Volumes of the right and left anterior temporal lobes and hippocampal formations were measured from magnetic resonance images in 52 healthy volunteers, aged 20-40 years. Subjects were selected by age, sex, and handedness to evaluate possible effect of these variables. Data were normalized for variation in total intracranial volume between individuals. Right-left asymmetry in the volumes of the anterior temporal lobes and hippocampal formations was a normal finding. The anterior temporal lobe of the non-dominant (right) hemisphere was larger than the left by a small (mean right-left difference, 2.3 cm3) but statistically significant amount (P less than .005) in right-handed subjects. No significant effect of age or sex was seen in normalized right or left anterior temporal lobe volume. The right hippocampal formation was larger than the left for all subjects by a small (mean right-left difference, 0.3 cm3) but statistically significant amount (P less than .001). No effect of age, sex, or handedness was seen in normalized hippocampal formation volumes.
A retrospective magnetic resonance (MR) imaging study was performed in 41 right-handed patients with presumed mesial sclerosis who underwent surgery for medically intractable, complex partial seizures of temporal lobe origin. The ability of each of five different MR imaging-based tests to lateralize the seizure disorder was determined. In order of decreasing usefulness the tests were (a) hippocampal formation (HF) volume measurements, (b) visual grading of MR images for unilateral HF atrophy, (c) anterior temporal lobe (ATL) volume measurements, (d) visual grading of MR images for unilateral ATL atrophy, and (e) evidence of unilateral medial temporal lobe signal intensity abnormalities on long repetition time MR images. A right-side minus left-side volume (designated DHF) was obtained to quantify unilateral HF atrophy with a single number. Patients with right-sided seizures had a median DHF of -0.4 cm3, while those with left-sided seizures had a median DHF of 0.8 cm3, consistent with atrophy of the HF ipsilateral to the seizure disorder. Conservative volumetric threshold values (-0.2 cm3 and 0.6 cm3), separating individual DHF measurements into right-side abnormal, indeterminate, and left-side abnormal, allowed DHF measurements to be 76% sensitive and 100% specific for correct seizure lateralization.
The newly recognized class of 5-hydroxytryptamine receptors (5HT3) may be involved in the induction of nausea, since their pharmacological antagonists are effective against emesis induced by chemotherapy. 5HT3 receptors are present on enteric neurons, and 5HT3 blockers may produce mild constipation; we thus hypothesized that 5HT3 receptors would modulate colonic motility. To determine if GR 38032F, a selective 5HT3 antagonist known to have antiemetic effects, influences colonic transit in health, a randomized, double-blind, placebo-controlled crossover study was performed. Using a radiopaque marker technique, colonic transit was quantified in 39 healthy volunteers (19 men, 20 nonpregnant women) 18-70 years of age. On a standard 25-g fiber diet, 16 mg of GR 38032F was given orally thrice daily. Gastrointestinal peptides (peptide YY, human pancreatic polypeptide, neurotensin, motilin, gastrin-cholecystokinin, substance P) were also measured in plasma fasting and postprandially. Mean total colonic transit time on placebo was 27.8 hr, while on GR 38032F it was 39.1 hr (P less than 0.0005). Transit times through the left colon (P less than 0.0005) and rectosigmoid (P less than 0.05) were prolonged by the drug, but right colonic transit was not significantly altered. Transit times did not correlate with age or gender, but subjects with shorter transit times were significantly more affected than were those with longer transit times. The peak release of peptide YY was minimally decreased following GR 38032F (P less than 0.01), but the peak and integrated postprandial responses of human pancreatic polypeptide, neurotensin, motilin, gastrin-cholecystokinin, and substance P were not significantly altered by the drug.(ABSTRACT TRUNCATED AT 250 WORDS)
An experiment was designed to compare the accuracy and reproducibility of three different techniques for in vivo magnetic resonance (MR) imaging-based volume measurements of brain structures. These techniques were tracing, thresholding, and random marking. Anterior temporal lobe (ATL) and hippocampal formation (HF) volumes in 10 volunteers were measured from MR images, as were four cylinders of known volume. The upper limit of accuracy of in vivo volume measurements is estimated to be within 0.1 cm3 of true volume for the HF and 0.9 cm3 for the ATL with a combined tracing-thresholding technique. Intra- and interobserver variations were estimated from the pooled standard deviations of HF and ATL measurements. With the combined tracing-thresholding technique, the coefficient of variation for HF measurement was 1.9%; for the ATL measurement, it was 0.7%. The results indicate that MR-based volume measurements of these brain structures can be made with high precision and reproducibility.
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