Publications by Year: 2002

OBJECTIVE: Disruptions in connectivity between the frontal and temporal lobes may explain some of the symptoms observed in schizophrenia. Conventional magnetic resonance imaging (MRI) studies, however, have not shown compelling evidence for white matter abnormalities, because white matter fiber tracts cannot be visualized by conventional MRI. Diffusion tensor imaging is a relatively new technique that can detect subtle white matter abnormalities in vivo by assessing the degree to which directionally organized fibers have lost their normal integrity. The first three diffusion tensor imaging studies in schizophrenia showed lower anisotropic diffusion, relative to comparison subjects, in whole-brain white matter, prefrontal and temporal white matter, and the corpus callosum, respectively. Here the authors focus on fiber tracts forming temporal-frontal connections. METHOD: Anisotropic diffusion was assessed in the uncinate fasciculus, the most prominent white matter tract connecting temporal and frontal brain regions, in 15 patients with chronic schizophrenia and 18 normal comparison subjects. A 1.5-T GE Echospeed system was used to acquire 4-mm-thick coronal line-scan diffusion tensor images. Maps of the fractional anisotropy were generated to quantify the water diffusion within the uncinate fasciculus. RESULTS: Findings revealed a group-by-side interaction for fractional anisotropy and for uncinate fasciculus area, derived from automatic segmentation. The patients with schizophrenia showed a lack of normal left-greater-than-right asymmetry seen in the comparison subjects. CONCLUSIONS: These findings demonstrate the importance of investigating white matter tracts in vivo in schizophrenia and support the hypothesis of a disruption in the normal pattern of connectivity between temporal and frontal brain regions in schizophrenia.

BACKGROUND AND PURPOSE: MR diffusion tensor imaging permits detailed visualization of white matter fiber tracts. This technique, unlike T2-weighted imaging, also provides information about fiber direction. We present findings of normal white matter fiber tract anatomy at high resolution obtained by using line scan diffusion tensor imaging. METHODS: Diffusion tensor images in axial, coronal, and sagittal sections covering the entire brain volume were obtained with line scan diffusion imaging in six healthy volunteers. Images were acquired for b factors 5 and 1000 s/mm(2) at an imaging resolution of 1.7 x 1.7 x 4 mm. For selected regions, images were obtained at a reduced field of view with a spatial resolution of 0.9 x 0.9 x 3 mm. For each pixel, the direction of maximum diffusivity was computed and used to display the course of white matter fibers. RESULTS: Fiber directions derived from diffusion tensor imaging were consistent with known white matter fiber anatomy. The principal fiber tracts were well observed in all cases. The tracts that were visualized included the following: the arcuate fasciculus; superior and inferior longitudinal fasciculus; uncinate fasciculus; cingulum; external and extreme capsule; internal capsule; corona radiata; auditory and optic radiation; anterior commissure; corpus callosum; pyramidal tract; gracile and cuneatus fasciculus; medial longitudinal fasciculus; rubrospinal, tectospinal, central tegmental, and dorsal trigeminothalamic tract; superior, inferior, and middle cerebellar peduncle; pallidonigral and strionigral fibers; and root fibers of the oculomotor and trigeminal nerve. CONCLUSION: We obtained a complete set of detailed white matter fiber anatomy maps of the normal brain by means of line scan diffusion tensor imaging at high resolution. Near large bone structures, line scan produces images with minimal susceptibility artifacts.

Magnetic resonance diffusion tensor imaging (DTI) is a new technique that can be used to visualize and measure the diffusion of water in brain tissue; it is particularly useful for evaluating white matter abnormalities. In this paper, we review research studies that have applied DTI for the purpose of understanding neuropsychiatric disorders. We begin with a discussion of the principles involved in DTI, followed by a historical overview of magnetic resonance diffusion-weighted imaging and DTI and a brief description of several different methods of image acquisition and quantitative analysis. We then review the application of this technique to clinical populations. We include all studies published in English from January 1996 through March 2002 on this topic, located by searching PubMed and Medline on the key words "diffusion tensor imaging" and "MRI." Finally, we consider potential future uses of DTI, including fiber tracking and surgical planning and follow-up.

Pathways within the visual system can be distinguished on the basis of selectivity for low or high spatial frequencies. Spatial frequency discrimination was evaluated in 17 medicated male patients with schizophrenia and 19 male control subjects. Subjects were required to discriminate whether pairs of high contrast, sinusoidally modulated gratings were the same or different in spatial frequency. Accuracy performance was compared at high, medium, and low spatial frequencies on tasks matched for control performance. Patients showed a greater performance decrement of 12% on low as compared with 4% on high spatial frequencies. These findings suggest a disturbance of right hemisphere mechanisms involved in spatial perception and attention in schizophrenia.

The increased use of image-guided surgery systems during neurosurgery has brought to prominence the inaccuracies of conventional intraoperative navigation systems caused by shape changes such as those due to brain shift. We propose a method to track the deformation of the brain and update preoperative images using intraoperative MR images acquired at different crucial time points during surgery. We use a deformable surface matching algorithm to capture the deformation of boundaries of key structures (cortical surface, ventricles and tumor) throughout the neurosurgical procedure, and a linear finite element elastic model to infer a volumetric deformation. The boundary data are extracted from intraoperative MR images using a real-time intraoperative segmentation algorithm. The algorithm has been applied to a sequence of intraoperative MR images of the brain exhibiting brain shift and tumor resection. Our results characterize the brain shift after opening of the dura and at the different stages of tumor resection, and brain swelling afterwards. Analysis of the average deformation capture was assessed by comparing landmarks identified manually and the results indicate an accuracy of 0.7+/-0.6 mm (mean+/-S.D.) for boundary surface landmarks, of 0.9+/-0.6 mm for landmarks inside the boundary surfaces, and 1.6+/-0.9 mm for landmarks in the vicinity of the tumor.

Water is an integral part of the structure in biological porous materials such as wood and starch. A problem often encountered in the preparation of samples for, e.g., electron microscopy is that removal of water leads to a decreasing distance between supermolecular structural elements and a distortion of the structure. It is, therefore, of interest to find methods to investigate these materials in the native water-swollen state. We present a method to study water-swollen biological porous structures using NMR to determine the amount and self-diffusion of water within the porous objects. The contribution of bulk water to the NMR signal is eliminated by performing experiments below the bulk freezing temperature. Further decrease of the temperature leads to a gradual freezing of water within the porous objects. The contribution of the freezing water fraction to the migration of water through the porous network is, thus, estimated. The results are rationalized in terms of the ultrastructure of the samples studied, namely, wood pulp fibers and potato starch granules.

We present a method for accurate image registration and motion compensation in multidimensional signals, such as two-dimensional (2-D) X-ray images and three-dimensional (3-D) computed tomography/magnetic resonance imaging volumes. The method is based on phase from quadrature filters, which makes it robust to noise and temporal intensity variations. The method is equally applicable to signals of two, three or higher number of dimensions. We use parametric models, e.g., affine models, finite elements or local affine models with global regularization. Experimental results show high accuracy for 2-D and 3-D motion compensation.

Obstructive sleep apnea is an important disorder because of both its prevalence and its cardiovascular and neurocognitive sequelae. Despite the fact that male sex is a major risk factor for this disorder, the mechanisms underlying this predisposition are unclear. To understand the pathophysiologic basis of the male predisposition for pharyngeal collapse, we performed a detailed analysis of the anatomic and physiologic features of the upper airway in a cohort of normal and near-normal subjects (equal number of men and women). Although no important physiologic (genioglossal electromyogram, airflow resistance) differences were observed between sexes, a number of anatomic differences were apparent. The pharyngeal airway length was substantially longer in men compared with women. There was also an increased cross-sectional area of the soft palate and an increased airway volume in men compared with women. Using signal-averaged anatomic data from male and female subjects, we developed representative male and female finite element airway models. This model demonstrated the male airway to be substantially more collapsible than the female airway, solely on the basis of anatomic differences. This study suggests that the male predisposition to pharyngeal collapse is anatomically based, primarily as the result of an increased length of vulnerable airway as well as increased soft palate size.

OBJECTIVE: Individuals with schizophrenia spectrum disorders evince similar genetic, neurotransmitter, neuropsychological, electrophysiological, and structural abnormalities. Magnetic resonance imaging (MRI) studies have shown smaller gray matter volume in patients with schizotypal personality disorder than in matched comparison subjects in the left superior temporal gyrus, an area important for language processing. In a further exploration, the authors studied two components of the superior temporal gyrus: Heschl’s gyrus and the planum temporale. METHOD: MRI scans were acquired from 21 male, neuroleptic-naive subjects recruited from the community who met DSM-IV criteria for schizotypal personality disorder and 22 male comparison subjects similar in age. Eighteen of the 21 subjects with schizotypal personality disorder had additional comorbid, nonpsychotic diagnoses. The superior temporal gyrus was manually delineated on coronal images with subsequent identification of Heschl’s gyrus and the planum temporale. Exploratory correlations between region of interest volumes and neuropsychological measures were also performed. RESULTS: Left Heschl’s gyrus gray matter volume was 21% smaller in the schizotypal personality disorder subjects than in the comparison subjects, a difference that was not associated with the presence of comorbid axis I disorders. There were no between-group volume differences in right Heschl’s gyrus or in the right or left planum temporale. Exploratory analyses also showed a correlation between poor logical memory and smaller left Heschl’s gyrus volume. CONCLUSIONS: Smaller left Heschl’s gyrus gray matter volume in subjects with schizotypal personality disorder may help to explain the previously reported abnormality in the left superior temporal gyrus and may be a vulnerability marker for schizophrenia spectrum disorders.

In animals, exposure to severe stress can damage the hippocampus. Recent human studies show smaller hippocampal volume in individuals with the stress-related psychiatric condition posttraumatic stress disorder (PTSD). Does this represent the neurotoxic effect of trauma, or is smaller hippocampal volume a pre-existing condition that renders the brain more vulnerable to the development of pathological stress responses? In monozygotic twins discordant for trauma exposure, we found evidence that smaller hippocampi indeed constitute a risk factor for the development of stress-related psychopathology. Disorder severity in PTSD patients who were exposed to trauma was negatively correlated with the hippocampal volume of both the patients and the patients’ trauma-unexposed identical co-twin. Furthermore, severe PTSD twin pairs-both the trauma-exposed and unexposed members-had significantly smaller hippocampi than non-PTSD pairs.