Buffalo Neuroimaging Analysis Center

Buffalo, NY, United States

Buffalo Neuroimaging Analysis Center

Buffalo, NY, United States
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Hulst H.E.,University Medical Center | Bergsland N.,Buffalo Neuroimaging Analysis Center | Schoonheim M.M.,University Medical Center | Dwyer M.G.,Buffalo Neuroimaging Analysis Center | And 2 more authors.
Multiple Sclerosis Journal | Year: 2013

Background: Gray-matter (GM) atrophy is strongly predictive of cognitive impairment in multiple sclerosis (MS) patients. The thalamus is the region where the atrophy/cognition correlation is most robust. However, few studies have assessed diffusion tensor imaging (DTI) metrics within the thalamus. Objective: This study was designed to determine if thalamus white matter DTI predicts cognitive impairment after accounting for the effects of volume loss. Methods: We enrolled 75 MS patients and 18 healthy controls undergoing 3T brain magnetic resonance imaging (MRI). Thalamus volumes were calculated on 3D T1 images. Voxelwise analyses of DTI metrics were performed within the thalamic white matter tracts. Neuropsychological (NP) testing, acquired using consensus standard methods, contributed measures of memory, cognitive processing speed and executive function. Results: All cognitive tests were significantly predicted (R2 =0.31, p<0.001) by thalamus volume after accounting for influence of demographics. Mean diffusivity was retained in regression models predicting all cognitive tests, adding from 7-13% of additional explained variance (p<0.02) after accounting for thalamus volume. Conclusions: We confirm the significant role of thalamus atrophy in MS-associated cognitive disorder, and further report that subtle thalamus pathology as detected by DTI adds incremental explained variance in predicting cognitive impairment. © 2013 The Author(s).

Leddy J.J.,University Sports Medicine | Cox J.L.,Buffalo Neuroimaging Analysis Center | Baker J.G.,University Sports Medicine | Zivadinov R.,Buffalo Neuroimaging Analysis Center | Willer B.,State University of New York at Buffalo
Journal of Head Trauma Rehabilitation | Year: 2013

PURPOSE: To compare functional magnetic resonance imaging (fMRI) activation patterns during a cognitive task, exercise capacity, and symptoms in postconcussion syndrome (PCS) patients who received exercise treatment (n = 4) with a PCS placebo stretching group (n = 4) and a healthy control group (n = 4). METHODS: Subjects completed a math processing task during fMRI and an exercise treadmill test before (time 1) and after approximately 12 weeks (time 2). Exercise subjects performed aerobic exercise at 80% of the heart rate (HR) attained on the treadmill test, 20 minutes per day with an HR monitor at home, 6 days per week. The program was modified as the HR for symptom exacerbation increased. RESULTS: At time 1, there was no difference in fMRI activation between the 2 PCS groups but healthy controls had significantly greater activation in the posterior cingulate gyrus, lingual gyrus, and cerebellum versus all PCS subjects (P < .05, corrected for multiple comparisons). At time 2, exercise PCS did not differ from healthy controls whereas placebo stretching PCS had significantly less activity in the cerebellum (P < .05 corrected) and in the anterior cingulate gyrus and thalamus (P < .001, uncorrected) versus healthy controls. At time 2, exercise PCS achieved a significantly greater exercise HR (P < .001) and had fewer symptoms (P < .0004) than placebo stretching PCS. Cognitive performance did not differ by group or time. CONCLUSIONS: Controlled aerobic exercise rehabilitation may help restore normal cerebral blood flow regulation, as indicated by fMRI activation, in PCS patients. The PCS symptoms may be related to abnormal cerebral blood flow regulation. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Clifford D.B.,Washington University in St. Louis | Nath A.,U.S. National Institutes of Health | Cinque P.,San Raffaele Scientific Institute | Brew B.J.,University of New South Wales | And 6 more authors.
Journal of NeuroVirology | Year: 2013

Immune reconstitution has improved outcomes for progressive multifocal leukoencephalopathy (PML), a potentially lethal brain disease caused by JC virus (JCV). However, an antiviral treatment to control JCV is needed when immune reconstitution is delayed or not possible. On the basis of in vitro efficacy, this study evaluated the effect of mefloquine on PML and factors that may predict PML outcomes. This 38-week, open-label, randomized, parallel-group, proof-of-concept study compared patients with PML who received standard of care (SOC) with those who received SOC plus mefloquine (250 mg for 3 days, then 250 mg weekly). Patients randomized to SOC could add mefloquine treatment at week 4. The primary endpoint was change from baseline to weeks 4 and 8 in JCV DNA copy number (load) in cerebrospinal fluid (CSF). Exploratory analyses evaluated factors that might correlate with clinical outcome. The majority of enrolled patients were HIV positive. Preplanned interim data analyses suggested that the study was unlikely to successfully demonstrate a significant difference between groups; therefore, the study was terminated prematurely. There was no significant difference between groups in CSF JCV DNA loads or clinical/MRI findings. Decrease in CSF JCV DNA load from baseline to week 4 was associated with a better clinical outcome at 16 weeks, as measured by Karnofsky scores. This study found no evidence of anti-JCV activity by mefloquine. An early decrease of CSF JCV DNA load appears to be associated with a better clinical outcome. © 2013 The Author(s).

Aliotta R.,State University of New York at Buffalo | Aliotta R.,Buffalo Neuroimaging Analysis Center | Cox J.L.,State University of New York at Buffalo | Cox J.L.,Buffalo Neuroimaging Analysis Center | And 13 more authors.
Human Brain Mapping | Year: 2014

Background: White matter (WM) microstructure may vary significantly in pediatric-onset (PO) and adult-onset (AO) patients with multiple sclerosis (MS), a difference that could be explained by the effects of an inherent plasticity in the affected pediatric brains early in the disease, and a phenomenon that does not occur later in life. This hypothesis would support the observation that disease progression is much slower in POMS compared to AOMS patients. Objectives: To examine WM microstructure in the brain of adults with POMS and AOMS, using tract based spatial statistics (TBSS) analysis of diffusion-tensor imaging (DTI). Methods: Adults with relapsing-remitting (RR) POMS, who were diagnosed before age of 18 years (n = 16), were compared with age-matched (AOA, n = 23) and disease duration-matched (AOD, n = 22) RR patients who developed MS after the age of 18 years. Scans were analyzed using the FSL software package (Oxford, UK) and statistics were performed using TBSS to evaluate WM microstructure between groups based on the mean fractional anisotropy (FA) values obtained from the DTI. Results: Widespread cortical and deep WM area differences characterized by increased FA values were seen in the AOAMS compared with POMS group (P < 0.05, TFCE corrected). Significantly increased FA values of posterior WM areas were detected in the AODMS compared with POMS group (P < 0.05, TFCE corrected). Conclusion: Increased FA values in WM areas of the AOMS compared with the POMS patients suggest that diffuse WM microstructure changes are more attributable to age of onset than a simple function of disease duration and age. © 2012 Wiley Periodicals, Inc.

Weinstock-Guttman B.,Jacobs Neurological Institute | Weinstock-Guttman B.,Baird Multiple Sclerosis Center | Ramanathan M.,Jacobs Neurological Institute | Ramanathan M.,State University of New York at Buffalo | And 11 more authors.
Neurology | Year: 2010

Background: African American (AA) patients with multiple sclerosis (MS) have more rapid disease progression and poorer responses to disease-modifying therapies than white American (WA) patients with MS. Objectives: To investigate brain MRI characteristics in AA compared to WA in a cohort of consecutive patients with MS. Methods: We studied 567 patients with MS (age: 45.1-SD 9.8 years, disease duration: 13.4-8.6 years), comprised of 488 WA and 79 AA. All patients obtained clinical and quantitative MRI evaluation. The majority of patients, 96% of AA and 94% of WA, were on disease-modifying therapies. The MRI measures included T1-, T2-, and gadolinium contrast-enhancing (CE) lesion volumes (LV) and CE number, global and tissue-specific brain atrophy, and magnetization transfer ratio (MTR) in lesions and normal-appearing gray matter (NAGM) and white matter (NAWM). The associations between race and clinical and MRI measurements were assessed in regression analysis. Results: The MTR values in lesions and in NAGM and NAWM were significantly lower in AA compared to WA. The AA group had 31% greater T2-LV and 101% greater T1-LV compared to WA. The MS Severity Score for AA (mean-SD = 4.3-2.9) was greater than for WA (3.8-2.5), despite a shorter disease duration in AA, indicating more aggressive clinical disease. Conclusions: African American patients showed increased tissue damage, as measured by magnetization transfer ratio, and presented higher lesion volumes compared to white Americans. The greater tissue damage and faster lesion volume accumulation may explain the rapid clinical progression in African American patients. © 2010 by AAN Enterprises, Inc.

Mak E.,Buffalo Neuroimaging Analysis Center | Mak E.,National Neuroscience Institute | Bergsland N.,Buffalo Neuroimaging Analysis Center | Bergsland N.,Instituto Of Ricovero E Cura A Carattere Scientifico S Maria Nascente | And 5 more authors.
American Journal of Neuroradiology | Year: 2014

BACKGROUND AND PURPOSE: The involvement of subcortical deep gray matter and cortical thinning associated with mild Parkinson disease remains poorly understood. We assessed cortical thickness and subcortical volumes in patients with Parkinson disease without dementia and evaluated their associations with cognitive dysfunction.MATERIALS AND METHODS: The study included 90 patients with mild Parkinson disease without dementia. Neuropsychological assessments classified the sample into patients with mild cognitive impairment (n=25) and patients without cognitive impairment (n=65). Volumetric data for subcortical structures were obtained by using the FMRIB Integrated Registration and Segmentation Tool while whole-brain, gray and white matter volumes were estimated by using Structural Image Evaluation, with Normalization of Atrophy. Vertex-based shape analyses were performed to investigate shape differences in subcortical structures. Vertex-wise group differences in cortical thickness were also assessed. Volumetric comparisons between Parkinson disease with mild cognitive impairment and Parkinson disease with no cognitive impairment were performed by using ANCOVA. Associations of subcortical structures with both cognitive function and disease severity were assessed by using linear regression models. RESULTS: Compared with Parkinson disease with no cognitive impairment, Parkinson disease with mild cognitive impairment demonstrated reduced volumes of the thalamus (P=.03) and the nucleus accumbens (P=.04). Significant associations were found for the nucleus accumbens and putamen with performances on the attention/working memory domains (P = .05) and nucleus accumbens and language domains (P = .04). The 2 groups did not differ in measures of subcortical shape or in cortical thickness. CONCLUSIONS: Patients with Parkinson disease with mild cognitive impairment demonstrated reduced subcortical volumes, which were associated with cognitive deficits. The thalamus, nucleus accumbens, and putamen may serve as potential biomarkers for Parkinson disease-mild cognitive impairment.

Gabelic T.,Buffalo Neuroimaging Analysis Center | Gabelic T.,University of Zagreb | Ramasamy D.P.,Buffalo Neuroimaging Analysis Center | Weinstock-Guttman B.,Jacobs Neurological Institute | And 7 more authors.
American Journal of Neuroradiology | Year: 2014

BACKGROUND AND PURPOSE: The exact prevalence of WM signal abnormalities in healthy relatives of MS patients and their impact on disease development has not been fully elucidated. The purpose of this study was to compare WM signal abnormality characteristics and the prevalence of radiologically isolated syndrome in healthy control subjects selected randomly from the population with the healthy relatives of patients with MS. MATERIALS AND METHODS: Healthy control subjects (n = 150) underwent physical and 3T MR imaging examinations. Healthy control subjects were classified as non-familial healthy control subjects (n = 82) if they had no family history of MS or as healthy relatives of patients with MS (n = 68) if they had ≥1 relative affected with MS. The presence of radiologically isolated syndrome was evaluated according to the Okuda criteria; dissemination in space onMRimaging and fulfillment of radiologically isolated syndrome criteria were also evaluated according to Swanton criteria. RESULTS: There was a significantly higher total volume ofWMsignal abnormality in the healthy relatives of patients withMScompared with the non-familial healthy control subjects (P = .024 for signal abnormality ≥3mmin size and P = .025 for all sizes). Periventricular localization and the number of lesions in all groups (P = .034 and P = .043) were significantly higher in the healthy relatives of patients with MS; 8.8% of the healthy relatives of patients with MS and 4.9% of non-familial healthy control subjects showed ≥9 WM signal abnormalities; 2.9% of subjects in the healthy relatives of patients with MS group and 2.4% of non-familial healthy control subjects fulfilled radiologically isolated syndrome according to the Okuda criteria, whereas 10.3% and 3.7% of subjects fulfilled radiologically isolated syndrome according to the Swanton criteria. In the healthy relatives of patients with MS, smoking was associated with the presence ofWMsignal abnormalities, whereas obesity was related to the presence of ≥9 WM signal abnormalities and to fulfillment of radiologically isolated syndrome according to the Swanton criteria. CONCLUSIONS: The frequency of WM signal abnormalities and radiologically isolated syndrome is higher in the healthy relatives of patients with multiple sclerosis patients compared with non-familial healthy control subjects.

Pfordresher P.Q.,State University of New York at Buffalo | Mantell J.T.,St. Mary's College of Maryland | Brown S.,McMaster University | Zivadinov R.,State University of New York at Buffalo | And 2 more authors.
Brain Research | Year: 2014

Alterations of auditory feedback during piano performance can be profoundly disruptive. Furthermore, different alterations can yield different types of disruptive effects. Whereas alterations of feedback synchrony disrupt performed timing, alterations of feedback pitch contents can disrupt accuracy. The current research tested whether these behavioral dissociations correlate with differences in brain activity. Twenty pianists performed simple piano keyboard melodies while being scanned in a 3-T magnetic resonance imaging (MRI) scanner. In different conditions they experienced normal auditory feedback, altered auditory feedback (asynchronous delays or altered pitches), or control conditions that excluded movement or sound. Behavioral results replicated past findings. Neuroimaging data suggested that asynchronous delays led to increased activity in Broca's area and its right homologue, whereas disruptive alterations of pitch elevated activations in the cerebellum, area Spt, inferior parietal lobule, and the anterior cingulate cortex. Both disruptive conditions increased activations in the supplementary motor area. These results provide the first evidence of neural responses associated with perception/action mismatch during keyboard production. © 2014 Elsevier B.V.

PubMed | CV Path Institute, NAMSA, University of Pennsylvania, Medstar Washington Hospital Center and 11 more.
Type: | Journal: Journal of the American College of Cardiology | Year: 2016

Neurological events and brain infarction after transcatheter aortic valve replacement (TAVR) are concerns which may be reduced with transcatheter embolic protection (TEP).Evaluate the safety and efficacy of TEP during TAVR.Nineteen centers randomized 363 patients undergoing TAVR to safety (n=123), device imaging (n=121), and control imaging (n=119). The primary safety endpoint was major adverse cardiac and cerebrovascular events (MACCE) at 30 days and the primary efficacy endpoint was reduction in new lesion volume in protected brain territories on MRI scans at 2-7 days. Patients underwent neurocognitive assessments and the debris captured was analyzed.MACCE (7.3%) was non-inferior to the performance goal (18.3%, pTEP was safe, captured embolic debris 99% patients, and did not change neurocognitive function. Reduction in new lesion volume on MR scans was not statistically significant.

PubMed | Sick Kids Hospital, Children's Hospital of Buffalo, Buffalo Neuroimaging Analysis Center and State University of New York at Buffalo
Type: | Journal: Pediatric neurology | Year: 2016

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disorder that is usually self-limited. Recent studies have suggested ongoing neurological deficits and neurocognitive impairment in these patients. Little information on the correlation of clinical and neuroimaging markers in ADEM is available. We examined potential clinical factors (e.g., age of onset, acute symptom duration, magnetic resonance imaging [MRI] lesions) and their relation to neurocognitive and psychosocial outcomes.This is a retrospective chart review of consecutive pediatric patients diagnosed with ADEM between 2006 and 2012. Patients were evaluated with standard neurological assessment, MRI of the brain, and neuropsychological evaluation.Twenty-three patients with ADEM with average age at neuropsychological assessment of 10.1years (3.50) were included. Five (22.7%) patients were impaired on three or more neurocognitive measures. Psychosocial problems were reported in 20%-40% of patients. Earlier age of onset was correlated with poorer sustained attention and psychosocial problems, whereas acute symptom duration and Expanded Disability Status Scale were not. MRI outcomes were correlated with psychosocial outcomes but not neuropsychological findings.Our findings suggest lingering cognitive and psychosocial deficits in children with a history of ADEM. Clinical features and MRI findings correlated more strongly with psychosocial outcomes than cognitive functioning. Further studies are needed to confirm relationships and other possible contributing factors to lingering deficits.

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