This work is concerned with the accurate quantification of brain water content under routine clinical conditions. Gelatin solutions of varying water content are first employed as a model of an edematous brain and longitudinal relaxation measurements are performed at proton Larmor frequencies of 5, 41, 63, and 100 MHz. These are followed with in vivo measurements in an experimental animal model of brain edema at 41 MHz. The results underscore the dominant role of total water content W in the relaxation process and verify the expected linearity between 1/T1 and 1/W. A scheme is presented and experimentally verified at 41 MHz for deducing the exact relationship of 1/T1 vs 1/W at any frequency. Knowledge of this relationship along with precise measurements of 1/T1 at a given field strength permits quantitative in vivo measures of brain water content to be obtained with a precision of about 0.01. It is concluded that routine, accurate, and noninvasive brain water measurements are possible by magnetic resonance imaging in a clinical environment.
An association between biochemical and biomechanical functional status and MR imaging parameters of articular cartilage was demonstrated. Linear correlations existed between modulus and proteoglycan content in terms of T2. Additionally, proteoglycan loss and collagen loss had differing effects on gadolinium-enhanced T1 when it was expressed as the ratio of T1 after gadolinium enhancement/T1 before gadolinium enhancement.
Most phantom media in current use exhibit T1 relaxation times that are significantly dependent on both temperature and operating frequency. This can introduce undesirable variability into relaxation measurements due to temperature fluctuations, and complicates direct comparison of imagers operating at different magnetic field strengths. Our investigations of a nickel-doped agarose gel system have demonstrated near independence of the proton relaxation rates to a wide range of temperatures and frequencies. We therefore propose the adoption of Ni2+ as a relaxation modifier for phantom materials used as relaxometry standards.
Objective
Minimal hepatic encephalopathy (MHE) impairs daily functioning in cirrhosis, but its functional brain impact is not completely understood.
Aim
To evaluate the effect of rifaximin, a gut-specific antibiotic, on the gut-liver-brain axis in MHE.
Hypothesis
Rifaximin will reduce endotoxemia, enhance cognition, increase activation during working memory(N-back) and reduce activation needed for inhibitory control tasks.
Methods
Cirrhotics with MHE underwent baseline endotoxin and cognitive testing, then underwent fMRI, diffusion tensor imaging and MR spectroscopy(MRS). On fMRI, two tasks; N-back (outcome: correct responses) and inhibitory control tests(outcomes: lure inhibition) were performed. All procedures were repeated after 8 weeks of rifaximin. Results were compared before/after rifaximin.
Results
20 MHE patients (59.7 years) were included; sixteen completed pre/post-rifaximin scanning with 92% medication compliance. Pre-rifaximin patients had cognitive impairment. At trial-end, there was a significantly higher correct 2-back responses, ICT lure inhibitions and reduced endotoxemia(p=0.002). This was accompanied by significantly higher activation from baseline in subcortical structures (thalamus, caudate, insula and hippocampus) and left parietal operculum (LPO) during N-back, decrease in fronto-parietal activation required for inhibiting lures, including LPO during ICT compared to baseline values. Connectivity studies in N-back showed significant shifts in linkages after therapy in fronto-parietal regions with a reduction in fractional anisotropy (FA) but not mean diffusivity (MD), and no change in MRS metabolites at the end of the trial.
Conclusion
A significant improvement in cognition including working memory and inhibitory control, and fractional anisotropy without effect on MD or MRS, through modulation of fronto-parietal and subcortical activation and connectivity was seen after open-label rifaximin therapy in MHE.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.