NeuroImage
-
Primary dysmenorrhea (PDM, menstrual pain without pelvic abnormality) is the most common gynecological disorder for women in the reproductive age. It is characterized by cramping pain and enhanced pain sensitivity during the menstruation period. PDM has been associated with peripheral and central sensitization. ⋯ These results show that ongoing menstrual pain in PDM is accompanied by abnormal brain metabolism. Disinhibition of thalamo-orbitofrontal-prefrontal networks may contribute to the generation of pain and hyperalgesia in PDM possibly by maintaining spinal and thalamic sensitization while increasing negative affect. Excessive excitatory input during menstrual pain may induce compensatory inhibitory mechanism in several somatic sensorimotor regions.
-
DBS depends on precise placement of the stimulating electrode into an appropriate target region. Image-based (direct) targeting has been limited by the ability of current technology to visualize DBS targets. We have recently developed and employed a Fast Gray Matter Acquisition T1 Inversion Recovery (FGATIR) 3T MRI sequence to more reliably visualize these structures. ⋯ The FGATIR scans allowed for localization of the thalamus, striatum, GPe/GPi, RN, and SNr and displayed sharper delineation of these structures. The FGATIR also revealed features not visible on other scan types: the internal lamina of the GPi, fiber bundles from the internal capsule piercing the striatum, and the boundaries of the STN. We hope that use of the FGATIR to aid initial targeting will translate in future studies to faster and more accurate procedures with consequent improvements in clinical outcomes.
-
To determine prospectively if qualitative and quantitative diffusion tensor imaging (DTI) metrics of white matter integrity are better than conventional magnetic resonance imaging (MRI) metrics for discriminating cerebellar diseases. ⋯ Qualitative and quantitative reductions in DTI metrics of white matter integrity in the cerebellar peduncles correlated better to clinical features of patients with sporadic and hereditary ataxias than conventional structural MRI measures of pontocerebellar atrophy.
-
Although the blood oxygenation level-dependent (BOLD) contrast is widely used in functional MRI (fMRI), its spatial specificity is compromised by the diversity of the participating vasculature, including large draining veins. Previous studies have shown that an alternative contrast mechanism based on functional changes of the apparent diffusion coefficient (ADC) can be sensitized to small vessels more closely tied to the sites of neural activity. ⋯ Our results show that, by using optimal parameters, the functional ADC changes are significantly higher in the middle cortical layers, whereas the BOLD signal changes are higher at the cortical surface and vary much less significantly across the cortex. These results are in good agreement with previous studies performed in anesthetized cats at 9.4 T and demonstrate the improved spatial specificity of the functional ADC contrast as compared to the BOLD contrast.
-
The combination of electromagnetic (EM) navigation with intraoperative fluoroscopic images has the potential to create the ideal environment for spinal surgical applications. This technology enhances standard intraoperative fluoroscopic information for localization of the pedicle entry point and trajectory and may be an effective alternative to other image-guided surgery (IGS) systems. This study was performed to assess the accuracy and time efficiency (placement and fluoroscopy) using EM navigation versus conventional fluoroscopy in the placement of pedicle guide-wires. ⋯ There were no significant differences in the proportion of pedicle, vertebral body, or facet joint breaches. A higher proportion of ideal trajectories was achieved in the EM group. Therefore, we have shown that an EM IGS system can assist the spine surgeon in minimally invasive pedicle screw insertion by providing high-accuracy K-wire placement with a significant reduction in fluoroscopy time.