This is an observational study to evaluate the safety of magnetic resonance imaging (MRI) to localize subdural grids and depth electrodes in patients with refractory epilepsy using a 1.5 Tesla MR scanner.
We implemented an optimized MRI protocol providing adequate image quality for the assessment of subdural grids and depth electrodes, while minimizing the specific absorption rate (SAR). We reviewed all MRI studies performed in patients with subdural grids and depth electrodes between January 2010 and October 2018. Image quality was graded as acceptable or nonacceptable for the assessment of intracranial device positioning. We reviewed the medical record and any imaging obtained after intracranial implant removal for adverse event or complication occurring during and after the procedure.
Ninety-nine patients with refractory epilepsy underwent MRI scans using a magnetization-prepared rapid acquisition of gradient echo sequence and a transmit-receive head coil with depth electrodes and subdural grids in place. Two patients underwent two separate depth electrode implantations for a total of 101 procedures and MRI scans. No clinical adverse events were reported during or immediately after imaging. Image quality was graded as acceptable for 97 MRI scans. Review of follow-up CT and MRI studies after implant removal, available for 70 patients, did not demonstrate unexpected complications in 69 patients.
In our experience, a low SAR MRI protocol can be used to safely localize intracranial subdural grids and depth electrode in patients with refractory epilepsy.
In our experience, a low SAR MRI protocol can be used to safely localize intracranial subdural grids and depth electrode in patients with refractory epilepsy.
Cognitive impairment is a critical health problem in the elderly population. Research has shown that patients with mild cognitive impairment (MCI) may develop dementia in later years. Therefore, early identification of MCI could allow for interventions to help delay the progression of this devastating disease. Our objective in this study was to detect the early presence of MCI in elderly patients via neuroimaging and dual-task performance.
Brain MRI scans from 21 older adult volunteers, including cognitively healthy adults (HA, n = 9, age = 68-79 years) and mild cognitively impaired (MCI, n = 12, age = 66-92 years) were analyzed using automatic segmentation techniques. Regional volume, surface area, and thickness measures were correlated with simultaneous performance of motor and cognitive tasks (dual-task) within a novel upper-extremity function (UEF) test, using multivariate analysis of variance models.
We found significant associations of dual-task performance with volume of five cortical brain regiossociation between atrophy of these brain structures and compromised dual-task performance among the MCI group.De novo, heterozygous, loss-of-function variants were identified in Pou domain, class 4, transcription factor 1 (POU4F1) via whole-exome sequencing in four independent probands presenting with ataxia, intention tremor, and hypotonia. POU4F1 is expressed in the developing nervous system, and **** homozygous for null alleles of Pou4f1 exhibit uncoordinated movements with newborns being unable to successfully right themselves to feed. Head magnetic resonance imaging of the four probands was reviewed and multiple abnormalities were noted, including significant cerebellar vermian atrophy and hypertrophic olivary degeneration in one proband. Transcriptional activation of the POU4F1 p.Gln306Arg protein was noted to be decreased when compared with wild type. These findings suggest that heterozygous, loss-of-function variants in POU4F1 are causative of a novel ataxia syndrome.Speech understanding in noisy situations is compromised in old age. https://www.selleckchem.com/products/BEZ235.html This study investigated the energetic and informational masking components of multi-talker babble noise and their influence on neural tracking of the speech envelope in a sample of healthy older adults. Twenty-three older adults (age range 65-80 years) listened to an audiobook embedded in noise while their electroencephalogram (EEG) was recorded. Energetic masking was manipulated by varying the signal-to-noise ratio (SNR) between target speech and background talkers and informational masking was manipulated by varying the number of background talkers. Neural envelope tracking was measured by calculating temporal response functions (TRFs) between speech envelope and EEG. Number of background talkers, but not SNR modulated the amplitude of an earlier (around 50 ms time lag) and a later (around 300 ms time lag) peak in the TRFs. Selective attention, but not working memory or peripheral hearing additionally modulated the amplitude of the later TRF peak. Finally, amplitude of the later TRF peak was positively related to accuracy in the comprehension task. The results suggest that stronger envelope tracking is beneficial for speech-in-noise understanding and that selective attention is an important ability supporting speech-in-noise understanding in multi-talker scenes.
Premature ventricular contractions (PVCs) may be found in any stage of arrhythmogenic right ventricular cardiomyopathy (ARVC) and have been associated with the risk of sustained ventricular tachycardia (VT).
To investigate the role of PVC ablation in ARVC patients.
We studied consecutive ARVC patients who underwent PVC ablation due to symptomatic high PVC burden. Mean daily PVC burden and antiarrhythmic drug (***) use were assessed before and after the procedure. Complete long-term success was defined as more than 80% reduction in PVC burden off of membrane-active AADs.
Eight patients (37 ± 15 years; 4 males) underwent PVC ablation. The mean daily PVC burden before ablation ranged from 5.4% to 24.8%. A total of 7 (87.5%) patients underwent epicardial ablation. Complete acute elimination of PVCs was achieved in 4 (50%) patients (no complications). The mean daily PVC burden variation ranged from an 87% reduction to a 26% increase after the procedure. Over a median follow-up of 345 days (range 182-3004 days), only one (12.
This is an observational study to evaluate the safety of magnetic resonance imaging (MRI) to localize subdural grids and depth electrodes in patients with refractory epilepsy using a 1.5 Tesla MR scanner.
We implemented an optimized MRI protocol providing adequate image quality for the assessment of subdural grids and depth electrodes, while minimizing the specific absorption rate (SAR). We reviewed all MRI studies performed in patients with subdural grids and depth electrodes between January 2010 and October 2018. Image quality was graded as acceptable or nonacceptable for the assessment of intracranial device positioning. We reviewed the medical record and any imaging obtained after intracranial implant removal for adverse event or complication occurring during and after the procedure.
Ninety-nine patients with refractory epilepsy underwent MRI scans using a magnetization-prepared rapid acquisition of gradient echo sequence and a transmit-receive head coil with depth electrodes and subdural grids in place. Two patients underwent two separate depth electrode implantations for a total of 101 procedures and MRI scans. No clinical adverse events were reported during or immediately after imaging. Image quality was graded as acceptable for 97 MRI scans. Review of follow-up CT and MRI studies after implant removal, available for 70 patients, did not demonstrate unexpected complications in 69 patients.
In our experience, a low SAR MRI protocol can be used to safely localize intracranial subdural grids and depth electrode in patients with refractory epilepsy.
In our experience, a low SAR MRI protocol can be used to safely localize intracranial subdural grids and depth electrode in patients with refractory epilepsy.
Cognitive impairment is a critical health problem in the elderly population. Research has shown that patients with mild cognitive impairment (MCI) may develop dementia in later years. Therefore, early identification of MCI could allow for interventions to help delay the progression of this devastating disease. Our objective in this study was to detect the early presence of MCI in elderly patients via neuroimaging and dual-task performance.
Brain MRI scans from 21 older adult volunteers, including cognitively healthy adults (HA, n = 9, age = 68-79 years) and mild cognitively impaired (MCI, n = 12, age = 66-92 years) were analyzed using automatic segmentation techniques. Regional volume, surface area, and thickness measures were correlated with simultaneous performance of motor and cognitive tasks (dual-task) within a novel upper-extremity function (UEF) test, using multivariate analysis of variance models.
We found significant associations of dual-task performance with volume of five cortical brain regiossociation between atrophy of these brain structures and compromised dual-task performance among the MCI group.De novo, heterozygous, loss-of-function variants were identified in Pou domain, class 4, transcription factor 1 (POU4F1) via whole-exome sequencing in four independent probands presenting with ataxia, intention tremor, and hypotonia. POU4F1 is expressed in the developing nervous system, and mice homozygous for null alleles of Pou4f1 exhibit uncoordinated movements with newborns being unable to successfully right themselves to feed. Head magnetic resonance imaging of the four probands was reviewed and multiple abnormalities were noted, including significant cerebellar vermian atrophy and hypertrophic olivary degeneration in one proband. Transcriptional activation of the POU4F1 p.Gln306Arg protein was noted to be decreased when compared with wild type. These findings suggest that heterozygous, loss-of-function variants in POU4F1 are causative of a novel ataxia syndrome.Speech understanding in noisy situations is compromised in old age. https://www.selleckchem.com/products/BEZ235.html This study investigated the energetic and informational masking components of multi-talker babble noise and their influence on neural tracking of the speech envelope in a sample of healthy older adults. Twenty-three older adults (age range 65-80 years) listened to an audiobook embedded in noise while their electroencephalogram (EEG) was recorded. Energetic masking was manipulated by varying the signal-to-noise ratio (SNR) between target speech and background talkers and informational masking was manipulated by varying the number of background talkers. Neural envelope tracking was measured by calculating temporal response functions (TRFs) between speech envelope and EEG. Number of background talkers, but not SNR modulated the amplitude of an earlier (around 50 ms time lag) and a later (around 300 ms time lag) peak in the TRFs. Selective attention, but not working memory or peripheral hearing additionally modulated the amplitude of the later TRF peak. Finally, amplitude of the later TRF peak was positively related to accuracy in the comprehension task. The results suggest that stronger envelope tracking is beneficial for speech-in-noise understanding and that selective attention is an important ability supporting speech-in-noise understanding in multi-talker scenes.
Premature ventricular contractions (PVCs) may be found in any stage of arrhythmogenic right ventricular cardiomyopathy (ARVC) and have been associated with the risk of sustained ventricular tachycardia (VT).
To investigate the role of PVC ablation in ARVC patients.
We studied consecutive ARVC patients who underwent PVC ablation due to symptomatic high PVC burden. Mean daily PVC burden and antiarrhythmic drug (AAD) use were assessed before and after the procedure. Complete long-term success was defined as more than 80% reduction in PVC burden off of membrane-active AADs.
Eight patients (37 ± 15 years; 4 males) underwent PVC ablation. The mean daily PVC burden before ablation ranged from 5.4% to 24.8%. A total of 7 (87.5%) patients underwent epicardial ablation. Complete acute elimination of PVCs was achieved in 4 (50%) patients (no complications). The mean daily PVC burden variation ranged from an 87% reduction to a 26% increase after the procedure. Over a median follow-up of 345 days (range 182-3004 days), only one (12.
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