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Ingeborg Goethals

Publications and source records attributed to Ingeborg Goethals.

26 records · Page 2Linked to original sources
PubMed2002

Is central benzodiazepine receptor imaging useful for the identification of epileptogenic foci in localization-related epilepsies?

In the presurgical evaluation of patients with partial epilepsies, the most extensively studied functional neuro-imaging modality to define the origin of seizure onset is fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET). Generally, this technique reveals a widespread zone of interictal glucose hypometabolism in the region of the epileptogenic focus. However, the technique may miss the epileptogenic region and FDG PET abnormalities may extend beyond the seizure onset zone. Consequently, for the precise identification of epileptogenic regions more specific imaging probes than FDG are warranted. This review considers the clinical utility of iomazenil (IMZ) SPET and flumazenil (FMZ) PET for the precise localization of epileptogenic foci in partial epilepsy syndromes.

Brain↗
PubMed2002

Analysis of clinical brain SPECT data based on anatomic standardization and reference to normal data: an ROC-based comparison of visual, semiquantitative, and voxel-based methods.

UNLABELLED: The technique of anatomic standardization and comparison with normal templates is increasingly used in clinical brain SPECT practice and allows automated, operator-independent volume-of-interest (VOI) or voxel-based analysis of whole-brain data. In 2 distinct clinical populations with severe traumatic brain injury and cognitive impairment, this study compared 3 widely available approaches that use normal templates to evaluate SPECT brain perfusion deficits. METHODS: In total, 74 subjects were studied. These included 14 patients with severe, traumatic brain injury (group 1; 10 males, 4 females; mean age +/- SD, 27.6 +/- 8.2 y) and 15 patients with cognitive impairment (group 2; 7 males, 8 females; mean age, 75.8 +/- 8.6 y). These data were compared with those from, respectively, 25 and 20 age- and sex-adjusted healthy volunteers. All data were analyzed in 4 ways. Three semiquantitative statistical algorithms were used: statistical parametric mapping (SPM) using SPM99, brain registration and analysis of SPECT studies (BRASS) using a voxelwise region-growing technique, and a predefined VOI approach. These results were compared with visual analysis based on consensus reading by 3 experienced nuclear medicine physicians. Receiver operating characteristic (ROC) analysis was performed at various statistical cutoffs. Moreover, as a measure of regional agreement, relative regional agreement between methods was assessed. RESULTS: In both study groups, BRASS voxel-based analysis was most accurate, as defined by the area under the ROC curve (0.97 for group 1 and 0.96 for group 2). VOI assessment was slightly more accurate than visual consensus analysis, whereas SPM showed, overall, a lower area under the ROC curve. SPM analysis was also significantly less sensitive at thresholds corresponding to low false-positive fractions. Regional analysis showed 83%-92% agreement between all methods. CONCLUSION: Under clinical conditions, classification of brain SPECT studies can greatly be aided by anatomic standardization techniques and reference to normal data. Under the investigated circumstances, SPM was found to have a lower sensitivity than VOI or voxelwise region-growing techniques, especially at low false-positive fractions.

Adolescent↗
PubMed2002

Toward clinical application of neuropsychological activation probes with SPECT: a spatial working memory task.

UNLABELLED: The concept of working memory is central to theories of human cognition, because it is essential to human skills such as decision making and deductive reasoning. Although PET and functional MRI have provided robust data on the recruitment of specific pathways in working memory tasks, the experimental settings of these studies may not be transferable to a clinical situation. Hence, to develop neuropsychological SPECT activation probes that are suitable for daily clinical practice, this study reports on a neuropsychological activation task of spatial working memory under classical neuropsychological test conditions in healthy subjects. METHODS: Reaction times and accuracy were measured as behavioral parameters and functional imaging data were analyzed with statistical parametric mapping to determine significant voxel-wise changes between the perception task and the memory task. RESULTS: Subjects reacted more slowly and performed less accurately during the memory task compared with the perception task, findings that are in keeping with other neuropsychological studies. Also, the overall pattern of brain activations revealed in our experiment is consistent with the data of the literature, thereby validating our test probe. CONCLUSION: From a practical viewpoint, the close resemblance of the test conditions of the SPECT procedure with those of the investigation room and the relative simplicity of the task under study probably constitute major advantages for future clinical application of the SPECT procedure in patients with cognitive impairments.

Adult↗
PubMedDate not supplied

Imaging of the 5-HT2A system: age-, gender-, and Alzheimer's disease-related findings.

Serotonin (5-HT) and more specifically the 5-HT(2A) receptor is involved in cognitive and non-cognitive behavior and plays an important role in Alzheimer's disease (AD). The objective was to assess the 5-HT(2A) binding potential (BP) in healthy volunteers and AD with SPECT and 123I-5-I-R91150, a selective radio-iodinated 5-HT(2A) receptor antagonist. Twenty-six controls and nine AD patients were included. A semiquantitive analysis with normalization on cerebellar uptake provided estimates of BP for 26 cortical regions of interest. An age-related decline of neocortical BP was found (11.6% per decade). Compared to age-matched controls, a generally decreased neocortical BP in AD was found with a significant regional reduction in the orbitofrontal, prefrontal, lateral frontal, cingulate, sensorimotor, parietal inferior, and occipital region. These results are in line with previous postmortem, in vitro, and PET findings. The age-related decline highlights the necessity for matched advanced age study samples. The fact that the 5-HT(2A) receptor is differentially affected in AD patients has implications for both the etiological basis and therapeutic management of AD.

Age Factors↗