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Biomedical subjects

M J Lowe

Publications and source records attributed to M J Lowe.

16 recordsLinked to original sources
PubMed2001

A multiple focused probe approach for high intensity focused ultrasound based surgery.

To produce deep-seated surgical lesions using ultrasound requires high power and intensity levels at the target sites. Conventionally, large transducers are used which require big apertures and so are generally suitable only for extra-corporeal access. Such transducers also result in strong off-focus maxima, where the resulting hot spots can destroy normal tissue whilst deep-seated large tissue volumes are being ablated. This paper describes a new approach in which it is proposed that multiple probes are used simultaneously, each at a relatively low power, to result in an overlapping focused region of high temperature without strong off-focus hot spots. Robotic techniques could be used to move the individual probes in coordination to sweep out the desired region of tissue ablation. Simulation and planning are the key to quality prediction for high intensity focused ultrasound (HIFU). Simplified two-dimensional and three-dimensional models of HIFU probes have been developed to study the characteristics of various multi-probe configurations. Preliminary simulation results show that the multi-probe system can be arranged successfully to minimise off-focus hot spots. Experimental results are presented which validate the modality and confirm this positive finding. Further prediction studies and planning will be necessary to achieve the most appropriate desired treatment, by varying the pulse duration and spacing.

Computer Simulation↗
PubMed2001

Temporal lobe activation demonstrates sex-based differences during passive listening.

PURPOSE: To evaluate potential sex differences in temporal lobe activation during the performance of a functional magnetic resonance (MR) imaging passive-listening paradigm. MATERIALS AND METHODS: Twenty strongly right-handed volunteers (10 men, 10 women) underwent imaging with a 1.5-T machine by using a gradient-echo echo-planar sequence. The task consisted of passive listening to simple narrative text interleaved with same-narrative text played backward. Volumes of interest were drawn around anterior and posterior areas of activation in bilateral temporal lobes. The peak percentage of activation and the percentage of activated voxels at single-voxel significance levels of 10(-2), 10(-3), and 10(-4) within each volume of interest were measured. An asymmetry index A was then calculated for both anterior and posterior volumes of interest such that A = (L - R)/(L + R), where R is either the peak percentage activation or the percentage of activated voxels within the right volume of interest and L is either the peak percentage activation or the percentage of activated voxels within the left volume of interest. The asymmetry indexes were compared between men and women by using a standard t test. RESULTS: Men showed a significantly higher degree of asymmetric activation than did women in both the anterior and posterior volumes of interest by using peak percentage activation and at all single-voxel significance levels. The degree of activation asymmetry was greater by using single-voxel significance measurements, compared with peak percentage activation measures. CONCLUSION: Women demonstrate a higher degree of bilateral language representation in temporal lobe regions than do men during passive listening. These findings, combined with the variable results of prior functional MR imaging language studies of sex differences, suggest that they may be task specific.

Adult↗
PubMed2001

Diffusion-weighted imaging of white matter abnormalities in patients with phenylketonuria.

Phenylketonuria (PKU) is an autosomal recessive disorder caused by a deficiency of the enzyme phenylalanine hydroxylase (EC 1.14.16.1). Affected patients develop elevated plasma and tissue levels of phenylalanine and its related ketoacids. Untreated patients usually exhibit severe mental retardation and poor motor function, with characteristic T2 white matter signal abnormalities on conventional MR images. In the present study, we performed diffusion-weighted imaging in three PKU patients. All three patients demonstrated significantly restricted diffusion in all white matter areas examined.

Adult↗
PubMed2000

Correlations in low-frequency BOLD fluctuations reflect cortico-cortical connections.

Cross-correlation of low-frequency temporal fluctuations (<0.08 Hz) was used to correlate widely separated anatomic regions during continuous performance of a spatial working memory task. The regions of highest correlation to right-hemisphere dorsolateral prefrontal cortex correspond to the regions of largest baseline signal change in a conventional block-style functional MRI paradigm. Additionally, it is shown that the correlations between elements of the functional network increase during performance of a task that activates the network when compared to a task that does not directly stimulate the functionally connected network.

Attention↗
PubMed2000

Quantitative comparison of functional contrast from BOLD-weighted spin-echo and gradient-echo echoplanar imaging at 1.5 Tesla and H2 15O PET in the whole brain.

Spin-echo and gradient-echo echoplanar functional magnetic resonance imaging (fMRI) studies at 1.5 Tesla (T) were used to obtain blood oxygenation level-dependent (BOLD) contrast images of the whole brain in seven strongly right-handed women during execution of a complex motor task. Five subjects underwent subsequent H215O positron emission tomography (PET) studies while performing the same task. Group-averaged results for changes in the MRI relaxation rates R2* and R2 at 1.5T in response to neuronal activation in nine cortical, subcortical, and cerebellar motor regions are reported. Results for each method are grouped according to tissue type-cerebral cortex (precentral gyrus and supplementary motor area), subcortical regions (thalamus and putamen), and cerebellar cortex (superior lobule). The observed changes in R2* from activation-induced oxygenation changes were more variable across brain regions with different tissue characteristics than observed changes in R2. The ratio of deltaR2* to deltaR2 was 3.3 +/- 0.9 for cerebral cortex and 2.0 +/- 0.6 for subcortical tissue. deltaR2*, deltaR2, and relative blood flow changes were deltaR2* = -0.201 +/- 0.040 (s-1), deltaR2 = -0.064 +/- 0.011 s(-1), and deltaf/f = 16.7 +/- 0.8% in the cerebral cortex; deltaR2* = -0.100 +/- 0.026 s(-1), deltaR2 = -0.049 +/- 0.009 s(-1), and deltaf/f = 9.4 +/- 0.7% in the subcortical regions; and deltaR2* = -0.215 +/- 0.093 s(-1), deltaR2 = -0.069 +/- 0.012 s(-1), and deltaf/f = 16.2 +/- 1.2% in the cerebellar cortex.

Adult↗
PubMed2000

Comparison of rhyming and word generation with FMRI.

Functional magnetic resonance imaging (FMRI) has been successfully used to non-invasively map language function, but has several disadvantages. These include severe motion sensitivity, which limits overt verbal responses in behavioral paradigms, such as word generation. The lack of overt responses prevents behavioral validation, making data interpretation difficult. Our objective was to compare the FMRI activation patterns of a novel silent rhyme determination task requiring a non-verbal response, to covert word generation from visually presented letters. Five strongly right-handed subjects performed both tasks during multi-slice coronal echo-planar T2*-weighted FMRI. Single subject activation maps were generated for each task by correlation analysis of single pixel time series to a boxcar reference function. These maps for the two tasks were separately interpolated to 256(3), transformed into Talairach space, summed, and thresholded at t>6. Combined activation maps from both tasks showed similar robust perisylvian language area activation, including inferior frontal gyrus, posterior superior temporal lobe, and fusiform gyrus. Subjects performed well on the rhyming task, which activated left hemisphere cortical regions more selectively than the word generation task. The rhyming task showed less activation than the word generation task in areas typically not considered specifically related to language function, such as the dorsolateral prefrontal cortex and anterior cingulate. The rhyming task is a useful tool for brain mapping and clinical applications, potentially more specific to cortical language areas than verbal fluency.

Adult↗
PubMed1999

Brain: gadolinium-enhanced fast fluid-attenuated inversion-recovery MR imaging.

PURPOSE: To determine the clinical utility of gadolinium-enhanced fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) imaging of the brain by comparing results with those at gadolinium-enhanced T1-weighted MR imaging with magnetization transfer (MT) saturation. MATERIALS AND METHODS: In 105 consecutive patients referred for gadolinium-enhanced brain imaging, FLAIR and T1-weighted MR imaging with MT saturation were performed before and after administration of gadopentetate dimeglumine (0.1 mmol per kilogram of body weight). Pre- and postcontrast images were evaluated to determine the presence of abnormal contrast enhancement and whether enhancement was more conspicuous with the FLAIR or T1-weighted sequences. RESULTS: Thirty-nine studies showed intracranial contrast enhancement. Postcontrast T1-weighted images with MT saturation showed superior enhancement in 14 studies, whereas postcontrast fast FLAIR images showed superior enhancement in 15 studies. Four cases demonstrated approximately equal contrast enhancement with both sequences. Six cases showed some areas of enhancement better with T1-weighted imaging with MT saturation and other areas better with postcontrast fast FLAIR imaging. Superficial enhancement was typically better seen with postcontrast fast FLAIR imaging. CONCLUSION: Fast FLAIR images have noticeable T1 contrast making gadolinium-induced enhancement visible. Gadolinium enhancement in lesions that are hyperintense on precontrast FLAIR images, such as intraparenchymal tumors, may be better seen on T1-weighted images than on postcontrast fast FLAIR images. However, postcontrast fast FLAIR images may be useful for detecting superficial abnormalities, such as meningeal disease, because they do not demonstrate contrast enhancement of vessels with slow flow as do T1-weighted images.

Brain↗
PubMed1998

Functional connectivity in single and multislice echoplanar imaging using resting-state fluctuations.

A previous report of correlations in low-frequency resting-state fluctuations between right and left hemisphere motor cortices in rapidly sampled single-slice echoplanar data is confirmed using a whole-body echoplanar MRI scanner at 1.5 T. These correlations are extended to lower sampling rate multislice echoplanar acquisitions and other right/left hemisphere-symmetric functional cortices. The specificity of the correlations in the lower sampling-rate acquisitions is lower due to cardiac and respiratory-cycle effects which are aliased into the pass-band of the low-pass filter. Data are combined for three normal right-handed male subjects. Correlations to left hemisphere motor cortex, visual cortex, and amygdala are measured in long resting-state scans.

Adult↗
PubMed1998

Reproducibility of fMRI results across four institutions using a spatial working memory task.

Four U.S. sites formed a consortium to conduct a multisite study of fMRI methods. The primary purpose of this consortium was to examine the reliability and reproducibility of fMRI results. FMRI data were collected on healthy adults during performance of a spatial working memory task at four different institutions. Two sets of data from each institution were made available. First, data from two subjects were made available from each site and were processed and analyzed as a pooled data set. Second, statistical maps from five to eight subjects per site were made available. These images were aligned in stereotactic space and common regions of activation were examined to address the reproducibility of fMRI results when both image acquisition and analysis vary as a function of site. Our grouped and individual data analyses showed reliable patterns of activation in dorsolateral prefrontal cortex and posterior parietal cortex during performance of the working memory task across all four sites. This multisite study, the first of its kind using fMRI data, demonstrates highly consistent findings across sites.

Adult↗
PubMed1998

Nurses' views on reporting medication incidents.

The purpose of this project was to identify nurses' beliefs about medication incident reporting. A new medication incident form was developed and trialled in six clinical units. Forty-three nurses from these areas were recruited to participate in the project, with a 20-point self-reporting questionnaire and focus group discussions being used to collect the data. Theme analysis of the data was undertaken with the results of the project indicating nurses report medication incidents that are life threatening to patients, but do not want identifying information collected about themselves. This situation represents nurses' fear of reprimand from those in authority and may also indicate an unwillingness to accept responsibility for errors in which they may be merely the final player in a complex series of events. The results of the project also highlight problems associated with self-reported medication incident monitoring and challenge its effectiveness in gathering data required by managers and staff development educators.

Attitude of Health Personnel↗
PubMed1997

Spatially filtering functional magnetic resonance imaging data.

When constructing MR images from acquired spatial frequency data, it can be beneficial to apply a low-pass filter to remove high frequency noise from the resulting images. This amounts to attenuating high spatial frequency fluctuations that can affect detected MR signal. A study is presented of spatially filtering MR data and possible ramifications on detecting regionally specific activation signal. It is shown that absolute activation levels are strongly dependent on the parameters of the filter used in image construction and that significance of an activation signal can be enhanced through appropriate filter selection. A comparison is made between spatially filtering MR image data and applying a Gaussian convolution kernel to statistical parametric maps.

Magnetic Resonance Imaging↗
PubMed1996

Human amygdala activation detected with echo-planar functional magnetic resonance imaging.

Echo-Planar functional magnetic resonance imaging (EP-fMRI) was used to study the activity of the amygdala while three normal female subjects viewed alternating blocks of affectively neutral and affectively negative still pictures. Bilateral activation in the amygdala that was significantly correlated with the changing valence of the visual stimuli was found in all three subjects. These findings are consistent with the large corpus of data from non-human studies suggesting that the amygdala is a key structure for extracting the affective significance from external stimuli. This is the first known report of phasic amygdala activation detected with EP-fMRI in normal human subjects responding to affective stimuli.

Adult↗
PubMedDate not supplied

Treatment of baseline drifts in fMRI time series analysis.

PURPOSE: Gradual drifting of baseline signal intensity is common in functional MRI (fMRI) time course data. Methods for dealing with this effect are studied. METHOD: Simulations and fMRI data are used to study three statistical models that account for baseline drift. A method is proposed in which the time course data are linear least-squares fit to a reference function that includes the slope of the baseline drift as a free parameter. RESULTS: It is shown that the least-squares method is equivalent to cross-correlation with Gram-Schmidt orthogonalization. Additionally, it is shown that certain paradigm designs improve the sensitivity of statistical tests when using any of the drift correction methods commonly employed. The least-squares method results in a variety of useful parameters such as activation amplitude, with a well characterized error. CONCLUSION: Very simple techniques can effectively account for observed drifts. It is important to design paradigms that are symmetric about the midpoint of the time series. In calculating confidence levels, a proper statistical model that accounts for baseline drifts is necessary to ensure accurate confidence level assessment.

Humans↗
PubMedDate not supplied

Comparison of fMRI and intraoperative direct cortical stimulation in localization of receptive language areas.

PURPOSE: The purpose of this work was to compare the cortical localization of receptive speech using functional MRI (fMRI) and direct intraoperative electrical stimulation. METHOD: Three strongly right-handed patients with primary neoplasms of the left parasylvian region underwent fMRI while subjected to a passive listening task designed to activate receptive language areas. All three subjects then underwent awake intraoperative language mapping using direct electrical stimulation of the cortex. RESULTS: In all three subjects, similar, but nonidentical, cortical regions were identified as involved in receptive language function by fMRI and direct cortical stimulation mapping. CONCLUSION: fMRI provides excellent receptive language mapping, but its results must be interpreted with caution due to conceptual and technical differences from direct cortical stimulation mapping.

Auditory Cortex↗