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Park BS, Lee DA, Lee H, Kim J, Ko J, Lee WH, Yi J, Park KM. Correlation of diffusion tensor tractography with obstructive sleep apnea severity. Brain Behav 2024; 14:e3541. [PMID: 38773829 PMCID: PMC11109523 DOI: 10.1002/brb3.3541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/28/2024] [Accepted: 04/28/2024] [Indexed: 05/24/2024] Open
Abstract
INTRODUCTION Using correlation tractography, this study aimed to find statistically significant correlations between white matter (WM) tracts in participants with obstructive sleep apnea (OSA) and OSA severity. We hypothesized that changes in certain WM tracts could be related to OSA severity. METHODS We enrolled 40 participants with OSA who underwent diffusion tensor imaging (DTI) using a 3.0 Tesla MRI scanner. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and quantitative anisotropy (QA)-values were used in the connectometry analysis. The apnea-hypopnea index (AHI) is a representative measure of the severity of OSA. Diffusion MRI connectometry that was used to derive correlational tractography revealed changes in the values of FA, MD, AD, RD, and QA when correlated with the AHI. A false-discovery rate threshold of 0.05 was used to select tracts to conduct multiple corrections. RESULTS Connectometry analysis revealed that the AHI in participants with OSA was negatively correlated with FA values in WM tracts that included the cingulum, corpus callosum, cerebellum, inferior longitudinal fasciculus, fornices, thalamic radiations, inferior fronto-occipital fasciculus, superior and posterior corticostriatal tracts, medial lemnisci, and arcuate fasciculus. However, there were no statistically significant results in the WM tracts, in which FA values were positively correlated with the AHI. In addition, connectometry analysis did not reveal statistically significant results in WM tracts, in which MD, AD, RD, and QA values were positively or negatively correlated with the AHI. CONCLUSION Several WM tract changes were correlated with OSA severity. However, WM changes in OSA likely involve tissue edema and not neuronal changes, such as axonal loss. Connectometry analyses are valuable tools for detecting WM changes in sleep disorders.
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Affiliation(s)
- Bong Soo Park
- Departments of Internal Medicine, Haeundae Paik HospitalInje University College of MedicineBusanSouth Korea
| | - Dong Ah Lee
- Departments of Neurology, Haeundae Paik HospitalInje University College of MedicineBusanSouth Korea
| | - Ho‐Joon Lee
- Departments of Radiology, Haeundae Paik HospitalInje University College of MedicineBusanSouth Korea
| | - Jinseung Kim
- Department of Family Medicine, Busan Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Junghae Ko
- Departments of Internal Medicine, Haeundae Paik HospitalInje University College of MedicineBusanSouth Korea
| | - Won Hee Lee
- Department of Neurosurgey, Busan Paik HospitalInje University College of MedicineBusanRepublic of Korea
| | - Jiyae Yi
- Departments of Internal Medicine, Haeundae Paik HospitalInje University College of MedicineBusanSouth Korea
| | - Kang Min Park
- Departments of Neurology, Haeundae Paik HospitalInje University College of MedicineBusanSouth Korea
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Park BS, Choi B, Heo CM, Lee YJ, Park S, Kim YW, Ko J, Lee DA, Park KM. The effects of the dialysis on the white matter tracts in patients with end-stage renal disease using differential tractography study. Sci Rep 2023; 13:20064. [PMID: 37973892 PMCID: PMC10654401 DOI: 10.1038/s41598-023-47533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/14/2023] [Indexed: 11/19/2023] Open
Abstract
This study aimed to determine whether white matter tracts correlate with kidney function using correlation tractography, and to investigate the effects of dialysis on white matter tracts in patients with end-stage renal disease (ESRD) using differential tractography. Ten patients with ESRD, who had a glomerular filtration rate of < 15 mL/min/1.73 m2, were enrolled in this prospective study. Diffusion tensor imaging (DTI) was performed both before and after dialysis. We discovered that white matter tracts correlated with the estimated glomerular filtration rate based on pre- and post-dialysis DTI using correlation tractography and investigated the differences in the white matter tracts between pre- and post-dialysis DTI in patients with ESRD using differential tractography. Correlation tractography revealed no quantitative anisotropy of the white matter tracts that correlated with the estimated glomerular filtration rate in pre- and post-dialysis patients with ESRD. Differential tractography revealed significant differences in several white matter tracts, particularly the cingulum, thalamic radiation, corpus callosum, and superior longitudinal fasciculus, between pre- and post-dialysis DTI, which revealed increased diffusion density after dialysis. We demonstrated the significant effects of dialysis on several white matter tracts in patients with ESRD using differential tractography, which showed increased diffusion density after dialysis. In this study, we confirmed the effects of dialysis on brain structure, especially white matter tracts.
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Affiliation(s)
- Bong Soo Park
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Byeongo Choi
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Chang Min Heo
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Yoo Jin Lee
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Sihyung Park
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Yang Wook Kim
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Junghae Ko
- Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea.
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Park KM, Kim KT, Lee DA, Cho YW. Correlation of Diffusion Tensor Tractography with Restless Legs Syndrome Severity. Brain Sci 2023; 13:1560. [PMID: 38002520 PMCID: PMC10670044 DOI: 10.3390/brainsci13111560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
This prospective study investigated white matter tracts associated with restless legs syndrome (RLS) severity in 69 patients with primary RLS using correlational tractography based on diffusion tensor imaging. Fractional anisotropy (FA) and quantitative anisotropy (QA) were analyzed separately to understand white matter abnormalities in RLS patients. Connectometry analysis revealed positive correlations between RLS severity and FA values in various white matter tracts, including the left and right cerebellum, corpus callosum forceps minor and major, corpus callosum body, right cingulum, and frontoparietal tract. In addition, connectometry analysis revealed that the FA of the middle cerebellar peduncle, left inferior longitudinal fasciculus, left corticospinal tract, corpus callosum forceps minor, right cerebellum, left frontal aslant tract, left dentatorubrothalamic tract, right inferior longitudinal fasciculus, left corticostriatal tract superior, and left cingulum parahippocampoparietal tract was negatively correlated with RLS severity in patients with RLS. However, there were no significant correlations between QA values and RLS severity. It is implied that RLS symptoms may be potentially reversible with appropriate treatment. This study highlights the importance of considering white matter alterations in understanding the pathophysiology of RLS and in developing effective treatment strategies.
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Affiliation(s)
- Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea; (K.M.P.); (D.A.L.)
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea;
| | - Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan 48108, Republic of Korea; (K.M.P.); (D.A.L.)
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea;
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Vogt LM, Yan H, Santyr B, Breitbart S, Anderson M, Germann J, Lizarraga KJ, Hewitt AL, Fasano A, Ibrahim GM, Gorodetsky C. Deep Brain Stimulation for Refractory Status Dystonicus in Children: Multicenter Case Series and Systematic Review. Ann Neurol 2023. [PMID: 37714824 DOI: 10.1002/ana.26799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVE We sought to better understand the workflow, outcomes, and complications of deep brain stimulation (DBS) for pediatric status dystonicus (SD). We present a systematic review, alongside a multicenter case series of pediatric patients with SD treated with DBS. METHODS We collected individual data regarding treatment, stimulation parameters, and dystonia severity for a multicenter case series (n = 8) and all previously published cases (n = 77). Data for case series were used to create probabilistic voxelwise maps of stimulated tissue associated with dystonia improvement. RESULTS In our institutional series, DBS was implanted a mean of 25 days after SD onset. Programming began a mean of 1.6 days after surgery. All 8 patients in our case series and 73 of 74 reported patients in the systematic review had resolution of their SD with DBS, most within 2 to 4 weeks of surgery. Mean follow-up for patients in the case series was 16 months. DBS target for all patients in the case series and 68 of 77 in our systematic review was the globus pallidus pars interna (GPi). In our case series, stimulation of the posterior-ventrolateral GPi was associated with improved dystonia. Mean dystonia improvement was 32% and 51% in our institutional series and systematic review, respectively. Mortality was 4% in the review, which is lower than reported for treatment with pharmacotherapy alone (10-12.5%). INTERPRETATION DBS is a feasible intervention with potential to reverse refractory pediatric SD and improve survival. More work is needed to increase awareness of DBS in this setting, so that it can be implemented in a timely manner. ANN NEUROL 2023.
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Affiliation(s)
- Lindsey M Vogt
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Han Yan
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Brendan Santyr
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application, Toronto, Ontario, Canada
| | - Sara Breitbart
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Melanie Anderson
- Library Services, University Health Network, Toronto, Ontario, Canada
| | - Jürgen Germann
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application, Toronto, Ontario, Canada
| | - Karlo J Lizarraga
- Motor Physiology and Neuromodulation Program, Division of Movement Disorders, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Angela L Hewitt
- Motor Physiology and Neuromodulation Program, Division of Movement Disorders, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
- Division of Child Neurology, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA
| | - Alfonso Fasano
- Krembil Brain Institute, Toronto, Ontario, Canada
- Center for Advancing Neurotechnological Innovation to Application, Toronto, Ontario, Canada
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - George M Ibrahim
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Carolina Gorodetsky
- Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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In vivo probabilistic atlas of white matter tracts of the human subthalamic area combining track density imaging and optimized diffusion tractography. Brain Struct Funct 2022; 227:2647-2665. [PMID: 36114861 PMCID: PMC9618529 DOI: 10.1007/s00429-022-02561-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022]
Abstract
The human subthalamic area is a region of high anatomical complexity, tightly packed with tiny fiber bundles. Some of them, including the pallidothalamic, cerebello-thalamic, and mammillothalamic tracts, are relevant targets in functional neurosurgery for various brain diseases. Diffusion-weighted imaging-based tractography has been suggested as a useful tool to map white matter pathways in the human brain in vivo and non-invasively, though the reconstruction of these specific fiber bundles is challenging due to their small dimensions and complex anatomy. To the best of our knowledge, a population-based, in vivo probabilistic atlas of subthalamic white matter tracts is still missing. In the present work, we devised an optimized tractography protocol for reproducible reconstruction of the tracts of subthalamic area in a large data sample from the Human Connectome Project repository. First, we leveraged the super-resolution properties and high anatomical detail provided by short tracks track-density imaging (stTDI) to identify the white matter bundles of the subthalamic area on a group-level template. Tracts identification on the stTDI template was also aided by visualization of histological sections of human specimens. Then, we employed this anatomical information to drive tractography at the subject-level, optimizing tracking parameters to maximize between-subject and within-subject similarities as well as anatomical accuracy. Finally, we gathered subject level tracts reconstructed with optimized tractography into a large-scale, normative population atlas. We suggest that this atlas could be useful in both clinical anatomy and functional neurosurgery settings, to improve our understanding of the complex morphology of this important brain region.
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Li M, Zhang Z, Wu X, Wang X, Liu X, Liang J, Chen G, Feng Y, Li M. Tractography of the Stria Terminalis in the Human Brain. Clin Anat 2022; 35:383-391. [PMID: 35102603 DOI: 10.1002/ca.23843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/08/2022]
Abstract
The aim of this study was to investigate the trajectory of the stria terminalis and develop a protocol for mapping the stria terminalis using multi-shell diffusion images based tractography. The stria terminalis was reconstructed by combining one region of interest at the amygdala with another region of interest at the bed nucleus of stria terminalis. In addition, one region of avoidance was placed on the fornix at the interventricular foramen and another was set at the anterior perforated substance. The fiber-tracking protocol was tested in a Human Connectome Project-842 template, 35 healthy subjects from Massachusetts General Hospital, and 20 healthy subjects from the Human Connectome Project using generalized q-sampling imaging based tractography. The stria terminalis was reconstructed in the Human Connectome Project-842 template, 35 Massachusetts General Hospital healthy subjects, and 20 Human Connectome Project healthy subjects with our protocol. The stria terminalis originated from the amygdala and travelled parallel to the fornix. Then, the stria terminalis followed a C-shaped trajectory around the inferior, posterior, and dorsal surfaces of the thalamus before projecting to the bed nucleus of stria terminalis between the thalamus and caudate nucleus. There were no significant differences in the quantitative anisotropy and fractional anisotropy values between the left and right stria terminalis. The stria terminalis was accurately visualized across subjects using multi-shell diffusion images through generalized q-sampling imaging based tractography. This method could be an important tool for the reconstruction and evaluation of the stria terminalis in various neurological disorders. One Sentence Summary The visualizetion of the stria terminalis through the multi-shell diffusion images using generalized q-sampling imaging based tractography.
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Affiliation(s)
- Mengjun Li
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Zhiping Zhang
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Xiaolong Wu
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Xu Wang
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Xiaohai Liu
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Jiantao Liang
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Ge Chen
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
| | - Yuanjing Feng
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Mingchu Li
- Department of Neurosurgery, Samii Clinical Neuroanatomy Research & Education Center, Capital Medical University Xuanwu Hospital, China International Neuroscience Institute (China-INI), Beijing, China
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Li MJ, Yeh FC, Huang SH, Huang CX, Zhang H, Liu J. Differential Tractography and Correlation Tractography Findings on Patients With Mild Traumatic Brain Injury: A Pilot Study. Front Hum Neurosci 2022; 16:751902. [PMID: 35126076 PMCID: PMC8811572 DOI: 10.3389/fnhum.2022.751902] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Differential tractography and correlation tractography are new tractography modalities to study neuronal changes in brain diseases, but their performances in detecting neuronal injuries are yet to be investigated in patients with mild traumatic brain injury (mTBI). Here we investigated the white matter injury in mTBI patients using differential and correlation tractography. The diffusion MRI was acquired at 33 mTBI patients and 31 health controls. 7 of the mTBI patients had one-year follow-up scans, and differential tractography was used to evaluate injured fiber bundles on these 7 patients. All subjects were evaluated using digital symbol substitution test (DSST) and trail making test A (TMT-A), and the correlation tractography was performed to explore the exact pathways related to the cognitive performance. Our results showed that differential tractography revealed neuronal changes in the corpus callosum in all 7 follow-up mTBI patients with FDR between 0.007 and 0.17. Further, the correlation tractography showed that the splenium of the corpus callosum, combined with the right superior longitudinal fasciculus and right cingulum, were correlated with DSST (FDR = 0.001669) in the acute mTBI patients. The cognitive impairment findings in the acute stage and the longitudinal findings in the corpus callosum in the chronic stage of mTBI patients suggest that differential tractography and correlation tractography are valuable tools in the diagnostic and prognostic evaluation of neuronal injuries in mTBI patients.
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Affiliation(s)
- Meng-Jun Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Fang-Cheng Yeh
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
- Department of Bioengineering, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Si-Hong Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chu-Xin Huang
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huiting Zhang
- MR Scientific Marketing, Siemens Healthcare Ltd., Wuhan, China
| | - Jun Liu
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
- *Correspondence: Jun Liu,
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