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Carass A, Cuzzocreo JL, Han S, Hernandez-Castillo CR, Rasser PE, Ganz M, Beliveau V, Dolz J, Ben Ayed I, Desrosiers C, Thyreau B, Romero JE, Coupé P, Manjón JV, Fonov VS, Collins DL, Ying SH, Onyike CU, Crocetti D, Landman BA, Mostofsky SH, Thompson PM, Prince JL. Comparing fully automated state-of-the-art cerebellum parcellation from magnetic resonance images. Neuroimage 2018; 183:150-172. [PMID: 30099076 PMCID: PMC6271471 DOI: 10.1016/j.neuroimage.2018.08.003] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [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: 04/28/2018] [Revised: 08/03/2018] [Accepted: 08/03/2018] [Indexed: 01/26/2023] Open
Abstract
The human cerebellum plays an essential role in motor control, is involved in cognitive function (i.e., attention, working memory, and language), and helps to regulate emotional responses. Quantitative in-vivo assessment of the cerebellum is important in the study of several neurological diseases including cerebellar ataxia, autism, and schizophrenia. Different structural subdivisions of the cerebellum have been shown to correlate with differing pathologies. To further understand these pathologies, it is helpful to automatically parcellate the cerebellum at the highest fidelity possible. In this paper, we coordinated with colleagues around the world to evaluate automated cerebellum parcellation algorithms on two clinical cohorts showing that the cerebellum can be parcellated to a high accuracy by newer methods. We characterize these various methods at four hierarchical levels: coarse (i.e., whole cerebellum and gross structures), lobe, subdivisions of the vermis, and the lobules. Due to the number of labels, the hierarchy of labels, the number of algorithms, and the two cohorts, we have restricted our analyses to the Dice measure of overlap. Under these conditions, machine learning based methods provide a collection of strategies that are efficient and deliver parcellations of a high standard across both cohorts, surpassing previous work in the area. In conjunction with the rank-sum computation, we identified an overall winning method.
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Affiliation(s)
- Aaron Carass
- Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Computer Science, The Johns Hopkins University, Baltimore, MD, 21218, USA.
| | - Jennifer L Cuzzocreo
- Department of Radiology, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Shuo Han
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, MD, 21218, USA; Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, 20892, USA
| | - Carlos R Hernandez-Castillo
- Consejo Nacional de Ciencia y Tecnología, Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Mexico
| | - Paul E Rasser
- Priority Research Centre for Brain & Mental Health and Stroke & Brain Injury, University of Newcastle, Callaghan, NSW, Australia
| | - Melanie Ganz
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark; Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Vincent Beliveau
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jose Dolz
- Laboratory for Imagery, Vision, and Artificial Intelligence, École de Technologie Supérieure, Montreal, QC, Canada
| | - Ismail Ben Ayed
- Laboratory for Imagery, Vision, and Artificial Intelligence, École de Technologie Supérieure, Montreal, QC, Canada
| | - Christian Desrosiers
- Laboratory for Imagery, Vision, and Artificial Intelligence, École de Technologie Supérieure, Montreal, QC, Canada
| | - Benjamin Thyreau
- Institute of Development, Aging and Cancer, Tohoku University, Japan
| | - José E Romero
- Instituto Universitario de Tecnologías de la Información y Comunicaciones (ITACA), Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain
| | - Pierrick Coupé
- University of Bordeaux, LaBRI, UMR 5800, PICTURA, Talence, F-33400, France; CNRS, LaBRI, UMR 5800, PICTURA, Talence, F-33400, France
| | - José V Manjón
- Instituto Universitario de Tecnologías de la Información y Comunicaciones (ITACA), Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain
| | - Vladimir S Fonov
- Image Processing Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - D Louis Collins
- Image Processing Laboratory, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Sarah H Ying
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Deana Crocetti
- Center for Neurodevelopmental Medicine and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA
| | - Bennett A Landman
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, 37235, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental Medicine and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA; Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA; Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA, 90292, USA; Departments of Neurology, Pediatrics, Psychiatry, Radiology, Engineering, and Ophthalmology, University of Southern California, Los Angeles, CA, 90033, USA
| | - Jerry L Prince
- Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD, 21218, USA; Department of Computer Science, The Johns Hopkins University, Baltimore, MD, 21218, USA
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Doty RL, MacGillivray MR, Talab H, Tourbier I, Reish M, Davis S, Cuzzocreo JL, Shepard NT, Pham DL. Balance in multiple sclerosis: relationship to central brain regions. Exp Brain Res 2018; 236:2739-2750. [PMID: 30019234 DOI: 10.1007/s00221-018-5332-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 07/13/2018] [Indexed: 11/30/2022]
Abstract
Dizziness, postural instability, and ataxia are among the most debilitating symptoms of multiple sclerosis (MS), reflecting, in large part, dysfunctional integration of visual, somatosensory, and vestibular sensory cues. However, the role of MS-related supratentorial lesions in producing such symptoms is poorly understood. In this study, motor control test (MCT) and dynamic sensory organization test (SOT) scores of 58 MS patients were compared to those of 72 healthy controls; correlations were determined between the MS scores of 49 patients and lesion volumes within 26 brain regions. Depending upon platform excursion direction and magnitude, MCT latencies, which were longer in MS patients than controls (p < 0.0001), were correlated with lesion volumes in the cortex, medial frontal lobes, temporal lobes, and parietal opercula (r's ranging from 0.20 to 0.39). SOT test scores were also impacted by MS and correlated with lesions in these same brain regions as well as within the superior frontal lobe (r's ranging from - 0.28 to - 0.40). The strongest and most consistent correlations occurred for the most challenging tasks in which incongruent visual and proprioceptive feedback were given. This study demonstrates that supratentorial lesion volumes are associated with quantitative balance measures in MS, in accord with the concept that balance relies upon highly convergent and multimodal neural pathways involving the skin, muscles, joints, eyes, and vestibular system.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA.
| | - Michael R MacGillivray
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
| | - Hussam Talab
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
| | - Isabelle Tourbier
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
| | - Megan Reish
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
| | - Sherrie Davis
- Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
| | | | - Neil T Shepard
- Division of Audiology, Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN, USA
| | - Dzung L Pham
- Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Bethesda, MD, USA
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Carass A, Roy S, Jog A, Cuzzocreo JL, Magrath E, Gherman A, Button J, Nguyen J, Prados F, Sudre CH, Jorge Cardoso M, Cawley N, Ciccarelli O, Wheeler-Kingshott CAM, Ourselin S, Catanese L, Deshpande H, Maurel P, Commowick O, Barillot C, Tomas-Fernandez X, Warfield SK, Vaidya S, Chunduru A, Muthuganapathy R, Krishnamurthi G, Jesson A, Arbel T, Maier O, Handels H, Iheme LO, Unay D, Jain S, Sima DM, Smeets D, Ghafoorian M, Platel B, Birenbaum A, Greenspan H, Bazin PL, Calabresi PA, Crainiceanu CM, Ellingsen LM, Reich DS, Prince JL, Pham DL. Longitudinal multiple sclerosis lesion segmentation: Resource and challenge. Neuroimage 2017; 148:77-102. [PMID: 28087490 PMCID: PMC5344762 DOI: 10.1016/j.neuroimage.2016.12.064] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [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: 08/19/2016] [Revised: 11/15/2016] [Accepted: 12/19/2016] [Indexed: 01/12/2023] Open
Abstract
In conjunction with the ISBI 2015 conference, we organized a longitudinal lesion segmentation challenge providing training and test data to registered participants. The training data consisted of five subjects with a mean of 4.4 time-points, and test data of fourteen subjects with a mean of 4.4 time-points. All 82 data sets had the white matter lesions associated with multiple sclerosis delineated by two human expert raters. Eleven teams submitted results using state-of-the-art lesion segmentation algorithms to the challenge, with ten teams presenting their results at the conference. We present a quantitative evaluation comparing the consistency of the two raters as well as exploring the performance of the eleven submitted results in addition to three other lesion segmentation algorithms. The challenge presented three unique opportunities: (1) the sharing of a rich data set; (2) collaboration and comparison of the various avenues of research being pursued in the community; and (3) a review and refinement of the evaluation metrics currently in use. We report on the performance of the challenge participants, as well as the construction and evaluation of a consensus delineation. The image data and manual delineations will continue to be available for download, through an evaluation website2 as a resource for future researchers in the area. This data resource provides a platform to compare existing methods in a fair and consistent manner to each other and multiple manual raters.
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Affiliation(s)
- Aaron Carass
- Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD 21218, USA; Department of Computer Science, The Johns Hopkins University, Baltimore, MD 21218, USA.
| | - Snehashis Roy
- CNRM, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20892, USA
| | - Amod Jog
- Department of Computer Science, The Johns Hopkins University, Baltimore, MD 21218, USA
| | - Jennifer L Cuzzocreo
- Department of Radiology, The Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Elizabeth Magrath
- CNRM, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20892, USA
| | - Adrian Gherman
- Department of Biostatistics, The Johns Hopkins University, Baltimore, MD 21205, USA
| | - Julia Button
- Department of Radiology, The Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - James Nguyen
- Department of Radiology, The Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | - Ferran Prados
- Translational Imaging Group, CMIC, UCL, NW1 2HE London, UK; NMR Research Unit, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Carole H Sudre
- Translational Imaging Group, CMIC, UCL, NW1 2HE London, UK
| | - Manuel Jorge Cardoso
- Translational Imaging Group, CMIC, UCL, NW1 2HE London, UK; Dementia Research Centre, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Niamh Cawley
- NMR Research Unit, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Olga Ciccarelli
- NMR Research Unit, UCL Institute of Neurology, WC1N 3BG London, UK
| | | | - Sébastien Ourselin
- Translational Imaging Group, CMIC, UCL, NW1 2HE London, UK; Dementia Research Centre, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Laurence Catanese
- VisAGeS: INSERM U746, CNRS UMR6074, INRIA, University of Rennes I, France
| | | | - Pierre Maurel
- VisAGeS: INSERM U746, CNRS UMR6074, INRIA, University of Rennes I, France
| | - Olivier Commowick
- VisAGeS: INSERM U746, CNRS UMR6074, INRIA, University of Rennes I, France
| | - Christian Barillot
- VisAGeS: INSERM U746, CNRS UMR6074, INRIA, University of Rennes I, France
| | - Xavier Tomas-Fernandez
- Computational Radiology Laboratory, Boston Childrens Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Simon K Warfield
- Computational Radiology Laboratory, Boston Childrens Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Suthirth Vaidya
- Biomedical Imaging Lab, Department of Engineering Design, Indian Institute of Technology, Chennai 600036, India
| | - Abhijith Chunduru
- Biomedical Imaging Lab, Department of Engineering Design, Indian Institute of Technology, Chennai 600036, India
| | - Ramanathan Muthuganapathy
- Biomedical Imaging Lab, Department of Engineering Design, Indian Institute of Technology, Chennai 600036, India
| | - Ganapathy Krishnamurthi
- Biomedical Imaging Lab, Department of Engineering Design, Indian Institute of Technology, Chennai 600036, India
| | - Andrew Jesson
- Centre For Intelligent Machines, McGill University, Montréal, QC H3A 0E9, Canada
| | - Tal Arbel
- Centre For Intelligent Machines, McGill University, Montréal, QC H3A 0E9, Canada
| | - Oskar Maier
- Institute of Medical Informatics, University of Lübeck, 23538 Lübeck, Germany
| | - Heinz Handels
- Institute of Medical Informatics, University of Lübeck, 23538 Lübeck, Germany
| | - Leonardo O Iheme
- Bahçeşehir University, Faculty of Engineering and Natural Sciences, 34349 Beşiktaş, Turkey
| | - Devrim Unay
- Bahçeşehir University, Faculty of Engineering and Natural Sciences, 34349 Beşiktaş, Turkey
| | | | | | | | - Mohsen Ghafoorian
- Institute for Computing and Information Sciences, Radboud University, 6525 HP Nijmegen, Netherlands
| | - Bram Platel
- Diagnostic Image Analysis Group, Radboud University Medical Center, 6525 GA Nijmegen, Netherlands
| | - Ariel Birenbaum
- Department of Electrical Engineering, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Hayit Greenspan
- Department of Biomedical Engineering, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Pierre-Louis Bazin
- Department of Neurophysics, Max Planck Institute, 04103 Leipzig, Germany
| | - Peter A Calabresi
- Department of Radiology, The Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
| | | | - Lotta M Ellingsen
- Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD 21218, USA; Department of Electrical and Computer Engineering, University of Iceland, 107 Reykjavík, Iceland
| | - Daniel S Reich
- Department of Radiology, The Johns Hopkins School of Medicine, Baltimore, MD 21287, USA; Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892, USA
| | - Jerry L Prince
- Department of Electrical and Computer Engineering, The Johns Hopkins University, Baltimore, MD 21218, USA; Department of Computer Science, The Johns Hopkins University, Baltimore, MD 21218, USA
| | - Dzung L Pham
- CNRM, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD 20892, USA
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Good KP, Tourbier IA, Moberg P, Cuzzocreo JL, Geckle RJ, Yousem DM, Pham DL, Doty RL. Unilateral olfactory sensitivity in multiple sclerosis. Physiol Behav 2016; 168:24-30. [PMID: 27780720 DOI: 10.1016/j.physbeh.2016.10.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 04/02/2016] [Revised: 09/27/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
It is not known whether lateralized olfactory sensitivity deficits are present in MS. Since projections from the olfactory bulb to the olfactory cortex are largely ipsilateral, and since both functional imaging and psychophysical studies suggest that the right side of the brain may be more involved in olfactory processing than the left, we addressed this issue by administering well-validated tests of odor detection, along with tests of odor identification, to each side of the nose of 73 MS patients and 73 age-, gender-, and race-matched normal controls. We also determined, in 63 of the MS patients, whether correlations were present between the olfactory test measures and MRI-determined lesions in brain regions ipsilateral and contralateral to the nose side that was tested. No significant left:right differences in either olfactory sensitivity or identification were present, although in both cases mean performance was lower in the MS than in the control subjects (ps<0.0001). Scores on the two sides of the nose were positively correlated with one another (threshold r=0.56, p<0.0001; Identification r=0.71, p<0.0001). The percent of MS patients whose bilateral test scores fell below the 10th percentile of controls did not differ between the odor identification and detection threshold tests. Both left and right odor identification and detection test scores were weakly correlated with lesion volumes in temporal and frontal lobe brain regions (r's<0.40). Our findings demonstrate that MS does not differentially influence odor perception on left and right sides of the nose, regardless of whether sensitivity or identification is being measured. They also indicate that tests of odor identification and detection are similarly influenced by MS and that such influences are associated with central brain lesions.
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Affiliation(s)
- Kimberley P Good
- Department of Psychiatry and Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Isabelle A Tourbier
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Paul Moberg
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jennifer L Cuzzocreo
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Rena J Geckle
- Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, United States
| | - David M Yousem
- Department of Radiology, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Dzung L Pham
- Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Bethesda, MD, United States
| | - Richard L Doty
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Doty RL, Tourbier IA, Pham DL, Cuzzocreo JL, Udupa JK, Karacali B, Beals E, Fabius L, Leon-Sarmiento FE, Moonis G, Kim T, Mihama T, Geckle RJ, Yousem DM. Taste dysfunction in multiple sclerosis. J Neurol 2016; 263:677-88. [PMID: 26810729 PMCID: PMC5399510 DOI: 10.1007/s00415-016-8030-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 10/28/2015] [Revised: 01/09/2016] [Accepted: 01/11/2016] [Indexed: 02/06/2023]
Abstract
Empirical studies of taste function in multiple sclerosis (MS) are rare. Moreover, a detailed assessment of whether quantitative measures of taste function correlate with the punctate and patchy myelin-related lesions found throughout the CNS of MS patients has not been made. We administered a 96-trial test of sweet (sucrose), sour (citric acid), bitter (caffeine) and salty (NaCl) taste perception to the left and right anterior (CN VII) and posterior (CN IX) tongue regions of 73 MS patients and 73 matched controls. The number and volume of lesions were assessed using quantitative MRI in 52 brain regions of 63 of the MS patients. Taste identification scores were significantly lower in the MS patients for sucrose (p = 0.0002), citric acid (p = 0.0001), caffeine (p = 0.0372) and NaCl (p = 0.0004) and were present in both anterior and posterior tongue regions. The percent of MS patients with identification scores falling below the 5th percentile of controls was 15.07 % for caffeine, 21.9 % for citric acid, 24.66 % for sucrose, and 31.50 % for NaCl. Such scores were inversely correlated with lesion volumes in the temporal, medial frontal, and superior frontal lobes, and with the number of lesions in the left and right superior frontal lobes, right anterior cingulate gyrus, and left parietal operculum. Regardless of the subject group, women outperformed men on the taste measures. These findings indicate that a sizable number of MS patients exhibit taste deficits that are associated with MS-related lesions throughout the brain.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA.
- Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Isabelle A Tourbier
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
- Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Dzung L Pham
- Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Bethesda, MD, USA
| | - Jennifer L Cuzzocreo
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, 21287, MD, USA
| | - Jayaram K Udupa
- Medical Imaging Section, Department of Radiology, Perelman School of Medicine, University of Pennsylvlania, Philadelphia, 19104, PA, USA
| | - Bilge Karacali
- Electrical and Electronics Engineering Department, İzmir Institute of Technology, Urla, Izmir, 35430, Turkey
| | - Evan Beals
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
- Department of Psychology, Michigan State University, 48824, East Lansing, MI, USA
| | - Laura Fabius
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
- Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Fidias E Leon-Sarmiento
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
- Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Gul Moonis
- Department of Radiology, Columbia University Medical Center, New York, NY, 10032, USA
| | - Taehoon Kim
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
- Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Toru Mihama
- Smell and Taste Center, Perelman School of Medicine, University of Pennsylvania, 5 Ravdin Building, 3400 Spruce Street, Philadelphia, PA, 19104-4823, USA
- Department of Otorhinolarynology: Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Rena J Geckle
- Department of Radiology, The Johns Hopkins Hospital, Baltimore, MD, 21287, USA
| | - David M Yousem
- Department of Radiology, The Johns Hopkins Hospital, Baltimore, MD, 21287, USA
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Nyquist PA, Yanek LR, Bilgel M, Cuzzocreo JL, Becker LC, Chevalier-Davis K, Yousem D, Prince J, Kral BG, Vaidya D, Becker DM. Effect of white matter lesions on manual dexterity in healthy middle-aged persons. Neurology 2015; 84:1920-6. [PMID: 25862800 DOI: 10.1212/wnl.0000000000001557] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 12/15/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES We hypothesized that integrated motor-visual functions measured by manipulative manual dexterity are affected by white matter lesion (WML) burden as measured on cranial MRI across relevant brain regions in subjects at risk of preclinical occult vascular disease. METHODS A real-time cross-sectional study of healthy subjects aged 29 to 74 years with a family history of early-onset coronary artery disease (n = 714; mean age, 51 ± 11 years; mean education, 14 ± 3 years; 42% male; 38% black) were identified from probands with coronary artery disease diagnosed before age 60 years. WMLs on 3-tesla brain MRI and Grooved Pegboard scores were measured. RESULTS WMLs were observed at all ages. Mean pegboard scores were 108 ± 18, similar to normal populations. In unadjusted analysis, WMLs and pegboard scores were significantly correlated by region (total WMLs, r = 0.34, p = 0.0001; frontal [r = 0.34, p < 0.0001], insula [r = 0.31, p < 0.0001], parietal [r = 0.31, p < 0.0001], and temporal [r = 0.17, p < 0.0001]). In multivariate analysis predicting (log) pegboard score adjusted for age, sex, race, education, regional or total volumes, and familial non-independence, total WML volume (p = 5.79E - 05) and regional WML volumes (p < 0.01) retained statistical significance in all but the youngest age quartile (29-43 years). CONCLUSIONS Greater WML volumes in different brain regions are associated with higher pegboard scores (worse performance) independent of age, sex, race, education, and total or regional volumes. This suggests that small vessel cerebrovascular disease may be present in healthy individuals in a preclinical state with measurable impact on complex integrative functions in individuals with excess risk of clinical vascular disease.
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Affiliation(s)
- Paul A Nyquist
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD.
| | - Lisa R Yanek
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Murat Bilgel
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Jennifer L Cuzzocreo
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Lewis C Becker
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Karinne Chevalier-Davis
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - David Yousem
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Jerry Prince
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Brian G Kral
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Dhananjay Vaidya
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Diane M Becker
- From the Departments of Neurology (P.A.N.), Anesthesiology and Critical Care Medicine (P.A.N.), and Neurosurgery (P.A.N.), and Department of Medicine, Division of General Internal Medicine (L.R.Y., L.C.B., K.C.-D., B.G.K., D.V., D.M.B.), GeneSTAR Research Program; Department of Biomedical Engineering (M.B., J.L.C., J.P.), Johns Hopkins School of Medicine; and Department of Medicine, Division of Cardiology (L.C.B., B.G.K.), and Department of Radiology, Divisions of Diagnostic Radiology and Neuroradiology (D.Y.), The Johns Hopkins Medical Institutions, Baltimore, MD
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7
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Eloyan A, Shou H, Shinohara RT, Sweeney EM, Nebel MB, Cuzzocreo JL, Calabresi PA, Reich DS, Lindquist MA, Crainiceanu CM. Health effects of lesion localization in multiple sclerosis: spatial registration and confounding adjustment. PLoS One 2014; 9:e107263. [PMID: 25233361 PMCID: PMC4169434 DOI: 10.1371/journal.pone.0107263] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 08/11/2014] [Indexed: 11/17/2022] Open
Abstract
Brain lesion localization in multiple sclerosis (MS) is thought to be associated with the type and severity of adverse health effects. However, several factors hinder statistical analyses of such associations using large MRI datasets: 1) spatial registration algorithms developed for healthy individuals may be less effective on diseased brains and lead to different spatial distributions of lesions; 2) interpretation of results requires the careful selection of confounders; and 3) most approaches have focused on voxel-wise regression approaches. In this paper, we evaluated the performance of five registration algorithms and observed that conclusions regarding lesion localization can vary substantially with the choice of registration algorithm. Methods for dealing with confounding factors due to differences in disease duration and local lesion volume are introduced. Voxel-wise regression is then extended by the introduction of a metric that measures the distance between a patient-specific lesion mask and the population prevalence map.
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Affiliation(s)
- Ani Eloyan
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Haochang Shou
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Russell T Shinohara
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Elizabeth M Sweeney
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America; Translational Neurology Unit, Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Mary Beth Nebel
- Laboratory for Neurocognitive and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, United States of America; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Jennifer L Cuzzocreo
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Peter A Calabresi
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Daniel S Reich
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America; Translational Neurology Unit, Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, United States of America; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America; Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Martin A Lindquist
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ciprian M Crainiceanu
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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8
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Sweeney EM, Vogelstein JT, Cuzzocreo JL, Calabresi PA, Reich DS, Crainiceanu CM, Shinohara RT. A comparison of supervised machine learning algorithms and feature vectors for MS lesion segmentation using multimodal structural MRI. PLoS One 2014; 9:e95753. [PMID: 24781953 PMCID: PMC4004572 DOI: 10.1371/journal.pone.0095753] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 03/28/2014] [Indexed: 11/18/2022] Open
Abstract
Machine learning is a popular method for mining and analyzing large collections of medical data. We focus on a particular problem from medical research, supervised multiple sclerosis (MS) lesion segmentation in structural magnetic resonance imaging (MRI). We examine the extent to which the choice of machine learning or classification algorithm and feature extraction function impacts the performance of lesion segmentation methods. As quantitative measures derived from structural MRI are important clinical tools for research into the pathophysiology and natural history of MS, the development of automated lesion segmentation methods is an active research field. Yet, little is known about what drives performance of these methods. We evaluate the performance of automated MS lesion segmentation methods, which consist of a supervised classification algorithm composed with a feature extraction function. These feature extraction functions act on the observed T1-weighted (T1-w), T2-weighted (T2-w) and fluid-attenuated inversion recovery (FLAIR) MRI voxel intensities. Each MRI study has a manual lesion segmentation that we use to train and validate the supervised classification algorithms. Our main finding is that the differences in predictive performance are due more to differences in the feature vectors, rather than the machine learning or classification algorithms. Features that incorporate information from neighboring voxels in the brain were found to increase performance substantially. For lesion segmentation, we conclude that it is better to use simple, interpretable, and fast algorithms, such as logistic regression, linear discriminant analysis, and quadratic discriminant analysis, and to develop the features to improve performance.
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Affiliation(s)
- Elizabeth M. Sweeney
- Department of Biostatistics, The Johns Hopkins University, Baltimore, Maryland, United States of America
- Translational Neuroradiology Unit, Neuroimmunology Branch, National Institute of Neurological Disease and Stroke, National Institute of Health, Bethesda, Maryland, United States of America
- * E-mail:
| | - Joshua T. Vogelstein
- Department of Statistical Science, Duke University, Durham, North Carolina, United States of America
- Center for the Developing Brain, Child Mind Institute, New York, New York, United States of America
| | - Jennifer L. Cuzzocreo
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Peter A. Calabresi
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Daniel S. Reich
- Department of Biostatistics, The Johns Hopkins University, Baltimore, Maryland, United States of America
- Translational Neuroradiology Unit, Neuroimmunology Branch, National Institute of Neurological Disease and Stroke, National Institute of Health, Bethesda, Maryland, United States of America
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Ciprian M. Crainiceanu
- Department of Biostatistics, The Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Russell T. Shinohara
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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9
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Abstract
Automatic and accurate detection of white matter lesions is a significant step toward understanding the progression of many diseases, like Alzheimer's disease or multiple sclerosis. Multi-modal MR images are often used to segment T2 white matter lesions that can represent regions of demyelination or ischemia. Some automated lesion segmentation methods describe the lesion intensities using generative models, and then classify the lesions with some combination of heuristics and cost minimization. In contrast, we propose a patch-based method, in which lesions are found using examples from an atlas containing multi-modal MR images and corresponding manual delineations of lesions. Patches from subject MR images are matched to patches from the atlas and lesion memberships are found based on patch similarity weights. We experiment on 43 subjects with MS, whose scans show various levels of lesion-load. We demonstrate significant improvement in Dice coefficient and total lesion volume compared to a state of the art model-based lesion segmentation method, indicating more accurate delineation of lesions.
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Affiliation(s)
- Snehashis Roy
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, USA
| | - Qing He
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, USA
| | - Aaron Carass
- Department of Electrical and Computer Engineering, The Johns Hopkins University, USA
| | - Amod Jog
- Department of Electrical and Computer Engineering, The Johns Hopkins University, USA
| | | | - Daniel S Reich
- Translational Neuroradiology Unit, Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, USA
| | - Jerry Prince
- Department of Electrical and Computer Engineering, The Johns Hopkins University, USA
| | - Dzung Pham
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for the Advancement of Military Medicine, USA
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10
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Nyquist PA, Talbot C, Bilgel M, Yanek LR, Becker LRC, Cuzzocreo JL, Mathias R, Berger A, Cheadle C, Becker DM. Abstract 43: Increased Activation of Inflammatory Genes in Monocytes of Healthy People with Ischemic White Matter Disease. Stroke 2014. [DOI: 10.1161/str.45.suppl_1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
Introduction:
White matter hyperintensities (WMH) on MRI represent small vessel ischemic cerebrovascular disease. Greater WMH burden is associated with higher levels of circulating inflammatory cytokines in persons > 65 years with dementia, suggesting a pro-inflammatory vascular process. We hypothesized that middle-aged, asymptomatic, apparently healthy high risk people with high WMH burden would demonstrate increased inflammatory gene expression in monocytes analyzed with microarray.
Methods:
Subjects (N=70) were identified from a larger MRI study in 593 healthy family members of persons with early-onset CAD (< 60 years). We obtained monocytes and examined gene expression in all subjects (mean age 58.1 ± 10 years, range 30-73; 55% female; 36% African American). These included 35 subjects with the greatest WMH burden using volumetric methods in the larger study, and 35 unrelated age-sex-race matched controls with the lowest WMH burden. Monocyte mRNA was analyzed on Illumina Human HT12 v4 microarrays. We performed unsupervised principal component analysis (PCA) followed by ANOVA between high and low WMH groups. Genes with 2 SD differences in expression between groups were included for Gene Ontology permutation analysis using 1000 permutations within “GoMiner”. Only genes with the lowest false discovery rate (FDR) were summarized.
Results:
PCA identified no significant clustering. A total of 1,315 genes were included in gene ontology analysis and resulted in 10 ontological categories with an FDR<0.01%. This included 164 genes all showing greater expression in the high WMH group. These were key inflammatory genes, such as tumor necrosis factor (TNF), interleukin-6 (IL-6), interleukin-8 (IL-8), toll like receptor 5 and 7 (TLR5, TLR7) and integrin alpha 5 and M (ITGA5, ITGAM).
Conclusions:
Gene microarray ontological analysis of monocytes in healthy middle aged high risk people with greater WMH burden shows increased activation of genes of known innate inflammatory pathways. These findings likely reflect greater pro-inflammatory processes in persons with greater WMH, consistent with the presence of inflammation-mediated occult small vessel cerebrovascular disease in a healthy middle-aged population at increased risk for vascular diseases.
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Affiliation(s)
| | | | - Murat Bilgel
- Biomedical Engineering, Johns Hopkins, Baltimore, MD
| | - Lisa R Yanek
- Neurology, Johns Hopkins, General Internal Medicine, MD
| | | | | | | | - Alan Berger
- Asthma and Allergy, Johns Hopkins, Baltimore, MD
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11
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Nyquist PA, Yanek LR, Bilgel M, Cuzzocreo JL, Becker LC, Chevalier K, Woessner T, Prince J, Becker DM. Abstract 109: Manipulative Dexterity is Associated with Occult White Matter Ischemic Lesions in Healthy Asymptomatic Persons at Increased Risk for Cardiovascular Disease. Stroke 2014. [DOI: 10.1161/str.45.suppl_1.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
Introduction:
Persons with a family history of early-onset coronary artery disease (CAD) have an excess risk of stroke and CAD. White matter lesions (WML) on MRI represent small vessel ischemic cerebrovascular disease and are associated with incident stroke and neurocognitive decline with age. We hypothesized manipulative manual dexterity, an integration of fine motor, visual spatial, and cognition function, may be affected by increased WML burden in task-relevant brain regions across age ranges in persons at risk for pre-clinical occult vascular disease. We tested this in a large population with a family history of early CAD.
Methods:
Healthy 29-74 year old subjects (N=714; mean age 51± 11 years; mean education 14 ± 3 years; 42% male, 38% Black) were identified from probands with CAD <60 years. WML location and volumes were measured on 3T FLAIR MRI. Manipulative manual dexterity was measured with standardized timed grooved pegboard test. Left and right pegboard scores were averaged.
Results:
WML were observed in all age groups; mean overall pegboard scores were 108±18, and were within reference norms. In unadjusted analysis, pegboard scores were highly correlated in the expected direction with total WML volumes, r=0.34, p=<.0001; subcortical volumes r=0.30, <.0001 periventricular volumes r=0.31, <.0001; and with most regional WML volumes; frontal 0.34, <.0001; insula r=0.31, p<.0001, parietal r=0.31, p<.0001, and temporal volumes r=0.17, p <.0001. In separate multivariate regression analyses predicting (log) pegboard score adjusted for age, sex, race, education and nonindependence of families (GEE), total WML volume became more statistically significant ( p=5.79E-05) while other regions retained statistical significance, p< 0.01.
Conclusions:
Our findings in a large population-based sample with a family history of early CAD confirm that greater WML volumes in multiple brain locations are associated with higher pegboard scores (worse performance) independent of age, sex, race, and education. This suggests that small vessel cerebrovascular disease is present in an early preclinical state and that WML volumes impact manipulative manual dexterity in healthy middle-aged and younger individuals with excess risk for clinical vascular disease.
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Affiliation(s)
| | - Lisa R Yanek
- General Internal Medicine, Johns Hopkins, Baltimore, MD
| | - Murat Bilgel
- Biomedical Engineering, Johns Hopkins, Baltimore, MD
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12
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Nyquist P, Bilgel M, Yanek LR, Moy TF, Becker LC, Cuzzocreo JL, Yousem DM, Prince J, Becker DM, Kral BG, Vaidya D. Abstract 110: Age Associated Brain Volume is More Closely Correlated to Periventricular than Deep White Matter Disease. Stroke 2014. [DOI: 10.1161/str.45.suppl_1.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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
Introduction:
The loss of total brain volume (TBV) due to aging is associated with increasing ischemic white matter lesion volume (WMH) and dementia. Lower TBV may be secondary to chronic ischemia and hypoperfusion throughout the periventricular white matter rather than the burden of focal ischemia in the deep white matter. We hypothesized lower TBV would be more closely correlated with increasing periventricular white matter lesion volume (PV) rather than deep white matter lesion volume (DWMH).
Methods:
We enrolled 593 asymptomatic family members of probands with premature coronary artery disease (<60 years). DWMH, PV, and TBV were measured with 3Tesla MRI. Multivariate regression was completed for DWMH, PV, and TBV using volume change per age decade controlling for sex, race, diabetes, smoking currently, hypertension, obesity , and intracranial volume (ICV) for TBV, and a spline incorporated at age 54.
Results:
Participants were 58% women, 37% African-American, 29-74 years old. TBV/ICV was more correlated to PV than DWMH (correlation coefficients -0.26 and -0.11, p=<0.001 and 0.006). The PV was greater with older age 9%/decade until age 54 (95% CI 4-15%) and 24%/decade after age 54 (95% CI 1.6-3.2%). TBV was reduced with older age: 1.1 % smaller/decade until age 54 (95% CI -0.6 to -1.6) and 2.4% smaller/decade after (95% CI -1.6 to -3.1). For PV and TBV their age association changed significantly after age 54 (p=0.012, and 0.014). DWMH age association remained constant regardless of age.
Conclusions:
PV is more strongly correlated to TBV than DWMH and the age associated changes in PV and TBV were more similar to one another than DWMH. The association of increasing PV with lower TBV may help to explain the association of cognitive and motor decline with increasing PV. Future longitudinal studies are needed to verify this association.
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13
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Shiee N, Bazin PL, Cuzzocreo JL, Ye C, Kishore B, Carass A, Calabresi PA, Reich DS, Prince JL, Pham DL. Reconstruction of the human cerebral cortex robust to white matter lesions: method and validation. Hum Brain Mapp 2013; 35:3385-401. [PMID: 24382742 DOI: 10.1002/hbm.22409] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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: 12/18/2012] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 11/08/2022] Open
Abstract
Cortical atrophy has been reported in a number of diseases, such as multiple sclerosis and Alzheimer's disease, that are also associated with white matter (WM) lesions. However, most cortical reconstruction techniques do not account for these pathologies, thereby requiring additional processing to correct for the effect of WM lesions. In this work, we introduce CRUISE(+), an automated process for cortical reconstruction from magnetic resonance brain images with WM lesions. The process extends previously well validated methods to allow for multichannel input images and to accommodate for the presence of WM lesions. We provide new validation data and tools for measuring the accuracy of cortical reconstruction methods on healthy brains as well as brains with multiple sclerosis lesions. Using this data, we validate the accuracy of CRUISE(+) and compare it to another state-of-the-art cortical reconstruction tool. Our results demonstrate that CRUISE(+) has superior performance in the cortical regions near WM lesions, and similar performance in other regions.
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Affiliation(s)
- Navid Shiee
- Image Analysis and Communication Laboratory, Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, Maryland; Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation for Advancement of Military Medicine, Bethesda, Maryland
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14
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Jung BC, Choi SI, Du AX, Cuzzocreo JL, Geng ZZ, Ying HS, Perlman SL, Toga AW, Prince JL, Ying SH. Principal component analysis of cerebellar shape on MRI separates SCA types 2 and 6 into two archetypal modes of degeneration. Cerebellum 2013; 11:887-95. [PMID: 22258915 DOI: 10.1007/s12311-011-0334-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Although "cerebellar ataxia" is often used in reference to a disease process, presumably there are different underlying pathogenetic mechanisms for different subtypes. Indeed, spinocerebellar ataxia (SCA) types 2 and 6 demonstrate complementary phenotypes, thus predicting a different anatomic pattern of degeneration. Here, we show that an unsupervised classification method, based on principal component analysis (PCA) of cerebellar shape characteristics, can be used to separate SCA2 and SCA6 into two classes, which may represent disease-specific archetypes. Patients with SCA2 (n=11) and SCA6 (n=7) were compared against controls (n=15) using PCA to classify cerebellar anatomic shape characteristics. Within the first three principal components, SCA2 and SCA6 differed from controls and from each other. In a secondary analysis, we studied five additional subjects and found that these patients were consistent with the previously defined archetypal clusters of clinical and anatomical characteristics. Secondary analysis of five subjects with related diagnoses showed that disease groups that were clinically and pathophysiologically similar also shared similar anatomic characteristics. Specifically, Archetype #1 consisted of SCA3 (n=1) and SCA2, suggesting that cerebellar syndromes accompanied by atrophy of the pons may be associated with a characteristic pattern of cerebellar neurodegeneration. In comparison, Archetype #2 was comprised of disease groups with pure cerebellar atrophy (episodic ataxia type 2 (n=1), idiopathic late-onset cerebellar ataxias (n=3), and SCA6). This suggests that cerebellar shape analysis could aid in discriminating between different pathologies. Our findings further suggest that magnetic resonance imaging is a promising imaging biomarker that could aid in the diagnosis and therapeutic management in patients with cerebellar syndromes.
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Affiliation(s)
- Brian C Jung
- Department of Neurology, The Johns Hopkins University, School of Medicine, Baltimore, MD, 21287, USA
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15
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Sweeney EM, Shinohara RT, Shiee N, Mateen FJ, Chudgar AA, Cuzzocreo JL, Calabresi PA, Pham DL, Reich DS, Crainiceanu CM. OASIS is Automated Statistical Inference for Segmentation, with applications to multiple sclerosis lesion segmentation in MRI. Neuroimage Clin 2013; 2:402-13. [PMID: 24179794 PMCID: PMC3777691 DOI: 10.1016/j.nicl.2013.03.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [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: 01/18/2013] [Revised: 02/23/2013] [Accepted: 03/05/2013] [Indexed: 10/31/2022]
Abstract
Magnetic resonance imaging (MRI) can be used to detect lesions in the brains of multiple sclerosis (MS) patients and is essential for diagnosing the disease and monitoring its progression. In practice, lesion load is often quantified by either manual or semi-automated segmentation of MRI, which is time-consuming, costly, and associated with large inter- and intra-observer variability. We propose OASIS is Automated Statistical Inference for Segmentation (OASIS), an automated statistical method for segmenting MS lesions in MRI studies. We use logistic regression models incorporating multiple MRI modalities to estimate voxel-level probabilities of lesion presence. Intensity-normalized T1-weighted, T2-weighted, fluid-attenuated inversion recovery and proton density volumes from 131 MRI studies (98 MS subjects, 33 healthy subjects) with manual lesion segmentations were used to train and validate our model. Within this set, OASIS detected lesions with a partial area under the receiver operating characteristic curve for clinically relevant false positive rates of 1% and below of 0.59% (95% CI; [0.50%, 0.67%]) at the voxel level. An experienced MS neuroradiologist compared these segmentations to those produced by LesionTOADS, an image segmentation software that provides segmentation of both lesions and normal brain structures. For lesions, OASIS out-performed LesionTOADS in 74% (95% CI: [65%, 82%]) of cases for the 98 MS subjects. To further validate the method, we applied OASIS to 169 MRI studies acquired at a separate center. The neuroradiologist again compared the OASIS segmentations to those from LesionTOADS. For lesions, OASIS ranked higher than LesionTOADS in 77% (95% CI: [71%, 83%]) of cases. For a randomly selected subset of 50 of these studies, one additional radiologist and one neurologist also scored the images. Within this set, the neuroradiologist ranked OASIS higher than LesionTOADS in 76% (95% CI: [64%, 88%]) of cases, the neurologist 66% (95% CI: [52%, 78%]) and the radiologist 52% (95% CI: [38%, 66%]). OASIS obtains the estimated probability for each voxel to be part of a lesion by weighting each imaging modality with coefficient weights. These coefficients are explicit, obtained using standard model fitting techniques, and can be reused in other imaging studies. This fully automated method allows sensitive and specific detection of lesion presence and may be rapidly applied to large collections of images.
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Affiliation(s)
- Elizabeth M. Sweeney
- Department of Biostatistics, The Johns Hopkins University, Baltimore, MD 21205, USA
- Translational Neuroradiology Unit, Neuroimmunology Branch, National Institute of Neurological Disease and Stroke, National Institute of Health, Bethesda, MD 20892, USA
| | - Russell T. Shinohara
- Translational Neuroradiology Unit, Neuroimmunology Branch, National Institute of Neurological Disease and Stroke, National Institute of Health, Bethesda, MD 20892, USA
- Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Navid Shiee
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation, Bethesda, MD 20892, USA
| | - Farrah J. Mateen
- Department of International Health, The Johns Hopkins University, Baltimore, MD 21205, USA
| | - Avni A. Chudgar
- Department of Radiology, Division of Emergency Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Jennifer L. Cuzzocreo
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Peter A. Calabresi
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Dzung L. Pham
- Center for Neuroscience and Regenerative Medicine, Henry M. Jackson Foundation, Bethesda, MD 20892, USA
| | - Daniel S. Reich
- Department of Biostatistics, The Johns Hopkins University, Baltimore, MD 21205, USA
- Translational Neuroradiology Unit, Neuroimmunology Branch, National Institute of Neurological Disease and Stroke, National Institute of Health, Bethesda, MD 20892, USA
- Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Jung BC, Choi SI, Du AX, Cuzzocreo JL, Ying HS, Landman BA, Perlman SL, Baloh RW, Zee DS, Toga AW, Prince JL, Ying SH. MRI shows a region-specific pattern of atrophy in spinocerebellar ataxia type 2. Cerebellum 2012; 11:272-9. [PMID: 21850525 DOI: 10.1007/s12311-011-0308-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this study, we used manual delineation of high-resolution magnetic resonance imaging (MRI) to determine the spatial and temporal characteristics of the cerebellar atrophy in spinocerebellar ataxia type 2 (SCA2). Ten subjects with SCA2 were compared to ten controls. The volume of the pons, the total cerebellum, and the individual cerebellar lobules were calculated via manual delineation of structural MRI. SCA2 showed substantial global atrophy of the cerebellum. Furthermore, the degeneration was lobule specific, selectively affecting the anterior lobe, VI, Crus I, Crus II, VIII, uvula, corpus medullare, and pons, while sparing VIIB, tonsil/paraflocculus, flocculus, declive, tuber/folium, pyramis, and nodulus. The temporal characteristics differed in each cerebellar subregion: (1) duration of disease: Crus I, VIIB, VIII, uvula, corpus medullare, pons, and the total cerebellar volume correlated with the duration of disease; (2) age: VI, Crus II, and flocculus correlated with age in control subjects; and (3) clinical scores: VI, Crus I, VIIB, VIII, corpus medullare, pons, and the total cerebellar volume correlated with clinical scores in SCA2. No correlations were found with the age of onset. Our extrapolated volumes at the onset of symptoms suggest that neurodegeneration may be present even during the presymptomatic stages of disease. The spatial and temporal characteristics of the cerebellar degeneration in SCA2 are region specific. Furthermore, our findings suggest the presence of presymptomatic atrophy and a possible developmental component to the mechanisms of pathogenesis underlying SCA2. Our findings further suggest that volumetric analysis may aid in the development of a non-invasive, quantitative biomarker.
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Affiliation(s)
- Brian C Jung
- Department of Neurology, The Johns Hopkins University, School of Medicine, Baltimore, MD 21287, USA
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Doty RL, Tourbier I, Davis S, Rotz J, Cuzzocreo JL, Treem J, Shephard N, Pham DL. Pure-tone auditory thresholds are not chronically elevated in multiple sclerosis. Behav Neurosci 2012; 126:314-24. [PMID: 22309444 DOI: 10.1037/a0027046] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [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] [Indexed: 11/08/2022]
Abstract
Despite the fact that acute cases of multiple sclerosis (MS)-related pure-tone hearing loss have been reported in the literature, consensus is lacking as to the chronic influences of MS on pure-tone thresholds. Most studies examining such influences have been limited by small sample sizes, lack of statistical comparisons between patients and controls, and confounding of the hearing measure with influences from sex and age. To date, associations between pure-tone thresholds and central MS-related brain lesions have not been assessed. In this study, pure-tone thresholds ranging from 0.5 to 8 kHz were measured in 73 MS patients and 73 individually age- and gender-matched normal controls. In 63 MS patients, correlations were computed between the threshold values and MRI-determined lesion activity in 26 central brain regions. Although thresholds were strongly influenced by sex, age, and tonal frequency, no meaningful influences of MS were discerned. Moreover, no significant association between the threshold values and central MS-related lesion activity was evident in any brain region evaluated. This study, the largest on this topic to use carefully matched control subjects and the sole study to assess relationships between auditory thresholds and central MS-related lesions, strongly suggests that (a) MS is not chronically associated with pure-tone hearing loss and (b) pure-tone thresholds are unrelated to MS lesion activity in higher brain regions. These findings, along with general reports from the literature, support the concept that when MS-related hearing threshold deficits are found, they are episodic and primarily dependent on lesions within the eighth nerve or brainstem.
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Affiliation(s)
- Richard L Doty
- Smell and Taste Center, University of Pennsylvania School of Medicine, 5 Ravdin Pavilion, 3400 Spruce Street, Philadelphia, PA 19104-4823, USA.
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Du AX, Cuzzocreo JL, Landman BA, Zee DS, Prince JL, Ying SH. Diffusion tensor imaging reveals disease-specific deep cerebellar nuclear changes in cerebellar degeneration. J Neurol 2010; 257:1406-8. [PMID: 20354716 PMCID: PMC2963035 DOI: 10.1007/s00415-010-5523-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 02/19/2010] [Accepted: 03/02/2010] [Indexed: 10/19/2022]
Affiliation(s)
- Annie X. Du
- Department of Pathology, The Johns Hopkins University School of Medicine, 2-210, 600 N. Wolfe St., Baltimore, MD 21287, USA
| | - Jennifer L. Cuzzocreo
- Department of Pathology, The Johns Hopkins University School of Medicine, 2-210, 600 N. Wolfe St., Baltimore, MD 21287, USA
| | | | - David S. Zee
- Department of Pathology, The Johns Hopkins University School of Medicine, 2-210, 600 N. Wolfe St., Baltimore, MD 21287, USA
| | - Jerry L. Prince
- 201B Clark Hall, 3400 North Charles Street, Baltimore, MD 21218, USA
| | - Sarah H. Ying
- Department of Pathology, The Johns Hopkins University School of Medicine, 2-210, 600 N. Wolfe St., Baltimore, MD 21287, USA
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Cuzzocreo JL, Yassa MA, Verduzco G, Honeycutt NA, Scott DJ, Bassett SS. Effect of handedness on fMRI activation in the medial temporal lobe during an auditory verbal memory task. Hum Brain Mapp 2009; 30:1271-8. [PMID: 18570207 DOI: 10.1002/hbm.20596] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Several studies have shown marked differences in the neural localization of language functions in the brains of left-handed individuals when compared with right-handers. Previous experiments involving functional lateralization have demonstrated cerebral blood flow patterns that differ concordantly with subject handedness while performing language-related tasks. The effect of handedness on function in specific stages of memory processing, however, is a largely unexplored area. We used a paired-associates verbal memory task to elicit activation of neural areas related to declarative memory, examining the hypothesis that there are differences in activation in the medial temporal lobe (MTL) between handedness groups. 15 left-handed and 25 right-handed healthy adults were matched for all major demographic and neuropsychological variables. Functional and structural imaging data were acquired and analyzed for group differences within MTL subregions. Our results show that activation of the MTL during declarative memory processing varies with handedness. While both groups showed activation in left and right MTL subregions, the left-handed group showed a statistically significant increase in the left hippocampus and amygdala during both encoding and recall. No increases in activation were found in the right-handed group. This effect was found in the absence of any differences in performance on the verbal memory task, structural volumetric disparities, or functional asymmetries. This provides evidence of functional differences between left-handers and right-handers, which extends to declarative memory processes.
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Affiliation(s)
- Jennifer L Cuzzocreo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
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Bazin PL, Cuzzocreo JL, Yassa MA, Gandler W, McAuliffe MJ, Bassett SS, Pham DL. Volumetric neuroimage analysis extensions for the MIPAV software package. J Neurosci Methods 2007; 165:111-21. [PMID: 17604116 PMCID: PMC2017110 DOI: 10.1016/j.jneumeth.2007.05.024] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.7] [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: 02/06/2007] [Revised: 05/17/2007] [Accepted: 05/17/2007] [Indexed: 10/23/2022]
Abstract
We describe a new collection of publicly available software tools for performing quantitative neuroimage analysis. The tools perform semi-automatic brain extraction, tissue classification, Talairach alignment, and atlas-based measurements within a user-friendly graphical environment. They are implemented as plug-ins for MIPAV, a freely available medical image processing software package from the National Institutes of Health. Because the plug-ins and MIPAV are implemented in Java, both can be utilized on nearly any operating system platform. In addition to the software plug-ins, we have also released a digital version of the Talairach atlas that can be used to perform regional volumetric analyses. Several studies are conducted applying the new tools to simulated and real neuroimaging data sets.
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Affiliation(s)
- Pierre-Louis Bazin
- Laboratory of Medical Image Computing, Neuroradiology Division, Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Jennifer L. Cuzzocreo
- Divisionof Psychiatric Neuroimaging, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Michael A. Yassa
- Divisionof Psychiatric Neuroimaging, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - William Gandler
- Biomedical Imaging Research Services Section, Center for Imaging Technology, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Matthew J. McAuliffe
- Biomedical Imaging Research Services Section, Center for Imaging Technology, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Susan S. Bassett
- Divisionof Psychiatric Neuroimaging, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Dzung L. Pham
- Laboratory of Medical Image Computing, Neuroradiology Division, Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, 21218, USA
- Corresponding author, 600 North Wolfe Street, Phipps B100, Baltimore, MD 21287, USA. Tel.:+1-410-614-3249; Fax:+1-410-614-1577 E-mail address: (D. L. Pham)
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