Magnetic Resonance Spectroscopy of the Brain in Alcohol Abuse.

Magnetic resonance (MR) technology produces data on brain structure and activity without relying on radiation or invasive surgery. Magnetic resonance imaging (MRI) creates images, and magnetic resonance spectroscopy (MRS) produces spectra based on the ability of atomic nuclei in tissues to absorb and release pulses of energy. MRS studies of alcohol in the brain reveal that only a portion of the alcohol in the brain can be detected by MR technology, suggesting that alcohol there exists in multiple pools. The pools not visible using MRS is hypothesized to be bound to cell membranes. Indirect evidence from MR studies of chronic alcohol abusers suggests that tolerance to alcohol's effects results in an increased rigidity of cell membranes that forces more alcohol to remain in the MR-visible pool (i.e., the pool not bound to membranes) compared with alcohol in the brains of nontolerant people

Multimodal MRI-based Imputation of the Aβ+ in Early Mild Cognitive Impairment.

ObjectiveTo identify brain atrophy from structural-MRI and cerebral blood flow(CBF) patterns from arterial spin labeling perfusion-MRI that are best predictors of the Aβ-burden, measured as composite 18F-AV45-PET uptake, in individuals with early mild cognitive impairment(MCI). Furthermore, to assess the relative importance of imaging modalities in classification of Aβ+/Aβ- early mild cognitive impairment.MethodsSixty-seven ADNI-GO/2 participants with early-MCI were included. Voxel-wise anatomical shape variation measures were computed by estimating the initial diffeomorphic mapping momenta from an unbiased control template. CBF measures normalized to average motor cortex CBF were mapped onto the template space. Using partial least squares regression, we identified the structural and CBF signatures of Aβ after accounting for normal cofounding effects of age, sex, and education.Results18F-AV45-positive early-MCIs could be identified with 83% classification accuracy, 87% positive predictive value, and 84% negative predictive value by multidisciplinary classifiers combining demographics data, ApoE ε4-genotype, and a multimodal MRI-based Aβ score.InterpretationMultimodal-MRI can be used to predict the amyloid status of early-MCI individuals. MRI is a very attractive candidate for the identification of inexpensive and non-invasive surrogate biomarkers of Aβ deposition. Our approach is expected to have value for the identification of individuals likely to be Aβ+ in circumstances where cost or logistical problems prevent Aβ detection using cerebrospinal fluid analysis or Aβ-PET. This can also be used in clinical settings and clinical trials, aiding subject recruitment and evaluation of treatment efficacy. Imputation of the Aβ-positivity status could also complement Aβ-PET by identifying individuals who would benefit the most from this assessment

Cognitive Reserve Associated with FDG-PET in Preclinical Alzheimer Disease

OBJECTIVE: To examine the effect of education (a surrogate measure of cognitive reserve) on FDG-PET brain metabolism in elderly cognitively healthy (HC) subjects with preclinical Alzheimer disease (AD). METHODS: Fifty-two HC subjects (mean age 75 years) with FDG-PET and CSF measurement of Abeta1-42 were included from the prospective Alzheimer's Disease Neuroimaging Initiative biomarker study. HC subjects received a research classification of preclinical AD if CSF Abeta1-42 was <192 pg/mL (Abeta1-42 [+]) vs HC with normal Abeta (Abeta1-42 [-]). In regression analyses, we tested the interaction effect between education and CSF Abeta1-42 status (Abeta1-42 [+] vs Abeta1-42 [-]) on FDG-PET metabolism in regions of interest (ROIs) (posterior cingulate, angular gyrus, inferior/middle temporal gyrus) and the whole brain (voxel-based). RESULTS: An interaction between education and CSF Abeta1-42 status was observed for FDG-PET in the posterior cingulate (p < 0.001) and angular gyrus ROIs (p = 0.03), but was not significant for the inferior/middle temporal gyrus ROI (p = 0.06), controlled for age, sex, and global cognitive ability (Alzheimer's Disease Assessment Scale-cognitive subscale). The interaction effect was such that higher education was associated with lower FDG-PET in the Abeta1-42 (+) group, but with higher FDG-PET in the Abeta1-42 (-) group. Voxel-based analysis showed that this interaction effect was primarily restricted to temporo-parietal and ventral prefrontal brain areas. CONCLUSIONS: Higher education was associated with lower FDG-PET in preclinical AD (Abeta1-42 [+]), suggesting that cognitive reserve had a compensatory function to sustain cognitive ability in presence of early AD pathology that alters FDG-PET metabolism

Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects

Brain changes reminiscent of Alzheimer disease (AD) have been previously reported in a substantial portion of elderly cognitive healthy (HC) subjects. The major aim was to evaluate the accuracy of MRI assessed regional gray matter (GM) volume, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET),and neuropsychological test scores to identify those HC subjects who subsequently convert to mild cognitive impairment (MCI) or AD dementia. We obtained in 54 healthy control (HC) subjects a priori defined region of interest (ROI) values of medial temporal and parietal FDG-PET and medial temporal GM volume. In logistic regression analyses, these ROI values were tested together with neuropsychological test scores (free recall, trail making test B (TMT-B)) as predictors of HC conversion during a clinical follow-up between 3 and 4 years. In voxelbased analyses, FDG-PET and MRI GM maps were compared between HC converters and HC non-converters. Out of the 54 HC subjects, 11 subjects converted to MCI or AD dementia. Lower FDG-PET ROI values were associated with higher likelihood of conversion (p = 0.004),with the area under the curve (AUC) yielding 82.0% (95% CI = (95.5%,68.5%)). The GM volume ROI was not a significant predictor (p = 0.07). TMT-B but not the free recall tests were a significant predictor (AUC = 71% (95% CI = 50.4%,91.7%)). For the combination of FDG-PET and TMT-B, the AUC was 93.4% (sensitivity = 82%,specificity = 93%). Voxel-based group comparison showed reduced FDG-PET metabolism within the temporo-parietal and prefrontal cortex in HC converters. In conclusion, medial temporal and-parietal FDG-PET and executive function show a clinically acceptable accuracy for predicting clinical progression in elderly HC subjects. (C) 2013 The Authors. Published by Elsevier Inc. All rights reserved

From Dyck Paths to Standard Young Tableaux

We present nine bijections between classes of Dyck paths and classes of standard Young tableaux (SYT). In particular, we consider SYT of flag and rectangular shapes, we give Dyck path descriptions for certain SYT of height at most 3, and we introduce a special class of labeled Dyck paths of semilength n that is shown to be in bijection with the set of all SYT with n boxes. In addition, we present bijections from certain classes of Motzkin paths to SYT. As a natural framework for some of our bijections, we introduce a class of set partitions which in some sense is dual to the known class of noncrossing partitions

K-Bayes Reconstruction for Perfusion MRI I: Concepts and Application

Despite the continued spread of magnetic resonance imaging (MRI) methods in scientific studies and clinical diagnosis, MRI applications are mostly restricted to high-resolution modalities, such as structural MRI. While perfusion MRI gives complementary information on blood flow in the brain, its reduced resolution limits its power for detecting specific disease effects on perfusion patterns. This reduced resolution is compounded by artifacts such as partial volume effects, Gibbs ringing, and aliasing, which are caused by necessarily limited k-space sampling and the subsequent use of discrete Fourier transform (DFT) reconstruction. In this study, a Bayesian modeling procedure (K-Bayes) is developed for the reconstruction of perfusion MRI. The K-Bayes approach (described in detail in Part II: Modeling and Technical Development) combines a process model for the MRI signal in k-space with a Markov random field prior distribution that incorporates high-resolution segmented structural MRI information. A simulation study was performed to determine qualitative and quantitative improvements in K-Bayes reconstructed images compared with those obtained via DFT. The improvements were validated using in vivo perfusion MRI data of the human brain. The K-Bayes reconstructed images were demonstrated to provide reduced bias, increased precision, greater effect sizes, and higher resolution than those obtained using DFT

Acid-base changes and acetate metabolism during routine and high-efficiency hemodialysis in children

Acid-base changes and acetate metabolism during routine and high-efficiency hemodialysis in children. Changes in acid-base status and plasma acetate concentrations were studied in eight children during 11 hemodialysis sessions. During dialysis, the blood bicarbonate concentration fell (20.5 ± 0.7 to 19.6 ± 0.8 mEq/liter), the PCO2 fell (33.4 ± 0.8 to 27.5 ± 1.4 mm Hg), and the pH rose (7.42 ± 0.01 to 7.48 ± 0.02). During the hour after dialysis, the bicarbonate concentration rose to normal (23.4 ± 0.7 mEq/liter), the PCO2 rose (32.8 ± 0.8 mm Hg), and the pH remained unchanged. The half-life of plasma acetate, measured after dialysis, was 8.7 min. During five “high-efficiency” dialysis sessions (urea clearance, > 3.0 ml/min/kg), blood bicarbonate concentration fell 3.2 mEq/liter, PCO2 fell 8.7 mm Hg, and plasma acetate rose to 7.51 mmoles/liter, whereas during six “routine efficiency” dialysis sessions (urea clearance, 1.5 to 3.0 ml/min/kg), blood bicarbonate rose 1.0 mEq/liter, PCO2 fell 36 mm Hg, and plasma acetate rose to 3.52 mmoles/liter. At 1 hour after the end of dialysis, blood bicarbonate, PCO2, and plasma acetate concentrations were similar in the two groups. Clinical problems occurred more frequently in the high-efficiency group during dialysis although the difference was not significant. The data indicate that (1) dialysis with acetate buffer effectively corrects pre-dialysis metabolic acidosis, (2) although children have a high rate of acetate metabolism, during high-efficiency dialysis this rate is exceeded by the influx of acetate, and acid-base abnormalities occur. These abnormalities are transient but may cause clinical problems.Modifications acido-basiques et métabolisme de l'acétate au cours de l'hémodialyse de routine ou à efficacité élevée chez l'enfant. Les modifications de l'état acido-basique et des concentrations plasmatiques d'acétate ont été étudiées chez huit enfants au cours de 11 séances d'hémodialyse. Au cours de la dialyse les bicarbonates diminuent (20,5 ± 0,7 à 19,6 ± 0,8 mEq/ litre), la PCO2 diminue (33,4 ± 0,8 à 27,5 ± 1,4 mm Hg), et le pH augmente (7,42 ± 0,01 à 7,48 ± 0,02). Au cours de l'heure qui suit la dialyse les bicarbonates s'élèvent à une valeur normale, 23,4 ± 0,07 mEq/litre, la PCO2 s'élève à 32,8 ± 0,8 mm Hg, et le pH est inchangé. La demi vie de l'acétate plasmatique, mesurée après la dialyse, était de 8,7 min. Au cours de cinq séances de dialyse à haute efficacité (clearance de l'urée, > 3,0 ml/min/kg) les bicarbonates baissent de 3,2 mEq/litre, la PCO2 de 8,7 mm Hg, et l'acétate plasmatique s'est élevé à 7,51 mmoles/litre alors qu'au cours de six séances de dialyse d'efficacité moyenne (clearance de l'urée, 1,5 à 3,0 ml/min/kg) les bicarbonates ont augmenté de 1,0 mEq/litre, la PCO2 a diminué de 3,6 mm Hg, et l'acétate plasmatique s'est élevé à 3,52 mmoles/litre. Une heure après la fin de la dialyse les bicarbonates, la PCO2 et l'acétate plasmatique étaient semblables dans les deux groupes. Des problèmes cliniques sont survenus plus souvent au cours de la dialyse dans le groups à haute efficacité bien que la différence ne soit pas significative. Ces résultats indiquent que (1) la dialyse avec le tampon acétate corrige efficacement l'acidose métabolique pré-dialytique, (2) bien que l'enfant ait une capacité élevée de métaboliser l'acétate, cette capacité est débordée, au cours de la dialyse à haute efficacité, par l'entrée d'acétate et des anomalies acidobasiques surviennent. Ces anomalies sont transitoires et peuvent déterminer des problèmes cliniques

Differences in Prefrontal, Limbic, and White Matter Lesion Volumes According to Cognitive Status in Elderly Patients with First-Onset Subsyndromal Depression

The purpose of this preliminary study was to test the hypothesis that subsyndromal depression is associated with the volume of medial prefrontal regional gray matter and that of white matter lesions (WMLs) in the brains of cognitively normal older people. We also explored the relationships between subsyndromal depression and medial prefrontal regional gray matter volume, limbic regional gray matter volume, and lobar WMLs in the brains of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). We performed a cross-sectional study comparing patients with subsyndromal depression and nondepressed controls with normal cognition (n = 59),MCI (n = 27),and AD (n = 27),adjusting for sex, age, years of education, and results of the Mini-Mental State Examination. Frontal WML volume was greater, and right medial orbitofrontal cortical volume was smaller in cognitively normal participants with subsyndromal depression than in those without subsyndromal depression. No volume differences were observed in medial prefrontal, limbic, or WML volumes according to the presence of subsyndromal depression in cognitively impaired patients. The absence of these changes in patients with MCI and AD suggests that brain changes associated with AD pathology may override the changes associated with subsyndromal depression

Differences in Prefrontal, Limbic, and White Matter Lesion Volumes According to Cognitive Status in Elderly Patients with First-Onset Subsyndromal Depression

The purpose of this preliminary study was to test the hypothesis that subsyndromal depression is associated with the volume of medial prefrontal regional gray matter and that of white matter lesions (WMLs) in the brains of cognitively normal older people. We also explored the relationships between subsyndromal depression and medial prefrontal regional gray matter volume, limbic regional gray matter volume, and lobar WMLs in the brains of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). We performed a cross-sectional study comparing patients with subsyndromal depression and nondepressed controls with normal cognition (n = 59),MCI (n = 27),and AD (n = 27),adjusting for sex, age, years of education, and results of the Mini-Mental State Examination. Frontal WML volume was greater, and right medial orbitofrontal cortical volume was smaller in cognitively normal participants with subsyndromal depression than in those without subsyndromal depression. No volume differences were observed in medial prefrontal, limbic, or WML volumes according to the presence of subsyndromal depression in cognitively impaired patients. The absence of these changes in patients with MCI and AD suggests that brain changes associated with AD pathology may override the changes associated with subsyndromal depression