Evaluation of Glaucomatous Damage via Functional Magnetic Resonance Imaging, and Correlations Thereof with Anatomical and Psychophysical Ocular Findings

PurposeTo evaluate the functional magnetic resonance imaging (fMRI) response to binocular visual stimulation and the association thereof with structural ocular findings and psychophysical test results in patients with glaucoma, and controls.MethodsCross-sectional study. Participants underwent a complete ophthalmic examination, including Humphrey 24-2 visual field (VF) testing and optical coherence tomography. Binocular VF in each quadrant was determined using an integrated method. Patients with glaucoma were assigned to three subgroups: initial, asymmetrical and severe glaucoma. Regions of interest (ROIs) were determined anatomically. fMRI (3 T) was performed using a bilaterally presented polar angle stimulus, and the accompanying changes in blood oxygen level-dependent (BOLD) signals were obtained from the occipital poles and calcarine ROIs. We used generalized estimation equation models to compare anatomical and functional data between the groups.ResultsA total of 25 subjects were enrolled, of whom 17 had glaucoma and 8 were controls. Significant associations between quadrant binocular VF sensitivities and fMRI responses were found in the occipital pole ROIs (p = 0.033) and the calcarine ROIs (p = 0.045). in glaucoma severity subgroup analysis, retinal nerve fiber layer (RNFL) thickness was associated with the BOLD response of the calcarine and occipital pole ROIs (p = 0.002 and 0.026, respectively). the initial and asymmetrical glaucoma subgroups had similar binocular VF sensitivities and RNFL thicknesses, but distinct BOLD responses.ConclusionsThe response of the visual cortex to binocular stimulation was associated with binocular VF sensitivity. RNFL thickness was associated with the BOLD response of the calcarine and occipital pole ROIs.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilHosp Israelita Albert Einstein, São Paulo, BrazilUniv São Paulo, Inst Psychol, Dept Expt Psychol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilFAPESP: 2007/07339-2Web of Scienc

Experimental and numerical investigations of a small animal coil for ultra-high field magnetic resonance imaging (7T)

The purpose of this work was to develop and investigate a radiofrequency (RF) coil to perform image studies on small animals using the 7T magnetic resonance imaging (MRI) system, installed in the imaging platform in the autopsy room (Portuguese acronym PISA), at the University of Sao Paulo, Brazil, which is the unique 7T MRI scanner installed in South America. Due to a high demand to create new specific coils for this 7T system, it is necessary to carefully assess the distribution of electromagnetic (EM) fields generated by the coils and evaluate the patient/object safety during MRI procedures. To achieve this goal 3D numerical methods were used to design and analyse a 8-rungs transmit/receive linearly driven birdcage coil for small animals. Calculated magnetic field (B1) distributions generated by the coil were crosschecked with measured results, indicating good confidence in the simulated results. Electric field results were post-processed and predictions of local specific absorption rate (SAR) values were achieved for a spherical phantom filled with muscle-like tissue, indicating that the sample would not suffer any unsafe deposition of energy. Post mortem abdomen images obtained from a rat presented good image quality and no artifacts related to field non-homogeneity were observed

Thermal measurements of a muscle-mimicking phantom during ultra-high field magnetic resonance imaging

At ultra-high field MRI (Bo>7T) it is crucial to predict and control the patient safety. Commonly patient safety is controlled by the power deposited in the tissue (specific absorption rate - SAR). However, temperature distributions do not always correlate directly with SAR distributions, which makes temperature control also a crucial parameter to guarantee patient safety. In this work, temperature changes were accessed by MR thermometry, specifically by the proton resonance frequency shift technique (PRF). A phantom mimicking muscle tissue was used to evaluate the temperature rise caused by the radiofrequency (RF) absorption during 7T MRI, applied through a commercial birdcage head coil. A pulse-sequence protocol was implemented for both, the generation of temperature increase and the MR thermometry. To control the temperature, a digital thermometer was used, and oil tubes were utilized to dismiss the drift effects for PRF. Measurements of the phantom’s dielectric characteristics, i.e. conductivity and permittivity, were in good agreement with the literature values for muscle. Spatio-temporal evaluations showed a temperature increase in time via RF exposure and the feasibility of measuring temperature maps using the PRF shift method. The accuracy of the PRF shift method increased when the drift effects were quantified and dismissed, indicating a PRF reading accuracy differing less than 0.5 °C from the thermometer. Results also validate our heating and temperature imaging protocol. This study is a valuable contribution to the evaluation of heating effects caused by RF absorption and demonstrates potential impact on future thermal investigations, which may use different heating sources, as well validate thermal simulations

Ecological responses to variable water regimes in arid-zone wetlands: Coongie Lakes, Australia

In dryland rivers, interactions between flow variability and complex geomorphology expose floodplain wetlands to long-term patterns of flooding and drying and highly variable short-term events. We consider whether the abundance and diversity of fish, macroinvertebrate and zooplankton communities in wetlands of the Coongie Lakes complex are influenced by long-term water regimes. To relate biological changes to changes in water regime, mean values of assemblage indices were ranked and correlated against ranked frequency of drying (i.e. water retention) in each waterbody. As water-retention time increased, fish species diversity (richness, evenness) and disease incidence rose, and fish species dominance and macroinvertebrate abundance decreased. The more mobile species of fish utilised the habitats and food resources provided by newly flooded waterbodies. We conclude that fish populations utilise wetlands with a variety of water regimes, and reductions in the frequency of inundation will decrease fish diversity with sequential losses of less mobile species.J. T. Puckridge, J. F. Costelloe and J. R. W. Rei

Associations (<i>p</i> values and betas) between BOLD signals from the regions of interest (ROIs), and the independent variables (quadrant binocular VF sensitivities and study group), calculated using generalized estimating equation models.

<p>ROI = region of interest; SE = standard error; VF = visual field.</p><p>Associations (<i>p</i> values and betas) between BOLD signals from the regions of interest (ROIs), and the independent variables (quadrant binocular VF sensitivities and study group), calculated using generalized estimating equation models.</p

Associations (<i>p</i> values and betas) between BOLD signals from the regions of interest (ROIs), and the independent variables (quadrant binocular VF sensitivities and study group), calculated using generalized estimating equation models.

<p>ROI = region of interest; SE = standard error; VF = visual field.</p><p>Associations (<i>p</i> values and betas) between BOLD signals from the regions of interest (ROIs), and the independent variables (quadrant binocular VF sensitivities and study group), calculated using generalized estimating equation models.</p

No post-conditioning in the human heart with thrombolysis in myocardial infarction flow 2-3 on admission

International audienceAIMS: Proof-of-concept evidence suggests that mechanical ischaemic post-conditioning (PostC) reduces infarct size when applied immediately after culprit coronary artery re-opening in ST-elevation myocardial infarction (STEMI) patients with thrombolysis in myocardial infarction 0-1 (TIMI 0-1) flow grade at admission. Whether PostC might also be protective in patients with a TIMI 2-3 flow grade on admission (corresponding to a delayed application of the post-conditioning algorithm) remains undetermined. METHODS AND RESULTS: In this multi-centre, randomized, single-blinded, controlled study, STEMI patients with a 2-3 TIMI coronary flow grade at admission underwent direct stenting of the culprit lesion, followed (PostC group) or not (control group) by four cycles of (1 min inflation/1 min deflation) of the angioplasty balloon to trigger post-conditioning. Infarct size was assessed both by cardiac magnetic resonance at Day 5 (primary endpoint) and cardiac enzymes release (secondary endpoint). Ninety-nine patients were prospectively enrolled. Baseline characteristics were comparable between control and PostC groups. Despite comparable size of area at risk (AAR) (38 +/- 12 vs. 38 +/- 13% of the LV circumference, respectively, P = 0.89) and similar time from onset to intervention (249 +/- 148 vs. 263 +/- 209 min, respectively, P = 0.93) in the two groups, PostC did not significantly reduce cardiac magnetic resonance infarct size (23 +/- 17 and 21 +/- 18 g in the treated vs. control group, respectively, P = 0.64). Similar results were found when using creatine kinase and troponin I release, even after adjustment for the size of the AAR. CONCLUSION: This study shows that infarct size reduction by mechanical ischaemic PostC is lost when applied to patients with a TIMI 2-3 flow grade at admission. This indicates that the timing of the protective intervention with respect to the onset of reperfusion is a key factor for preventing lethal reperfusion injury in STEMI patients. CLINICAL TRIAL NUMBER: NCT01483755

Baseline characteristics of control group and glaucoma group.

<p>BCVA = best corrected visual acuity; logMAR = logarithm of the minimal angle of resolution; SD = standard deviation; RNFL = retinal nerve fiber layer; SAP = standard automated perimetry; MD = mean deviation; dB = decibel.</p><p>Baseline characteristics of control group and glaucoma group.</p

The severities of visual field defects in both eyes of the glaucoma group and subgroup classification.

<p>The severities of visual field defects in both eyes of the glaucoma group and subgroup classification.</p