Corticospinal Tract (CST) reconstruction based on fiber orientation distributions(FODs) tractography

The Corticospinal Tract (CST) is a part of pyramidal tract (PT), and it can innervate the voluntary movement of skeletal muscle through spinal interneurons (the 4th layer of the Rexed gray board layers), and anterior horn motorneurons (which control trunk and proximal limb muscles). Spinal cord injury (SCI) is a highly disabling disease often caused by traffic accidents. The recovery of CST and the functional reconstruction of spinal anterior horn motor neurons play an essential role in the treatment of SCI. However, the localization and reconstruction of CST are still challenging issues; the accuracy of the geometric reconstruction can directly affect the results of the surgery. The main contribution of this paper is the reconstruction of the CST based on the fiber orientation distributions (FODs) tractography. Differing from tensor-based tractography in which the primary direction is a determined orientation, the direction of FODs tractography is determined by the probability. The spherical harmonics (SPHARM) can be used to approximate the efficiency of FODs tractography. We manually delineate the three ROIs (the posterior limb of the internal capsule, the cerebral peduncle, and the anterior pontine area) by the ITK-SNAP software, and use the pipeline software to reconstruct both the left and right sides of the CST fibers. Our results demonstrate that FOD-based tractography can show more and correct anatomical CST fiber bundles

Meyer's loop tractography for image-guided surgery depends on imaging protocol and hardware

Introduction Surgical resection is an effective treatment for temporal lobe epilepsy but can result in visual field defects. This could be minimized if surgeons knew the exact location of the anterior part of the optic radiation (OR), the Meyer's loop. To this end, there is increasing prevalence of image-guided surgery using diffusion MRI tractography. Despite considerable effort in developing analysis methods, a wide discrepancy in Meyer's loop reconstructions is observed in the literature. Moreover, the impact of differences in image acquisition on Meyer's loop tractography remains unclear. Here, while employing the same state-of-the-art analysis protocol, we explored the extent to which variance in data acquisition leads to variance in OR reconstruction. Methods Diffusion MRI data were acquired for the same thirteen healthy subjects using standard and state-of-the-art protocols on three scanners with different maximum gradient amplitudes (MGA): Siemens Connectom (MGA = 300 mT/m); Siemens Prisma (MGA = 80 mT/m) and GE Excite-HD (MGA = 40 mT/m). Meyer's loop was reconstructed on all subjects and its distance to the temporal pole (ML-TP) was compared across protocols. Results A significant effect of data acquisition on the ML-TP distance was observed between protocols (p < .01 to 0.0001). The biggest inter-acquisition discrepancy for the same subject across different protocols was 16.5 mm (mean: 9.4 mm, range: 3.7–16.5 mm). Conclusion We showed that variance in data acquisition leads to substantive variance in OR tractography. This has direct implications for neurosurgical planning, where part of the OR is at risk due to an under-estimation of its location using conventional acquisition protocols

MR in vivo tractography for the reconstruction of cranial nerves course

Aim The aim of my Ph.D. was to implement a diffusion tensor tractography (DTT) pipeline to reconstruct cranial nerve I (olfactory) to study COVID-19 patients, and anterior optic pathway (AOP, including optic nerve, chiasm, and optic tract) to study patients with sellar/parasellar tumors, and with Leber’s Hereditary Optic Neuropathy (LHON). Methods We recruited 23 patients with olfactory dysfunction after COVID-19 infection (mean age 37±14 years, 12 females); 27 patients with sellar/parasellar tumors displacing the optic chiasm eligible for endonasal endoscopic surgery (mean age 53. ±16.4 years, 13 female) and 6 LHON patients (mutation 11778/MT-ND4, mean age 24.9±15.7 years). Sex- and age-matched healthy control were also recruited. In LHON patients, optical coherence tomography (OCT) was performed. Acquisitions were performed on a clinical high field 3-T MRI scanner, using a multi-shell HARDI (High Angular Resolution Diffusion Imaging) sequence (b-values 0-300-1000-2000 s/mm2, 64 maximum gradient directions, 2mm3 isotropic voxel). DTT was performed with a multi-tissue spherical deconvolution approach and mean diffusivity (MD) DTT metrics were compared with healthy controls using an unpaired t-test. Correlations of DTT metrics with clinical data were sought by regression analysis. Results In all 23 hypo/anosmic patients with previous COVID-19 infection the CN I was successfully reconstructed with no DTT metrics alterations, thus suggesting the pathogenetic role of central olfactory cortical system dysfunction. In all 27 patients with sellar/parasellar tumors the AOP was reconstructed, and in 11/13 (84.7%) undergoing endonasal endoscopic surgery the anatomical fidelity of the reconstruction was confirmed; a significant decrease in MD within the chiasma (p<0.0001) was also found. In LHON patients a reduction of MD in the AOP was significantly associated with OCT parameters (p=0.036). Conclusions Multi-shell HARDI diffusion-weighted MRI followed by multi-tissue spherical deconvolution for the DTT reconstruction of the CN I and AOP has been implemented, and its utility demonstrated in clinical practice

사람에서 점멸광자극을 이용한 성공적인 감마뇌파동조 유도의 결정 요인

학위논문(박사) -- 서울대학교대학원 : 자연과학대학 뇌인지과학과, 2023. 2. 김기웅.Background and Objectives: Although gamma entrainment using flickering light stimulus (FLS) of 40Hz was effective in reducing pathologies and enhancing cognitive function in mouse models of Alzheimers disease (AD), its efficacy was controversial in AD patients. The conflicting results in AD patients may be attributable to a couple of key factors. First, the optimal parameters of FLS for gamma entrainment may be different between diurnal humans and nocturnal mice. Second, the response to optimal FLS may be different between AD patients due to inter-individual difference in the microstructural integrity of white matter (WM) tracts. This study aimed to find the optimal parameters (color, luminal intensity and flickering frequency) of FLS for entraining gamma rhythms in diurnal humans and to examine the effect of fractional anisotropy (FA) of WM tracts on the entrainment and propagation of gamma rhythms. Methods: We first investigated the optimal color (white, red, green, and blue), luminal intensity (10 cd/m2, 100 cd/m2, 400 cd/m2, and 700 cd/m2), and frequency (32 - 50 Hz) of FLS for entraining gamma rhythms in visual cortex using event-related desynchronization/event-related synchronization (ERD/ERS) and for propagating gamma rhythm entrained in visual cortex to other brain regions using spectral Granger Causality (sGC) in 16 cognitively normal young adults (24.0 ± 3.7 yrs) and 35 cognitively normal older adults (70.0 ± 2.4 yrs). We also examined the adverse effects of FLS in both younger and older adults. Then we examined the effect of the FA of posterior thalamic radiations on the ERS of gamma rhythms entrained in visual cortex and that of and middle and superior longitudinal fasciculi on the sGC of the connectivity from visual cortex to temporal and frontal regions in 26 cognitively normal older adults using analysis of variance and linear regression analyses. Results: The FLSs using the lights of longer wavelengths such as white (p < 0.05) and red (p < 0.01) entrained and propagated gamma rhythms better than those of shorter wavelengths such as green and blue. The FLSs using stronger lights such as 700 cd/m2 (p < 0.001) and 400 cd/m2 (p < 0.01) entrained and propagated gamma rhythms better than weaker lights of 100 cd/m2 and 10 cd/m2. The FLSs flickering at 34-38 Hz were best for entraining and propagating gamma rhythm in younger adults (entrainment at Pz: p < 0.05, propagation: p < 0.05) while those flickering at 32-34 Hz were best for older adults (entrainment at Pz: p < 0.05, propagation: p < 0.001). In older adults, white FLSs of 700 cd/m2 flickering at 32–34 Hz entrained the gamma rhythms most strongly at visual cortex (p < 0.05) and propagated them most widely to other brain regions (p < 0.05). The FLSs of 700 cd/m2 flickering at 32 Hz entrained gamma rhythms worse in the visual cortex of the older adults whose FA of left posterior thalamic radiation was low than in those whose FA of left posterior thalamic radiation was not low (p 0.05), and their severity of adverse effects was milder than that in younger adults. Conclusion: In diurnal human, optimal flickering frequency for gamma entrainment was about 20% lower than that in nocturnal mice. Although the FLSs of stronger luminal intensity and the longer wavelength may entrain gamma rhythms better, they may result in more and severe adverse effects. In older adults, white or red FLSs of 700 cd/m2 flickering at 32-34 Hz may be optimal for entraining and propagating gamma rhythms. Since gamma rhythms were not properly entrained by optimal FLS in the older adults whose microstructural integrity of the white matter tracts was impaired, the integrity of the white matter tracts involved in the entrainment and propagation of gamma rhythm should be measured and considered in determining the indication of gamma entrainment using visual stimulation.연구배경 및 목적: 40Hz 점멸광자극 (flickering light stimulation, FLS)을 사용한 감마뇌파동조는 알츠하이머병 (Alzheimers disease, AD) 모델 쥐에서 병리를 감소시키고 인지 기능을 향상시키는 데 효과적이었지만 알츠하이머병 환자에서는 그 효능에 대해 논란이 있다. 알츠하이머병 환자의 상충되는 결과는 몇 가지 주요 요인에 기인할 수 있다. 첫째, 감마뇌파동조를 위한 FLS의 최적 매개변수는 일주 동물인 인간과 야행성 동물인 쥐 간에 다를 수 있다. 둘째, 최적의 FLS에 대한 반응은 백질 (white matter, WM) 섬유 다발 미세 구조적 무결성의 개인 간 차이로 인해 알츠하이머병 환자 간에 다를 수 있다. 이 연구는 일주 동물인 인간에서 감마뇌파를 동반하기 위한 FLS의 최적 매개변수 (색상, 밝기 및 점멸 주파수)를 찾고 감마뇌파의 동반 및 전파에 대한 백질 섬유 다발의 확산비등방성 (fractional anisotropy, FA)의 영향을 조사하는 것을 목표로 했다. 연구방법: 인지기능이 정상인 젊은 성인 16명과 노인 35명을 대상으로, 시각피질에 감마뇌파동조를 유도하고, 동조 된 시각피질의 감마뇌파를 다른 뇌 영역으로의 전파시킬 수 있는 FLS의 최적 색상 (백색, 적색, 녹색 및 청색), 밝기 (10 cd/m2, 100 cd/m2, 400 cd/m2 및 700 cd/m2) 및 점멸 주파수 (32-50 Hz)를 사건 관련 비 동기화/사건 관련 동기화 (event-related desynchronization/event-related synchronization, ERD/ERS)와 스펙트럼 그랜저 인과성 (spectral Granger Causality, sGC) 분석을 이용하여 조사했다. 아울러 젊은 성인과 노인에서 FLS의 부작용을 조사했다. 이어서 감마뇌파가 FLS에 의해 시각피질에 적절하게 동조 된 인지기능이 정상인 노인 26명을 대상으로, 시각피질에서 동조 된 감마뇌파의 ERS와 시각피질과 측두 및 전두 영역들 간 연결성인 sGC에 후방시상방사와 중간 및 상부 세로다발들의 확산비등방성이 미치는 영향을 회귀분석과 분산분석을 이용하여 조사했다. 연구결과: 사람에서는 백색 (p < 0.05) 및 적색 (p < 0.01)과 같은 장파장 FLS가 녹색 및 청색과 같은 단파장 FLS보다 감마뇌파동조를 더 강하게 유발하고, 동조 된 감마뇌파를 더 넓은 뇌 영역으로 전파시켰다. 또 700 cd/m2 (p < 0.001) 및 400 cd/m2 (p < 0.01)와 같은 강한 휘도 FLS는 100 cd/m2 및 10 cd/m2와 같은 약한 휘도 FLS보다 감마뇌파동조를 더 강하게 유발하고, 동조 된 감마뇌파를 더 넓은 뇌 영역으로 전파시켰다. 34-38 Hz에서 점멸하는 FLS는 젊은 성인에서 감마뇌파를 동반하고 전파하는 데 가장 효과적이었고 (Pz에서 동반: p < 0.05, 전파: p < 0.05) 32-34 Hz에서 점멸하는 FLS는 노인에게 가장 효과적이었다 (Pz에서 동반: p < 0.05, 전파: p < 0.001). 노인에서 32-34 Hz에서 점멸하는 700 cd/m2의 백색 FLS는 시각 피질에서 가장 강하게 감마뇌파를 동반하고 (p < 0.05) 다른 뇌 영역으로 가장 널리 전파했다 (p < 0.05). 32 Hz에서 점멸하는 700 cd/m2의 FLS는 좌후시상방사선의 FA가 낮지 않은 노인보다 낮은 노인에서 감마뇌파가 시각피질에 덜 동반된다 (p 0.05), 부작용의 심각성은 젊은 성인보다 경미했다. 결론: 주행성인 인간에서 감마 동조를 위한 최적의 점멸 주파수는 야행성 쥐보다 약 20% 낮았다. 더 강한 휘도와 더 긴 파장의 FLS가 감마뇌파를 더 잘 동조 시킬 수 있지만 더 크고 심각한 부작용을 초래할 수 있다. 노인의 경우 32-34 Hz에서 점멸하는 700 cd/m2의 백색 또는 적색 FLS가 감마뇌파를 동조하고 전파하는 데 최적일 수 있다. 감마뇌파는 백질 섬유 다발의 미세 구조적 무결성이 손상된 노인에서는 최적의 FLS에 의해 적절하게 동조 되지 않았기 때문에, 감마뇌파의 동조 및 전파와 관련된 백질 영역의 무결성은 시각적 자극을 사용하여 감마뇌파동조 적용을 결정할 때 측정되고 고려되어야 한다.1. Introduction 1 1.1. Background 1 1.2. Purpose 4 2. Methods 6 2.1. Study design 6 2.1.1. Study 1. Investigation on the optimal parameters of FLS for gamma entrainment in humans 6 2.1.2. Study 2. Investigation on the effect of WM microstructural integrity on the gamma entrainment by FLS in humans 7 2.2. Participants 7 2.2.1. Study 1. Investigation on the optimal parameters of FLS for gamma entrainment in humans 7 2.2.2. Study 2. Investigation on the effect of WM microstructural integrity on the gamma entrainment by FLS in humans 8 2.2.3. Clinical evaluation of the participants 8 2.3. Research ethics 9 2.4. FLS 9 2.5. Recording, preprocessing and analysis of EEG 10 2.6. Acquisition, preprocessing and analysis of DTI 13 2.7. Statistical analyses 14 3. Results 16 3.1. Effects of the rsEEG spectral band power on cognitive function 16 3.2. Entrainment and propagation of the gamma rhythms by FLS 16 3.3. Effects of the FLS color on gamma entrainment and propagation 17 3.4. Effects of the FLS intensity on gamma entrainment and propagation 18 3.5. Effects of the FLS frequency on gamma entrainment and propagation 18 3.6. Effects of the microstructural integrity of WM tracts on the gamma entrainment and propagation 20 3.7. Adverse effects 21 4. Discussions 23 5. Conclusions 35 Bibliography 66 국문초록 81박