Safety of a dedicated brain MRI protocol in patients with a vagus nerve stimulator

Although implanted metallic devices constitute a relative contraindication to magnetic resonance imaging (MRI) scanning, the safety of brain imaging in a patient with a vagus nerve stimulator (VNS) is classified as “conditional,” provided that specific manufacturer guidelines are followed when a transmit and receive head coil is used at 1.5 or 3.0 Tesla. The aim of this study was to evaluate the safety of performing brain MRI scans in patients with the VNS. From September 2009 until November 2011, 101 scans were requested in 73 patients with the VNS in The Netherlands. Patients were scanned according to the manufacturer's guidelines. No patient reported any side effect, discomfort, or pain during or after the MRI scan. In one patient, a lead break was detected based on device diagnostics after the MRI‐scan. However, because no system diagnostics had been performed prior to MR scanning in this patient, it is unclear whether MR scanning was responsible for the lead break. The indication for most scans was epilepsy related. Twenty‐six scans (26%) were part of a (new) presurgical evaluation and could probably better have been performed prior to VNS implantation. Performing brain MRI scans in patients with an implanted VNS is safe when a modified MRI protocol is followed.     

Evaluation of regional cortical blood flow by thermal diffusion using a Peltier stack

The possibility of quantitative evaluation of cerebral blood flow (CBF) by thermal diffusion has been reported, when the thermal gradient was created by a Peltier stack. We already described the linear relationship between the CBF and the inverse of thermal gradient elsewhere when the CBF measured by hydrogen clearance (Hydrogen CBF) was compared to the values estimated by thermal diffusion. In this paper, the correlation of linear relationship between the thermal CBF and hydrogen CBF in each animal was first investigated. Secondary, the possibility of in vitro calibration for quantitative evaluation was discussed. Two kinds of probes were manufactured. One was treated not to leak the heat from the Peltier stack except the sensors for the experimental or intraoperative use, and the other was not treated to minimize the size of probe for the long-term use by implantation into the subdural space. When the thermal CBF was compared to hydrogen CBF in each of 3 cats, a linear relationship was obtained in each and the values showing gradient and constant of the regression line were similar in each cat. Moreover, a good linear relationship was also observed when all measurements in 3 cats were included. These results suggested that there is no difference between each animal in the relationship of thermal and hydrogen CBF when the same probe is employed. In addition, the probe can be characterized with two values, and these are gradient and constant of the linear relationship. The fact that the blood flow is proportional to the heat conductivity indicates that the heat conductivity of some material is equivalent to some CBF value in the brain tissue.(ABSTRACT TRUNCATED AT 250 WORDS)     

Assessment of gastric volume changes with sonometry compared with barostat

AIM: The aim was to investigate the validity of sonometry on the assessment of gastric volumes in comparison with gastric barostat. METHOD: Six dogs were implanted with gastric serosal electrodes, sonometric sensors, and a gastric cannula. Experiments were performed to assess sensor distance when an intragastric balloon was inflated with different volumes, after a meal with or without a balloon, and with gastric electrical stimulation. RESULTS: (i) The distance measured using sonometry was reproducible and stable, and there was a correlation between sensor distance and the gastric volume measured with barostat. (ii) Simultaneous recordings by sonometry and barostat showed a similar postprandial response, while the postprandial increase of the sensor distance was much smaller without the balloon (3.2+/-0.2 mm vs 9.7+/-1.5 mm, P<0.02). (iii) The sensor distance was increased with gastric electrical stimulation. CONCLUSIONS: Sonometry is able to detect gastric volume changes as validated by gastric perturbations with distensions, food ingestion and electrical stimulation. The postprandial increase in gastric volume measured by sonometry with barostat balloon is greater because of the presence of the intragastric balloon.     

Physical modeling of pulse artefact sources in simultaneous EEG/fMRI

The collection of electroencephalography (EEG) data during simultaneous functional magnetic resonance imaging (fMRI) is impeded by large artefacts in the EEG recordings, with the pulse artefact (PA) being particularly challenging because of its persistence even after application of artefact correction algorithms. Despite several possible causes of the PA having been hypothesized, few studies have rigorously quantified the contributions from the different putative sources. This article presents analytic expressions and simulations describing two possible sources of the PA corresponding to different movements in the strong static field of the MR scanner: cardiac‐pulse‐driven head rotation and blood‐flow‐induced Hall voltages. Models of head rotation about a left–right axis and flow in a deep artery running in the anterior–posterior direction reproduced properties of the PA including the left/right spatial variation of polarity. Of these two sources, head rotation was shown to be the most likely source of the PA with simulated magnitudes of >200 μV being generated at 3 T, similar to the in vivo PA magnitudes, for an angular velocity of just 0.5°/s. Smaller artefact voltages of less than 10 μV were calculated for flow in a model artery with physical characteristics similar to the internal carotid artery. A deeper physical understanding of the PA is a key step in working toward production of higher fidelity EEG/fMRI data: analytic expressions for the artefact voltages can guide a redesign of the wiring layout on EEG caps to minimize intrinsic artefact pickup, while simulated artefact maps could be incorporated into selective filters. Hum Brain Mapp, 2010. © 2009 Wiley‐Liss, Inc.     

Combined diffusion-weighted and perfusion-weighted flow heterogeneity magnetic resonance imaging in acute stroke

BACKGROUND AND PURPOSE: The heterogeneity of microvascular flows is known to be an important determinant of the efficacy of oxygen delivery to tissue. Studies in animals have demonstrated decreased flow heterogeneity (FH) in states of decreased perfusion pressure. The purpose of the present study was to assess microvascular FH changes in acute stroke with use of a novel perfusion-weighted MRI technique and to evaluate the ability of combined diffusion-weighted MRI and FH measurements to predict final infarct size. METHODS: Cerebral blood flow, FH, and plasma mean transit time (MTT) were measured in 11 patients who presented with acute (<12 hours after symptom onset) stroke. Final infarct size was determined with follow-up MRI or CT scanning. RESULTS: In normal brain tissue, the distribution of relative flows was markedly skewed toward high capillary flow velocities. Within regions of decreased cerebral blood flow, plasma MTT was prolonged. Furthermore, subregions were identified with significant loss of the high-flow component of the flow distribution, thereby causing increased homogeneity of flow velocities. In parametric maps that quantify the acute deviation of FH from that of normal tissue, areas of extreme homogenization of capillary flows predicted final infarct size on follow-up scans of 10 of 11 patients. CONCLUSIONS: Flow heterogeneity and MTT can be rapidly assessed as part of a routine clinical MR examination and may provide a tool for planning of individual stroke treatment, as well as in targeting and evaluation of emerging therapeutic strategies.     

Inter‐subject alignment of MEG datasets in a common representational space

Pooling neural imaging data across subjects requires aligning recordings from different subjects. In magnetoencephalography (MEG) recordings, sensors across subjects are poorly correlated both because of differences in the exact location of the sensors, and structural and functional differences in the brains. It is possible to achieve alignment by assuming that the same regions of different brains correspond across subjects. However, this relies on both the assumption that brain anatomy and function are well correlated, and the strong assumptions that go into solving the under‐determined inverse problem given the high‐dimensional source space. In this article, we investigated an alternative method that bypasses source‐localization. Instead, it analyzes the sensor recordings themselves and aligns their temporal signatures across subjects. We used a multivariate approach, multiset canonical correlation analysis (M‐CCA), to transform individual subject data to a low‐dimensional common representational space. We evaluated the robustness of this approach over a synthetic dataset, by examining the effect of different factors that add to the noise and individual differences in the data. On an MEG dataset, we demonstrated that M‐CCA performs better than a method that assumes perfect sensor correspondence and a method that applies source localization. Last, we described how the standard M‐CCA algorithm could be further improved with a regularization term that incorporates spatial sensor information. Hum Brain Mapp 38:4287–4301, 2017. © 2017 Wiley Periodicals, Inc.     

Targeting the subthalamic nucleus for deep brain stimulation: technical approach and fusion of pre- and postoperative MR images to define accuracy of lead placement

OBJECTIVES: To define the role of magnetic resonance imaging (MRI) and intraoperative electrophysiological recording in targeting the subthalamic nucleus (STN) in Parkinson's disease and to determine accuracy of electrode placement. PATIENTS AND METHODS: We implanted 54 electrodes into the STN in 27 patients. Target planning was done by coordinate guidelines and visualising the STN on MRI and defined in relation to the mid-point of the AC-PC line. Intraoperative microelectrode recording was used. We adjusted electrode positions for placement in the centre of the STN electrical activity and verified this on postoperative MRI in 16 cases, which were fused to the preoperative images to measure actual error in electrode placement in the three axes. RESULTS: Based on coordinate calculation and MRI localisation, the mean of the target was 11.5 mm lateral, 2.5 mm posterior and 4.1 mm inferior to the mid-point of the AC-PC line. Fifty good electrophysiological recordings of the STN (average length 4.65 mm) were achieved and target point adjusted in 90% of lead placements. The mean of the final target after electrophysiological correction was 11.7 mm lateral, 2.1 mm posterior, and 3.8 mm inferior to the mid-point. The distance from the centre of the electrode artefact to the final target used after electrophysiological recording on the fused images was 0.48 mm, 0.69 mm, and 2.9 mm in the x, y, and z axes, respectively. No postoperative MRI related complication was observed. CONCLUSION: Both direct visualisation of the STN on MRI and intraoperative electrophysiological recording are important in defining the best target. Individual variations exist in the location of the STN target. Fewer tracks were required to define STN activity on the side operated first. Our current stereotactic method of electrode placement is relatively accurate.     

A voice-detecting sensor and a scanning keyboard emulator to support word writing by two boys with extensive motor disabilities

The present study assessed the use of a voice-detecting sensor interfaced with a scanning keyboard emulator to allow two boys with extensive motor disabilities to write. Specifically, the study (a) compared the effects of the voice-detecting sensor with those of a familiar pressure sensor on the boys' writing time, (b) checked which of the sensors the boys preferred, and (c) conducted a social validation assessment of the boys' performance with the two sensors, employing psychology students as raters. The difference in the boys' overall mean writing time per letter across sensors was, by the end of the study, about 1.5s. This difference favored the pressure sensor for one of the boys and the voice-detecting sensor for the other boy. Both boys showed preference for the voice-detecting sensor. Moreover, the psychology students involved in the social validation assessment indicated that such sensor was more satisfactory, suitable, and educationally relevant than the pressure sensor, and represented the solution that they as raters supported more.     

An electronic device for artefact suppression in human local field potential recordings during deep brain stimulation

The clinical efficacy of high-frequency deep brain stimulation (DBS) for Parkinson's disease and other neuropsychiatric disorders likely depends on the modulation of neuronal rhythms in the target nuclei. This modulation could be effectively measured with local field potential (LFP) recordings during DBS. However, a technical drawback that prevents LFPs from being recorded from the DBS target nuclei during stimulation is the stimulus artefact. To solve this problem, we designed and developed 'FilterDBS', an electronic amplification system for artefact-free LFP recordings (in the frequency range 2-40 Hz) during DBS. After defining the estimated system requirements for LFP amplification and DBS artefact suppression, we tested the FilterDBS system by conducting experiments in vitro and in vivo in patients with advanced Parkinson's disease undergoing DBS of the subthalamic nucleus (STN). Under both experimental conditions, in vitro and in vivo, the FilterDBS system completely suppressed the DBS artefact without inducing significant spectral distortion. The FilterDBS device pioneers the development of an adaptive DBS system retroacted by LFPs and can be used in novel closed-loop brain-machine interface applications in patients with neurological disorders.     

Simultaneous EEG and functional MRI of epileptic activity: a case report.

OBJECTIVES: Attempts to localize the source of epileptic activity by linking electroencephalographic (EEG) abnormalities to blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) signal alterations are hampered mainly by EEG distortions during MRI, subject motion, and unknown hemodynamic response characteristics. METHODS: Using T2*-weighted echo-planar imaging at 2.0 T (2 s temporal resolution, 2 x 2 x 4 mm(3) spatial resolution), this work demonstrates strategies to alleviate some of these problems while studying a patient who had ideopathic generalized epilepsy with poly-spike and slow-wave complexes. RESULTS: Continuous EEG recordings during dynamic MRI (500 ms scanning, 1500 ms delay) and post-examination derivation of an EEG reference function for MRI analysis revealed positive BOLD MRI responses with temporal characteristics similar to those obtained for functional challenges. CONCLUSIONS: The ability to map focal epileptic activity and/or associated cognitive processing provides new potential for both epilepsy research and clinical patient management.     

Tomographic cerebral blood flow scanning in diagnosis of psychiatric disorders

The paper summarises the role of tomographic cerebral blood flow SPECT scanning in psychiatric diagnostics, its' physical and radiopharmaceutical basis, pathological physiology of cerebrovascular circulation in psychiatric disorders and interpretation of cerebral blood flow scanning results by the clinician. Cerebral blood flow scanning is, to some extent, a functional equivalent of CT/MRI scanning. In psychiatry cerebral blood flow SPECT scanning's basic application is the differentiation of dementia and cognitive impairment, in particular Alzheimer's disease, frontotemporal lobar degeneration and multi-infarct dementia. The other indications for brain SPECT scanning involve the organic brain lesions and medico-legal diagnostics, including the sequelae of cranio-cerebral trauma. Contraindications and economical aspects are underlined.     

植入式葡萄糖传感器膜材料壳聚糖与Nafion的组织相容性比较

背景：壳聚糖是天然高分子多糖，可单独或者与其他材料复合制作敷料、药物、基因载体、生物涂层、组织工程支架、传感器膜材料等。 目的：了解壳聚糖作为植入式葡萄糖传感器膜材料的组织相容性，并与Nafion膜进行对比。 方法：制备壳聚糖膜并对其理化性质进行表征，比较壳聚糖膜皮下植入与肌肉植入、Nafion膜肌肉植入的生物相容性。 结果与结论：壳聚糖膜的厚度、溶胀率、表观密度等理化参数可以通过浓度、铸膜液体积来控制；壳聚糖膜能生物降解，63 d皮下植入的降解率为(17.0±9.9)%，说明壳聚糖的体内降解速度较慢。壳聚糖膜皮下植入引起的炎症反应较肌肉植入重，63 d后形成的纤维包膜比肌肉植入要厚(P < 0.05)；肌肉植入Nafion与壳聚糖膜引起材料周围纤维包膜厚度差异无显著性意义(P > 0.05)，两者均在15 d以后趋于稳定。证明壳聚糖膜能生物降解，与Nafion膜均有较好的组织相容性。     

Effect of Fluosol on oxygen availability, regional cerebral blood flow, and infarct size in a model of temporary focal cerebral ischemia

Twenty-four cats had an intravenous infusion of either Fluosol or saline and then were subjected to 2 hours of middle cerebral artery occlusion. All the animals infused with Fluosol and one-half the animals infused with saline were ventilated with 100% O2. Tissue oxygen availability and regional cerebral blood flow were measured by platinum electrodes using direct voltage recordings for oxygen measurements and hydrogen clearance curves for measurements of cerebral blood flow. With 100% oxygenation tissue oxygen availability increased significantly in the Fluosol treated animals, however, during the time of ischemia oxygen availability decreased below baseline values to about an equal level whether the animals were treated with Fluosol or saline. Regional cerebral blood flow fell to a similar value in all groups during the time of occlusion. One hour after reperfusion blood flow increased considerably above baseline values in all groups and oxygen availability also increased in all groups but particularly in the Fluosol treated animals. Overall mortality and the size of infarction 1 week after the ischemic insult were not significantly different in the three groups. Mortality was directly related to the size of the infarct which, in turn, was related to the degree of ischemia during the time of occlusion.     

Bio-inspired sensorization of a biomechatronic robot hand for the grasp-and-lift task

It has been concluded from numerous neurophysiological studies that humans rely on detecting discrete mechanical events that occur when grasping, lifting and replacing an object, i.e., during a prototypical manipulation task. Such events represent transitions between phases of the evolving manipulation task such as object contact, lift-off, etc., and appear to provide critical information required for the sequential control of the task as well as for corrections and parameterization of the task. We have sensorized a biomechatronic anthropomorphic hand with the goal to detect such mechanical transients. The developed sensors were designed to specifically provide the information about task-relevant discrete events rather than to mimic their biological counterparts. To accomplish this we have developed (1) a contact sensor that can be applied to the surface of the robotic fingers and that show a sensitivity to indentation and a spatial resolution comparable to that of the human glabrous skin, and (2) a sensitive low-noise three-axial force sensor that was embedded in the robotic fingertips and showed a frequency response covering the range observed in biological tactile sensors. We describe the design and fabrication of these sensors, their sensory properties and show representative recordings from the sensors during grasp-and-lift tasks. We show how the combined use of the two sensors is able to provide information about crucial mechanical events during such tasks. We discuss the importance of the sensorized hand as a test bed for low-level grasp controllers and for the development of functional sensory feedback from prosthetic devices.     

超顺磁性氧化铁标记神经干细胞移植入局灶性脑缺血大鼠纹状体的MRI示踪及其对学习记忆的影响

目的 探讨以超顺磁性氧化铁（SPIO）标记的胎鼠神经干细胞（NSCs）移植入局灶性脑缺血大鼠纹状体的MRI示踪及其对学习与记忆的影响。方法 体外培养的胎鼠NSCs用Fe2O3-多聚左旋赖氨酸（Fe2O3-PLL）标记，普鲁士蓝和台盼蓝染色分别检测标记率和细胞活力。将大鼠随机分为A组（正常对照组）、B组（正常标记NSCs移植组）、C组（脑缺血组）、D组（标记NSCs移植组）、E组（未标记NSCs移植组）及F组（灭活标记NSCs移植组）。取C组、D组、E组和F组大鼠制备局灶性脑缺血模型；将标记及未标记的NSCs悬液及灭活的标记NSCs悬液分别定向注射于B组、D组、E组和F组大鼠左侧纹状体内；移植后3d、7d、2周、3周、4周，对A组、C组、D组和E组分别进行Y型电迷宫检测；对B组、D组和F组进行活体MRI示踪扫描；MRI扫描后的大鼠行脑组织切片普鲁士蓝染色，观察移植的NSCs分布。结果NSCs的FeO3-PLL标记率近100％，标记的NSCs细胞活力为95％。与C组比较，D组和E组移植后各时间点大鼠的学习与记忆能力明显改善（均P〈0.05）；MRI显示移植4周后D组移植区低信号影范围较大；脑组织切片可见移植的NSCs沿胼胝体向对侧迁移。结论 Fe2O3-PLL标记不影响NSCs活力；移植NSCs能改善脑缺血大鼠的学习与记忆功能；移植的NSCs可向病灶区迁移。     

Fast and effective removal of contamination from scalp electrical recordings

ObjectiveTo present a new, automated and fast artefact-removal approach which significantly reduces the effect of contamination in scalp electrical recordings.MethodWe used spectral and temporal characteristics of different sources recorded during a typical scalp electrical recording in order to improve a fast and effective artefact removal approach. Our experiments show that correlation coefficient and spectral gradient of brain components differ from artefactual components. We trained two binary support vector machine classifiers such that one separates brain components from muscle components, and the other separates brain components from mains power and environmental components. We compared the performance of the proposed approach with seven currently used alternatives on three datasets, measuring mains power artefact reduction, muscle artefact reduction and retention of brain neurophysiological responses.ResultsThe proposed approach significantly reduces the main power and muscle contamination from scalp electrical recording without affecting brain neurophysiological responses. None of the competitors outperformed the new approach.ConclusionsThe proposed approach is the best choice for artefact reduction of scalp electrical recordings. Further improvements are possible with improved component analysis algorithms.SignificanceThis paper provides a definitive answer to an important question: Which artefact removal algorithm should be used on scalp electrical recordings?     

Acoustic sensor for monitoring adhesion of Neuro-2A cells in real-time

Neuronal adhesion plays a fundamental role in growth, migration, regeneration and plasticity of neurons. However, current methods for studying neuronal adhesion cannot monitor this phenomenon quantitatively in real-time. In this work, we demonstrate the use of an acoustic sensor to measure adhesion of neuro-blastoma cells (Neuro-2A) in real-time. An acoustic sensor consisting of a quartz crystal sandwiched between gold electrodes was placed in a flow cell and filled with 600 microl of phosphate buffered saline (PBS). Two sets of in vitro experiments were performed using sensors that had uncoated gold electrodes and sensors that were coated with a known neuronal adhesion promoter (poly-l-lysine or PLL). The instantaneous resonant frequency and the equivalent motional resistance of the acoustic sensor were monitored every second. Cell Tracker was used to confirm neuronal adhesion to the surface. Addition of 10 microl of media and Neuro-2A cells into the above set-up elicited exponential changes in the resonant frequency and motional resistance of the quartz crystal with time to reach steady state in the range of 2-11 h. The steady-state change in resonant frequency in response to addition of neurons was linearly related to the number of Neuro-2A cells added (R2=0.94). Acoustic sensors coated with the adhesion promoter, PLL showed a much higher change in resonant frequency for approximately the same number of neurons. We conclude that the acoustic sensor has sufficient sensitivity to monitor neuronal adhesion in real-time. This has potential applications in the study of mechanisms of neuron-substrate interactions and the effect of molecular modulators in the extra cellular matrix.     

Sensor noise suppression

We present a method to remove the effects of sensor-specific noise in multiple-channel recordings such as magnetoencephalography (MEG) or electroencephalography (EEG). The method assumes that every source of interest is picked up by more than one sensor, as is the case with systems with spatially dense sensors. To reduce noise, each sensor signal is projected on the subspace spanned by its neighbors and replaced by its projection. In this process, components specific to the sensor (typically wide-band noise and/or 'glitches') are eliminated, while sources of interest are retained. Evaluation with real and simulated MEG signals shows that the method removes sensor-specific noise effectively, without removing or distorting signals of interest. It complements existing noise-reduction methods that target environmental or physiological noise.     

纳米磁化标记神经干细胞的MRI大鼠活体示踪实验研究

目的:探讨用MRI活体示踪移植磁化标记神经干细胞在创伤性脑损伤模型大鼠脑内迁移和分布的可行性。方法:建立大鼠脑部左侧半球脑损伤模型。2周后将磁化标记胚胎神经干细胞立体定向移植入大鼠脑部右侧半球。在移植后1、3d及1、2周分别行大鼠头部MRI。结果:移植后行头颅MRI可见移植部位FSET2 WI和GRET2 序列呈环形低信号。实验组大鼠头颅MRI脑内有一低信号线,指向对侧脑挫伤部位。结论:用MRI活体示踪移植磁化标记神经干细胞在TBI模型大鼠脑内迁移和分布是可行的。     

fMRI activation in continuous and spike-triggered EEG-fMRI studies of epileptic spikes

PURPOSE: To evaluate functional magnetic resonance imaging (fMRI) with simultaneous EEG for finding metabolic sources of epileptic spikes. To find the localizing value of activated regions and factors influencing fMRI responses. METHODS: Patients with focal epilepsy and frequent spikes were subjected to spike-triggered or continuous fMRI with simultaneous EEG. Results were analyzed in terms of fMRI activation, concordance with the location of EEG spiking and anatomic MRI abnormalities, and other EEG and clinical variables. In four patients, results also were compared with those of intracerebral EEG. RESULTS: Forty-eight studies were performed on 38 patients. Seventeen studies were not analyzed, primarily because no spikes occurred during scanning. Activation was obtained in 39% of 31 studies, with an activation volume of 2.55 +/- 4.84 cc. Activated regions were concordant with EEG localization in almost all studies and confirmed by intracerebral EEG in four patients. Forty percent of patients without an MRI lesion showed activation; 37.5% of patients with a lesion had an activation; the activation was near or inside the lesion. Bursts of spikes were more likely to generate an fMRI response than were isolated spikes (76 vs. 11%; p < 0.05). CONCLUSIONS: Combining EEG and fMRI in focal epilepsy yields regions of activation that are presumably the source of spiking activity. These regions are highly linked with epileptic foci and epileptogenic lesions in a significant number of patients. Activation also is found in patients with no visible MRI lesion. Intracerebral recordings largely confirm that these activation regions represent epileptogenic areas. It is still unclear why many patients show no activation.