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Courtney MR, Antonic-Baker A, Chen Z, Sinclair B, Nicolo JP, Neal A, Marotta C, Bunyamin J, Law M, Kwan P, O'Brien TJ, Vivash L. Association of Localizing 18F-FDG-PET Hypometabolism and Outcome Following Epilepsy Surgery: Systematic Review and Meta-Analysis. Neurology 2024; 102:e209304. [PMID: 38626375 DOI: 10.1212/wnl.0000000000209304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Although commonly used in the evaluation of patients for epilepsy surgery, the association between the detection of localizing 18fluorine fluorodeoxyglucose PET (18F-FDG-PET) hypometabolism and epilepsy surgery outcome is uncertain. We conducted a systematic review and meta-analysis to determine whether localizing 18F-FDG-PET hypometabolism is associated with favorable outcome after epilepsy surgery. METHODS A systematic literature search was undertaken. Eligible publications included evaluation with 18F-FDG-PET before epilepsy surgery, with ≥10 participants, and those that reported surgical outcome at ≥12 months. Random-effects meta-analysis was used to calculate the odds of achieving a favorable outcome, defined as Engel class I, International League Against Epilepsy class 1-2, or seizure-free, with localizing 18F-FDG-PET hypometabolism, defined as concordant with the epilepsy surgery resection zone. Meta-regression was used to characterize sources of heterogeneity. RESULTS The database search identified 8,916 studies, of which 98 were included (total patients n = 4,104). Localizing 18F-FDG-PET hypometabolism was associated with favorable outcome after epilepsy surgery for all patients with odds ratio (OR) 2.68 (95% CI 2.08-3.45). Subgroup analysis yielded similar findings for those with (OR 2.64, 95% CI 1.54-4.52) and without epileptogenic lesion detected on MRI (OR 2.49, 95% CI 1.80-3.44). Concordance with EEG (OR 2.34, 95% CI 1.43-3.83), MRI (OR 1.69, 95% CI 1.19-2.40), and triple concordance with both (OR 2.20, 95% CI 1.32-3.64) was associated with higher odds of favorable outcome. By contrast, diffuse 18F-FDG-PET hypometabolism was associated with worse outcomes compared with focal hypometabolism (OR 0.34, 95% CI 0.22-0.54). DISCUSSION Localizing 18F-FDG-PET hypometabolism is associated with favorable outcome after epilepsy surgery, irrespective of the presence of an epileptogenic lesion on MRI. The extent of 18F-FDG-PET hypometabolism provides additional information, with diffuse hypometabolism associated with worse surgical outcome than focal 18F-FDG-PET hypometabolism. These findings support the incorporation of 18F-FDG-PET into routine noninvasive investigations for patients being evaluated for epilepsy surgery to improve epileptogenic zone localization and to aid patient selection for surgery.
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Affiliation(s)
- Merran R Courtney
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Ana Antonic-Baker
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Zhibin Chen
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Benjamin Sinclair
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - John-Paul Nicolo
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Andrew Neal
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Cassandra Marotta
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Jacob Bunyamin
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Meng Law
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Patrick Kwan
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Terence J O'Brien
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
| | - Lucy Vivash
- From the Department of Neuroscience (M.R.C., A.A.-B., Z.C., B.S., J.-P.N., A.N., C.M., J.B., M.L., P.K., T.J.O.B., L.V.), School of Translational Medicine, Monash University; Department of Neurology (M.R.C., B.S., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Alfred Health; Department of Neurology (M.R.C., J.-P.N., A.N., P.K., T.J.O.B., L.V.), Royal Melbourne Hospital; Department of Radiology (M.L.), Alfred Health; Department of Electrical and Computer Systems Engineering (M.L.), Monash University; and Department of Medicine (P.K., T.J.O.B., L.V.), The University of Melbourne, Victoria, Australia
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Chen J, Ngo A, Rodríguez-Cruces R, Royer J, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Yasuda CL, Alvim MKM, Bonilha L, Gleichgerrcht E, Focke NK, Kreilkamp B, Domin M, von Podewils F, Langner S, Rummel C, Wiest R, Martin P, Kotikalapudi R, Bender B, O’Brien TJ, Sinclair B, Vivash L, Kwan P, Desmond PM, Lui E, Duma GM, Bonanni P, Ballerini A, Vaudano AE, Meletti S, Tondelli M, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Rüber T, Bauer T, Weber B, Caldairou B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Pardoe H, Severino M, Striano P, Tortora D, Kaestner E, Hatton SN, Arienzo D, Vos SB, Ryten M, Taylor PN, Duncan JS, Whelan CD, Galovic M, Winston GP, Thomopoulos SI, Thompson PM, Sisodiya SM, Labate A, McDonald CR, Caciagli L, Bernasconi N, Bernasconi A, Larivière S, Schrader D, Bernhardt BC. A WORLDWIDE ENIGMA STUDY ON EPILEPSY-RELATED GRAY AND WHITE MATTER COMPROMISE ACROSS THE ADULT LIFESPAN. bioRxiv 2024:2024.03.02.583073. [PMID: 38496668 PMCID: PMC10942350 DOI: 10.1101/2024.03.02.583073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Objectives Temporal lobe epilepsy (TLE) is commonly associated with mesiotemporal pathology and widespread alterations of grey and white matter structures. Evidence supports a progressive condition although the temporal evolution of TLE is poorly defined. This ENIGMA-Epilepsy study utilized multimodal magnetic resonance imaging (MRI) data to investigate structural alterations in TLE patients across the adult lifespan. We charted both grey and white matter changes and explored the covariance of age-related alterations in both compartments. Methods We studied 769 TLE patients and 885 healthy controls across an age range of 17-73 years, from multiple international sites. To assess potentially non-linear lifespan changes in TLE, we harmonized data and combined median split assessments with cross-sectional sliding window analyses of grey and white matter age-related changes. Covariance analyses examined the coupling of grey and white matter lifespan curves. Results In TLE, age was associated with a robust grey matter thickness/volume decline across a broad cortico-subcortical territory, extending beyond the mesiotemporal disease epicentre. White matter changes were also widespread across multiple tracts with peak effects in temporo-limbic fibers. While changes spanned the adult time window, changes accelerated in cortical thickness, subcortical volume, and fractional anisotropy (all decreased), and mean diffusivity (increased) after age 55 years. Covariance analyses revealed strong limbic associations between white matter tracts and subcortical structures with cortical regions. Conclusions This study highlights the profound impact of TLE on lifespan changes in grey and white matter structures, with an acceleration of aging-related processes in later decades of life. Our findings motivate future longitudinal studies across the lifespan and emphasize the importance of prompt diagnosis as well as intervention in patients.
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Affiliation(s)
- Judy Chen
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Alexander Ngo
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raúl Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S. Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Fernando Cendes
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa L. Yasuda
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | - Marina K. M. Alvim
- Department of Neurology, University of Campinas-–UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K. Focke
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Barbara Kreilkamp
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Epilepsy Center, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Germany
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M. Desmond
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Elaine Lui
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Gian Marco Duma
- Scientific Institute IRCCS E.Medea, Epilepsy Unit, Conegliano (TV), Italy
| | - Paolo Bonanni
- Scientific Institute IRCCS E.Medea, Epilepsy Unit, Conegliano (TV), Italy
| | - Alice Ballerini
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Elisabetta Vaudano
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
- Primary Care Department, Azienda Sanitaria Locale di Modena, Modena, Italy
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA
| | - Colin P. Doherty
- Department of Neurology, St James’ Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L. Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D. Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne VIC 3010, Australia
| | - Rhys H. Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Contol and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children’s Hospital IRCCS, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Meyer Children’s Hospital IRCCS, Florence, Italy
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Italy
| | | | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Theodor Rüber
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Tobias Bauer
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J. A. Carr
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Eugenio Abela
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Mark P. Richardson
- School of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | - Heath Pardoe
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, United States
| | | | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Erik Kaestner
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Sean N. Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Donatello Arienzo
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Sjoerd B. Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Mina Ryten
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Bucks, UK
| | - Peter N. Taylor
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- CNNP Lab, ICOS group, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - John S. Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Christopher D. Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Marian Galovic
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zürich, Zürich, Switzerland
| | - Gavin P. Winston
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Department of Medicine, Division of Neurology, Queen’s University, Kingston, ON, Canada
| | - Sophia I. Thomopoulos
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Paul M. Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Angelo Labate
- Neurophysiopathology and Movement Disorders Clinic, Regional Epilepsy Center, University of Messina, Italy
| | - Carrie R. McDonald
- Department of Radiation Medicine and Applied Sciences; Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, United States
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Bucks, UK
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Harvard University, Boston, MA, USA
| | - Dewi Schrader
- BC Children’s Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Boris C. Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
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Hlauschek G, Nicolo J, Sinclair B, Law M, Yasuda CL, Cendes F, Lossius MI, Kwan P, Vivash L. Role of the glymphatic system and perivascular spaces as a potential biomarker for post-stroke epilepsy. Epilepsia Open 2024; 9:60-76. [PMID: 38041607 PMCID: PMC10839409 DOI: 10.1002/epi4.12877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/29/2023] [Indexed: 12/03/2023] Open
Abstract
Stroke is one of the most common causes of acquired epilepsy, which can also result in disability and increased mortality rates particularly in elderly patients. No preventive treatment for post-stroke epilepsy is currently available. Development of such treatments has been greatly limited by the lack of biomarkers to reliably identify high-risk patients. The glymphatic system, including perivascular spaces (PVS), is the brain's waste clearance system, and enlargement or asymmetry of PVS (ePVS) is hypothesized to play a significant role in the pathogenesis of several neurological conditions. In this article, we discuss potential mechanisms for the role of perivascular spaces in the development of post-stroke epilepsy. Using advanced MR-imaging techniques, it has been shown that there is asymmetry and impairment of glymphatic function in the setting of ischemic stroke. Furthermore, studies have described a dysfunction of PVS in patients with different focal and generalized epilepsy syndromes. It is thought that inflammatory processes involving PVS and the blood-brain barrier, impairment of waste clearance, and sustained hypertension affecting the glymphatic system during a seizure may play a crucial role in epileptogenesis post-stroke. We hypothesize that impairment of the glymphatic system and asymmetry and dynamics of ePVS in the course of a stroke contribute to the development of PSE. Automated ePVS detection in stroke patients might thus assist in the identification of high-risk patients for post-stroke epilepsy trials. PLAIN LANGUAGE SUMMARY: Stroke often leads to epilepsy and is one of the main causes of epilepsy in elderly patients, with no preventative treatment available. The brain's waste removal system, called the glymphatic system which consists of perivascular spaces, may be involved. Enlargement or asymmetry of perivascular spaces could play a role in this and can be visualised with advanced brain imaging after a stroke. Detecting enlarged perivascular spaces in stroke patients could help identify those at risk for post-stroke epilepsy.
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Affiliation(s)
- Gernot Hlauschek
- Division of Clinical Neuroscience, National Centre for Epilepsy, member of ERN EpicareOslo University HospitalNorway
- The University of OsloOsloNorway
- Department of Neurosciences, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - John‐Paul Nicolo
- Department of Neurosciences, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyThe AlfredMelbourneVictoriaAustralia
- Departments of Medicine and NeurologyThe University of Melbourne, Royal Melbourne HospitalParkvilleVictoriaAustralia
| | - Benjamin Sinclair
- Department of Neurosciences, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyThe AlfredMelbourneVictoriaAustralia
| | - Meng Law
- Department of Neurosciences, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of RadiologyThe AlfredMelbourneVictoriaAustralia
| | | | | | - Morten Ingvar Lossius
- Division of Clinical Neuroscience, National Centre for Epilepsy, member of ERN EpicareOslo University HospitalNorway
- The University of OsloOsloNorway
| | - Patrick Kwan
- Department of Neurosciences, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyThe AlfredMelbourneVictoriaAustralia
- Departments of Medicine and NeurologyThe University of Melbourne, Royal Melbourne HospitalParkvilleVictoriaAustralia
| | - Lucy Vivash
- Department of Neurosciences, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyThe AlfredMelbourneVictoriaAustralia
- Departments of Medicine and NeurologyThe University of Melbourne, Royal Melbourne HospitalParkvilleVictoriaAustralia
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Hlauschek G, Lossius MI, Schwartz DL, Silbert LC, Hicks AJ, Ponsford JL, Vivash L, Sinclair B, Kwan P, O'Brien TJ, Shultz SR, Law M, Spitz G. Reduced total number of enlarged perivascular spaces in post-traumatic epilepsy patients with unilateral lesions - a feasibility study. Seizure 2023; 113:1-5. [PMID: 37847935 DOI: 10.1016/j.seizure.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/21/2023] [Accepted: 10/12/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND We investigated the value of automated enlarged perivascular spaces (ePVS) quantification to distinguish chronic traumatic brain injury (TBI) patients with post-traumatic epilepsy (PTE+) from chronic TBI patients without PTE (PTE-) in a feasibility study. METHODS Patients with and without PTE were recruited and underwent an MRI post-TBI. Multimodal auto identification of ePVS algorithm was applied to T1-weighted MRIs to segment ePVS. The total number of ePVS was calculated and corrected for white matter volume, and an asymmetry index (AI) derived. RESULTS PTE was diagnosed in 7 out of the 99 participants (male=69) after a median time of less than one year since injury (range 10-22). Brain lesions were observed in all 7 PTE+ cases (unilateral=4, 57%; bilateral=3, 43%) as compared to 40 PTE- cases (total 44%; unilateral=17, 42%; bilateral=23, 58%). There was a significant difference between PTE+ (M=1.21e-4, IQR [8.89e-5]) and PTE- cases (M=2.79e-4, IQR [6.25e-5]) in total corrected numbers of ePVS in patients with unilateral lesions (p=0.024). No differences in AI, trauma severity and lesion volume were seen between groups. CONCLUSION This study has shown that automated quantification of ePVS is feasible and provided initial evidence that individuals with PTE with unilateral lesions may have fewer ePVS compared to TBI patients without epilepsy. Further studies with larger sample sizes should be conducted to determine the value of ePVS quantification as a PTE-biomarker.
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Affiliation(s)
- Gernot Hlauschek
- Division of Clinical Neuroscience, National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway; The University of Oslo, Oslo, Norway; Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia.
| | - Morten I Lossius
- Division of Clinical Neuroscience, National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway; The University of Oslo, Oslo, Norway.
| | - Daniel L Schwartz
- Oregon Health & Science University, Oregon Alzheimer's Disease Research Center, Neurology, Advanced Imaging Research Center, USA.
| | - Lisa C Silbert
- Oregon Health & Science University, Oregon Alzheimer's Disease Research Center, Neurology, Advanced Imaging Research Center, USA.
| | - Amelia J Hicks
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.
| | - Jennie L Ponsford
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.
| | - Lucy Vivash
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Alfred, Melbourne, Australia,; Departments of Medicine and Neurology, The University of Melbourne, Royal Melbourne Hospital, Parkville, Australia.
| | - Benjamin Sinclair
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Alfred, Melbourne, Australia,.
| | - Patrick Kwan
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Alfred, Melbourne, Australia,; Departments of Medicine and Neurology, The University of Melbourne, Royal Melbourne Hospital, Parkville, Australia.
| | - Terrence J O'Brien
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Alfred, Melbourne, Australia,; Departments of Medicine and Neurology, The University of Melbourne, Royal Melbourne Hospital, Parkville, Australia.
| | - Sandy R Shultz
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Alfred, Melbourne, Australia,; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Australia; Health Sciences, Vancouver Island University, Nanaimo, Canada.
| | - Meng Law
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Department of Radiology, The Alfred, Melbourne, Australia.
| | - Gershon Spitz
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.
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Hicks AJ, Sinclair B, Shultz SR, Pham W, Silbert LC, Schwartz DL, Rowe CC, Ponsford JL, Law M, Spitz G. Associations of Enlarged Perivascular Spaces With Brain Lesions, Brain Age, and Clinical Outcomes in Chronic Traumatic Brain Injury. Neurology 2023; 101:e63-e73. [PMID: 37156615 PMCID: PMC10351302 DOI: 10.1212/wnl.0000000000207370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/17/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Enlarged perivascular spaces (ePVS) have been identified as a key signature of glymphatic system dysfunction in neurologic conditions. The incidence and clinical implications of ePVS after traumatic brain injury (TBI) are not yet understood. We investigated whether individuals with chronic moderate-to-severe TBI had an increased burden of ePVS and whether ePVS burden is modulated by the presence of focal lesions, older brain age, and poorer sleep quality. We examined whether an increased burden of ePVS was associated with poorer cognitive and emotional outcomes. METHODS Using a cross-sectional design, participants with a single moderate-to-severe chronic TBI (sustained ≥10 years ago) were recruited from an inpatient rehabilitation program. Control participants were recruited from the community. Participants underwent 3T brain MRI, neuropsychological assessment, and clinical evaluations. ePVS burden in white matter was quantified using automated segmentation. The relationship between the number of ePVS, group membership, focal lesions, brain age, current sleep quality, and outcome was modeled using negative binomial and linear regressions. RESULTS This study included 100 participants with TBI (70% male; mean age = 56.8 years) and 75 control participants (54.3% male; mean age = 59.8 years). The TBI group had a significantly greater burden of ePVS (prevalence ratio rate [PRR] = 1.29, p = 0.013, 95% CI 1.05-1.57). The presence of bilateral lesions was associated with greater ePVS burden (PRR = 1.41, p = 0.021, 95% CI 1.05-1.90). There was no association between ePVS burden, sleep quality (PRR = 1.01, p = 0.491, 95% CI 0.98-1.048), and sleep duration (PRR = 1.03, p = 0.556, 95% CI 0.92-1.16). ePVS was associated with verbal memory (β = -0.42, p = 0.006, 95% CI -0.72 to -0.12), but not with other cognitive domains. The burden of ePVS was not associated with emotional distress (β = -0.70, p = 0.461, 95% CI -2.57 to 1.17) or brain age (PRR = 1.00, p = 0.665, 95% CI 0.99-1.02). DISCUSSION TBI is associated with a greater burden of ePVS, especially when there have been bilateral brain lesions. ePVS was associated with reduced verbal memory performance. ePVS may indicate ongoing impairments in glymphatic system function in the chronic postinjury period.
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Affiliation(s)
- Amelia J Hicks
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Benjamin Sinclair
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Sandy R Shultz
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - William Pham
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Lisa C Silbert
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Daniel L Schwartz
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Christopher C Rowe
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Jennie L Ponsford
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Meng Law
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia
| | - Gershon Spitz
- From the Monash-Epworth Rehabilitation Research Centre (A.J.H., J.L.P., G.S.), Turner Institute for Brain and Mental Health, School of Psychological Sciences, and Department of Neuroscience (A.J.H., B.S., S.R.S., W.P., M.L., G.S.), Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton; Department of Neurology (B.S.), Alfred Health, Melbourne, Australia; Health and Human Services (S.S.), Vancouver Island University, Nanaimo; Division of Medical Sciences (S.S.), University of Victoria, British Columbia, Canada; NIA-Layton Oregon Aging & Alzheimer's Disease Research Center (L.C.S., D.L.S.), Oregon Health & Science University; Department of Neurology (L.C.S.), Portland Veterans Affairs Health Care System; Advanced Imaging Research Center (D.L.S.), Oregon Health & Science University, Portland; Department of Molecular Imaging and Therapy (C.C.R.), Austin Health, Heidelberg; Florey Department of Neuroscience and Mental Health (C.C.R.), University of Melbourne, Parkville; and Department of Radiology (M.L.), Alfred Health, Melbourne, Australia.
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Pham W, Lynch M, Spitz G, O’Brien T, Vivash L, Sinclair B, Law M. A critical guide to the automated quantification of perivascular spaces in magnetic resonance imaging. Front Neurosci 2022; 16:1021311. [PMID: 36590285 PMCID: PMC9795229 DOI: 10.3389/fnins.2022.1021311] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
The glymphatic system is responsible for waste clearance in the brain. It is comprised of perivascular spaces (PVS) that surround penetrating blood vessels. These spaces are filled with cerebrospinal fluid and interstitial fluid, and can be seen with magnetic resonance imaging. Various algorithms have been developed to automatically label these spaces in MRI. This has enabled volumetric and morphological analyses of PVS in healthy and disease cohorts. However, there remain inconsistencies between PVS measures reported by different methods of automated segmentation. The present review emphasizes that importance of voxel-wise evaluation of model performance, mainly with the Sørensen Dice similarity coefficient. Conventional count correlations for model validation are inadequate if the goal is to assess volumetric or morphological measures of PVS. The downside of voxel-wise evaluation is that it requires manual segmentations that require large amounts of time to produce. One possible solution is to derive these semi-automatically. Additionally, recommendations are made to facilitate rigorous development and validation of automated PVS segmentation models. In the application of automated PVS segmentation tools, publication of image quality metrics, such as the contrast-to-noise ratio, alongside descriptive statistics of PVS volumes and counts will facilitate comparability between studies. Lastly, a head-to-head comparison between two algorithms, applied to two cohorts of astronauts reveals how results can differ substantially between techniques.
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Affiliation(s)
- William Pham
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Miranda Lynch
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Gershon Spitz
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Terence O’Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Radiology, Alfred Health Hospital, Melbourne, VIC, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
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Moses J, Sinclair B, Schwartz DL, Silbert LC, O’Brien TJ, Law M, Vivash L. Perivascular spaces as a marker of disease severity and neurodegeneration in patients with behavioral variant frontotemporal dementia. Front Neurosci 2022; 16:1003522. [PMID: 36340772 PMCID: PMC9633276 DOI: 10.3389/fnins.2022.1003522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/06/2022] [Indexed: 11/19/2022] Open
Abstract
Background Behavioural Variant Frontotemporal Dementia (bvFTD) is a rapidly progressing neurodegenerative proteinopathy. Perivascular spaces (PVS) form a part of the brain’s glymphatic clearance system. When enlarged due to poor glymphatic clearance of toxic proteins, PVS become larger and more conspicuous on MRI. Therefore, enlarged PVS may be a useful biomarker of disease severity and progression in neurodegenerative proteinopathies such as bvFTD. This study aimed to determine the utility of PVS as a biomarker of disease progression in patients with bvFTD. Materials and methods Serial baseline and week 52 MRIs acquired from ten patients with bvFTD prospectively recruited and followed in a Phase 1b open label trial of sodium selenate for bvFTD were used in this study. An automated algorithm quantified PVS on MRI, which was visually inspected and validated by a member of the study team. The number and volume of PVS were extracted and mixed models used to assess the relationship between PVS burden and other measures of disease (cognition, carer burden scale, protein biomarkers). Additional exploratory analysis investigated PVS burden in patients who appeared to not progress over the 12 months of selenate treatment (i.e., “non-progressors”). Results Overall, PVS cluster number (ß = −3.27, CI [−7.80 – 1.27], p = 0.267) and PVS volume (ß = −36.8, CI [−84.9 – 11.3], p = 0.171) did not change over the paired MRI scans 12 months apart. There was association between cognition total composite scores and the PVS burden (PVS cluster ß = −0.802e–3, CI [9.45e–3 – −6.60e–3, p ≤ 0.001; PVS volume ß = −1.30e–3, CI [−1.55e–3 – −1.05e–3], p ≤ 0.001), as well as between the change in the cognition total composite score and the change in PVS volume (ß = 4.36e–3, CI [1.33e–3 – 7.40e–3], p = 0.046) over the trial period. There was a significant association between CSF t-tau and the number of PVS clusters (ß = 2.845, CI [0.630 – 5.06], p = 0.036). Additionally, there was a significant relationship between the change in CSF t-tau and the change in the number of PVS (ß = 1.54, CI [0.918 – 2.16], p < 0.001) and PVS volume (ß = 13.8, CI [6.37 – 21.1], p = 0.003) over the trial period. An association was found between the change in NfL and the change in PVS volume (ß = 1.40, CI [0.272 – 2.52], p = 0.045) over time. Within the “non-progressor” group (n = 7), there was a significant relationship between the change in the CSF total-tau (t-tau) levels and the change in the PVS burden (PVS cluster (ß = 1.46, CI [0.577 – 2.34], p = 0.014; PVS volume ß = 14.6, CI [3.86 – 25.4], p = 0.032) over the trial period. Additionally, there was evidence of a significant relationship between the change in NfL levels and the change in the PVS burden over time (PVS cluster ß = 0.296, CI [0.229 – 0.361], p ≤ 0.001; PVS volume ß = 3.67, CI [2.42 – 4.92], p = 0.002). Conclusion Analysis of serial MRI scans 12 months apart in patients with bvFTD demonstrated a relationship between PVS burden and disease severity as measured by the total cognitive composite score and CSF t-tau. Further studies are needed to confirm PVS as a robust marker of neurodegeneration in proteinopathies.
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Affiliation(s)
- Jasmine Moses
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Daniel L. Schwartz
- NIA-Layton Oregon Aging and Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Advanced Imaging Research Center, Oregon Health and Science University, Portland, OR, United States
| | - Lisa C. Silbert
- NIA-Layton Oregon Aging and Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, OR, United States
- Department of Neurology, Portland Veterans Affairs Health Care System, Portland, OR, United States
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- *Correspondence: Lucy Vivash,
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8
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Lynch M, Pham W, Sinclair B, O’Brien TJ, Law M, Vivash L. Perivascular spaces as a potential biomarker of Alzheimer's disease. Front Neurosci 2022; 16:1021131. [PMID: 36330347 PMCID: PMC9623161 DOI: 10.3389/fnins.2022.1021131] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/23/2022] [Indexed: 07/20/2023] Open
Abstract
Alzheimer's disease (AD) is a highly damaging disease that affects one's cognition and memory and presents an increasing societal and economic burden globally. Considerable research has gone into understanding AD; however, there is still a lack of effective biomarkers that aid in early diagnosis and intervention. The recent discovery of the glymphatic system and associated Perivascular Spaces (PVS) has led to the theory that enlarged PVS (ePVS) may be an indicator of AD progression and act as an early diagnostic marker. Visible on Magnetic Resonance Imaging (MRI), PVS appear to enlarge when known biomarkers of AD, amyloid-β and tau, accumulate. The central goal of ePVS and AD research is to determine when ePVS occurs in AD progression and if ePVS are causal or epiphenomena. Furthermore, if ePVS are indeed causative, interventions promoting glymphatic clearance are an attractive target for research. However, it is necessary first to ascertain where on the pathological progression of AD ePVS occurs. This review aims to examine the knowledge gap that exists in understanding the contribution of ePVS to AD. It is essential to understand whether ePVS in the brain correlate with increased regional tau distribution and global or regional Amyloid-β distribution and to determine if these spaces increase proportionally over time as individuals experience neurodegeneration. This review demonstrates that ePVS are associated with reduced glymphatic clearance and that this reduced clearance is associated with an increase in amyloid-β. However, it is not yet understood if ePVS are the outcome or driver of protein accumulation. Further, it is not yet clear if ePVS volume and number change longitudinally. Ultimately, it is vital to determine early diagnostic criteria and early interventions for AD to ease the burden it presents to the world; ePVS may be able to fulfill this role and therefore merit further research.
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Affiliation(s)
- Miranda Lynch
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - William Pham
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Terence J. O’Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
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9
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Courtney MR, Antonic-Baker A, Sinclair B, Nicolo JP, Neal A, Law M, Kwan P, O'Brien TJ, Vivash L. 18F-FDG-PET hypometabolism as a predictor of favourable outcome in epilepsy surgery: protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e065440. [PMID: 36202585 PMCID: PMC9540844 DOI: 10.1136/bmjopen-2022-065440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION A substantial proportion of patients who undergo surgery for drug resistant focal epilepsy do not become seizure free. While some factors, such as the detection of hippocampal sclerosis or a resectable lesion on MRI and electroencephalogram-MRI concordance, can predict favourable outcomes in epilepsy surgery, the prognostic value of the detection of focal hypometabolism with 18F-fluorodeoxyglucose positive emission tomography (18F-FDG-PET) hypometabolism is uncertain. We propose a protocol for a systematic review and meta-analysis to examine whether localisation with 18F-FDG-PET hypometabolism predicts favourable outcomes in epilepsy surgery. METHODS AND ANALYSIS A systematic literature search of Medline, Embase and Web of Science will be undertaken. Publications which include evaluation with 18F-FDG-PET prior to surgery for drug resistant focal epilepsy, and which report ≥12 months of postoperative surgical outcome data will be included. Non-human, non-English language publications, publications with fewer than 10 participants and unpublished data will be excluded. Screening and full-text review of publications for inclusion will be undertaken by two independent investigators, with discrepancies resolved by consensus or a third investigator. Data will be extracted and pooled using random effects meta-analysis, with heterogeneity quantified using the I2 analysis. ETHICS AND DISSEMINATION Ethics approval is not required. Once complete, the systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022324823.
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Affiliation(s)
- Merran R Courtney
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Ana Antonic-Baker
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - John-Paul Nicolo
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Neal
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Meng Law
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, Victoria, Australia
| | - Patrick Kwan
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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10
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Larivière S, Royer J, Rodríguez-Cruces R, Paquola C, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Yasuda CL, Bonilha L, Gleichgerrcht E, Focke NK, Domin M, von Podewills F, Langner S, Rummel C, Wiest R, Martin P, Kotikalapudi R, O'Brien TJ, Sinclair B, Vivash L, Desmond PM, Lui E, Vaudano AE, Meletti S, Tondelli M, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Winston GP, Griffin A, Singh A, Tiwari VK, Kreilkamp BAK, Lenge M, Guerrini R, Hamandi K, Foley S, Rüber T, Weber B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Severino M, Striano P, Tortora D, Kaestner E, Hatton SN, Vos SB, Caciagli L, Duncan JS, Whelan CD, Thompson PM, Sisodiya SM, Bernasconi A, Labate A, McDonald CR, Bernasconi N, Bernhardt BC. Structural network alterations in focal and generalized epilepsy assessed in a worldwide ENIGMA study follow axes of epilepsy risk gene expression. Nat Commun 2022; 13:4320. [PMID: 35896547 PMCID: PMC9329287 DOI: 10.1038/s41467-022-31730-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 06/30/2022] [Indexed: 12/12/2022] Open
Abstract
Epilepsy is associated with genetic risk factors and cortico-subcortical network alterations, but associations between neurobiological mechanisms and macroscale connectomics remain unclear. This multisite ENIGMA-Epilepsy study examined whole-brain structural covariance networks in patients with epilepsy and related findings to postmortem epilepsy risk gene expression patterns. Brain network analysis included 578 adults with temporal lobe epilepsy (TLE), 288 adults with idiopathic generalized epilepsy (IGE), and 1328 healthy controls from 18 centres worldwide. Graph theoretical analysis of structural covariance networks revealed increased clustering and path length in orbitofrontal and temporal regions in TLE, suggesting a shift towards network regularization. Conversely, people with IGE showed decreased clustering and path length in fronto-temporo-parietal cortices, indicating a random network configuration. Syndrome-specific topological alterations reflected expression patterns of risk genes for hippocampal sclerosis in TLE and for generalized epilepsy in IGE. These imaging-transcriptomic signatures could potentially guide diagnosis or tailor therapeutic approaches to specific epilepsy syndromes.
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Affiliation(s)
- Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raúl Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Casey Paquola
- Institute for Neuroscience and Medicine (INM-1), Forschungszentrum Jülich, Jülich, Germany
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Fernando Cendes
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K Focke
- Department of Neurology, University of Medicine Göttingen, Göttingen, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewills
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Melbourne, VIC, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Melbourne, VIC, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Melbourne, VIC, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Patricia M Desmond
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Elaine Lui
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Anna Elisabetta Vaudano
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, OCB Hospital, Azienda Ospedaliera-Universitaria, Modena, Italy
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Department of Biomedical, Metabolic and Neural Science, University of Modena and Reggio Emilia, Modena, Italy
- Primary Care Department, Azienda Sanitaria Locale di Modena, Modena, Italy
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Colin P Doherty
- Department of Neurology, St James' Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Rhys H Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Contol and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China
| | - Gavin P Winston
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Aoife Griffin
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Science, Queens University Belfast, Belfast, UK
| | - Aditi Singh
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Science, Queens University Belfast, Belfast, UK
| | - Vijay K Tiwari
- Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry & Biomedical Science, Queens University Belfast, Belfast, UK
| | | | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Khalid Hamandi
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Whales, Cardiff, UK
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Theodor Rüber
- Department of Epileptology, University of Bonn Medical Center, Bonn, Germany
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main, Germany
- Center for Personalized Translational Epilepsy Research (CePTER), Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J A Carr
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark P Richardson
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, US
| | | | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Erik Kaestner
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, US
| | - Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, US
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Angelo Labate
- Neurology, BIOMORF Dipartment, University of Messina, Messina, Italy
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, US
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
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11
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Park BY, Larivière S, Rodríguez-Cruces R, Royer J, Tavakol S, Wang Y, Caciagli L, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Alvim MKM, Yasuda C, Bonilha L, Gleichgerrcht E, Focke NK, Kreilkamp BAK, Domin M, von Podewils F, Langner S, Rummel C, Rebsamen M, Wiest R, Martin P, Kotikalapudi R, Bender B, O’Brien TJ, Law M, Sinclair B, Vivash L, Kwan P, Desmond PM, Malpas CB, Lui E, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Weber B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Severino M, Striano P, Parodi C, Tortora D, Hatton SN, Vos SB, Duncan JS, Galovic M, Whelan CD, Bargalló N, Pariente J, Conde-Blanco E, Vaudano AE, Tondelli M, Meletti S, Kong X, Francks C, Fisher SE, Caldairou B, Ryten M, Labate A, Sisodiya SM, Thompson PM, McDonald CR, Bernasconi A, Bernasconi N, Bernhardt BC. Topographic divergence of atypical cortical asymmetry and atrophy patterns in temporal lobe epilepsy. Brain 2022; 145:1285-1298. [PMID: 35333312 PMCID: PMC9128824 DOI: 10.1093/brain/awab417] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/15/2021] [Accepted: 08/14/2021] [Indexed: 12/20/2022] Open
Abstract
Temporal lobe epilepsy, a common drug-resistant epilepsy in adults, is primarily a limbic network disorder associated with predominant unilateral hippocampal pathology. Structural MRI has provided an in vivo window into whole-brain grey matter structural alterations in temporal lobe epilepsy relative to controls, by either mapping (i) atypical inter-hemispheric asymmetry; or (ii) regional atrophy. However, similarities and differences of both atypical asymmetry and regional atrophy measures have not been systematically investigated. Here, we addressed this gap using the multisite ENIGMA-Epilepsy dataset comprising MRI brain morphological measures in 732 temporal lobe epilepsy patients and 1418 healthy controls. We compared spatial distributions of grey matter asymmetry and atrophy in temporal lobe epilepsy, contextualized their topographies relative to spatial gradients in cortical microstructure and functional connectivity calculated using 207 healthy controls obtained from Human Connectome Project and an independent dataset containing 23 temporal lobe epilepsy patients and 53 healthy controls and examined clinical associations using machine learning. We identified a marked divergence in the spatial distribution of atypical inter-hemispheric asymmetry and regional atrophy mapping. The former revealed a temporo-limbic disease signature while the latter showed diffuse and bilateral patterns. Our findings were robust across individual sites and patients. Cortical atrophy was significantly correlated with disease duration and age at seizure onset, while degrees of asymmetry did not show a significant relationship to these clinical variables. Our findings highlight that the mapping of atypical inter-hemispheric asymmetry and regional atrophy tap into two complementary aspects of temporal lobe epilepsy-related pathology, with the former revealing primary substrates in ipsilateral limbic circuits and the latter capturing bilateral disease effects. These findings refine our notion of the neuropathology of temporal lobe epilepsy and may inform future discovery and validation of complementary MRI biomarkers in temporal lobe epilepsy.
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Affiliation(s)
- Bo-yong Park
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
- Department of Data Science, Inha University, Incheon, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raul Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Shahin Tavakol
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Yezhou Wang
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Lorenzo Caciagli
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Fernando Cendes
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | - Marina K M Alvim
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa Yasuda
- Department of Neurology, University of Campinas–UNICAMP, Campinas, São Paulo, Brazil
| | | | | | - Niels K Focke
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewils
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Michael Rebsamen
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Radiology, Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Terence J O’Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M Desmond
- Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Charles B Malpas
- Departments of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Elaine Lui
- Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Colin P Doherty
- Department of Neurology, St James’ Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, Member of the European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Rhys H Thomas
- Transitional and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Department of Artificial Intelligence, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Emanuele Bartolini
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano, Prato, Italy
| | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
- The Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J A Carr
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Mark P Richardson
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Mariasavina Severino
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Costanza Parodi
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Domenico Tortora
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Núria Bargalló
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Radiology CDIC, Hospital Clinic Barcelona, Barcelona, Spain
| | - Jose Pariente
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Anna Elisabetta Vaudano
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Tondelli
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Meletti
- Neurology Unit, Azienda Ospedaliero-Universitaria of Modena, OCB Hospital, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Xiang‐Zhen Kong
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, China
| | - Clyde Francks
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Simon E Fisher
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Mina Ryten
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, University College London, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, University College London, London, UK
- Department of Genetics and Genomic Medicine, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Angelo Labate
- Neurology, BIOMORF Department, University of Messina, Messina, Italy
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK
| | - Paul M Thompson
- Imaging Genetics Center, Mark & Mary Stevens Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
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12
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Sinclair B, Cahill V, Seah J, Kitchen A, Vivash LE, Chen Z, Malpas CB, O'Shea MF, Desmond PM, Hicks RJ, Morokoff AP, King JA, Fabinyi GC, Kaye AH, Kwan P, Berkovic SF, Law M, O'Brien TJ. Machine Learning Approaches for Imaging-Based Prognostication of the Outcome of Surgery for Mesial Temporal Lobe Epilepsy. Epilepsia 2022; 63:1081-1092. [PMID: 35266138 PMCID: PMC9545680 DOI: 10.1111/epi.17217] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/09/2022] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
Objectives Around 30% of patients undergoing surgical resection for drug‐resistant mesial temporal lobe epilepsy (MTLE) do not obtain seizure freedom. Success of anterior temporal lobe resection (ATLR) critically depends on the careful selection of surgical candidates, aiming at optimizing seizure freedom while minimizing postoperative morbidity. Structural MRI and FDG‐PET neuroimaging are routinely used in presurgical assessment and guide the decision to proceed to surgery. In this study, we evaluate the potential of machine learning techniques applied to standard presurgical MRI and PET imaging features to provide enhanced prognostic value relative to current practice. Methods Eighty two patients with drug resistant MTLE were scanned with FDG‐PET pre‐surgery and T1‐weighted MRI pre‐ and postsurgery. From these images the following features of interest were derived: volume of temporal lobe (TL) hypometabolism, % of extratemporal hypometabolism, presence of contralateral TL hypometabolism, presence of hippocampal sclerosis, laterality of seizure onset volume of tissue resected and % of temporal lobe hypometabolism resected. These measures were used as predictor variables in logistic regression, support vector machines, random forests and artificial neural networks. Results In the study cohort, 24 of 82 (28.3%) who underwent an ATLR for drug‐resistant MTLE did not achieve Engel Class I (i.e., free of disabling seizures) outcome at a minimum of 2 years of postoperative follow‐up. We found that machine learning approaches were able to predict up to 73% of the 24 ATLR surgical patients who did not achieve a Class I outcome, at the expense of incorrect prediction for up to 31% of patients who did achieve a Class I outcome. Overall accuracies ranged from 70% to 80%, with an area under the receiver operating characteristic curve (AUC) of .75–.81. We additionally found that information regarding overall extent of both total and significantly hypometabolic tissue resected was crucial to predictive performance, with AUC dropping to .59–.62 using presurgical information alone. Incorporating the laterality of seizure onset and the choice of machine learning algorithm did not significantly change predictive performance. Significance Collectively, these results indicate that "acceptable" to "good" patient‐specific prognostication for drug‐resistant MTLE surgery is feasible with machine learning approaches utilizing commonly collected imaging modalities, but that information on the surgical resection region is critical for optimal prognostication.
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Affiliation(s)
- Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department Neurology, Alfred Health, Melbourne, Victoria, Australia
| | - Varduhi Cahill
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Sheffield, United Kingdom.,Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, United Kingdom.,Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Jarrel Seah
- Department of Radiology, Alfred Health, Melbourne, Victoria, Australia
| | - Andy Kitchen
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Lucy E Vivash
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department Neurology, Alfred Health, Melbourne, Victoria, Australia
| | - Zhibin Chen
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Charles B Malpas
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department Neurology, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Marie F O'Shea
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia.,Comprehensive Epilepsy Program, Austin Health, Melbourne, Victoria, Australia
| | - Patricia M Desmond
- Department of Radiology, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Rodney J Hicks
- Peter MacCallum Cancer Centre and the Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew P Morokoff
- Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - James A King
- Department of Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Gavin C Fabinyi
- Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Victoria, Australia
| | - Andrew H Kaye
- Department of Neurosurgery, Hadassah Hebrew University Hospital, Jerusalem, Israel
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department Neurology, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Samuel F Berkovic
- Epilepsy Research Centre, University of Melbourne, Austin Hospital, Melbourne, Victoria, Australia.,Comprehensive Epilepsy Program, Austin Health, Melbourne, Victoria, Australia
| | - Meng Law
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Radiology, Alfred Health, Melbourne, Victoria, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department Neurology, Alfred Health, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.,Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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13
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Kolbe S, Garcia L, Yu N, Boonstra F, Clough M, Sinclair B, White O, van der Walt A, Butzkueven H, Fielding J, Law M. Lesion Volume in Relapsing Multiple Sclerosis is Associated with Perivascular Space Enlargement at the Level of the Basal Ganglia. AJNR Am J Neuroradiol 2022; 43:238-244. [PMID: 35121585 PMCID: PMC8985682 DOI: 10.3174/ajnr.a7398] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Perivascular spaces surround the blood vessels of the brain and are involved in neuroimmune functions and clearance of metabolites via the glymphatic system of the brain. Enlarged perivascular spaces could be a marker of dysfunction in these processes and, therefore, are highly relevant to monitoring disease activity in MS. This study aimed to compare the number of enlarged perivascular spaces in people with relapsing MS with MR imaging markers of inflammation and brain atrophy. MATERIALS AND METHODS Fifty-nine patients (18 with clinically isolated syndrome, 22 with early and 19 with late relapsing-remitting MS) were scanned longitudinally (mean follow-up duration = 19.6 [SD, 0.5] months) using T2-weighted, T1-weighted, and FLAIR MR imaging. Two expert raters identified and counted enlarged perivascular spaces on T2-weighted MR images from 3 ROIs (the centrum semiovale, basal ganglia, and midbrain). Baseline and change with time in the number of enlarged perivascular spaces were correlated with demographics and lesion and brain volumes. RESULTS Late relapsing-remitting MS had a greater average number of enlarged perivascular spaces at baseline at the level of the basal ganglia (72.3) compared with early relapsing-remitting MS (60.5) and clinically isolated syndrome (54.7) (F = 3.4, P = .042), and this finding correlated with lesion volume (R = 0.44, P = .0004) but not brain atrophy (R = -0.16). Enlarged perivascular spaces increased in number with time in all regions, and the rate of increase did not differ among clinical groups. CONCLUSIONS Enlarged perivascular spaces at the level of the basal ganglia are associated with greater neuroinflammatory burden, and the rate of enlargement appears constant in patients with relapsing-remitting disease phenotypes.
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Affiliation(s)
- S.C. Kolbe
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia,Departments of Radiology (S.C.K., M.L.)
| | - L.M. Garcia
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia
| | - N. Yu
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia,Department of Neurology (N.Y.), The Nanjing Brain Hospital Affiliated with Nanjing Medical University, Nanjing, Jiangsu, China
| | - F.M. Boonstra
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia
| | - M. Clough
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia
| | - B. Sinclair
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia
| | - O. White
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia,Neurology (O.W., A.v.d.W., H.B.), Alfred Hospital, Melbourne, Victoria, Australia
| | - A. van der Walt
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia,Neurology (O.W., A.v.d.W., H.B.), Alfred Hospital, Melbourne, Victoria, Australia
| | - H. Butzkueven
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia,Neurology (O.W., A.v.d.W., H.B.), Alfred Hospital, Melbourne, Victoria, Australia
| | - J. Fielding
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia
| | - M. Law
- From the Department of Neuroscience (S.C.K., L.M.G., N.Y., F.M.B., M.C., B.S., O.W., A.v.d.W., H.B., J.F., M.L.) Monash University, Melbourne, Victoria, Australia,Departments of Radiology (S.C.K., M.L.)
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14
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Yu N, Sinclair B, Posada LMG, Chen Z, Di Q, Lin X, Kolbe S, Hlauschek G, Kwan P, Law M. Asymmetric distribution of enlarged perivascular spaces in centrum semiovale may be associated with epilepsy after acute ischemic stroke. CNS Neurosci Ther 2022; 28:343-353. [PMID: 34981639 PMCID: PMC8841310 DOI: 10.1111/cns.13786] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 01/12/2023] Open
Abstract
Objective To investigate the factors influencing enlarged perivascular space (EPVS) characteristics at the onset of acute ischemic stroke (AIS), and whether the PVS characteristics can predict later post‐stroke epilepsy (PSE). Methods A total of 312 patients with AIS were identified, of whom 58/312 (18.6%) developed PSE. Twenty healthy participants were included as the control group. The number of PVS in the basal ganglia (BG), centrum semiovale (CS), and midbrain (MB) was manually calculated on T2‐weighted MRI. The scores and asymmetry index (AI) of EPVS in each region were compared among the enrolled participants. Other potential risk factors for PSE were also analyzed, including NIHSS at admission and stroke etiologies. Results The EPVS scores were significantly higher in the bilateral BG and CS of AIS patients compared to those of the control group (both p < 0.01). No statistical differences in EPVS scores in BG, CS, and MB were obtained between the PSE group and the nonepilepsy AIS group (all p > 0.01). However, markedly different AI scores in CS were found between the PSE group and the nonepilepsy AIS group (p = 0.004). Multivariable analysis showed that high asymmetry index of EPVS (AI≥0.2) in CS was an independent predictor for PSE (OR = 3.7, 95% confidence interval 1.5–9.1, p = 0.004). Conclusions Asymmetric distribution of EPVS in CS may be an independent risk factor and a novel imaging biomarker for the development of PSE. Further studies to understand the mechanisms of this association and confirmation with larger patient populations are warranted.
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Affiliation(s)
- Nian Yu
- Department of Neurology, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Neurology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Department of Radiology, Alfred Hospital, Melbourne, Vic., Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Monash University, Melbourne, Vic., Australia.,Department of Neurology, Alfred Hospital, Melbourne, Vic., Australia
| | | | - Zhibin Chen
- Department of Neuroscience, Monash University, Melbourne, Vic., Australia
| | - Qing Di
- Department of Neurology, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xingjian Lin
- Department of Neurology, The Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Scott Kolbe
- Department of Neuroscience, Monash University, Melbourne, Vic., Australia
| | - Gernot Hlauschek
- National Centre for Epilepsy, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Patrick Kwan
- Department of Neurology, Royal Melbourne Hospital, Melbourne, Vic., Australia.,Department of Neuroscience, Monash University, Melbourne, Vic., Australia.,Department of Neurology, Alfred Hospital, Melbourne, Vic., Australia.,Department of Medicine, University of Melbourne, Melbourne, Vic., Australia
| | - Meng Law
- Department of Radiology, Alfred Hospital, Melbourne, Vic., Australia.,Department of Neuroscience, Monash University, Melbourne, Vic., Australia.,Department of Neurological Surgery, University of Southern California, Los Angeles, California, USA
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15
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Sinclair B, Steward C, Venkatraman V, Aljondi R, Cox KL, Ellis KA, Ames D, Masters CL, Phal PM, Sharman MJ, Cyarto EV, Lai MMY, Szoeke C, Lautenschlager NT, Desmond PM. Effects of a physical activity intervention on brain atrophy in older adults at risk of dementia: a randomized controlled trial. Brain Imaging Behav 2021; 15:2833-2842. [PMID: 34757564 DOI: 10.1007/s11682-021-00577-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 09/29/2021] [Indexed: 11/29/2022]
Abstract
Lack of physical activity is a risk factor for dementia, however, the utility of interventional physical activity programs as a protective measure against brain atrophy and cognitive decline is uncertain. Here we present the effect of a randomized controlled trial of a 24-month physical activity intervention on global and regional brain atrophy as characterized by longitudinal voxel-based morphometry with T1-weighted MRI images. The study sample consisted of 98 participants at risk of dementia, with mild cognitive impairment or subjective memory complaints, and having at least one vascular risk factor for dementia, randomized into an exercise group and a control group. Between 0 and 24 months, there was no significant difference detected between groups in the rate of change in global, or regional brain volumes.
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Affiliation(s)
- Benjamin Sinclair
- Department of Radiology, University of Melbourne, Melbourne, Australia. .,University of Melbourne, Melbourne, Australia. .,Department of Neuroscience, Monash University, Melbourne, Australia. .,Alfred Health, Melbourne, Australia.
| | - Chris Steward
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Vijay Venkatraman
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Rowa Aljondi
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia.,College of Applied Medical Sciences, Department of Applied Radiologic Technology, University of Jeddah, Jeddah, Saudi Arabia
| | - Kay L Cox
- Medical School, University of Western Australia, Perth, Australia
| | - Kathryn A Ellis
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - David Ames
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
| | - Colin L Masters
- The Florey Institute, University of Melbourne, Melbourne, Australia
| | - Pramit M Phal
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | | | - Elizabeth V Cyarto
- Bolton Clarke Research Institute, Brisbane, Australia.,Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Michelle M Y Lai
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Curtin Medical School, Curtin University, Perth, WA, Australia
| | | | - Nicola T Lautenschlager
- University of Melbourne, Melbourne, Australia.,Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,NorthWestern Mental Health, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Patricia M Desmond
- Department of Radiology, University of Melbourne, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
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16
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Sharpe C, Sinclair B, Kwan P, Hicks RJ, O'Brien TJ, Vivash L. Longitudinal changes of focal cortical glucose hypometabolism in adults with chronic drug resistant temporal lobe epilepsy. Brain Imaging Behav 2021; 15:2795-2803. [PMID: 34671889 DOI: 10.1007/s11682-021-00576-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/28/2022]
Abstract
A high proportion of patients with drug-resistant temporal lobe epilepsy (TLE) show focal relative hypometabolism in the region of the epileptogenic zone on [18F]-Fluorodeoxyglucose positron emission tomography (FDG PET). However, whether focal (hypo)metabolism changes over time has not been well studied. We analysed repeated [18F]-FDG PET scans of patients with TLE to determine longitudinal changes in glucose metabolism. Adults (n = 16; 9 female, 7 male) diagnosed with drug resistant chronic TLE were assessed. Each patient had two [18F]-FDG PET scans that were 2-95 months apart. Region-of-interest analysis was performed on MR images onto which PET scans were coregistered to determine the relative [18F]-FDG uptake (normalised to pons) in the bilateral hippocampi and temporal lobes. Statistical Parametric Mapping analysis investigated global voxel-wise changes in relative metabolism between timepoints. Normalised [18F]-FDG uptake did not change with time in the ipsilateral (baseline 1.14 ± 0.03, follow-up 1.19 ± -0.04) or contralateral hippocampus (baseline 1.18 ± 0.03, follow-up 1.19 ± 0.03). Uptake in the temporal neocortex also remained stable (ipsilateral baseline 1.35 ± 0.03, follow-up 1.30 ± 0.04; contralateral baseline 1.38 ± 0.04, follow-up 1.33 ± 0.03). The was no relationship between change in uptake on the repeated scans and the time between the scans. SPM analysis showed increases in metabolism in the ipsilateral temporal lobe in 2/16 patients. No areas of decreased metabolism concordant to the epileptogenic zone were identified. [18F]-FDG uptake showed no significant changes over time in patients with drug-resistant TLE. This suggests that repeating FDG-PET scans in patients with subtle or no hypometabolism is of low clinical yield.
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Affiliation(s)
- Catherine Sharpe
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia
| | - Benjamin Sinclair
- Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia.,Department of Neurosciences, The Central Clinical School, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Patrick Kwan
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia.,Department of Neurosciences, The Central Clinical School, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Rodney J Hicks
- Centre for Molecular Imaging, The Peter MacCallum Cancer Centre, Parkville, VIC, Australia
| | - Terence J O'Brien
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia.,Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia.,Department of Neurosciences, The Central Clinical School, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia.,Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia. .,Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia. .,Department of Neurosciences, The Central Clinical School, Monash University, Level 6 The Alfred Centre, 99 Commercial Road, Melbourne, VIC, 3004, Australia. .,Department of Neurology, Alfred Health, Melbourne, VIC, Australia.
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17
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Nicolo JP, Moffat B, Wright DK, Sinclair B, Neal A, Lui E, Desmond P, Glarin R, Davis KA, Reddy R, Yan B, O'Brien TJ, Kwan P. 7T Magnetic Resonance Imaging Quantification of Brain Glutamate in Acute Ischaemic Stroke. J Stroke 2021; 23:281-284. [PMID: 34102764 PMCID: PMC8189859 DOI: 10.5853/jos.2020.04784] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/03/2021] [Indexed: 01/08/2023] Open
Affiliation(s)
- John-Paul Nicolo
- Department of Neurology, Royal Melbourne Hospital, Parkville, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.,Department of Neurosciences, The Central Clinical School, Monash University, Melbourne, Australia
| | - Bradford Moffat
- Melbourne Node of the National Imaging Facility, Department of Radiology, University of Melbourne, Parkville, Australia
| | - David K Wright
- Department of Neurosciences, The Central Clinical School, Monash University, Melbourne, Australia
| | - Benjamin Sinclair
- Department of Neurosciences, The Central Clinical School, Monash University, Melbourne, Australia
| | - Andrew Neal
- Department of Neurology, Royal Melbourne Hospital, Parkville, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.,Department of Neurosciences, The Central Clinical School, Monash University, Melbourne, Australia
| | - Elaine Lui
- Department of Radiology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medicine & Radiology, University of Melbourne, Parkville, Australia
| | - Patricia Desmond
- Department of Radiology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medicine & Radiology, University of Melbourne, Parkville, Australia
| | - Rebecca Glarin
- Department of Radiology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medicine & Radiology, University of Melbourne, Parkville, Australia
| | - Kathryn A Davis
- Penn Epilepsy Center, Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Ravinder Reddy
- Center for Magnetic Resonance & Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Bernard Yan
- Department of Neurology, Royal Melbourne Hospital, Parkville, Australia.,Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Terence J O'Brien
- Department of Neurology, Royal Melbourne Hospital, Parkville, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.,Department of Neurosciences, The Central Clinical School, Monash University, Melbourne, Australia
| | - Patrick Kwan
- Department of Neurology, Royal Melbourne Hospital, Parkville, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.,Department of Neurosciences, The Central Clinical School, Monash University, Melbourne, Australia
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18
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Nicolo JP, Chen Z, Moffat B, Wright DK, Sinclair B, Glarin R, Neal A, Thijs V, Seneviratne U, Yan B, Cloud G, O'Brien TJ, Kwan P. Study protocol for a phase II randomised, double-blind, placebo-controlled trial of perampanel as an antiepileptogenic treatment following acute stroke. BMJ Open 2021; 11:e043488. [PMID: 33972334 PMCID: PMC8112439 DOI: 10.1136/bmjopen-2020-043488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Stroke is a common cause of epilepsy that may be mediated via glutamate dysregulation. There is currently no evidence to support the use of antiseizure medications as primary prevention against poststroke epilepsy. Perampanel has a unique antiglutamatergic mechanism of action and may have antiepileptogenic properties. This study aims to evaluate the efficacy and safety of perampanel as an antiepileptogenic treatment in patients at high risk of poststroke epilepsy. METHODS AND ANALYSIS Up to 328 patients with cortical ischaemic stroke or lobar haemorrhage will be enrolled, and receive their first treatment within 7 days of stroke onset. Patients will be randomised (1:1) to receive perampanel (titrated to 6 mg daily over 4 weeks) or matching placebo, stratified by stroke subtype (ischaemic or haemorrhagic). Treatment will be continued for 12 weeks after titration. 7T MRI will be performed at baseline for quantification of cerebral glutamate by magnetic resonance spectroscopy and glutamate chemical exchange saturation transfer imaging. Blood will be collected for measurement of plasma glutamate levels. Participants will be followed up for 52 weeks after randomisation.The primary study outcome will be the proportion of participants in each group free of late (more than 7 days after stroke onset) poststroke seizures by the end of the 12-month study period, analysed by Fisher's exact test. Secondary outcomes will include time to first seizure, time to treatment withdrawal and 3-month modified Rankin Scale score. Quality of life, cognitive function, mood and adverse events will be assessed by standardised questionnaires. Exploratory outcomes will include correlation between cerebral and plasma glutamate concentration and stroke and seizure outcomes. ETHICS AND DISSEMINATION This study was approved by the Alfred Health Human Research Ethics Committee (HREC No 44366, Reference 287/18). TRIAL REGISTRATION NUMBER ACTRN12618001984280; Pre-results.
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Affiliation(s)
- John-Paul Nicolo
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Zhibin Chen
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Bradford Moffat
- Melbourne Node of the National Imaging Facility, Department of Radiology, University of Melbourne, Parkville, Victoria, Australia
| | - David K Wright
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - Rebecca Glarin
- Melbourne Node of the National Imaging Facility, Department of Radiology, University of Melbourne, Parkville, Victoria, Australia
| | - Andrew Neal
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Vincent Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health-Austin Campus, Heidelberg, Victoria, Australia
- Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
| | - Udaya Seneviratne
- Department of Neuroscience, Monash University, Clayton, Victoria, Australia
- Department of Neurology, Monash Medical Centre, Clayton, Victoria, Australia
| | - Bernard Yan
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Geoffrey Cloud
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
| | - Terence J O'Brien
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Patrick Kwan
- Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Neuroscience, Monash University Central Clinical School, Melbourne, Victoria, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
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19
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Hlauschek G, Sinclair B, Brinkmann B, Fuge J, Kwan P, O'Brien TJ, Vivash L. The effect of injection time on rates of epileptogenic zone localization using SISCOM and STATISCOM. Epilepsy Behav 2021; 118:107945. [PMID: 33845344 DOI: 10.1016/j.yebeh.2021.107945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The identification of hyperperfusion on ictal single-photon emission computed tomography (SPECT) scan is a technique for the localization of the epileptogenic zone (EZ) in patients with focal epilepsy undergoing presurgical evaluation. The accuracy of this technique has been improved by subtraction from an interictal image and coregistration with magnetic resonance imaging (MRI) (subtraction ictal SPECT coregistered to MRI (SISCOM)), and subsequently by the development of Statistical Ictal SPECT Co-registered to MRI (STATISCOM) which is reported to further improve localization accuracy by statistically accounting for random variation between images. However, the use of ictal SPECT is limited by the necessity for rapid injection of the radiotracer. The purpose of this study was to investigate the effect of tracer injection time on EZ localization rates using both STATISCOM and SISCOM. METHODS Consecutive patients with drug-resistant focal epilepsy who had an ictal SPECT scan while admitted to the video-electroencephalography (EEG) monitoring unit at the Royal Melbourne Hospital, Victoria, Australia, and a subsequent interictal scan, between 2009 and 2017 were included. The information collected included age, sex, seizure type, epilepsy diagnosis, and injection time. Statistical Ictal SPECT Co-registered to MRI and SISCOM images were generated and reviewed by two blinded reviewers. The rates of potential localization of the EZ, and the agreement with the EEG, were determined for each scan. Localization rates were compared between ictal scans with different radiotracer injection time windows (<30 s, 30-45 s, 45-60 s, 60-90 s, 90-120 s, >120 s). RESULTS Seventy patients (male = 32, 16-67 years) were included in the study. Overall agreement between the primary raters was moderate for STATISCOM (k = 0.44) and SISCOM (k = 0.57). The ability of SPECT to localize the potential EZ was 69% (48/70) for STATISCOM and 59% (41/70) for SISCOM. Injection time was not associated with the rate of localizing the potential EZ for STATISCOM (p = 0.64), whereas for SISCOM there was a trend that shorter injection times were associated with better ability to localize the potential EZ (p = 0.06). Agreement between SPECT and video-EEG data was 54% (38/70) for STATISCOM and 39% (27/70) for SISCOM. Statistical Ictal SPECT Co-registered to MRI did not show any difference of agreement across injection time groups (p = 0.42) whereas SISCOM showed better agreement with video-EEG data in the earlier injection time groups (p = 0.02). No differences in agreement between SPECT and video-EEG data were seen between patients with and without MRI lesions for either STATISCOM or SISCOM. Statistical Ictal SPECT Co-registered to MRI showed significantly better agreement for temporal than extratemporal seizures, with no difference of agreement between early (<45 s) and late (>45 s) injections. CONCLUSION Statistical Ictal SPECT Co-registered to MRI showed overall higher agreement rates with EZ localization by video-EEG than SISCOM, which was not affected by the injection times. Statistical Ictal SPECT Co-registered to MRI may provide localizing information for "late" injections where visual reads and SISCOM are inconclusive.
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Affiliation(s)
- Gernot Hlauschek
- Division of Clinical Neuroscience, National Centre for Epilepsy, Oslo University Hospital, Norway; Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Benjamin Sinclair
- Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia; Department of Neurosciences, Monash University, Melbourne, VIC, Australia
| | - Benjamin Brinkmann
- Division of Epilepsy, Department of Neurology, Mayo Clinic, Rochester, USA
| | - Joshua Fuge
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Patrick Kwan
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia; Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia; Department of Neurosciences, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
| | - Terence J O'Brien
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia; Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia; Department of Neurosciences, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia
| | - Lucy Vivash
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia; Department of Medicine and Radiology, University of Melbourne, Parkville, VIC, Australia; Department of Neurosciences, Monash University, Melbourne, VIC, Australia; Department of Neurology, Alfred Hospital, Melbourne, VIC, Australia.
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20
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Larivière S, Rodríguez-Cruces R, Royer J, Caligiuri ME, Gambardella A, Concha L, Keller SS, Cendes F, Yasuda C, Bonilha L, Gleichgerrcht E, Focke NK, Domin M, von Podewills F, Langner S, Rummel C, Wiest R, Martin P, Kotikalapudi R, O'Brien TJ, Sinclair B, Vivash L, Desmond PM, Alhusaini S, Doherty CP, Cavalleri GL, Delanty N, Kälviäinen R, Jackson GD, Kowalczyk M, Mascalchi M, Semmelroch M, Thomas RH, Soltanian-Zadeh H, Davoodi-Bojd E, Zhang J, Lenge M, Guerrini R, Bartolini E, Hamandi K, Foley S, Weber B, Depondt C, Absil J, Carr SJA, Abela E, Richardson MP, Devinsky O, Severino M, Striano P, Tortora D, Hatton SN, Vos SB, Duncan JS, Whelan CD, Thompson PM, Sisodiya SM, Bernasconi A, Labate A, McDonald CR, Bernasconi N, Bernhardt BC. Network-based atrophy modeling in the common epilepsies: A worldwide ENIGMA study. Sci Adv 2020; 6:6/47/eabc6457. [PMID: 33208365 PMCID: PMC7673818 DOI: 10.1126/sciadv.abc6457] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/05/2020] [Indexed: 06/10/2023]
Abstract
Epilepsy is increasingly conceptualized as a network disorder. In this cross-sectional mega-analysis, we integrated neuroimaging and connectome analysis to identify network associations with atrophy patterns in 1021 adults with epilepsy compared to 1564 healthy controls from 19 international sites. In temporal lobe epilepsy, areas of atrophy colocalized with highly interconnected cortical hub regions, whereas idiopathic generalized epilepsy showed preferential subcortical hub involvement. These morphological abnormalities were anchored to the connectivity profiles of distinct disease epicenters, pointing to temporo-limbic cortices in temporal lobe epilepsy and fronto-central cortices in idiopathic generalized epilepsy. Negative effects of age on atrophy further revealed a strong influence of connectome architecture in temporal lobe, but not idiopathic generalized, epilepsy. Our findings were reproduced across individual sites and single patients and were robust across different analytical methods. Through worldwide collaboration in ENIGMA-Epilepsy, we provided deeper insights into the macroscale features that shape the pathophysiology of common epilepsies.
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Affiliation(s)
- Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Raúl Rodríguez-Cruces
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Jessica Royer
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | | | - Antonio Gambardella
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autónoma de México, Querétaro, México
| | - Simon S Keller
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Fernando Cendes
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Clarissa Yasuda
- Department of Neurology, University of Campinas-UNICAMP, Campinas, São Paulo, Brazil
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | | | - Niels K Focke
- Department of Clinical Neurophysiology, University of Medicine Göttingen, Göttingen, Germany
| | - Martin Domin
- Institute of Diagnostic Radiology and Neuroradiology, Functional Imaging Unit, University Medicine Greifswald, Greifswald, Germany
| | - Felix von Podewills
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Soenke Langner
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Christian Rummel
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Bern, Switzerland
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin Sinclair
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Patricia M Desmond
- Departments of Medicine and Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Saud Alhusaini
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Colin P Doherty
- Department of Neurology, St. James' Hospital, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Norman Delanty
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
- FutureNeuro SFI Research Centre, Dublin, Ireland
| | - Reetta Kälviäinen
- Epilepsy Center, Neuro Center, Kuopio University Hospital, European Reference Network for Rare and Complex Epilepsies EpiCARE, Kuopio, Finland
- Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Graeme D Jackson
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Magdalena Kowalczyk
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Mario Mascalchi
- Neuroradiology Research Program, Meyer Children Hospital of Florence, University of Florence, Florence, Italy
| | - Mira Semmelroch
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Hamid Soltanian-Zadeh
- Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- Departments of Research Administration and Radiology, Henry Ford Health System, Detroit, MI, USA
| | | | - Junsong Zhang
- Cognitive Science Department, Xiamen University, Xiamen, China
| | - Matteo Lenge
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery Department, Children's Hospital A. Meyer-University of Florence, Italy
| | - Renzo Guerrini
- Child Neurology Unit and Laboratories, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy
| | - Emanuele Bartolini
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano, Prato, Italy
| | - Khalid Hamandi
- Cardiff University Brain Research Imaging Centre (CUBRIC), College of Biomedical Sciences, Cardiff University, Cardiff, UK
- Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Sonya Foley
- Welsh Epilepsy Unit, Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Julie Absil
- Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Sarah J A Carr
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eugenio Abela
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mark P Richardson
- Division of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | | | | | | | - Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, USC Keck School of Medicine, Los Angeles, CA, USA
| | - Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Angelo Labate
- Neuroscience Research Center, University Magna Græcia, Catanzaro, CZ, Italy
- Institute of Neurology, University Magna Græcia, Catanzaro, CZ, Italy
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, CA, USA
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada.
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21
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Ma D, Cardoso MJ, Zuluaga MA, Modat M, Powell NM, Wiseman FK, Cleary JO, Sinclair B, Harrison IF, Siow B, Popuri K, Lee S, Matsubara JA, Sarunic MV, Beg MF, Tybulewicz VLJ, Fisher EMC, Lythgoe MF, Ourselin S. Substantially thinner internal granular layer and reduced molecular layer surface in the cerebellar cortex of the Tc1 mouse model of down syndrome - a comprehensive morphometric analysis with active staining contrast-enhanced MRI. Neuroimage 2020; 223:117271. [PMID: 32835824 PMCID: PMC8417772 DOI: 10.1016/j.neuroimage.2020.117271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/03/2020] [Accepted: 08/10/2020] [Indexed: 12/18/2022] Open
Abstract
Down Syndrome is a chromosomal disorder that affects the development of cerebellar cortical lobules. Impaired neurogenesis in the cerebellum varies among different types of neuronal cells and neuronal layers. In this study, we developed an imaging analysis framework that utilizes gadolinium-enhanced ex vivo mouse brain MRI. We extracted the middle Purkinje layer of the mouse cerebellar cortex, enabling the estimation of the volume, thickness, and surface area of the entire cerebellar cortex, the internal granular layer, and the molecular layer in the Tc1 mouse model of Down Syndrome. The morphometric analysis of our method revealed that a larger proportion of the cerebellar thinning in this model of Down Syndrome resided in the inner granule cell layer, while a larger proportion of the surface area shrinkage was in the molecular layer.
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Affiliation(s)
- Da Ma
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Centre for Advanced Biomedical Imaging, University College London, United Kingdom; School of Engineering Science, Simon Fraser University, Burnaby, Canada.
| | - Manuel J Cardoso
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Maria A Zuluaga
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Data Science Department, EURECOM, France
| | - Marc Modat
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
| | - Nick M Powell
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Frances K Wiseman
- UK Dementia Research Institute at University College London, UK London; Down Syndrome Consortium (LonDownS), London, United Kingdom
| | - Jon O Cleary
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom; Department of Radiology, Guy´s and St Thomas' NHS Foundation Trust, United Kingdom; Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, University of Melbourne, Melbourne, Australia
| | - Benjamin Sinclair
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Ian F Harrison
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Bernard Siow
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom; The Francis Crick Institute, London, United Kingdom
| | - Karteek Popuri
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Sieun Lee
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Joanne A Matsubara
- Department of Ophthalmology & Visual Science, University of British Columbia, Vancouver, Canada
| | - Marinko V Sarunic
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, Canada
| | - Victor L J Tybulewicz
- The Francis Crick Institute, London, United Kingdom; Department of Immunology and Inflammation, Imperial College, London, United Kingdom
| | | | - Mark F Lythgoe
- Centre for Advanced Biomedical Imaging, University College London, United Kingdom
| | - Sebastien Ourselin
- Department of Medical Physics and Biomedical Engineering, University College London, United Kingdom; School of Biomedical Engineering & Imaging Sciences, King's College London, United Kingdom
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22
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Hatton SN, Huynh KH, Bonilha L, Abela E, Alhusaini S, Altmann A, Alvim MKM, Balachandra AR, Bartolini E, Bender B, Bernasconi N, Bernasconi A, Bernhardt B, Bargallo N, Caldairou B, Caligiuri ME, Carr SJA, Cavalleri GL, Cendes F, Concha L, Davoodi-bojd E, Desmond PM, Devinsky O, Doherty CP, Domin M, Duncan JS, Focke NK, Foley SF, Gambardella A, Gleichgerrcht E, Guerrini R, Hamandi K, Ishikawa A, Keller SS, Kochunov PV, Kotikalapudi R, Kreilkamp BAK, Kwan P, Labate A, Langner S, Lenge M, Liu M, Lui E, Martin P, Mascalchi M, Moreira JCV, Morita-Sherman ME, O’Brien TJ, Pardoe HR, Pariente JC, Ribeiro LF, Richardson MP, Rocha CS, Rodríguez-Cruces R, Rosenow F, Severino M, Sinclair B, Soltanian-Zadeh H, Striano P, Taylor PN, Thomas RH, Tortora D, Velakoulis D, Vezzani A, Vivash L, von Podewils F, Vos SB, Weber B, Winston GP, Yasuda CL, Zhu AH, Thompson PM, Whelan CD, Jahanshad N, Sisodiya SM, McDonald CR. White matter abnormalities across different epilepsy syndromes in adults: an ENIGMA-Epilepsy study. Brain 2020; 143:2454-2473. [PMID: 32814957 PMCID: PMC7567169 DOI: 10.1093/brain/awaa200] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/07/2020] [Accepted: 04/30/2020] [Indexed: 12/22/2022] Open
Abstract
The epilepsies are commonly accompanied by widespread abnormalities in cerebral white matter. ENIGMA-Epilepsy is a large quantitative brain imaging consortium, aggregating data to investigate patterns of neuroimaging abnormalities in common epilepsy syndromes, including temporal lobe epilepsy, extratemporal epilepsy, and genetic generalized epilepsy. Our goal was to rank the most robust white matter microstructural differences across and within syndromes in a multicentre sample of adult epilepsy patients. Diffusion-weighted MRI data were analysed from 1069 healthy controls and 1249 patients: temporal lobe epilepsy with hippocampal sclerosis (n = 599), temporal lobe epilepsy with normal MRI (n = 275), genetic generalized epilepsy (n = 182) and non-lesional extratemporal epilepsy (n = 193). A harmonized protocol using tract-based spatial statistics was used to derive skeletonized maps of fractional anisotropy and mean diffusivity for each participant, and fibre tracts were segmented using a diffusion MRI atlas. Data were harmonized to correct for scanner-specific variations in diffusion measures using a batch-effect correction tool (ComBat). Analyses of covariance, adjusting for age and sex, examined differences between each epilepsy syndrome and controls for each white matter tract (Bonferroni corrected at P < 0.001). Across 'all epilepsies' lower fractional anisotropy was observed in most fibre tracts with small to medium effect sizes, especially in the corpus callosum, cingulum and external capsule. There were also less robust increases in mean diffusivity. Syndrome-specific fractional anisotropy and mean diffusivity differences were most pronounced in patients with hippocampal sclerosis in the ipsilateral parahippocampal cingulum and external capsule, with smaller effects across most other tracts. Individuals with temporal lobe epilepsy and normal MRI showed a similar pattern of greater ipsilateral than contralateral abnormalities, but less marked than those in patients with hippocampal sclerosis. Patients with generalized and extratemporal epilepsies had pronounced reductions in fractional anisotropy in the corpus callosum, corona radiata and external capsule, and increased mean diffusivity of the anterior corona radiata. Earlier age of seizure onset and longer disease duration were associated with a greater extent of diffusion abnormalities in patients with hippocampal sclerosis. We demonstrate microstructural abnormalities across major association, commissural, and projection fibres in a large multicentre study of epilepsy. Overall, patients with epilepsy showed white matter abnormalities in the corpus callosum, cingulum and external capsule, with differing severity across epilepsy syndromes. These data further define the spectrum of white matter abnormalities in common epilepsy syndromes, yielding more detailed insights into pathological substrates that may explain cognitive and psychiatric co-morbidities and be used to guide biomarker studies of treatment outcomes and/or genetic research.
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Affiliation(s)
- Sean N Hatton
- Department of Neurosciences, Center for Multimodal Imaging and Genetics,
University of California San Diego, La Jolla 92093 CA, USA
| | - Khoa H Huynh
- Center for Multimodal Imaging and Genetics, University of California San
Diego, La Jolla 92093 CA, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina,
Charleston 29425 SC, USA
| | - Eugenio Abela
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry,
Psychology and Neuroscience, Kings College London, London SE5 9NU UK
| | - Saud Alhusaini
- Neurology Department, Yale School of Medicine, New Haven 6510 CT,
USA
- Molecular and Cellular Therapeutics, The Royal College of Surgeons in
Ireland, Dublin, Ireland
| | - Andre Altmann
- Centre of Medical Image Computing, Department of Medical Physics and Biomedical
Engineering, University College London, London WC1V 6LJ, UK
| | - Marina K M Alvim
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Akshara R Balachandra
- Center for Multimodal Imaging and Genetics, UCSD School of
Medicine, La Jolla 92037 CA, USA
- Boston University School of Medicine, Boston 2118 MA, USA
| | - Emanuele Bartolini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- USL Centro Toscana, Neurology Unit, Nuovo Ospedale Santo Stefano,
Prato, Italy
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University Hospital
Tübingen, Tübingen 72076, Germany
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Boris Bernhardt
- Montreal Neurological Institute, McGill University, Montreal
H3A2B4 QC, Canada
| | - Núria Bargallo
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques
August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain
| | - Benoit Caldairou
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute, McGill
University, Montreal H3A 2B4 QC, Canada
| | - Maria E Caligiuri
- Neuroscience Research Center, University Magna Graecia, viale Europa,
Germaneto, 88100, Catanzaro, Italy
| | - Sarah J A Carr
- Neuroscience, Institute of Psychiatry, Psychology and
Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Gianpiero L Cavalleri
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular
Sciences, Dublin D02 YN77 Ireland
- FutureNeuro Research Centre, Science Foundation Ireland, Dublin
D02 YN77, Ireland
| | - Fernando Cendes
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Luis Concha
- Institute of Neurobiology, Universidad Nacional Autonoma de
Mexico, Queretaro 76230, Mexico
| | - Esmaeil Davoodi-bojd
- Radiology and Research Administration, Henry Ford Hospital, 1
Detroit 48202 MI, USA
| | - Patricia M Desmond
- Department of Radiology, Royal Melbourne Hospital, University of
Melbourne, Melbourne 3050 Victoria, Australia
| | | | - Colin P Doherty
- Division of Neurology, Trinity College Dublin, TBSI, Pearce
Street, Dublin D02 R590, Ireland
- FutureNeuro SFI Centre for Neurological Disease, RCSI, St Stephen’s
Green, Dublin D02 H903, Ireland
| | - Martin Domin
- Functional Imaging Unit, University Medicine Greifswald,
Greifswald 17475 M/V, Germany
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of
Neurology, Queen Square, London WC1N 3BG, UK
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire SL9 0RJ, UK
| | - Niels K Focke
- Clinical Neurophysiology, University Medicine Göttingen, 37099
Göttingen, Germany
- Department of Epileptology, University of Tübingen, 72076
Tübingen, Germany
| | | | - Antonio Gambardella
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular
Sciences, Dublin D02 YN77 Ireland
- Institute of Neurology, University Magna Graecia, 88100,
Catanzaro, Italy
| | | | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
| | - Khalid Hamandi
- The Wales Epilepsy Unit, Cardiff and Vale University Health
Board, Cardiff CF144XW, UK
- Brain Research Imaging Centre, Cardiff University, Cardiff CF24
4HQ, UK
| | - Akari Ishikawa
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Simon S Keller
- Institute of Translational Medicine, University of Liverpool,
Liverpool L69 3BX, UK
- Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK
| | - Peter V Kochunov
- Maryland Psychiatric Research Center, 55 Wade Ave, Baltimore
21228, MD, USA
| | - Raviteja Kotikalapudi
- Department of Neurology and Epileptology, University Hospital
Tübingen, Tübingen 72076 BW, Germany
- Department of Diagnostic and Interventional Neuroradiology, University Hospital
Tübingen, Tübingen 72076 BW, Germany
| | - Barbara A K Kreilkamp
- Institute of Translational Medicine, University of Liverpool,
Liverpool L69 3BX, UK
- Walton Centre NHS Foundation Trust, Liverpool L9 7LJ, UK
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
| | - Angelo Labate
- Neuroscience Research Center, University Magna Graecia, viale Europa,
Germaneto, 88100, Catanzaro, Italy
- Institute of Neurology, University Magna Graecia, 88100,
Catanzaro, Italy
| | - Soenke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt
University Greifswald Faculty of Medicine, Greifswald 17475, Germany
- Institute for Diagnostic and Interventional Radiology, Pediatric and
Neuroradiology, Rostock University Medical Centre, Rostock 18057, Germany
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories,
Children’s Hospital A. Meyer-University of Florence, Florence, Italy
- Functional and Epilepsy Neurosurgery Unit, Children’s Hospital A.
Meyer-University of Florence, Florence 50139, Italy
| | - Min Liu
- Department of Neurology, Montreal Neurological Institute,
Montreal H3A 2B4 QC, Canada
| | - Elaine Lui
- Department of Radiology, Royal Melbourne Hospital, University of
Melbourne, Melbourne 3050 Victoria, Australia
- Department of Medicine and Radiology, University of Melbourne,
3Parkville 3050 Victoria, Australia
| | - Pascal Martin
- Department of Epileptology, University of Tübingen, 72076
Tübingen, Germany
| | - Mario Mascalchi
- Meyer Children Hospital University of Florence, Florence 50130
Tuscany, Italy
| | - José C V Moreira
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Marcia E Morita-Sherman
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
- Cleveland Clinic, Cleveland 44195 OH, USA
| | - Terence J O’Brien
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne 3004 Victoria,
Australia
| | - Heath R Pardoe
- Department of Neurology, New York University School of Medicine,
New York City 10016 NY, USA
| | - José C Pariente
- Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques
August Pi i Sunyer (IDIBAPS), Barcelona 8036 Barcelona, Spain
| | - Letícia F Ribeiro
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Mark P Richardson
- Division of Neuroscience, King’s College London, Institute of
Psychiatry, London SE5 8AB, UK
| | - Cristiane S Rocha
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Raúl Rodríguez-Cruces
- Montreal Neurological Institute, McGill University, Montreal
H3A2B4 QC, Canada
- Institute of Neurobiology, Universidad Nacional Autonoma de
Mexico, Queretaro 76230, Mexico
| | - Felix Rosenow
- Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt,
Germany, Frankfurt 60528 Hesse, Germany
- Center for Personalized Translational Epilepsy Research (CePTER),
Goethe-University Frankfurt, Frankfurt a. M. 60528, Germany
| | - Mariasavina Severino
- Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa 16147
Liguria, Italy
| | - Benjamin Sinclair
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne 3004 Victoria,
Australia
| | - Hamid Soltanian-Zadeh
- Radiology and Research Administration, Henry Ford Health System,
Detroit 48202-2692 MI, USA
- School of Electrical and Computer Engineering, University of
Tehran, Tehran 14399-57131, Iran
| | - Pasquale Striano
- IRCCS Istituto Giannina Gaslini, Genoa 16147 Liguria, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal
and Child Health, University of Genova, Genova, Italy
| | - Peter N Taylor
- School of Computing, Newcastle University, Urban Sciences Building, Science
Square, Newcastle upon Tyne NE4 5TG, UK
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Newcastle
University, Newcastle upon Tyne NE2 4HH, UK
- Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK
| | - Domenico Tortora
- Radiology and Research Administration, Henry Ford Health System,
Detroit 48202-2692 MI, USA
| | - Dennis Velakoulis
- Royal Melbourne Hospital, Melbourne 3050 Victoria, Australia
- University of Melbourne, Parkville, Melbourne 3050 Victoria,
Australia
| | - Annamaria Vezzani
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano
20156 Italy
| | - Lucy Vivash
- Department of Neuroscience, Central Clinical School, Monash
University, Melbourne 3004 Victoria, Australia
- Department of Medicine, University of Melbourne, Royal Melbourne
Hospital, Parkville 3050 Victoria, Australia
| | - Felix von Podewils
- Epilepsy Center, University Medicine Greifswald, Greifswald 17489
Mecklenburg-Vorpommern, Germany
| | - Sjoerd B Vos
- Centre for Medical Image Computing, University College London,
London, WC1V 6LJ, UK
- Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire,
SL9 0RJ, UK
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition Research, University of
Bonn, Venusberg Campus 1, Bonn 53127 NRW, Germany
| | - Gavin P Winston
- Epilepsy Society, MRI Unit, Chalfont St Peter, Buckinghamshire,
SL9 0RJ, UK
- Department of Medicine, Division of Neurology, Queen's
University, Kingston K7L 3N6 ON, Canada
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire, SL9 0RJ UK
| | - Clarissa L Yasuda
- Department of Neurology, University of Campinas - UNICAMP, Campinas 13083-888
São Paulo, Brazil
| | - Alyssa H Zhu
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Christopher D Whelan
- Molecular and Cellular Therapeutics, The Royal College of Surgeons in
Ireland, Dublin, Ireland
- Research and Early Development (RED), Biogen Inc., Cambridge, MA
02139, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and
Informatics, USC Keck School of Medicine, Los Angeles 90232 CA, USA
| | - Sanjay M Sisodiya
- MRI Unit, Chalfont Centre for Epilepsy, Chalfont-St-Peter,
Buckinghamshire, SL9 0RJ UK
- Chalfont Centre for Epilepsy, Chalfont-St-Peter, SL9 0RJ Bucks,
UK
| | - Carrie R McDonald
- Department of Psychiatry, Center for Multimodal Imaging and Genetics,
University of California San Diego, La Jolla 92093 CA, USA
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23
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Sisodiya SM, Whelan CD, Hatton SN, Huynh K, Altmann A, Ryten M, Vezzani A, Caligiuri ME, Labate A, Gambardella A, Ives‐Deliperi V, Meletti S, Munsell BC, Bonilha L, Tondelli M, Rebsamen M, Rummel C, Vaudano AE, Wiest R, Balachandra AR, Bargalló N, Bartolini E, Bernasconi A, Bernasconi N, Bernhardt B, Caldairou B, Carr SJ, Cavalleri GL, Cendes F, Concha L, Desmond PM, Domin M, Duncan JS, Focke NK, Guerrini R, Hamandi K, Jackson GD, Jahanshad N, Kälviäinen R, Keller SS, Kochunov P, Kowalczyk MA, Kreilkamp BA, Kwan P, Lariviere S, Lenge M, Lopez SM, Martin P, Mascalchi M, Moreira JC, Morita‐Sherman ME, Pardoe HR, Pariente JC, Raviteja K, Rocha CS, Rodríguez‐Cruces R, Seeck M, Semmelroch MK, Sinclair B, Soltanian‐Zadeh H, Stein DJ, Striano P, Taylor PN, Thomas RH, Thomopoulos SI, Velakoulis D, Vivash L, Weber B, Yasuda CL, Zhang J, Thompson PM, McDonald CR. The ENIGMA-Epilepsy working group: Mapping disease from large data sets. Hum Brain Mapp 2020; 43:113-128. [PMID: 32468614 PMCID: PMC8675408 DOI: 10.1002/hbm.25037] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 05/01/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023] Open
Abstract
Epilepsy is a common and serious neurological disorder, with many different constituent conditions characterized by their electro clinical, imaging, and genetic features. MRI has been fundamental in advancing our understanding of brain processes in the epilepsies. Smaller-scale studies have identified many interesting imaging phenomena, with implications both for understanding pathophysiology and improving clinical care. Through the infrastructure and concepts now well-established by the ENIGMA Consortium, ENIGMA-Epilepsy was established to strengthen epilepsy neuroscience by greatly increasing sample sizes, leveraging ideas and methods established in other ENIGMA projects, and generating a body of collaborating scientists and clinicians to drive forward robust research. Here we review published, current, and future projects, that include structural MRI, diffusion tensor imaging (DTI), and resting state functional MRI (rsfMRI), and that employ advanced methods including structural covariance, and event-based modeling analysis. We explore age of onset- and duration-related features, as well as phenomena-specific work focusing on particular epilepsy syndromes or phenotypes, multimodal analyses focused on understanding the biology of disease progression, and deep learning approaches. We encourage groups who may be interested in participating to make contact to further grow and develop ENIGMA-Epilepsy.
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Affiliation(s)
- Sanjay M. Sisodiya
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBucksUK
| | - Christopher D. Whelan
- Department of Molecular and Cellular TherapeuticsThe Royal College of Surgeons in IrelandDublinIreland
| | - Sean N. Hatton
- Center for Multimodal Imaging and GeneticsUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Khoa Huynh
- Center for Multimodal Imaging and GeneticsUniversity of California San DiegoLa JollaCaliforniaUSA
| | - Andre Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Mina Ryten
- UCL Queen Square Institute of NeurologyLondonUK
| | - Annamaria Vezzani
- Department of NeuroscienceIstituto di Ricerche Farmacologiche Mario Negri IRCCSMilanItaly
| | - Maria Eugenia Caligiuri
- Neuroscience Research Center, Department of Medical and Surgical SciencesUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
| | - Angelo Labate
- Neuroscience Research Center, Department of Medical and Surgical SciencesUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
- Institute of NeurologyUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
| | - Antonio Gambardella
- Neuroscience Research Center, Department of Medical and Surgical SciencesUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
- Institute of NeurologyUniversity “Magna Græcia" of CatanzaroCatanzaroItaly
| | | | - Stefano Meletti
- Department of Biomedical, Metabolic, and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Neurology UnitOCB Hospital, AOU ModenaModenaItaly
| | - Brent C. Munsell
- Department of PsychiatryUniversity of North CarolinaChapel HillNorth CarolinaUSA
- Department of Computer ScienceUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Leonardo Bonilha
- Department of NeurologyMedical University of South CarolinaCharlestonSouth CarolinaUSA
| | | | - Michael Rebsamen
- Support Center for Advanced NeuroimagingUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Christian Rummel
- Support Center for Advanced NeuroimagingUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Anna Elisabetta Vaudano
- Department of Biomedical, Metabolic, and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Neurology UnitOCB Hospital, AOU ModenaModenaItaly
| | - Roland Wiest
- Support Center for Advanced NeuroimagingUniversity Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of BernBernSwitzerland
| | - Akshara R. Balachandra
- Center for Multimodal Imaging and GeneticsUniversity of California San DiegoLa JollaCaliforniaUSA
- Boston University School of MedicineBostonMassachusettsUSA
| | - Núria Bargalló
- Magnetic Resonance Image Core FacilityInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de BarcelonaBarcelonaSpain
- Radiology Department of Center of Image DiagnosisHospital Clinic de BarcelonaBarcelonaSpain
| | - Emanuele Bartolini
- Neurology UnitUSL Centro Toscana, Nuovo Ospedale Santo StefanoPratoItaly
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Boris Bernhardt
- McConnell Brain Imaging CenterMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Benoit Caldairou
- Neuroimaging of Epilepsy LaboratoryMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Sarah J.A. Carr
- NeuroscienceInstitute of Psychiatry, Psychology and NeuroscienceLondonUK
| | - Gianpiero L. Cavalleri
- School of Pharmacy and Biomolecular SciencesThe Royal College of Surgeons in IrelandDublinIreland
- FutureNeuro SFI Research CentreDublinIreland
| | - Fernando Cendes
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Luis Concha
- Instituto de NeurobiologíaUniversidad Nacional Autónoma de MéxicoQuerétaroMexico
| | - Patricia M. Desmond
- Department of RadiologyRoyal Melbourne Hospital, University of MelbourneMelbourneVictoriaAustralia
| | - Martin Domin
- Functional Imaging Unit, Department of Diagnostic Radiology and NeuroradiologyUniversity Medicine GreifswaldGreifswaldGermany
| | - John S. Duncan
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyLondonUK
- Chalfont Centre for EpilepsyBucksUK
| | - Niels K. Focke
- University Medicine GöttingenClinical NeurophysiologyGöttingenGermany
| | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesChildren's Hospital A. Meyer‐University of FlorenceFlorenceItaly
| | - Khalid Hamandi
- The Wales Epilepsy Unit, Department of NeurologyUniversity Hospital of WalesCardiffUK
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUK
| | - Graeme D. Jackson
- Department of NeurologyAustin HealthHeidelbergVictoriaAustralia
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneVictoriaAustralia
| | - Neda Jahanshad
- Imaging Genetics CenterMark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Reetta Kälviäinen
- Kuopio University HospitalMember of EpiCARE ERNKuopioFinland
- Institute of Clinical MedicineNeurology, University of Eastern FinlandKuopioFinland
| | - Simon S. Keller
- Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
- The Walton CentreNHS Foundation TrustLiverpoolUK
| | - Peter Kochunov
- Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreMarylandUSA
| | - Magdalena A. Kowalczyk
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneVictoriaAustralia
| | - Barbara A.K. Kreilkamp
- Institute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
- The Walton CentreNHS Foundation TrustLiverpoolUK
| | - Patrick Kwan
- Department of Neuroscience, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Sara Lariviere
- McConnell Brain Imaging CenterMontreal Neurological Institute, McGill UniversityMontrealQuébecCanada
| | - Matteo Lenge
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesChildren's Hospital A. Meyer‐University of FlorenceFlorenceItaly
- Functional and Epilepsy Neurosurgery Unit, Neurosurgery DepartmentChildren's Hospital A. Meyer‐University of FlorenceFlorenceItaly
| | - Seymour M. Lopez
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Pascal Martin
- Department of Neurology and EpileptologyHertie Institute for Clinical Brain Research, University Hospital TübingenTübingenGermany
| | - Mario Mascalchi
- 'Mario Serio' Department of Clinical and Experimental Medical SciencesUniversity of FlorenceFlorenceItaly
| | - José C.V. Moreira
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Marcia E. Morita‐Sherman
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
- Cleveland Clinic Neurological InstituteClevelandOhioUSA
| | - Heath R. Pardoe
- Department of NeurologyNew York University School of MedicineNew YorkNew YorkUSA
| | - Jose C. Pariente
- Magnetic Resonance Image Core FacilityInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de BarcelonaBarcelonaSpain
| | - Kotikalapudi Raviteja
- Department of Neurology and EpileptologyHertie Institute for Clinical Brain Research, University Hospital TübingenTübingenGermany
- Department of Diagnostic and Interventional NeuroradiologyUniversity Hospitals TübingenTübingenGermany
- Department of Clinical NeurophysiologyUniversity Hospital GöttingenGoettingenGermany
| | - Cristiane S. Rocha
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Raúl Rodríguez‐Cruces
- Instituto de NeurobiologíaUniversidad Nacional Autónoma de MéxicoQuerétaroMexico
- Montreal Neurological Institute and HospitalMcGill UniversityMontrealQuébecCanada
| | | | - Mira K.H.G. Semmelroch
- Florey Department of Neuroscience and Mental HealthUniversity of MelbourneVictoriaAustralia
- The Florey Institute of Neuroscience and Mental HealthAustin CampusHeidelbergVictoriaAustralia
| | - Benjamin Sinclair
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Alfred HealthMelbourneVictoriaAustralia
| | - Hamid Soltanian‐Zadeh
- Radiology and Research AdministrationHenry Ford Health SystemDetroitMichiganUSA
- School of Electrical and Computer EngineeringCollege of Engineering, University of TehranTehranIran
| | - Dan J. Stein
- South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience InstituteUniversity of Cape Townon Risk & Resilience in Mental DisordersCape TownSouth Africa
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases UnitIRCCS Istituto 'G. Gaslini'GenovaItaly
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child HealthUniversity of GenovaItaly
| | - Peter N. Taylor
- School of ComputingNewcastle UniversityNewcastle upon TyneUK
| | - Rhys H. Thomas
- Institute of Translational and Clinical ResearchNewcastle UniversityNewcastle upon TyneUK
| | - Sophia I. Thomopoulos
- Imaging Genetics CenterMark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Dennis Velakoulis
- Department of Medicine, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaUK
- Department of NeuropsychiatryRoyal Melbourne HospitalParkvilleVictoriaAustralia
| | - Lucy Vivash
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyRoyal Melbourne HospitalMelbourneVictoriaAustralia
| | - Bernd Weber
- Institute of Experimental Epileptology and Cognition ResearchUniversity of BonnBonnGermany
| | - Clarissa Lin Yasuda
- Department of Neurology and Neuroimaging LaboratoryUniversity of Campinas – UNICAMPCampinasSão PauloBrazil
| | - Junsong Zhang
- Cognitive Science DepartmentSchool of Informatics, Xiamen UniversityXiamenChina
| | - Paul M. Thompson
- Imaging Genetics CenterMark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern CaliforniaMarina del ReyCaliforniaUSA
| | - Carrie R. McDonald
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
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Murray GC, McKenzie K, Quigley A, Sinclair B. The Relationship between Training and the Experience of Aggression in the Workplace in Residential Care Staff Working in Learning Disability Services. ACTA ACUST UNITED AC 2020. [DOI: 10.1177/174462959900300408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study used a questionnaire to examine the following in 50 social care staff: the experience of workplace aggression in staff supporting individuals with a learning disability, the extent to which staff had received training in the prevention and management of aggressive behaviour and the relationship between training and staff confidence in dealing with aggression. The majority of staff were found to have experienced assault in the course of their work. Despite this, less than half had received training in the prevention and management of aggression. Such training seemed to impact differently on males and females, with trained males feeling confident in managing aggression, and untrained males feeling anxious. In contrast, the majority of females reported feelings of anxiety regardless of previous training. Staff reported strategies for dealing with aggression which mainly involved withdrawal of themselves and others rather than physical interventions. However, there was a neglect of longer-term strategies for dealing with aggression. Implications for practice are discussed.
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Affiliation(s)
- G. C. Murray
- Consultant Clinical Psychologist, Dingleton Hospital, Melrose, Roxburghshire
| | - K. McKenzie
- Consultant Clinical Psychologist, Edenhall Hospital, Musselburgh, East Lothian
| | - A. Quigley
- Assistant Psychologist, Dingleton Hospital, Melrose, Roxburghshire
| | - B. Sinclair
- Service Performance Manager, Dingleton Hospital, Melrose, Roxburghshire, TD6 9HN, UK
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25
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Murray GC, McKenzie K, Quigley A, Sinclair B. Gender Differences in Assault Levels in a Health Service Unit for People with Learning Disabilities and Severely Challenging Behaviour. ACTA ACUST UNITED AC 2020. [DOI: 10.1177/174462959900300305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study examines gender differences and levels of threatened, attempted and actual assaults on staff working in a health service in-patient unit for individuals with learning disabilities over a 35-month period. It was found that the staff experienced high levels of assault overall, but that women experienced significantly higher levels of both threatened and total assaults as compared with men. Implications of the findings are discussed.
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Affiliation(s)
- G. C. Murray
- Consultant Clinical Psychologist, Dingleton Hospital, Melrose, Roxburghshire
| | - K. McKenzie
- Consultant Clinical Psychologist, Edenhall Hospital, Musselburgh, East Lothian
| | - A. Quigley
- Assistant Psychologist Dingleton Hospital, Melrose, Roxburghshire
| | - B. Sinclair
- Service Performance Manager, Dingleton Hospital, Melrose, Roxburghshire, TD6 9HN, UK
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26
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Cahill V, Sinclair B, Malpas CB, McIntosh AM, Chen Z, Vivash LE, O'Shea MF, Wilson SJ, Desmond PM, Berlangieri SU, Hicks RJ, Rowe CC, Morokoff AP, King JA, Fabinyi GC, Kaye AH, Kwan P, Berkovic SF, O'Brien TJ. Metabolic patterns and seizure outcomes following anterior temporal lobectomy. Ann Neurol 2019; 85:241-250. [DOI: 10.1002/ana.25405] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 01/21/2023]
Affiliation(s)
- Varduhi Cahill
- Departments of Medicine and Neurology; Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Manchester Centre for Clinical Neurosciences; Salford Royal NHS Foundation Trust; Salford United Kingdom
- Division of Neuroscience and Experimental Psychology; School of Biological Sciences, University of Manchester; Manchester United Kingdom
| | - Benjamin Sinclair
- Departments of Medicine and Radiology; University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Departments of Neuroscience and Neurology; Alfred Health, Central Clinical School, Monash University; Melbourne Victoria Australia
| | - Charles B. Malpas
- Departments of Medicine and Neurology; Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Departments of Neuroscience and Neurology; Alfred Health, Central Clinical School, Monash University; Melbourne Victoria Australia
- Murdoch Children's Research Institute; Melbourne Victoria Australia
- Melbourne School of Psychological Sciences; University of Melbourne; Melbourne Victoria Australia
| | - Anne M. McIntosh
- Departments of Medicine and Neurology; Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Departments of Neuroscience and Neurology; Alfred Health, Central Clinical School, Monash University; Melbourne Victoria Australia
- Epilepsy Research Centre; University of Melbourne, Austin Hospital; Melbourne Victoria Australia
| | - Zhibin Chen
- Departments of Medicine and Neurology; Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Departments of Neuroscience and Neurology; Alfred Health, Central Clinical School, Monash University; Melbourne Victoria Australia
| | - Lucy E. Vivash
- Departments of Medicine and Neurology; Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Departments of Neuroscience and Neurology; Alfred Health, Central Clinical School, Monash University; Melbourne Victoria Australia
| | - Marie F. O'Shea
- Comprehensive Epilepsy Program; Austin Hospital; Melbourne Victoria Australia
| | - Sarah J. Wilson
- Melbourne School of Psychological Sciences; University of Melbourne; Melbourne Victoria Australia
- Comprehensive Epilepsy Program; Austin Hospital; Melbourne Victoria Australia
| | - Patricia M. Desmond
- Departments of Medicine and Radiology; University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
| | | | - Rodney J. Hicks
- Peter MacCallum Cancer Centre and the Sir Peter MacCallum Department of Oncology; University of Melbourne; Melbourne Victoria Australia
| | - Christopher C. Rowe
- Epilepsy Research Centre; University of Melbourne, Austin Hospital; Melbourne Victoria Australia
- Florey Institute of Neuroscience and Mental Health; University of Melbourne; Melbourne Victoria Australia
| | - Andrew P. Morokoff
- Department of Surgery; University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
| | - James A. King
- Department of Surgery; University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Gavin C. Fabinyi
- Department of Surgery; University of Melbourne, Austin Hospital; Melbourne Victoria Australia
| | - Andrew H. Kaye
- Department of Surgery; University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Patrick Kwan
- Departments of Medicine and Neurology; Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Departments of Neuroscience and Neurology; Alfred Health, Central Clinical School, Monash University; Melbourne Victoria Australia
| | - Samuel F. Berkovic
- Epilepsy Research Centre; University of Melbourne, Austin Hospital; Melbourne Victoria Australia
- Comprehensive Epilepsy Program; Austin Hospital; Melbourne Victoria Australia
| | - Terence J. O'Brien
- Departments of Medicine and Neurology; Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital; Melbourne Victoria Australia
- Departments of Neuroscience and Neurology; Alfred Health, Central Clinical School, Monash University; Melbourne Victoria Australia
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27
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Thompson R, Mitrou G, Brown S, Almond E, Bandurek I, Brockton N, Kälfors M, McGinley-Gieser D, Sinclair B, Meincke L, Wiseman M, Allen K. Major new review of global evidence on diet, nutrition and physical activity: A blueprint to reduce cancer risk. NUTR BULL 2018. [DOI: 10.1111/nbu.12345] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Thompson
- World Cancer Research Fund International; London UK
| | - G. Mitrou
- World Cancer Research Fund International; London UK
| | - S. Brown
- World Cancer Research Fund International; London UK
| | - E. Almond
- World Cancer Research Fund International; London UK
| | - I. Bandurek
- World Cancer Research Fund International; London UK
| | - N. Brockton
- American Institute for Cancer Research; Washington DC USA
| | - M. Kälfors
- World Cancer Research Fund International; London UK
| | | | - B. Sinclair
- World Cancer Research Fund International; London UK
| | - L. Meincke
- World Cancer Research Fund International; London UK
| | - M. Wiseman
- World Cancer Research Fund International; London UK
| | - K. Allen
- World Cancer Research Fund International; London UK
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Alghamdi S, Sinclair B, Cowin G, Brereton I, Tesiram YA. Magnetic resonance spin-spin relaxation time estimation in a rat model of fatty liver disease. J Magn Reson Imaging 2017. [PMID: 28639264 DOI: 10.1002/jmri.25786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To compare mono- and bi-exponential relaxation model equations to discriminate between normal and fatty liver disease. MATERIALS AND METHODS Six rats on a choline deficient amino acid modified (CDAA) diet and six on normal chow were studied. Multiple spin echo images with increasing echo times (TEs) were collected at 9.4T. Pixel-wise T2 maps were generated using mono-exponential decay function to calculate T2M , and a bi-exponential to calculate, short T2 component (T2S ), long T2 component (T2L ), and fractions of these components (ρS , ρL ), respectively. Statistical F-tests and Akaike's information criterion (AIC) were used to assess the relative performance of the two models. RESULTS F-test and AIC showed that in the CDAA group, T2 bi-exponential model described the signal of T2 weighted imaging of the liver better than the mono-exponential model. Controls were best described by the mono-exponential model. Mean values for T2M , T2L , T2S , ρS , ρL were 31.2 ± 0.7 ms, 72.8 ± 3.3 ms, 8.2 ± 0.6 ms,71.2 ± 2.1%, 30.4 ± 1.3%, respectively, in CDAA rats, compared with 18.8 ± 0.5 ms, 32.3 ± 0.7 ms, 9.2 ± 1.8 ms, 79 ± 2%, 21.0 ± 1.1% in controls. CONCLUSION In the fatty liver of CDAA rats we have shown that T2 weighted images fit the bi-exponential model better than mono-exponential decays thus providing a better description of the data. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:468-476.
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Affiliation(s)
- Sami Alghamdi
- The University of Queensland, Centre for Advanced Imaging, Brisbane, Queensland, Australia.,College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia
| | - Benjamin Sinclair
- The University of Queensland, Centre for Advanced Imaging, Brisbane, Queensland, Australia
| | - Gary Cowin
- The University of Queensland, Centre for Advanced Imaging, Brisbane, Queensland, Australia
| | - Ian Brereton
- The University of Queensland, Centre for Advanced Imaging, Brisbane, Queensland, Australia
| | - Yasvir A Tesiram
- The University of Queensland, Centre for Advanced Imaging, Brisbane, Queensland, Australia
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Sinclair B, Hansell NK, Blokland GAM, Martin NG, Thompson PM, Breakspear M, de Zubicaray GI, Wright MJ, McMahon KL. Heritability of the network architecture of intrinsic brain functional connectivity. Neuroimage 2015. [PMID: 26226088 DOI: 10.1016/j.neuroimage.2015.07.048] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The brain's functional network exhibits many features facilitating functional specialization, integration, and robustness to attack. Using graph theory to characterize brain networks, studies demonstrate their small-world, modular, and "rich-club" properties, with deviations reported in many common neuropathological conditions. Here we estimate the heritability of five widely used graph theoretical metrics (mean clustering coefficient (γ), modularity (Q), rich-club coefficient (ϕnorm), global efficiency (λ), small-worldness (σ)) over a range of connection densities (k=5-25%) in a large cohort of twins (N=592, 84 MZ and 89 DZ twin pairs, 246 single twins, age 23 ± 2.5). We also considered the effects of global signal regression (GSR). We found that the graph metrics were moderately influenced by genetic factors h(2) (γ=47-59%, Q=38-59%, ϕnorm=0-29%, λ=52-64%, σ=51-59%) at lower connection densities (≤ 15%), and when global signal regression was implemented, heritability estimates decreased substantially h(2) (γ=0-26%, Q=0-28%, ϕnorm=0%, λ=23-30%, σ=0-27%). Distinct network features were phenotypically correlated (|r|=0.15-0.81), and γ, Q, and λ were found to be influenced by overlapping genetic factors. Our findings suggest that these metrics may be potential endophenotypes for psychiatric disease and suitable for genetic association studies, but that genetic effects must be interpreted with respect to methodological choices.
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Affiliation(s)
- Benjamin Sinclair
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD 4072, Australia; School of Psychology, University of Queensland, Brisbane, QLD 4072 Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia.
| | - Narelle K Hansell
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia.
| | | | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia.
| | - Paul M Thompson
- Imaging Genetics Center, Dept. of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90095, USA.
| | - Michael Breakspear
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia.
| | | | - Margaret J Wright
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4029, Australia.
| | - Katie L McMahon
- Centre for Advanced Imaging, University of Queensland, Brisbane, QLD 4072, Australia.
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30
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Straatman L, Chakrabarti S, Grewal J, Rabinovitz S, Whitehouse S, Sinclair B. UTILIZATION OF CONDITION SPECIFIC LONG TERM CARE PLANS TO FACILITATE TRANSITION TO THE ADULT HEALTHCARE SYSTEM (ON TRAC). Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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31
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Hamlyn E, McAllister J, Winston A, Sinclair B, Amin J, Carr A, Cooper DA. Is screening for sexually transmitted infections in men who have sex with men who receive non-occupational HIV post-exposure prophylaxis worthwhile? Sex Transm Infect 2006; 82:21-3. [PMID: 16461596 PMCID: PMC2563841 DOI: 10.1136/sti.2005.014662] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND/AIMS Non-occupational HIV post-exposure prophylaxis (NPEP) is routinely prescribed after high risk sexual exposure. This provides an opportunity to screen and treat individuals at risk of concurrent sexually transmitted infections (STI). The aim of this study was to assess the efficacy of an STI screening programme in individuals receiving NPEP. METHODS STI screens were offered to all individuals receiving NPEP from March 2001 to May 2004. Screen results were compared to type of sexual exposure and baseline patient characteristics. RESULTS A total of 253 subjects were screened, representing 85% of the target population. All were men who have sex with men (MSM). Common exposure risks were receptive anal intercourse (RAI) in 61% and insertive anal intercourse (IAI) in 33%. 32 (13%) individuals had one or more STI. The most common STIs were rectal infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in 11 (4.5%) and six (2.5%) individuals, respectively. Subjects with rectal CT were significantly more likely to be co-infected with rectal NG (p<0.001). There was no association between the presence of a rectal STI and age or exposure risk. Only six (19%) individuals with an STI were symptomatic at screening. CONCLUSION In this cohort of MSM receiving NPEP, high rates of concomitant STIs are observed highlighting the importance of STI screening in this setting.
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Affiliation(s)
- E Hamlyn
- HIV, Immunology and Infectious Diseases Clinical Services Unit, St Vincent's Hospital, Victoria Street, Sydney, 2010, Australia.
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32
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Carninci P, Kasukawa T, Katayama S, Gough J, Frith MC, Maeda N, Oyama R, Ravasi T, Lenhard B, Wells C, Kodzius R, Shimokawa K, Bajic VB, Brenner SE, Batalov S, Forrest ARR, Zavolan M, Davis MJ, Wilming LG, Aidinis V, Allen JE, Ambesi-Impiombato A, Apweiler R, Aturaliya RN, Bailey TL, Bansal M, Baxter L, Beisel KW, Bersano T, Bono H, Chalk AM, Chiu KP, Choudhary V, Christoffels A, Clutterbuck DR, Crowe ML, Dalla E, Dalrymple BP, de Bono B, Della Gatta G, di Bernardo D, Down T, Engstrom P, Fagiolini M, Faulkner G, Fletcher CF, Fukushima T, Furuno M, Futaki S, Gariboldi M, Georgii-Hemming P, Gingeras TR, Gojobori T, Green RE, Gustincich S, Harbers M, Hayashi Y, Hensch TK, Hirokawa N, Hill D, Huminiecki L, Iacono M, Ikeo K, Iwama A, Ishikawa T, Jakt M, Kanapin A, Katoh M, Kawasawa Y, Kelso J, Kitamura H, Kitano H, Kollias G, Krishnan SPT, Kruger A, Kummerfeld SK, Kurochkin IV, Lareau LF, Lazarevic D, Lipovich L, Liu J, Liuni S, McWilliam S, Madan Babu M, Madera M, Marchionni L, Matsuda H, Matsuzawa S, Miki H, Mignone F, Miyake S, Morris K, Mottagui-Tabar S, Mulder N, Nakano N, Nakauchi H, Ng P, Nilsson R, Nishiguchi S, Nishikawa S, Nori F, Ohara O, Okazaki Y, Orlando V, Pang KC, Pavan WJ, Pavesi G, Pesole G, Petrovsky N, Piazza S, Reed J, Reid JF, Ring BZ, Ringwald M, Rost B, Ruan Y, Salzberg SL, Sandelin A, Schneider C, Schönbach C, Sekiguchi K, Semple CAM, Seno S, Sessa L, Sheng Y, Shibata Y, Shimada H, Shimada K, Silva D, Sinclair B, Sperling S, Stupka E, Sugiura K, Sultana R, Takenaka Y, Taki K, Tammoja K, Tan SL, Tang S, Taylor MS, Tegner J, Teichmann SA, Ueda HR, van Nimwegen E, Verardo R, Wei CL, Yagi K, Yamanishi H, Zabarovsky E, Zhu S, Zimmer A, Hide W, Bult C, Grimmond SM, Teasdale RD, Liu ET, Brusic V, Quackenbush J, Wahlestedt C, Mattick JS, Hume DA, Kai C, Sasaki D, Tomaru Y, Fukuda S, Kanamori-Katayama M, Suzuki M, Aoki J, Arakawa T, Iida J, Imamura K, Itoh M, Kato T, Kawaji H, Kawagashira N, Kawashima T, Kojima M, Kondo S, Konno H, Nakano K, Ninomiya N, Nishio T, Okada M, Plessy C, Shibata K, Shiraki T, Suzuki S, Tagami M, Waki K, Watahiki A, Okamura-Oho Y, Suzuki H, Kawai J, Hayashizaki Y. The transcriptional landscape of the mammalian genome. Science 2005; 309:1559-63. [PMID: 16141072 DOI: 10.1126/science.1112014] [Citation(s) in RCA: 2607] [Impact Index Per Article: 137.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This study describes comprehensive polling of transcription start and termination sites and analysis of previously unidentified full-length complementary DNAs derived from the mouse genome. We identify the 5' and 3' boundaries of 181,047 transcripts with extensive variation in transcripts arising from alternative promoter usage, splicing, and polyadenylation. There are 16,247 new mouse protein-coding transcripts, including 5154 encoding previously unidentified proteins. Genomic mapping of the transcriptome reveals transcriptional forests, with overlapping transcription on both strands, separated by deserts in which few transcripts are observed. The data provide a comprehensive platform for the comparative analysis of mammalian transcriptional regulation in differentiation and development.
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Roy N, Fraser K, Lane G, Sinclair B, McNabb W. Polyethylene glycol increases intestinal absorption
and hepatic uptake of indole and skatole in sheep
fed sulla. J Anim Feed Sci 2004. [DOI: 10.22358/jafs/73932/2004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sinclair B, McNabb W, Greaney K, Lee J, Reynolds G, Ulyatt M, Roy N, Harris P. Feeding frequency of fresh white clover (<i>Trifolium
repens</i>) and ammonia metabolism in the ovine liver. J Anim Feed Sci 2004. [DOI: 10.22358/jafs/73935/2004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Roy N, Sinclair B, Treloar B, Peters J, McNabb W. Polyethylene glycol reduces the net flux of
branched-chain amino acids across the mammary
gland in ewes fed sulla. J Anim Feed Sci 2004. [DOI: 10.22358/jafs/73933/2004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Barnett M, Roy N, McCoard S, Sinclair B, Davis S, McNabb W. Protein synthesis in mammary epithelial cells
harvested from cows treated with growth hormone
or atropine. J Anim Feed Sci 2004. [DOI: 10.22358/jafs/73940/2004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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McCoard S, Roy N, Sinclair B, Deighton M, McNabb W. The effect of growth hormone on milk protein gene
expression in the bovine mammary gland. J Anim Feed Sci 2004. [DOI: 10.22358/jafs/73959/2004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Filler G, Wong H, Condello AS, Charbonneau C, Sinclair B, Kovesi T, Hutchison J. Early dialysis in a neonate with intrauterine lisinopril exposure. Arch Dis Child Fetal Neonatal Ed 2003; 88:F154-6. [PMID: 12598508 PMCID: PMC1721521 DOI: 10.1136/fn.88.2.f154] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In general, angiotensin converting enzyme (ACE) inhibitors should be discontinued in pregnancy, as they can induce an ACE fetopathy. For the treatment of the latter, early peritoneal dialysis is recommended for in utero exposure to captopril and enalapril, although the outcome is poor. Early peritoneal dialysis has not previously been reported for lisinopril induced multiorgan failure. A case is reported in which treatment was given on postnatal day 3. The patient recovered from oligoanuria to almost normal renal function, and heart, brain, and musculoskeletal injury was reversible. This is despite relatively poor clearance of the drug through peritoneal dialysis. Analysis of the pharmacokinetic data suggests that haemodialysis or haemofiltration would be more efficacious for removal of the drug, and these treatments should be performed if available.
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Affiliation(s)
- G Filler
- Department of Paediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K2H 7M9, Canada.
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Palmini A, Chandler C, Andermann F, Costa Da Costa J, Paglioli-Neto E, Polkey C, Rosenblatt B, Montes J, Martínez JV, Farmer JP, Sinclair B, Aronyk K, Paglioli E, Coutinho L, Raupp S, Portuguez M. Resection of the lesion in patients with hypothalamic hamartomas and catastrophic epilepsy. Neurology 2002; 58:1338-47. [PMID: 12011278 DOI: 10.1212/wnl.58.9.1338] [Citation(s) in RCA: 133] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Patients with hypothalamic hamartomas (HH) often have severe refractory epilepsy, incapacitating behavioral abnormalities, and cognitive decline. Attempts to control the seizure disorder by resection of apparently epileptogenic mesial temporal or other cortical structures have failed consistently. OBJECTIVE To report a series of 13 patients in whom the hamartoma itself was resected. METHODS All patients underwent preoperative evaluation between ages 2 and 33 years and had subtotal or complete resection of the hamartoma. Follow-up ranged from 1 to 5.5 years (mean: 2.8 y). RESULTS Preoperatively, all patients had variable combinations of gelastic, complex partial, and generalized seizures. Eight had drop attacks. In addition, all had marked behavior abnormalities and cognitive impairment. Postoperatively, two patients are completely seizure-free and 11 are either seizure-free or have achieved a greater than 90% reduction of drop attacks and generalized tonic-clonic seizures. However, minor gelastic, complex partial, and atypical absence seizures have persisted in 11 patients, although at significantly reduced rates. In addition, there has been a dramatic improvement in behavior and cognition. Three patients had an anterior thalamic and one a capsular infarct, which left only minimal long-term deficits. Exact location of the lesion in relation to the interpeduncular fossa and the walls of the third ventricle correlated with extent of excision, seizure control, and complication rate. CONCLUSION Resection can alleviate both the seizures and the behavioral and cognitive abnormalities of hypothalamic hamartomas, but complications are frequent.
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Affiliation(s)
- A Palmini
- Porto Alegre Epilepsy Surgery Program, Hospital São Lucas da PUCRS, Brazil.
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Almadani M, Blayney M, Kee Fung KF, Sinclair B. Long-Term Outcome after Amnioreduction for Twin-to-Twin Transfusion Syndrome. Paediatr Child Health 2002. [DOI: 10.1093/pch/7.suppl_a.45aa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
STUDY DESIGN A case series is reported. OBJECTIVE To improve understanding of the potential mechanisms associated with cerebral microemboli during scoliosis surgery in adolescents. SUMMARY OF BACKGROUND DATA Paradoxical cerebral fat microembolization during scoliosis surgery has been associated with right-to-left shunting through an undetected patent foramen ovale. The prevalence of this cardiac defect in the adult population may be as high as 15% to 25%. Although the clinical relevance of this embolic phenomenon during scoliosis surgery has not been investigated, a few reports have documented its fatal consequences. It has been suspected in some patients with postoperative reduced visual function, particularly after complex instrumented fusions. METHODS Bilateral transcranial Doppler (2 MHz) was used to monitor cerebral microemboli in the right and left middle cerebral arteries during spinal instrumentation and fusion in four patients. Additionally, transthoracic or transesophageal echocardiography incorporating pulse and color Doppler (3.5-5 MHz) and a contrast test was used in these patients to detect atrial shunts. RESULTS Intraoperative transcranial Doppler monitoring detected high rates of cerebral microemboli associated with the presence of an atrial communication in two adolescents. In two additional patients with no detected brain microembolization, echocardiographic examination indicated the absence of an atrial shunt. CONCLUSION The study findings suggest that unrecognized atrial communications in adolescents undergoing scoliosis surgery contribute to higher rates of Doppler-detected cerebral microemboli than those found in adolescents without this congenital defect.
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Affiliation(s)
- R A Rodriguez
- Division of Cardiology, Department of Pediatrics, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario, Canada.
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Kovesi T, Sinclair B, MacCormick J, Matzinger MA, Carpenter B. Primary ciliary dyskinesia associated with a novel microtubule defect in a child with Down's syndrome. Chest 2000; 117:1207-9. [PMID: 10767266 DOI: 10.1378/chest.117.4.1207] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
We present a child with Down's syndrome, bilateral lower lobe bronchiectasis, sinusitis, and severe ear disease who was found to have a novel ciliary defect, with a frequent, partial absence of the walls of the A subunits of some peripheral doublets. The defect caused the A subunits to be "U-shaped" rather than "O-shaped." A nuclear nasal mucociliary transport study confirmed that this defect was associated with abnormal mucociliary transport. The ciliary defect was not observed in a biopsy performed in a second patient who had Down's syndrome.
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Affiliation(s)
- T Kovesi
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Canada.
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Han RK, Sinclair B, Newman A, Silverman ED, Taylor GW, Walsh P, McCrindle BW. Recognition and management of Kawasaki disease. CMAJ 2000; 162:807-12. [PMID: 10750471 PMCID: PMC1231277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Kawasaki disease is the leading cause of acquired heart disease in children in the developed world, with coronary artery aneurysms occurring in up to 25% of untreated cases. The mean annual incidence of Kawasaki disease across Canada is about 13 per 100,000 children less than 5 years of age, based on hospital discharge data from 1990 to 1995. The cause remains unknown, and the diagnosis is based on the same clinical criteria used to describe the disease over 30 years ago. However, nonspecific clinical features, evolving presentations and atypical or incomplete presentations make early diagnosis and timely treatment difficult. Delays in diagnosis and treatment, which occur more frequently in older children, are associated with an increased risk of coronary artery aneurysms. Hence, high diagnostic suspicion and prompt referral are required to reduce the rate of cardiac complications.
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Affiliation(s)
- R K Han
- Division of Cardiology, University of Toronto, Ont
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Li X, Shiota T, Delabays A, Teien D, Zhou X, Sinclair B, Pandian NG, Sahn DJ. Flow convergence flow rates from 3-dimensional reconstruction of color Doppler flow maps for computing transvalvular regurgitant flows without geometric assumptions: An in vitro quantitative flow study. J Am Soc Echocardiogr 1999; 12:1035-44. [PMID: 10588778 DOI: 10.1016/s0894-7317(99)70099-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study was designed to develop and test a 3-dimensional method for direct measurement of flow convergence (FC) region surface area and for quantitating regurgitant flows with an in vitro flow system. BACKGROUND Quantitative methods for characterizing regurgitant flow events such as flow convergence with 2-dimensional color flow Doppler imaging systems have yielded variable results and may not be accurate enough to characterize those more complex spatial events. METHOD Four differently shaped regurgitant orifices were studied: 3 flat orifices (circular, rectangular, triangular) and a nonflat one mimicking mitral valve prolapse (all 4 orifice areas = 0.24 cm(2)) in a pulsatile flow model at 8 to 9 different regurgitant flow rates (10 to 50 mL/beat). An ultrasonic flow probe and meter were connected to the flow model to provide reference flow data. Video composite data from the color Doppler flow images of the FC were reconstructed after computer-controlled 180 degrees rotational acquisition was performed. FC surface area (S cm(2)) was calculated directly without any geometric assumptions by measuring parallel sliced flow convergence arc lengths through the FC volume and multiplying each by the slice thickness (2.5 to 3.2 mm) over 5 to 8 slices and then adding them together. Peak regurgitant flow rate (milliliters per second) was calculated as the product of 3-dimensional determined S (cm(2)) multiplied by the aliasing velocity (centimeters per second) used for color Doppler imaging. RESULTS For all of the 4 shaped orifices, there was an excellent relationship between actual peak flow rates and 3-dimensional FC-calculated flow rates with the direct measurement of the surface area of FC (r = 0.99, mean difference = -7.2 to -0.81 mL/s, % difference = -5% to 0%), whereas a hemielliptic method implemented with 3 axial measurements of the flow convergence zone from 2-dimensional planes underestimated actual flow rate by mean difference = -39.8 to -18.2 mL/s, % difference = -32% to -17% for any given orifice. CONCLUSIONS Three-dimensional reconstruction of flow based on 2-dimensional color Doppler may add quantitative spatial information, especially for complex flow events. Direct measurement of 3-dimensional flow convergence surface areas may improve accuracy for estimation of the severity of valvular regurgitation.
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Affiliation(s)
- X Li
- Clinical Care Center for Congenital Heart Disease, Oregon Health Sciences University, Portland, OR 97201, USA
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Abstract
We report a rare case of severe hemolytic anemia following repair of a congenital heart defect without the use of prosthetic material. A review of the literature, diagnosis, and management are described. Although this is an unusual complication following congenital heart surgery, a high index of suspicion must be maintained and a possible mechanical cause should be sought and corrected.
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Affiliation(s)
- J C Tsang
- Department of Cardiovascular Surgery, The Montreal Children's Hospital, McGill University, Quebec, Canada
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Clawson JJ, Sinclair B. "Medical Miranda"--improved emergency medical dispatch information from police officers. Prehosp Disaster Med 1999; 14:93-6. [PMID: 10558323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
INTRODUCTION Medical Miranda, also called Secondary Emergency Notification of Dispatch (SEND), is a low cost, effective, and welcome addition to emergency medical dispatching systems. The benefits are recognized by emergency medical dispatchers who receive feeder calls from associated public safety agencies that have trained both their field staff and call-takers in the Medical Miranda protocol. HYPOTHESIS The dispatchers would be more satisfied with feeder agencies that used the SEND protocol. METHODS A survey was conducted and analyzed, taking advantage of a situation in which two agencies (one used SEND) fed calls to the same communication center. RESULTS Dispatchers were more satisfied with the information gained from the feeder agency that used the SEND protocol and believed that the officers and dispatchers of that agency had a far better understanding of the emergency medical dispatcher's needs. CONCLUSIONS When the emergency medical dispatcher does not talk directly with the reporting scene personnel or caller, Medical Miranda increases the usefulness of the information the dispatcher receives, helps the dispatcher better understand the reported medical emergency, and improves response appropriateness in emergency medical service (EMS) systems where responses routinely are prioritized.
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Affiliation(s)
- J J Clawson
- Medical Priority Consultants, Inc., Salt Lake City, UT 84111, USA.
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Maeno YV, Kamenir SA, Sinclair B, van der Velde ME, Smallhorn JF, Hornberger LK. Prenatal features of ductus arteriosus constriction and restrictive foramen ovale in d-transposition of the great arteries. Circulation 1999; 99:1209-14. [PMID: 10069789 DOI: 10.1161/01.cir.99.9.1209] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although most neonates with d-transposition of the great arteries (TGA) have an uncomplicated preoperative course, some with a restrictive foramen ovale (FO), ductus arteriosus (DA) constriction, or pulmonary hypertension may be severely hypoxemic and even die shortly after birth. Our goal was to determine whether prenatal echocardiography can identify these high-risk fetuses with TGA. METHODS AND RESULTS We reviewed the prenatal and postnatal echocardiograms and outcomes of 16 fetuses with TGA/intact ventricular septum or small ventricular septal defect. Of the 16 fetuses, 6 prenatally had an abnormal FO (fixed position, flat, and/or redundant septum primum). Five of the 6 had restrictive FO at birth. Five fetuses had DA narrowing at the pulmonary artery end in utero, and 6 had a small DA (diameter z score of <-2.0). Of 4 fetuses with the most diminutive DA, 2 also had an abnormal appearance of the FO, and both died immediately after birth. One other fetus had persistent pulmonary hypertension. Eight fetuses had abnormal Doppler flow pattern in the DA (continuous high-velocity flow, n=1; retrograde diastolic flow, n=7). CONCLUSIONS Abnormal features of the FO, DA, or both are present in fetuses with TGA at high risk for postnatal hypoxemia. These features may result from the abnormal intrauterine hemodynamics in TGA. A combination of restrictive FO and DA constriction in TGA may be associated with early neonatal death.
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Affiliation(s)
- Y V Maeno
- Division of Cardiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Ishii M, Jones M, Shiota T, Yamada I, Sinclair B, Heinrich RS, Yoganathan AP, Sahn DJ. Temporal variability of vena contracta and jet areas with color Doppler in aortic regurgitation: a chronic animal model study. J Am Soc Echocardiogr 1998; 11:1064-71. [PMID: 9812100 DOI: 10.1016/s0894-7317(98)70158-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of our study was to determine the temporal variability of regurgitant color Doppler jet areas and the width of the color Doppler imaged vena contracta for evaluating the severity of aortic regurgitation. METHODS Twenty-nine hemodynamically different states were obtained pharmacologically in 8 sheep 20 weeks after surgery to produce aortic regurgitation. Aortic regurgitation was quantified by peak and mean regurgitant flow rates, regurgitant stroke volumes, and regurgitant fractions determined using pulmonary and aortic electromagnetic flow probes and meters balanced against each other. The regurgitant jet areas and the widths of color Doppler imaged vena contracta were measured at 4 different times during diastole to determine the temporal variability of this parameter. RESULTS When measured at 4 different temporal points in diastole, a significant change was observed in the size of the color Doppler imaged regurgitant jet (percent of difference: from 31.1% to 904%; 233% +/- 245%). Simple linear regression analysis between each color jet area at 4 different periods in diastole and flow meter-based severity of the aortic regurgitation showed only weak correlation (0.23 < r < 0.49). In contrast, for most conditions only a slight change was observed in the width of the color Doppler imaged vena contracta during the diastolic regurgitant period (percent of difference, vena contracta: from 2.4% to 12.9%, 5.8% +/- 3.2%). In addition, for each period the width of the color Doppler imaged vena contracta at the 4 different time periods in diastole correlated quite strongly with volumetric measures of the severity of aortic regurgitation (0.81 < r < 0.90) and with the instantaneous flow rate for the corresponding period (0.85 < r < 0.87). CONCLUSIONS Color Doppler imaged vena contracta may provide a simple, practical, and accurate method for quantifying aortic regurgitation, even when using a single frame color Doppler flow mapping image.
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Affiliation(s)
- M Ishii
- Oregon Health Sciences University, Portland, Oregon, USA
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Rodriguez RA, Hosking MC, Duncan WJ, Sinclair B, Teixeira OH, Cornel G. Cerebral blood flow velocities monitored by transcranial Doppler during cardiac catheterizations in children. Cathet Cardiovasc Diagn 1998; 43:282-90. [PMID: 9535365 DOI: 10.1002/(sici)1097-0304(199803)43:3<282::aid-ccd9>3.0.co;2-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Transcranial Doppler (TCD) was used to evaluate brain circulation during cardiac catheterizations in 32 children requiring pulmonary (n=10) or aortic balloon dilatations (n=2), ductus arteriosus coil insertions (n=5), or angiography (n=15). Cerebral blood flow velocity (CBFV) in the middle cerebral artery was measured before (baseline), during, and after each procedure (mean+/-95%ci). High-intensity transient signals (HITS) were also detected during these maneuvers. Balloon angioplasty decreased CBFV by 63+/-11% from baseline (P < 0.01). Shorter durations of the inflation cycle resulted in earlier CBFV recovery (r=0.78). During angiography, CBFV increased by 11+/-4% (P < 0.01) in all except one case that showed retrograde diastolic flow. Mean total HITS count was 44 (95%ci.limits: 27,74). These signals were more frequently found in septal defects or systemic arterial manipulations. Pediatric cardiac catheterization may impose transient fluctuations in brain perfusion as indicated by TCD, but their clinical implications are uncertain. CBFV changes during balloon angioplasty emphasize the importance of rapid inflation/deflation cycles. TCD can monitor such changes and evaluate preventive measures.
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Affiliation(s)
- R A Rodriguez
- Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Canada.
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50
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Ishii M, Jones M, Shiota T, Heinrich R, Yamada I, Sinclair B, Yoganathan AP, Sahn DJ. Evaluation of eccentric aortic regurgitation by color Doppler jet and color Doppler-imaged vena contracta measurements: an animal study of quantified aortic regurgitation. Am Heart J 1996; 132:796-804. [PMID: 8831369 DOI: 10.1016/s0002-8703(96)90314-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To evaluate the utility of measurements of the color Doppler jet area, jet length, and width of the color Doppler-imaged vena contracta (the smallest flow diameter in any part of the flow acceleration field) as methods for quantifying aortic regurgitation (AR), eight sheep with surgically induced AR were studied. AR was quantified as peak and mean regurgitant flow rates, regurgitant stroke volumes, and regurgitant fractions as determined with pulmonary and aortic electromagnetic flow probes and flowmeters balanced against each other. Simple linear regression analysis between the maximal color jet areas, jet length, and flowmeter data showed only moderately good correlation (jet area: 0.42 < or = r < or = 0.57, SEE = 2.85 cm2; jet length: 0.42 < or = r < or = 0.59, SEE = 1.23 cm). In contrast, the width of color Doppler-imaged vena contracta was a better indicator of the severity of AR on the basis of the electromagnetic flowmeter methods (0.73 < or = r < or = 0.90, SEE = 0.15 cm). Therefore the color Doppler jet length and jet area methods have limited use for determining AR, whereas the width of the color Doppler-imaged vena contracta can be used for quantifying the severity of AR.
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Affiliation(s)
- M Ishii
- Oregon Health Sciences University, Portland, USA
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