Joost P.A. Kuijer

Correlating the alpha rhythm to BOLD using simultaneous EEG/fMRI: Inter-subject variability

Simultaneous recording of electroencephalogram/functional magnetic resonance images (EEG/fMRI) was applied to identify blood oxygenation level-dependent (BOLD) changes associated with spontaneous variations of the alpha rhythm, which is considered the hallmark of the brain resting state. The analysis was focused on inter-subject variability associated with the resting state. Data from 7 normal subjects are presented. Confirming earlier findings, three subjects showed a negative correlation between the BOLD signal and the average power time series within the alpha band (8--12 Hz) in extensive areas of the occipital, parietal and frontal lobes. In small thalamic areas, the BOLD signal was positively correlated with the alpha power. For subjects 3 and 4, who displayed two different states during the data acquisition time, it was shown that the corresponding correlation patterns were different, thus demonstrating the state dependency of the results. In subject 5, the changes in BOLD were observed mainly in the frontal and temporal lobes. Subject 6 only showed positive correlations, thus contradicting the negative BOLD alpha power cortical correlations that were found in most subjects. Results suggest that the resting state varies over subjects and, sometimes, even within one subject. As the resting state plays an important role in many fMRI experiments, the inter-subject variability of this state should be addressed when comparing fMRI results from different subjects.

Quantification of regional contractile function after infarction: strain analysis superior to wall thickening analysis in discriminating infarct from remote myocardium

OBJECTIVES Using two-dimensional wall thickening (WT) (expressed as percentage) and strain analysis, regional contractile myocardial function was quantified and compared in 13 control subjects and 13 patients with a first myocardial infarction (MI). The findings in the patient group were related to global ventricular function and infarct size. BACKGROUND In patients with coronary artery disease, regions with dysfunctional myocardium cannot be differentiated easily from regions with normal function by planar WT analysis. Physiologic factors, in combination with limitations of conventional imaging techniques, affect the calculation of WT. Quantitative assessment of contractile function by magnetic resonance (MR) tissue tagging and strain analysis may be less affected by these factors. METHODS Two-dimensional regional WT and strain were calculated in three short-axis MR cine and tagged images, respectively. Left ventricular volumes and ejection fraction (EF) were obtained from a series of contiguous short-axis cine images. RESULTS In patients with infarct-related ventricles, WT and strain analysis both revealed reduced myocardial function, as compared with control subjects (p < 0.005 and p < 0.001, respectively). However, WT analysis yielded no significant regional differences in function between infarct-related and remote myocardium (p = 0.064), whereas strain analysis did (p < 0.005). For detecting dysfunctional myocardium of electrocardiographically and angiographically defined infarct areas, WT analysis had a sensitivity of 69% and a specificity of 92%, whereas strain analysis demonstrated a sensitivity of 92% and a specificity of 99%. The EF correlated with WT (r = 0.76, p < 0.005) and strain (r = 0.89, p < 0.001). CONCLUSIONS Two-dimensional strain analysis is more accurate than planar WT analysis in discriminating dysfunctional from functional myocardium, and it provides a strong correlation between regional myocardial and global ventricular function.

The hemodynamic response of the alpha rhythm: An EEG/fMRI study

EEG was recorded during fMRI scanning of 16 normal controls in resting condition with eyes closed. Time variations of the occipital alpha band amplitudes were correlated to the fMRI signal variations to obtain insight into the hemodynamic correlates of the EEG alpha activity. Contrary to earlier studies, no a priori assumptions were made on the expected shape of the alpha band response function (ARF). The ARF of different brain regions and subjects were explored and compared. It was found that: (1) the ARF of the thalamus is mainly positive. (2) The ARFs at the occipital and left and right parietal points are similar in amplitude and timing. (3) The peak time of the thalamus is a few seconds earlier than that of occipital and parietal cortex. (4) No systematic BOLD activity was found preceding the alpha band activity, although in the two subjects with the strongest alpha band power such correlation was present. (5) There is a strong and immediate positive correlation at the eyeball, and a strong negative correlation at the back of the eye. Furthermore, it was found that in one subject the cortical ARF was positive, contrary to the other subjects. Finally, a cluster analysis of the observed ARF, in combination with a Modulated Sine Model (MSM) fit to the estimated ARF, revealed that within the cortex the ARF peak time shows a spatial pattern that may be interpreted as a traveling wave. The spatial pattern of alpha band response function represents the combined effect of local differences in electrical alpha band activity and local differences in the hemodynamic response function (HRF) onto these electrical activities. To disentangle the contributions of both factors, more advanced integration of EEG inverse modeling and hemodynamic response modeling is required in future studies.

Cerebral blood flow measured with 3D pseudocontinuous arterial spin-labeling MR imaging in Alzheimer disease and mild cognitive impairment: a marker for disease severity.

PURPOSE To compare quantitative cerebral blood flow (CBF) values in patients with Alzheimer disease (AD), patients with mild cognitive impairment (MCI), and subjects with subjective complaints by using a whole-brain three-dimensional (3D) pseudocontinuous arterial spin-labeling (ASL) technique at 3.0 T. MATERIALS AND METHODS The local institutional review board approved the study. All subjects provided informed consent. Whole-brain 3D fast spin-echo pseudocontinuous ASL images were acquired at 3.0 T in 71 patients with AD (mean age, 65 years ± 7; 55% women), 35 patients with MCI (mean age, 65 years ± 8; 42% women), and 73 subjects with subjective complaints (mean age, 60 years ± 9; 39% women) who visited a memory clinic. Analyses were performed by using both uncorrected maps and maps corrected for partial volume effects. Regional CBF was compared by using analyses of variance; permutation tests were used for voxel-wise comparisons. Associations with cognition (Mini-Mental State Examination) were investigated by using linear regression analyses. All analyses were corrected for age and sex. RESULTS Uncorrected CBF was decreased in patients with AD compared with subjects with subjective complaints (27 mL/100 g/min ± 5 vs 33 mL/100 g/min ± 5; P < .001), with strongest reductions in the parietal lobes (22 mL/100 g/min ± 6 vs 30 mL/100 g/min ± 5; ie, decrease of 27%). Corrected cortical CBF showed similar results. In patients with MCI, CBF was decreased in the precuneus and the parietal and occipital lobes compared with subjects with subjective complaints. Voxel-wise comparisons confirmed the region of interest-based findings, showing the largest CBF differences in the precuneus and bilateral parietal cortex. Uncorrected and corrected cortical CBF were associated with cognition across diagnostic groups (β = 0.46 and β = 0.42, P < .001) and within the AD group (β = 0.41 and β = 0.42, P < .001). CONCLUSION CBF measured with 3D pseudocontinuous ASL MR imaging helps detect functional changes in the prodromal and more advanced stages of AD and is a marker for disease severity.

Steady-state free precession with myocardial tagging: CSPAMM in a single breathhold

A method is presented that combines steady‐state free precession (SSFP) cine imaging with myocardial tagging. Before the tagging preparation at each ECG‐R wave, the steady‐state magnetization is stored as longitudinal magnetization by an α/2 flip‐back pulse. Imaging is continued immediately after tagging preparation, using linearly increasing startup angles (LISA) with a rampup over 10 pulses. Interleaved segmented k‐space ordering is used to prevent artifacts from the increasing signal during the LISA rampup. First, this LISA‐SSFP method was evaluated regarding ghost artifacts from the steady‐state interruption by comparing LISA with an α/2 startup method. Next, LISA‐SSFP was compared with spoiled gradient echo (SGRE) imaging, regarding tag contrast‐to‐noise ratio and tag persistence. The measurements were performed in phantoms and in six subjects applying breathhold cine imaging with tagging (temporal resolution 51 ms). The results show that ghost artifacts are negligible for the LISA method. Compared to the SGRE reference, LISA‐SSFP was two times faster, with a slightly better tag contrast‐to‐noise. Additionally, the tags persisted 126 ms longer with LISA‐SSFP than with SGRE imaging. The high efficiency of LISA‐SSFP enables the acquisition of complementary tagged (CSPAMM) images in a single breathhold. Magn Reson Med 49:722–730, 2003.

Improved harmonic phase myocardial strain maps

Magnetic resonance tagging has proven a valuable tool in the quantification of myocardial deformation. However, time‐consuming postprocessing has discouraged the use of this technique in clinical routine. Recently, the harmonic phase (HARP) technique was introduced for automatic calculation of myocardial strain maps from tagged images. In this study, a comparison was made between HARP instantaneous strain maps calculated from single tagged images (SPAMM) and those calculated from subtracted tagged images (CSPAMM). The performance was quantified using simulated images of an incompressible cylinder in the ‘end‐systolic’ state with realistic image contrast and noise. The error in the second principal stretch ratio was 0.009 ± 0.032 (mean ± SD) for the SPAMM acquisition, and 0.007 ± 0.016 for CSPAMM at identical contrast‐to‐noise ratio. Furthermore, differences between the methods were illustrated with in vivo strain maps. Those calculated from CSPAMM images showed fewer artifacts and were less sensitive to the choice of cut‐off frequencies in the HARP band‐pass filter. A prerequisite for the method to become practical is that the CSPAMM images should be acquired in a single breathhold. Magn Reson Med 46:993–999, 2001.

Constant volume of the human lens and decrease in surface area of the capsular bag during accommodation: an MRI and Scheimpflug Study.

PURPOSE A change in surface area of the capsular bag and a change in volume of the lens can indicate whether a change in the shape of the lens during accommodation is due to the compressibility or the elasticity of the lens material. METHODS 3D magnetic resonance imaging (MRI) was used to image the complete shape of the lens in a group of five healthy subjects between 18 and 35 years of age. A parametric representation of the cross-sectional shape was fitted to the edges of the lens, which were determined with a Canny edge filter. Based on a partition of the lens into eight parts, the parametric shape makes it possible to calculate the mean cross-sectional area, the volume, and the surface area as a function of accommodation. Corrected Scheimpflug imaging was used to validate the results obtained with MRI. RESULTS No significant difference in central anterior and posterior radius of curvature and thickness was found between the MRI and Scheimpflug measurements. In accordance with the Helmholtz accommodation theory, a decrease in the anterior and posterior radius of curvature and equatorial diameter and an increase in lens thickness occurred with accommodation. During accommodation, the mean cross-sectional area increased and the surface area decreased. However, no significant change in lens volume was found. CONCLUSIONS The preservation of lens volume implies that the internal human lens material can be assumed to be incompressible and is undergoing elastic deformation. Furthermore, the change in surface area indicates that the capsular bag also undergoes elastic deformation.

Cerebral Blood Flow by Using Pulsed Arterial Spin-Labeling in Elderly Subjects with White Matter Hyperintensities

BACKGROUND AND PURPOSE: On MR imaging, white matter hyperintensities (WMH) on T2-weighted images are generally considered as a surrogate marker of ischemic small vessel disease in elderly subjects. Pulsed arterial spin-labeling (PASL) is a noninvasive MR perfusion-weighted technique. We hypothesized that elderly subjects with diffuse confluent WMH should have lower cerebral blood flow (CBF) measurements than subjects with punctiform or beginning confluent WMH. MATERIALS AND METHODS: MR images of 21 subjects (13 women; mean age, 76 years; SD, 5), stratified for the degree of WMH, from a single center within the multinational Leukoaraiosis and Disability (LADIS) study, were investigated. CBF images were obtained by means of quantitative imaging of perfusion by using a single-subtraction second version, with thin-section TI periodic saturation PASL. Values of cortical gray matter, subcortical (including white matter and deep gray matter), and global CBF were calculated. CBF measurements of subjects with diffuse confluent WMH (n = 7) were compared with those of subjects with punctiform or beginning confluent WMH (n = 14). RESULTS: Subjects with diffuse confluent WMH were found to have approximately 20% lower mean global CBF (43.5 mL/100 mL/min; SD, 6.3) than subjects with punctiform or beginning confluent WMH (57.9 mL/100 mL/min; SD, 8.6; P < .01), as well as approximately 20% lower mean subcortical (P < .01) and cortical gray matter CBF (P < .05). CONCLUSION: PASL revealed a significant reduction of CBF measurements in elderly subjects with diffuse confluent WMH.

Multicontrast MR imaging at 7T in multiple sclerosis: highest lesion detection in cortical gray matter with 3D-FLAIR

BACKGROUND AND PURPOSE: 7T MR imaging has led to improved detection and classification of cortical MS lesions, mainly based on T2*-weighted gradient-echo sequences. Depiction of cortical GM by using the recommended MS imaging protocol has not yet been investigated at 7T. We aimed to investigate prospectively which recommended sequence for clinical use has the highest value at 7T, in terms of GM and WM lesion detection. MATERIALS AND METHODS: Thirty-seven patients with MS (mean age, 43.8 years; 25 women) and 7 healthy controls (mean age, 40.4 years; 5 women) underwent multicontrast 7T MR imaging including the recommended clinical 2D-T2WI, 3D-T1WI, 3D-FLAIR, and GM-specific 3D-DIR. Lesions were scored and categorized anatomically by 3 raters, in consensus. The value of sequences was evaluated lesion-wise and patient-wise (Wilcoxon signed-rank test). RESULTS: At 7T, 3D-FLAIR detected the highest number of total cortical GM lesions (217), 89% more than 3D-DIR and 87% and 224% more than 2D-T2WI and 3D-T1WI. Patient-wise analysis showed that this difference between 3D-FLAIR and 3D-DIR was statistically significant (P < .04), and most pronounced for the number of mixed lesions (P < .03). 3D-FLAIR also detected the highest number of total WM lesions (2605), but the difference with 3D-DIR and 3D-T1WI was not significant. CONCLUSIONS: When using recommended clinical sequences at 7T, the best way to detect cortical GM lesions is with 3D-FLAIR and not by GM-specific 3D-DIR or by conventional 2D-T2WI and 3D-T1WI sequences.

Three-Dimensional Myocardial Strains at End-Systole and During Diastole in the Left Ventricle of Normal Humans

This paper presents the three-dimensional strains in the normal human left ventricle (LV) at end-systole and during diastole. Magnetic resonance tissue tagging was used to measure strain in the left-ventricular heart wall in 10 healthy volunteers aged between 28 and 61 years. The three-dimensional motion was calculated from the displacement of marker points in short- and long-axis cine images, with a time resolution of 30 msec. Homogeneous strain analysis of small tetrahedrons was used to calculate deformation in 18 regions of the LV over a time span of 300 msec starting at end systole. End-systolic radial strain was largest near the heart base, and circumferential and longitudinal strains were largest near the apex. During diastole, the circumferential-longitudinal shear strain (associated with LV torsion) was found to recover earlier than the axial strains. Assessment of three-dimensional diastolic strain is possible with MR tagging. Comparison of patient strain against normal strain may permit early detection of regional diastolic dysfunction.