Cerebral Blood Flow Improvement after Indirect Revascularization for Pediatric Moyamoya Disease: A Statistical Analysis of Arterial Spin-Labeling MRI

Blauwblomme, Thomas; Lemaître, Hervé; Naggara, Olivier; Calmon, Raphaël; Kossorotoff, Manoëlle; Bourgeois, Marie; Mathon, Bertrand; Puget, Stéphanie; Zérah, Michel; Brunelle, Françis; Sainte‐Rose, Christian; Boddaert, Nathalie

doi:10.3174/ajnr.a4592

Cited by 41 publications

(28 citation statements)

References 16 publications

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“…Voxel-based analyses were performed on smoothed and normalized ASL images within a GM mask in under SPM8, as previously. 40 At the individual level, voxel-based analysis was performed using the general linear model, comparing the patient to a control group of 30 healthy pediatric controls according to a methodology previously described. 25 Results were interpreted with a significance level set at whole-brain P = .05 FWE, and P = .001 uncorrected.…”

Section: Asl Preprocessing and Analysismentioning

confidence: 99%

Complete hemispherotomy leads to lateralized functional organization and lower level of consciousness in the isolated hemisphere

et al. 2020

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Section: Asl Preprocessing and Analysismentioning

confidence: 99%

Complete hemispherotomy leads to lateralized functional organization and lower level of consciousness in the isolated hemisphere

et al. 2020

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“…Catheter angiography, CTA, and MRA have demonstrated neovascularization within the EDAS operative territory through transdural and transpial collateral vessels. 12,13 Increased donor STA and MMA vessel sizes, and a decrease in preoperative native collaterals following EDAS, has also been reported. 5,12,14,15 Beyond anatomic changes, investigating tissue perfusion is necessary as alterations in tissue perfusion are dynamic processes that may not correlate directly with structural changes.…”

Section: Introductionmentioning

confidence: 91%

Evaluation of Encephaloduroarteriosynangiosis Efficacy Using Probabilistic Independent Component Analysis Applied to Dynamic Susceptibility Contrast Perfusion MRI

Laiwalla¹,

Kurth

Leu

et al. 2017

AJNR Am J Neuroradiol

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Background and Purpose Indirect cerebral revascularization has been successfully used for treatment in moyamoya disease and symptomatic intracranial atherosclerosis. While angiographic neovascularization has been demonstrated after surgery, measurements of local tissue perfusion are scarce and may not reflect the reported successful clinical outcomes. We investigated probabilistic independent component analysis and conventional perfusion parameters from DSC-MRI to measure post-surgical changes in tissue perfusion. Materials and Methods In this prospective study, thirteen patients underwent unilateral indirect cerebral revascularization and received DSC-MRI before and after surgery. Conventional perfusion parameters (rCBV, rCBF, and TTP), and probabilistic independent components that reflect the relative contributions of DSC signals consistent with arterial, capillary, and venous hemodynamics were calculated and examined for significant changes after surgery. Results were compared to post-surgical DSA studies to determine whether changes in tissue perfusion were due to post-surgical neovascularization. Results Prior to surgery, tissue within the affected hemisphere demonstrated a high probability for hemodynamics consistent with venous flow and a low probability for hemodynamics consistent with arterial flow, whereas the contralateral control hemisphere demonstrated the reverse. Consistent with symptomatic improvement, the probability for venous hemodynamics within the affected hemisphere decreased with time after surgery (p = 0.002). No other perfusion parameters demonstrated this association. Post-surgical DSA revealed an association between an increased preoperative venous probability in the symptomatic hemisphere and neovascularization after surgery. Conclusion Probabilistic independent component analysis yielded sensitive measurements of changes in local tissue perfusion that may be associated with newly formed vasculature after indirect cerebral revascularization surgery.

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“…Due to the poor spatial resolution of the ASL images, the registration was done in an indirect but robust way including the preprocessing of structural T1 data (Blauwblomme et al, 2016). The preprocessing steps were achieved using the Voxel Based Morphometry toolbox (Ashburner and Friston, 2000) (VBM8) (http://www.neuro.uni-jena.de/vbm), implemented in Matlab (Mathworks Inc., Sherborn, MA, USA).…”

Section: Asl Preprocessingmentioning

confidence: 99%

“…Eventually the normalized ASL images are smoothed using a 10mm isotropic filter. Voxel-based analyses were performed on smoothed and normalized ASL images within a grey matter mask in under SPM8, as previously (Blauwblomme et al, 2016). At the individual level, voxel-based analysis was performed using the general linear model, comparing the patient to a control group of 30 healthy pediatric controls according to a methodology previously described (Boisgontier et al, 2018).…”

Section: Asl Preprocessingmentioning

confidence: 99%

Functional cortico-subcortical reorganization after complete hemispheric disconnection for intractable epilepsy

Blauwblomme

Demertzi

Tacchela

et al. 2019

Preprint

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Hemispherotomy is a treatment for drug-resistant epilepsy with the whole hemisphere involved in seizure onset. As recovery mechanisms are still debated, we characterize functional reorganization with multimodal MRI in two children operated on the right hemisphere (RH). We found that interhemispheric functional connectivity was abolished in both patients. The healthy left hemispheres (LH) displayed focal hyperperfusion in motor and limbic areas, and preserved network-level organization. The disconnected RHs were hypoperfused despite sustained network-level organization. Functional connectivity was increased in the left thalamo-cortical loop and between the cerebelli. The classification probability of the RH corresponding to a minimally conscious state was smaller than for the LH. We conclude that after hemispherotomy, neurological rehabilitation is sustained by cortical disinhibition and reinforcement of connectivity driven by subcortical structures in the remaining hemisphere. Our results highlight the effect of vascularization on functional connectivity and raise inquiries about the conscious state of the isolated hemisphere. Clinical outcomes of hemispherectomy for epilepsy in childhood and adolescence. Brain. 2003; 126(Pt 3):556-66. doi: 10.1093/brain/awg052. Funnell MG, Corballis PM, Gazzaniga MS. Insights into the functional specificity of the human corpus callosum. Brain. 2000; 123 ( Pt 5:920-926. doi: 10.1093/brain/123.5.920. Gazzaniga MS. Forty-five years of split-brain research and still going strong. Nature Reviews Neuroscience. 2005; 6(8):653-659. Gold L, Lauritzen M. Neuronal deactivation explains decreased cerebellar blood flow in response to focal cerebral ischemia or suppressed neocortical function.spherectomy for treatment of refractory epilepsy in the pediatric age group: a systematic review. A. The reorganization of sensorimotor function in children after hemispherectomy. A functional MRI and somatosensory evoked potential study.

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Cerebral Blood Flow Improvement after Indirect Revascularization for Pediatric Moyamoya Disease: A Statistical Analysis of Arterial Spin-Labeling MRI

Cited by 41 publications

References 16 publications

Complete hemispherotomy leads to lateralized functional organization and lower level of consciousness in the isolated hemisphere

Complete hemispherotomy leads to lateralized functional organization and lower level of consciousness in the isolated hemisphere

Evaluation of Encephaloduroarteriosynangiosis Efficacy Using Probabilistic Independent Component Analysis Applied to Dynamic Susceptibility Contrast Perfusion MRI

Functional cortico-subcortical reorganization after complete hemispheric disconnection for intractable epilepsy

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