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Zhang X, Xiang F, Li D, Yang F, Yu S, Wang X. Adult-onset combined oxidative phosphorylation deficiency type 14 manifests as epileptic status: a new phenotype and literature review. BMC Neurol 2024; 24:15. [PMID: 38166857 PMCID: PMC10759640 DOI: 10.1186/s12883-023-03480-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Combined oxidative phosphorylation deficiency (COXPD) is a severe disorder with early onset and autosomal recessive inheritance, and has been divided into 51 types (COXPD1-COXPD51). COXPD14 is caused by a mutation in the FARS2 gene, which encodes mitochondrial phenylalanyl-tRNA synthetase (mt-PheRS), an enzyme that transfers phenylalanine to its cognate tRNA in mitochondria. Since the first case was reported in 2012, an increasing number of FARS2 variations have been subsequently identified, which present three main phenotypic manifestations: early onset epileptic encephalopathy, hereditary spastic paraplegia, and juvenile-onset epilepsy. To our knowledge, no adult cases have been reported in the literature. METHODS We report in detail a case of genetically confirmed COXPD14 and review the relevant literature. RESULTS Approximately 58 subjects with disease-causing variants of FARS2 have been reported, including 31 cases of early onset epileptic encephalopathy, 16 cases of hereditary spastic paraplegia, 3 cases of juvenile-onset epilepsy, and 8 cases of unknown phenotype. We report a case of autosomal recessive COXPD14 in an adult with status epilepticus as the only manifestation with a good prognosis, which is different from that in neonatal or infant patients reported in the literature. c.467C > T (p.T156M) has been previously reported, while c.119_120del (p.E40Vfs*87) is novel, and, both mutations are pathogenic. CONCLUSIONS This case of autosomal recessive COXPD14 in an adult only presented as status epilepticus, which is different from the patients reported previously. Our study expands the mutation spectrum of FARS2, and we tended to define the phenotypes based on the clinical manifestation rather than the age of onset.
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Affiliation(s)
- Xu Zhang
- Department of Neurology, The First Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, People's Republic of China
| | - Feng Xiang
- Department of Neurology, The First Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, People's Republic of China
| | - Desheng Li
- Department of Neurology, The First Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, People's Republic of China
| | - Fei Yang
- Department of Neurology, The First Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, People's Republic of China
| | - Shengyuan Yu
- Department of Neurology, The First Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, People's Republic of China
| | - Xiangqing Wang
- Department of Neurology, The First Medical Center of Chinese PLA General Hospital, 28# Fuxing Road, Beijing, People's Republic of China.
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Fischer D, Rapalino O, Fecchio M, Edlow BL. Ictal fMRI: Mapping Seizure Topography with Rhythmic BOLD Oscillations. Brain Sci 2022; 12:1710. [PMID: 36552169 PMCID: PMC9775283 DOI: 10.3390/brainsci12121710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) has shown elevations in the blood-oxygen-level-dependent (BOLD) signal associated with, but insensitive for, seizure. Rather than evaluating absolute BOLD signal elevations, assessing rhythmic oscillations in the BOLD signal with fMRI may improve the accuracy of seizure mapping. We report a case of a patient with non-convulsive, right hemispheric seizures who underwent fMRI. Unbiased processing methods revealed a map of rhythmically oscillating BOLD signal over the cortical region affected by seizure, and synchronous BOLD signal in the contralateral cerebellum. High-resolution fMRI may help identify the spatial topography of seizure and provide insights into seizure physiology.
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Affiliation(s)
- David Fischer
- Division of Neurocritical Care, Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Otto Rapalino
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02129, USA
| | - Matteo Fecchio
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Brian L. Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
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Zhu Y, Ruan G, Cheng Z, Zou S, Zhu X. Lateralization of the crossed cerebellar diaschisis-associated metabolic connectivities in cortico-ponto-cerebellar and cortico-rubral pathways. Neuroimage 2022; 260:119487. [PMID: 35850160 DOI: 10.1016/j.neuroimage.2022.119487] [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: 11/29/2021] [Revised: 06/21/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore the glucose metabolic profile of extrapyramidal system in patients with crossed cerebellar diaschisis (CCD). Furthermore, the metabolic connectivities in cortico-ponto-cerebellar and cortico-rubral pathways associated with CCD were also investigated. A total of 130 CCD positive (CCD+) and 424 CCD negative (CCD-) patients with unilateral cerebral hemisphere hypometabolism on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) were enrolled. Besides, the control group consisted of 56 subjects without any brain structural and metabolic abnormalities. Apart from the "autocorrelation", metabolic connectivity pattern of right or left affected cerebellar hemisphere involved unilateral (left or right, respectively) caudate, pallidum, putamen, thalamus and red nucleus, in CCD+ patients with left or right supratentorial lesions, respectively (Puncorrected < 0.001, cluster size > 200). CCD+ group had significantly lower asymmetry index (AI) in cortico-ponto-cerebellar pathway (including ipsilateral cerebral white matter, ipsilateral pons, contralateral cerebellum white matter and contralateral cerebellum exterior cortex) and cortico-rubral pathway (including ipsilateral caudate, thalamus proper, pallidum, putamen, ventral diencephalon and red nucleus) than those of both CCD- and control groups (all P < 0.05). AI in contralateral cerebellum exterior cortex was significantly positively correlated with that in ipsilateral caudate, putamen, pallidum, thalamus proper, ventral diencephalon, red nucleus and pons among CCD+ group (all P < 0.01), but only with that in ipsilateral caudate and putamen among CCD- group (both P < 0.001). These results provide additional insight into the involvement of both cortico-ponto-cerebellar and cortico-rubral pathways in the presence of CCD, underlining the need for further investigation about the role of their aberrant metabolic connectivities in the associated symptoms of CCD.
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Affiliation(s)
- Yuankai Zhu
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China
| | - Ge Ruan
- Department of Radiology, Hospital, Hubei University, Wuhan 430062, China
| | - Zhaoting Cheng
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China
| | - Sijuan Zou
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China
| | - Xiaohua Zhu
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China.
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Zhu Y, Ruan G, Zou S, Cheng Z, Zhu X. Voxel-based analysis of the metabolic asymmetrical and network patterns in hypermetabolism-associated crossed cerebellar diaschisis. Neuroimage Clin 2022; 35:103032. [PMID: 35597028 PMCID: PMC9123269 DOI: 10.1016/j.nicl.2022.103032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/06/2022] [Accepted: 05/02/2022] [Indexed: 10/27/2022]
Abstract
Crossed cerebellar diaschisis (CCD) has been widely investigated in patients with supratentorial hypometabolism, however, the available evidence about the metabolic feature of CCD in patients with contralateral supratentorial hypermetabolism is lacking. This study aimed to assess the metabolic asymmetrical profile, network pattern and predisposing factors for the hypermetabolism-associated CCD, by using voxel-based asymmetry index (AI) and brain network analyses. Seventy CCD positive (CCD+) and 99 CCD negative (CCD-) patients with unilateral supratentorial hypermetabolism were introduced. Among different brain regions with AImax or AImin, striatum & thalamus was accompanied by the highest positive rate of CCD (85.7% or 70.1%, respectively). CCD+ group had significantly greater AImax (median [IQR], 0.62 [0.44-0.84] vs. 0.47 [0.35-0.61]), supratentorial hypermetabolic volume (1183.5 [399.3-3026.8] vs. 386.0 [152.0-1193.0]) and hypometabolic volume (37796.5 [24741.8-53278.0] vs. 3337.0 [1020.0-17193.0]), and lower AImin (-0.85 [-1.05--0.73] vs. -0.49 [-0.68--0.35]) compared with CCD- group (all P < 0.001). Logistic regression analysis manifested that patients with AImin located at striatum & thalamus were 16.4 times more likely to present CCD than those at frontal lobe (OR = 16.393; 95% CI, 4.463-60.207; P < 0.001), and the occurrence of CCD was also associated with AImax (OR = 49.594; 95% CI, 5.519-445.653; P < 0.001) and AImin (OR = 3.133 × 10-4, 95% CI, 1.693 × 10-5-5.799 × 10-3, P < 0.001). Brain network analysis indicated that the relative hypermetabolism in the contralateral supplementary motor cortex (SMC) and precuneus gyrus were constant in the CCD related patterns. These results demonstrated that the greater AImax, lower AImin and AImin located at striatum & thalamus should be predisposing factors for CCD in patients with unilateral supratentorial hypermetabolism. Relative increased activities in the contralateral SMC and precuneus gyrus might be attributed to a compensatory mechanism for the abnormal brain network related to CCD.
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Affiliation(s)
- Yuankai Zhu
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ge Ruan
- Department of Radiology, Hospital, Hubei University, Wuhan 430062, China
| | - Sijuan Zou
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhaoting Cheng
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaohua Zhu
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Wang DJJ, Le Bihan D, Krishnamurthy R, Smith M, Ho ML. Noncontrast Pediatric Brain Perfusion: Arterial Spin Labeling and Intravoxel Incoherent Motion. Magn Reson Imaging Clin N Am 2021; 29:493-513. [PMID: 34717841 DOI: 10.1016/j.mric.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Noncontrast magnetic resonance imaging techniques for measuring brain perfusion include arterial spin labeling (ASL) and intravoxel incoherent motion (IVIM). These techniques provide noninvasive and repeatable assessment of cerebral blood flow or cerebral blood volume without the need for intravenous contrast. This article discusses the technical aspects of ASL and IVIM with a focus on normal physiologic variations, technical parameters, and artifacts. Multiple pediatric clinical applications are presented, including tumors, stroke, vasculopathy, vascular malformations, epilepsy, migraine, trauma, and inflammation.
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Affiliation(s)
- Danny J J Wang
- USC Institute for Neuroimaging and Informatics, SHN, 2025 Zonal Avenue, Health Sciences Campus, Los Angeles, CA 90033, USA
| | - Denis Le Bihan
- NeuroSpin, Centre d'études de Saclay, Bâtiment 145, Gif-sur-Yvette 91191, France
| | - Ram Krishnamurthy
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mark Smith
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive - ED4, Columbus, OH 43205, USA.
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Hertel A, Wenz H, Al-Zghloul M, Hausner L, FrÖlich L, Groden C, FÖrster A. Crossed Cerebellar Diaschisis in Alzheimer's Disease Detected by Arterial Spin-labelling Perfusion MRI. In Vivo 2021; 35:1177-1183. [PMID: 33622918 DOI: 10.21873/invivo.12366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/27/2020] [Accepted: 01/05/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Crossed cerebellar diaschisis (CCD) is a phenomenon with depressed metabolism and hypoperfusion in the cerebellum. Using arterial spin-labelling perfusion weighted magnetic resonance imaging (ASL PWI), we investigated the frequency of CCD in patients with Alzheimer's disease (AD) and differences between patients with and without CCD. PATIENTS AND METHODS In patients with AD who underwent a standardized magnetic resonance imaging including ASL PWI cerebral blood flow was evaluated in the cerebellum, and brain segmentation/volumetry was performed using mdbrain (mediaire GmbH, Berlin, Germany) and FSL FIRST (Functional Magnetic Resonance Imaging of the Brain Software Library). RESULTS In total, 65 patients were included, and 22 (33.8%) patients were assessed as being CCD-positive. Patients with CCD had a significantly smaller whole brain volume (862.8±49.9 vs. 893.7±62.7 ml, p=0.049) as well as white matter volume (352.9±28.0 vs. 374.3±30.7, p=0.008) in comparison to patients without CCD. CONCLUSION It was possible to detect CCD by ASL PWI in approximately one-third of patients with AD and was associated with smaller whole brain and white matter volume.
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Affiliation(s)
- Alexander Hertel
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Holger Wenz
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Mansour Al-Zghloul
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Lutz FrÖlich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Christoph Groden
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany
| | - Alex FÖrster
- Department of Neuroradiology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany;
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Hou Y, Guo K, Fan X, Shang K, Wang J, Wang Z, Shan Y, Zhao G, Lu J. Crossed cerebellar diaschisis: risk factors and prognostic value in focal cortical dysplasia by 18F-FDG PET/CT. Ann Nucl Med 2021; 35:719-727. [PMID: 33840039 DOI: 10.1007/s12149-021-01613-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Crossed cerebellar diaschisis (CCD) has been widely studied in hemispheric stroke but is less characterized in epilepsy. In this study, we used 18F-FDG PET/CT to investigate the risk factors for CCD and its prognostic value for intractable epilepsy caused by focal cortical dysplasia (FCD). METHODS One hundred medically intractable epilepsy patients pathologically diagnosed with FCD postoperatively were included and classified into two groups: CCD+ and CCD-. PET/CT images were analyzed qualitatively by visual assessment and semi-quantitatively using the absolute asymmetry index (|AI|). Clinical factors, including age, sex, body mass index (BMI), age at seizure onset, epilepsy duration, seizure type, seizure frequency, electroencephalography (EEG) and brain magnetic resonance imaging (MRI), were retrospectively assessed from medical records. Follow-up outcomes were evaluated according to the Engel classification at 3, 6, 12, 24 and 36 months postoperatively. RESULTS Of the 100 patients, 77 (77.0%) were classified as CCD-, and 23 (23.0%) were classified as CCD + . CCD+ patients had a higher number of lobes involved on PET (3.61 ± 2.16 vs 2.26 ± 1.01, P < 0.001) than CCD- patients. CCD- patients showed more negative MRI results than CCD + patients (P = 0.02). At 12 months postoperatively, 70.7% (29/41) of CCD- patients and 30.8% (4/13) of CCD + patients presented a favourable prognosis (P = 0.02). Significant differences in the average |AI| values in the posterior frontal and anterior temporal lobes were found between CCD+ and CCD- patients (P < 0.05). CONCLUSION The number of lobes involved on PET, structural anomalies on MRI, the |AI| values in the posterior frontal and anterior temporal lobes may be predisposing factors for CCD. CCD occurrence may help predict the prognosis of FCD patients at 12 months postoperatively.
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Affiliation(s)
- Yaqin Hou
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Kun Guo
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Xiaotong Fan
- Department of Neurosurgery, China INI, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Kun Shang
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Jingjuan Wang
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Zhenming Wang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yongzhi Shan
- Department of Neurosurgery, China INI, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Guoguang Zhao
- Department of Neurosurgery, China INI, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
| | - Jie Lu
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China.
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
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Takahashi S, Horiguchi T. Relationship between ischaemic symptoms during the early postoperative period in patients with moyamoya disease and changes in the cerebellar asymmetry index. Clin Neurol Neurosurg 2020; 197:106090. [PMID: 32693340 DOI: 10.1016/j.clineuro.2020.106090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to clarify the relationship between ischaemic symptoms during the early postoperative period in patients with moyamoya disease and changes in the cerebellar asymmetry index (AI), a parameter used to quantitatively identify crossed cerebellar diaschisis (CCD). PATIENTS AND METHODS We analysed the data of 18 patients with moyamoya disease who underwent quantitative IMP-cerebral blood flow SPECT at least once during the follow-up period. Cerebellar AI scores were calculated using the CBF of the cerebellum calculated automatically from multiple slices of SPECT images with automated ROI setup software and categorized and statistically examined according to the presence or absence of ischaemic symptoms. RESULTS The cerebellar AI calculated from SPECT performed in the patients who presented with ischaemic symptoms was 0.094 ± 0.023 (mean ± SD), which was significantly elevated compared to the value of 0.013 ± 0.025 (mean ± SD) calculated from SPECT performed when the patients did not present with ischaemic symptoms (p < 0.0001). Limiting the time of SPECT to calculate the cerebellar AI to be compared to the acute phase within 2 weeks after surgery did not change this trend, and again, the cerebellar AI was statistically significantly elevated in the presence of ischaemic symptoms (0.094 ± 0.023 (mean ± SD)) compared to the AI in the absence of ischaemic symptoms (0.000081 ± 0.026 (mean ± SD)) (p = 0.0003). In patients who underwent quantitative SPECT in the acute phase during the first postoperative week, the cerebellar AI values calculated from the results of SPECT performed during the preoperative period as well as multiple times during postoperative period were followed over time in each case. The cerebellar AI increased in patients who presented with symptoms of ischaemia postoperatively but then tended to decrease reversibly and approach zero with the disappearance of symptoms of ischaemia. CONCLUSIONS Since the cerebellar AI reflects the symptom of ischaemia in patients with moyamoya disease, especially in the early stage after revascularization surgery, and is a parameter that improves with symptom improvement, it seems to be useful for understanding the state of cerebral blood flow after bypass surgery in patients with moyamoya disease.
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Affiliation(s)
- Satoshi Takahashi
- Department of Neurosurgery, Keio University, School of Medicine, Tokyo, Japan.
| | - Takashi Horiguchi
- Department of Neurosurgery, Keio University, School of Medicine, Tokyo, Japan
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Application of a 3D pseudocontinuous arterial spin-labeled perfusion MRI scan combined with a postlabeling delay value in the diagnosis of neonatal hypoxic-ischemic encephalopathy. PLoS One 2019; 14:e0219284. [PMID: 31283776 PMCID: PMC6613698 DOI: 10.1371/journal.pone.0219284] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/20/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Currently, there are many studies on the application of the 3D pseudocontinuous arterial spin-labeled (3D-pcASL) perfusion MRI technique for adult brain examinations, but few studies exist on the application of the technique for child brain examinations. PURPOSE To explore the application of a 3D-pcASL perfusion MRI scan combined with postlabeling delay (PLD) for assessing neonatal hypoxic-ischemic encephalopathy (HIE). MATERIALS AND METHODS Two-hundred neonates diagnosed with neonatal HIE were equally divided into five groups (40/group): 0- to <24-hour-old HIE group, 1- to <3-day-old HIE group, 3- to <7-day-old HIE group, 7- to <15-day-old HIE group and 15- to 28-day-old HIE group; 200 healthy neonates were equivalently divided. All 10 groups received a conventional and a 3D-pcASL perfusion MRI scan. For groups <3 days old, PLD values for the 3D-pcASL cerebral perfusion MRI scan were preset at 1025 ms; in all other groups, PLD values were preset at 1525 ms. CBF values for the 3D-pcASL cerebral perfusion MRI were compared between the HIE and corresponding control groups to determine the distinguishing characteristics of CBF values in HIE neonates. RESULTS On the 3D-pcASL cerebral perfusion MRI scan, in the 1- to <3-day-old groups, HIE neonate CBF values were higher than those of controls in all brain regions (excluding the frontal lobe); in the 0- to <24-hour-old and 3- to <7-day-old groups, HIE neonate CBF values were lower than those of corresponding controls in all brain regions; in the 7- to <15-day-old and 15- to 28-day-old groups, there were no significant differences in the CBF values between groups in any brain regions. CONCLUSIONS The 3D-pcASL perfusion MRI scan combined with a PLD can assist in the early diagnosis of neonatal HIE, as this method more comprehensively reflects the HIE pathological process.
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Application of Postlabeling Delay Time in 3-Dimensional Pseudocontinuous Arterial Spin-Labeled Perfusion Imaging in Normal Children. J Comput Assist Tomogr 2019; 43:697-707. [DOI: 10.1097/rct.0000000000000911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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