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Biomedical subjects

S K Holland

Publications and source records attributed to S K Holland.

At least 19 recordsLinked to original sources

Functional magnetic resonance imaging reveals atypical language organization in children following perinatal left middle cerebral artery stroke.

We used verb generation and story listening tasks during fMRI to study language organization in children (7, 9 and 12 years old) with perinatal left MCA infarctions. Healthy, age-matched comparison children (n = 39) showed activation in left Broca's area during the verb generation task; in contrast, stroke subjects showed activation either bilaterally or in the right hemisphere homologue during both tasks. In Wernicke's area, comparison subjects showed left lateralization (verb generation) and bilateral activation (L > R) (story listening). Stroke subjects instead showed bilateral or right lateralization (verb generation) and bilateral activation (R > L) (story listening). Language is distributed atypically in children with perinatal left hemisphere stroke.

Brain Mapping↗

Normative pediatric brain data for spatial normalization and segmentation differs from standard adult data.

Spatial normalization and morphological studies of pediatric brain imaging data based on adult reference data may not be appropriate due to the developmental differences between the two populations. In this study, we set out to create pediatric templates and a priori brain tissue data from a large collection of normal, healthy children to compare it to standard adult data available within a widely used imaging software solution (SPM99, WDOCN, London, UK). Employing four different processing strategies, we found considerable differences between our pediatric data and the adult data. We conclude that caution should be used when analyzing pediatric brain data using adult a priori information. To assess the effects of using pediatric a priori brain information, the data obtained in this study is available to the scientific community from our website (www.irc.cchmc.org).

Adolescent↗

Functional magnetic resonance imaging in pediatrics.

Functional magnetic resonance imaging (fMRI) allows non-invasive assessment of human brain function in vivo by detecting blood flow differences. In this review, we want to illustrate the background and different aspects of performing functional magnetic resonance imaging (fMRI) in the pediatric age group. An overview over current and future applications of fMRI will be given, and typical problems, pitfalls, and benefits of doing fMRI in the pediatric age group are discussed. We conclude that fMRI can successfully be applied in children and holds great promise for both research and clinical purposes.

Attention Deficit Disorder with Hyperactivity↗

Age-related changes in regional activation during working memory in young adults: an fMRI study.

Several lines of evidence suggest that working memory diminishes with advancing age, with concomitant functional changes in associated neuronal activation in frontal cortical regions and hippocampi. No studies to date, however, have investigated age-related changes in neuronal activation in these regions during performance of a working memory task in younger subjects without working memory deficits. In this study, we utilized fMRI to examine changes in brain activation with increasing age in specific regions-of-interest. Eleven healthy subjects performed a "two-back" working memory task and a matched "zero-back" attention task during fMRI. There was no association between age and performance on either task. Left hippocampal activation significantly correlated with age (P = 0.01) and right hippocampal activation showed an association with age (P = 0.09). This study demonstrates that increasing age is associated with increased activation of hippocampus even in young patients without evidence of working memory deficits and suggests that functional changes may precede overt evidence of working memory deficits.

Adult↗

Changes in neuronal activation with increasing attention demand in healthy volunteers: an fMRI study.

Several lines of evidence suggest that structures involved in mediating attention differentially respond to increasing processing demand. Investigation of differences in neuronal activation, however, has been complicated by methodological inconsistencies and concomitant discrepancies in degree of difficulty and subject effort between disparate tasks. In this study, we utilized fMRI to compare neural activation patterns associated with two related attention tasks associated with different degrees of processing load while controlling for degree of performance difficulty. Healthy volunteers performed two continuous performance tasks, utilizing an identical pairs paradigm (CPT-IP) and a matched simple number recognition paradigm with degraded stimuli (CPT-DS) during a single fMRI scan. Degree of stimulus resolution degradation in the latter CPT was designed to equalize degree of performance difficulty between the two tasks. CPT-IP and CPT-DS were both associated with activation of frontal, limbic, subcortical, and sensory integratory structures. CPT-IP administration was associated with significantly greater activation of left dorsolateral prefrontal cortex, bilateral posterior temporal cortex, bilateral putamen, and thalamus. This study demonstrates both that differing attention tasks are associated with a high degree of functional overlap and that increasing processing demand is associated with increased activation of specific portions of attentional networks.

Adult↗

Normal fMRI brain activation patterns in children performing a verb generation task.

Although much is known concerning brain-language relations in adults, little is known about how these functions might be represented during the developmental period. We report results from 17 normal children, ages 7-18 years, who have successfully completed a word fluency paradigm during functional magnetic resonance imaging at 3 Tesla. Regions of activation replicate those reported for adult subjects. However, a statistically significant association between hemispheric lateralization of activation and age was found in the children. Specifically, although most subjects at all ages showed left hemisphere dominance for this task, the degree of lateralization increased with age. This study demonstrates that fMRI can reveal developmental shifts in the pattern of brain activation associated with semantic language function.

Adolescent↗

Three-dimensional MR microscopy of a transgenic mouse model of dilated cardiomyopathy.

BACKGROUND: Scientists are now able to alter the genetics of vertebrate embryos routinely to produce animal models of human developmental diseases. However, our understanding of structural changes in these animal models is limited by current methodologies. Histological techniques, although providing great anatomic detail, display only "static" data (one time point only) in two dimensions. Ultrasound may be used to generate continuous time course data, but is limited by interobserver variation, limited acoustic windows, and relatively low resolution. OBJECTIVE: To apply the high resolution, non-destructive, and three-dimensional acquisition capabilities of magnetic resonance (MR) microscopy to compare the hearts of normal mice versus an established transgenic mouse model of dilated cardiomyopathy. MATERIALS AND METHODS: Transgenic mice exhibiting dilated cardiomyopathy were developed via the introduction of a mutated, heart-specific gene (myosin light chain). Postmortem cardiac imaging was performed on the transgenic mice and normal controls. MR imaging was performed on a Bruker 3T imaging magnet using a custom radiofrequency coil following contrast perfusion of the atrial and ventricular chambers. Image resolution was 156 microm isotropic voxels. MR images were compared to gross pathologic specimens. Imaging data were post-processed using custom software to calculate the volumes of the atria and ventricles and to display the three-dimensional morphology of the chambers and myocardium. RESULTS: Of the seven mice scanned, four exhibited normal right atrial (average = 14.8 microl +/- 1.4), left atrial (average = 8.5 microl +/-0.3), right ventricular (average = 12.9 microl +/-2.7), and left ventricular (average 3.3 microl +/-0.5) volumes. Three mice exhibited dilatation of the right and left cardiac chambers (RA average = 23.9 microl +/-5.6; LA average = 15.9 microl +/-4.8; RV average = 32.5 microl +/- 6.8; LV average 24.0 microl +/-1.4). The gross morphology was verified upon autopsy of the animals and correlated with the animal's genotype. The differences in volumes between the normal and dilated cardiomyopathy mice were statistically significant (P values ranged from 0.001 to 0.024 for the different chambers). CONCLUSION: MR microscopy is a potentially useful tool for developmental biology research. The imaging of mouse hearts is feasible, and these methods provide quantitative and qualitative morphologic data of a mouse model of dilated cardiomyopathy not available using traditional methods.

Animals↗

MR imaging of murine arthritis using ultrasmall superparamagnetic iron oxide particles.

The objective of this work was to determine the ability of magnetic resonance (MR) imaging with ultrasmall superparamagnetic iron oxide (USPIO) particles to provide quantitative measures of inflammation in autoimmune arthritis. Mice were injected intravenously or intra-articularly with USPIO followed by magnetic resonance and histological assessment of the knee joint. Comparisons were made between MR microimages and histology in naïve mice and mice with collagen-induced arthritis.Following intravenous administration, accumulation of USPIO was observed in the popliteal lymph nodes, but not the joint. Administration of USPIO intra-articularly resulted in signal loss in the joint. The MR signal intensity could be quantified and correlated with iron staining in the synovial lining. A marked increase in USPIO uptake and a corresponding decrease in signal intensity were observed in arthritic, compared to naïve mice. Areas of focal signal loss corresponded to foci of iron staining by histology. These studies may provide a basis for the clinical application of USPIO in arthritis for assessing disease severity and monitoring response to therapy.

Animals↗

Functional magnetic resonance imaging of the pediatric swallow: imaging the cortex and the brainstem.

OBJECTIVE: To design and implement a functional magnetic resonance imaging (fMRI) protocol to investigate the cortical and brainstem patterns of activity in children with regard to the act of swallowing. STUDY DESIGN: Pilot study to assess the clinical feasibility of the project. METHODS: Using a 3T Bruker Biospec 30/60 MRI scanner, images were obtained using the Behavior Interleaved Gradient/Blood Oxygen Level Dependent (BIG-BOLD) image acquisition method. Initially, regions of interest (ROI) were developed to identify the mean time from the onset of a swallow to maximum cortical blood flow in the motor cortex. Using this data to design the BIG-BOLD acquisition method followed by postprocessing of the data, images from two volunteer adults and four volunteer children were obtained. RESULTS: The average time from the onset of a swallow to maximum cortical blood flow was 6 to 8 seconds. Regions of cortical activity include pre- and post-central gyrus (Brodmann's areas 3 and 4), superior motor cortex (B.A. 24), insula, inferior frontal cortex (B.A. 44 and 45), Heschl gyrus (B.A. 41 and 42), putamen, globus pallidus, and the superior temporal gyrus (B.A. 38). Of particular note is the first mapping of the functional activity of swallowing at the level of the brainstem; activity was seen in the region of the nucleus ambiguous. CONCLUSIONS: fMRI provides a novel means of studying the central processes of both normal swallowing and its various pathologic forms in children. Further understanding of how a child coordinates a swallow and how this coordination can be altered at the level of the brainstem and cortex may aid in the development of novel rehabilitative strategies.

Adolescent↗

Simultaneous correction of ghost and geometric distortion artifacts in EPI using a multiecho reference scan.

A computationally efficient technique is described for the simultaneous removal of ghosting and geometrical distortion artifacts in echo-planar imaging (EPI) utilizing a multiecho, gradient-echo reference scan. Nyquist ghosts occur in EPI reconstructions because odd and even lines of k-space are acquired with opposite polarity, and experimental imperfections such as gradient eddy currents, imperfect pulse sequence timing, B0 field inhomogeneity, susceptibility, and chemical shift result in the even and odd lines of k-space being offset by different amounts relative to the true center of the acquisition window. Geometrical distortion occurs due to the limited bandwidth of the EPI images in the phase-encode direction. This distortion can be problematic when attempting to overlay an activation map from a functional magnetic resonance imaging experiment generated from EPI data on a high-resolution anatomical image. The method described here corrects for geometrical distortion related to B0 inhomogeneity, gradient eddy currents, radio-frequency pulse frequency offset, and chemical shift effect. The algorithm for removing ghost artifacts utilizes phase information in two dimensions and is, thus, more robust than conventional one-dimensional methods. An additional reference scan is required which takes approximately 2 min for a matrix size of 64 X 64 and a repetition time of 2 s. Results from a water phantom and a human brain at 3 T demonstrate the effectiveness of the method for removing ghosts and geometric distortion artifacts.

Algorithms↗

Perfusion imaging in the pediatric patient.

The prevalence of cerebrovascular disease in children is much higher than most clinicians and neuroradiologists suspect, when all primary and secondary causes are considered. Most signal alterations found on MR imaging in childhood central nervous system pathologic conditions result from causes other than a decrease in tissue perfusion. In addition to conventional MR imaging, the ability to assess changes in tissue water by diffusion imaging and tissue perfusion by perfusion-weighted imaging can prove useful to asses cerebral hemodynamics in various pathologic disorders. Exogenous contrast bolus dynamic perfusion-weighted imaging is especially useful in children to differentiate between ischemic injury and other conditions that may alter T2 relaxation, such as demyelination and edema. Perfusion imaging has proved to be a robust and valuable tool to assess the hemodynamic component in childhood CNS disease related to neoplasms and complications from their therapy, cerebrovascular occlusive disease, childhood CNS arteriopathies and trauma.

Cerebrovascular Circulation↗

Hypoglycemic brain injury: potentiation from respiratory depression and injury aggravation from hyperglycemic treatment overshoots.

Hypoglycemia can cause brain dysfunction, brain injury, and death. The present study seeks to broaden current information regarding mechanisms of hypoglycemic brain injury by investigating a novel etiology. The cat's high resistance to brain injury from hypoglycemia suggested that additional influences such as respiratory depression might play a facilitating role. Three groups of cats were exposed to fasting and insulin-induced hypoglycemia (HG; n = 6), euglycemic respiratory depression (RD; n = 5), and combined hypoglycemic respiratory depression (HG/RD; n = 10). The HG animals were maintained at <1.5 mmol (mean 1 mmol) serum glucose concentration for 2 to 6.6 hours. The respiratory depression was associated with PaO2 and PaCO2 values of approximately 50 mm Hg for 1 hour and of approximately 35 and approximately 75 mm Hg, respectively, for the second hour. Magnetic resonance diffusion-weighted imaging estimated brain energy state before, during, and after hypoglycemia. The hypoglycemic respiratory depression exposures were terminated either to euglycemia (n = 4) or to hyperglycemia (n = 6). Brain injury was assessed after 5 to 7 days of survival. Cats exposed to hypoglycemia alone maintained unchanged diffusion coefficients; that is, they lacked evidence of brain energy failure and all six remained brain-intact. Only 1 of 5 euglycemic RD but 10 of 10 HG/RD cats developed brain damage (HG and RD vs. HG/RD, P < 0.01). This difference in brain injury rates suggests injury potentiation by hypoglycemia and respiratory depression acting together. Three injury patterns emerged, including activation of microglia, selective neuronal necrosis, and laminar cortical necrosis. Widespread activation of microglia suggesting damage to neuronal cell processes affected all damaged brains. Selective neuronal necrosis affecting the cerebral cortex, hippocampus, and basal ganglia was observed in all but one case. Instances of laminar cortical necrosis were limited to cats exposed to hypoglycemic respiratory depression treated with hyperglycemia. Thus, treatment with hyperglycemia compared with euglycemia after hypoglycemic respiratory depression exposures significantly increased the brain injury scores (24 +/- 6 vs. 13 +/- 2 points; P < 0.05). This new experimental hypoglycemia model's contribution lies in recognizing additional factors that critically define the occurrence of hypoglycemic brain injury.

Animals↗

NMR relaxation times in the human brain at 3.0 tesla.

Relaxation time measurements at 3.0 T are reported for both gray and white matter in normal human brain. Measurements were made using a 3.0 T Bruker Biospec magnetic resonance imaging (MRI) scanner in normal adults with no clinical evidence of neurological disease. Nineteen subjects, 8 female and 11 male, were studied for T1 and T2 measurements, and 7 males were studied for T2. Measurements were made using a saturation recovery method for T1, a multiple spin-echo experiment for T2, and a fast low-angle shot (FLASH) sequence with 14 different echo times for T2. Results of the measurements are summarized as follows. Average T1 values measured for gray matter and white matter were 1331 and 832 msec, respectively. Average T2 values measured for gray matter and white matter were 80 and 110 msec, respectively. The average T2 values for occipital and frontal gray matter were 41.6 and 51.8 msec, respectively. Average T2 values for occipital and frontal white matter were 48.4 and 44.7 msec, respectively. ANOVA tests of the measurements revealed that for both gray and white matter there were no significant differences in T1 from one location in the brain to another. T2 in occipital gray matter was significantly higher (0.0001 < P < .0375) than the rest of the gray matter, while T2 in frontal white matter was significantly lower (P < 0.0001). Statistical analysis of cerebral hemispheric differences in relaxation time measurements showed no significant differences in T1 values from the left hemisphere compared with the right, except in insular gray matter, where this difference was significant at P = 0.0320. No significant difference in T2 values existed between the left and right cerebral hemispheres. Significant differences were apparent between male and female relaxation time measurements in brain.

Adult↗

A position-sensitive superheated emulsion chamber for three-dimensional photon dosimetry.

A position-sensitive detector chamber is introduced for the three-dimensional (3D) dosimetry of photon-emitting brachytherapy sources. The detector is based on an extremely fine suspension of monochloropentafluoroethane droplets emulsified in a gel. The droplets are highly superheated at room temperature and their evaporation can be triggered by photon interactions, leading to the formation of microscopic bubbles. Thus, when photon-emitting brachytherapy sources are inserted into the detector, bubble distributions form around them, enabling visualization of the radiation field. The tissue-equivalent emulsifier gel is highly viscous and keeps the bubbles immobilized at the location of their formation. Bubbles can then be imaged by nuclear magnetic resonance or optical scanning techniques. After the imaging, the detector can be pressurized in order to recondense the bubbles to the liquid phase. In a few minutes, the device is annealed and ready to be used again for repeated measurements improving the counting statistics. The photon sensitivity of the monochloropentafluoroethane droplets was determined with highly filtered, quasi-monochromatic x-ray beams and radionuclide gamma sources. The air-kerma response presents a broad maximum at low energies, due to the relatively high effective atomic number of the halocarbon molecule. A prototype chamber was built and successfully tested: bubble distributions deriving from the insertion of a 125I source were imaged by means of a slice-selective 3D gradient-echo technique. These experiments confirm the potential and viability of this new approach to 3D photon dosimetry.

Brachytherapy↗

Magnetic resonance imaging of microbubbles in a superheated emulsion chamber for brachytherapy dosimetry.

This paper describes development of magnetic resonance imaging (MRI) techniques for three-dimensional (3D) imaging of a position-sensitive detector for brachytherapy dosimetry. The detector is a 0.5 l chamber containing an emulsion of halocarbon-115 droplets in a tissue-equivalent glycerin-based gel. The halocarbon droplets are highly superheated and expand into vapor microbubbles upon irradiation. Brachytherapy sources can be inserted into the superheated emulsion chamber to create distributions of bubbles. Three-dimensional MRI of the chamber is then performed. A 3D gradient-echo technique was optimized for spatial resolution and contrast between bubbles and gel. Susceptibility gradients at the interfaces between bubbles and gel are exploited to enhance contrast so microscopic bubbles can be imaged using relatively large voxel sizes. Three-dimensional gradient-echo images are obtained with an isotropic resolution of 300 microns over a 77 mm x 77 mm x 9.6 mm field-of-view in an imaging time of 14 min. A post-processing technique was developed to semi-automatically segment the bubbles from the images and to assess dose distributions based on the measured bubble densities. Relative dose distributions are computed from MR images for a 125I brachytherapy source and the results compare favorably to relative radial dose distributions calculated as recommended by Task Group 43 of the American Association of Physicists in Medicine.

Algorithms↗

Proton MR spectroscopic characteristics of pediatric pilocytic astrocytomas.

PURPOSE: We report the common characteristics of juvenile pilocytic astrocytomas revealed by proton MR spectroscopy. METHODS: Eight children with pilocytic astrocytomas were studied with proton MR spectroscopy. The selected sampling volume was approximately 4 cm3, obtained from solid tumor. To localize the sampling volume, we used point-resolved spectroscopy (PRESS) and stimulated-echo acquisition mode (STEAM) techniques to acquire long- and short-TE spectra, respectively. Spectra from PRESS and STEAM sequences were processed using Lorentzian-to-Gaussian transformation and exponential apodization, respectively. For PRESS (2000/270) spectra, peaks of creatine, choline, N-acetylaspartate (NAA), and lactate resonances were integrated; for STEAM (2000/20) spectra, we measured the amplitude of the peaks at 3.2, 2.0, 1.3 and 0.9 ppm. RESULTS: An elevated lactate doublet was observed in the PRESS spectra. The choline/NAA ratio was 3.40. The amplitude ratios of the lipid pattern (0.9, 1.3 and 2.0 ppm) to choline were all below one. CONCLUSION: Despite the benign histology of the tumor, which generally lacks necrosis, a lactate signal was detected in all eight patients studied. A dominant lipid pattern was not observed.

Aspartic Acid↗

19F NMR monitoring of in vivo tumor metabolism after biochemical modulation of 5-fluorouracil by the uridine phosphorylase inhibitor 5-benzylacyclouridine.

A uridine phosphorylase inhibitor, 5-benzylacyclouridine (BAU), has been utilized as biochemical modulator of 5-fluorouracil (5-FU) anti-tumor activity in a murine tumor model. The effect of BAU on 5-FU metabolism has been evaluated using in vitro and in vivo 19F NMR spectroscopy. The analysis of the NMR data revealed an increased formation and retention of fluorouracil nucleotides and fluorouridine in colon 38 tumors treated with the regimen containing BAU and a reduction in 5-FU catabolites (alpha-fluoro-beta-ureidopropionic acid and alpha-fluoro-beta-alanine). In the normal tissues evaluated, the presence of BAU did not significantly alter the metabolism and presence of fluoropyrimidine species, indicating a more selective effect on tumor tissues. Therapy experiments on C57/BL6 mice bearing colon 38 tumor showed that the administration of 120 mg/kg BAU 30 min before 5-FU at 85 mg/kg, on a weekly basis, resulted in an increased antineoplastic effect compared to the same dose of 5-FU alone. A smaller dose of 5-FU (60 mg/kg) also administered 30 min after 120 mg/kg BAU caused a reduction in tumor growth similar to 5-FU alone. The addition of BAU to 5-FU (85 mg/kg) resulted in a slight increase, although statistically nonsignificant, in host toxicity without causing any toxic death during the chemotherapeutic treatment. 19F NMR spectroscopy is here shown to be a powerful technique to evaluate changes in the metabolism of fluoropyrimidines after the use of biochemical modulator and to allow a correlation between improved therapeutic response with the biochemical effects generated in tissues.

Animals↗

Imaging oxygen tension in liver and spleen by 19F NMR.

19F NMR imaging of the perfluorocarbon emulsion Fluosol has been used to study regional variations in oxygen tension in rat liver and spleen. We have used the linear dependence of spin lattice relaxation rate (1/T1) on the partial oxygen pressure (pO2) of Fluosol to determine the oxygen tension in the reticuloendothelial system (RES) of the liver and spleen of male Sprague-Dawley rats which have received serial infusions of Fluosol. Oxygen tension maps have been computed from 19F NMR images using a calibration obtained for Fluosol in vitro at 37.5 degrees C. The spatial resolution of the pO2 maps computed using this technique is 1.2 x 1.2 mm in 3-mm thick slices. Calculations from in vivo pO2 maps indicate an average change in the median pO2 of the RES from 118 to 80 mmHg for (n = 7) rats breathing 95% O2 and 5% CO2 (carbogen) and air, respectively.

Animals↗