Prevalence of co-occurring diagnoses in people exposed to alcohol prenatally: Findings from a meta-analysis

BACKGROUND

Individuals with prenatal alcohol exposure (PAE) commonly experience co-occurring diagnoses, which are often overlooked and misdiagnosed and have detrimental impacts on accessing appropriate services. The prevalence of these co-occurring diagnoses varies widely in the existing literature and has not been examined in PAE without an FASD diagnosis.

METHOD

A search was conducted in five databases and the reference sections of three review papers, finding a total of 2180 studies. 57 studies were included in the final analysis with a cumulative sample size of 29,644. Bayesian modeling was used to determine aggregate prevalence rates of co-occurring disorders and analyze potential moderators.

RESULTS

82 % of people with PAE had a co-occurring diagnosis. All disorders had a higher prevalence in individuals with PAE than the general population with attention deficit hyperactivity disorder, learning disorder, and intellectual disability (ID) being the most prevalent. Age, diagnostic status, and sex moderated the prevalence of multiple disorders.

LIMITATIONS

While prevalence of disorders is crucial information, it does not provide a direct representation of daily functioning and available supports. Results should be interpreted in collaboration with more individualized research to provide the most comprehensive representation of the experience of individuals with PAE.

CONCLUSIONS

Co-occurring diagnoses are extremely prevalent in people with PAE, with older individuals, females, and those diagnosed with FASD being most at risk for having a co-occurring disorder. These findings provide a more rigorous examination of the challenges faced by individuals with PAE than has existed in the literature, providing clinicians with information to ensure early identification and effective treatment of concerns to prevent lifelong challenges.

Tumor Cell-Intrinsic PD-L1 Effects on Radiation-Induced Locoregional Antitumor Immunity

PURPOSE/OBJECTIVE(S)

Targeting PD-L1 is a beneficial strategy to reinvigorate antitumor immunity, however variable response and resistance are challenging and suggest the need for multimodality approaches. Tumor cell-intrinsic PD-L1 signals also regulate non-canonical pathogenic pathways that may impact treatment resistance. Ionizing radiation (IR) can induce antitumor immunity and has demonstrated therapeutic synergy with immunotherapy in some cases, however tumor-driven immunologic mechanisms affecting clinical outcomes remain incompletely understood. In this study, we investigated the impact of tumor cell-intrinsic PD-L1 signals on IR-induced locoregional immune response and tumor control.

MATERIALS/METHODS

We used orthotopic B16-F10 melanoma (WT-B16) and 4T1 triple negative breast cancer (WT-4T1) murine tumor models, as well as PD-L1 disabled variants (KO) generated by CRISPR/Cas9, implanted bilaterally. IR (10 Gy) was targeted at one tumor alone to evaluate both direct and indirect IR effects based on tumor PD-L1 status. We evaluated response by tumor volume (TV) measurements, flow cytometry of tumor-infiltrating lymphocytes (TILs) and tumor draining lymph nodes (TDLNs) in both irradiated and unirradiated compartments, and granzyme B (GZB) PET imaging to assess functional in vivo changes. Chemokine-based multiplex assays were used to assess cell lines receiving IR (4Gy) and ex vivo tumor lysates and serum.

RESULTS

IR-induced local tumor control was not significantly affected based on tumor PD-L1 status, however deactivation of tumor cell PD-L1 enhanced IR-induced regional tumor control. Unirradiated WT tumors in mice harboring irradiated KO but not irradiated WT tumors demonstrated a significant mean reduction in TV with instances of complete distant tumor regression. PET imaging demonstrated a nearly 2-fold higher concentration of GZB in KO versus WT tumors, in line with known locally immunosuppressive effects of tumor PD-L1. Remarkably, GZB levels were >1.5-fold higher in unirradiated WT tumors in mice harboring an irradiated KO versus WT tumor, which correlated with a 50% increase in PD-1+CD8+ T cells. Higher levels of CD62+CD44- naïve CD4+ (4-fold) and CD8+ (2-fold) memory T cells were seen in TDLNs of irradiated KO versus WT tumors. Cytokine levels positively correlated with immune recruitment and activation status, as CXCL10, CCL2 and CCL5 were significantly upregulated in PD-L1 KO versus WT tumors cells.

CONCLUSION

Results from this study demonstrate cell-intrinsic PD-L1 inhibits IR-induced locoregional immune activation and frequency of regional tumor control, with clinical implications including therapeutic targeting of tumor cell-intrinsic PD-L1 signals to enhance IR-induced immunogenicity, utility of IR based on tumor PD-L1 status particularly in the metastatic setting, and immunotherapy combinations. Future studies investigating mechanisms of resistance to IR-induced immune activation to enhance responsiveness are warranted.

Arterial Spin-Labeling Perfusion Metrics in Pediatric Posterior Fossa Tumor Surgery

BACKGROUND AND PURPOSE

Pediatric posterior fossa tumors often present with hydrocephalus; postoperatively, up to 25% of patients develop cerebellar mutism syndrome. Arterial spin-labeling is a noninvasive means of quantifying CBF and bolus arrival time. The aim of this study was to investigate how changes in perfusion metrics in children with posterior fossa tumors are modulated by cerebellar mutism syndrome and hydrocephalus requiring pre-resection CSF diversion.

MATERIALS AND METHODS

Forty-four patients were prospectively scanned at 3 time points (preoperatively, postoperatively, and at 3-month follow-up) with single- and multi-inflow time arterial spin-labeling sequences. Regional analyses of CBF and bolus arrival time were conducted using coregistered anatomic parcellations. ANOVA and multivariable, linear mixed-effects modeling analysis approaches were used. The study was registered at clinicaltrials.gov (NCT03471026).

RESULTS

CBF increased after tumor resection and at follow-up scanning (P = .045). Bolus arrival time decreased after tumor resection and at follow-up scanning (P = .018). Bolus arrival time was prolonged (P = .058) following the midline approach, compared with cerebellar hemispheric surgical approaches to posterior fossa tumors. Multivariable linear mixed-effects modeling showed that regional perfusion changes were more pronounced in the 6 children who presented with symptomatic obstructive hydrocephalus requiring pre-resection CSF diversion, with hydrocephalus lowering the baseline mean CBF by 20.5 (standard error, 6.27) mL/100g/min. Children diagnosed with cerebellar mutism syndrome (8/44, 18.2%) had significantly higher CBF at follow-up imaging than those who were not (P = .040), but no differences in pre- or postoperative perfusion parameters were seen.

CONCLUSIONS

Multi-inflow time arterial spin-labeling shows promise as a noninvasive tool to evaluate cerebral perfusion in the setting of pediatric obstructive hydrocephalus and demonstrates increased CBF following resolution of cerebellar mutism syndrome.

Differential gene expression analysis identified determinants of cell fate plasticity during radiation-induced regeneration in Drosophila

Ionizing radiation (IR) is used to treat half of all cancer patients because of its ability to kill cells. IR, however, can induce stem cell-like properties in non-stem cancer cells, potentiating tumor regrowth and reduced therapeutic success. We identified previously a subpopulation of cells in Drosophila larval wing discs that exhibit IR-induced stem cell-like properties. These cells reside in the future wing hinge, are resistant to IR-induced apoptosis, and are capable of translocating, changing fate, and participating in regenerating the pouch that suffers more IR-induced apoptosis. We used here a combination of lineage tracing, FACS-sorting of cells that change fate, genome-wide RNAseq, and functional testing of 42 genes, to identify two key changes that are required cell-autonomously for IR-induced hinge-to-pouch fate change: (1) repression of hinge determinants Wg (Drosophila Wnt1) and conserved zinc-finger transcription factor Zfh2 and (2) upregulation of three ribosome biogenesis factors. Additional data indicate a role for Myc, a transcriptional activator of ribosome biogenesis genes, in the process. These results provide a molecular understanding of IR-induced cell fate plasticity that may be leveraged to improve radiation therapy.

Ionizing radiation (IR) is used to treat half of all cancer patients because of its ability to kill cells but treatment failures are common because tumors grow back (regenerate). Here, we asked which changes in the properties of cells facilitate regeneration in Drosophila (fruit flies) after exposure to radiation. We identified six genes whose products increase or decrease the regenerative potential of cells. These results help us understand how tissues regenerate after IR damage and will aid in designing better therapies that involve radiation.

ImmunoglobuliN in the Treatment of Encephalitis (IgNiTE): protocol for a multicentre randomised controlled trial

INTRODUCTION

Infectious and immune-mediated encephalitides are important but under-recognised causes of morbidity and mortality in childhood, with a 7% death rate and up to 50% morbidity after prolonged follow-up. There is a theoretical basis for ameliorating the immune response with intravenous immunoglobulin (IVIG), which is supported by empirical evidence of a beneficial response following its use in the treatment of viral and autoimmune encephalitis. In immune-mediated encephalitis, IVIG is often used after a delay (by weeks in some cases), while diagnosis is confirmed. Wider use of IVIG in infectious encephalitis and earlier use in immune-mediated encephalitis could improve outcomes for these conditions. We describe the protocol for the first ever randomised control trial of IVIG treatment for children with all-cause encephalitis.

METHODS AND ANALYSIS

308 children (6 months to 16 years) with a diagnosis of acute/subacute encephalitis will be recruited in ∼30 UK hospitals and randomised to receive 2 doses (1 g/kg/dose) of either IVIG or matching placebo, in addition to standard treatment. Recruitment will be over a 42-month period and follow-up of each participant will be for 12 months post randomisation. The primary outcome is 'good recovery' (score of 2 or lower on the Glasgow Outcome Score Extended-paediatric version), at 12 months after randomisation. Additional secondary neurological measures will be collected at 4-6 weeks after discharge from acute care and at 6 and 12 months after randomisation. Safety, radiological, other autoimmune and tertiary outcomes will also be assessed.

ETHICS AND DISSEMINATION

This trial has been approved by the UK National Research Ethics committee (South Central-Oxford A; REC 14/SC/1416). Current protocol: V4.0 (10/03/2016). The findings will be presented at national and international meetings and conferences and published in peer-reviewed journals.

TRIAL REGISTRATION NUMBERS

NCT02308982, EudraCT201400299735 and ISRCTN15791925; Pre-results.

Quantitative magnetic resonance imaging in neuropsychiatric systemic lupus erythematosus

Neuropsychiatric symptoms are common in systemic lupus erythematosus (SLE) but are poorly understood.Although there is a wide spectrum of clinical manifestations, brain histologyoften simply shows a bland vasculopathy. Magnetic resonance techniques such as magnetic resonance spectroscopy, magnetization transfer imaging and diffusion weighted imaging have been used to try to improve our understandingof the pathophysiologicalmechanisms involved in neuropsychiatric lupus (NPSLE). This article reviews the current literature on the use of these techniques and their possible future role as diagnostic tools in NPSLE.

Abstract P1-12-07: Delayed initiation of adjuvant chemotherapy among breast cancer patients: A population-based study

BACKGROUND: Adjuvant chemotherapy improves outcomes of breast cancer patients; however the optimal timing to initiation of chemotherapy remains unknown. No study has evaluated the relationship between time to chemotherapy (TTC) and outcome in a population-based study of patients treated with contemporary regimens according to tumor subtype. In this large study we identified the determinants associated with a delay in the initiation of chemotherapy and determined whether TTC is related to outcome.

METHODS: Breast cancer patients diagnosed with stage I-III breast cancer between 2005-2010 and treated with adjuvant chemotherapy were identified in the California Cancer Registry. TTC was defined as number of days between surgery and the day the first dose of adjuvant chemotherapy was administered. Delayed TTC was defined as >91 days. Logistic regression and Cox-proportional hazard modeling were used.

RESULTS: A total of 24,843 patients were included. Factors associated with delays in TTC included low socioeconomic status, reconstructive surgical procedure, non-private insurance and Hispanic or non-Hispanic black race/ethnicity. Compared to patients receiving chemotherapy within 31 days from surgery, there was no evidence of adverse outcome among those with TTC of 31-60 or 60-90 days. To the contrary, patients treated >91 days from surgery experienced statistically significant worse overall survival (OS) (HR=1.34; 95%CI 1.15-1.57) and worse breast cancer specific survival (BCSS) (HR=1.27; 95%CI 1.05-1.53). In a subgroup analysis according to breast cancer subtype, TTC >91 days had a statistically significant detrimental impact among patients with triple negative breast cancer (TNBC) in terms of both OS (HR=1.53; 95%CI 1.17-2.00) and BCSS (HR=1.53; 95%CI 1.17-2.07).

CONCLUSIONS: In this large cohort of breast cancer patients treated with contemporary regimens, a delaying in the initiation of adjuvant chemotherapy >91 days was associated with adverse outcomes. A delay in TTC is particularly detrimental among patients with TNBC. The majority of the determinants of delays in chemotherapy initiation are socio-demographic in nature. As medical providers we must make every effort to provide timely care to all our patients so they can receive the full benefit of our current treatments.

Citation Format: Chavez-MacGregor M, Clark CA, Lichetensztajn DY, Giordano SH. Delayed initiation of adjuvant chemotherapy among breast cancer patients: A population-based study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-12-07.

Stylet penetration behaviors of Myzus persicae (Hemiptera: Aphididae) on four Ipomoea spp. infected or noninfected with sweet potato potyviruses

Myzus persicae (Sulzer) is an efficient vector of potyviruses in sweet potato, Ipomoea batatas (L.). These potyviruses also infect members of the morning glory family Ipomoea cordatotriloba Dennstedt and Ipomoea hederacea Jacqin commonly found within or around sweet potato fields. Infection of sweet potato with potyviruses increases the intrinsic rate of increase of M. persicae. Thus, from the epidemiological stand point, virus infection can modify vector population dynamics, and therefore increase virus spread. To better understand this, stylet penetration behaviors of M. persicae on virus infected and noninfected sweet potato cvs. 'Beauregard' and 'Evangeline', as well as morning glory plants I. cordatotriloba and I. hederacea were monitored. Stylet penetration behaviors associated with nonpersistent virus transmission such as time to first intracellular puncture (potential drop), number of potential drops, duration of potential drop, duration of potential drop subphase II-3, and number of potential drops with subphase II-3 pulses were significantly increased on virus-infected compared with noninfected Beauregard, but greatly reduced on virus-infected compared with noninfected I. hederacea plants. Stylet penetration behaviors associated with host acceptance such as reduced nonprobing duration and nonprobing events were greater on virus-infected compared with noninfected Beauregard plants. In contrast, on Evangeline, I. cordatotriloba and I. hederacea stylet penetration behaviors by M. persicae indicate it had less preference for virus-infected compared with noninfected plants.

Prolonged febrile seizures cause reversible reductions in white matter integrity

Prolonged febrile seizures (PFS) are the commonest cause of childhood status epilepticus and are believed to carry a risk of neuronal damage, in particular to the mesial temporal lobe. This study was designed to determine: i) the effect of prolonged febrile seizures on white matter and ii) the temporal evolution of any changes seen.

33 children were recruited 1 month following PFS and underwent diffusion tensor imaging (DTI) with repeat imaging at 6 and 12 months after the original episode of PFS. 18 age-matched healthy control subjects underwent similar investigations at a single time point. Tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) between patients and controls on a voxel-wise basis within the white matter skeleton.

Widespread reductions in FA along multiple white matter tracts were found at 1 and 6 months post-PFS, but these had resolved at 12 months. At one month post-PFS the main changes seen were reductions in AD but at 6 months these had predominantly changed to increases in RD.

These widespread white matter changes have not previously been noted following PFS. There are many possible explanations, but one plausible hypothesis is that this represents a temporary halting of normal white matter development caused by the seizure, that then resumes and normalises in the majority of children.

•

Widespread reductions in FA occur in children after prolonged febrile seizures.

•

These reductions persist up to 6 months post-PFS but resolve by 1 year.

•

This may represent a seizure-related disruption of white matter development.

Population dynamics of three aphid species (Hemiptera: Aphididae) on four Ipomoea spp. infected or noninfected with sweetpotato potyviruses

Three aphid species, Aphis gossypii Glover and Myzus persicae (Sulzer) (efficient sweetpotato potyvirus vectors) and Rhopalosiphum padi (L.) (an inefficient vector), are commonly found in sweet potato, Ipomoea batatas (L.), in Louisiana. Field-grown sweet potatoes are naturally infected with several potyviruses: Sweet potato feathery mottle virus, Sweet potato virus G, and Sweet potato virus 2. Thus, these aphids commonly encounter virus-infected hosts. What is not known is how each of these aphids responds to sweet potato, either infected or virus-free. The objectives of this study were to 1) determine if these aphid species can colonize mixed virus-infected sweet potato 'Beauregard', and if so, 2) determine the effects of virus infection on the population dynamics of each aphid. A. gossypii failed to larviposit and R. padi deposited a single nymph that died within a day on mixed virus-infected Beauregard. M. persicae larviposited and colonized Beauregard and further life-table analyses were warranted. M. persicae had a significantly greater reproduction on sweet potato cultivars Beauregard and 'Evangeline' with mixed virus infection compared with noninfected plants. On morning glory species, Ipomoea cordatotriloba (Dennestedt) and Ipomoea hederacea (Jacquin), M. persicae had a significantly lower reproduction on Sweet potato feathery mottle virus-infected compared with noninfected plants.

The Role of Aphid Abundance, Species Diversity, and Virus Titer in the Spread of Sweetpotato Potyviruses in Louisiana and Mississippi

Sweet potato feathery mottle virus (SPFMV), Sweet potato virus G (SPVG), and Sweet potato virus 2 (SPV2) are sweetpotato (Ipomoea batatas) potyviruses nonpersistently transmitted by aphids. Our objective was to determine how aphid abundance, aphid species diversity, and virus titers relate to the spread of SPFMV, SPVG, and SPV2 in Louisiana and Mississippi sweetpotato fields. The most abundant aphid species were Aphis gossypii, Myzus persicae, Rhopalosiphum padi, and Therioaphis trifolii. Aphids were captured during the entire crop cycle but virus infection of sentinel plants occurred mainly during the months of June to August. SPFMV was more commonly detected than SPVG or SPV2 in sentinel plants. Virus titers for SPFMV were higher in samples beginning in late June. Because significant aphid populations were present during April to June when virus titers were low in sweetpotato and there was very little virus infection of sentinel plants, low virus titers may have limited aphid acquisition and transmission opportunities. This is the first study to comprehensively examine aphid transmission of potyviruses in sweetpotato crops in the United States and includes the first report of R. maidis and R. padi as vectors of SPFMV, though they were less efficient than A. gossypii or M. persicae.

Endothelial cell protein C receptor-mediated redistribution and tissue-level accumulation of factor VIIa

BACKGROUND

Recent studies show that activated factor VII (FVIIa) binds to the endothelial cell protein C receptor (EPCR) on the vascular endothelium; however, the importance of this interaction in hemostasis or pathophysiology is unknown.

OBJECTIVE

The aim of the present study was to investigate the role of the FVIIa interaction with EPCR on the endothelium in mediating FVIIa transport from the circulation to extravascular tissues.

METHODS

Wild-type, EPCR-deficient or ECPR-over-expressing mice were injected with human recombinant (r)FVIIa (120 μg kg(-1) body weight) via the tail vein. At varying time intervals after rFVIIa administration, blood and various tissues were collected to measure FVIIa antigen and activity levels. Tissue sections were analyzed by immunohistochemistry for FVIIa and EPCR.

RESULTS

The data reveal that, after intravenous (i.v.) injection, rFVIIa rapidly disappears from the blood and associates with the endothelium in an EPCR-dependent manner. Immunohistochemical analyses revealed that the association of FVIIa with the endothelium was maximal at 30 min and thereafter progressively declined. The FVIIa association with the endothelium was undetectable at time points exceeding 24 h post-FVIIa administration. The levels of rFVIIa accumulated in tissue correlate with expression levels of EPCR in mice and FVIIa associated with tissues remained functionally active for periods of at least 7 days.

CONCLUSIONS

The observation that an EPCR-dependent association of FVIIa with the endothelium is most pronounced soon after rFVIIa administration and subsequently declines temporally, combined with the retention of functionally active FVIIa in tissue homogenates for extended periods, indicates that FVIIa binding to EPCR on the endothelium facilitates the transport of FVIIa from circulation to extravascular tissues where TF resides.

Effect of Host Plant, Aphid Species, and Virus Infection Status on Transmission of Sweetpotato feathery mottle virus

Sweetpotato feathery mottle virus (SPFMV) is a nonpersistently transmitted virus known to infect sweetpotato (Ipomoea batatas) and wild morning glory plants. SPFMV is vectored by various aphid species, among them the green peach aphid, Myzus persicae, and the cotton aphid, Aphis gossypii. Our objective was to determine whether differences in acquisition hosts (sweetpotato and morning glory), aphid species (M. persicae and A. gossypii), and infection status (single versus mixed infection) influenced transmission of SPFMV. SPFMV transmission from I. hederacea with a natural mixed infection by A. gossypii (39%) was significantly greater than in other host-virus combinations. Successful transmissions by A. gossypii were significantly greater compared with M. persicae in all host-virus combinations. Virus titers in source leaves were significantly greater in single- and mixed-infected I. hederacea and single-infected I. cordatotriloba compared with other host-virus combinations. There was a significant positive correlation between virus titer and transmission by both aphid species. These results suggest that, under controlled conditions, SPFMV is more readily transmitted from infected morning glory plants than from sweetpotato. Additionally, mixed-infected plants are better virus sources for transmission than single-infected, and A. gossypii is a more efficient vector than M. persicae under laboratory conditions.

Pattern recognition of MRSI data shows regions of glioma growth that agree with DTI markers of brain tumor infiltration

Gliomas are the most common primary brain tumors and the majority are highly malignant, with one of the worst prognoses for patients. Gliomas are characterized by invasive growth into normal brain tissue that makes complete surgical resection and accurate radiotherapy planning extremely difficult. We have performed independent component analysis of magnetic resonance spectroscopy imaging data from human gliomas to segment brain tissue into tumor core, tumor infiltration, and normal brain, with confirmation by diffusion tensor imaging analysis. Our data are consistent with previous studies that compared anomalies in isotropic and anisotropic diffusion images to determine regions of potential glioma infiltration. We show that coefficients of independent components can be used to create colored images for easy visual identification of regions of infiltrative tumor growth.

Burkholderia glumae and B. gladioli Cause Bacterial Panicle Blight in Rice in the Southern United States

Bacterial panicle blight (BPB) is among the three most limiting rice diseases in Louisiana and the southern United States. The identity and characterization of pathogens associated with this disease was unclear. This research details studies carried out on the pathogens causing BPB on rice in Louisiana and other rice producing southern states. Bacterial strains were isolated from BPB-infected sheath, panicle, or grain samples collected from rice fields in Louisiana, Arkansas, Texas, and Mississippi. In greenhouse inoculation tests, 292 of 364 strains were pathogenic on rice seedlings or panicles. Identification of strains in the pathogen complex by growth on S-PG medium, carbon source utilization profile (Biolog), cellular fatty acid analysis, and polymerase chain reaction (PCR) methods revealed that 76 and 5% of the strains were Burkholderia glumae and B. gladioli, respectively. The other strains have not been conclusively identified. Although strains of both species produced similar symptoms on rice, B. glumae strains were generally more aggressive and caused more severe symptoms on rice than B. gladioli. Virulent strains of both species produced toxoflavin in culture. The two species had similar growth responses to temperature, and optima ranged from 38 to 40°C for B. glumae and 35 to 37°C for B. gladioli. PCR was the most sensitive and accurate method tested for identifying the bacterial pathogens to the species level. The 16S rDNA gene and 16S-23S rDNA internal transcribed spacer (ITS) region sequences of the B. glumae and B. gladioli strains from rice showed more than 99% sequence homology with published sequences. A real-time PCR system was developed to detect and quantify this pathogen from infected seed lots. Our results clearly indicate that B. glumae and B. gladioli were the major pathogens causing BPB in the southern United States.

A structural equation modeling investigation of age-related variance in executive function and DTI measured white matter damage

Cognitive changes in normal aging have been explained by the frontal-executive hypothesis, but the assumptions made by this hypothesis concerning the neurobiological causes are still a matter of debate. Executive functions (EF) may activate neural networks that include disparate grey matter regions, and rely on the integrity of white matter connections. In 118 adults (50-90 years old) from the GENIE study, white matter integrity was measured using diffusion tensor imaging, and information processing speed, fluid intelligence and EF were assessed. A theory-driven structural equation model was developed to test associations between variables. The model was revised, removing non-significant paths. The adjusted model explained well the covariance in our data; and suggested that the reduction in white matter integrity associated with age directly affected only working memory. Fluid intelligence was mediated by all measured cognitive variables. The results suggest that white matter integrity may be particularly important for abilities activating complex neural networks, as occurs in working memory. Integration of the information processing speed and frontal-executive hypotheses may provide important information regarding common, unique, and mediating factors in cognitive aging.

Impact of interictal epileptic activity on normal brain function in epileptic encephalopathy: an electroencephalography-functional magnetic resonance imaging study

Using electroencephalography (EEG) in combination with functional magnetic resonance imaging (fMRI), we studied a 9.5-year-old girl who developed cognitive and behavioral regression in association with intense interictal bilaterally synchronous epileptic discharges (IBSEDs) both during the awake state and during sleep. During runs of IBSEDs, EEG-fMRI demonstrated deactivations in the lateral and medial frontoparietal cortices, posterior cingulate gyrus, and cerebellum together with focal relative activations in the right frontal, parietal, and temporal cortices. The deactivations probably reflect the repercussion of the interictal epileptic activity on normal brain function which might cause the neuropsychological regression by inducing repetitive interruptions of neurophysiological function resulting in a chronic state of specific psychomotor impairment. The relative activations could possibly indicate the source of epileptic activity rapidly spreading to other brain regions.

Interactions Among Sweet potato chlorotic stunt virus and Different Potyviruses and Potyvirus Strains Infecting Sweetpotato in the United States

Sweet potato virus disease (SPVD) is the most serious viral disease of sweetpotato globally. This disease is caused by the synergistic interaction between the aphid-transmitted potyvirus Sweet potato feathery mottle virus (SPFMV) and the whitefly-transmitted crinivirus Sweet potato chlorotic stunt virus (SPCSV). In sweetpotato, titers of SPFMV have been shown to be significantly enhanced when coinfecting with SPCSV. In this study, the effect of SPCSV on titers of different potyviruses and potyvirus strains infecting sweetpotato in the United States was investigated using real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). No significant difference was observed in titers of the russet crack strain of SPFMV (SPFMV-RC), Ipomoea vein mosaic virus (IVMV), and Sweet potato virus G (SPVG) between single and mixed infections. Titers of all potyviruses and potyvirus strains evaluated were enhanced in the presence of SPCSV, suggesting that a conserved mechanism may underlie these interactions. Titers of the common strain of SPFMV (SPFMV-C), which did not cause SPVD-like symptoms when coinfecting with SPCSV, were also significantly enhanced in the presence of SPCSV. Furthermore, titers of SPCSV were found to be lower in treatments involving pairwise infections compared with plants infected by SPCSV alone. The degree of potyvirus titer enhancement did not correspond to the severity of symptoms observed in certain treatments involving pairwise infections.

First Report of a Begomovirus Infecting Sweetpotato in Kenya

Previous surveys for viruses in sweetpotatoes (Ipomoea batatas) in Africa did not assay for the presence of begomoviruses such as Sweet potato leaf curl virus (SPLCV), which have been found recently in the Americas and Asia. Symptomatic sweetpotato plants, including some with leaf curling symptoms similar to those observed in SPLCV-infected sweet-potato plants (2), were collected from a germplasm collection plot at Kakamega Research Station in Western Kenya during February 2005. Whiteflies, the vectors for begomoviruses, were observed in the same plots. Ipomoea setosa plants graft-inoculated with scions from the symptomatic sweetpotato developed leaf curl, leaf roll, interveinal chlorosis, and stunting symptoms similar to those caused by infection with SPLCV alone or in combination with Sweet potato feathery mottle virus. Total DNA was isolated from 10 I. setosa plants using the GenElute Plant Genomic DNA Kit (Sigma-Aldrich Inc., St. Louis, MO). Sweetpotato cuttings from 39 clones, selected from the Kenyan germplasm collection for their resistance or susceptibility to sweetpotato virus disease (SPVD), were sent to the Plant Germplasm Quarantine Office of USDA-ARS. The cuttings were planted in a greenhouse. Total DNA was extracted from sweetpotato leaves 1 month later using a cetyltrimethylammoniumbromide (CTAB) extraction method (1). Degenerate primers SPG1/SPG2, developed for PCR detection of begomoviruses (1), amplified a 912-bp DNA fragment from 3 of 10 DNA extracts from I. setosa and 5 of 39 sweetpotato plants held in quarantine. The primers anneal to regions of open reading frame (ORF) AC2 and ORF AC1 that are highly conserved in begomoviruses infecting sweetpotato. SPLCV-specific primers PW285-1/PW285-2 (2) amplified a 512-bp DNA fragment of ORF AC1 from seven samples (two from I. setosa and five from I. batatas). Amplicons from three independent PCR assays of two samples and single PCR assays of four additional samples were cloned into the pGEM-T Easy vector. Clone inserts were sequenced, and compared with sequences deposited in GenBank using the basic local alignment search tool (BLAST). Sequences were closely related to SPLCV (GenBank Accession No. AF104036) with nucleotide sequence identities varying from 93% (GenBank Accession No. DQ361004) to 97% (GenBank Accession No. DQ361005). The presence of the virus poses a challenge to the dissemination of planting materials in the region because begomovirus-infected plants often do not show symptoms. To our knowledge, this is the first report of a begomovirus infecting sweetpotato in Kenya or the East African Region. References: (1) R. Li et al. Plant Dis. 88:1347, 2004. (2) P. Lotrakul et al. Plant Dis. 82:1253, 1998.

Real-Time PCR Assays for Detection and Quantification of Sweetpotato Viruses

Viral diseases, especially those caused by mixed infections, are among the economically most important diseases of sweetpotato. The difficulties inherent in detecting, quantifying, and isolating viruses directly from sweetpotato have impeded progress in sweetpotato virus research. Real-time polymerase chain reaction (PCR) assays were developed for the detection and relative quantification in singleplex reactions of the potyviruses Sweet potato feathery mottle virus (SPFMV), Sweet potato virus G (SPVG), and Ipomoea vein mosaic virus (IVMV); the crinivirus Sweet potato chlorotic stunt virus (SPCSV); and the begomovirus Sweet potato leaf curl virus(SPLCV) directly from infected sweetpotato plants. There was no significant effect from potential inhibitors in total nucleic acid extracts from sweetpotato leaves on the performance of the real-time PCR assays. Virus titers of SPFMV, IVMV, and SPVG were quantified using real-time PCR and found to be lower in singly infected sweetpotato plants compared with singly infected Brazilian morning-glory (Ipomoea setosa Ker.) and I. nil cv. Scarlet O'Hara plants. Real-time PCR was a more efficient detection method for SPLCV than conventional PCR assay.

Effects of breakfast meal composition on second meal metabolic responses in adults with Type 2 diabetes mellitus

OBJECTIVE

We tested the relative importance of a low-glycemic response versus a high glycemic response breakfast meal on postprandial serum glucose, insulin and free fatty acid (FFA) responses after consumption of a standardized mid-day meal in adult individuals with Type 2 diabetes mellitus (DM).

DESIGN

Following an overnight fast of 8-10 h, a randomized crossover intervention using control and test meals was conducted over a 3-week-period. A fasting baseline measurement and postprandial measurements at various time intervals after the breakfast and mid-day meal were taken.

SUBJECTS

Forty-five Type 2 DM subjects completed the requirements and were included in the study results.

INTERVENTIONS

Two different breakfast meals were administered during the intervention: (A) a high glycemic load breakfast meal consisting of farina (kJ 1833; carbohydrate (CHO) 78 g and psylium soluble fiber 0 g), (B) a low-glycemic load breakfast meal consisting of a fiber-loop cereal (kJ 1515; CHO 62 g and psyllium soluble fiber 6.6 g). A standardized lunch was provided approximately 4 h after breakfast. Blood plasma concentrations and area under the curve (AUC) values for glucose, insulin and FFA were measured in response to the breakfast and mid-day lunch. Statistical analyses were performed using SAS software (8.02). Comparisons between diets were based on adjusted Bonferroni t-tests.

RESULTS

In post-breakfast analyses, Breakfast B had significantly lower area under the curve (AUC) values for plasma glucose and insulin compared to Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were higher for Breakfast B than for Breakfast A (P<0.05) (95% confidence level). Post-lunch analyses indicated similar glucose responses for the two breakfast types. Insulin AUC values for Breakfasts B were significantly lower than Breakfast A (P<0.05) (95% confidence level). The AUC values for FFA were unaffected by breakfast type.

CONCLUSIONS

These data indicate that ingesting a low-glycemic load meal containing psyllium soluble fiber at breakfast significantly improves the breakfast postprandial glycemic, insulinemic and FFA responses in adults with Type 2 DM. These data revealed no residual postprandial effect of the psyllium soluble fiber breakfast meal beyond the second meal consumed. Thus, there was no evidence of an improvement postprandially in the glycemic, insulinemic and FFA responses after the consumption of the lunch meal.

Damage within a network of white matter regions underlies executive dysfunction in CADASIL

OBJECTIVE

To identify the important sites of white matter disruption that underpin executive dysfunction in CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy), a genetic model of pure subcortical vascular disease.

METHODS

The anatomic pattern of correlation between tissue integrity and executive function was explored with diffusion tensor imaging (DTI), which provides quantitative measures of tissue integrity. Eighteen nondemented patients with CADASIL underwent DTI and cognitive assessment. DTI was normalized to a standard template and correlations assessed at every voxel across the brain with Statistical Parametric Mapping with cluster-level correction for multiple comparisons.

RESULTS

For executive tasks, correlations were found in a number of discrete regions in the white matter of the frontal lobes. A distinct, nonoverlapping pattern of correlation was seen for verbal memory. Significant independent correlations remained in some regions after co-varying for age and IQ.

CONCLUSIONS

Different cognitive functions correlate with structural integrity at different sites in the white and subcortical gray matter. The distribution of regions correlating specifically with executive function provides clues to the organization of the relevant cognitive networks and their important white matter projections. The cingulum bundle is one candidate tract that may carry anteroposterior connections important for executive processes.

White matter damage on diffusion tensor imaging correlates with age-related cognitive decline

BACKGROUND

Damage to white matter tracts, resulting in "cerebral disconnection," may underlie age-related cognitive decline.

METHODS

Using diffusion tensor MRI (DTI) to investigate white matter damage, and magnetic resonance spectroscopy (MRS) to look at its underlying pathologic basis, the authors investigated the relationship between white matter structure and cognition in 106 healthy middle-aged and elderly adults. Fractional anisotropy (FA) and mean diffusivity (MD) values, whole brain white matter histograms, and regions of interest placed in the white matter of the centrum semiovale were analyzed. Correlations with executive function, working memory, and information-processing speed were performed.

RESULTS

There was a progressive reduction in FA and increase in diffusivity with age in both region of interest (r = 0.551, p < 0.001), and whole brain histograms (r = 0.625, p < 0.001). DTI values correlated with performance in all three cognitive domains. After controlling for age, DTI parameters correlated with working memory but not with the other two cognitive domains. MRS studies found a correlation of N-acetyl aspartate, a neuronal marker, with DTI parameters (r = 0.253, p < 0.05).

CONCLUSION

The results are consistent with white matter damage due to axonal loss, causing age- related cognitive decline. Working memory may be particularly dependent on complex networks dependent on white matter connections.

Effects of Common Viruses on Yield and Quality of Beauregard Sweetpotato in Louisiana

During cycles of vegetative propagation, sweetpotato accumulates viruses that are thought to contribute to decline in yield and quality of cultivars, but the effects of specific viruses, many of which have been described only recently, are unknown. Field plots planted with graft-inoculated plants of a virus-tested (VT) mericlone of cv. Beauregard were used to assess the effects of three common potyviruses, Sweet potato feathery mottle virus (SPFMV), Sweet potato virus G (SPVG), and Ipomoea vein mosaic virus (IVMV); and a begomovirus, Sweet potato leaf curlvirus (SPLCV), compared with natural inoculum introduced by grafting plants from farmers' stock. Single infections with SPFMV, SPVG, or IVMV did not significantly affect yield, whereas mixed infections with SPFMV + SPVG or SPFMV + SPVG + IVMV resulted in mean yields 14% less than the VT controls. Infection with SPLCV resulted in mean yields 26% less than the VT controls, despite not causing symptoms on the foliage. However, grafting with farmers' plants infected with an unknown mixture of pathogens resulted in mean yields 31 to 44% less than the VT controls. Infection with potyviruses resulted in storage roots with tan periderm and infection with SPLCV induced darker periderm than the rosy VT controls. Infection with the viruses known to occur commonly in the United States did not reproduce the magnitude of yield reduction that has been observed with naturally infected plants.

Pigmented striae of the anterior lens capsule and age-associated pigment dispersion of variable degree in a group of older African-Americans: an age, race, and gender matched study

PURPOSE

To investigate pigmented striae of the anterior lens capsule in African-Americans, a potential indicator of significant anterior segment pigment dispersion.

METHODS

A group of 40 African-American subjects who exhibited pigmented lens striae (PLS) were identified from a non-referred, primary eye care population in Chicago, IL, USA. These subjects were then compared to an age, race, and gender matched control group relative to refractive error and the presence or absence of diabetes and hypertension.

RESULTS

The PLS subjects (mean age = 65.4 +/- 8.8 years, range = 50-87 years) consisted of 36 females and 4 males. PLS were bilateral in 36 (85%) of the 40 subjects. Among the eyes with PLS, 21 (55%) of 38 right eyes and 22 (61%) of 36 left eyes also had significant corneal endothelial pigment dusting, commonly in the shape of a Krukenberg's spindle. Ten (25%) of the PLS subjects had either glaucoma or ocular hypertension (7 bilateral, 3 unilateral). The presence of trabecular meshwork pigment varied from minimal to heavy. The mean +/- SD (range) refractive error of the PLS right eyes was +1.61 +/- 1.43D (-1.50 to +5.00D) and +1.77 +/- 1.37D (-1.00 to +5.00D) for the left eyes. Based on these data, the PLS right eyes were +1.63D (Student's t, p = 0.0001; 95% CI = +0.82 to +2.44D) more hyperopic on average than the control right eyes, and the PLS left eyes were +1.77D (p = 0.0001; 95% CI = +0.92 to +2.63D) more hyperopic on average than the control left eyes. Trend analysis showed a gradually increasing likelihood of PLS with increasing magnitude of hyperopia in both eyes (Mantel-Haenszel chi-square, p = 0.001). Among PLS subjects, 24 (60%) of 40 were hypertensive and 9 (23%) of 40 were diabetic. However, these proportions were not significantly different (two-tailed Fisher's exact test; hypertension: p = 0.30; diabetes: p = 0.70) from the randomly selected controls.

CONCLUSIONS

Among our African-American group, which consisted predominately of females >50 years of age, the likelihood of PLS increased with increasing hyperopic refractive error. This finding is consistent with the possibility that PLS may, in some circumstances, indicate a significant pigment dispersal process due to iris-lens rubbing that may be associated with crowding of anterior segment structures. Additional study is warranted to further assess the nature of PLS, their precise relationship with an age-related pigment dispersal process, and their true significance as a risk factor for development of glaucoma.

Properties of Strains of Sweet potato feathery mottle virus and Two Newly Recognized Potyviruses Infecting Sweet Potato in the United States

Some biological and molecular properties of six potyvirus isolates (LSU-1, -2, -3, and -5; 95-2; and 95-6) from sweet potato (Ipomoea batatas) were evaluated. Isolates LSU-1 and -3 and 95-2 were transmitted by Aphis gossypii and Myzus persicae while LSU-2 and -5 were not transmitted by either aphid. The partial nucleotide sequence of the nuclear inclusion b (NIb) and the coat protein (CP) genes of these six isolates were compared with the corresponding sequences of 17 Sweet potato feathery mottle virus (SPFMV) strains and 18 other potyviruses. LSU-1 and -3 had high sequence similarity to the published sequences for Sweet potato virus G (SPVG), did not react with antisera to other known sweet potato viruses, and caused distinct symptoms. We propose to designate these two isolates as SPVG. This report documents the occurrence of this virus in the United States and provides the first characterization of its biological properties. LSU-2 and -5 were distinct in symptomatology; partial Nib, CP nucleotide, and derived amino acid sequence; and serology to other viruses. We propose to call this virus (LSU isolates 2 and 5) Ipomoea vein mosaic virus. The present study revealed a high degree of sequence similarity between 95-6 and the common strain of SPFMV, and between 95-2 and the russet crack strain of SPFMV. Results from this study suggest not only that at least two strains of SPFMV occur in the United States, but that two other potyviruses also are present.

A framework based on spin glass models for the inference of anatomical connectivity from diffusion-weighted MR data - a technical review

A family of methods aiming at the reconstruction of a putative fascicle map from any diffusion-weighted dataset is proposed. This fascicle map is defined as a trade-off between local information on voxel microstructure provided by diffusion data and a priori information on the low curvature of plausible fascicles. The optimal fascicle map is the minimum energy configuration of a simulated spin glass in which each spin represents a fascicle piece. This spin glass is embedded into a simulated magnetic external field that tends to align the spins along the more probable fiber orientations according to diffusion models. A model of spin interactions related to the curvature of the underlying fascicles introduces a low bending potential constraint. Hence, the optimal configuration is a trade-off between these two kind of forces acting on the spins. Experimental results are presented for the simplest spin glass model made up of compass needles located in the center of each voxel of a tensor based acquisition.

First Report of Geotrichum candidum as a Pathogen of Sweetpotato Storage Roots from Flooded Fields in North Carolina and Louisiana

In October 1997, samples of diseased sweetpotato (Ipomoea batatas (L.) Lam.) roots from storage were submitted for diagnosis to the Plant Disease and Insect Clinic at North Carolina State University. Two organisms were detected from soft rotted roots: Rhizopus stolonifer (Ehrenb.:Fr.) Vuill. (cause of Rhizopus soft rot) and Geotrichum candidum Link. Attempts to duplicate a soft rot by stab-inoculation of sweetpotato roots with a pure culture of G. candidum were unsuccessful. In Louisiana, following heavy rains due to Tropical Storm Frances in 1998, sweetpotato roots exhibiting a cortical tissue collapse at time of harvest were submitted to Louisiana State University for disease identification. Isolations from lesion margins consistently yielded G. candidum. Attempts to reproduce the disease by stab-inoculation produced only a few restricted lesions 5 to 15 mm in diameter. In 1999, rains from hurricanes Dennis, Floyd, and Irene caused extensive flooding in sweetpotato-growing areas of the North Carolina Coastal Plain. Extensive losses occurred in many fields due to a condition known as "souring," and G. candidum was frequently detected sporulating on the surface of soured roots. This provided a clue for reproducing the disease artificially (1). In 2000, the disease was successfully reproduced. Sterile, wood toothpicks were dragged across a pure culture of G. candidum and inserted (1.5 cm deep) into the mid-section of sweetpotato (cv. Beauregard) roots. Roots were submerged in water at room temperature (23°C) for 24 to 48 h. Each of four roots was inoculated four times, and sterile toothpicks were stabbed into the controls. Additional controls consisted of an inoculated root that was not submerged in water, and a root that was not wounded or inoculated but submerged in water. Following submersion, roots were incubated at room temperature for 5 days. The experiment was repeated. Isolations from diseased tissues consistently yielded G. candidum. Symptoms consisted of slightly sunken, circular lesions, typically 15 to 50 mm in diameter. In cross-section, diseased tissue surrounding the wound was darkened, soft (but not watery), and extended 1 to 20 mm on either side of the wound. None of the controls showed signs of decay. These symptoms are consistent with but do not represent the full range of symptoms observed in the field. Souring of sweetpotato is likely the result of a complex of factors including predisposition of roots by water-saturated soil and the pathogenic effects of G. candidum. To our knowledge, this is the first known report of rot caused by G. candidum on sweetpotato in the United States. G. candidum was reported on sweetpotato in India, but no pathogenicity tests were reported (2). References: (1) E. Cohen and J. W. Eckert. Plant Dis. 75:166, 1991. (2) N. C. Mandal and M. K. Dasgupta. Indian J. Mycol. Plant Pathol. 10:31, 1980.

Diffusion time dependence of the apparent diffusion tensor in healthy human brain and white matter disease

The diffusion time dependence of the brain water diffusion tensor provides information regarding diffusion restriction and hindrance but has received little attention, primarily due to limitations in gradient amplitude available on clinical MRI systems, required to achieve short diffusion times. Using new, more powerful gradient hardware, the diffusion time dependence of tensor-derived metrics were studied in human brain in the range 8-80 ms, which encompasses the shortest diffusion times studied to date. There was no evidence for a change in mean diffusivity, fractional anisotropy, or in the eigenvalues with diffusion time in healthy human brain. The findings are consistent with a model of unrestricted, but hindered water diffusion with semipermeable membranes, likely originating from the extracellular space in which the average extracellular separation is less than 7 microns. Similar findings in two multiple sclerosis plaques indicated that the size of the water diffusion space in the lesion did not exceed this dimension.

Diffusion tensor imaging: concepts and applications

The success of diffusion magnetic resonance imaging (MRI) is deeply rooted in the powerful concept that during their random, diffusion-driven displacements molecules probe tissue structure at a microscopic scale well beyond the usual image resolution. As diffusion is truly a three-dimensional process, molecular mobility in tissues may be anisotropic, as in brain white matter. With diffusion tensor imaging (DTI), diffusion anisotropy effects can be fully extracted, characterized, and exploited, providing even more exquisite details on tissue microstructure. The most advanced application is certainly that of fiber tracking in the brain, which, in combination with functional MRI, might open a window on the important issue of connectivity. DTI has also been used to demonstrate subtle abnormalities in a variety of diseases (including stroke, multiple sclerosis, dyslexia, and schizophrenia) and is currently becoming part of many routine clinical protocols. The aim of this article is to review the concepts behind DTI and to present potential applications.

Water diffusion is elevated in widespread regions of normal-appearing white matter in multiple sclerosis and correlates with diffusion in focal lesions

Pathological changes in the normal-appearing white matter in multiple sclerosis are well recognised, but their relationship to pathology in focal lesions is not well understood. Magnetic resonance diffusion imaging is sensitive to abnormalities in the integrity, size and geometry of water spaces in brain tissue. This study investigated the anatomical distribution of normal-appearing white matter diffusion abnormalities and their relationship to diffusion in focal lesions in multiple sclerosis (MS). The average apparent diffusion coefficient (ADCav) was measured by three-axis echoplanar diffusion imaging in normal-appearing white matter regions and lesions throughout the brain in 40 patients, and in white matter in 14 matched controls. The correlation between the ADCav in normal-appearing white matter and lesions was determined. In controls and patients, diffusion was highest in the corpus callosum. Patients had a higher mean ADCav than controls in widespread regions including the corpus callosum, cerebellar, temporal and occipital normal-appearing white matter. Mean normal-appearing white matter ADCav correlated strongly with mean lesion ADCav (r = 0.67, P < 0.001). This study demonstrates that water diffusion is elevated in widespread areas of normal-appearing white matter in MS, and is correlated with diffusion in lesions. These findings suggest that the pathogenetic mechanisms causing tissue damage in lesions and normal-appearing white matter are at least partly linked.

Combined functional magnetic resonance imaging and diffusion tensor imaging demonstrate widespread modified organisation in malformation of cortical development

A patient with a mild left hemiparesis and a malformation of cortical development in the right hemisphere was investigated with fMRI (functional magnetic resonance imaging) and DTI (diffusion tensor imaging). The motor cortex was studied using a finger tapping fMRI experiment. The fibre orientation was studied by displaying the principal eigenvector of the diffusion tensor in the spatially normalised brain of the patient and of control subjects. In addition, the anisotropy (directionality) of water diffusion of the patient was statistically compared with control subjects. The malformation was located in the right central region in the expected position of the motor cortex. fMRI showed activation anterior and posterior to the malformation. DTI disclosed that fibres with rostrocaudal orientation, presumably representing the pyramidal tract, were deviating from their normal orientation and passing around the malformation. There were widespread regions of reduced anisotropy affecting both hemispheres. In conclusion, fMRI and DTI provided concordant information showing widespread modified functional and structural organisation including regions which appeared normal on standard imaging.

Towards inference of human brain connectivity from MR diffusion tensor data

This paper describes a method to infer the connectivity induced by white matter fibers in the living human brain. This method stems from magnetic resonance tensor imaging (DTI), a technique which gives access to fiber orientations. Given typical DTI spatial resolution, connectivity is addressed at the level of fascicles made up by a bunch of parallel fibers. We propose first an algorithm dedicated to fascicle tracking in a direction map inferred from diffusion data. This algorithm takes into account fan-shaped fascicle forks usual in actual white matter organization. Then, we propose a method of inferring a regularized direction map from diffusion data in order to improve the robustness of the tracking. The regularization stems from an analogy between white matter organization and spaghetti plates. Finally, we propose a study of the tracking behavior according to the weight given to the regularization and some examples of the tracking results with in vivo human brain data.

Water diffusion compartmentation and anisotropy at high b values in the human brain

Biexponential diffusion decay is demonstrated in the human brain in vivo using b factors up to 4000 sec mm(-2). Fitting of the signal decay data yields values for the slow and fast diffusion components and volume fractions in agreement with previous studies in rat and human brain. In addition, differences in the fitted parameters are demonstrated in the white and gray matter and diffusion anisotropy is demonstrated in both the slow and fast diffusing components. Apparent anisotropy in the component fractions is discussed in terms of directionally dependent exchange rates between the compartments. The lack of a relationship between the estimated contribution to the signal of the fast and slow components and echo time appears to rule out T(2) differences in the observed water compartments. Values obtained for the fast diffusion coefficient, including differences between white and gray matter and the degree of anisotropy are compatible with the predictions of extracellular diffusion of water based on tortuosity models and the diffusion of tetramethylammonium ions in rat brain.

Water diffusion compartmentation and anisotropy at high b values in the human brain

Biexponential diffusion decay is demonstrated in the human brain in vivo using b factors up to 4000 sec mm(-2). Fitting of the signal decay data yields values for the slow and fast diffusion components and volume fractions in agreement with previous studies in rat and human brain. In addition, differences in the fitted parameters are demonstrated in the white and gray matter and diffusion anisotropy is demonstrated in both the slow and fast diffusing components. Apparent anisotropy in the component fractions is discussed in terms of directionally dependent exchange rates between the compartments. The lack of a relationship between the estimated contribution to the signal of the fast and slow components and echo time appears to rule out T(2) differences in the observed water compartments. Values obtained for the fast diffusion coefficient, including differences between white and gray matter and the degree of anisotropy are compatible with the predictions of extracellular diffusion of water based on tortuosity models and the diffusion of tetramethylammonium ions in rat brain.

Whitefly Transmission of Sweetpotato chlorotic stunt virus

The genus Crinivirus of the plant virus family Closteroviridae include members that are bipartite and whitefly-transmitted (2). The Crinivirus, Sweetpotato chlorotic stunt virus (SPCSV), was described from sweetpotato (Ipomoea batatas) in Nigeria (1). Vector transmission studies of SPCSV were conducted using two whitefly species, the sweetpotato whitefly (Bemisia tabaci biotype B) and the bandedwinged whitefly (Trialeurodes abutilonea). Whitefly colonies were reared in the laboratory on cotton plants in plexiglass cages. To evaluate transmission efficiency, single whiteflies were used in all experiments. Whiteflies were given 2-day acquisition access periods on I. batatas cv. White Bunch co-infected with SPCSV and Sweetpotato feathery mottle virus (SPFMV). Single whiteflies were then placed on individual healthy I. nil cv. Scarlet O'Hara seedlings for 2-day inoculation access periods. Plants then were sprayed with imidacloprid insecticide and placed in the greenhouse. Four independent tests were performed with each whitefly species. Seven to 10 days after exposing test plants to B. tabaci, 6 of 35, 4 of 28, 5 of 30, and 3 of 25 I. nil plants showed symptoms that consisted of leaf distortion and yellowing. In similar experiments conducted with T. abutilonea, 1 of 33, 0 of 32, 1 of 30, and 2 of 28 I. nil plants showed symptoms. Two weeks after inoculations, reverse transcription- polymerase chain reaction assays were performed with all 22 symptomatic and five randomly selected symptomless plants using primers that amplify the SPCSV heat shock protein 70 (HSP70) homolog gene fragment (446 bp). All 22 symptomatic plants were positive while the five symptomless plants tested were negative. Lower transmission rates were obtained with T. abutilonea (3.2%) when compared with B. tabaci (15.2%). These two whiteflies are present in sweetpotato fields in Louisiana and may play an important role in the spread of SPCSV. This represents the first report of transmission of SPCSV by the bandedwinged whitefly References: (1) S. Winter et al. Phytopathology 82:869-875, 1992. (2) G. C. Wisler et al. Plant Dis. 82:270-280, 1998.

The pathogenesis of lesions and normal-appearing white matter changes in multiple sclerosis: a serial diffusion MRI study

The idea that the initiating event in the formation of all new multiple sclerosis lesions is a focal blood-brain barrier (BBB) leakage associated with perivascular inflammation has been challenged recently by the observation of subtle abnormalities in some quantitative magnetic resonance (MR) parameters (including the magnetization transfer ratio) prior to lesion enhancement. MR diffusion imaging can non-invasively quantify the average apparent diffusion coefficient (ADC(av)), a measure of water molecule random motion that is sensitive to pathological change in multiple sclerosis lesions and to abnormalities in the normal-appearing white matter (NAWM). We therefore used MR diffusion imaging to investigate the dynamic evolution of water diffusion measurements in new enhancing multiple sclerosis lesions, in the NAWM from which they arise, and in anatomically matched contralateral NAWM regions from which no visible lesions develop. Gadolinium diethylenetriaminepentaacetic acid (Gd)-enhanced MRI and MR diffusion studies were performed monthly for 1 year in five multiple sclerosis patients with clinically and radiologically active disease. The ADC(av) was calculated at each time point of the study (before, during and after lesion appearance on Gd-enhanced scans) for each new enhancing lesion, and for regions matched for size and position in the contralateral NAWM. A steady and moderate increase in ADC(av) in prelesion NAWM was observed, which was followed by a rapid and marked increase at the time of Gd enhancement and a slower decay after the cessation of enhancement. In matched contralateral NAWM regions there was a significant but milder increase in ADC(av) at the time of the first noted lesion enhancement. These findings indicate that new focal lesions associated with frank BBB leakage are preceded by subtle, progressive alterations in tissue integrity beyond the resolution of conventional MRI. The increases in ADC(av) in anatomically matched contralateral regions after lesions have appeared supports the concept that structural damage in lesions causes damage or dysfunction in connected areas of NAWM.

Diffusion tensor imaging can detect and quantify corticospinal tract degeneration after stroke

Diffusion tensor imaging (DTI) fully characterises water molecule mobility in vivo, allowing an exploration of fibre tract integrity and orientation in the human brain. Using DTI this study demonstrates reduced fibre coherence (anisotropy) associated with cerebral infarction and in the corticospinal tract remote from the lesion, in five patients 2 to 6 months after ischaemic stroke. The study highlights the potential of DTI to detect and monitor the structural degeneration of fibre pathways, which may provide a better understanding of the pattern of clinical evolution after stroke.

Cerebral hemodynamics in CADASIL before and after acetazolamide challenge assessed with MRI bolus tracking

BACKGROUND

White matter lesions in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are underlaid by severe ultrastructural changes of the arteriolar wall. Although chronic ischemia is presumed to cause the tissue lesions, the pattern of perfusion abnormalities and hemodynamic reserve in CADASIL, particularly within the white matter, remains unknown.

METHODS

We used the MRI bolus tracking method in 15 symptomatic patients with CADASIL (5 with dementia) and 10 age-matched control subjects before and 20 minutes after the intravenous injection of acetazolamide (ACZ, 17 mg/kg). Cerebral blood flow (CBF), blood volume (CBV), and mean transit time (MTT) were calculated both in the cortex and in the white matter according to the singular value decomposition technique. Perfusion parameters were obtained in regions of hyperintensities and within the normal-appearing white matter as observed on T2-weighted images. Analysis was performed with both absolute and relative (region/whole brain) values.

RESULTS

A significant reduction in absolute and relative CBF and CBV was found within areas of T2 hyperintensities in white matter in the absence of significant variations of MTT. This reduction was more severe in demented than in nondemented patients. No significant change in absolute CBF and CBV values was observed in the cortex of patients with CADASIL. A decrease in relative CBF and CBV values was detected in the occipital cortex. After ACZ administration, CBF and CBV increased significantly in both the cortex and white matter of affected subjects, but the increase in absolute CBF was lower within areas of increased signal on T2-weighted images in patients than in the white matter of control subjects.

CONCLUSIONS

In CADASIL, both basal perfusion and hemodynamic reserve are decreased in areas of T2 hyperintensities in the white matter. This hypoperfusion appears to be related to the clinical severity. The significant effect of ACZ on CBF and CBV suggests that cerebral perfusion might be increased using pharmacological vasodilation in CADASIL.

Regularization of diffusion-based direction maps for the tracking of brain white matter fascicles

Magnetic resonance diffusion tensor imaging (DTI) provides information about fiber local directions in brain white matter. This paper addresses inference of the connectivity induced by fascicles made up of numerous fibers from such diffusion data. The usual fascicle tracking idea, which consists of following locally the direction of highest diffusion, is prone to erroneous forks because of problems induced by fiber crossing. In this paper, this difficulty is partly overcomed by the use of a priori knowledge of the low curvature of most of the fascicles. This knowledge is embedded in a model of the bending energy of a spaghetti plate representation of the white matter used to compute a regularized fascicle direction map. A new tracking algorithm is then proposed to highlight putative fascicle trajectories from this direction map. This algorithm takes into account potential fan shaped junctions between fascicles. A study of the tracking behavior according to the influence given to the a priori knowledge is proposed and concrete tracking results obtained with in vivo human brain data are illustrated. These results include putative trajectories of some pyramidal, commissural, and various association fibers.

Test liquids for quantitative MRI measurements of self-diffusion coefficient in vivo

A range of liquids suitable as quality control test objects for measuring the accuracy of clinical MRI diffusion sequences (both apparent diffusion coefficient and tensor) has been identified and characterized. The self-diffusion coefficients for 15 liquids (3 cyclic alkanes: cyclohexane to cyclooctane, 9 n-alkanes: n-octane to n-hexadecane, and 3 n-alcohols: ethanol to 1-propanol were measured at 15-30 degrees C using an NMR spectrometer. Values at 22 degrees C range from 0.36 to 2.2 10(-9) m(2)s(-1). Typical 95% confidence limits are +/-2%. Temperature coefficients are 1.7-3.2% degrees C. T1 and T2 values at 1.5 T and proton density are given. n-tridecane has a diffusion coefficient close to that of normal white matter. The longer n-alkanes may be useful T2 standards. Measurements from a spin-echo MRI sequence agreed to within 2%.

Diffusion tensor imaging demonstrates deviation of fibres in normal appearing white matter adjacent to a brain tumour

The objective was to study fibre orientation in the cerebral white matter of a patient with a brain tumour using diffusion tensor imaging (DTI). A patient with a mild left hemiparesis and a tumour in the right frontal lobe and 20 healthy volunteers were scanned with a DTI sequence. The scans were spatially normalised and the fibre orientation in the patient compared with the fibre orientation in normal controls. DTI disclosed a change of the orientation of fibres in the patient compared with normal controls. In the normal appearing white matter adjacent to the tumour fibres deviated from the normal superior inferior orientation in the corona radiata by about 30 degrees. This finding was consistent with a displacement by distant mass effect rather than a destruction of fibres, in agreement with the neurological examination. In conclusion, DTI demonstrated a deviation of fibres in normal appearing white matter adjacent to a tumour. The technique will improve understanding of the effects of structural abnormalities on fibres. This will assist the interpretation of clinical findings and functional imaging studies and guide neurosurgical interventions.

Test liquids for quantitative MRI measurements of self-diffusion coefficient in vivo

A range of liquids suitable as quality control test objects for measuring the accuracy of clinical MRI diffusion sequences (both apparent diffusion coefficient and tensor) has been identified and characterized. The self-diffusion coefficients for 15 liquids (3 cyclic alkanes: cyclohexane to cyclooctane, 9 n-alkanes: n-octane to n-hexadecane, and 3 n-alcohols: ethanol to 1-propanol were measured at 15-30 degrees C using an NMR spectrometer. Values at 22 degrees C range from 0.36 to 2.2 10(-9) m(2)s(-1). Typical 95% confidence limits are +/-2%. Temperature coefficients are 1.7-3.2% degrees C. T1 and T2 values at 1.5 T and proton density are given. n-tridecane has a diffusion coefficient close to that of normal white matter. The longer n-alkanes may be useful T2 standards. Measurements from a spin-echo MRI sequence agreed to within 2%.

Improved reduction of motion artifacts in diffusion imaging using navigator echoes and velocity compensation

Navigator echoes provide a means with which to remove motion artifacts from diffusion-weighted images obtained using any multishot imaging technique. However, residual motion artifact is often present in the corrected images rendering the technique unreliable. It is shown that velocity-compensated diffusion sensitization when used in tandem with a navigator echo further reduces the degree of residual motion artifacts present in the corrected images and improves the reliability and clinical utility of the technique. This is demonstrated by applying a method for quantification of motion artifact to brain images of healthy volunteers scanned using both conventional (Stejskal-Tanner) and velocity-compensated gradient sensitization. Other factors affecting the efficacy of the navigator echo technique, such as brain pulsatile motion, gradient b factor, and navigator echo signal-to-noise ratio, are also discussed.

Neuropathological abnormalities of the corpus callosum in schizophrenia: a diffusion tensor imaging study

OBJECTIVES

Diffusion tensor imaging (DTI), a technique capable of examining water diffusion in different tissues and the organisation of white matter tracts, was used to investigate the neuropathology of the corpus callosum in vivo in patients with schizophrenia.

METHODS

Diffusion tensor imaging was performed in 20 schizophrenic patients and 25 healthy controls. Two complementary measures, mean diffusivity and fractional anisotropy, which are considered to be sensitive indices of axonal integrity, were obtained from regions of interest in the genu (anterior) and splenium (posterior) of the corpus callosum.

RESULTS

Mean diffusivity was significantly increased and fractional anisotropy significantly reduced in the splenium but not the genu of the corpus callosum in the schizophrenic group compared with controls. There were no significant sex differences in the DTI measures for either the schizophrenic or control group. Clinical variables such as age, duration of illness, dose of antipsychotic medication, and schizophrenic symptoms did not predict the DTI changes in the schizophrenic patients.

CONCLUSIONS

The presence of DTI changes in the splenium but not the genu of the corpus callosum suggests that there may be a focal disruption of commisural connectivity in schizophrenia. However, these findings do not exclude the possibility of abnormalities in other areas of the corpus callosum or other regions of white matter and further research using different methods of analysis may enable us to clarify this. Diffusion tensor imaging is a valuable tool in investigating the structure of white matter in schizophrenia.