Biomedical subjects

Margret Hund-Georgiadis

Publications and source records attributed to Margret Hund-Georgiadis.

11 recordsLinked to original sources

PubMed2026

Modulation of heart rate and heart rate variability during animal-assisted treatment of patients in a minimally conscious state: A randomized controlled crossover study.

BACKGROUND: Animal-assisted treatment (AATx) is a promising and increasingly used approach in neurorehabilitation, yet its psychophysiological effects remain largely unexplored. Patients in a minimally conscious state (MCS) show severely altered consciousness with minimal but definite behavioral signs of awareness. Because behavioral assessment in this population is limited, psychophysiological measures such as heart rate (HR) and heart rate variability (HRV) may offer valuable insights into autonomic regulation during therapy. AIM: The present study investigated whether AATx influences HR and HRV compared to treatment as usual (TAU). METHODS: A randomized controlled crossover design with repeated measures was conducted. HR and HRV data were recorded using an Empatica E4 wristband, and linear mixed-effects models were fitted for each outcome variable. The analytic sample included twenty-one patients with MCS who completed at least one of the four sessions. RESULTS: We found a significant decrease in mean HR (estimate = -12.75, p = .041) and a significant increase in the standard deviation of normal-to-normal intervals (SDNN) (estimate = 15.76, p = .020) during AATx compared to TAU from the pretreatment to the posttreatment phase, indicating enhanced parasympathetic activation and greater autonomic flexibility. Other HRV parameters revealed no significant effects of AATx, though trends were consistent with the hypotheses. CONCLUSIONS: These findings provide preliminary physiological evidence that AATx can modulate autonomic activity in MCS patients. Despite limitations related to sample size and recording quality, the results highlight the potential of AATx as an emotionally engaging intervention in early neurorehabilitation.

Humans↗

PubMed2006

Characterization of cortical thickness and ventricular width in normal aging: a morphometric study at 3 Tesla.

PURPOSE: To describe loss of cortical thickness and ventricular enlargement during normal aging in a sample of 525 neurologically and psychiatrically inconspicuous subjects (17-68 years old). MATERIALS AND METHODS: An automated segmentation algorithm was applied to assess cortical thickness and compared with conventional measurements of ventricular indices (ventricular body index (VBI), anterior horn index (AHI), and third ventricular width) as performed in clinical practice. Regression analysis was performed to elucidate the relationship between a decrease of the cortical mantle and increase in ventricular width with aging. RESULTS: Cortical thickness decreases with age (r = -0.49, P < 0.01; r = -0.502 in male and r = -0.461 in female subjects). Regarding the ventricular indices, we found a significant correlation with age for both the whole sample and the subdivision by gender. Cortical thickness and ventricular width are closely correlated (r = -0.43 in women, r = -0.468 in men, P < 0.001 each). The bandwidth of variance scales up with aging in all parameters. The results are discussed in terms of the underlying mechanisms of normal aging. CONCLUSION: Our findings suggest that a decrease in cortical thickness and increase in ventricular width occur with normal aging. The enlargement of the third ventricle correlates the most strongly with age.

Adolescent↗

PubMed2005

Regional impairment of cerebrovascular reactivity and BOLD signal in adults after stroke.

BACKGROUND AND PURPOSE: Comparative studies across populations using functional magnetic resonance imaging (fMRI) rely on a similar relationship between blood oxygen level-dependent (BOLD) signal and neural activity. However, in elderly and patients with cerebrovascular disease, impaired cerebrovascular dynamics and neurovascular coupling may explain differences in BOLD contrast across populations and brain regions. The purpose of the study was to determine whether poststroke patients have regional heterogeneities of cerebrovascular reactivity (CVR) and their potential influence on voxel-wise motor-related BOLD signal. METHODS: Using fMRI, 8 fully recovered patients from stroke in the frontal lobe without cortical lesion in the regions of interest located in the primary sensorimotor cortex (SMC), supplementary motor area (SMA), and cerebellum (CRB) were compared with 8 healthy subjects. Motor-related BOLD signal changes (%SC) were evaluated during simple unimanual and bimanual tasks, and CVR was evaluated during hyperventilation (HV). Analyses were performed using Lipsia software in SMC, SMA, and CRB. RESULTS: In controls, amplitudes of BOLD signal were symmetrical in all regions of interest during all motor tasks and HV. In patients, %SC was decreased in SMC and SMA of the lesioned hemisphere despite their apparent anatomical integrity for all tasks. Impaired CVR was a predictor of impaired motor-related BOLD response in the SMC during contralateral movements (beta=-1.87; R=-0.75; P=0.03). CONCLUSIONS: These preliminary findings suggest that CVR heterogeneities may account for task-related BOLD signal changes in patients after stroke.

Adult↗

PubMed2005

Morphometry demonstrates loss of cortical thickness in cerebral microangiopathy.

OBJECTIVE: To evaluate the role of MR morphometry in the characterization of cerebral microangiopathy (CMA) in relation to clinical and neuropsychological impairment. SUBJECTS AND METHODS: 3D MR images of 27 patients and 27 age-matched controls were morphometrically analysed for regional thickness. The normalized values were related to the patients' clinical and neuropsychological scores. The patients were categorised according to the amount of structural MR signal changes. A ventricle index reflecting internal atrophy was related to MR morphology and cortical thickness as an indicator for external atrophy. RESULTS: Cortical thickness was significantly reduced in the patients group (3.03 mm +/- 0.26 vs. 3.22 mm +/-0.13 in controls, p=0.001). The severest loss of cortical thickness occurred in severe CMA. Internal and external atrophy evolved in parallel and both showed a significant relationship with structural MR-abnormalities (p<0.05; r=-0.7; r=0.67; r=-0.74, respectively). Neuropsychological performance correlated strongly with the loss of cortical thickness. CONCLUSIONS: Cortical thickness was identified as the most sensitive parameter to characterize CMA. A strong correlation was found of morphometric parameters to the severity of CMA based on a score derived from T2-weighted MRI. The degree of cortical atrophy was directly related to the degree of neuropsychological impairment. Our findings suggest that the cortical thickness is a valid marker in the structural and clinical characterization of CMA.

Analysis of Variance↗

PubMed2005

The effect of esmolol on cerebral blood flow, cerebral vasoreactivity, and cognitive performance: a functional magnetic resonance imaging study.

BACKGROUND: Esmolol is often applied perioperatively to maintain stable hemodynamic conditions in neurosurgical patients. Little is known, however, about its effects on cerebral circulation. The authors employed functional magnetic resonance imaging based on blood oxygenation level-dependent contrast to explore the effect of esmolol on the human brain. The purpose of the study was to investigate the effect of esmolol on cerebral blood flow, cerebral vasoreactivity, and cognitive performance. METHODS: Ten healthy volunteers were investigated in two separate experimental sessions using functional magnetic resonance imaging. During the first experimental session, a hyperventilation task and a cognitive task, subjects had to perform both tasks twice, once after administration of an esmolol bolus of 1 mg/kg followed by a continuous infusion of 150 microg.kg.min and once without beta-blockade, in a random order. During the second experimental session subjects were scanned at resting state after administration of esmolol. Furthermore, the effect of the esmolol dose on hemodynamic changes caused by beta-adrenergic stimulation with orciprenaline was investigated. RESULTS: Esmolol decreased heart rate and blood pressure during the various experimental conditions and blunted the increase in heart rate and blood pressure caused by orciprenaline. Infusion of esmolol affects neither the blood oxygenation level-dependent contrast during the functional challenges nor the reaction times during the cognitive task. However, the esmolol bolus caused a brief blood oxygenation level-dependent contrast increase. CONCLUSION: The results indicate that effective beta-blockade with esmolol does not affect cerebral blood flow, cerebrovascular reactivity, or cognitive performance.

Adrenergic beta-Agonists↗

PubMed2003

Morphology-based cortical thickness estimation.

We describe a new approach to estimating the cortical thickness of human brains using magnetic resonance imaging data. Our algorithm is part of a processing chain consisting of a brain segmentation (skull stripping), as well as white and grey matter segmentation procedures. In this paper, only the grey matter segmentation together with the cortical thickness estimation is described. In contrast to many existing methods, our estimation method is voxel-based and does not use any surface meshes. While this fact poses a principal limit on the accuracy that can be achieved by our method, it offers tremendous advantages with respect to practical applicability. In particular, it is applicable to data sets showing severe cortical atrophies that involve areas of high curvature and extremely thin gyral stalks. In contrast to many other methods, it is entirely automatic and very fast with computation times of a few minutes. Our method has been used in two clinical studies involving a total of 27 patients and 23 healthy subjects.

Algorithms↗

PubMed2003

Determination of cerebrovascular reactivity by means of FMRI signal changes in cerebral microangiopathy: a correlation with morphological abnormalities.

BACKGROUND AND PURPOSE: A reduced cerebrovascular reactivity (CR) is a risk factor of cerebrovascular disease. In this study, we implemented a protocol to assess CR by means of functional MRI (fMRI) using hyperventilation. SUBJECTS AND METHODS: In 5 patients with cerebral microangiopathy (CM/lacunar infarction and white matter degeneration), 6 healthy elderly subjects (age-matched control), and 6 young healthy subjects, the CR in response to hyperventilation was evaluated by fMRI using gradient echo-planar Imaging. The percentage signal change normalized by end-tidal CO(2) value was measured in various brain regions. RESULTS: All subjects performed hyperventilation well without adverse reaction and significant gross motion. Patients with CM showed significant qualitative and quantitative differences (p < 0.05) as compared to controls. The volume of gray matter showing significant CR was significantly reduced in patients: by 40% in comparison to the age-matched elderly control group and by 60% when compared with the young controls. The CR impairment was most pronounced in the frontal cortices with a drastically reduced magnitude of the magnetic resonance (MR) signal change in the patients (-0.62 +/- 0.2% in patients versus -2.0 +/- 0.36% in age-matched controls, p < 0.0001). A strong relation was evident between the fMRI-based CR reduction in patients with CM and the individual severity of structural MR abnormalities (p = 0.002). CONCLUSION: This study demonstrates that fMRI-based signal changes in response to hyperventilation reliably reflect cerebral vasoreactivity. The protocol is feasible in healthy young and elderly controls and patients with CM. Quantitative and qualitative assessment of the signal decrease in the T(2)-weighted MR sequence and coregistration with individual anatomical data allow the generation of an individual cerebral vasoreactivity map. Future research will address the effect of CR reduction on neuropsychological parameters in patients with CM.

Adult↗

PubMed2002

Do quiescent arachnoid cysts alter CNS functional organization?: A fMRI and morphometric study.

OBJECTIVE: To investigate whether congenital and clinically quiescent arachnoid cysts (AC) in the left temporal fossa alter the functional organization of adjacent cortices. METHODS: fMRI mapping was applied in five right-handed asymptomatic patients to determine the functional organization of language. Moreover, morphometry was performed in each patient to gain the size of cortical surface areas and cortical thickness values in the neighboring brain adjacent to the AC and explicitly in the left opercular region. RESULTS: Four patients showed a clear left hemisphere language dominance regardless of the cyst size; a mixed laterality of language organization was found in the remaining patient. An interesting dissociation of morphometric data was assessed when comparing strongly language-related cortices in the inferior frontal gyrus with the entire neighboring cortices. Morphometry in the neighboring brain regions of the AC showed 1) overall reduced cortical surface areas and 2) a decrease in cortical thickness compared to the homologous right side. However, the surface area of the fronto-opercular region in the left inferior frontal gyrus-i.e., the pars triangularis and the pars opercularis-was larger on the left as compared to the right side. Both structures have earlier been identified to represent the morphologic substrate of language dominance in the left hemisphere. CONCLUSION: Arachnoid cysts do not disturb the normal asymmetry of hemisphere language organization despite delicate locations adjacent to the left inferior frontal gyrus.

Adult↗

PubMed2002

Non-invasive regime for language lateralization in right- and left-handers by means of functional MRI and dichotic listening.

Language lateralization was assessed by two independent functional techniques, fMRI and a dichotic listening test (DLT), in an attempt to establish a reliable and non-invasive protocol of dominance determination. This should particularly address the high intraindividual variability of language lateralization and allow decision-making in individual cases. Functional MRI of word classification tasks showed robust language lateralization in 17 right-handers and 17 left-handers in terms of activation in the inferior frontal gyrus. The DLT was introduced as a complementary tool to MR mapping for language dominance assessment, providing information on perceptual language processing located in superior temporal cortices. The overall agreement of lateralization assessment between the two techniques was 97.1%. Conflicting results were found in one subject, and diverging indices in ten further subjects. Increasing age, non-familial sinistrality, and a non-dominant writing hand were identified as the main factors explaining the observed mismatch between the two techniques. This finding stresses the concept of an intrahemispheric distribution of language function that is obviously associated with certain behavioral characteristics.

Adult↗

PubMed2002

Characterization of cerebral microangiopathy using 3 Tesla MRI: correlation with neurological impairment and vascular risk factors.

PURPOSE: To investigate whether clinical and neuropsychological impairment in cerebral small-vessel disease (CSVD) can be evaluated by means of morphological magnetic resonance imaging (MRI). MATERIALS AND METHODS: MRI at 3 Tesla in T2- and T1-weighted sequences was evaluated in 44 patients with cerebral microangiopathy, and 30 patients with combined cerebral micro- and macroangiopathy. The MR characteristics were correlated to clinical data, attentional impairment, and the patients' individual vascular risk factor profiles. Fifteen healthy age-matched control subjects participated in the study to assess MR signal changes in nonhypertensive elderly subjects. RESULTS: Patients and normal controls differed significantly in the extent of MR signal changes. A close relation between age, obesity, hypertension, and MR signal abnormalities was evident in all patients. Patients with pure CSVD additionally showed an association between their MR-defined severity of disease and their degree of neurological impairment, and their vascular risk score. In contrast, attentional impairment did not relate to the MR-defined severity of CSVD. CONCLUSION: MR signal changes in CSVD show a close relationship to some risk factors of individual patients.

Analysis of Variance↗

PubMed2002

An investigation of functional and anatomical connectivity using magnetic resonance imaging.

This article examines functional and anatomical connectivity in healthy human subjects measured with magnetic resonance imaging methods. Anatomical connectivity in white matter is obtained from measurements of the diffusion tensor. A Monte-Carlo simulation determines the probability that a particle diffuses between two points, with the probability of a jump in a particular direction from a given voxel being based on the local value of the diffusion tensor components. Functional connectivity between grey matter pixels is assessed without recourse to a specific activation paradigm, by calculating the correlation coefficient between random fluctuations in the blood oxygenation level-dependent signal time course in different pixels. The methods are used to examine the anatomical and functional connectivities between crowns of adjacent gyri. A high functional connectivity was found between grey matter pixels, with white matter displaying only very low correlation. A comparison of the measurements of anatomical and functional connectivity found that there is no simple correlation between these measures, except that low values of functional connectivity were not found together with high values of anatomical connectivity. Furthermore pairs of regions situated around the central sulcus indicated a dependence of the two connectivity measures on each other. These results are in accordance with an interpretation that regions which are clearly directly linked by white matter fiber tracts should show high functional connectivity, but that the inverse need not be true as functional connectivity may also be indirectly mediated via more distant grey matter regions.

Algorithms↗