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Lange F, Verma V, Harvey-Jones K, Mitra S, Tachtsidis I. Neonatal Brain Temperature Monitoring Based on Broadband Near-Infrared Spectroscopy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1438:167-172. [PMID: 37845456 DOI: 10.1007/978-3-031-42003-0_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
We present here the initial development of a novel algorithm based on broadband near-infrared spectroscopy (bNIRS) data to estimate the changes in brain temperature (BT) in neonates. We first explored the validity of the methodology on a simple numerical phantom and reported good agreements between the theoretical and retrieved values of BT and hemodynamic parameters changes, which are the parameters usually targeted by bNIRS. However, we noted an underestimation of the absolute values of temperature and haemoglobins' concentration changes when large variations of tissue saturation were induced, probably due to a crosstalk between the species in this specific case. We then tested this methodology on data acquired on 2 piglets during a protocol that induces seizures. We showed that despite a decrease in rectal temperature (RT) over time (-0.1048 °C 1.5 h after seizure induction, 95% CI: -0.1035 to -0.1061 °C), BT was raising (0.3122 °C 1.5 h after seizure induction, 95% CI: 0.3207 to 0.3237 °C). We also noted that the piglet displaying the largest decrease in RT also displays the highest increase in BT, which could be a marker of the severity of the seizure induced brain injury. These initial results are encouraging and show that having access to the changes in BT non-invasively could help to better understand the impact of BT on injury severity and to improve the current cooling methodologies in the neonatal neurocritical care following neonatal encephalopathy.
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Affiliation(s)
- F Lange
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK.
| | - V Verma
- Institute for Women's Health, University College London, London, UK
| | - K Harvey-Jones
- Institute for Women's Health, University College London, London, UK
| | - S Mitra
- Institute for Women's Health, University College London, London, UK
| | - I Tachtsidis
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
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2
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Sung D, Risk BB, Kottke PA, Allen JW, Nahab F, Fedorov AG, Fleischer CC. Comparisons of healthy human brain temperature predicted from biophysical modeling and measured with whole brain MR thermometry. Sci Rep 2022; 12:19285. [PMID: 36369468 PMCID: PMC9652378 DOI: 10.1038/s41598-022-22599-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
Brain temperature is an understudied parameter relevant to brain injury and ischemia. To advance our understanding of thermal dynamics in the human brain, combined with the challenges of routine experimental measurements, a biophysical modeling framework was developed to facilitate individualized brain temperature predictions. Model-predicted brain temperatures using our fully conserved model were compared with whole brain chemical shift thermometry acquired in 30 healthy human subjects (15 male and 15 female, age range 18-36 years old). Magnetic resonance (MR) thermometry, as well as structural imaging, angiography, and venography, were acquired prospectively on a Siemens Prisma whole body 3 T MR scanner. Bland-Altman plots demonstrate agreement between model-predicted and MR-measured brain temperatures at the voxel-level. Regional variations were similar between predicted and measured temperatures (< 0.55 °C for all 10 cortical and 12 subcortical regions of interest), and subcortical white matter temperatures were higher than cortical regions. We anticipate the advancement of brain temperature as a marker of health and injury will be facilitated by a well-validated computational model which can enable predictions when experiments are not feasible.
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Affiliation(s)
- Dongsuk Sung
- grid.213917.f0000 0001 2097 4943Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA
| | - Benjamin B. Risk
- grid.189967.80000 0001 0941 6502Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA USA
| | - Peter A. Kottke
- grid.213917.f0000 0001 2097 4943Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA USA
| | - Jason W. Allen
- grid.213917.f0000 0001 2097 4943Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Neurology, Emory University School of Medicine, Atlanta, GA USA
| | - Fadi Nahab
- grid.189967.80000 0001 0941 6502Department of Neurology, Emory University School of Medicine, Atlanta, GA USA
| | - Andrei G. Fedorov
- grid.213917.f0000 0001 2097 4943Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA USA ,grid.213917.f0000 0001 2097 4943Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA USA
| | - Candace C. Fleischer
- grid.213917.f0000 0001 2097 4943Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA USA ,grid.213917.f0000 0001 2097 4943Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Wesley Woods Health Center, Emory University School of Medicine, 1841 Clifton Road, Atlanta, GA 30329 USA
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3
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Diprose WK, Morgan CA, Wang MT, Diprose JP, Lin JC, Sheriff S, Campbell D, Barber PA. Active conductive head cooling of normal and infarcted brain: A magnetic resonance spectroscopy imaging study. J Cereb Blood Flow Metab 2022; 42:2058-2065. [PMID: 35707879 PMCID: PMC9580175 DOI: 10.1177/0271678x221107988] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Active conductive head cooling is a simple and non-invasive intervention that may slow infarct growth in ischemic stroke. We investigated the effect of active conductive head cooling on brain temperature using whole brain echo-planar spectroscopic imaging. A cooling cap (WElkins Temperature Regulation System, 2nd Gen) was used to administer cooling for 80 minutes to healthy volunteers and chronic stroke patients. Whole brain echo-planar spectroscopic imaging scans were obtained before and after cooling. Brain temperature was estimated using the Metabolite Imaging and Data Analysis System software package, which allows voxel-level temperature calculations using the chemical shift difference between metabolite (N-acetylaspartate, creatine, choline) and water resonances. Eleven participants (six healthy volunteers, five post-stroke) underwent 80 ± 5 minutes of cooling. The average temperature of the coolant was 1.3 ± 0.5°C below zero. Significant reductions in brain temperature (ΔT = -0.9 ± 0.7°C, P = 0.002), and to a lesser extent, rectal temperature (ΔT = -0.3 ± 0.1°C, P = 0.03) were observed. Exploratory analysis showed that the occipital lobes had the greatest reduction in temperature (ΔT = -1.5 ± 1.2°C, P = 0.002). Regions of infarction had similar temperature reductions to the contralateral normal brain. Future research could investigate the feasibility of head cooling as a potential neuroprotective strategy in patients being considered for acute stroke therapies.
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Affiliation(s)
- William K Diprose
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Catherine A Morgan
- Centre for Advanced MRI, The University of Auckland, Auckland, New Zealand.,School of Psychology and Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - Michael Tm Wang
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | | | - Joanne C Lin
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Sulaiman Sheriff
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Doug Campbell
- Department of Anaesthesia and Perioperative Medicine, Auckland City Hospital, Auckland, New Zealand
| | - P Alan Barber
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Neurology, Auckland City Hospital, Auckland, New Zealand
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4
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Dong Z, Milak MS, Mann JJ. Proton magnetic resonance spectroscopy thermometry: Impact of separately acquired full water or partially suppressed water data on quantification and measurement error. NMR IN BIOMEDICINE 2022; 35:e4681. [PMID: 34961997 DOI: 10.1002/nbm.4681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/02/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
In proton magnetic resonance spectroscopy (1 H MRS) thermometry, separately acquired full water and partially suppressed water are commonly used for measuring temperature. This paper compares these two approaches. Single-voxel 1 H MRS data were collected on a 3-T GE scanner from 26 human subjects. Every subject underwent five continuous MRS sessions, each separated by a 2-min phase. Each MRS session lasted 13 min and consisted of two free induction decays (FIDs) without water suppression (with full water [FW or w]) and 64 FIDs with partial water suppression (with partially suppressed water [PW or w']). Frequency differences between the two FWs, the first two PWs, the second FW and the first PW (FW2 , PW1 ), or between averaged water ( wav' ) and N-acetylaspartate (NAA), were measured. Intrasubject and intersubject variations of the frequency differences were used as a metric for the error in temperature measurement. The intrasubject variations of frequency differences between FW2 and PW1fw2-fw1' , calculated from the five MRS sessions for each subject, were larger than those between the two FWs or between the first two PWs (p = 1.54 x 10-4 and p = 1.72 x 10-4 , respectively). The mean values of intrasubject variations of fw2-fw1' for all subjects were 4.7 and 4.5 times those of fw2-fw1 and fw2'-fw1' , respectively. The intrasubject variations of the temperatures based on frequency differences, fw2-fNAA or ( fw1'-fNAA ), were about 2.5 times greater than those based on averaged water and NAA frequencies (fwav'-fNAA ). The mean temperature measured from (fwav'-fNAA ) (n = 26) was 0.29°C lower than that measured from fw2-fNAA and was 0.83°C higher than that from ( fw1'-fNAA ). It was concluded that the use of separately acquired unsuppressed or partially suppressed water signals may result in large errors in frequency and, consequently, temperature measurement.
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Affiliation(s)
- Zhengchao Dong
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, New York, USA
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA
| | - Matthew S Milak
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, New York, USA
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA
| | - J John Mann
- Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, New York, USA
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA
- Department of Radiology, Columbia University, College of Physicians and Surgeons, New York, New York, USA
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5
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Ding H, Lv G, Cai X, Chen J, Cheng Z, Peng Y, Tang G, Shi Z, Xie Y, Fu X, Yin L, Yang J, Wang Y, Sheng X. An Optoelectronic thermometer based on microscale infrared-to-visible conversion devices. LIGHT, SCIENCE & APPLICATIONS 2022; 11:130. [PMID: 35525849 PMCID: PMC9079085 DOI: 10.1038/s41377-022-00825-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/09/2022] [Accepted: 04/27/2022] [Indexed: 05/11/2023]
Abstract
Thermometric detectors are crucial in evaluating the condition of target objects spanning from environments to the human body. Optical-based thermal sensing tools have received extensive attention, in which the photon upconversion process with low autofluorescence and high tissue penetration depth is considered as a competent method for temperature monitoring, particularly in biomedical fields. Here, we present an optoelectronic thermometer via infrared-to-visible upconversion, accomplished by integrated light receiving and emission devices. Fully fabricated thin-film, microscale devices present temperature-dependent light emission with an intensity change of 1.5% °C-1 and a spectral shift of 0.18 nm °C-1. The sensing mechanism is systematically characterized and ascribed to temperature dependent optoelectronic properties of the semiconductor band structure and the circuit operation condition. Patterned device arrays showcase the capability for spatially resolved temperature mapping. Finally, in vitro and in vivo experiments implemented with integrated fiber-optic sensors demonstrate real-time thermal detection of dynamic human activity and in the deep brain of animals, respectively.
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Affiliation(s)
- He Ding
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China.
| | - Guoqing Lv
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
| | - Xue Cai
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Center for Flexible Electronics Technology, and IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China
| | - Junyu Chen
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Center for Flexible Electronics Technology, and IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China
| | - Ziyi Cheng
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
| | - Yanxiu Peng
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
| | - Guo Tang
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Center for Flexible Electronics Technology, and IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China
| | - Zhao Shi
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Center for Flexible Electronics Technology, and IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China
| | - Yang Xie
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Center for Flexible Electronics Technology, and IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China
| | - Xin Fu
- School of Materials Science and Engineering, Tsinghua University, Beijing, 100084, China
| | - Lan Yin
- School of Materials Science and Engineering, Tsinghua University, Beijing, 100084, China
| | - Jian Yang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
| | - Yongtian Wang
- Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing, 100081, China
| | - Xing Sheng
- Department of Electronic Engineering, Beijing National Research Center for Information Science and Technology, Institute for Precision Medicine, Center for Flexible Electronics Technology, and IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, 100084, China.
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6
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Paul PS, Cho JY, Wu Q, Karthivashan G, Grabovac E, Wille H, Kulka M, Kar S. Unconjugated PLGA nanoparticles attenuate temperature-dependent β-amyloid aggregation and protect neurons against toxicity: implications for Alzheimer's disease pathology. J Nanobiotechnology 2022; 20:67. [PMID: 35120558 PMCID: PMC8817552 DOI: 10.1186/s12951-022-01269-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 01/16/2022] [Indexed: 12/26/2022] Open
Abstract
Conversion of β-amyloid (Aβ) peptides from soluble random-coil to aggregated protein enriched with β-sheet-rich intermediates has been suggested to play a role in the degeneration of neurons and development of Alzheimer’s disease (AD) pathology. Aggregation of Aβ peptide can be prompted by a variety of environmental factors including temperature which can influence disease pathogenesis. Recently, we reported that FDA-approved unconjugated poly (d,l-lactide-co-glycolide) (PLGA) nanoparticles can have beneficial effects in cellular and animal models of AD by targeting different facets of the Aβ axis. In this study, using biochemical, structural and spectroscopic analyses, we evaluated the effects of native PLGA on temperature-dependent Aβ aggregation and its ability to protect cultured neurons from degeneration. Our results show that the rate of spontaneous Aβ1–42 aggregation increases with a rise in temperature from 27 to 40 °C and PLGA with 50:50 resomer potently inhibits Aβ aggregation at all temperatures, but the effect is more profound at 27 °C than at 40 °C. It appears that native PLGA, by interacting with the hydrophobic domain of Aβ1–42, prevents a conformational shift towards β-sheet structure, thus precluding the formation of Aβ aggregates. Additionally, PLGA triggers disassembly of matured Aβ1–42 fibers at a faster rate at 40 °C than at 27 °C. PLGA-treated Aβ samples can significantly enhance viability of cortical cultured neurons compared to neurons treated with Aβ alone by attenuating phosphorylation of tau protein. Injection of native PLGA is found to influence the breakdown/clearance of Aβ peptide in the brain. Collectively, these results suggest that PLGA nanoparticles can inhibit Aβ aggregation and trigger disassembly of Aβ aggregates at temperatures outside the physiological range and can protect neurons against Aβ-mediated toxicity thus validating its unique therapeutic potential in the treatment of AD pathology.
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Affiliation(s)
- Pallabi Sil Paul
- Department of Medicine (Neurology), Centre for Prions and Protein Folding Diseases, University of Alberta, Edmonton, AB, T6G 2M8, Canada
| | - Jae-Young Cho
- Nanotechnology Research Centre, National Research Council Canada, Edmonton, AB, T6G 2M9, Canada
| | - Qi Wu
- Department of Medicine (Neurology), Centre for Prions and Protein Folding Diseases, University of Alberta, Edmonton, AB, T6G 2M8, Canada
| | - Govindarajan Karthivashan
- Department of Medicine (Neurology), Centre for Prions and Protein Folding Diseases, University of Alberta, Edmonton, AB, T6G 2M8, Canada
| | - Emily Grabovac
- Nanotechnology Research Centre, National Research Council Canada, Edmonton, AB, T6G 2M9, Canada
| | - Holger Wille
- Department of Biochemistry, Centre for Prions and Protein Folding Diseases, University of Alberta, Edmonton, AB, T6G 2M8, Canada
| | - Mariana Kulka
- Nanotechnology Research Centre, National Research Council Canada, Edmonton, AB, T6G 2M9, Canada.,Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB, T6G 2E1, Canada
| | - Satyabrata Kar
- Department of Medicine (Neurology), Centre for Prions and Protein Folding Diseases, University of Alberta, Edmonton, AB, T6G 2M8, Canada. .,Departments of Medicine (Neurology) and Psychiatry, Centre for Prions and Protein Folding Diseases, University of Alberta, Edmonton, AB, T6G 2M8, Canada.
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7
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Verma V, Lange F, Bainbridge A, Harvey-Jones K, Robertson NJ, Tachtsidis I, Mitra S. Brain temperature monitoring in newborn infants: Current methodologies and prospects. Front Pediatr 2022; 10:1008539. [PMID: 36268041 PMCID: PMC9577084 DOI: 10.3389/fped.2022.1008539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/15/2022] [Indexed: 02/02/2023] Open
Abstract
Brain tissue temperature is a dynamic balance between heat generation from metabolism, passive loss of energy to the environment, and thermoregulatory processes such as perfusion. Perinatal brain injuries, particularly neonatal encephalopathy, and seizures, have a significant impact on the metabolic and haemodynamic state of the developing brain, and thereby likely induce changes in brain temperature. In healthy newborn brains, brain temperature is higher than the core temperature. Magnetic resonance spectroscopy (MRS) has been used as a viable, non-invasive tool to measure temperature in the newborn brain with a reported accuracy of up to 0.2 degrees Celcius and a precision of 0.3 degrees Celcius. This measurement is based on the separation of chemical shifts between the temperature-sensitive water peaks and temperature-insensitive singlet metabolite peaks. MRS thermometry requires transport to an MRI scanner and a lengthy single-point measurement. Optical monitoring, using near infrared spectroscopy (NIRS), offers an alternative which overcomes this limitation in its ability to monitor newborn brain tissue temperature continuously at the cot side in real-time. Near infrared spectroscopy uses linear temperature-dependent changes in water absorption spectra in the near infrared range to estimate the tissue temperature. This review focuses on the currently available methodologies and their viability for accurate measurement, the potential benefits of monitoring newborn brain temperature in the neonatal intensive care unit, and the important challenges that still need to be addressed.
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Affiliation(s)
- Vinita Verma
- Institute for Women's Health, University College London, London, United Kingdom
| | - Frederic Lange
- Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Alan Bainbridge
- Medical Physics and Engineering, University College London Hospital, London, United Kingdom
| | - Kelly Harvey-Jones
- Institute for Women's Health, University College London, London, United Kingdom
| | - Nicola J Robertson
- Institute for Women's Health, University College London, London, United Kingdom
| | - Ilias Tachtsidis
- Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Subhabrata Mitra
- Institute for Women's Health, University College London, London, United Kingdom
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8
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Estrada E. Cascading from SARS-CoV-2 to Parkinson's Disease through Protein-Protein Interactions. Viruses 2021; 13:897. [PMID: 34066091 PMCID: PMC8150712 DOI: 10.3390/v13050897] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/21/2021] [Accepted: 05/06/2021] [Indexed: 12/18/2022] Open
Abstract
Extensive extrapulmonary damages in a dozen of organs/systems, including the central nervous system (CNS), are reported in patients of the coronavirus disease 2019 (COVID-19). Three cases of Parkinson's disease (PD) have been reported as a direct consequence of COVID-19. In spite of the scarce data for establishing a definitive link between COVID-19 and PD, some hypotheses have been proposed to explain the cases reported. They, however, do not fit well with the clinical findings reported for COVID-19 patients, in general, and for the PD cases reported, in particular. Given the importance of this potential connection, we present here a molecular-level mechanistic hypothesis that explains well these findings and will serve to explore the potential CNS damage in COVID-19 patients. The model explaining the cascade effects from COVID-19 to CNS is developed by using bioinformatic tools. It includes the post-translational modification of host proteins in the lungs by viral proteins, the transport of modified host proteins via exosomes out the lungs, and the disruption of protein-protein interaction in the CNS by these modified host proteins. Our hypothesis is supported by finding 44 proteins significantly expressed in the CNS which are associated with PD and whose interactions can be perturbed by 24 host proteins significantly expressed in the lungs. These 24 perturbators are found to interact with viral proteins and to form part of the cargoes of exosomes in human tissues. The joint set of perturbators and PD-vulnerable proteins form a tightly connected network with significantly more connections than expected by selecting a random cluster of proteins of similar size from the human proteome. The molecular-level mechanistic hypothesis presented here provides several routes for the cascading of effects from the lungs of COVID-19 patients to PD. In particular, the disruption of autophagy/ubiquitination processes appears as an important mechanism that triggers the generation of large amounts of exosomes containing perturbators in their cargo, which would insult several PD-vulnerable proteins, potentially triggering Parkinsonism in COVID-19 patients.
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Affiliation(s)
- Ernesto Estrada
- Institute of Mathematics and Applications, University of Zaragoza, Pedro Cerbuna 12, 50009 Zaragoza, Spain;
- ARAID Foundation, Government of Aragon, 50018 Zaragoza, Spain
- Institute for Cross-Disciplinary Physics and Complex Systems (IFISC, UIB-CSIC), Campus Universitat de les Illes Balears, E-07122 Palma de Mallorca, Spain
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9
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Brain Temperature Measured by Magnetic Resonance Spectroscopy to Predict Clinical Outcome in Patients with Infarction. SENSORS 2021; 21:s21020490. [PMID: 33445603 PMCID: PMC7827727 DOI: 10.3390/s21020490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 02/01/2023]
Abstract
Acute ischemic stroke is characterized by dynamic changes in metabolism and hemodynamics, which can affect brain temperature. We used proton magnetic resonance (MR) spectroscopy under everyday clinical settings to measure brain temperature in seven patients with internal carotid artery occlusion to explore the relationship between lesion temperature and clinical course. Regions of interest were selected in the infarct area and the corresponding contralateral region. Single-voxel MR spectroscopy was performed using the following parameters: 2000-ms repetition time, 144-ms echo time, and 128 excitations. Brain temperature was calculated from the chemical shift between water and N-acetyl aspartate, choline-containing compounds, or creatine phosphate. Within 48 h of onset, compared with the contralateral region temperature, brain temperature in the ischemic lesion was lower in five patients and higher in two patients. Severe brain swelling occurred subsequently in three of the five patients with lower lesion temperatures, but in neither of the two patients with higher lesion temperatures. The use of proton MR spectroscopy to measure brain temperature in patients with internal carotid artery occlusion may predict brain swelling and subsequent motor deficits, allowing for more effective early surgical intervention. Moreover, our methodology allows for MR spectroscopy to be used in everyday clinical settings.
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10
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Clinical Performance and Future Potential of Magnetic Resonance Thermometry in Hyperthermia. Cancers (Basel) 2020; 13:cancers13010031. [PMID: 33374176 PMCID: PMC7794787 DOI: 10.3390/cancers13010031] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Hyperthermia is a treatment for cancer patients, which consists of heating the body to 43 °C. The temperature during treatment is usually measured by placing temperature probes intraluminal or invasively. The only clinically used option to measure temperature distributions non-invasively and in 3D is by MR thermometry (MRT). However, in order to be able to replace conventional temperature probes, MRT needs to become more reliable. In this review paper, we propose standardized performance thresholds for MRT, based on our experience of treating nearly 4000 patients. We then review the literature to assess to what extent these requirements are already being met in the clinic today and identify common problems. Lastly, using pre-clinical results in the literature, we assess where the biggest potential is to solve the problems identified. We hope that by standardizing MRT parameters as well as highlighting current and promising developments, progress in the field will be accelerated. Abstract Hyperthermia treatments in the clinic rely on accurate temperature measurements to guide treatments and evaluate clinical outcome. Currently, magnetic resonance thermometry (MRT) is the only clinical option to non-invasively measure 3D temperature distributions. In this review, we evaluate the status quo and emerging approaches in this evolving technology for replacing conventional dosimetry based on intraluminal or invasively placed probes. First, we define standardized MRT performance thresholds, aiming at facilitating transparency in this field when comparing MR temperature mapping performance for the various scenarios that hyperthermia is currently applied in the clinic. This is based upon our clinical experience of treating nearly 4000 patients with superficial and deep hyperthermia. Second, we perform a systematic literature review, assessing MRT performance in (I) clinical and (II) pre-clinical papers. From (I) we identify the current clinical status of MRT, including the problems faced and from (II) we extract promising new techniques with the potential to accelerate progress. From (I) we found that the basic requirements for MRT during hyperthermia in the clinic are largely met for regions without motion, for example extremities. In more challenging regions (abdomen and thorax), progress has been stagnating after the clinical introduction of MRT-guided hyperthermia over 20 years ago. One clear difficulty for advancement is that performance is not or not uniformly reported, but also that studies often omit important details regarding their approach. Motion was found to be the common main issue hindering accurate MRT. Based on (II), we reported and highlighted promising developments to tackle the issues resulting from motion (directly or indirectly), including new developments as well as optimization of already existing strategies. Combined, these may have the potential to facilitate improvement in MRT in the form of more stable and reliable measurements via better stability and accuracy.
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11
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Zhang Y, Taub E, Mueller C, Younger J, Uswatte G, DeRamus TP, Knight DC. Reproducibility of whole-brain temperature mapping and metabolite quantification using proton magnetic resonance spectroscopy. NMR IN BIOMEDICINE 2020; 33:e4313. [PMID: 32348017 DOI: 10.1002/nbm.4313] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
Assessing brain temperature can provide important information about disease processes (e.g., stroke, trauma) and therapeutic effects (e.g., cerebral hypothermia treatment). Whole-brain magnetic resonance spectroscopic imaging (WB-MRSI) is increasingly used to quantify brain metabolites across the entire brain. However, its feasibility and reliability for estimating brain temperature needs further validation. Therefore, the present study evaluates the reproducibility of WB-MRSI for temperature mapping as well as metabolite quantification across the whole brain in healthy volunteers. Ten healthy adults were scanned on three occasions 1 week apart. Brain temperature, along with four commonly assessed brain metabolites-total N-acetyl-aspartate (tNAA), total creatine (tCr), total choline (tCho) and myo-inositol (mI)-were measured from WB-MRSI data. Reproducibility was evaluated using the coefficient of variation (CV). The measured mean (range) of the intra-subject CVs was 0.9% (0.6%-1.6%) for brain temperature mapping, and 4.7% (2.5%-15.7%), 6.4% (2.4%-18.9%) and 14.2% (4.4%-52.6%) for tNAA, tCho and mI, respectively, with reference to tCr. Consistently larger variability was found when using H2 O as the reference for metabolite quantifications: 7.8% (3.3%-17.8%), 7.8% (3.1%-18.0%), 9.8% (3.7%-31.0%) and 17.0% (5.9%-54.0%) for tNAA, tCr, tCho and mI, respectively. Further, the larger the brain region (indicated by a greater number of voxels within that region), the better the reproducibility for both temperature and metabolite estimates. Our results demonstrate good reproducibility of whole-brain temperature and metabolite measurements using the WB-MRSI technique.
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Affiliation(s)
- Yue Zhang
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
- Department of Neurosurgery and Core for Advanced MRI, Baylor College of Medicine, Houston, Texas, US
| | - Edward Taub
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
| | - Christina Mueller
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
| | - Jarred Younger
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
| | - Gitendra Uswatte
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
- Department of Physical Therapy, University of Alabama at Birmingham, Alabama, US
| | - Thomas Patrick DeRamus
- TReNDs Center for Translational Research in Neuroimaging and Data Science, Georgia, US
- Department of Psychology, Georgia State University, Georgia, US
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
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12
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Wu TW, Wisnowski JL, Geisler RF, Reitman A, Ho E, Tamrazi B, Chapman R, Blüml S. An In Vivo Assessment of Regional Brain Temperature during Whole-Body Cooling for Neonatal Encephalopathy. J Pediatr 2020; 220:73-79.e3. [PMID: 32089332 PMCID: PMC7265905 DOI: 10.1016/j.jpeds.2020.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/05/2019] [Accepted: 01/10/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess differences in regional brain temperatures during whole-body hypothermia and test the hypothesis that brain temperature profile is nonhomogenous in infants with hypoxic-ischemic encephalopathy. STUDY DESIGN Infants with hypoxic-ischemic encephalopathy were enrolled prospectively in this observational study. Magnetic resonance (MR) spectra of basal ganglia, thalamus, cortical gray matter, and white matter (WM) were acquired during therapeutic hypothermia. Regional brain tissue temperatures were calculated from the chemical shift difference between water signal and metabolites in the MR spectra after performing calibration measurements. Overall difference in regional temperature was analyzed by mixed-effects model; temperature among different patterns and severity of injury on MR imaging also was analyzed. Correlation between temperature and depth of brain structure was analyzed using repeated-measures correlation. RESULTS In total, 53 infants were enrolled (31 girls, mean gestational age: 38.6 ± 2 weeks; mean birth weight: 3243 ± 613 g). MR spectroscopy was acquired at mean age of 2.2 ± 0.6 days. A total of 201 MR spectra were included in the analysis. The thalamus, the deepest structure (36.4 ± 2.3 mm from skull surface), was lowest in temperature (33.2 ± 0.8°C, compared with basal ganglia: 33.5 ± 0.9°C; gray matter: 33.6 ± 0.7°C; WM: 33.8 ± 0.9°C, all P < .001). Temperatures in more superficial gray matter and WM regions (depth: 21.9 ± 2.4 and 21.5 ± 2.2 mm) were greater than the rectal temperatures (33.4 ± 0.4°C, P < .03). There was a negative correlation between temperature and depth of brain structure (rrm = -0.36, P < .001). CONCLUSIONS Whole-body hypothermia was effective in cooling deep brain structures, whereas superficial structures were warmer, with temperatures significantly greater than rectal temperatures.
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Affiliation(s)
- Tai-Wei Wu
- Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Los Angeles, CA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Jessica L. Wisnowski
- Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA;,Rudi Schulte Research Institute, Santa Barbara, CA
| | - Robert F. Geisler
- Division of Neonatology, Children’s Hospital, Fetal and Neonatal Institute, Los Angeles
| | - Aaron Reitman
- Division of Neonatology, Children’s Hospital, Fetal and Neonatal Institute, Los Angeles
| | - Eugenia Ho
- Division of Neurology, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Benita Tamrazi
- Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Rachel Chapman
- Division of Neonatology, Children’s Hospital, Fetal and Neonatal Institute, Los Angeles;,Department of Pediatrics, Keck School of Medicine, University of Southern California
| | - Stefan Blüml
- Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA;,Rudi Schulte Research Institute, Santa Barbara, CA
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13
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Dehkharghani S, Qiu D. MR Thermometry in Cerebrovascular Disease: Physiologic Basis, Hemodynamic Dependence, and a New Frontier in Stroke Imaging. AJNR Am J Neuroradiol 2020; 41:555-565. [PMID: 32139425 DOI: 10.3174/ajnr.a6455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/02/2020] [Indexed: 01/20/2023]
Abstract
The remarkable temperature sensitivity of the brain is widely recognized and has been studied for its role in the potentiation of ischemic and other neurologic injuries. Pyrexia frequently complicates large-vessel acute ischemic stroke and develops commonly in critically ill neurologic patients; the profound sensitivity of the brain even to minor intraischemic temperature changes, together with the discovery of brain-to-systemic as well as intracerebral temperature gradients, has thus compelled the exploration of cerebral thermoregulation and uncovered its immutable dependence on cerebral blood flow. A lack of pragmatic and noninvasive tools for spatially and temporally resolved brain thermometry has historically restricted empiric study of cerebral temperature homeostasis; however, MR thermometry (MRT) leveraging temperature-sensitive nuclear magnetic resonance phenomena is well-suited to bridging this long-standing gap. This review aims to introduce the reader to the following: 1) fundamental aspects of cerebral thermoregulation, 2) the physical basis of noninvasive MRT, and 3) the physiologic interdependence of cerebral temperature, perfusion, metabolism, and viability.
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Affiliation(s)
- S Dehkharghani
- From the Department of Radiology (S.D.), New York University Langone Health, New York, New York
| | - D Qiu
- Department of Radiology (D.Q.), Emory University Hospital, Atlanta, Georgia
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14
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Kokuryo D, Kumamoto E, Kuroda K. Recent technological advancements in thermometry. Adv Drug Deliv Rev 2020; 163-164:19-39. [PMID: 33217482 DOI: 10.1016/j.addr.2020.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 07/25/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022]
Abstract
Thermometry is the key factor for achieving successful thermal therapy. Although invasive thermometry with a probe has been used for more than four decades, this method can only detect the local temperature within the probing volume. Noninvasive temperature imaging using a tomographic technique is ideal for monitoring hot-spot formation in the human body. Among various techniques, such as X-ray computed tomography, microwave tomography, echo sonography, and magnetic resonance (MR) imaging, the proton resonance frequency shift method of MR thermometry is the only method currently available for clinical practice because its temperature sensitivity is consistent in most aqueous tissues and can be easily observed using common clinical scanners. New techniques are being proposed to improve the robustness of this method against tissue motion. MR techniques for fat thermometry were also developed based on relaxation times. One of the latest non-MR techniques to attract attention is photoacoustic imaging.
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Affiliation(s)
- Daisuke Kokuryo
- Graduate School of System Informatics, Kobe University, Japan
| | - Etsuko Kumamoto
- Information Science and Technology Center, Kobe University, Japan
| | - Kagayaki Kuroda
- School of Information Science and Technology, Tokai University, Japan; Center for Frontier Medical Engineering, Chiba University, Japan.
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15
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Pesonen E, Silvasti-Lundell M, Niemi TT, Kivisaari R, Hernesniemi J, Mäkinen MT. In response to: "Temperature monitoring with zero-heat-flux technology in neurosurgical patients". J Clin Monit Comput 2019; 33:931-932. [PMID: 30771199 DOI: 10.1007/s10877-019-00275-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Eero Pesonen
- Division of Anesthesiology, Department of Anesthesiology and Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Marja Silvasti-Lundell
- Division of Anesthesiology, Department of Anesthesiology and Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tomi T Niemi
- Division of Anesthesiology, Department of Anesthesiology and Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riku Kivisaari
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Hernesniemi
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marja-Tellervo Mäkinen
- Division of Anesthesiology, Department of Anesthesiology and Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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16
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Odéen H, Parker DL. Magnetic resonance thermometry and its biological applications - Physical principles and practical considerations. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2019; 110:34-61. [PMID: 30803693 PMCID: PMC6662927 DOI: 10.1016/j.pnmrs.2019.01.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/23/2019] [Indexed: 05/25/2023]
Abstract
Most parameters that influence the magnetic resonance imaging (MRI) signal experience a temperature dependence. The fact that MRI can be used for non-invasive measurements of temperature and temperature change deep inside the human body has been known for over 30 years. Today, MR temperature imaging is widely used to monitor and evaluate thermal therapies such as radio frequency, microwave, laser, and focused ultrasound therapy. In this paper we cover the physical principles underlying the biological applications of MR temperature imaging and discuss practical considerations and remaining challenges. For biological tissue, the MR signal of interest comes mostly from hydrogen protons of water molecules but also from protons in, e.g., adipose tissue and various metabolites. Most of the discussed methods, such as those using the proton resonance frequency (PRF) shift, T1, T2, and diffusion only measure temperature change, but measurements of absolute temperatures are also possible using spectroscopic imaging methods (taking advantage of various metabolite signals as internal references) or various types of contrast agents. Currently, the PRF method is the most used clinically due to good sensitivity, excellent linearity with temperature, and because it is largely independent of tissue type. Because the PRF method does not work in adipose tissues, T1- and T2-based methods have recently gained interest for monitoring temperature change in areas with high fat content such as the breast and abdomen. Absolute temperature measurement methods using spectroscopic imaging and contrast agents often offer too low spatial and temporal resolution for accurate monitoring of ablative thermal procedures, but have shown great promise in monitoring the slower and usually less spatially localized temperature change observed during hyperthermia procedures. Much of the current research effort for ablative procedures is aimed at providing faster measurements, larger field-of-view coverage, simultaneous monitoring in aqueous and adipose tissues, and more motion-insensitive acquisitions for better precision measurements in organs such as the heart, liver, and kidneys. For hyperthermia applications, larger coverage, motion insensitivity, and simultaneous aqueous and adipose monitoring are also important, but great effort is also aimed at solving the problem of long-term field drift which gets interpreted as temperature change when using the PRF method.
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Affiliation(s)
- Henrik Odéen
- University of Utah, Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, 729 Arapeen Drive, Salt Lake City, UT 84108-1217, USA.
| | - Dennis L Parker
- University of Utah, Utah Center for Advanced Imaging Research, Department of Radiology and Imaging Sciences, 729 Arapeen Drive, Salt Lake City, UT 84108-1217, USA.
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17
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Pesonen E, Silvasti-Lundell M, Niemi TT, Kivisaari R, Hernesniemi J, Mäkinen MT. The focus of temperature monitoring with zero-heat-flux technology (3M Bair-Hugger): a clinical study with patients undergoing craniotomy. J Clin Monit Comput 2018; 33:917-923. [PMID: 30467673 PMCID: PMC6710334 DOI: 10.1007/s10877-018-0227-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/16/2018] [Indexed: 11/29/2022]
Abstract
In the noninvasive zero-heat-flux (ZHF) method, deep body temperature is brought to the skin surface when an insulated temperature probe with servo-controlled heating on the skin creates a region of ZHF from the core to the skin. The sensor of the commercial Bair-Hugger ZHF device is placed on the forehead. According to the manufacturer, the sensor reaches a depth of 1-2 cm below the skin. In this observational study, the anatomical focus of the Bair-Hugger ZHF sensor was assessed in pre- and postoperative CT or MRI images of 29 patients undergoing elective craniotomy. Assuming the 2-cm depth from the forehead skin surface, the temperature measurement point preoperatively reached the brain cortex in all except one patient. Assuming the 1-cm depth, the preoperative temperature measurement point did not reach the brain parenchyma in any of the patients and was at the cortical surface in two patients. Corresponding results were obtained postoperatively, although either sub-arachnoid fluid or air was observed in all CT/MRI images. Craniotomy did not have a detectable effect on the course of the ZHF temperatures. In Bland-Altman analysis, the agreement of ZHF temperature with the nasopharyngeal temperature was 0.11 (95% confidence interval - 0.54 to 0.75) °C and with the bladder temperature - 0.14 (- 0.81 to 0.52) °C. As conclusions, within the reported range of the Bair-Hugger ZHF measurement depth, the anatomical focus of the sensor cannot be determined. Craniotomy did not have a detectable effect on the course of the ZHF temperatures that showed good agreement with the nasopharyngeal and bladder temperatures.
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Affiliation(s)
- Eero Pesonen
- Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Marja Silvasti-Lundell
- Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tomi T Niemi
- Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Riku Kivisaari
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Juha Hernesniemi
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marja-Tellervo Mäkinen
- Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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18
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Verius M, Frank F, Gizewski E, Broessner G. Magnetic Resonance Spectroscopy Thermometry at 3 Tesla: Importance of Calibration Measurements. Ther Hypothermia Temp Manag 2018; 9:146-155. [PMID: 30457932 DOI: 10.1089/ther.2018.0027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
To demonstrate the importance of calibration measurements in 3 Tesla proton magnetic resonance (MR) spectroscopy (1H-MRS) thermometry for human brain temperature estimation for routine clinical applications. In vitro proton MR spectroscopy to obtain calibration constants of the water-chemical shift was conducted at 3 Tesla with a temperature-controlled phantom, containing a pH-buffered aqueous solution of N-acetyl aspartate (NAA), creatine (Cr), methylene protons of Cr (Cr2), dimethyl silapentane sulfonic acid (DSS), and sodium formate (NaFor). Estimations of absolute human brain temperature were performed utilizing the correlation of temperature to the water-chemical shift for the resonances of NAA, Cr, and Cr2. Data for calibration of the metabolites' chemical shift differences and in vivo temperature estimations were acquired with single-voxel point-resolved spectroscopy (PRESS) sequences (repetition time/echo time = 2000/30 ms; voxel size 2 × 2 × 2 cm3). Spectroscopy data were quantified in the time-domain, and a Pearson correlation analysis was performed to estimate the correlation between the chemical shift of metabolites and measured temperatures. The correlation coefficients (r) of our calibration measurements were NAA 0.9975 (±0.0609), Cr -0.9979 (±0.0621), Cr2 - 0.9973 (±0.0577), DSS -0.9976 (±0.0615), and NaFor -0.8132 (±2.348). The mean calculated brain temperature was 37.78 ± 1.447°C, and the mean tympanic temperature was 36.83 ± 0.2456°C. Calculated temperatures derived from Cr and Cr2 provided significant (p = 0.0241 and p = 0.0210, respectively) correlations with measured temperatures (r = 0.4108 and r = -0.4194, respectively). Calibration measurements are vital for 1H-MRS thermometry. Small numeric differences in measured signal and data preprocessing without any calibration measurements reduce accuracy of temperature calculations, which indicates that calculated temperatures should be interpreted with caution. Application of this method for clinical purposes warrants further investigation and a more practical approach.
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Affiliation(s)
- Michael Verius
- 1 Medizinische Universität Innsbruck, Neuroimaging Research Core Facility, Innsbruck, Austria
| | - Florian Frank
- 2 Medizinische Universität Innsbruck, Universitätsklinik für Neurologie, Innsbruck, Austria
| | - Elke Gizewski
- 1 Medizinische Universität Innsbruck, Neuroimaging Research Core Facility, Innsbruck, Austria.,3 Medizinische Universität Innsbruck, Universitätsklinik für Neuroradiologie, Innsbruck, Austria
| | - Gregor Broessner
- 2 Medizinische Universität Innsbruck, Universitätsklinik für Neurologie, Innsbruck, Austria
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19
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Tsutsui S, Nanba T, Yoshioka Y, Sasaki M, Fujiwara S, Kobayashi M, Yoshida K, Miyoshi K, Sato S, Ogasawara K. Preoperative brain temperature imaging on proton magnetic resonance spectroscopy predicts hemispheric ischemia during carotid endarterectomy for unilateral carotid stenosis with inadequate collateral blood flow. Neurol Res 2018; 40:617-623. [PMID: 29600890 DOI: 10.1080/01616412.2018.1457130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective Preoperative magnetic resonance (MR) angiography sometimes shows the absence of collateral flow via the circle of Willis. This study examined whether brain temperature (BT) imaging on multi-voxel proton MR spectroscopy after this finding increases the accuracy of predicting hemispheric ischemia during internal carotid artery (ICA) clamping during endarterectomy for patients with symptomatic unilateral carotid stenosis. Methods In 52 patients with ICA stenosis (≥70%) and absence of collateral blood flow via the circle of Willis on preoperative MR angiography, BT imaging was displayed using proton multi-voxel MR spectroscopy. The difference between BTs in the affected and contralateral hemispheres (BTaffected hemisphere - BTcontralateral hemisphere) in the deep white matter of the centrum semiovale was calculated and defined as hemispheric ΔBT. Development of cerebral hemispheric ischemia during ICA clamping was determined from intraoperative electroencephalography (EEG). Results Multivariate analysis revealed that high preoperative hemispheric ΔBT was significantly associated with development of EEG-defined hemispheric ischemia (95% confidence intervals [CIs], 5.376-15.452; p = 0.006). The positive-predictive value for development of EEG-defined hemispheric ischemia was significantly greater for preoperative hemispheric ΔBT following preoperative MR angiography (95%CI, 42-87%) than for preoperative MR angiography alone (95%CI, 13-37%). Conclusions For patients without collateral flow via the circle of Willis, BT imaging increases the predictive accuracy for development of hemispheric ischemia during ICA clamping during CEA.
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Affiliation(s)
- Shouta Tsutsui
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
| | - Takamasa Nanba
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
| | - Yoshichika Yoshioka
- b Open and Transdisciplinary Research Initiatives , Osaka University , Suita , Japan
| | - Makoto Sasaki
- c Division of Ultra-High Field MRI, School of Medicine , Iwate Medical University , Morioka , Japan
| | - Shunrou Fujiwara
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
| | - Masakazu Kobayashi
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
| | - Kenji Yoshida
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
| | - Kenya Miyoshi
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
| | - Shinpei Sato
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
| | - Kuniaki Ogasawara
- a Department of Neurosurgery , Iwate Medical University , Morioka , Japan
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20
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Onitsuka S, Nakamura D, Onishi T, Arimitsu T, Takahashi H, Hasegawa H. Ice slurry ingestion reduces human brain temperature measured using non-invasive magnetic resonance spectroscopy. Sci Rep 2018; 8:2757. [PMID: 29426888 PMCID: PMC5807509 DOI: 10.1038/s41598-018-21086-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/29/2018] [Indexed: 11/09/2022] Open
Abstract
We previously reported that ice slurry ingestion reduced forehead skin temperature, thereby potentially reducing brain temperature (Tbrain). Therefore, in the current study, we investigated the effect of ice slurry ingestion on Tbrain using proton magnetic resonance spectroscopy, which is a robust, non-invasive method. Eight male participants ingested 7.5 g/kg of either a thermoneutral drink (37 °C; CON) or ice slurry (-1 °C; ICE) for about 5 min following a 15-min baseline period. Then, participants remained at rest for 30 min. As physiological indices, Tbrain, rectal temperature (Tre), mean skin temperature, nude body mass, and urine specific gravity were measured. Subjective thermal sensation (TS) and thermal comfort (TC) were measured before and after the experiment. Tbrain and Tre significantly reduced after ingestion of ICE compared with after ingestion of CON, and there was a significant correlation between Tbrain and Tre. The other physiological indices were not significantly different between beverage conditions. TS and TC were significantly lower with ICE than with CON (p < 0.05). These results indicate that ice slurry ingestion can cool the brain, as well as the body's core.
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Affiliation(s)
- Sumire Onitsuka
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Higashihiroshima, 739-8521, Japan.,Japan Society for the Promotion of Science, Tokyo, 102-0083, Japan
| | | | | | - Takuma Arimitsu
- College of Sport and Health Science, Ritsumeikan University, Kusatsu, 525-8577, Japan
| | | | - Hiroshi Hasegawa
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Higashihiroshima, 739-8521, Japan.
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21
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Owji ZP, Gilbert G, Saint-Martin C, Wintermark P. Brain Temperature Is Increased During the First Days of Life in Asphyxiated Newborns: Developing Brain Injury Despite Hypothermia Treatment. AJNR Am J Neuroradiol 2017; 38:2180-2186. [PMID: 28860214 DOI: 10.3174/ajnr.a5350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/12/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE Therapeutic hypothermia is the current treatment for neonates with hypoxic-ischemic encephalopathy. It is believed to work by decreasing the brain temperature and reducing the baseline metabolism and energy demand of the brain. This study aimed to noninvasively assess brain temperature during the first month of life in neonates with hypoxic-ischemic encephalopathy treated with hypothermia. MATERIALS AND METHODS Neonates with hypoxic-ischemic encephalopathy treated with hypothermia and healthy neonates were enrolled prospectively. MR imaging was used to identify the presence and extent of brain injury. MR imaging multivoxel spectroscopy was used to derive brain temperatures in the basal ganglia and white matter at different time points during the first month of life. Brain temperature measurements were compared between neonates with hypoxic-ischemic encephalopathy and healthy neonates. RESULTS Forty-three term neonates with hypoxic-ischemic encephalopathy treated with hypothermia had a total of 74 spectroscopy scans, and 3 healthy term neonates had a total of 9 spectroscopy scans during the first month of life. Brain temperatures were lower in neonates with hypoxic-ischemic encephalopathy during hypothermia, compared with the healthy neonates (respectively, on day 1 of life: basal ganglia, 38.81°C ± 2.08°C, and white matter, 39.11°C ± 1.99°C; and on days 2-3 of life: basal ganglia, 38.25°C ± 0.91°C, and white matter, 38.54°C ± 2.79°C). However, neonates with hypoxic-ischemic encephalopathy who developed brain injury had higher brain temperatures during hypothermia (respectively, on day 1 of life: basal ganglia, 35.55°C ± 1.31°C, and white matter, 37.35°C ± 2.55°C; and on days 2-3 of life: basal ganglia, 35.20°C ± 1.15°C, and white matter, 35.44°C ± 1.90°C) compared with neonates who did not develop brain injury (respectively, on day 1 of life: basal ganglia, 34.46°C ± 1.09°C, and white matter, 33.97°C ± 1.42°C; and on days 2-3 of life: basal ganglia, 33.90°C ± 1.34°C, and white matter, 33.07°C ± 1.71°C). Also, brain temperatures tended to remain slightly higher in the neonates who developed brain injury around day 10 of life and around 1 month of age. CONCLUSIONS Therapeutic hypothermia using current guidelines decreased the brain temperature of neonates with hypoxic-ischemic encephalopathy during the first days of life but did not prevent an early increase of brain temperature in neonates with hypoxic-ischemic encephalopathy who developed brain injury despite this treatment.
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Affiliation(s)
- Z P Owji
- From the Department of Pediatrics, Division of Newborn Medicine, Research Institute of the McGill University Health Centre (Z.P.O., P.W.)
| | - G Gilbert
- MR Clinical Science (G.G.), Philips Healthcare, Montreal, Quebec, Canada
| | - C Saint-Martin
- Department of Pediatric Radiology (C.S.-M.), Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
| | - P Wintermark
- From the Department of Pediatrics, Division of Newborn Medicine, Research Institute of the McGill University Health Centre (Z.P.O., P.W.)
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Nanba T, Nishimoto H, Yoshioka Y, Murakami T, Sasaki M, Uwano I, Fujiwara S, Terasaki K, Ogasawara K. Apparent brain temperature imaging with multi-voxel proton magnetic resonance spectroscopy compared with cerebral blood flow and metabolism imaging on positron emission tomography in patients with unilateral chronic major cerebral artery steno-occlusive disease. Neuroradiology 2017; 59:923-935. [PMID: 28776269 DOI: 10.1007/s00234-017-1890-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/20/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of the present study was to determine whether apparent brain temperature imaging using multi-voxel proton magnetic resonance (MR) spectroscopy correlates with cerebral blood flow (CBF) and metabolism imaging in the deep white matter of patients with unilateral chronic major cerebral artery steno-occlusive disease. METHODS Apparent brain temperature and CBF and metabolism imaging were measured using proton MR spectroscopy and 15O-positron emission tomography (PET), respectively, in 35 patients. A set of regions of interest (ROIs) of 5 × 5 voxels was placed on an MR image so that the voxel row at each edge was located in the deep white matter of the centrum semiovale in each cerebral hemisphere. PET images were co-registered with MR images with these ROIs and were re-sliced automatically using image analysis software. RESULTS In 175 voxel pairs located in the deep white matter, the brain temperature difference (affected hemisphere - contralateral hemisphere: ΔBT) was correlated with cerebral blood volume (CBV) (r = 0.570) and oxygen extraction fraction (OEF) ratios (affected hemisphere/contralateral hemisphere) (r = 0.641). We excluded voxels that contained ischemic lesions or cerebrospinal fluid and calculated the mean values of voxel pairs in each patient. The mean ΔBT was correlated with the mean CBF (r = - 0.376), mean CBV (r = 0.702), and mean OEF ratio (r = 0.774). CONCLUSIONS Apparent brain temperature imaging using multi-voxel proton MR spectroscopy was correlated with CBF and metabolism imaging in the deep white matter of patients with unilateral major cerebral artery steno-occlusive disease.
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Affiliation(s)
- Takamasa Nanba
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Hideaki Nishimoto
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Yoshichika Yoshioka
- Open and Transdisciplinary Research Initiatives, Osaka University, 3-1 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Toshiyuki Murakami
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Makoto Sasaki
- Institute for Biomedical Science, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Ikuko Uwano
- Institute for Biomedical Science, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Shunrou Fujiwara
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Kazunori Terasaki
- Cyclotron Research Center, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Kuniaki Ogasawara
- Department of Neurosurgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
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Kim HY, Kwon JA, Kang T, Choi I. Rapid and high-throughput colorimetric screening for anti-aggregation reagents of protein conformational diseases by using gold nanoplasmonic particles. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2017; 13:1575-1585. [DOI: 10.1016/j.nano.2017.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/29/2016] [Accepted: 01/09/2017] [Indexed: 01/04/2023]
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24
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Holper L, Mitra S, Bale G, Robertson N, Tachtsidis I. Prediction of brain tissue temperature using near-infrared spectroscopy. NEUROPHOTONICS 2017; 4:021106. [PMID: 28630878 PMCID: PMC5469395 DOI: 10.1117/1.nph.4.2.021106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/15/2017] [Indexed: 08/17/2023]
Abstract
Broadband near-infrared spectroscopy (NIRS) can provide an endogenous indicator of tissue temperature based on the temperature dependence of the water absorption spectrum. We describe a first evaluation of the calibration and prediction of brain tissue temperature obtained during hypothermia in newborn piglets (animal dataset) and rewarming in newborn infants (human dataset) based on measured body (rectal) temperature. The calibration using partial least squares regression proved to be a reliable method to predict brain tissue temperature with respect to core body temperature in the wavelength interval of 720 to 880 nm with a strong mean predictive power of [Formula: see text] (animal dataset) and [Formula: see text] (human dataset). In addition, we applied regression receiver operating characteristic curves for the first time to evaluate the temperature prediction, which provided an overall mean error bias between NIRS predicted brain temperature and body temperature of [Formula: see text] (animal dataset) and [Formula: see text] (human dataset). We discuss main methodological aspects, particularly the well-known aspect of over- versus underestimation between brain and body temperature, which is relevant for potential clinical applications.
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Affiliation(s)
- Lisa Holper
- University of Zurich, Hospital of Psychiatry, Department of Psychiatry, Psychotherapy, and Psychosomatics, Zurich, Switzerland
| | - Subhabrata Mitra
- University College London and Neonatal Unit, University College London Hospitals Trust, Institute for Women’s Health, London, United Kingdom
| | - Gemma Bale
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Nicola Robertson
- University College London and Neonatal Unit, University College London Hospitals Trust, Institute for Women’s Health, London, United Kingdom
| | - Ilias Tachtsidis
- University College London, Biomedical Optics Research Laboratory, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
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25
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Dehkharghani S, Fleischer CC, Qiu D, Yepes M, Tong F. Cerebral Temperature Dysregulation: MR Thermographic Monitoring in a Nonhuman Primate Study of Acute Ischemic Stroke. AJNR Am J Neuroradiol 2017; 38:712-720. [PMID: 28126752 DOI: 10.3174/ajnr.a5059] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/06/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Cerebral thermoregulation remains poorly understood. Temperature dysregulation is deeply implicated in the potentiation of cerebrovascular ischemia. We present a multiphasic, MR thermographic study in a nonhuman primate model of MCA infarction, hypothesizing detectable brain temperature disturbances and brain-systemic temperature decoupling. MATERIALS AND METHODS Three Rhesus Macaque nonhuman primates were sourced for 3-phase MR imaging: 1) baseline MR imaging, 2) 7-hour continuous MR imaging following minimally invasive, endovascular MCA stroke induction, and 3) poststroke day 1 MR imaging follow-up. MR thermometry was achieved by multivoxel spectroscopy (semi-localization by adiabatic selective refocusing) by using the proton resonance frequency chemical shift. The relationship of brain and systemic temperatures with time and infarction volumes was characterized by using a mixed-effects model. RESULTS Following MCA infarction, progressive cerebral hyperthermia was observed in all 3 subjects, significantly outpacing systemic temperature fluctuations. Highly significant associations were observed for systemic, hemispheric, and global brain temperatures (F-statistic, P = .0005 for all regressions) relative to the time from stroke induction. Significant differences in the relationship between temperature and time following stroke onset were detected when comparing systemic temperatures with ipsilateral (P = .007), contralateral (P = .004), and infarction core (P = .003) temperatures following multiple-comparisons correction. Significant associations were observed between infarction volumes and both systemic (P ≤ .01) and ipsilateral (P = .04) brain temperatures, but not contralateral brain temperature (P = .08). CONCLUSIONS Successful physiologic and continuous postischemic cerebral MR thermography was conducted and prescribed in a nonhuman primate infarction model to facilitate translatability. The results confirm hypothesized temperature disturbance and decoupling of physiologic brain-systemic temperature gradients. These findings inform a developing paradigm of brain thermoregulation and the applicability of brain temperature as a neuroimaging biomarker in CNS injury.
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Affiliation(s)
- S Dehkharghani
- From the Departments of Radiology and Imaging Sciences (S.D., D.Q., F.T.)
- Neurology (S.D., M.Y.), Emory University Hospital, Atlanta, Georgia
| | - C C Fleischer
- Department of Biomedical Engineering (C.C.F.), Emory University and Georgia Institute of Technology, Atlanta, Georgia
| | - D Qiu
- From the Departments of Radiology and Imaging Sciences (S.D., D.Q., F.T.)
| | - M Yepes
- Neurology (S.D., M.Y.), Emory University Hospital, Atlanta, Georgia
| | - F Tong
- From the Departments of Radiology and Imaging Sciences (S.D., D.Q., F.T.)
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26
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Maudsley AA, Goryawala MZ, Sheriff S. Effects of tissue susceptibility on brain temperature mapping. Neuroimage 2016; 146:1093-1101. [PMID: 27693198 DOI: 10.1016/j.neuroimage.2016.09.062] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/15/2016] [Accepted: 09/26/2016] [Indexed: 02/07/2023] Open
Abstract
A method for mapping of temperature over a large volume of the brain using volumetric proton MR spectroscopic imaging has been implemented and applied to 150 normal subjects. Magnetic susceptibility-induced frequency shifts in gray- and white-matter regions were measured and included as a correction in the temperature mapping calculation. Additional sources of magnetic susceptibility variations of the individual metabolite resonance frequencies were also observed that reflect the cellular-level organization of the brain metabolites, with the most notable differences being attributed to changes of the N-Acetylaspartate resonance frequency that reflect the intra-axonal distribution and orientation of the white-matter tracts with respect to the applied magnetic field. These metabolite-specific susceptibility effects are also shown to change with age. Results indicate no change of apparent brain temperature with age from 18 to 84 years old, with a trend for increased brain temperature throughout the cerebrum in females relative for males on the order of 0.1°C; slightly increased temperatures in the left hemisphere relative to the right; and a lower temperature of 0.3°C in the cerebellum relative to that of cerebral white-matter. This study presents a novel acquisition method for noninvasive measurement of brain temperature that is of potential value for diagnostic purposes and treatment monitoring, while also demonstrating limitations of the measurement due to the confounding effects of tissue susceptibility variations.
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27
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Hartmann J, Gellermann J, Brandt T, Schmidt M, Pyatykh S, Hesser J, Ott O, Fietkau R, Bert C. Optimization of Single Voxel MR Spectroscopy Sequence Parameters and Data Analysis Methods for Thermometry in Deep Hyperthermia Treatments. Technol Cancer Res Treat 2016; 16:470-481. [PMID: 27422012 DOI: 10.1177/1533034616656310] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The difference in the resonance frequency of water and methylene moieties of lipids quantifies in magnetic resonance spectroscopy the absolute temperature using a predefined calibration curve. The purpose of this study was the investigation of peak evaluation methods and the magnetic resonance spectroscopy sequence (point-resolved spectroscopy) parameter optimization that enables thermometry during deep hyperthermia treatments. MATERIALS AND METHODS Different Lorentz peak-fitting methods and a peak finding method using singular value decomposition of a Hankel matrix were compared. Phantom measurements on organic substances (mayonnaise and pork) were performed inside the hyperthermia 1.5-T magnetic resonance imaging system for the parameter optimization study. Parameter settings such as voxel size, echo time, and flip angle were varied and investigated. RESULTS Usually all peak analyzing methods were applicable. Lorentz peak-fitting method in MATLAB proved to be the most stable regardless of the number of fitted peaks, yet the slowest method. The examinations yielded an optimal parameter combination of 8 cm3 voxel volume, 55 millisecond echo time, and a 90° excitation pulse flip angle. CONCLUSION The Lorentz peak-fitting method in MATLAB was the most reliable peak analyzing method. Measurements in homogeneous and heterogeneous phantoms resulted in optimized parameters for the magnetic resonance spectroscopy sequence for thermometry.
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Affiliation(s)
- J Hartmann
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - J Gellermann
- 2 Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany.,3 Praxis/Zentrum für Strahlentherapie und Radioonkologie, Berlin, Germany
| | - T Brandt
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Schmidt
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Pyatykh
- 4 Medical Faculty Mannheim, Experimental Radiation Oncology, Heidelberg University, Mannheim, Germany
| | - J Hesser
- 4 Medical Faculty Mannheim, Experimental Radiation Oncology, Heidelberg University, Mannheim, Germany
| | - O Ott
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - R Fietkau
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - C Bert
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Bain AR, Nybo L, Ainslie PN. Cerebral Vascular Control and Metabolism in Heat Stress. Compr Physiol 2016; 5:1345-80. [PMID: 26140721 DOI: 10.1002/cphy.c140066] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This review provides an in-depth update on the impact of heat stress on cerebrovascular functioning. The regulation of cerebral temperature, blood flow, and metabolism are discussed. We further provide an overview of vascular permeability, the neurocognitive changes, and the key clinical implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced peripheral resistance secondary to skin vasodilatation. Therefore, when hyperthermia is combined with conditions that increase cardiovascular strain, for example, orthostasis or dehydration, the inability to preserve cerebral perfusion pressure further reduces CBF. A reduced cerebral perfusion pressure is in turn the primary mechanism for impaired tolerance to orthostatic challenges. Any reduction in CBF attenuates the brain's convective heat loss, while the hyperthermic-induced increase in metabolic rate increases the cerebral heat gain. This paradoxical uncoupling of CBF to metabolism increases brain temperature, and potentiates a condition whereby cerebral oxygenation may be compromised. With levels of experimentally viable passive hyperthermia (up to 39.5-40.0 °C core temperature), the associated reduction in CBF (∼ 30%) and increase in cerebral metabolic demand (∼ 10%) is likely compensated by increases in cerebral oxygen extraction. However, severe increases in whole-body and brain temperature may increase blood-brain barrier permeability, potentially leading to cerebral vasogenic edema. The cerebrovascular challenges associated with hyperthermia are of paramount importance for populations with compromised thermoregulatory control--for example, spinal cord injury, elderly, and those with preexisting cardiovascular diseases.
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Affiliation(s)
- Anthony R Bain
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
| | - Lars Nybo
- Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Philip N Ainslie
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
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29
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Kikuchi C, Inoue M, Okawa K, Taguchi J, Hirota Y, Yanagiya Y. [Evaluation of the Effect of Adiabatic Pulse and B1 Shim to the Radio Frequency Homogeneity in Chemical Shift Imaging]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2016; 72:326-333. [PMID: 27097994 DOI: 10.6009/jjrt.2016_jsrt_72.4.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
It is considered that the enhancement of chemical shift and the elevation of signal-to-noise ratio (SNR) induced by high magnetic fields are useful for the evaluation of metabolism using magnetic resonance spectroscopy (MRS). However, the reduction of the localization in MRS seems to be caused by the decreased homogeneity of radio frequency (RF) pulses, especially in chemical shift imaging (CSI). To search the influence of B1 shim mode and the significance of adiabatic pulses, we have examined the changes of RF homogeneity using 3 T magnetic resonance imaging (MRI) with the water phantom and the metabolites phantom (containing acetate and lactate) in CSI. The RF homogeneity and chemical shift artifact were obviously improved using the adiabatic pulses. Improvement of the homogeneity of RF pulses was observed when B1 shim was used. These results suggest the usefulness of CSI using adiabatic pulses and B1 shim when small amount of metabolites of target is measured in MRS.
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Affiliation(s)
- Chie Kikuchi
- Department of Radiology, Tokyo Sekishinkai Shinryoku Neurosurgery
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30
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Oyama K, Zeeb V, Kawamura Y, Arai T, Gotoh M, Itoh H, Itabashi T, Suzuki M, Ishiwata S. Triggering of high-speed neurite outgrowth using an optical microheater. Sci Rep 2015; 5:16611. [PMID: 26568288 PMCID: PMC4645119 DOI: 10.1038/srep16611] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 10/16/2015] [Indexed: 12/12/2022] Open
Abstract
Optical microheating is a powerful non-invasive method for manipulating biological functions such as gene expression, muscle contraction, and cell excitation. Here, we demonstrate its potential usage for regulating neurite outgrowth. We found that optical microheating with a water-absorbable 1,455-nm laser beam triggers directional and explosive neurite outgrowth and branching in rat hippocampal neurons. The focused laser beam under a microscope rapidly increases the local temperature from 36 °C to 41 °C (stabilized within 2 s), resulting in the elongation of neurites by more than 10 μm within 1 min. This high-speed, persistent elongation of neurites was suppressed by inhibitors of both microtubule and actin polymerization, indicating that the thermosensitive dynamics of these cytoskeletons play crucial roles in this heat-induced neurite outgrowth. Furthermore, we showed that microheating induced the regrowth of injured neurites and the interconnection of neurites. These results demonstrate the efficacy of optical microheating methods for the construction of arbitrary neural networks.
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Affiliation(s)
- Kotaro Oyama
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan.,Department of Cell Physiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Vadim Zeeb
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan.,Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region 142292, Russia
| | - Yuki Kawamura
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan
| | - Tomomi Arai
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan.,Department of Cell Physiology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Mizuho Gotoh
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan
| | - Hideki Itoh
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan.,Institute of Medical Biology, Agency for Science, Technology and Research (A*STAR), 8A Biomedical Grove, #06-06 Immunos, Singapore 138648, Singapore
| | - Takeshi Itabashi
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan
| | - Madoka Suzuki
- WASEDA Bioscience Research Institute in Singapore (WABIOS), 11 Biopolis Way, #05-02 Helios, Singapore 138667, Singapore.,Organization for University Research Initiatives, Waseda University, #304, Block 120-4, 513 Wasedatsurumaki-cho, Shinjuku-ku, Tokyo, 162-0041 Japan
| | - Shin'ichi Ishiwata
- Department of Physics, School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo, Shinjuku-ku, Tokyo 169-8555, Japan.,WASEDA Bioscience Research Institute in Singapore (WABIOS), 11 Biopolis Way, #05-02 Helios, Singapore 138667, Singapore.,Organization for University Research Initiatives, Waseda University, #304, Block 120-4, 513 Wasedatsurumaki-cho, Shinjuku-ku, Tokyo, 162-0041 Japan
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31
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Park HJ, Seol JH, Ku J, Kim S. Computational Study on the Thermal Effects of Implantable Magnetic Stimulation Based on Planar Coils. IEEE Trans Biomed Eng 2015; 63:158-67. [PMID: 26468905 DOI: 10.1109/tbme.2015.2490244] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
GOAL Micromagnetic stimulation using coils sufficiently small to be implanted has been suggested as a potential method to overcome the limitations of electrical stimulation. We investigated the temperature increases in the brain implanted with planar coils. METHODS We conducted computational simulations on the thermal effects of implantable magnetic stimulation in a brain model using finite-element analysis, by varying geometric parameters of planar spiral coils, and repetitive stimulation pulse patterns. RESULTS It was revealed that the temperature increase in the brain can be controlled by a careful design of coils to implant. The coil diameter greater than 8 mm was required to induce a temperature rise in the brain of less than 1 °C. If the coil diameter was larger than 10 mm, the subsequent temperature rises in the brain tissue was maintained consistently at about 0.24 °C or lower. CONCLUSION Selection of the number of coil turns must rely on tradeoffs between the required current and voltage that the implanted source can generate, as the required voltage increases while the required current decreases with increasing number of coil turns. Additionally, the coil insulation with a thickness of a few micrometers was found to suppress the temperature rise in the brain effectively. SIGNIFICANCE Although these simulations employed only one threshold value of 10 V/m, which is rather on the lower end of stimulation threshold, the simulation results are expected to serve as guidelines for designing planar coils to be implanted in the brain for magnetic stimulation.
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32
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Islam S, Hampton-Till J, Watson N, Mannakkara NN, Hamarneh A, Webber T, Magee N, Abbey L, Jagathesan R, Kabir A, Sayer J, Robinson N, Aggarwal R, Clesham G, Kelly P, Gamma R, Tang K, Davies JR, Keeble TR. Early targeted brain COOLing in the cardiac CATHeterisation laboratory following cardiac arrest (COOLCATH). Resuscitation 2015; 97:61-7. [PMID: 26410565 DOI: 10.1016/j.resuscitation.2015.09.386] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/11/2015] [Accepted: 09/16/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Trials demonstrate significant clinical benefit in patients receiving therapeutic hypothermia (TH) after cardiac arrest. However, incidence of mortality and morbidity remains high in this patient group. Rapid targeted brain hypothermia induction, together with prompt correction of the underlying cause may improve outcomes in these patients. This study investigates the efficacy of Rhinochill, an intranasal cooling device over Blanketrol, a surface cooling device in inducing TH in cardiac arrest patients within the cardiac catheter laboratory. METHODS 70 patients were randomized to TH induction with either Rhinochill or Blanketrol. Primary outcome measures were time to reach tympanic ≤34 °C from randomisation as a surrogate for brain temperature and oesophageal ≤34 °C from randomisation as a measurement of core body temperature. Secondary outcomes included first hour temperature drop, length of stay in intensive care unit, hospital stay, neurological recovery and all-cause mortality at hospital discharge. RESULTS There was no difference in time to reach ≤34 °C between Rhinochill and Blanketrol (Tympanic ≤34 °C, 75 vs. 107 mins; p=0.101; Oesophageal ≤34 °C, 85 vs. 115 mins; p=0.151). Tympanic temperature dropped significantly with Rhinochill in the first hour (1.75 vs. 0.94 °C; p<0.001). No difference was detected in any other secondary outcome measures. Catheter laboratory-based TH induction resulted in a survival to hospital discharge of 67.1%. CONCLUSION In this study, Rhinochill was not found to be more efficient than Blanketrol for TH induction, although there was a non-significant trend in favour of Rhinochill that potentially warrants further investigation with a larger trial.
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Affiliation(s)
- Shahed Islam
- Post Graduate Medical Institute (PMI), Anglia Ruskin University, Chelmsford, UK; The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - James Hampton-Till
- Post Graduate Medical Institute (PMI), Anglia Ruskin University, Chelmsford, UK
| | - Noel Watson
- Post Graduate Medical Institute (PMI), Anglia Ruskin University, Chelmsford, UK; The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | | | - Ashraf Hamarneh
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Teresa Webber
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Neil Magee
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Lucy Abbey
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Rohan Jagathesan
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Alamgir Kabir
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Jeremy Sayer
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Nicholas Robinson
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Rajesh Aggarwal
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Gerald Clesham
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Paul Kelly
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Reto Gamma
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - Kare Tang
- The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK
| | - John R Davies
- Post Graduate Medical Institute (PMI), Anglia Ruskin University, Chelmsford, UK; The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK.
| | - Thomas R Keeble
- Post Graduate Medical Institute (PMI), Anglia Ruskin University, Chelmsford, UK; The Essex Cardiothoracic Centre (CTC), Basildon, Essex, SS16 5NL, UK.
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33
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Babourina-Brooks B, Simpson R, Arvanitis TN, Machin G, Peet AC, Davies NP. MRS thermometry calibration at 3 T: effects of protein, ionic concentration and magnetic field strength. NMR IN BIOMEDICINE 2015; 28:792-800. [PMID: 25943246 DOI: 10.1002/nbm.3303] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 06/04/2023]
Abstract
MRS thermometry has been utilized to measure temperature changes in the brain, which may aid in the diagnosis of brain trauma and tumours. However, the temperature calibration of the technique has been shown to be sensitive to non-temperature-based factors, which may provide unique information on the tissue microenvironment if the mechanisms can be further understood. The focus of this study was to investigate the effects of varied protein content on the calibration of MRS thermometry at 3 T, which has not been thoroughly explored in the literature. The effects of ionic concentration and magnetic field strength were also considered. Temperature reference materials were controlled by water circulation and freezing organic fixed-point compounds (diphenyl ether and ethylene carbonate) stable to within 0.2 °C. The temperature was measured throughout the scan time with a fluoro-optic probe, with an uncertainty of 0.16 °C. The probe was calibrated at the National Physical Laboratory (NPL) with traceability to the International Temperature Scale 1990 (ITS-90). MRS thermometry measures were based on single-voxel spectroscopy chemical shift differences between water and N-acetylaspartate (NAA), Δ(H20-NAA), using a Philips Achieva 3 T scanner. Six different phantom solutions with varying protein or ionic concentration, simulating potential tissue differences, were investigated within a temperature range of 21-42 °C. Results were compared with a similar study performed at 1.5 T to observe the effect of field strengths. Temperature calibration curves were plotted to convert Δ(H20-NAA) to apparent temperature. The apparent temperature changed by -0.2 °C/% of bovine serum albumin (BSA) and a trend of 0.5 °C/50 mM ionic concentration was observed. Differences in the calibration coefficients for the 10% BSA solution were seen in this study at 3 T compared with a study at 1.5 T. MRS thermometry may be utilized to measure temperature and the tissue microenvironment, which could provide unique unexplored information for brain abnormalities and other pathologies.
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Affiliation(s)
- Ben Babourina-Brooks
- School of Cancer Sciences, University of Birmingham, Birmingham, West Midlands, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Robert Simpson
- Temperature Group, National Physical Laboratory, Teddington, Middlesex, UK
| | - Theodoros N Arvanitis
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK
| | - Graham Machin
- Temperature Group, National Physical Laboratory, Teddington, Middlesex, UK
| | - Andrew C Peet
- School of Cancer Sciences, University of Birmingham, Birmingham, West Midlands, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Nigel P Davies
- School of Cancer Sciences, University of Birmingham, Birmingham, West Midlands, UK
- Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
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Rango M, Bonifati C, Bresolin N. Post-Activation Brain Warming: A 1-H MRS Thermometry Study. PLoS One 2015; 10:e0127314. [PMID: 26011731 PMCID: PMC4444346 DOI: 10.1371/journal.pone.0127314] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 04/14/2015] [Indexed: 11/24/2022] Open
Abstract
Purpose Temperature plays a fundamental role for the proper functioning of the brain. However, there are only fragmentary data on brain temperature (Tbr) and its regulation under different physiological conditions. Methods We studied Tbr in the visual cortex of 20 normal subjects serially with a wide temporal window under different states including rest, activation and recovery by a visual stimulation-Magnetic Resonance Spectroscopy Thermometry combined approach. We also studied Tbr in a control region, the centrum semiovale, under the same conditions. Results Visual cortex mean baseline Tbr was higher than mean body temperature (37.38 vs 36.60, P<0.001). During activation Tbr remained unchanged at first and then showed a small decrease (-0.20 C°) around the baseline value. After the end of activation Tbr increased consistently (+0.60 C°) and then returned to baseline values after some minutes. Centrum semiovale Tbr remained unchanged through rest, visual stimulation and recovery. Conclusion These findings have several implications, among them that neuronal firing itself is not a major source of heat release in the brain and that there is an aftermath of brain activation that lasts minutes before returning to baseline conditions.
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Affiliation(s)
- Mario Rango
- Department of Neurological Sciences, IRCCS Ca’ Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
- Magnetic Resonance Spectroscopy Center, IRCCS Ca’ Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
- * E-mail:
| | - Cristiana Bonifati
- Department of Neurological Sciences, IRCCS Ca’ Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
- Magnetic Resonance Spectroscopy Center, IRCCS Ca’ Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
| | - Nereo Bresolin
- Department of Neurological Sciences, IRCCS Ca’ Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
- Magnetic Resonance Spectroscopy Center, IRCCS Ca’ Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
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Dehkharghani S, Mao H, Howell L, Zhang X, Pate KS, Magrath PR, Tong F, Wei L, Qiu D, Fleischer C, Oshinski JN. Proton resonance frequency chemical shift thermometry: experimental design and validation toward high-resolution noninvasive temperature monitoring and in vivo experience in a nonhuman primate model of acute ischemic stroke. AJNR Am J Neuroradiol 2015; 36:1128-35. [PMID: 25655874 DOI: 10.3174/ajnr.a4241] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 11/27/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Applications for noninvasive biologic temperature monitoring are widespread in biomedicine and of particular interest in the context of brain temperature regulation, where traditionally costly and invasive monitoring schemes limit their applicability in many settings. Brain thermal regulation, therefore, remains controversial, motivating the development of noninvasive approaches such as temperature-sensitive nuclear MR phenomena. The purpose of this work was to compare the utility of competing approaches to MR thermometry by using proton resonance frequency chemical shift. We tested 3 methodologies, hypothesizing the feasibility of a fast and accurate approach to chemical shift thermometry, in a phantom study at 3T. MATERIALS AND METHODS A conventional, paired approach (difference [DIFF]-1), an accelerated single-scan approach (DIFF-2), and a new, further accelerated strategy (DIFF-3) were tested. Phantom temperatures were modulated during real-time fiber optic temperature monitoring, with MR thermometry derived simultaneously from temperature-sensitive changes in the water proton chemical shift (∼0.01 ppm/°C). MR thermometry was subsequently performed in a series of in vivo nonhuman primate experiments under physiologic and ischemic conditions, testing its reproducibility and overall performance. RESULTS Chemical shift thermometry demonstrated excellent agreement with phantom temperatures for all 3 approaches (DIFF-1: linear regression R(2) = 0.994; P < .001; acquisition time = 4 minutes 40 seconds; DIFF-2: R(2) = 0.996; P < .001; acquisition time = 4 minutes; DIFF-3: R(2) = 0.998; P < .001; acquisition time = 40 seconds). CONCLUSIONS These findings confirm the comparability in performance of 3 competing approaches to MR thermometry and present in vivo applications under physiologic and ischemic conditions in a primate stroke model.
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Affiliation(s)
- S Dehkharghani
- From the Department of Radiology and Imaging Sciences (S.D., H.M., K.S.P., F.T., D.Q., J.N.O.), Emory University Hospital, Atlanta, Georgia
| | - H Mao
- From the Department of Radiology and Imaging Sciences (S.D., H.M., K.S.P., F.T., D.Q., J.N.O.), Emory University Hospital, Atlanta, Georgia
| | - L Howell
- Yerkes National Primate Research Center (L.H., X.Z.), Emory University, Atlanta, Georgia
| | - X Zhang
- Yerkes National Primate Research Center (L.H., X.Z.), Emory University, Atlanta, Georgia
| | - K S Pate
- From the Department of Radiology and Imaging Sciences (S.D., H.M., K.S.P., F.T., D.Q., J.N.O.), Emory University Hospital, Atlanta, Georgia
| | - P R Magrath
- Department of Biomedical Engineering (P.R.M.), Northwestern University, Evanston, Illinois
| | - F Tong
- From the Department of Radiology and Imaging Sciences (S.D., H.M., K.S.P., F.T., D.Q., J.N.O.), Emory University Hospital, Atlanta, Georgia
| | - L Wei
- Department of Biomedical Engineering (L.W., C.F.), Emory University-Georgia Institute of Technology, Atlanta, Georgia
| | - D Qiu
- From the Department of Radiology and Imaging Sciences (S.D., H.M., K.S.P., F.T., D.Q., J.N.O.), Emory University Hospital, Atlanta, Georgia
| | - C Fleischer
- Department of Biomedical Engineering (L.W., C.F.), Emory University-Georgia Institute of Technology, Atlanta, Georgia
| | - J N Oshinski
- From the Department of Radiology and Imaging Sciences (S.D., H.M., K.S.P., F.T., D.Q., J.N.O.), Emory University Hospital, Atlanta, Georgia
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Wu TW, McLean C, Friedlich P, Wisnowski J, Grimm J, Panigrahy A, Bluml S, Seri I. Brain temperature in neonates with hypoxic-ischemic encephalopathy during therapeutic hypothermia. J Pediatr 2014; 165:1129-34. [PMID: 25151196 DOI: 10.1016/j.jpeds.2014.07.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 06/02/2014] [Accepted: 07/08/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To noninvasively determine brain temperature of neonates with hypoxic-ischemic encephalopathy (HIE) during and after therapeutic hypothermia. STUDY DESIGN Using a phantom, we derived a calibration curve to calculate brain temperature based on chemical shift differences in magnetic resonance spectroscopy. We enrolled infants admitted for therapeutic hypothermia and assigned them to a moderate HIE (M-HIE) or severe HIE (S-HIE) group based on Sarnat staging. Rectal (core) temperature and magnetic resonance spectroscopy data used to derive regional brain temperatures (basal ganglia, thalamus, and cortical gray matter) were acquired concomitantly during and after therapeutic hypothermia. We compared brain and rectal temperature in the M-HIE and S-HIE groups during and after therapeutic hypothermia using 2-tailed t-tests. RESULTS Eighteen patients (14 with M-HIE and 4 with S-HIE) were enrolled. As expected, both brain and rectal temperatures were lower during therapeutic hypothermia than after therapeutic hypothermia. Brain temperature in patients with S-HIE was higher than in those with M-HIE both during (35.1 ± 1.3°C vs 33.7 ± 1.2°C; P < .01) and after therapeutic hypothermia (38.1 ± 1.5°C vs 36.8 ± 1.3°C; P < .01). The brain-rectal temperature gradient was also greater in the S-HIE group both during and after therapeutic hypothermia. CONCLUSION For this analysis of a small number of patients, brain temperature and brain-rectal temperature gradient were higher in neonates with S-HIE than in those with M-HIE during and after therapeutic hypothermia. Further studies are needed to determine whether further decreasing brain temperature in neonates with S-HIE is safe and effective in improving outcome.
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Affiliation(s)
- Tai-Wei Wu
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Claire McLean
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Philippe Friedlich
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jessica Wisnowski
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - John Grimm
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ashok Panigrahy
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Stefan Bluml
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Istvan Seri
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
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Babourina-Brooks B, Wilson M, Arvanitis TN, Peet AC, Davies NP. MRS water resonance frequency in childhood brain tumours: a novel potential biomarker of temperature and tumour environment. NMR IN BIOMEDICINE 2014; 27:1222-9. [PMID: 25125325 PMCID: PMC4491353 DOI: 10.1002/nbm.3177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 06/13/2014] [Accepted: 07/10/2014] [Indexed: 06/03/2023]
Abstract
(1)H MRS thermometry has been investigated for brain trauma and hypothermia monitoring applications but has not been explored in brain tumours. The proton resonance frequency (PRF) of water is dependent on temperature but is also influenced by microenvironment factors, such as fast proton exchange with macromolecules, ionic concentration and magnetic susceptibility. (1)H MRS has been utilized for brain tumour diagnostic and prognostic purposes in children; however, the water PRF measure may provide complementary information to further improve characterization. Water PRF values were investigated from a repository of MRS data acquired from childhood brain tumours and children with apparently normal brains. The cohort consisted of histologically proven glioma (22), medulloblastoma (19) and control groups (28, MRS in both the basal ganglia and parietal white matter regions). All data were acquired at 1.5 T using a short TE (30 ms) single voxel spectroscopy (PRESS) protocol. Water PRF values were calculated using methyl creatine and total choline. Spectral peak amplitude weighted averaging was used to improve the accuracy of the measurements. Mean PRF values were significantly larger for medulloblastoma compared with glioma, with a difference in the means of 0.0147 ppm (p < 0.05), while the mean PRF for glioma was significantly lower than for the healthy cohort, with a difference in the means of 0.0061 ppm (p < 0.05). This would suggest the apparent temperature of the glioma group was ~1.5 °C higher than the medulloblastomas and ~0.7 °C higher than a healthy brain. However, the PRF shift may not reflect a change in temperature, given that alterations in protein content, microstructure and ionic concentration contribute to PRF shifts. Measurement of these effects could also be used as a supplementary biomarker, and further investigation is required. This study has shown that the water PRF value has the potential to be used for characterizing childhood brain tumours, which has not been reported previously.
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Affiliation(s)
- Ben Babourina-Brooks
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
| | - Martin Wilson
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
| | - Theodoros N Arvanitis
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
- Institute of Digital Healthcare, WMG, University of WarwickCoventry, UK
| | - Andrew C Peet
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
| | - Nigel P Davies
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation TrustBirmingham, West Midlands, UK
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Dobrakowski PP, Machowska-Majchrzak AK, Labuz-Roszak B, Majchrzak KG, Kluczewska E, Pierzchała KB. MR-guided focused ultrasound: a new generation treatment of Parkinson's disease, essential tremor and neuropathic pain. Interv Neuroradiol 2014; 20:275-82. [PMID: 24976088 DOI: 10.15274/inr-2014-10033] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 01/26/2014] [Indexed: 12/16/2022] Open
Abstract
The application of high intense focused ultrasound (HIFU) is currently the subject of many experimental and clinical trials. The combination of HIFU with MRI guidance known as MR-guided focused ultrasound (MRgFUS) appears to be particularly promising to ablate tissues located deep in the brain. The method can be the beginning of interventional neurology and an important alternative to neurosurgery. Studies conducted to date show the effectiveness of the method both in chronic diseases and in emergency cases. The safety and effectiveness of this method have been observed in parkinsonian and essential tremor as well as in neuropathic pain. The procedure does not require anaesthesia. Ionizing radiation is not used and there is no risk of cumulative dose. Such advantages may result in low complication rates and medical justification for further development of MRgFUS.
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Affiliation(s)
| | | | - Beata Labuz-Roszak
- Clinical Department of Neurology, Medical University of Silesia; Zabrze, Poland
| | | | - Ewa Kluczewska
- Clinical Department of Neurology, Medical University of Silesia; Zabrze, Poland
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Rango M, Arighi A, Bonifati C, Del Bo R, Comi G, Bresolin N. The brain is hypothermic in patients with mitochondrial diseases. J Cereb Blood Flow Metab 2014; 34:915-20. [PMID: 24619278 PMCID: PMC4013774 DOI: 10.1038/jcbfm.2014.38] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 12/27/2013] [Accepted: 01/19/2014] [Indexed: 02/01/2023]
Abstract
We sought to study brain temperature in patients with mitochondrial diseases in different functional states compared with healthy participants. Brain temperature and mitochondrial function were monitored in the visual cortex and the centrum semiovale at rest and during and after visual stimulation in seven individuals with mitochondrial diseases (n=5 with mitochondrial DNA mutations and n=2 with nuclear DNA mutations) and in 14 age- and sex-matched healthy control participants using a combined approach of visual stimulation, proton magnetic resonance spectroscopy (MRS), and phosphorus MRS. Brain temperature in control participants exhibited small changes during visual stimulation and a consistent increase, together with an increase in high-energy phosphate content, after visual stimulation. Brain temperature was persistently lower in individuals with mitochondrial diseases than in healthy participants at rest, during activation, and during recovery, without significant changes from one state to another and with a decrease in the high-energy phosphate content. The lowest brain temperature was observed in the patient with the most deranged mitochondrial function. In patients with mitochondrial diseases, the brain is hypothermic because of malfunctioning oxidative phosphorylation. Neuronal activity is reduced at rest, during physiologic brain stimulation, and after stimulation.
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Affiliation(s)
- Mario Rango
- 1] Department of Neurological Sciences, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy [2] Magnetic Resonance Spectroscopy Center, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
| | - Andrea Arighi
- 1] Department of Neurological Sciences, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy [2] Magnetic Resonance Spectroscopy Center, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
| | - Cristiana Bonifati
- 1] Department of Neurological Sciences, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy [2] Magnetic Resonance Spectroscopy Center, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
| | - Roberto Del Bo
- Department of Neurological Sciences, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
| | - Giacomo Comi
- Department of Neurological Sciences, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
| | - Nereo Bresolin
- 1] Department of Neurological Sciences, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy [2] Magnetic Resonance Spectroscopy Center, IRCCS Ca' Granda-Ospedale Maggiore Policlinico Foundation, University of Milan, Milan, Italy
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40
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Noninvasive measurement of human brain temperature adjacent to arteriovenous malformation using 3.0T magnetic resonance spectroscopy. Clin Neurol Neurosurg 2013; 115:445-9. [DOI: 10.1016/j.clineuro.2012.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 02/23/2012] [Accepted: 06/16/2012] [Indexed: 11/22/2022]
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41
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Ghavami M, Rezaei M, Ejtehadi R, Lotfi M, Shokrgozar MA, Abd Emamy B, Raush J, Mahmoudi M. Physiological temperature has a crucial role in amyloid β in the absence and presence of hydrophobic and hydrophilic nanoparticles. ACS Chem Neurosci 2013; 4:375-8. [PMID: 23509973 DOI: 10.1021/cn300205g] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Amyloid beta fibrillation can lead to major disorder of neurons processes and is associated with several neuronal diseases (e.g., Alzheimer's disease). We report here an importance of slight temperature changes, in the physiological range (35-42 °C), on the amyloid fibrillation process in the presence and absence of hydrophilic (silica) and hydrophobic (polystyrene) nanoparticles (NPs). The results highlight the fact that slight increases in temperature can induce inhibitory and acceleratory effects of hydrophobic and hydrophilic NPs on the fibrillation process, respectively. Using further in vivo considerations, the outcomes of this study can be used for considerable modifications on the current diagnosis and treatment approaches in amyloid-involved diseases.
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Affiliation(s)
- Mahdi Ghavami
- National Cell Bank, Pasteur Institute of Iran, Tehran, Iran
| | - Meisam Rezaei
- Department of Physics, Sharif University of Technology, Tehran, Iran
| | - Reza Ejtehadi
- Department of Physics, Sharif University of Technology, Tehran, Iran
| | - Mina Lotfi
- Department
of Nanotechnology,
Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Jens Raush
- Systems
Biology Ireland, University College Dublin, Belfield, Dublin 4, Ireland
| | - Morteza Mahmoudi
- Department
of Nanotechnology,
Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
- Nanotechnology Research Center,
Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
The maintenance of a stable temperature is of the utmost importance for the proper functioning of the brain. Brain temperature is tightly linked to mitochondrial energetics. Although Parkinson's disease is characterized by mitochondrial dysfunction, no data are available on brain temperature. We measured the temperature in the visual cortex and in the centrum semiovale at rest by proton magnetic resonance spectroscopy in patients with Parkinson's disease and in age-matched and sex-matched control participants. We report evidence of increased temperature in the visual cortex and, to a minor extent, in the centrum semiovale of patients with Parkinson's disease. The increase in brain temperature is best explained by an energy loss along the oxidative phosphorylation/respiratory chain.
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Chen F, Ni YC. Magnetic resonance diffusion-perfusion mismatch in acute ischemic stroke: An update. World J Radiol 2012; 4:63-74. [PMID: 22468186 PMCID: PMC3314930 DOI: 10.4329/wjr.v4.i3.63] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 02/22/2012] [Accepted: 03/01/2012] [Indexed: 02/06/2023] Open
Abstract
The concept of magnetic resonance perfusion-diffusion mismatch (PDM) provides a practical and approximate measure of the tissue at risk and has been increasingly applied for the evaluation of hyperacute and acute stroke in animals and patients. Recent studies demonstrated that PDM does not optimally define the ischemic penumbra; because early abnormality on diffusion-weighted imaging overestimates the infarct core by including part of the penumbra, and the abnormality on perfusion weighted imaging overestimates the penumbra by including regions of benign oligemia. To overcome these limitations, many efforts have been made to optimize conventional PDM. Various alternatives beyond the PDM concept are under investigation in order to better define the penumbra. The PDM theory has been applied in ischemic stroke for at least three purposes: to be used as a practical selection tool for stroke treatment; to test the hypothesis that patients with PDM pattern will benefit from treatment, while those without mismatch pattern will not; to be a surrogate measure for stroke outcome. The main patterns of PDM and its relation with clinical outcomes were also briefly reviewed. The conclusion was that patients with PDM documented more reperfusion, reduced infarct growth and better clinical outcomes compared to patients without PDM, but it was not yet clear that thrombolytic therapy is beneficial when patients were selected on PDM. Studies based on a larger cohort are currently under investigation to further validate the PDM hypothesis.
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Chadzynski GL, Bender B, Groeger A, Erb M, Klose U. Tissue specific resonance frequencies of water and metabolites within the human brain. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2011; 212:55-63. [PMID: 21752679 DOI: 10.1016/j.jmr.2011.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Revised: 06/10/2011] [Accepted: 06/11/2011] [Indexed: 05/31/2023]
Abstract
Chemical shift imaging (CSI) without water suppression was used to examine tissue-specific resonance frequencies of water and metabolites within the human brain. The aim was to verify if there are any regional differences in those frequencies and to determine the influence of chemical shift displacement in slice-selection direction. Unsuppressed spectra were acquired at 3T from nine subjects. Resonance frequencies of water and after water signal removal of total choline, total creatine and NAA were estimated. Furthermore, frequency distances between the water and those resonances were calculated. Results were corrected for chemical shift displacement. Frequency distances between water and metabolites were consistent and greater for GM than for WM. The highest value of WM to GM difference (14ppb) was observed for water to NAA frequency distance. This study demonstrates that there are tissue-specific differences between frequency distances of water and metabolites. Moreover, the influence of chemical shift displacement in slice-selection direction is showed to be negligible.
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Affiliation(s)
- Grzegorz L Chadzynski
- MR Research Group, Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler strasse 3, 72076 Tuebingen, Germany.
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Kobayashi T, Isobe T, Shiotani S, Saito H, Saotome K, Kaga K, Miyamoto K, Kikuchi K, Hayakawa H, Akutsu H, Homma K. Postmortem magnetic resonance imaging dealing with low temperature objects. Magn Reson Med Sci 2011; 9:101-8. [PMID: 20885082 DOI: 10.2463/mrms.9.101] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In Japan, the medical examiner system is not widespread, the rate of autopsy is low, and many medical institutions therefore perform postmortem imaging using clinical equipment. Postmortem imaging is performed to clarify cause of death, select candidates for autopsy, make a guide map for autopsy, or provide additional information for autopsy. Findings are classified into 3 categories: cause of death and associated changes, changes induced by cardiopulmonary resuscitation, and postmortem changes. Postmortem magnetic resonance imaging shows characteristic changes in signal intensity related to low body temperature after death; they are low temperature images.
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Affiliation(s)
- Tomoya Kobayashi
- Department of Radiological Technology, Tsukuba Medical Center, Tsukuba, Ibaraki, Japan.
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Murakami T, Ogasawara K, Yoshioka Y, Ishigaki D, Sasaki M, Kudo K, Aso K, Nishimoto H, Kobayashi M, Yoshida K, Ogawa A. Brain Temperature Measured by Using Proton MR Spectroscopy Predicts Cerebral Hyperperfusion after Carotid Endarterectomy. Radiology 2010; 256:924-31. [DOI: 10.1148/radiol.10090930] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Covaciu L, Rubertsson S, Ortiz-Nieto F, Ahlström H, Weis J. Human brain MR spectroscopy thermometry using metabolite aqueous-solution calibrations. J Magn Reson Imaging 2010; 31:807-14. [DOI: 10.1002/jmri.22107] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Chan KWY, Chow AM, Chan KC, Yang J, Wu EX. Magnetic resonance spectroscopy of the brain under mild hypothermia indicates changes in neuroprotection-related metabolites. Neurosci Lett 2010; 475:150-5. [PMID: 20362032 DOI: 10.1016/j.neulet.2010.03.066] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 03/24/2010] [Accepted: 03/25/2010] [Indexed: 11/25/2022]
Abstract
Brain hypothermia has demonstrated pronounced neuroprotective effect in patients with cardiac arrest, ischemia and acute liver failure. However, its underlying neuroprotective mechanisms remain to be elucidated in order to improve therapeutic outcomes. Single voxel proton magnetic resonance spectroscopy ((1)H-MRS) was performed using a 7 Tesla MRI scanner on normal Sprague-Dawley rats (N=8) in the same voxel under normothermia (36.5 degrees C) and 30min mild hypothermia (33.5 degrees C). Levels of various brain proton metabolites were compared. The level of lactate (Lac) and myo-inositol (mI) increased in the cortex during hypothermia. In the thalamus, taurine (Tau), a cryogen in brain, increased and choline (Cho) decreased. These metabolic alterations indicated the onset of a number of neuroprotective processes that include attenuation of energy metabolism, excitotoxic pathways, brain osmolytes and thermoregulation, thus protecting neuronal cells from damage. These experimental findings demonstrated that (1)H-MRS can be applied to investigate the changes of specific metabolites and corresponding neuroprotection mechanisms in vivo noninvasively, and ultimately improve our basic understanding of hypothermia and ability to optimize its therapeutic efficacy.
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Affiliation(s)
- Kannie W Y Chan
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Choi JH, Marshall RS, Neimark MA, Konstas AA, Lin E, Chiang YT, Mast H, Rundek T, Mohr JP, Pile-Spellman J. Selective brain cooling with endovascular intracarotid infusion of cold saline: a pilot feasibility study. AJNR Am J Neuroradiol 2010; 31:928-34. [PMID: 20053807 DOI: 10.3174/ajnr.a1961] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Endovascular brain cooling as a method for rapid and selective induction of hypothermic neuroprotection has not been systematically studied in humans. In this clinical pilot study we investigated the feasibility, safety, and physiologic responses of short-term brain cooling with IC-CSI. MATERIALS AND METHODS We studied 18 patients (50 +/- 10 years old, 9 women) undergoing follow-up cerebral angiography after previous treatment of vascular malformations. Isotonic saline (4-17 degrees C) was infused into 1 internal carotid artery at 33 mL/min for 10 minutes. Brain (JVB) and bladder/esophageal temperature measurements (n = 9) were performed. Both MCAs were monitored with transcranial Doppler sonography (n = 13). Arterial and JV blood were sampled to estimate hemodilution and brain oxygen extraction. RESULTS JVB temperature dropped approximately 0.84 +/- 0.13 degrees C and systemic temperature by 0.15 +/- 0.08 degrees C from baseline (JVB versus systemic temperature: P = .0006). Systolic MCA-flow velocities decreased from 101 +/- 27 to 73 +/- 18 cm/s on the infused side and from 83 +/- 24 to 78 +/- 21 cm/s on the contralateral side (relative changes, -26 +/- 8% versus -4 +/- 27%; P = .009). Changes in hematocrit (-1.2 +/- 1.1%) and cerebral arteriovenous oxygen difference (0.2 +/- 1.0 mL O(2)/100 mL) were not significant. Doppler data showed no signs of vascular spasm or microemboli. No focal neurologic deficits occurred. Pain was not reported. CONCLUSIONS The results of this pilot study suggest that brain cooling can be achieved safely, rapidly, and selectively by means of IC-CSI, opening a new potential avenue for acute neuroprotection. Clinical investigations with control of infusion parameters and measurements of CBF, oxygen consumption, and brain temperature are warranted.
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Affiliation(s)
- J H Choi
- Department of Radiology, Interventional Neuroradiology, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York 10032, USA.
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Ishigaki D, Ogasawara K, Yoshioka Y, Chida K, Sasaki M, Fujiwara S, Aso K, Kobayashi M, Yoshida K, Terasaki K, Inoue T, Ogawa A. Brain temperature measured using proton MR spectroscopy detects cerebral hemodynamic impairment in patients with unilateral chronic major cerebral artery steno-occlusive disease: comparison with positron emission tomography. Stroke 2009; 40:3012-6. [PMID: 19590051 DOI: 10.1161/strokeaha.109.555508] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Brain temperature is determined by the balance between heat produced by cerebral energy turnover and heat removed by cerebral blood flow. The purpose of the present study was to investigate whether brain temperature measured noninvasively using proton MR spectroscopy can detect cerebral hemodynamic impairment in patients with unilateral chronic internal carotid or middle cerebral artery occlusive disease when compared with positron emission tomography. METHODS Brain temperature, cerebral blood flow, and metabolism were measured using proton MR spectroscopy and (15)O-positron emission tomography, respectively, in 21 normal subjects and 37 patients. Positron emission tomography images were coregistered with MR images and resliced automatically using image analysis software. Regions of interest placed in both cerebral hemispheres on MR images were automatically superimposed in these resliced positron emission tomography images. RESULTS A significant correlation was observed between brain temperature difference (affected hemisphere-contralateral hemisphere) and both cerebral blood volume and oxygen extraction fraction ratio (affected hemisphere/contralateral hemisphere; r=0.607; P=0.0004 and r=0.631; P=0.0002). With abnormally elevated cerebral blood volume or oxygen extraction fraction ratio defined as higher than the mean +2 SDs obtained from normal subjects, brain temperature difference provided 86% or 92% sensitivity and 87% or 84% specificity with 80% or 73% positive and 91% or 95% negative predictive values for detecting abnormally elevated cerebral blood volume or oxygen extraction fraction ratios, respectively. CONCLUSIONS Brain temperature measured using proton MR spectroscopy can detect cerebral hemodynamic impairment in patients with unilateral chronic major cerebral artery steno-occlusive disease.
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Affiliation(s)
- Daiya Ishigaki
- Advanced Research Center, School of Medicine, Iwate Medical University, Morioka, Japan
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