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K Baudendistel

Publications and source records attributed to K Baudendistel.

11 recordsLinked to original sources

[Event-related functional magnetic resonance imaging of cerebral pain processing].

Neurofunctional magnetic resonance imaging (fMRI) offers the possibility to map cerebral activity non-invasively. The development of event-related techniques during the past years allows to study brain processes with high spatial and temporal resolution. Based on these techniques, EPI- and FLASH sequences were developed in this study, to investigate cerebral processing of experimental thermal pain stimulation. Phasic and tonic stimulation paradigms were developed with an MR-compatible contact thermode. Functional mapping of pain-relevant areas was performed with these paradigms, as well as a specification of the temporal characteristics of the activation. Further, a randomized paradigm with several stimulus intensities could differentiate graded functional responses, dependent on stimulus intensity in specific "regions-of-interest". In this design, randomizing the stimulus order reduced habituation effects, while continuous subjective magnitude estimation of the stimuli kept attention of subjects maximal.

Brain↗

[Cerebrospinal fluid protein tau levels in the differential diagnosis of Alzheimer's disease].

Tau protein concentration in cerebrospinal fluid was determined in 55 patients with Alzheimer's disease (AD), 18 patients with vascular dementia (VD), 19 patients with dementia caused by other disorders and 14 patients with major depression. Significantly (p < 0.05) elevated protein tau concentrations were found in AD patients (564.5 +/- 275.5 pg/ml) compared to all other patient groups (VD: 406.5 +/- 263.9 pg/ml; other dementia: 275.0 +/- 135.4 pg/ml; depression: 212.9 +/- 115.6 pg/ml). However, tau levels in AD patients covered a broad range (163.2 pg/ml-1200 pg/ml). AD patients with tau levels below the 25%-percentile of the distribution (among them a high percentage of patients with presenile onset) showed tau levels similar to those of the patients with late life depression. No significant correlations between tau levels and clinical variables such as severity of dementia, age, age of onset, duration of illness, and cerebral changes as assessed by volumetric magnetic resonance imaging could be demonstrated. Similarly, we could not find an influence of either APO-E genotype or psychotropic medication on the tau levels in AD patients. In accordance with other studies our results confirm elevated tau levels in AD compared to elderly not demented control subjects. Comparing groups, this finding applies as well with respect to VD and other dementing disorders. However, elevated tau levels cannot be detected in a subgroup of AD patients. This finding needs to be further investigated in future studies.

Aged↗

Motor dysfunction and sensorimotor cortex activation changes in schizophrenia: A study with functional magnetic resonance imaging.

Recent studies demonstrate a diminished activation of the sensorimotor cortex and supplementary motor area (SMA) in schizophrenia which may be involved in the pathogenesis of neurological soft signs (NSS). Yet, the question whether a retarded motor performance may account for these changes remained to be clarified. Twelve DSM-III-R schizophrenics and 12 healthy controls were included. All subjects were right-handed. Nine patients received clozapine, two conventional neuroleptics, and one was drug-free. Functional magnetic resonance imaging (fMRI) was obtained in a resting condition and during pronation/supination at three speed levels (low, medium, and high) with motor performance recorded simultaneously using a pronation/supination device. While measures of motor retardation (i.e., repetition rate and amplitude of the movements) did not differ between patients and controls, the variability of performance was significantly (P < 0.05) increased in the patients' group. In addition, patients with schizophrenia showed a significantly (P < 0.05) decreased activation of the sensorimotor cortices. Similar, although nonsignificant (P = 0.09) activation changes were observed in the SMA. Activation differences were more pronounced at a slow speed and in the drug-free patient. These results confirm a diminished sensorimotor cortex and SMA activation and indicate that variability of performance rather than retarded performance per se may correspond to these changes.

Adult↗

Improved target volume definition in radiosurgery of arteriovenous malformations by stereotactic correlation of MRA, MRI, blood bolus tagging, and functional MRI.

In this methodological paper the authors report the stereotactic correlation of different magnetic resonance imaging (MRI) techniques [MR angiography (MRA), MRI, blood bolus tagging (STAR), and functional MRI] in 10 patients with cerebral arteriovenous malformations (AVM) and its application in precision radiotherapy planning. The patient's head was fixed in a stereotactic localization system that is usable at the MR and the linear accelerator installations. By phantom measurements different materials (steel, aluminium, titanium, plastic, wood, ceramics) used for the stereotactic system were tested for mechanical stability and geometrical MR image distortion. All metallic stereotactic rings (closed rings made of massive metal) led to a more or less dramatic geometrical distortion and signal cancellation in the MR images. The best properties-nearly no distortion and high mechanical stability-are provided by a ceramic ring. If necessary, the remaining geometrical MR image distortion can be "corrected" (reducing displacements to the size of a pixel) by calculations based on modeling the distortion as a fourth-order two-dimensional polynomial. Using this method multimodality matching can be performed automatically as long as all images are acquired in the same examination and the patient is sufficiently immobilized. Precise definition of the target volume could be performed by the radiotherapist either directly in MR images or in calculated projection MR angiograms obtained by a maximum-intensity projection algorithm. As a result, information about the hemodynamics of the AVM was provided by a three-dimensional (3D) phase-contrast flow measurement and a dynamic MRA with the STAR technique leading to an improved definition of the size of the nidus, the origin of the feeding arteries, and the pattern of the venous drainage. In addition, functional MRI was performed in patients with lesions close to the primary motor cortex area leading to an improved definition of structures at risk for high-dose application in radiosurgery. The different imaging techniques of MR provide a sensitive, noninvasive, 3D method for defining target volume, critical structures, and for calculating dose distributions for radiosurgery of cerebral arteriovenous malformations, because dose calculation of radiosurgery at sufficient accuracy can be based on 3D MR data of the geometrical conformation of the patient's head.

Algorithms↗

Monitoring of task performance during functional magnetic resonance imaging of sensorimotor cortex at 1.5 T.

Functional magnetic resonance imaging (fMRI) has found widespread clinical interest. Difficulties in clinical use of the fMRI technique arise, considering the lack of knowledge about activation task performance. This accounts especially for sensorimotor activation studies, in which performance of the sensorimotor activation task is-if at all-usually rated visually by subjective or semiquantitative methods (i.e., defining categories of performance such as neurological soft signs scales). Recently, instrumental methods for the measurement and analysis of motor performance have been developed. Pronation/supination (hand rotation) movement was shown to be an easily measurable and promising motor task. We have adapted a mechanic device (pronation/supination device, PSD) to monitor motor performance during the fMRI experiment. In a feasibility study, an investigation of fMRI activation strength dependence of sensorimotor cortices and supplementary motor area upon task frequency (25, 50, and 75 cycles/min) was carried out on 10 right-handed healthy volunteers. Furthermore, the authors report the observation of stimulus-induced activation changes in the cerebellum during pronation/supination movement.

Hand↗

Functional magnetic resonance imaging in a stereotactic setup.

The localization of critical structures within the brain is important for the planning of therapeutic strategies. Functional MRI is capable to assess functional response of cortical structures to certain stimuli. The authors present two techniques for functional MRI (fMRI) in a stereotactic set-up. The skull of the patients has been immobilized for stereotactic treatment planning either with a self developed stereotactic ceramic frame and bony fixation or with an individual precision mask system made of light cast. It has been shown that this frame does not produce any image distortion. fMRI was performed using a modified FLASH sequence on a conventional 1.5 T MRI scanner with a specially developed linear polarized head coil. The imaging technique used was an optimized conventional 2D and 3D, first order flow rephased, gradient echo sequence (FLASH) with fat-suppression and reduce bandwidth (16-28 Hz/pixel) and TR = 80-120 ms, TE = 60 ms, flip angle = 40 degrees, matrix = 128 x 128, FOV = 150-250 mm, slice-thickness = 2-5 mm, NEX = 1, and a total single scan time for one image of about 7 sec. The motor cortex stimulation was achieved by touching each finger to thumb in a sequential, self-paced, and repetitive manner. Statistical parametric maps based on student's test were calculated. Pixels with a highly significant signal increase (p < 0.001) are overlaid on T1w SE images. The primary motor and sensory cortex could be visualized with this method in all 10 patients that were imaged in this study. Due to tight fixation of the patient's skull there have been no motion artifacts. These results show that functional MRI is feasible in an stereotactic set-up with an standard 1.5 T scanner. This is a prerequisite for the exact pre therapeutic assessment of the function of cortical centers.

Brain↗

Postprocessing of functional MRI data of motor cortex stimulation measured with a standard 1.5 T imager.

Functional magnetic resonance imaging (fMRI) is usually based on acquisition of alternating series of images under rest and an activation task (stimulus). Brain activation maps can be generated from fMRI data sets by applying several mathematical methods. Two methods of image postprocessing have been compared: (i) simple difference of mean values between rest and stimulation, and (ii) Student's t-test. The comparison shows that the difference method is very sensitive to arbitrary signal fluctuations as seen mainly in large vessels (e.g., in the sagittal sinus), leading to insignificantly activated spots in brain activation maps. In contrary, Student's t-test maps show strongly reduced sensitivity for fluctuations and have the advantage of giving activation thresholds by setting significance levels. This allows the comparison of activation strength between patient collectives by using a grid overlay technique leading to an observer independent quantification of the stimulation effects. The method was able to reproduce previous findings of activation differences between healthy volunteers and schizophrenic patients. Moreover, a simple algorithm for the correction of slight head movements during the functional imaging task is presented. The algorithm is based on shifting the fMRI data set relative to a reference image by maximizing the linear correlation coefficients. This leads to a further reduction of insignificant brain activation and to an improvement in brain activation map quality.

Adult↗

Sensorimotor cortex and supplementary motor area changes in schizophrenia. A study with functional magnetic resonance imaging.

BACKGROUND: Neurological soft signs (NSS) such as a disturbed finger-to-thumb opposition are frequently found in schizophrenia. To identify the underlying cerebral changes we investigated sensorimotor cortex and supplementary motor area (SMA) activation during finger-to-thumb opposition using functional magnetic resonance imaging (fMRI). METHOD: Ten DSM-III-R schizophrenics and seven healthy controls were included. All subjects were right-handed. fMRI was carried out in a resting condition followed by an activation state (finger-to-thumb opposition) and the activities in the sensorimotor cortices and SMA recorded. RESULTS: All subjects showed a significant activation of the SMA and both ipsilateral and contralateral sensorimotor cortices. In the controls, ipsilateral finger-to-thumb opposition was associated with a greater left than right hemispheric sensorimotor cortex coactivation. When compared with the healthy controls, the schizophrenic patients showed a decreased activation of both sensorimotor cortices and SMA, as well as a reversed lateralisation effect. CONCLUSION: Sensorimotor cortex and SMA dysfunction are associated with motor disturbances in schizophrenia.

Adult↗

[Functional magnetic resonance tomography of movement disorders in patients with schizophrenia].

UNLABELLED: Neurological soft signs (NSS), which are minor motor and sensory deficits, e.g., during finger-to-thumb opposition, are frequently found in schizophrenia. The purpose of this study was to investigate differences in the cerebral activation pattern in ten schizophrenic patients and ten healthy volunteers using functional MRI. METHODS: fMRI was performed using a modified FLASH sequence (TR/TE/alpha = 100/60/40 degrees) and a conventional 1.5 T MR scanner. Color-coded statistical parametric maps based on Student's t-test were calculated. Activation strength was quantified using a 5 x 6 grid over-lay. RESULTS: The volunteers showed a higher activation strength during left hand movement compared to right hand movement. This lateralization effect was reversed in patients who showed overall reduced activation strength. CONCLUSIONS: Disturbed interhemispheric balance in schizophrenic patients during motor task performance can be demonstrated using fMRI. These findings support the hypothesis that changes in the sensorimotor cortex may be involved in the development of NSS.

Adult↗

Functional 2D and 3D magnetic resonance imaging of motor cortex stimulation at high spatial resolution using standard 1.5 T imager.

This paper reports the effects of motor cortex stimulation of normal volunteers using conventional MR imaging techniques on standard 1.5 T clinical scanner. Improvement in signal-to-noise (S/N) ratio has been achieved by using a commercially available eye/ear surface coil with a loop of 8.5 cm in diameter. Magnet shimming with all first order coils was performed to the volunteer's head resulting in a magnetic field homogeneity of about 0.1-0.2 ppm. The imaging technique used was an optimized conventional 2D and 3D, first order flow rephased, gradient-echo sequence (FLASH) with fat-suppression and reduced bandwidth (16-28 Hz/pixel) and TR = 80-120 ms, TE = 60 ms, flip angle = 40 degrees, matrix = 128 x 128, FOV = 150-250 mm, slice-thickness = 2-5 mm, NEX = 1, and a total single scan time for one image of about 12-16 s. In the 3D FLASH measurements, a slab of 32 mm thickness with 16 partitions was evaluated. The motor cortex stimulation was achieved by touching each finger to thumb in a sequential, self-paced, and repetitive manner. During stimulation, an increase in signal of order 10-20% was detected in the motor and sensory cortex due to reduced partial volume effects and optimized S/N for the measurements at small voxel size. 3D FLASH imaging at high spatial resolution shows good anatomical correlation of signal increase with gray matter of the motor and sensory cortex. The reported data demonstrate the technical feasibility of functional 2D and 3D MR imaging at high spatial resolution using optimized conventional sequences and equipment.

Humans↗

In vivo quantification of brain volumes in subcortical vascular dementia and Alzheimer's disease. An MRI-based study.

Quantitative magnetic resonance imaging (MRI) was used to assess global and regional cerebral volumes in patients with a clinical diagnosis of subcortical vascular dementia (VD) and Alzheimer's disease (AD). Whole brain volume, cerebrospinal fluid volume, volumes of the temporal, frontal and parietal lobes, the cerebellum and the amygdala-hippocampus complex were determined using a personal computer-based software. Seventeen patients with VD, 22 patients with AD and 13 healthy controls were included. Analysis of covariance using age as covariate demonstrated significant mean differences between controls and dementia groups with respect to all morphological parameters. However, apart from the volume of the cerebellum no significant volumetric differences were found between VD and AD. These results indicate that MRI-based volumetry allows differentiation between AD or VD from normal controls and that measurement of cerebellar volume may be of use to separate vascular and degenerative dementia. However, since the distribution of cerebral atrophy in both dementia groups is very similar, it is suggested that the atrophic changes are not specific to the underlying cause but rather reflect the selective vulnerability of neuronal structures.

Aged↗