Comparison of the endocranial- and brain volumes in brachycephalic dogs, mesaticephalic dogs and Cavalier King Charles spaniels in relation to their body weight

BACKGROUND: A number of studies have attempted to quantify the relative volumes of the endocranial volume and brain parenchyma in association with the pathogenesis of the Chiari-like malformation (CLM) in the Cavalier King Charles spaniel (CKCS). In our study we examine the influence of allometric scaling of the brain and cranial cavity volume on morphological parameters in different dog breeds. MRI scans of 110 dogs (35 mesaticephalic dogs, 35 brachycephalic dogs, 20 CKCSs with SM, and 20 CKCSs without SM) have been used to create 3-dimensional volumetric models of skull and brain parts. Volumes were related to body weight calculating the adjusted means for different breeds. RESULTS: There was a strong global dependency of all volumes to body weight (P<0.0001). The adjusted means of the absolute and relative volumes of brain parenchyma and cranial compartments are not significantly larger in CKCSs in comparison to brachycephalic and mesaticephalic dogs. A difference in absolute or relative volumes between CKCSs with and without SM after relating these values to body weight could not be identified. The relative volume of the hindbrain parenchyma (caudal fossa parenchyma percentage) was larger in brachycephalic dogs than in CKCSs, without causing herniation or SM. CONCLUSION: An influence of body weight exist in dogs, which can be sufficiently large to render conclusions on the difference in volumes of the brain and skull unsafe unless some account of the body weight is taken in the analysis. The results of this study challenge the role of overcrowding for the development of SM in dogs

Skeletal Muscle–Derived Cell Implantation for the Treatment of Fecal Incontinence: A Randomized, Placebo-Controlled Study

Background and Aims: Fecal incontinence (FI) improvement following injection of autologous skeletal muscle–derived cells has been previously suggested. This study aimed to test the efficacy and safety of said cells through a multicenter, placebo-controlled study, to determine an appropriate cell dose, and to delineate the target patient population that can most benefit from cell therapy. Methods: Patients experiencing FI for at least 6 months were randomized to receive a cell-free medium or low or high dose of cells. All patients received pelvic floor electrical stimulation before and after treatment. Incontinence episode frequency (IEF), FI quality of life, FI burden assessed on a visual analog scale, Wexner score, and parameters reflecting anorectal physiological function were all assessed for up to 12 months. Results: Cell therapy improved IEF, FI quality of life, and FI burden, reaching a preset level of statistical significance in IEF change compared with the control treatment. Post hoc exploratory analyses indicated that patients with limited FI duration and high IEF at baseline are most responsive to cells. Effects prevailed or increased in the high cell count group from 6 to 12 months but plateaued or diminished in the low cell count and control groups. Most physiological parameters remained unaltered. No unexpected adverse events were observed. Conclusions: Injection of a high dose of autologous skeletal muscle–derived cells followed by electrical stimulation significantly improved FI, particularly in patients with limited FI duration and high IEF at baseline, and could become a valuable tool for treatment of FI, subject to confirmatory phase 3 trial(s). (ClinicalTrialRegister.eu; EudraCT Number: 2010-021463-32)

Statistical Instability of TBSS Analysis Based on DTI Fitting Algorithm

Voxel-based DTI analysis is an important approach in the comparison of subject groups by detecting and localizing gray and white matter changes in the brain. One of the principal problems for intersubject comparison is the absence of a “gold standard” processing pipeline. As a result, contradictory results may be obtained from identical data using different data processing pipelines, for example, in the data normalization or smoothing procedures. Tract-based spatial statistics (TBSS) shows potential to overcome this problem by automatic detection of white matter changes and decreasing variation in the performed analysis. However, skeleton projection approaches, such as TBSS, critically depend on the accuracy of the diffusion scalar metric estimations. In this work, we demonstrate that the agreement and reliability of TBSS results depend on the applied DTI data processing algorithm. Statistical tests have been performed using two in vivo measured datasets and compared with different implementations of the least squares algorithm. As a result, we recommend repeating TBSS analysis using different fitting algorithms, in particular, using on iteratively-assessed robust estimators, as accurate and more reliable approach in voxel-based analysis, particularly, for TBSS. Repeating TBSS analysis allows one to detect and localize suspicious regions in white matter which were estimated as the regions with significant difference. Finally, we did not find a favorite fitting algorithm (or class of them) which can be marked as more reliable for group comparison

Diffusion kurtosis metrics as biomarkers of microstructural development: A comparative study of a group of children and a group of adults

The most common modality of diffusion MRI used in the ageing and development studies is diffusion tensor imaging (DTI) providing two key measures, fractional anisotropy and mean diffusivity. Here, we investigated diffusional changes occurring between childhood (average age 10.3 years) and mitddle adult age (average age 54.3 years) with the help of diffusion kurtosis imaging (DKI), a recent novel extension of DTI that provides additional metrics quantifying non-Gaussianity of water diffusion in brain tissue. We performed voxelwise statistical between-group comparison of diffusion tensor and kurtosis tensor metrics using two methods, namely, the tract-based spatial statistics (TBSS) and the atlas-based regional data analysis. For the latter, fractional anisotropy, mean diffusivity, mean diffusion kurtosis, and other scalar diffusion tensor and kurtosis tensor parameters were evaluated for white matter fibres provided by the Johns-Hopkins-University Atlas in the FSL toolkit (http://fsl.fmrib.ox.ac.uk/fsl/fslwiki/Atlases). Within the same age group, all evaluated parameters varied depending on the anatomical region. TBSS analysis showed that changes in kurtosis tensor parameters beyond adolescence are more widespread along the skeleton in comparison to the changes of the diffusion tensor metrics. The regional data analysis demonstrated considerably larger between-group changes of the diffusion kurtosis metrics than of diffusion tensor metrics in all investigated regions. The effect size of the parametric changes between childhood and middle adulthood was quantified using Cohen's d. We used Cohen's d related to mean diffusion kurtosis to examine heterogeneous maturation of various fibres. The largest changes of this parameter (interpreted as reflecting the lowest level of maturation by the age of children group) were observed in the association fibres, cingulum (gyrus) and cingulum (hippocampus) followed by superior longitudinal fasciculus and inferior longitudinal fasciculus. The smallest changes were observed in the commissural fibres, forceps major and forceps minor. In conclusion, our data suggest that DKI is sensitive to developmental changes in local microstructure and environment, and is particularly powerful to unravel developmental differences in major association fibres, such as the cingulum and superior longitudinal fasciculus