bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep Gray Matter Involvement on Brain MRI Scans Is Associated with Clinical Progression in Multiple Sclerosis
Authors: Neema Mohit , Arora Ashish , Healy Brian C. , Guss Zachary D. , Brass Steven D. , Duan Yang , Buckle Guy J. , Glanz Bonnie I. , Stazzone Lynn , Khoury Samia J. , Weiner Howard L. , Guttmann Charles R.G. , Bakshi Rohit 
Published: October 2009

ABSTRACTBACKGROUND Conventional brain MRI lesion measures have unreliable associations with clinical progression in multiple sclerosis (MS). Gray matter imaging may improve clinical‐MRI correlations. METHODS We tested if gray matter MRI measures and conventional measures of lesions/atrophy predicted clinical progression in a 4‐year longitudinal study of 97 patients with MS. Baseline and follow‐up brain MRI were analyzed for basal ganglia and thalamic normalized T2 signal intensity, whole brain T2‐hyperintense lesion volume, and whole brain atrophy. Logistic regression tested the ability of baseline or on‐study change in MRI to predict disability progression, as reported by area under the receiver operator characteristics curve (AUC). RESULTS Lower caudate T2‐intensity at baseline (P= .04; AUC = .69) and on‐study decreasing T2‐intensity in the putamen (P= .03; AUC = .70) and thalamus (P= .01; AUC = .71) were the MRI variables associated with clinical progression when regression modeling was adjusted for length of follow‐up interval, baseline EDSS, disease duration, age, and sex. CONCLUSIONS Gray matter T2‐hypointensity, suggestive of excessive iron deposition is associated with worsening disability in patients with MS. Gray matter MRI assessment may be able to capture neurodegenerative aspects of the disease, with more clinical relevance than derived from conventional MRI measures.
Adult Cerebellopontine Angle Medulloblastoma Originating in the Pons Mimicking Focal Brainstem Tumor
Authors: Yoshimura Junichi , Nishiyama Kenichi , Fukuda Masafumi , Watanabe Masaki , Igarashi Hironaka , Fujii Yukihiko 
Published: October 2009

ABSTRACT We herein report a rare case of cerebellopontine angle (CPA) medulloblastoma originating in the brainstem that demonstrated a very unusual clinical presentation and radiological appearances. A 25‐year‐old female was admitted to our hospital with a right hearing disturbance and a right facial palsy. A small non‐enhanced lesion having minimal mass effect in the right CPA was identified by using a 1.5‐tesla‐MR system, whose size remained almost unchanged a year. The 3‐tesla MR images revealed that the precise region was in the right side of the tegmentum of the lower pons to the inferior cerebellar peduncle and the flocculus. MR spectroscopic images using a 3‐tesla system revealed a high ratio of choline‐to‐N‐acetylaspartate in the region of interest in comparison to the contra‐lateral side. Craniotomy and biopsy were performed. The histopathological diagnosis was medulloblastoma. The patient received craniospinal irradiation and chemotherapy, and achieved complete remission by the time of the follow‐up MR images. She is now doing well with a full recovery of the right facial palsy. MR spectroscopic imaging is considered to be quite useful for the management of this rare type of brainstem tumor.
Pallidal Deep Brain Stimulation and L‐Dopa Effect on PET Motor Activation in Advanced Parkinson's Disease
Authors: Valálik István , Emri Miklós , Lengyel Zsolt , Mikecz Pál , Trón Lajos , Csókay András , Márián Teréz 
Published: October 2009

ABSTRACTBACKGROUND AND PURPOSE The antiakinetic effect of internal Globus pallidus deep brain stimulation (Gpi‐DBS) in Parkinson's disease is not clear and not either how this effect is modulated by L‐dopa. METHODS Left Gpi‐DBS and/or L‐dopa effect was studied with auditory paced right‐handed sequential movements on 15O‐butanol positron emission tomography (PET) in five patients. Rest and for conditions during movements (DBS off/L‐dopa off; DBS on/L‐dopa off; DBS off/L‐dopa on; DBS on/L‐dopa on) were compared with statistical parametric mapping. RESULTS Gpi‐DBS activated the right supplementary motor area/premotor (SMA/PMC), and right insular cortex (IC), and as L‐dopa decreased the left sensorimotor cortex (M1/S1) activity. L‐dopa increased the left ventrolateral thalamus (VLTH), and decreased the left superior parietal cortex (PC) activity. Gpi‐DBS and L‐dopa interaction showed right SMA/PMC, IC, and left PC activation, decrease of left VLTH, PMC, and dorsolateral prefrontal cortex (PFC) activity. CONCLUSIONS The improvement of bradykinesia with Gpi‐DBS is secondary and contributed to the regress of M1/S1‐related rigidity and compensatory SMA/PMC, and IC activation. L‐dopa and Gpi‐DBS alone each reduces M1/S1 overactivity. Interaction ignores this effect, moreover has akinetic effect in the left VLTH, PMC, and PFC. Motor improvement possibly related to left PC and compensatory right SMA/PMC, and IC activation.
Neurological Manifestations in Chagas Disease without Cardiac Dysfunction: Correlation between Dysfunction of the Parasympathetic Nervous System and White Matter Lesions in the Brain
Authors: Py Marco , Pedrosa Roberto , Silveira Juliana , Medeiros Aline , Andre Charles 
Published: October 2009

ABSTRACT Chagas disease (American Trypanosomyasis) is endemic in South America. It has been associated with autonomic dysfunction and increased stroke risk. OBJECTIVE To correlate findings in neurological examination, autonomic nervous system function, and brain magnetic resonance imaging (MRI), in patients with chronic Chagas disease. METHODS Neurological findings of 64 patients from a hospital cohort were correlated with disease stage (according to Los Andes classification) and with signs of autonomic nervous system function (respiratory sinus arrhythmia test). Also, 27 subjects with no cardiac dysfunction (phase IA) had MRI evaluation. Results were correlated with autonomic nervous system variables using Spearman correlation coefficient and Mann‐Whitney test. RESULTS There was a significant correlation between the presence and number of white matter hyperintensities in MRI and the respiratory sinus arrhythmia test. There was no correlation between disease stage and autonomic nervous system dysfunction. CONCLUSION There is a significant correlation between parasympathetic nervous system dysfunction and the presence of white matter lesions in patients with chronic Chagas disease without cardiac dysfunction. The pathogenesis of such lesions is unknown, but cardiac arrhythmias could be involved. As hypertension was frequent in our sample and also correlated to MRI hyperintensities, studies excluding hypertensive patients are needed to confirm our results.
Transcranial Doppler Sonography: Abnormal Waveform Pattern of Intracranial Arteries in Acute Aortic Arch Dissection
Authors: Vadikolias Konstantinos , Heliopoulos John , Bougioukas Ioannis , Prassopoulos Panos , Piperidou Charitomeni 
Published: October 2009

ABSTRACT We describe an interesting pattern of transcranial Doppler (TCD) intracranial blood flow waveforms in a patient with an acute aortic arch type A dissection. A 49‐year‐old patient presented with a low blood pressure after a syncopal episode, severe chest pain, and mild left hemiparesis. Contrast‐enhanced computed tomography revealed the aortic arch dissection and the formation of the false lumen. TCD revealed an abnormal waveform pattern recorded in middle cerebral, internal carotid, and anterior cerebral arteries bilaterally with a pre‐systolic sharp wave that gave the appearance of duplicated systolic phase. Our finding adds another interesting pattern of hemodynamic changes in cerebral circulation in patients with acute aortic arch dissections.
MR Spectroscopy Findings in Lafora Disease
Authors: Altindag Ebru , Kara Batuhan , Baykan Betul , Terzibasioglu Ege , Sencer Serra , Onat Levent , Sı Mustafa 
Published: October 2009

ABSTRACTPURPOSE Our aim was to investigate the [1H] MR spectroscopy (MRS) findings of Lafora Disease (LD), which is a disabling form of progressive myoclonic epilepsy. METHODS Twelve patients diagnosed with LD and 12 control subjects underwent MRS studies with single‐voxels of 8 cc obtained in the frontal lobe, pons, and cerebellum. The metabolites and NAA/Cr, NAA/Cho, Cho/Cr, mI/Cr ratios were calculated. Subgroup analysis was also done between 5 patients with EPM2B and 6 patients with EPM2A mutations. Two investigators scored neurological symptom severity. RESULTS We found a statistically significant difference of NAA/Cho ratio in LD patients compared with normal controls in cerebellum (P= 0.04). In addition, both myoclonus and ataxia scores showed significant correlation with NAA/Cho ratios in the pons (P= 0.03, P= 0.04) and in the cerebellum (P= 0.04, P= 0.01), respectively. CONCLUSION We conclude that the cerebellum is the mostly affected structure in LD and there are significant correlations of MRS findings with some clinical parameters. The differences in the group may be related to different genetic mutations besides disease duration and other clinical variables. MRS studies could provide insights about the severity of the involvement of LD.
HOXA1 A218G Polymorphism is Associated with Smaller Cerebellar Volume in Healthy Humans
Authors: Canu Elisa , Boccardi Marina , Ghidoni Roberta , Benussi Luisa , Duchesne Simon , Testa Cristina , Binetti Giuliano , Frisoni Giovanni B. 
Published: October 2009

ABSTRACTBACKGROUND AND PURPOSE The Homeobox A1 (HOXA1) gene plays a critical role during development of the hindbrain in mice. Little is currently known about the relation between this gene and human brain development. The HOXA1 A218G polymorphism has been found to be associated with autism and larger head circumference in autistic patients. Similar effects were revealed also in healthy children but not in adult controls. The aim of this study was to investigate the role of the A218G polymorphism on the hindbrain structure of healthy adults. METHODS Healthy persons from two independent groups underwent 3‐dimensional high resolution magnetic resonance (MR) exam. Group A was made of 80 persons (27 G allele carriers and 53 non‐carriers) and Group B of 72 (26 carriers and 46 non‐carriers). Statistical parametric mapping 2 (SPM2) were used to perform voxel‐based analysis of the gray matter (GM) of the hindbrain in carriers and non. Significance threshold was set at .05 with small volume correction using a cerebellar mask. RESULTS In Group A, G carriers exhibited decreased GM volume in the superior posterior and anterior lobe of the cerebellum bilaterally. In Group B, decreased GM volume were found across the entire left cerebellar cortex. CONCLUSIONS These data suggest that the HOXA1 A218G polymorphism may affect cerebellar development in humans.
Forceps Minor Region Signal Abnormality “Ears of the Lynx”: An Early MRI Finding in Spastic Paraparesis with Thin Corpus Callosum and Mutations in the Spatacsin Gene (SPG11) on Chromosome 15
Authors: Riverol M. , Samaranch L. , Pascual B. , Pastor P. , Irigoyen J. , Pastor M.A. , De Castro P. , Masdeu J.C. 
Published: October 2009

ABSTRACTBACKGROUND AND PURPOSE A thin corpus callosum on magnetic resonance imaging (MRI) characterizes a type of autosomal recessive disorder with progressive spastic paraparesis and cognitive impairment. Known as Hereditary Spastic Paraparesis with Thin Corpus Callosum (HSP‐TCC), it has been associated with mutations of the SPG11 gene. No other specific MRI findings have been reported. METHODS We studied with MRI four patients from three families with HSP‐TCC who had identified causal mutations in the SPG11 gene. RESULTS In all individuals studied the region of the forceps minor of the corpus callosum, corresponding to the genu fibers, appeared bright on T2‐weighted and dark on T1‐weighted images. On axial sections, the frontal horn region bore a remarkable resemblance to the ears of a lynx, with the areas of abnormal signal reminiscent of the tufts of hair crowning the tips of the ears of this animal. Less specific findings included a box‐shape appearance of the calloso‐caudate angle and diffusely increased signal in the hemispheric white matter. CONCLUSION Abnormal MRI signal in the region of the forceps minor of the corpus callosum is a characteristic early imaging finding of HSP‐TCC with SPG11 mutations.
Stent‐Assisted Parent Artery Occlusion of Giant Cerebrovascular Aneurysms to Avoid Mass Effect
Authors: Hussain Syed I. , Lynch John R. , Wolfe Thomas , Fitzsimmons Brian‐Fred , Zaidat Osama O. 
Published: October 2009

ABSTRACTBACKGROUND Endovascular treatment of giant cerebrovascular aneurysms (GCA) may be challenging due to risk of worsening mass effect, thromboembolism, rupture, and recurrence. The purpose of this study was to provide a preliminary evaluation of GCA therapy using stent‐assisted coil parent artery occlusion (PAO) to reduce the likelihood of mass effect, aneurysm recurrence, and vessel recanalization. MATERIALS AND METHODS Five patients with GCAs were treated by PAO by deploying detachable coils within a Neuroform‐3 stent across the aneurysm neck. Patients were monitored clinically to note any changes after treatment. Magnetic resonance angiography was performed 3 to 12 months after stent placement, and incomplete PAO and aneurysm recurrence were noted. RESULTS Stent‐assisted PAO was technically successful in all GCAs with no residual aneurysm filling and without any coil herniation into the aneurysm sac. None of the patients had recanalization of the vessel or GCA or clinical worsening over a follow‐up period of 3‐17 months. Symptomatic mass effect improved in 2 and resolved in 2 patients. CONCLUSION Based on our preliminary experience, stent‐assisted PAO in GCAs is technically feasible and may be a valid option in patients who tolerate balloon test occlusion to minimize the likelihood of increased mass effect from coil embolization.
Clinical and MRI Characteristics of Levamisole‐Induced Leukoencephalopathy in 16 Patients
Authors: Xu Ning'an , Zhou Wenbin , Li Shuyu , Zhou Gaofeng , Zhang Ning , Liang Jinghui 
Published: October 2009

ABSTRACTOBJECTIVE To study the clinical and radiological characteristics of levamisole‐induced leukoencephalopathy (LILE) in patients with recurrent aphthous ulcers (RAU) or infected with Ascaris. METHODS The medical histories of 16 patients with LILE were analyzed, including clinical manifestations, brain magnetic resonance imaging (MRI) characteristics, cerebrospinal fluid, and brain biopsy findings. RESULTS The main clinical manifestations of LILE were motor weakness (75.0%), dysphasia or aphasia (50.0%), cognitive disorder (50.0%), and facial palsy (43.8%). The MRI of 16 cases showed plaque and round or oval demyelinating lesions in white matter, which revealed a signal hypointensity on T1‐weighted and diffusion‐weighted images (DWI), and demonstrated hyperintensity on T2‐weighted and fluid‐attenuated inversion recovery (FLAIR) images. The MRI revealed peripheral ring‐type enhancement about the focus after Gd‐DTPA administration and edema around some lesions, without mass effect. T2‐weighted and FLAIR images were highly sensitive to the lesions. Brain biopsy in 1 patient showed multifocal demyelinating lesions without perivascular cuffing by lymphocytes. Treatment generally consisted of steroids and hyperbaric oxygen therapy, and patients recovered to normal condition. CONCLUSIONS A single normal dose of levamisole can induce leukoencephalopathy in patients with RAU or Ascaris. The diagnosis depends on the clinical features and imaging appearances. Steroid therapy might be a good choice of treatment.
Transient Seizure‐Related MRI Abnormalities
Authors: Ong Benjamin , Bergin Patrick , Heffernan Theresa , Stuckey Stephen 
Published: October 2009

ABSTRACT Reversible edema following seizure activity has been well described; however, there are now a number of further distinct MR findings described in the literature, also documented to be transient and associated with seizure activity. A concise review of these described transient conventional magnetic resonance imaging manifestations of seizure activity is presented in pictorial essay format. In addition to posterior reversible encephalopathy syndrome appearances, less common abnormalities involving the cerebral and cerebellar cortices, deep gray matter, meninges, hippocampi, and corpus callosum are presented and highlighted.
Diffusion Tensor Imaging Findings in School‐Aged Autistic Children
Authors: Brito Adriana Rocha , Vasconcelos Marcio Moacyr , Domingues Romeu Cortes , Hygino da Cruz Jr Luiz Celso , Rodrigues Leise de Souza , Gasparetto Emerson L. , Calçada Carlos Adolfo B. Pinto 
Published: October 2009

ABSTRACTOBJECTIVE To analyze and compare cerebral white matter tracts through diffusion tensor imaging in autistic and normal children. METHODS This is a case‐control study on a sample of eight male, right‐handed children diagnosed with autism according to Diagnostic and Statistical Manual of Mental Disorders‐4th Edition criteria, and eight healthy age‐ and sex‐matched controls. Imaging studies were performed on a 1.5‐T scanner (Symphony Maestro Class, Siemens, Erlangen, Germany). Fractional anisotropy was calculated for the frontopontine and corticospinal tracts, frontal subcortical white matter, anterior cingulate, corpus callosum, striatum, internal capsule, optic radiation, superior and inferior longitudinal fascicles, and cerebellum. Analysis of significance was based on analysis of variance test for the mean fractional anisotropy values. RESULTS Median age of cases was 9.53 ± 1.83 years, and of controls, 9.57 ± 1.36 years. Diffusion tensor imaging findings included significant reduction of fractional anisotropy in the anterior corpus callosum (P= .008), right corticospinal tract (P= .044), posterior limb of right and left internal capsules (P= .003 and .049, respectively), left superior cerebellar peduncle (P= .031), and right and left middle cerebellar peduncles (P= .043 and .039, respectively) in autistic children. CONCLUSIONS The diffusion tensor imaging findings in children with autistic disorder suggest impairment of white matter microstructure, possibly associated with reduced connectivity in corpus callosum, internal capsule, and superior and middle cerebellar peduncles.
Prevalence and Prediction of Left Atrial Thrombus in Patients with a Recent Cerebral Ischemic Event, Who Are in Sinus Rhythm: A Single‐Center Experience
Authors: Yahia Abutaher M. , Shaukat Aasma , Kirmani Jawad F. , Latorre Julius Gene , Qureshi Adnan I. 
Published: October 2009

ABSTRACTBACKGROUND Left atrial thrombus (LAT) is frequently present in patients with cerebral ischemic events (CIE) who are in atrial fibrillation. The prevalence and predictor of LAT in patients who are in sinus rhythm (SR) is unclear. OBJECTIVE To determine the prevalence and identify predictors of LAT formation in patients with CIE who are in SR. METHODS Consecutive patients with CIE who are in SR were evaluated by transesophageal echocardiography (TEE) from July 2000 to August 2001. Patient demographics including cerebrovascular risk factors were recorded. RESULTS LAT was present in 5.5%. Left ventricular systolic dysfunction (LVSD) was present in 25 (10%). Patients’ mean age was 59 ± 14 years and 119 (50%) were male. In the univariate analysis, LAT was associated with LVSD (odds ratio [OR] 9.24, 95% confidence interval [CI] 2.8; 10.3) and male patients (OR 4.56, 95% CI: 1.6, 12.6) who had coronary artery disease (OR 3.4, 95% CI: 1.3, 8.4). In the multivariate analysis, LVSD (OR 10.6, CI 2.2‐51.6) strongly predicted the development of LAT. CONCLUSIONS LAT is not uncommon in patients CIE, who are in sinus rhythm, especially those with poor left ventricular functions. TEE should be considered in patients with CIE and LVSD for early detection and treatment of LAT.
Natural History of Asymptomatic Intracranial Arterial Stenosis
Authors: Taylor Robert A. , Kasner Scott E. 
Published: October 2009

ABSTRACT The prevalence and natural history of asymptomatic intracranial arterial stenosis are not very well characterized. Existing data suggest that incidentally discovered asymptomatic intracranial stenosis presents a fairly low risk of stroke, though substantial uncertainty remains. Patients may be at greater risk if there are tandem stenoses. Methods to stratify the risk of stroke with asymptomatic intracranial atherosclerotic lesions have yet to be established and validated. In general, aggressive intervention for an asymptomatic intracranial stenosis is not currently recommended.
Diagnosis and Quantitation of Intracranial Stenosis
Authors: Feldmann Edward 
Published: October 2009

ABSTRACT Noninvasive tests, transcranial Doppler, magnetic resonance angiography and computed tomography angiography, and invasive catheter angiography are available to diagnose the presence and quantify the severity of intracranial atherosclerotic stenosis. Each test has its advantages and disadvantages, including the gold standard of catheter angiography. Careful use and measurements with any test are crucial to optimal research and treatment of patients suspected of harboring intracranial atherosclerotic stenosis. Rigorous trials assessing the performance of these tests are few in number. The design and results of the SONIA trial are reviewed. The clinical utility of the SONIA approach and data set, in both clinical and research settings, is reviewed.
The Evolution and Role of Endovascular Therapy for the Treatment of Intracranial Atherosclerotic Disease
Authors: Rasmussen Peter A. ,   on behalf of the US Wingspan Registry Group
Published: October 2009

ABSTRACT Intracranial atherosclerotic disease (ICAD) is being seen as an increasingly important cause of transient ischemic attack and stroke. Attention on this disease entity has been focused as a result of two recent events: the publication of the WASID trial and the recent Food and Drug Administration approval of the Wingspan‐Gateway stent system. This manuscript will review the evolution of the role of endovascular therapy in the management of ICAD. In addition, the available devices currently available for endovascular therapy will be reviewed with an eye toward peri‐procedural and follow‐up complication rates.