed echo-planar spectroscopic imaging sequence for three-dimensional (3D) MRSI. For image reconstruction, we propose a method that can determine the subspace structure and the high-resolution spatiospectral reconstruction from the hybrid data sets generated by the proposed sequences, incorporating field inhomogeneity correction and edge-preserving regularization.

RESULTS

Phantom and in vivo brain experiments were performed to evaluate the performance of the proposed method. For 2D MRSI experiments, SPICE is able to produce high-SNR spatiospectral distributions with an approximately 3 mm nominal in-plane resolution from a 10-min acquisition. For 3D MRSI experiments, SPICE is able to achieve an approximately 3 mm in-plane and 4 mm through-plane resolution in about 25 min.

CONCLUSION

Special data acquisition and reconstruction methods have been developed for high-resolution (1) H-MRSI of the brain using SPICE. Using these methods, SPICE is able to produce spatiospectral distributions of (1) H metabolites in the brain with high spatial resolution, while maintaining a good SNR. These capabilities should prove useful for practical applications of SPICE. Magn Reson Med 76:1059-1070, 2016. © 2015 Wiley Periodicals, Inc.

Field-inhomogeneity-corrected low-rank filtering of magnetic resonance spectroscopic imaging data

Low signal-to-noise ratio has been a major problem in magnetic resonance spectroscopic imaging (MRSI). A low-rank approximation based denoising method has been recently proposed to address this problem by exploiting the partial separability properties of MRSI data. However, field inhomogeneity, an unavoidable complication in practice, can violate the partial separability assumption and thus degrade the denoising performance of the low-rank filtering method. This paper presents a field-inhomogeneity-corrected low-rank filtering method to achieve more robust denoising of practical MRSI data. In vivo experiment results have been used to demonstrate the effectiveness of the proposed method.

Suitability of poroelastic and viscoelastic mechanical models for high and low frequency MR elastography

PURPOSE

Descriptions of the structure of brain tissue as a porous cellular matrix support application of a poroelastic (PE) mechanical model which includes both solid and fluid phases. However, the majority of brain magnetic resonance elastography (MRE) studies use a single phase viscoelastic (VE) model to describe brain tissue behavior, in part due to availability of relatively simple direct inversion strategies for mechanical property estimation. A notable exception is low frequency intrinsic actuation MRE, where PE mechanical properties are imaged with a nonlinear inversion algorithm.

METHODS

This paper investigates the effect of model choice at each end of the spectrum of in vivo human brain actuation frequencies. Repeat MRE examinations of the brains of healthy volunteers were used to compare image quality and repeatability for each inversion model for both 50 Hz externally produced motion and ≈1 Hz intrinsic motions. Additionally, realistic simulated MRE data were generated with both VE and PE finite element solvers to investigate the effect of inappropriate model choice for ideal VE and PE materials.

RESULTS

In vivo, MRE data revealed that VE inversions appear more representative of anatomical structure and quantitatively repeatable for 50 Hz induced motions, whereas PE inversion produces better results at 1 Hz. Reasonable VE approximations of PE materials can be derived by equating the equivalent wave velocities for the two models, provided that the timescale of fluid equilibration is not similar to the period of actuation. An approximation of the equilibration time for human brain reveals that this condition is violated at 1 Hz but not at 50 Hz. Additionally, simulation experiments when using the "wrong" model for the inversion demonstrated reasonable shear modulus reconstructions at 50 Hz, whereas cross-model inversions at 1 Hz were poor quality. Attenuation parameters were sensitive to changes in the forward model at both frequencies, however, no spatial information was recovered because the mechanisms of VE and PE attenuation are different.

CONCLUSIONS

VE inversions are simpler with fewer unknown properties and may be sufficient to capture the mechanical behavior of PE brain tissue at higher actuation frequencies. However, accurate modeling of the fluid phase is required to produce useful mechanical property images at the lower frequencies of intrinsic brain motions.

Improved Low-Rank Filtering of Magnetic Resonance Spectroscopic Imaging Data Corrupted by Noise and B₀ Field Inhomogeneity

GOAL

To improve the signal-to-noise ratio (SNR) of magnetic resonance spectroscopic imaging (MRSI) data.

METHODS

A low-rank filtering method recently proposed for denoising MRSI data is extended by: 1) incorporating tissue boundary constraints to enable local low-rank filtering, and 2) integrating B0 field inhomogeneity correction by rank-minimization to make the low-rank model more effective.

RESULTS

The proposed method was validated using both simulated and in vivo MRSI data. Its denoising performance is also compared with an upper bound based on the constrained Cramér-Rao lower bound for low-rank filtering.

CONCLUSION

Low-rank filtering can effectively improve the SNR of MRSI data corrupted by both noise and B0 field inhomogeneity.

SIGNIFICANCE

The proposed low-rank filtering method will enhance the practical utility of high-resolution MRSI, where SNR has been a limiting factor.

Fisheries Closed Areas Strengthen Scallop Larval Settlement and Connectivity Among Closed Areas and Across International Open Fishing Grounds: A Model Study

This study examined whether a measured increase in average body size of adult sea scallops inside three fishery closed areas on Georges Bank (GB), United States (US), was sufficient to increase larval supply to closed areas and open fishing areas in both US and Canadian areas of the Bank. The effects of adult scallop density-at-size and fecundity-at-size on egg production were compared among open and closed fishery areas, countries, and time periods before and after the closed areas were established. Estimated egg production was then used to define spawning conditions in a coupled biological-physical larval tracking model that simulated larval development, mortality, and dispersal. Results showed that order of magnitude increases in larval settlement after closure were facilitated by increases in size-dependant egg production inside and dispersal from Closed Areas I and II, but not Nantucket Lightship Closed Area. The distributions of both egg production and larval settlement became more uniform across the Bank, causing the relative contribution of Canadian larvae to US scallop aggregations to decrease after establishment of Closed Areas I and II. Decreases in small and medium-sized scallop density in Canada and decreases in large scallops over the US-Southern Flank after closure caused local declines in egg production but were not sufficient to negatively affect larval settlement at the regional scale. Our model suggests that the establishment of fishery closed areas on GB considerably strengthened larval supply and settlement within and among several adult scallop aggregations.