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Biomedical subjects

J Felblinger

Publications and source records attributed to J Felblinger.

At least 19 recordsLinked to original sources

Suppression of MR gradient artefacts on electrophysiological signals based on an adaptive real-time filter with LMS coefficient updates.

Electrocardiogram (ECG) acquisition is still a challenge as gradient artefacts superimposed on the electrophysiological signal can only be partially removed. The signal shape of theses artefacts can be similar to the QRS-complex, causing possible misinterpretation during patient monitoring and false triggering/gating of the MRI. For their real-time suppression, an adaptive filter is proposed. The adaptive filter is based on the noise-canceller configuration with LMS coefficient updates. The references of the noise canceller are the three gradient signals that are acquired simultaneously with the noisy ECG. Tests were done on patients, on volunteers and using an MR-safe ECG simulator. The noise canceller's performance was measured offline, simulating real-time processing by point-by-point operations. To create worst-case scenarios, clinical sequences with strong- and fast-switching gradients have been chosen. The noise-cancelling filter reduces the gradient artefacts' peak amplitudes by 80-99% after adaptation, without changing the desired ECG signal shape. The estimated reduction of total average power of the MR gradient artefacts is 62-98%. The proposed filter is capable of reducing artefacts due to strong- and fast-switching gradients in real-time applications and worst-case situations. The quality of the ECG is sufficiently high that a standard one-lead QRS-detector can be used for gating/triggering the MRI. For permanent patient monitoring, further improvements are needed.

Algorithms↗

Verbal instructions and top-down saccade control.

Few studies have addressed the interaction between instruction content and saccadic eye movement control. To assess the impact of instructions on top-down control, we instructed 20 healthy volunteers to deliberately delay saccade triggering, to make inaccurate saccades or to redirect saccades--i.e. to glimpse towards and then immediately opposite to the target. Regular pro- and antisaccade tasks were used for comparison. Bottom-up visual input remained unchanged and was a gap paradigm for all instructions. In the inaccuracy and delay tasks, both latencies and accuracies were detrimentally impaired by either type of instruction and the variability of latency and accuracy was increased. The intersaccadic interval (ISI) required to correct erroneous antisaccades was shorter than the ISI for instructed direction changes in the redirection task. The word-by-word instruction content interferes with top-down saccade control. Top-down control is a time consuming process, which may override bottom-up processing only during a limited time period. It is questionable whether parallel processing is possible in top-down control, since the long ISI for instructed direction changes suggests sequential planning.

Acoustic Stimulation↗

Visual exploration behaviour during clock reading in Alzheimer's disease.

Eye movement behaviour during visual exploration of 24 patients with probable Alzheimer's disease and 24 age-matched controls was compared in a clock reading task. Controls were found to focus exploration on distinct areas at the end of each clock hand. The sum of these two areas of highest fixation density was defined as the informative region of interest (ROI). In Alzheimer's disease patients, visual exploration was less focused, with fewer fixations inside the ROI, and the time until the first fixation was inside the ROI was significantly delayed. Changes of fixation distribution correlated significantly with the ability to read the clock correctly, but did not correlate with dementia severity. In Alzheimer's disease patients, fixations were longer and saccade amplitudes were smaller. The altered visual exploration in Alzheimer's disease might be related to parietal dysfunction or to an imbalance between a degraded occipito-parietal and relatively preserved occipito-temporal visual network.

Aged↗

Hemispheric asymmetry in visuospatial attention assessed with transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) was used to study visuospatial attention processing in ten healthy volunteers. In a forced choice recognition task the subjects were confronted with two symbols simultaneously presented during 120 ms at random positions, one in the left and the other in the right visual field. The subject had to identify the presented pattern out of four possible combinations and to press the corresponding response key within 2 s. Double-pulse TMS (dTMS) with a 100-ms interstimulus interval (ISI) and an intensity of 80% of the stimulator output (corresponding to 110-120% of the motor threshold) was applied by a non-focal coil over the right or left posterior parietal cortex (PPC, corresponding to P3/P4 of the international 10-20 system) at different time intervals after onset of the visual stimulus (starting at 120 ms, 270 ms and 520 ms). Double-pulse TMS over the right PPC starting at 270 ms led to a significant increase in percentage of errors in the contralateral, left visual field (median: 23% with TMS vs 13% without TMS, P=0.0025). TMS applied earlier or later showed no effect. Furthermore, no significant increase in contra- or ipsilateral percentage of errors was found when the left parietal cortex was stimulated with the same timing. These data indicate that: (1) parietal influence on visuospatial attention is mainly controlled by the right lobe since the same stimulation over the left parietal cortex had no significant effect, and (2) there is a vulnerable time window to disturb this cortical process, since dTMS had a significant effect on the percentage of errors in the contralateral visual hemifield only when applied 270 ms after visual stimulus presentation.

Adult↗

Functional organisation of the saccadic reference system processing extraretinal signals in humans.

In order to investigate the neuronal network involved in processing extraretinal signals, functional magnetic resonance imaging (fMRI) was applied to subjects performing the double step saccade paradigm. There, the calculation of the amplitude of the second saccade must rely on extraretinal signals of the first. When compared to a task where both saccades could be performed by means of retinal signals alone, a parieto-frontal cortical network was activated, including lateral intraparietal area, precuneus, insula, inferior frontal gyrus and anterior cingulum.

Adult↗

Double-pulse transcranial magnetic stimulation over the frontal eye field facilitates triggering of memory-guided saccades.

The study investigated the influence of double-pulse transcranial magnetic stimulation (dTMS) on memory-guided saccade triggering. Double pulses with interstimulus intervals (ISIs) of 35, 50, 65 or 80 ms were applied over the right frontal eye field (FEF) and as control over the occipital cortex. A significant dTMS effect was found exclusively for contralateral saccades; latency of memory-guided saccades was reduced after FEF stimulation with an ISI of 50 ms compared to latency without stimulation. This effect proved to be specific for the ISI of 50 ms over the FEF because control stimulation with the same ISI over the occipital cortex had no significant effect on latency of memory-guided saccades. The results of our study showed that, by using an appropriate ISI, dTMS is able to facilitate contralateral saccade triggering by stimulating the FEF. This suggests that TMS interferes specifically with saccade triggering mechanisms, probably by acting on presaccadic neurons of the FEF.

Adult↗

Saccadic eye movement disturbances in whiplash patients with persistent complaints.

In order to analyse the possible basis of subjective complaints following whiplash injury, horizontal eye movements were examined in subjects with persistent complaints ('symptomatic group') and subjects who had completely recovered ('recovered group'). The results for the symptomatic and recovered groups were compared with those for age-matched, healthy volunteers (control group). A battery of different saccade paradigms was employed: two were reflexive saccade tasks including a gap and an overlap task, and two were intentional saccade tasks consisting of an antisaccade and a memory-guided saccade task. In addition, the symptomatic and recovered groups also underwent psychiatric evaluation in a structured clinical interview, and all groups were assessed for emotional functioning using the Beck Depression Inventory (BDI). The recovered group did not differ significantly from the control group in saccade performance and emotional functioning. The symptomatic group showed dissociation of their performances of reflexive and intentional saccade tasks: performance in reflexive saccade tasks was normal, but in intentional saccade tasks the symptomatic group showed significantly impaired inhibition of unwanted reflexive saccades, impaired saccade triggering (i.e. increased latency) and a higher percentage error in amplitude in memory-guided saccades. Based on clinical interviews, no signs of major depression or dysthymia were found in any of the groups. Compared with the other two groups, the symptomatic group had significantly higher overall BDI scores, but these resulted from BDI dimensions that were non-specific to depression, viz. 'physiological manifestations' (e.g. fatigue, sleep disturbance) or 'performance difficulty' (e.g. work inhibition). In summary, in the symptomatic group the pattern of eye movement disturbances together with normal performance in reflexive saccade tasks and impaired performance in the intentional saccade tasks, especially impaired inhibitory function, suggests dysfunction of prefrontal and frontal cortical structures.

Adult↗

MRI measurement of the functional blood flow changes in a large superficial vein draining the motor cortex.

In this study, phase-contrast MR techniques are applied in order to measure the blood flow changes induced by a motor task in a large superficial vein draining the motor cortex. The measurements were applied to six healthy volunteers, in motor rest conditions and during performance of a motor task. The latter consisted of sequential finger-to-thumb opposition. The task was actually executed and mentally simulated. Significant blood flow increases were found when changing from from mental simulation to actual execution of the motor task (increases ranging between 1.6 and 10.3 ml/min, i.e. 9% and 45%, respectively) and from resting conditions to actual execution of the motor task (increases ranging between 1.7 and 14.0 ml/min, i.e. 32% and 72%, respectively).

Adult↗

Restoration of electrophysiological signals distorted by inductive effects of magnetic field gradients during MR sequences.

A generally applicable method for almost complete suppression of signal artifacts on electrophysiological signals caused by B0-gradient switching (gradient noise) is presented. The method is demonstrated for electrocardiograms (ECGs) but can also be used for other electrophysiological signals. It takes advantage of the fact that under certain conditions, the effect of switching the B0-field gradient upon an electrophysiological signal can be modeled as a linear time-invariant system and fully characterized by pulse response functions. It is shown how the system's pulse response functions of the X, Y, and Z gradients can be determined and how gradient noise can be eliminated efficiently. The elimination of gradient noise by the proposed method causes in the current arrangement a constant delay of 128 msec, which is acceptable for patient monitoring and magnetic resonance sequence triggering.

Artifacts↗

Methods and reproducibility of cardiac/respiratory double-triggered (1)H-MR spectroscopy of the human heart.

Localized (1)H-MR spectroscopy is sensitive to motion and has mostly been applied to the brain. For the human heart, cardiac and respiratory motion lead to displacements on the order of the localized voxel and lead to substantial variations of voxel content, lineshape, water suppression, and signal phase and amplitude. Combined respiratory and cardiac double triggering can avoid these complications to a large extent. Three methods of double triggering are evaluated, with reproducibility established in nine subjects for a method based on respiratory modulation of the ECG amplitude and a visual feedback mechanism. Quantitated with respect to water, within-subject reproducibilities for this setup were 9% for trimethylammonium compounds, 10% for creatine/phosphocreatine, and 13% for lipids. ANOVA showed significant differences between subjects which may relate to natural variability between subjects or exact location within the heart. Unresolved issues for this technique are its susceptibility to precise placement of ECG electrodes and the reasons for failure in 20% of examination. With this technique it is possible to investigate open questions in cardiac pathophysiology, such as the creatine content in chronic heart disease. Variants of this triggering method may also improve cardiovascular MRI methods relying on data acquired in several heartbeats. Magn Reson Med 42:903-910, 1999.

Adult↗

Effect of exercise on the creatine resonances in 1H MR spectra of human skeletal muscle.

1H MR spectra of human muscles were recorded before, during, and after fatiguing exercise. In contrast to expectations, it was found that the spectral contributions of creatine/phosphocreatine (Cr/PCr) were subject to change as a function of exercise. In particular, the dipolar-coupled methylene protons of Cr/PCr were found to be reduced in intensity in proportion to the co-registered PCr levels. Recovery after exercise and behavior under ischemic conditions provide further evidence to suggest that the contributions of the CH2 protons of Cr/PCr to 1H MR spectra of human muscle in vivo reflect PCr rather than Cr levels. Variation of experimental parameters showed that this effect is not due to a trivial change in relaxation times. At present it can only be speculated about why the Cr resonances have reduced NMR visibility. If temporary binding to macromolecules should be involved, the free Cr concentration-important for equilibrium calculations of the creatine kinase reaction-might be different from what was previously assumed.

Adult↗

Creatine supplementation--part II: in vivo magnetic resonance spectroscopy.

PURPOSE: Our purpose was to study effects of creatine (Cr) supplementation on muscle metabolites noninvasively by means of magnetic resonance spectroscopy (MRS) before and after supplementation with Cr or placebo. METHODS: 1H-MRS was used in a comprehensive, double-blind, cross-over study in 10 volunteers to measure Cr in m. tibialis anterior and m. rectus femoris at rest. PCr/ATP was observed in m. quadriceps femoris by 31P-MRS at rest and after exercise. RESULTS: A significant increase in total Cr was observed with Cr intake in m. tibialis anterior (+9.6 +/- 1.7%, P = 0.001) and in m. rectus femoris (+18.0 +/- 1.8%, P < 0.001). PCr/ATP showed a significant increase (+23.9 +/- 2.3%, P < 0.001) in m. quadriceps femoris at rest with Cr supplementation. Post-Cr supplementation recovery rates from exercise were significantly lower (k = 0.029 s(-1), P < 0.01) compared with postplacebo consumption (k = 0.034 s(-1)) and presupplementation (k = 0.037 s(-1)). However, higher levels of PCr/ATP at rest compensate for this reduction of the recovery rate after Cr supplementation. The increase of PCr/ATP determined by 31P-MRS correlates with the increase of Cr observed by 1H-MRS (r = 0.824, P < 0.001). CONCLUSION: Noninvasive observation of Cr and PCr after Cr supplementation shows an increase in a muscle specific manner. Higher preexercise levels of PCr/ATP at rest compensate for significantly slower recovery rates of PCr/ATP after Cr supplementation.

Adenosine Triphosphate↗

Effects of physiologic motion of the human brain upon quantitative 1H-MRS: analysis and correction by retro-gating.

Signal loss and absolute quantitation errors in 1H-MRS (localized proton MR spectroscopy) because of physiologic brain motion are analyzed quantitatively. Cardiac and respiratory related motion lead to substantial phase dispersion when using a standard, short echo-time STEAM sequence. The loss in signal area varies from 6-7% with TM (middle interval time in a STEAM sequence) = 13.7 ms, to 25-39% with TM = 100 ms. The variation in signal area because of motion-related phase dispersion is up to 16% for TM = 100 ms. The signal phase as a function of the position in the cardiac cycle is shown to be reproducible. Maximal differences in the signal phase are over 180 degrees for long TMs. ECG-gating reduces the phase dispersion considerably but introduces problems with variable repetition times. Using a phase calibration curve recorded with the water suppression turned off, it is possible to retrogate subsequent untriggered acquisitions with the water suppression activated, if the time points in the cardiac cycle are recorded for each acquisition. The gain in signal intensity is between 3 and 21%. For absolute quantification via brain water, this phase analysis has the important consequence that reference scans must be phased individually before co-adding, otherwise metabolite concentrations may be severely overestimated.

Brain↗

Recording of electrical brain activity in a magnetic resonance environment: distorting effects of the static magnetic field.

The technical limitations of electroencephalography (EEG) and flashed visually-evoked potentials (VEP) recordings in the static magnetic field of the MR system were systematically studied. A main artifact occurring in the magnetic field was found to be correlated with the heart cycle and had amplitudes in the range of EEG and VEP signals. For VEP recordings, a substantial reduction of this effect was achieved by subtraction of the averaged artifact from the averaged composed signal (VEP and artifact) resulting in the VEP signal alone. However, for continuous EEG recordings, there is no such solution, since the observed effect is not sufficiently constant in amplitude, and the standard deviation of the amplitude of the effect is often larger than the EEG amplitude.

Artifacts↗

Functional organisation of saccades and antisaccades in the frontal lobe in humans: a study with echo planar functional magnetic resonance imaging.

The cortical activation pattern of saccades and antisaccades (versus rest) in the frontal lobe was analysed using an echo planar imaging (EPI) technique in 10 healthy subjects. Statistical analysis of activity in the dorsolateral prefrontal cortex disclosed a significantly greater activation during antisaccades in this region than during saccades. On the other hand, activity in the frontal eye fields was not statistically different in both tasks. These results confirm the important role of the dorsolateral prefrontal cortex for the correct performance of antisaccades obtained by studies in humans with isolated lesions of the dorsolateral prefrontal cortex.

Adult↗

Amplitude demodulation of the electrocardiogram signal (ECG) for respiration monitoring and compensation during MR examinations.

A method for respiration monitoring during MR-sequences using the electrocardiogram signal (ECG) is presented. The basic principle is known in conventional patient monitoring and is based on the fact that the amplitude of the ECG-signal varies with respiratory motion. A demodulation of this "cardio-respiratory signal" yields a respiration curve that can be used for patient monitoring, triggering, or respiration compensation of MRI sequences. Since no drift is introduced by digital demodulation, this method is superior to analog signal processing. The proposed method was applied during MR examinations using an optically coupled ECG sensor that has the advantage of almost negligible interference due to the MR sequences (< < 10% of the main ECG signal). The respiration signal obtained is strongly correlated (r = 0.79 to 0.98) with the position of the diaphragm in inferior-superior direction measured during breath-holding MRI.

Adult↗

Effect of ethanol and fructose on liver metabolism: a dynamic 31Phosphorus magnetic resonance spectroscopy study in normal volunteers.

In vivo 31Phosphorus magnetic resonance spectroscopy (31P-MRS) permits evaluation of dynamic changes of individual phosphorus-containing metabolites in the liver parenchyma, such as phosphomonoester (PME), adenosine triphosphate, and inorganic phosphate (Pi). Intravenous fructose load alters phosphorus metabolites and allows assessment of liver function by 31P-MRS. 31P-MRS data obtained in alcoholic liver disease are however inconclusive. To study the hypothesis that fructose load can be used to investigate metabolic effects of ethanol ingestion, the interaction of different metabolites--i.e., fructose and ethanol--were followed in vivo. Using a 1.5 Tesla magnetic resonance system, six healthy volunteers were examined in three sessions each: a session after administration of (a) fructose only (250 mg/kg) was compared with (b) fructose load after ethanol ingestion (0.8 g/kg). A control experiment (c) was done after ethanol only. Spectra were acquired using one-dimensional chemical shift imaging with a temporal resolution of 5 min. Following a fructose load, the concomitant uptake of ethanol showed drastic changes of individual metabolic steps of the hepatic metabolism (averages +/- standard deviation). While the velocity of the net formation of PME (relative increase 0.46 +/- 0.11 without ethanol vs. 0.61 +/- 0.25 with ethanol) and the use of adenosine triphosphate (-0.13 +/- 0.03 vs. -0.16 +/- 0.03) and Pi (-0.022 +/- 0.009 vs. -0.021 +/- 0.004) were not significantly affected by ethanol uptake, a significant (p < 0.01) reduction of PME degradation (31.3 +/- 9.4 vs. 61.9 +/- 16.9 relative total area) and absence of an overshoot for Pi (10.5 +/- 4.9 vs. -7.1 +/- 5.3 relative area 13 min to 43 min) was observed after ethanol administration. Dynamic 31P-MRS allows the observation of individual steps of hepatic metabolism in situ; fructose metabolism in the human liver is slowed down by concomitant ethanol ingestion after the phosphorylation step of fructose. This could be explained by inhibition of aldolase rather than ethanol-induced changes of the hepatic redox state. Fructose load can be used to study effects of alcohol ingestion and might therefore be useful in patients with alcoholic liver disease.

Adenosine Triphosphate↗