tag:blogger.com,1999:blog-41107903493208002992024-02-21T10:21:38.245-08:00Brainmarkers.comBrain Atrophy Indices: simple methods for assessing atrophy of brain structures on MRIAnonymoushttp://www.blogger.com/profile/04796162963517707328noreply@blogger.comBlogger27125tag:blogger.com,1999:blog-4110790349320800299.post-51562337506998869452022-03-27T11:47:00.009-07:002022-03-27T11:48:30.450-07:00Using visual score to measure atrophy of substantia innominata<p> </p><div class="separator" style="clear: both; text-align: center;"><a href="https://media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs12883-022-02642-0/MediaObjects/12883_2022_2642_Fig1_HTML.png?as=webp" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="386" data-original-width="685" height="225" src="https://media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs12883-022-02642-0/MediaObjects/12883_2022_2642_Fig1_HTML.png?as=webp" title="Measurement example. *: Anterior commissure; + : nucleus basalis Meynert; red line: horizontal line under the anterior commissure; blue line: line under the nucleus basalis Meynert; yellow line: distance" width="400" /></a></div><br /><p></p><p><br /></p><div class="separator" style="clear: both; text-align: center;"><a href="https://media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs12883-022-02642-0/MediaObjects/12883_2022_2642_Fig2_HTML.png?as=webp" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="788" data-original-width="685" height="400" src="https://media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs12883-022-02642-0/MediaObjects/12883_2022_2642_Fig2_HTML.png?as=webp" title="Atrophy score example.: Showing examples of the visual atrophy score. It should be mentioned that in case 3 no gray matter is detectable, even if the measured distance is normal" width="348" /></a></div><br /><p>Reference: <span face="-apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif" style="background-color: white; color: #333333; font-size: 16px;">Khadhraoui, E., Müller, S.J., Hansen, N. </span><i style="background-color: white; box-sizing: inherit; color: #333333; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;">et al.</i><span face="-apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif" style="background-color: white; color: #333333; font-size: 16px;"> Manual and automated analysis of atrophy patterns in dementia with Lewy bodies on MRI. </span><i style="background-color: white; box-sizing: inherit; color: #333333; font-family: -apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif; font-size: 16px;">BMC Neurol</i><span face="-apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif" style="background-color: white; color: #333333; font-size: 16px;"> </span><span face="-apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif" style="background-color: white; box-sizing: inherit; color: #333333; font-size: 16px; font-weight: bolder;">22, </span><span face="-apple-system, BlinkMacSystemFont, "Segoe UI", Roboto, Oxygen-Sans, Ubuntu, Cantarell, "Helvetica Neue", sans-serif" style="background-color: white; color: #333333; font-size: 16px;">114 (2022). https://doi.org/10.1186/s12883-022-02642-0</span></p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-53772303885496114012021-04-03T01:15:00.011-07:002021-04-03T01:17:41.215-07:00Using visual scales to determine brain atrophy subtypes in Alzheimer’s Disease<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg51dVk7vA03fxJXNHq2g5pQf4zZw2i2y5rcnW3nSvFgFCbYp7EPC9vQzugyX3CFlrsjIe1D8SWsCxPtJ9v2yB-zr1-YSg9eJw2PAxSr_H28eQMKy9h62ghLuOmybSqE_PAaKtt1CTrrl-q/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="533" data-original-width="900" height="330" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg51dVk7vA03fxJXNHq2g5pQf4zZw2i2y5rcnW3nSvFgFCbYp7EPC9vQzugyX3CFlrsjIe1D8SWsCxPtJ9v2yB-zr1-YSg9eJw2PAxSr_H28eQMKy9h62ghLuOmybSqE_PAaKtt1CTrrl-q/w558-h330/image.png" width="558" /></a></div><div class="separator" style="clear: both; text-align: center;"><span face=""Open Sans", Verdana, Arial, sans-serif" style="background-color: white; color: #333333; text-align: start;"><span style="font-size: x-small;">AD subtypes based on patterns of brain atrophy. Regional atrophy was measured with the MTA, PA, and GCA-F visual rating scales based only on T1-weighted images. In the 3 visual rating scales, a score of zero denotes no atrophy, whereas scores from 1 to 3 (PA and GCA-F) or 4 (MTA) indicate an increasing degree of atrophy. The typical AD subtype was defined as abnormal MTA together with abnormal PA and/or abnormal GCA-F. The limbic-predominant subtype was defined as abnormal MTA alone with normal PA and GCA-F. The hippocampal-sparing subtype included abnormal PA and/or abnormal GCA-F but normal MTA. The minimal atrophy subtype was defined as normal scores in MTA, PA, and GCA-F. The figure shows examples of each subtype in axial and coronal sections of the brain. AD, Alzheimer’s disease; MTA, medial temporal atrophy scale; PA, posterior atrophy scale; GCA-F, global cortical atrophy scale – frontal subscale; A, anterior part of the brain; P, posterior part of the brain; R, right; L, left.</span></span></div><div class="separator" style="clear: both; text-align: center;"><span face=""Open Sans", Verdana, Arial, sans-serif" style="background-color: white; color: #333333; text-align: start;"><span style="font-size: x-small;"><br /></span></span></div><div class="separator" style="clear: both; text-align: left;"><span style="font-family: inherit; font-size: x-small;">Reference: <a class="blocklink" href="https://doi.org/10.1159/000515322" style="-webkit-font-smoothing: antialiased; background-color: white; border: 0px; color: #f89300; display: inline-block; font-stretch: inherit; font-variant-east-asian: inherit; font-variant-numeric: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 15px; scroll-behavior: smooth; text-align: left;">https://doi.org/10.1159/000515322</a></span></div><p></p>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-82301380702018061252020-03-09T09:42:00.001-07:002020-03-09T09:43:20.947-07:00Medial temporal atrophy in preclinical dementia: visual and automated assessment during six year follow-up<div style="text-align: justify;">
Medial temporal lobe (MTL) atrophy is an important morphological marker of many dementias and is closely related to cognitive decline. In this study we aimed to characterize longitudinal progression of MTL atrophy in 93 individuals with subjective cognitive decline and mild cognitive impairment followed up over six years, and to assess if clinical rating scales are able to detect these changes. All MRI images were visually rated according to Scheltens' scale of medial temporal atrophy (MTA) by two neuroradiologists and AVRA, a software for automated MTA ratings. The images were also segmented using FreeSurfer's longitudinal pipeline in order to compare the MTA ratings to volumes of the hippocampi and inferior lateral ventricles. We found that MTL atrophy rates increased with CSF biomarker abnormality, used to define preclinical stages of Alzheimer's Disease. Both AVRA's and the radiologists' MTA ratings showed a similar longitudinal trajectory as the subcortical volumes, suggesting that visual rating scales provide a valid alternative to automatic segmentations. While the MTA scores from each radiologist showed strong correlations to subcortical volumes, the inter-rater agreement was low. We conclude that the main limitation of quantifying MTL atrophy with visual ratings in clinics is the subjectiveness of the assessment.</div>
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<a href="https://www.biorxiv.org/content/10.1101/2020.03.05.979229v1.full.pdf" target="_blank">Full text</a></div>
Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-4110790349320800299.post-18487922721503112252019-12-18T06:46:00.001-08:002019-12-18T06:46:44.555-08:00Imaging Patterns of Toxic and Metabolic Brain Disorders<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://pubs.rsna.org/na101/home/literatum/publisher/rsna/journals/content/radiographics/2019/rg.2019.39.issue-6/rg.2019190016/20190930/images/medium/rg.2019190016.fig2.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="416" data-original-width="500" src="https://pubs.rsna.org/na101/home/literatum/publisher/rsna/journals/content/radiographics/2019/rg.2019.39.issue-6/rg.2019190016/20190930/images/medium/rg.2019190016.fig2.gif" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: x-small;"><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">Illustration shows the most important general imaging patterns in toxic and metabolic brain disorders. White areas = areas of involvement. These include symmetric basal ganglia and/or thalami involvement (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(A)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; symmetric dentate nuclei involvement (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(B)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; prominent cortical gray matter involvement (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(C)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; symmetric periventricular white matter involvement (with gray matter sparing) (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(D)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; corticospinal tract involvement (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(E)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; corpus callosum involvement (coronal view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(F)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; asymmetric white matter involvement (demyelinating disease pattern) (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(G)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; parieto-occipital subcortical vasogenic edema (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(H)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">; and central pons involvement (axial view) </span><i style="background-color: white; box-sizing: border-box; font-family: "Open Sans", sans-serif; text-align: start;">(I)</i><span style="background-color: white; font-family: "Open Sans", sans-serif; text-align: start;">.</span></span></td></tr>
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Reference: <a class="epub-section__doi__text" href="https://doi.org/10.1148/rg.2019190016" style="background-color: white; box-sizing: border-box; color: black; cursor: pointer; font-family: "Open Sans", sans-serif; font-size: 14px; outline: 0px; text-decoration-line: none; transition: color 0.3s ease 0s;">https://doi.org/10.1148/rg.2019190016</a>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-49583783390884173792019-11-24T06:57:00.001-08:002019-11-24T06:58:01.816-08:00Linear vs volume measures of ventricle size in hydrocephalus: relation to present and future gait and cognition<div style="text-align: justify;">
Objective To compare the clinical utility of volume-based ratios with the standard linear ratio of Evans index (EI) by examining their associations with gait, cognition, and other patient and imaging variables. </div>
<div style="text-align: justify;">
Methods From MRI scans of 1,774 participants in the Mayo Clinic Study of Aging, we calculated 3 ventricle size measures: Evan index (frontal horn width divided by widest width of skull inner table), total ventricular volume, and frontal horn volume as ratios of total intracranial volume. Gait was measured by a timed 25-foot walk and cognition by a composite of psychometric tests. We also evaluated variables associated with the measures of ventricular size. Further, we evaluated gait and cognition associations with MRI of extraventricular findings seen in normal-pressure hydrocephalus: disproportionate enlargement of subarachnoid space (DESH) and focal sulcal dilations (FSD). </div>
<div style="text-align: justify;">
Results Ventricular volume measures had stronger association with gait and cognition measures than EI. In decreasing order of strength of association with ventricle size were DESH, FSD, white matter hyperintensity volume ratio, age, male sex, cortical thickness, and education. Modest evidence was observed that FSD was associated with future decline in gait and cognition. </div>
<div style="text-align: justify;">
Conclusion Ventricular volume measures are clinically more useful than EI in indicating current and future gait and cognition. Multiple factors are associated with ventricle volume size, including FSD and DESH, suggesting that changes in CSF dynamics may go beyond simple ventriculomegaly. </div>
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DOI: https://doi.org/10.1212/WNL.0000000000008673Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-72131226208967074652019-11-09T02:52:00.002-08:002019-11-09T02:53:30.650-08:00Thalamic nuclei in frontotemporal dementia: Mediodorsal nucleus involvement is universal but pulvinar atrophy is unique to C9orf72<div style="text-align: justify;">
Thalamic atrophy is a common feature across all forms of FTD but little is known about specific nuclei involvement. We aimed to investigate in vivo atrophy of the thalamic nuclei across the FTD spectrum. A cohort of 402 FTD patients (age: mean(SD) 64.3(8.2) years; disease duration: 4.8(2.8) years) was compared with 104 age‐matched controls (age: 62.5(10.4) years), using an automated segmentation of T1‐weighted MRIs to extract volumes of 14 thalamic nuclei. Stratification was performed by clinical diagnosis (180 behavioural variant FTD (bvFTD), 85 semantic variant primary progressive aphasia (svPPA), 114 nonfluent variant PPA (nfvPPA), 15 PPA not otherwise specified (PPA‐NOS), and 8 with associated motor neurone disease (FTD‐MND), genetic diagnosis (27 MAPT, 28 C9orf72, 18 GRN), and pathological confirmation (37 tauopathy, 38 TDP‐43opathy, 4 FUSopathy). The mediodorsal nucleus (MD) was the only nucleus affected in all FTD subgroups (16–33% smaller than controls). The laterodorsal nucleus was also particularly affected in genetic cases (28–38%), TDP‐43 type A (47%), tau‐CBD (44%), and FTD‐MND (53%). The pulvinar was affected only in the C9orf72 group (16%). Both the lateral and medial geniculate nuclei were also affected in the genetic cases (10–20%), particularly the LGN in C9orf72 expansion carriers. Use of individual thalamic nuclei volumes provided higher accuracy in discriminating between FTD groups than the whole thalamic volume. The MD is the only structure affected across all FTD groups. Differential involvement of the thalamic nuclei among FTD forms is seen, with a unique pattern of atrophy in the pulvinar in C9orf72 expansion carriers.</div>
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<a href="https://onlinelibrary.wiley.com/cms/attachment/61488423-46f5-4368-9c0a-e3bfe388d80b/hbm24856-fig-0001-m.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="274" data-original-width="500" height="218" src="https://onlinelibrary.wiley.com/cms/attachment/61488423-46f5-4368-9c0a-e3bfe388d80b/hbm24856-fig-0001-m.png" width="400" /></a></div>
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<a href="https://onlinelibrary.wiley.com/doi/10.1002/hbm.24856" target="_blank"><br /></a></div>
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<a href="https://onlinelibrary.wiley.com/doi/10.1002/hbm.24856" target="_blank">Full text</a></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-2920934664293602362019-03-23T03:42:00.001-07:002019-03-23T03:42:57.585-07:00Brain volumes and their ratios in Alzheimer´s disease on magnetic resonance imaging segmented using Freesurfer 6.0<br />
<ul>
<li>Study shows 44 brain regions volume changes with Alzheimer's disease. </li>
<li>Volumes were calculated both in absolute values and ratios to the whole brain volume. </li>
<li>The hippocampo-horn proportion is effective for hippocampal atrophy evaluation. </li>
<li>This method can be simplified for visual assessment.</li>
</ul>
<div>
<a href="https://www.sciencedirect.com/science/article/pii/S0925492718302324" target="_blank">Abstract</a></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-83547608213116956212019-01-20T08:50:00.000-08:002019-01-20T08:50:25.133-08:00A new MR imaging index for differentiation of progressive supranuclear palsy-parkinsonism from Parkinson's disease<section class="articleHighlights" id="abs0015" style="background-color: white; color: #333333; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 12px; overflow-wrap: normal;"><h2 class="sectionTitle" style="display: inline-block; font-family: Georgia, serif; font-size: 24px; font-weight: normal; line-height: 25px; margin: 0px 0px 3px; padding: 7px 0px 0px; text-rendering: optimizelegibility;" tabindex="0">
Highlights</h2>
<div class="content" style="line-height: 1.5em;">
<div style="line-height: 1.5em; margin-bottom: 1.2em;">
</div>
<ul class="ce-list" id="ulist0010" style="list-style: none; margin: 0px 0px 0px 2em; padding: 0px;">
<li id="u0010" style="display: block; margin: 0px; padding: 0px;"><span class="label" style="margin-left: -20px; padding-right: 5px; text-align: right;">•</span>Distinguishing PSP-P from PD is challenging in the early stages of the disease.</li>
<li id="u0015" style="display: block; margin: 0px; padding: 0px;"><span class="label" style="margin-left: -20px; padding-right: 5px; text-align: right;">•</span>Few data exist on the usefulness of MRPI for diagnosing PSP-P patients.</li>
<li id="u0020" style="display: block; margin: 0px; padding: 0px;"><span class="label" style="margin-left: -20px; padding-right: 5px; text-align: right;">•</span>MRPI 2.0 is a new version of MRPI which includes the 3rd ventricular width.</li>
<li id="u0025" style="display: block; margin: 0px; padding: 0px;"><span class="label" style="margin-left: -20px; padding-right: 5px; text-align: right;">•</span>MRPI 2.0 accurately differentiated patients with PSP-P from those with PD.</li>
<li id="u0030" style="display: block; margin: 0px; padding: 0px;"><span class="label" style="margin-left: -20px; padding-right: 5px; text-align: right;">•</span>MRPI 2.0 accurately diagnosed PSP-P in the absence of vertical ocular palsy.</li>
<li id="u0030" style="display: block; margin: 0px; padding: 0px;"><br /></li>
</ul>
<div style="line-height: 1.5em; margin-bottom: 1.2em;">
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</section><div class="abstract" style="background: rgb(250, 250, 250); border: 1px solid rgb(238, 238, 238); clear: none; color: #333333; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 12px;">
<h2 class="sectionTitle" style="display: inline-block; font-family: Georgia, serif; font-size: 24px; font-weight: normal; line-height: 25px; margin: 0px 0px 3px; padding: 7px 0px 0px; text-rendering: optimizelegibility;" tabindex="0">
Abstract</h2>
<div class="content" style="line-height: 1.5em;">
<section style="overflow-wrap: normal;"><h3 class="sectionTitle" style="display: inline-block; font-family: Georgia, serif; font-size: 18px; font-weight: normal; line-height: 18px; margin: 0px 0px 3px; padding: 7px 0px 0px; text-rendering: optimizelegibility;" tabindex="0">
Introduction</h3>
<div class="content" style="line-height: 1.5em;">
<div style="line-height: 1.5em; margin-bottom: 1.2em;">
Differentiating clinically progressive supranuclear palsy-parkinsonism (PSP-P) from Parkinson's disease (PD) may be challenging, especially in the absence of vertical supranuclear gaze palsy (VSGP). The Magnetic Resonance Parkinsonism Index (MRPI) has been reported to accurately distinguish between PSP and PD, yet few data exist on the usefulness of this biomarker for the differentiation of PSP-P from PD.</div>
</div>
</section></div>
<div class="content" style="line-height: 1.5em;">
<section style="overflow-wrap: normal;"><h3 class="sectionTitle" style="display: inline-block; font-family: Georgia, serif; font-size: 18px; font-weight: normal; line-height: 18px; margin: 0px 0px 3px; padding: 7px 0px 0px; text-rendering: optimizelegibility;" tabindex="0">
Methods</h3>
<div class="content" style="line-height: 1.5em;">
<div style="line-height: 1.5em; margin-bottom: 1.2em;">
Thirty-four patients with PSP-P, 46 with PSP-Richardson's syndrome (PSP-RS), 53 with PD, and 53 controls were enrolled. New consensus criteria for the clinical diagnosis of PSP were used as the reference standard. The MRPI, and a new index termed MRPI 2.0 including the measurement of the third ventricle width (MRPI multiplied by third ventricle width/frontal horns width ratio), were calculated on T1-weighted MR images.</div>
</div>
</section></div>
<div class="content" style="line-height: 1.5em;">
<section style="overflow-wrap: normal;"><h3 class="sectionTitle" style="display: inline-block; font-family: Georgia, serif; font-size: 18px; font-weight: normal; line-height: 18px; margin: 0px 0px 3px; padding: 7px 0px 0px; text-rendering: optimizelegibility;" tabindex="0">
Results</h3>
<div class="content" style="line-height: 1.5em;">
<div style="line-height: 1.5em; margin-bottom: 1.2em;">
The MRPI differentiated patients with PSP-P from those with PD with sensitivity and specificity of 73.5% and 98.1%, respectively, while the MRPI 2.0 showed higher sensitivity (100%) and similar specificity (94.3%) in differentiating between these two groups. Both biomarkers showed excellent performance in differentiating PSP-P patients with VSGP from those with PD, but the MRPI 2.0 was much more accurate (95.8%) than MRPI in differentiating PSP-P patients with slowness of vertical saccades from PD patients.</div>
</div>
</section></div>
<div class="content" style="line-height: 1.5em;">
<section style="overflow-wrap: normal;"><h3 class="sectionTitle" style="display: inline-block; font-family: Georgia, serif; font-size: 18px; font-weight: normal; line-height: 18px; margin: 0px 0px 3px; padding: 7px 0px 0px; text-rendering: optimizelegibility;" tabindex="0">
Conclusion</h3>
<div class="content" style="line-height: 1.5em;">
<div style="line-height: 1.5em; margin-bottom: 1.2em;">
The MRPI 2.0 accurately differentiated PSP-P patients from those with PD. This new index was more powerful than MRPI in differentiating PSP patients in the early stage of the disease with slowness of vertical saccades from patients with PD, thus helping clinicians to consolidate the diagnosis based on clinical features, in vivo.</div>
</div>
</section></div>
</div>
<span style="background-color: white; color: #333333; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 12px;">DOI: </span><a href="https://doi.org/10.1016/j.parkreldis.2018.07.016" style="background-color: white; color: #0099cc; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 12px;">https://doi.org/10.1016/j.parkreldis.2018.07.016</a>Unknownnoreply@blogger.com1tag:blogger.com,1999:blog-4110790349320800299.post-57765849081790777282018-10-14T07:19:00.000-07:002018-10-14T07:20:04.791-07:00Parietal atrophy score on magnetic resonance imaging of the brain in normally aging peopleAim: Our intention was to create a simple visual evaluation of parietal atrophy on MRI of the brain useful in identifying neurodegenerative dementias, especially Alzheimer‘s disease. We assessed the changes of the parietal regions dur ing natural aging. Patients and methods: We created a new rat ing scale that we named the Parietal atrophy score. This method is based on semiquantitative scoring of three structures on coronal slices in the entire parietal lobe: parietal gyri, sulcus cingularis posterior and precuneus. Each structure was rated accord ing to the visual classification size as 0 – a normal size without atrophy, 1 – a borderline finding or 2 – a considerable atrophy. These ratings were sum marized into one score for each hemisphere and then these two were integrated into one score for the entire brain. Using a visual rating scale, we clas sified the parietal regions in 74 elderly subjects with a normal Mini-Mental State Examination score (29 ± 1 point) with a wide range of ages between 48–87 years. Results: Increas ing age is as sociated with a mild progression of the parietal lobe atrophy (r = 0.2; p = 0.05). The over all score of the parietal tissue was not as sociated with education, gender or hand dominance. Conclusion: Our new visual rating system of parietal atrophy is an easy and fast method for use in clinical practice. Natural aging is accompanied with negligible parietal atrophic changes.
Parietal atrophy score on magnetic resonance imaging of the brain in normally aging people.<br />
<br />
<ul class="nova-e-list nova-e-list--size-m nova-e-list--type-inline nova-e-list--spacing-none research-detail-meta__item-list" id="yui_3_14_1_1_1539526457678_2741" style="background-color: white; color: #777777; font-family: Roboto, Arial, sans-serif; font-size: 14px; line-height: 1; list-style: none; margin: 0px; padding: 0px;">
<li class="nova-e-list__item" style="display: inline; line-height: 1.3; margin-bottom: 0.5em;">DOI: </li>
<li class="nova-e-list__item" id="yui_3_14_1_1_1539526457678_2740" style="display: inline; line-height: 1.3;">10.14735/amcsnn2018414</li>
</ul>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-76962666563876282018-10-06T10:11:00.002-07:002018-10-06T10:11:56.144-07:00A new MR imaging index for differentiation of progressive supranuclear palsy-parkinsonism from Parkinson's disease<h3>
Highlights</h3>
<ul>
<li>Distinguishing PSP-P from PD is challenging in the early stages of the disease.</li>
<li>Few data exist on the usefulness of MRPI for diagnosing PSP-P patients.</li>
<li>MRPI 2.0 is a new version of MRPI which includes the 3rd ventricular width</li>
<li>MRPI 2.0 accurately differentiated patients with PSP-P from those with PD.</li>
<li>MRPI 2.0 accurately diagnosed PSP-P in the absence of vertical ocular palsy.</li>
</ul>
<span style="font-size: x-small;"><br /><b>Reference: </b>Quattrone A, Morelli M, Nigro S, Quattrone A, Vescio B, Arabia G, Nicoletti G,Nisticò R, Salsone M, Novellino F, Barbagallo G, Le Piane E, Pugliese P, Bosco D,
Vaccaro MG, Chiriaco C, Sabatini U, Vescio V, Stanà C, Rocca F, Gullà D,
Caracciolo M. A new MR imaging index for differentiation of progressive
supranuclear palsy-parkinsonism from Parkinson's disease. Parkinsonism Relat
Disord. 2018 Sep;54:3-8. doi: 10.1016/j.parkreldis.2018.07.016</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-32109616405617356702018-08-25T00:51:00.000-07:002018-08-25T00:51:00.690-07:00Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.elsevier.es/ficheros/publicaciones/02134853/unassign/S021348531830152X/v1_201806090827/es/main.assets/thumbnail/gr1.jpeg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><span style="font-size: x-small;"><img border="0" src="http://www.elsevier.es/ficheros/publicaciones/02134853/unassign/S021348531830152X/v1_201806090827/es/main.assets/thumbnail/gr1.jpeg" data-original-height="74" data-original-width="150" height="197" width="400" /></span></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: x-small;">Corpus callosum index</span></td></tr>
</tbody></table>
<span style="font-size: x-small;"><br /><br /><b>References</b></span><div>
<span style="font-size: x-small;">Pérez-Álvarez AI, Suárez-Santos P, González-Delgado M, Oliva-Nacarino P.
Quantification of brain atrophy in multiple sclerosis using two-dimensional
measurements. Neurologia. 2018 Jun 8. pii: S0213-4853(18)30152-X. doi:
10.1016/j.nrl.2018.04.004<br />Figueira, Fernando Faria Andrade, Santos, Valeria Silva dos, Figueira, Gustavo Medeiros Andrade, & Silva, Ângela Correa Marques da. (2007). Corpus Callosum Index: A practical method for long-term follow-up in multiple sclerosis. Arquivos de Neuro-Psiquiatria, 65(4a), 931-935. <a href="https://dx.doi.org/10.1590/S0004-282X2007000600001">https://dx.doi.org/10.1590/S0004-282X2007000600001</a></span></div>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-1975342534022627532018-08-22T00:25:00.000-07:002018-08-22T00:25:30.040-07:00A ‘Comprehensive Visual Rating Scale’ for predicting progression to dementia in patients with mild cognitive impairment<div style="text-align: justify;">
Background Numerous efforts have been made to identify biomarkers for predicting the progression of dementia in patients with mild cognitive impairment (MCI), and recently, a comprehensive visual rating scale (CVRS) based on magnetic resonance imaging (MRI) has been validated to assess structural changes in the brain of elderly patients. Based on this, the present study investigated the use of CVRS for predicting dementia and elucidated its association with cognitive change in patients with MCI over a three-year follow-up. Methods We included 340 patients with MCI with more than one follow-up visit. Data were obtained from the Alzheimer’s disease Neuroimaging Initiative study. We assessed all the patients using CVRS and determined their progression to dementia during a follow-up period of over 3 years. The cox proportional hazards model was used to analyze hazard ratios (HRs) of CVRS for disease progression. Further, multiple cognitive measures of the patients over time were fitted using the random effect model to assess the effect of initial CVRS score on subsequent cognitive changes. Results Of 340 patients, 69 (20.2%) progressed to dementia and the median baseline score (interquartile range) of CVRS significantly differed between stable MCI and progressive MCI (9 (5–13) vs 13 (8–17), p<0.001). The initial CVRS score was independently associated with an increased risk of progression to dementia (HR 1.123, 95% confidence interval [CI] 1.059–1.192). From 12 to 24 months, the effect of the interaction between CVRS and interval of follow-up visit on cognitive performance achieved significance (p<0.001). Conclusions Baseline CVRS predicted the progression to dementia in patients with MCI, and was independently associated with longitudinal cognitive decline.</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhe8nyjz6dubfMDzormhwZasK6Vp_sTZnK4IDQUWeYSOcQ8UFYLCkN3KEC79nZ1ZmwbwBZlOHWu-vcvqeSnC2_PK-3QUp5ev0nYwditxWaTuVbxKmAApIT63Tk51Yjmnsvo8SW6HttvMqkl/s1600/comprehensive+visual+rating+scale.PNG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="468" data-original-width="810" height="230" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhe8nyjz6dubfMDzormhwZasK6Vp_sTZnK4IDQUWeYSOcQ8UFYLCkN3KEC79nZ1ZmwbwBZlOHWu-vcvqeSnC2_PK-3QUp5ev0nYwditxWaTuVbxKmAApIT63Tk51Yjmnsvo8SW6HttvMqkl/s400/comprehensive+visual+rating+scale.PNG" width="400" /></a></div>
<span style="background-color: white; color: #333333; font-family: "arial"; font-size: 13px;">Reference: Jang J-W, Park JH, Kim S, Park YH, Pyun J-M, Lim J-S, et al. (2018) A ‘Comprehensive Visual Rating Scale’ for predicting progression to dementia in patients with mild cognitive impairment. PLoS ONE 13(8): e0201852. https://doi.org/10.1371/journal.pone.0201852</span>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-63791004860831346712018-02-22T01:40:00.000-08:002020-02-22T01:41:01.766-08:00Related Radiopaedia articles<ul style="background-color: white; box-sizing: border-box; color: #3d3d3d; font-family: "Open Sans", sans-serif; font-size: 12.96px; margin: 0px 0px 0px 20px; padding: 0px;">
<li style="box-sizing: border-box; margin: 4px 0px 6px;">measurements and ratios<ul style="box-sizing: border-box; margin: 0px 0px 0px 20px; padding: 0px;">
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/midbrain-to-pons-area-ratio-psp?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">midbrain to pons area ratio</a> (for PSP)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/magnetic-resonance-parkinsonism-index-1?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">Magnetic Resonance Parkinsonism Index (MRPI)</a> (for PSP)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/frontal-horn-width-to-intercaudate-distance-ratio?lang=us" style="background: transparent; box-sizing: border-box; color: #698fc0; outline: 0px;">frontal horn width to intercaudate distance ratio (FH/CC)</a> (for Huntington disease)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/intercaudate-distance-to-inner-table-width-ratio?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">intercaudate distance to inner table width ratio (CC/IT)</a> (for Huntington disease)</li>
</ul>
</li>
<li style="box-sizing: border-box; margin: 4px 0px 6px;">signs<ul style="box-sizing: border-box; margin: 0px 0px 0px 20px; padding: 0px;">
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/hummingbird-sign-midbrain?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">hummingbird sign</a> (of PSP)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/mickey-mouse-appearance-1?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">Mickey Mouse sign</a> (of PSP)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/morning-glory-sign-midbrain?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">morning glory sign</a> (of PSP)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/hot-cross-bun-sign-pons?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">hot cross bun sign</a> (of MSA-C)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/hockey-stick-sign-creutzfeldt-jakob-disease?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">hockey stick sign</a> (of Creutzfeldt-Jakob disease)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/pulvinar-sign-creutzfeldt-jakob-disease?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">pulvinar sign</a> (of Creutzfeldt-Jakob disease)</li>
</ul>
</li>
<li style="box-sizing: border-box; margin: 4px 0px 6px;">scoring systems<ul style="box-sizing: border-box; margin: 0px 0px 0px 20px; padding: 0px;">
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/fazekas-scale-for-white-matter-lesions?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">Fazekas scale for white matter lesions</a></li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/posterior-atrophy-score-of-parietal-atrophy?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">posterior atrophy score of parietal atrophy</a> (PA/PCA) (Koedam score)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/medial-temporal-lobe-atrophy-score?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">medial temporal lobe atrophy score</a> (MTA score)</li>
<li style="background: url("https://prod-assets-static.radiopaedia.org/assets/new-article/dot-bullet-697d843006b45fa8d78d4e3c505e363e379bd658d31b00087f33ce6738a80475.png") left 8px no-repeat; box-sizing: border-box; list-style-type: none; margin: 4px 0px 6px; padding-left: 14px;"><a class="internal" href="https://radiopaedia.org/articles/global-cortical-atrophy-scale?lang=us" style="background: transparent; box-sizing: border-box; color: #41699b; text-decoration-line: none;">global cortical atrophy scale</a> (GCA scale)</li>
</ul>
</li>
</ul>
Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-9207991206882781612017-03-27T13:48:00.003-07:002017-03-27T13:48:45.760-07:00Corpus Callosum as a biomarker of lobar degeneration<a href="http://scholar.google.es/scholar_url?url=http://repository.tudelft.nl/assets/uuid:fa452ea4-3f2c-4fac-8935-c20ea12a990f/Thesis_Georgios_Sotiropoulos.pdf&hl=es&sa=X&scisig=AAGBfm3qsCG_-A9LBDBBNTczYH2BeGZ6lg&nossl=1&oi=scholaralrt" style="background-color: white; color: #1155cc; font-family: Times, "Times New Roman", serif;" target="_blank"><span class="il">Corpus</span> <span class="il">Callosum</span> as a <b>biomarker </b>for <b>Alzheimer </b>and Multiple Sclerosis</a><br />
<h3 style="background-color: white; color: #222222; font-weight: normal; margin: 0px; max-width: 44.5em;">
<span style="font-family: Times, Times New Roman, serif; font-size: small;"><br /></span></h3>
<a href="http://www.neurology.org/content/88/13/1265.abstract?etoc" target="_blank"><span style="font-family: Times, Times New Roman, serif;">Corpus callosal atrophy and associations with cognitive impairment in Parkinson disease</span></a>Anonymoushttp://www.blogger.com/profile/04796162963517707328noreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-1538886238512695722017-02-22T10:13:00.003-08:002017-03-27T13:47:26.908-07:00New MRI visual rating scalesSix visual rating scales, three alreary described: medial temporal, posterior, anterior temporal and three new/addapted: orbito-frontal, anterior cingulate and fronto-insula) were assessed in this study<br />
<br />
<div>
<b>Time to perform visual rating</b><br />
Mean time to perform and record all six visual rating scales based on three raters assessing the subset study population ( n = 80) was 2.9 ± 1.3 min. Individual rater means and standard deviations were 2.7 ± 1.1, 2.4 ± 1.0 and 3.6 ± 1.6 min.</div>
<div>
<br />
<b> Inter-rater reliability of visual rating scores</b><br />
Single measure and average measure ICC results for each scale are shown in <a href="https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/aww005#supplementary-data">Supplementary Table 1</a> . For the single measures ICC values, representing the reliability of each scale at the level of the individual rater, the MTA scale performed best overall, with very similar results achieved with two raters assessing all 257 scans, and four raters scoring 80 scans [ICC(2,1) ≥ 0.79]. The PA, OF and FI scales also demonstrated good reliability [ICC(2,1) ≥0.71] based on two raters assessing the total study population; reliability was slightly reduced when performed by four raters in the subset population [ICC(2,1) ≥ 0.58]. The reliability of the AC scale was lowest overall [ICC(2,1) range = 0.49–0.62]. As expected, the reliability based on mean rater scores was consistently greater for all scales [ICC(2,k) ≥ 0.73]. There were no material differences in reliability based on the larger or smaller population samples for any scale with the exception of the AT and AC scales, which were less reliable in the larger population sample.</div>
<div>
<br />
Correlation of grey matter volume with visual rating scores<br />
Voxel-based morphometry analysis revealed a negative partial correlation of higher visual rating score with lower grey matter density for all visual rating scales. </div>
<div>
<br /></div>
<div>
Reference:</div>
Lorna Harper, Giorgio G. Fumagalli, Frederik Barkhof, Philip Scheltens, John T. O’Brien, Femke Bouwman, Emma J. Burton, Jonathan D. Rohrer, Nick C. Fox, Gerard R. Ridgway, Jonathan M. Schott; MRI visual rating scales in the diagnosis of dementia: evaluation in 184 post-mortem confirmed cases. Brain 2016; 139 (4): 1211-1225. doi: 10.1093/brain/aww005<a href="https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/aww005" target="_blank">https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/aww005</a>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-24247640130979323252016-01-12T10:09:00.001-08:002016-01-12T10:09:21.564-08:00Methods used for measuring atrophy in Multiple Sclerosis<br class="Apple-interchange-newline" />
<table class="" id="table-1" style="background-color: #fffffe; border-collapse: initial; border-spacing: 0px; border-top-color: rgb(205, 205, 205); border-top-style: solid; border-width: 1px 0px 0px; color: #030303; font-family: monospace; font-size: 12px; font-stretch: inherit; line-height: 21px; margin: 0px 0px 15px; outline: 0px; padding: 0px; vertical-align: baseline; width: 594px;"><tbody align="left" class="table-left table-vbottom" id="tbody-1" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 0px; vertical-align: baseline;" valign="bottom">
<tr class="rowsep" id="tr-1" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-1" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Location/generic methodology</td><td class="table-vbottom" colspan="1" id="td-2" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Method</td><td class="table-vbottom" colspan="1" id="td-3" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Advantages</td><td class="table-vbottom" colspan="1" id="td-4" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Disadvantages</td></tr>
<tr class="" id="tr-2" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-5" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Brain/linear and regional measures</td><td class="table-vbottom" colspan="1" id="td-6" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Third ventricle width</td><td class="table-vbottom" colspan="1" id="td-7" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Easy to implement; rapid analysis; standard acquisition methods; enables targeting of eloquent regions</td><td class="table-vbottom" colspan="1" id="td-8" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Limited anatomical scope; may miss subtle effects; may exhibit user bias; high user input</td></tr>
<tr class="" id="tr-3" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-9" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-10" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Third ventricle volume</td><td class="table-vbottom" colspan="1" id="td-11" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-12" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-4" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-13" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-14" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Brain width</td><td class="table-vbottom" colspan="1" id="td-15" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-16" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-5" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-17" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-18" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Corpus callosum width</td><td class="table-vbottom" colspan="1" id="td-19" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-20" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-6" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-21" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-22" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Volume on central brain slices</td><td class="table-vbottom" colspan="1" id="td-23" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-24" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-7" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-25" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-26" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Stereology</td><td class="table-vbottom" colspan="1" id="td-27" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-28" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-8" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-29" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Brain/whole brain segmentation approaches</td><td class="table-vbottom" colspan="1" id="td-30" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">CSF volumes</td><td class="table-vbottom" colspan="1" id="td-31" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Increased automation reduces user bias and user input; generally higher measurement precision</td><td class="table-vbottom" colspan="1" id="td-32" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Complex analysis methods; possibly more complex acquisition schemes</td></tr>
<tr class="" id="tr-9" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-33" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-34" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">BPF</td><td class="table-vbottom" colspan="1" id="td-35" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-36" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-10" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-37" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-38" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">WBR</td><td class="table-vbottom" colspan="1" id="td-39" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-40" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-11" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-41" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-42" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">BICCR</td><td class="table-vbottom" colspan="1" id="td-43" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-44" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-12" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-45" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-46" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Fuzzy connectedness</td><td class="table-vbottom" colspan="1" id="td-47" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-48" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-13" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-49" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-50" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Probabilistic segmentation (SPM)</td><td class="table-vbottom" colspan="1" id="td-51" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-52" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-14" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-53" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-54" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">TDS</td><td class="table-vbottom" colspan="1" id="td-55" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-56" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-15" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-57" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-58" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">SIENAX</td><td class="table-vbottom" colspan="1" id="td-59" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-60" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-16" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-61" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Brain/registration‐based methods</td><td class="table-vbottom" colspan="1" id="td-62" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">MIDAS</td><td class="table-vbottom" colspan="1" id="td-63" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Regional atrophy may become apparent</td><td class="table-vbottom" colspan="1" id="td-64" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Complex analysis methods; limited application to multiple sclerosis to date</td></tr>
<tr class="" id="tr-17" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-65" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-66" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Voxel‐based morphometry</td><td class="table-vbottom" colspan="1" id="td-67" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-68" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-18" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-69" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-70" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">SIENA</td><td class="table-vbottom" colspan="1" id="td-71" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-72" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-19" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-73" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Spinal cord</td><td class="table-vbottom" colspan="1" id="td-74" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Manual outlining</td><td class="table-vbottom" colspan="1" id="td-75" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Straightforward</td><td class="table-vbottom" colspan="1" id="td-76" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Possible user bias; high user input</td></tr>
<tr class="" id="tr-20" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-77" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-78" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Semi‐automated outline of 3D axial images</td><td class="table-vbottom" colspan="1" id="td-79" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Precise</td><td class="table-vbottom" colspan="1" id="td-80" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="" id="tr-21" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-81" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-82" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Automated whole cord volume measurement</td><td class="table-vbottom" colspan="1" id="td-83" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Little user input</td><td class="table-vbottom" colspan="1" id="td-84" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Complex analysis methods; limited application to date</td></tr>
<tr class="" id="tr-22" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-85" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Optic nerve</td><td class="table-vbottom" colspan="1" id="td-86" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Manual outlining</td><td class="table-vbottom" colspan="1" id="td-87" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Straightforward</td><td class="table-vbottom" colspan="1" id="td-88" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Possible user bias; high user input</td></tr>
<tr class="" id="tr-23" style="background-color: inherit; border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-89" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-90" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Semi‐automated outline of 3D axial images</td><td class="table-vbottom" colspan="1" id="td-91" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Precise</td><td class="table-vbottom" colspan="1" id="td-92" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td></tr>
<tr class="rowsep" id="tr-24" style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="table-vbottom" colspan="1" id="td-93" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom"></td><td class="table-vbottom" colspan="1" id="td-94" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Automated whole nerve volume measurement</td><td class="table-vbottom" colspan="1" id="td-95" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Little user input</td><td class="table-vbottom" colspan="1" id="td-96" rowspan="1" style="border-bottom-color: rgb(205, 205, 205); border-bottom-style: solid; border-width: 0px 0px 1px; font-family: Helvetica, Arial, sans-serif; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 0px !important; margin-left: 0px; margin-right: 0px; margin-top: 0px; outline: 0px; padding: 5px 8px; vertical-align: baseline;" valign="bottom">Complex analysis methods; limited application to date</td></tr>
</tbody></table>
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<span style="font-size: x-small;">TDS = template‐driven segmentation; MIDAS = Medical Image Display and Analysis Software.</span></div>
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Source: <span style="background-color: transparent;">David H. Miller, Frederik Barkhof, Joseph A. Frank, Geoffrey J. M. Parker, Alan J. Thompson. </span><span style="background-color: transparent;">Measurement of atrophy in multiple sclerosis: pathological basis, methodological aspects and clinical relevance . Brain 2002. </span><span style="background-color: transparent;">DOI: </span><a href="http://dx.doi.org/10.1093/brain/awf177" style="background-color: transparent;">http://dx.doi.org/10.1093/brain/awf177</a></div>
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-83561050932898242212016-01-02T02:28:00.003-08:002016-01-02T02:33:08.723-08:00Related publications: BALI: An MRI-Based Semiquantitative Index for the Evaluation of Brain Atrophy and LesionsCategorizing and grading criteria of the BALI<br />
<br />
Categories Criteria<br />
GM-SV (gray
matter lesions
and small vessels)
0 = absence; 1 = punctuate foci in gray matter or multiple small vessels in subcortical area;
2 = beginning confluence of foci in gray matter or diffuse small vessels in subcortical area;
3 = large confluent lesions in gray matter (rare, evidence for stroke-related malacia foci)<br />
PV (periventricular
lesions)
0 = absence; 1 = ‘caps’ or pencil-thin lining; 2 = smooth ‘halo’; 3 = irregular periventricular
abnormal signal intensities extending into the deep white matter<br />
DWM (deep
white matter
lesions)
0 = absence; 1 = punctuate foci; 2 = beginning of confluence foci; 3 = large confluent areas;
4 = large confluent white matter areas involving all cerebral lobes; 5 = complete confluent
white matter disease<br />
BG (basal ganglia
and surrounding
area lesions)
0 = absence; 1 = 1 focal lesion; 2 = >1 focal lesion; 3 = large confluent lesions
IT (infratentorial
region lesions)
0 = absence; 1 = 1 focal lesion; 2 = >1 focal lesion; 3 = large confluent lesions<br />
GA (global
atrophy)
0 = no obvious atrophy; 1 = mild atrophy; 2 = moderate atrophy; 3 = severe atrophy<br />
Other lesions 0 = no other kind of disease; 1 = any 1 kind of brain neoplasm, deformation or trauma;
2 = any 2 kinds of brain neoplasm, deformation or trauma; 3 = simultaneous presence
of brain neoplasm, deformation and trauma<br />
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<a href="http://www.ajnr.org/content/35/3/504/F1/graphic-1.medium.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://www.ajnr.org/content/35/3/504/F1/graphic-1.medium.gif" height="400" width="343" /></a></div>
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<a href="https://www.karger.com/Article/Pdf/319537" target="_blank">Full text</a>Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-45984109757116647872016-01-02T01:42:00.003-08:002016-01-02T02:41:38.756-08:00Related publications: Brain volume/cerebrospinal fluid index (BV/CSF index) in the diagnosis of Alzheimer's disease<div style="text-align: justify;">
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<h4 style="text-align: center;">
<b>BV/CSF index= (Total WM + Total GM) / Total spaces containing CSF</b></h4>
<div style="text-align: right;">
<div style="text-align: center;">
The B<span style="text-align: center;">V/CSF index may also be named as <i>yrRA-WB(I-II-III-IV-sulci)</i></span><span class="mo" id="MathJax-Span-70" style="background-color: white; border: 0px; box-sizing: border-box; color: #222222; display: inline; font-family: STIXGeneral-Regular; font-size: 17.92px; margin: 0px; padding: 0px; position: static; text-align: left; transition: none; vertical-align: 0px; white-space: nowrap;"> </span><span style="text-align: center;">using the standarized <a href="http://www.cureus.com/articles/3001-indices-of-regional-brain-atrophy-formulae-and-nomenclature" target="_blank">terminology</a></span></div>
</div>
<br />
Background: Global brain atrophy is present in normal aging and different neurodegenerative disorders such as Alzheimer's disease (AD) and is becoming widely used to monitor disease progression. Summary: The brain volume/cerebrospinal fluid index (BV/CSF index) is validated in this study as a measurement of global brain atrophy. We tested the ability of the BV/CSF index to detect global brain atrophy, investigated the influence of confounders, provided normative values and cut-offs for mild, moderate and severe brain atrophy, and studied associations with different outcome variables. A total of 1,009 individuals were included [324 healthy controls, 408 patients with mild cognitive impairment (MCI) and 277 patients with AD]. Magnetic resonance images were segmented using FreeSurfer, and the BV/CSF index was calculated and studied both cross-sectionally and longitudinally (1-year follow-up). Both AD patients and MCI patients who progressed to AD showed greater global brain atrophy compared to stable MCI patients and controls. Atrophy was associated with older age, larger intracranial volume, less education and presence of the ApoE ε4 allele. Significant correlations were found with clinical variables, CSF biomarkers and several cognitive tests. Key Messages: The BV/CSF index may be useful for staging individuals according to the degree of global brain atrophy, and for monitoring disease progression. It also shows potential for predicting clinical changes and for being used in the clinical routine.</div>
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<span style="font-size: x-small;"><b>Reference: </b>Camila Orellana, Daniel Ferreira, J.-Sebastian Muehlboeck, Patrizia Mecocci, Bruno Vellas, Magda Tsolaki, Iwona Kłoszewska, Hilkka Soininen, Simon Lovestone, Andrew Simmons, Lars-Olof Wahlund, Eric WestmanMeasuring Global Brain Atrophy with the Brain Volume/Cerebrospinal Fluid Index: Normative Values, Cut-Offs and Clinical Associations. Neurodegener Dis (DOI: 10.1159/000442443)<br /><br /> <a href="http://www.karger.com/ProdukteDB/miscArchiv/000/442/443/000442443_sm.html">Free Supplementary Material</a></span><br />
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Unknownnoreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-36176433169521602982015-12-19T01:08:00.000-08:002016-03-26T08:05:32.702-07:00Comparison of structural MRI methodologies for measuring atrophy of structures in the medial temporal lobeThere are several approaches for quantifying the size of MTL structures using structural neuroimaging, including visual rating scales (VRS), volumetry (3D), planimetry (2D) and linear measures (1D), as depicted in this figure.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6mac9texVXib9meOt-ELym6DVOiuusqDOeiFGJS6n2HAkzCra4TjFdmhmRa2thYNPOhmGFxXaDn9sG3TVuqo2wSX7DTGotH2Rqb8xiG7xFTkKqpafmYFTW8RZEEAtJ2GzfWw7YPItwYZr/s1600/Captura+de+pantalla+2015-12-19+a+las+9.59.52.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="272" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh6mac9texVXib9meOt-ELym6DVOiuusqDOeiFGJS6n2HAkzCra4TjFdmhmRa2thYNPOhmGFxXaDn9sG3TVuqo2wSX7DTGotH2Rqb8xiG7xFTkKqpafmYFTW8RZEEAtJ2GzfWw7YPItwYZr/s400/Captura+de+pantalla+2015-12-19+a+las+9.59.52.png" width="400" /></a></div>
<br />
<br />
A comparison among the different
methods for quantifying atrophy of the MTL based
on structural neuroimaging is presented in this table.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilTfPs3dLdUscQO_TXpheo0r8kSX0xOkiVLOktvzvx4eCW198PLw7z0gRcx2T9b_PRzecNla06Hvw0zIIeZZT4xINZMuZOXsY24xjbz13Ds-s9qQJIfsFI4iI2X-Vz-kZBRbBAMatjg1Hi/s1600/Captura+de+pantalla+2015-12-19+a+las+9.56.27.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="206" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilTfPs3dLdUscQO_TXpheo0r8kSX0xOkiVLOktvzvx4eCW198PLw7z0gRcx2T9b_PRzecNla06Hvw0zIIeZZT4xINZMuZOXsY24xjbz13Ds-s9qQJIfsFI4iI2X-Vz-kZBRbBAMatjg1Hi/s400/Captura+de+pantalla+2015-12-19+a+las+9.56.27.png" width="400" /></a></div>
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Comparison compare the results of a manual planimetric measure (the yearly rate of absolute atrophy of the medial temporal lobe, 2D-yrA-MTL) with the results of an automated volumetric measure (the yearly rate of atrophy of the hippocampus, 3D-yrA-H).<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://assets.cureus.com/uploads/figure/file/4567/article_river_6b9d1da0cea611e597ec35c398ddd353-Figure_1_Cureus.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://assets.cureus.com/uploads/figure/file/4567/article_river_6b9d1da0cea611e597ec35c398ddd353-Figure_1_Cureus.png" height="200" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="background-color: white; color: #222222; font-family: 'Proxima Nova', 'Helvetica Neue', Arial, sans-serif; font-size: 16px; line-height: 22.4px; text-align: start;">ROC curves in the differential diagnosis of AD vs controls (left) and AD vs MCI (right). </span></td></tr>
</tbody></table>
<br />Unknownnoreply@blogger.com4tag:blogger.com,1999:blog-4110790349320800299.post-65191961162838735312015-10-27T05:33:00.000-07:002015-06-14T10:38:02.010-07:00Medial Temporal Lobe indices: Concept & Description<div style="text-align: justify;">
<div style="text-align: justify;">
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The recent focus on biomarkers in the diagnosis of Alzheimer's disease (AD) and its prodromal stage have created a need to translate research findings into tools for use in everyday clinical practice. Although AD and mild cognitive impairment (MCI) are commonly diagnosed using sets of clinical criteria, MRI findings may aid the clinical diagnosis, and may predict clinical progression. In AD, the medial temporal lobe (MTL) gets atrophied out of proportion to other brain areas in comparison to healthy age-matched controls and this fact may be used to ease the diagnosis. Indeed, the new research criteria have recently been proposed for AD, and MCI that incorporate (disproportionate) medial temporal lobe or hippocampal atrophy on MRI as one of the supportive features.<br />
<br />
Age-associated differences are detected in the MTL with an acceleration of Medial Temporal Lobe Atrophy (MTA) starting around 72 years of age in healthy people (<a href="http://www.ijcem.com/files/ijcem1401017.pdf" target="_blank">read more</a>). However, these changes are modest and their rate of progression over time is relatively slow with a mean rate of about 1.6% per year. Accelerated MTA is a consistent finding in AD and MCI with rates of about 2.8% in stable MCI, 3.7% in MCI transitioning to AD (MCI progressors), and up to 4.0% in AD. Frontotemporal dementia may also lead to MTA, but in a different pattern: frontotemporal dementia and semantic dementia show atrophy in the anterior portion of the hippocampus, and in semantic dementia the atrophy is asymmetrical, with the left hippocampus being affected more severely. No significant hippocampal atrophy is detected in non-fluent progressive aphasia. Other diseases such as dementia with Lewy bodies do not show MTA or it is much milder.<br />
<br />
In contrast to MTA, ventricular enlargement (body of lateral ventricles) in old people lacks specificity, representing a measure of global brain atrophy due to aging or any neurodegenerative disorder. Ventricular enlargement correlates with decline in cognitive performance and with cerebrospinal fluid pathologic markers of AD and several studied have assessed different methods based on the lateral ventricles measurements as AD biomarkers. However, it is well known that ventricular enlargement is a measure of global brain atrophy and is strongly associated with aging both in healthy and diseased people. In addition, almost any neurodegenerative disorder affecting the brain hemispheres leads to some degree of ventricular enlargement, including Parkinson’s disease, Frontotemporal Dementia, Lewy-Bodies Dementia and Corticobasal Degeneration and so do some psychiatric conditions. Thus, it is interesting to compare measures indicative of atrophy in the MTL with measures indicative of global brain atrophy. I propose the next indices, that allow us to interpret result of atrophy measures easier:</div>
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Planimetry methods consist in measuring the area of regions of interest (ROI). The areas of several ROI can be compared using ratios and indices. The <b>Medial Temporal-Lobe Atrophy index (MTAi)</b>, is a simple method for measuring the relative extent of atrophy in the MTL in relation to the global brain atrophy. This 2D-method consists on calculating a ratio using the area of 3 regions traced manually on one single coronal MRI slide at the level of the interpeduncular fossa: 1. the medial temporal lobe region (A); 2. the parenchyma within the medial temporal region, that includes the hippocampus and the parahippocampal gyrus -the fimbria taenia and plexus choroideus were excluded- (B); and 3. the body of the ipsilateral lateral ventricle (C). Therefrom we can compute the “2D-Medial Temporal Atrophy” <b>(2D-MTA=A-B) </b>that represents absolute atrophy of the MTL; and the ratio “Medial Temporal Atrophy index” <b>(MTAi = (A-B) x10 / C) </b>that represents relative atrophy of the MTL.<b> </b><span style="color: black;">The MTAi is suitable to assess the asymmetry of relative MTA within a subject. High asymmetry is typical of some types of FTLD. However, a</span><span style="color: black;">s there is important interindividual variability in the size of the lateral ventricles, this index is not recommended for comparing subjects but to track the progression in a given subject over time. Indeed, if </span>we have 2 MRI studies from different times (1= first one, 2=second one), we can also compute the <b>yearly rate of MTA (yrMTA) </b> as follows: yrMTA=<i>(A<span style="font-size: xx-small;">2</span>-B<span style="font-size: xx-small;">2</span>)-(A<span style="font-size: xx-small;">1</span>-B<span style="font-size: xx-small;">1</span><b>)</b> x 1200 / (#months between MRI studies) </i>and the <b>yearly rate of relative MTA (yrRMTA)</b> as follows: <i>yrRMTA=(A<span style="font-size: xx-small;">2</span>-B<span style="font-size: xx-small;">2</span>)-(A<span style="font-size: xx-small;">1</span>-B<span style="font-size: xx-small;">1</span><b>)</b> x 1200 / (C<span style="font-size: xx-small;">2</span>-C<span style="font-size: xx-small;">1</span>) x (#months between MRI studies). </i>High values are suggestive of "disproportionated" MTA in relation to the extent of global brain atrophy, and therefore the pattern of atrophy matches the expected in typical AD.<br />
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Volumetric methods are more sophisticated. The <b>Medial Temporal-Lobe ratio (MTLr)</b> compares the volume of the MTL with the whole hemispheric volume. To find out the MTLr we need 1. the volume of the hippocampus (A); the volume of the parahippocampal gyrus (B); 3. the volume of the whole brain hemisphere (C). We can compute the ratio “Medial Temporal Lobe ratio” as follows: <i>MTLr = (A+B)</i><i><span class="st">^</span>2 / C</i>. Low values are suggestive of MTL atrophy, and therefore the pattern of atrophy matches the expected in typical AD. </div>
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If we have 2 MRI studies from different times (1= first one, 2=second one), we can also compute the <b>yearly rate of MTL atrophy</b> <i>(yrMTL) =(A1+B1)-(A2+B2) x 1200 / (#months between MRI studies) </i>and the <b>yearly rate of relative MTL atrophy</b> as follows: <i>(yrMTLr) =(A1+B1)-(A2+B2) x 1200 / (C2-C1) x (#months between MRI studies). </i></div>
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The <b>Hippocampus ratio (Hr)</b> compares the volume of the hippocampus with the whole hemispheric volume. To find out the HAr we need 1. the volume of the hippocampus (A); 2. the volume of the ipsilateral brain hemisphere (B). We can compute the ratio “Hippocampus ratio” as follows: <i>HAr= A</i><i><span class="st">^</span>2 / B.</i> Low values are suggestive of hippocampus atrophy, and therefore the pattern of atrophy matches the expected in typical AD. </div>
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If we have 2 MRI studies from different times (1= first one, 2=second one), we can also compute the <b>yearly rate of Hippocampus Atrophy</b> as follows:<b> </b><i>(yrHA)= (A1-A2) x 1200 / (#months between MRI studies)</i><i> </i>and the <b>yearly rate of relative Hippocampus atrophy</b> as follows: <i>(yrHAr)=(A1-A2) x 1200 / (B1-B2) x (#months between MRI studies).</i></div>
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The <b>Hippocampus-Ventricle index (HVi)</b> is the addition of the volume of the hippocampus plus the tenth part of the volume of the the lateral ventricle. Then, to find out the HVi we need 1. the normalized volume of the hippocampus (A); 2. the normalized volume of the the lateral ventricle (B). We can compute the ratio “Hippocampus-Ventricle index” as follows: <i>HVi = A</i><i>+(B/10)</i>. Low HVi values are suggestive of AD pathology in incipient stages, while high HVi values are suggestive of global brain atrophy due to aging or any neurodegenerative disease other than AD. Intermediate values are not informative.<br />
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<td style="border: 1px solid rgb(0, 0, 0); height: 42px; padding: 4px; width: 69px;" valign="bottom"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Compares</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 42px; padding: 4px; width: 90px;" valign="bottom"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Parameters needed to calculate it</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 42px; padding: 4px; width: 100px;" valign="bottom"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Computing</b></span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 42px; padding: 4px; width: 98px;" valign="bottom"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Interpretation</b></span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 126px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Temporal horn index (Ti)</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 126px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Volume of the temporal horn with the volume of the lateral ventricles</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 126px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Temporal horn volume (A) and the lateral ventricular volume (B)</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 126px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">THi= A / B</span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 126px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Low values are suggestive of MTL atrophy, and therefore the pattern of atrophy matches the pattern expected in typical AD</span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 139px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Medial Temporal-Lobe ratio (MTLr) </b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 139px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Volume of the MTL with the ipsilateral hemispheric volume</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 139px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">The volume of the hippocampus (A); the volume of the parahippocampal gyrus (B); the volume of the whole brain hemisphere (C)</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 139px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">MTLr = (A+B)</span><span style="color: black; font-family: Trebuchet MS; font-size: 8px; letter-spacing: 0px;"><sup>2</sup></span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> / C</span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 139px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Low values are suggestive of MTL atrophy, and therefore the pattern of atrophy matches the pattern expected in typical AD</span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 57px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Yearly rate of MTL atrophy (yrMTLA)</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 57px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Not an index</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 57px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">A and B as in MTLr in 2 different MRI studies</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 57px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">(yrMTL) = (A1+B1) - (A2+B2) </span><span style="color: black; font-family: Symbol; font-size: 12px; letter-spacing: 0px;">×</span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> 1200 / (# mo between MRI studies) </span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 57px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">High values are expected in typical AD</span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 140px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Yearly rate of relative MTL atrophy (yrRMTLA)</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 140px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Rate of atrophy of the MTL with the rate of enlargement of the ipsilateral lateral ventricles</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 140px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">A, B and C as in MTLr in 2 different MRI studies</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 140px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">yrRMTA = (A1+B1)-(A2+B2) </span><span style="color: black; font-family: Symbol; font-size: 12px; letter-spacing: 0px;">×</span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> 1200 / (C2-C1) </span><span style="color: black; font-family: Symbol; font-size: 12px; letter-spacing: 0px;">×</span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> (# mo between MRI studies)</span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 140px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">High values are expected in early typical AD</span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 139px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Hippocampus ratio (Hr)</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 139px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Volume of the hippocampus with the ipsilateral hemispheric volume</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 139px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">The volume of the hippocampus (A); the volume of the ipsilateral brain hemisphere (B)</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 139px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Hr = A</span><span style="color: black; font-family: Trebuchet MS; font-size: 8px; letter-spacing: 0px;"><sup>2</sup></span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> / B</span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 139px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Low values are suggestive of hippocampus atrophy, and therefore the pattern of atrophy matches the pattern expected in typical AD</span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 57px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Yearly rate of Hippocampus Atrophy (yrHA)</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 57px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Not an index</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 57px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">A as in Hr in 2 different MRI studies</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 57px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">(yrHA) = (A1-A2) </span><span style="color: black; font-family: Symbol; font-size: 12px; letter-spacing: 0px;">×</span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> 1200 / (# mo between MRI studies) </span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 57px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">High values are expected in typical AD</span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 140px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Yearly rate of relative Hippocampus Atrophy (yrRHA)</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 140px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Rate of atrophy of the hippocampus with the rate of atrophy of the ipsilateral hemisphere</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 140px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">A and B as in Hr in 2 different MRI studies</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 140px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">yrRHA = (A1-A2) </span><span style="color: black; font-family: Symbol; font-size: 12px; letter-spacing: 0px;">×</span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> 1200 / (B1-B2) </span><span style="color: black; font-family: Symbol; font-size: 12px; letter-spacing: 0px;">×</span><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"> (# mo between MRI studies)</span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 140px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">High values are expected in early typical AD</span></td>
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<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 1px 1px 0px; height: 168px; padding: 4px; width: 79px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;"><b>Hippocampus-Ventricle index (HVi)</b></span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 168px; padding: 4px; width: 69px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Addition of the volume of the hippocampus plus the 10th part of the volume of the lateral ventricle</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 168px; padding: 4px; width: 90px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Normalized volume of the hippocampus (A); normalized volume of the lateral ventricle (B)</span></td>
<td style="border: 1px solid rgb(0, 0, 0); height: 168px; padding: 4px; width: 100px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">HVi = A + (B/10)</span></td>
<td style="border-color: rgb(0, 0, 0); border-style: solid; border-width: 1px 0px 1px 1px; height: 168px; padding: 4px; width: 98px;" valign="top"><span style="color: black; font-family: Trebuchet MS; font-size: 12px; letter-spacing: 0px;">Low HVi values are suggestive of AD pathology in incipient stages; high HVi values are suggestive of global brain atrophy due to aging or any neurodegenerative disease other than AD</span></td>
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<span style="background-color: white; color: #222222; font-family: arial, sans-serif; font-size: 13px; text-align: left;">Volumetric indices for comparing the extent/rate of atrophy in the medial temporal lobe with the extent/rate of global brain atrophy (<a href="http://imedpub.com/ojs/index.php/jneuro/article/view/853/578" target="_blank">full text</a>).</span><br />
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<a name='more'></a><br />
In PNFA there is often asymmetrical atrophy (though this can be subtle initially), predominantly affecting the left hemisphere and especially the inferior frontal lobe and/or anterior insula. With increasing disease progression there is involvement of left superior temporal, middle and superior frontal and anterior parietal lobes. There is also involvement of the caudate, and the right hemisphere. Some small studies suggest there may be different patterns of atrophy in PNFA patients with PSP compared to those without PSP, and also in those with progranulin mutations (FTLD-TDP pathologically) compared to those without. Progranulin mutations tend to be associated with very asymmetrical atrophy more widely affecting the frontal, temporal and parietal lobes.<br />
Patients with logopenic aphasia have more posterior cortical atrophy than patients with PNFA, with left posterior temporal and parietal atrophy as well as hippocampal and posterior cingulate involvement, consistent with the high frequency of Alzheimer's pathology in this group.<br />
Patients with SD characteristically have asymmetrical temporal lobe atrophy, usually more marked in the left hemisphere. It chiefly affects the anterior and inferior temporal lobe (also including the amygdala and hippocampus) with relative sparing of the superior temporal gyrus but striking atrophy of the pole with an antero-posterior gradient within the temporal lobe. As the disease progresses, areas within the left hemisphere outside the temporal lobe are involved, namely orbitofrontal, inferior frontal, insular, and anterior cingulate cortices, together with increasing atrophy of the right temporal lobe. This spread contributes to the behavioural changes in later SD. A 'mirror' pattern of initial atrophy and disease progression is seen in those patients presenting with right greater than left temporal lobe involvement. Although SD is characteristically FTLD-TDP pathologically, in small numbers of cases, Pick's disease (FTLD-tau) and occasionally Alzheimer's disease pathology are seen. There is a qualitatively different pattern in those with Alzheimer's disease with mostly hippocampal involvement, lack of the knife-edge anterior temporal atrophy seen in the other groups and without the sparing of the superior temporal gyrus. Other pathologies may have more posterior extension of atrophy.<br />
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More info:<br />
<h6 id="TracingGuidelinesDocumentsandManuals-hippocampus.pdfANewMethodfortheInVivoVolumetricMeasurementoftheHumanHippocampusWithHighNeuroanatomicalAccuracy-J.Pantel,D.S.O'Leary,K.Cretsinger,H.J.Bockholt,H.Keefe,V.A.MagnottaandN.C.Andreason" style="background-color: white; margin: 21px 0px 4px; padding: 0px; text-align: left;">
<ul>
<li><a href="http://imedpub.com/ojs/index.php/jneuro/article/view/853/578" style="font-family: Arial, Helvetica, FreeSans, sans-serif; font-size: small;" target="_blank">Volumetric indices and rates of atrophy for the assessment of medial temporal lobe atrophy</a></li>
<li style="font-family: Arial, Helvetica, FreeSans, sans-serif; font-size: 10pt;"><span style="font-weight: normal;"><span style="color: blue; font-size: 10pt;"><span style="color: blue; outline: none;"><a href="https://www.icts.uiowa.edu/confluence/download/attachments/72385476/hippocampus.pdf?version=1&modificationDate=1370624466711&api=v2" style="color: #326ca6; outline: none;">hippocampus.pdf</a></span> </span><span style="font-size: 10pt;"> A New Method for the In Vivo Volumetric Measurement of the Human Hippocampus With High Neuroanatomical Accuracy - J. Pantel, D.S. O'Leary, K. Cretsinger, H.J. Bockholt, H. Keefe, V.A. Magnotta and N.C. Andreason</span></span></li>
<li style="font-family: Arial, Helvetica, FreeSans, sans-serif; font-size: 10pt;"><span style="font-weight: normal;"><span style="color: blue; font-size: 10pt;"><a href="https://www.icts.uiowa.edu/confluence/download/attachments/72385476/Hippocampus_tracing_guide.pdf?version=1&modificationDate=1370625787248&api=v2" style="color: #326ca6; outline: none;"><span style="color: blue;">Hippocampus_tracing_guide.pdf</span></a></span><span style="font-size: 10pt;"> Hippocampus Tracing Guidelines - J. Pantel, K. Cretsinger, H. Keefe</span></span></li>
<li style="font-family: Arial, Helvetica, FreeSans, sans-serif; font-size: 10pt;"><span style="font-weight: normal;"><span style="color: blue; font-size: 10pt;"><a href="https://www.icts.uiowa.edu/confluence/download/attachments/72385476/hippo_guidelines.doc?version=1&modificationDate=1370625799900&api=v2" style="color: #326ca6; outline: none;"><span style="color: blue;">hippo_guidelines.doc</span></a> </span><span style="font-size: 10pt;"> Hippocampus Guidelines - H. Keefe</span></span></li>
<li style="font-family: Arial, Helvetica, FreeSans, sans-serif; font-size: 10pt;"><span style="font-weight: normal;"><span style="color: blue; font-size: 10pt;"><a href="https://www.icts.uiowa.edu/confluence/download/attachments/72385476/Hippocampus_images.doc?version=1&modificationDate=1370624466722&api=v2" style="color: #326ca6; outline: none;"><span style="color: blue;">Hippocampus_images.doc</span></a> </span><span style="font-size: 10pt;"> Hippocampus Guide traces - K. Jones</span></span></li>
<li style="font-family: Arial, Helvetica, FreeSans, sans-serif; font-size: 10pt;"><span style="font-weight: normal;"><span style="font-size: 10pt;"><a href="https://hal.inria.fr/hal-01145728/document" target="_blank">Regional Flux Analysis for Discovering and QuantifyingAnatomical Changes: an Application to the BrainMorphometry in Alzheimer’s Disease</a></span></span></li>
</ul>
</h6>
</div>
Anonymoushttp://www.blogger.com/profile/04796162963517707328noreply@blogger.com3tag:blogger.com,1999:blog-4110790349320800299.post-27463876562679954642015-10-11T12:03:00.000-07:002018-10-14T07:23:50.674-07:00Corpus callosum index: a practical method for long-term follow-up in multiple sclerosis<br />
<div style="text-align: justify;">
Rather than acute inflammation, long-standing multiple sclerosis (MS) course is hallmarked by relentless axonal loss and brain atrophy, both with subtle clinical expression and scarcely visible on conventional MRI studies. Brain atrophy imaging has sophisticated methodological requirements, not always practical and accessible to most centers. Corpus callosum (CC) is a major inter-hemispheric white matter bundle, grossly affected by long term MS and easily assessed by MRI (1)</div>
<div style="text-align: justify;">
CCI is an easy to use MRI marker for estimating brain atrophy in patients with MS. Brain atrophy as measured with CCI was associated with disability progression but it was not an independent predictor of long-term disability (2).</div>
<div>
<span style="background-color: white; font-family: "arial" , "helvetica" , "clean" , sans-serif; font-size: 13px; line-height: 11.9999px;"><br /></span></div>
<span style="font-size: x-small;"></span><br />
<div>
<span style="font-size: x-small;"><span style="font-size: x-small;"><b>References:</b></span></span></div>
<span style="font-size: x-small;">
1. Figueira FF, Santos VS, Figueira GM, Silva AC. Corpus callosum index: a
practical method for long-term follow-up in multiple sclerosis. Arq
Neuropsiquiatr. 2007 Dec;65(4A):931-5<br />2. Yaldizli O, Atefy R, Gass A, Sturm D, Glassl S, Tettenborn B, Putzki N. Corpus callosum index and long-term disability in multiple sclerosis patients. J Neurol.
2010 Aug;257(8):1256-64</span>Anonymoushttp://www.blogger.com/profile/04796162963517707328noreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-67123035338461660342015-01-18T11:37:00.001-08:002015-06-14T10:35:49.519-07:00Linear measures for assessing gray matter atrophy in Multiple Sclerosis<div style="text-align: justify;">
The the bicaudate ratio (BCR) is increased in MS and is more closely associated with cognitive dysfunction than are other magnetic resonance imaging surrogate markers including whole-brain atrophy. Increased BCR is best explained by frontal horn ventricular enlargement due to atrophy of deep frontal subcortical white matter. This highlights the close relationship between subcortical atrophy and cognitive impairment in patients with MS (<a href="http://archneur.jamanetwork.com/article.aspx?articleid=781417" target="_blank">read more</a>) and AD (<a href="http://www.cumc.columbia.edu/dept/sergievsky/pdfs/measuringcerebralatrophy.pdf" target="_blank">read more</a>).</div>
<div style="text-align: justify;">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://amaprodu.silverchair.netdna-cdn.com/data/Journals/NEUR/6867/s_noc10201f1.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://amaprodu.silverchair.netdna-cdn.com/data/Journals/NEUR/6867/s_noc10201f1.png" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="background-color: #eeeeee; color: #333333; font-family: Georgia, Cambria, Times, 'Times New Roman', serif; font-size: 13.1428575515747px; line-height: 11.1428575515747px; text-align: start;">Fluid-attenuated inversion-recovery magnetic resonance imaging scan of a patient with multiple sclerosis showing the technique of determining the bicaudate ratio (BCR). The BCR is the minimum intercaudate distance (solid line) divided by brain width along the same line (dashed line).</span></td></tr>
</tbody></table>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629007/bin/nihms87278f1.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629007/bin/nihms87278f1.gif" height="320" width="251" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="background-color: white; font-family: 'Times New Roman', stixgeneral, serif; line-height: 21.9987621307373px; text-align: left;"><span style="font-size: x-small;">Bicaudate ratio. The yellow represents the distance between the two apices of the caudate nuclei. The inner skull dimension is shown in turquoise. The bicaudate ratio is derived by dividing the ventricular dimension (yellow) by the inner skull dimension</span></span></td></tr>
</tbody></table>
<br />
<br />
<br />
<div style="text-align: justify;">
However, although the bicaudate ratio is a fairly good measure of caudate atrophy, seems to be poor measures of caudate size when no atrophy is present (<a href="http://www.ajnr.org/content/12/6/1217.full.pdf" target="_blank">read more</a>). </div>
Anonymoushttp://www.blogger.com/profile/04796162963517707328noreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-73958202031555946672014-12-04T10:56:00.000-08:002019-03-23T03:44:01.762-07:00Yearly Rates of Relative Atrophy<br />
<div class="p1" style="text-align: justify;">
<span class="s1">Yearly rates of Relative Atrophy (yrRA) are useful to compare the progression of the atrophy of a given brain structure in comparison with the progression of global brain atrophy. These methods are useful in the diagnosis and follow up of several neurodegenerative conditions, such as Alzheimer's disease (1) and Multiple Sclerosis (2). Thus, yrRA can be referenced to the ventricular system or referenced to the whole brain:</span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"></span><br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-family: inherit;">Global brain atrophy can be assessed well directly, measuring the loss of volume of the whole brain, well indirectly, measuring the enlargement of the volume of the ventricular system that correlates with the extent of brain atrophy. </span></span><span style="font-family: inherit;">Thus, yearly rates of relative atrophy can be referenced to the ventricular system or referenced to the whole brain:</span></div>
<h3>
</h3>
<h4>
<b>VENTRICULAR-REFERENCED</b></h4>
<span style="font-family: inherit;">For <b>telencephalic structures</b>, one can compute the yearly rate of relative atrophy, comparing the change in the volume of ROIs, with the change of volume in the lateral ventricle system</span><br />
<br />
<blockquote class="tr_bq">
yrR*A= (A1-A2) x 1200 / (B2-B1) x (#months between MRI studies)<br />
<span style="font-size: x-small;">where * is the ROI<br />A1 is the volume of the ROI in the first MRI and A2 the volume of the ROI in the second MRI<br />B1 is the volume of the ventricular system in the first MRI and B2 the volume of the ventricular system in the second MRI</span></blockquote>
These methods can be computed for each hemisphere separately, or for both brain hemispheres together (taking the addition of volumes of A on both hemispheres and the addition of volumes of B on both hemispheres).<br />
<ul>
</ul>
<div>
<span style="font-family: inherit;">For <b>diencephalic structures</b>, one can compute the yearly rate of relative atrophy, comparing the change in the volume of ROIs, with the change of volume in the lateral ventricles plus the third ventricle</span><br />
<br />
<blockquote class="tr_bq">
yrR*A= (A1-A2) x 1200 / (B2-B1) x (#months between MRI studies)<br />
<span style="font-size: x-small;">where * is the ROI<br />A1 is the volume of the ROI in the first MRI and A2 the volume of the ROI in the second MRI<br />B1 is the volume of the ventricular system in the first MRI and B2 the volume of the ventricular system in the second MRI</span></blockquote>
<br /></div>
<span style="font-family: inherit;">For </span><b>structures in the</b><span style="font-family: inherit;"> <b><i>posterior fossa</i></b>, one can compute the yearly rate of relative atrophy, comparing the change in the volume of ROIs, with the change of volume in the fourth ventricle.</span><br />
<div>
<blockquote class="tr_bq">
yrR*A= (A1-A2) x 1200 / (B2-B1) x (#months between MRI studies)<br />
<span style="font-size: x-small;">where * is the ROI</span><br />
<span style="font-size: x-small;">A1 is the volume of the ROI in the first MRI and A2 the volume of the ROI in the second MRI</span><br />
<span style="font-size: x-small;">B1 is the volume of the forth ventricle in the first MRI and B2 the volume of the forth ventricle in the second MRI</span></blockquote>
</div>
<div>
<h4>
<b>WHOLE BRAIN-REFERENCED</b></h4>
<span style="font-family: inherit;">For <b>telencephalic and diencephalic structures</b>, one can compute the yearly rate of relative atrophy, comparing the change in the volume of ROIs, with the change of volume in the brain hemisphere</span><span style="font-family: inherit;">.</span><br />
<blockquote class="tr_bq">
yrR*A= (A1-A2) x 1200 / (B2-B1) x (#months between MRI studies)<br />
<span style="font-size: x-small;">where * is the ROI</span><br />
<span style="font-size: x-small;">A1 is the volume of the ROI in the first MRI and A2 the volume of the ROI in the second MRI</span><br />
<span style="font-size: x-small;">B1 is the volume of the the brain hemisphere in the first MRI and B2 the volume of the the brain hemisphere in the second MRI</span></blockquote>
These methods can be computed for each hemisphere separately, or for both brain hemispheres together (taking the addition of volumes of A on both hemispheres and the addition of volumes of B on both hemispheres).<i style="background-color: white; color: #222222; line-height: 12.3199996948242px; text-align: justify;"><span style="font-family: inherit;"><br /></span></i><br />
<br />
<span style="font-family: inherit;">For </span><b>structures in the</b><span style="font-family: inherit;"> <b><i>posterior fossa</i></b>, one can compute the yearly rate of relative atrophy, comparing the change in the volume of ROIs, with the change of volume in parenchyma located in the posterior fossa, including the cerebellum and the brain stem</span>.<br />
<div>
<br /></div>
<div>
These methods can be computed for each side separately: </div>
<div>
<blockquote class="tr_bq">
yrR*A= (A1-A2) x 1200 / (B1-B2) x (#months between MRI studies)<br />
<span style="font-size: x-small;">where * is the ROI</span><br />
<span style="font-size: x-small;">A1 is the volume of the ROI in the first MRI and A2 the volume of the ROI in the second MRI. </span><br />
<span style="font-size: x-small;">B1 is the volume of the parenchyma located in the posterior fossain the first MRI and B2 the volume of the parenchyma located in the posterior fossa in the second MRI</span></blockquote>
<span style="font-family: inherit;"></span><br />
<a name='more'></a><h4>
<span style="font-family: inherit;">Table 1. Most useful ROI</span></h4>
<br />
<span style="font-family: inherit;">Most useful telencephalic ROI:</span><br />
<ul>
<li><span style="font-family: inherit;">Forebrain Parenchyma: yrRFPA</span></li>
<li><span style="font-family: inherit;">Whole Cortical Gray Matter: yrRwCGMA</span></li>
<li><span style="font-family: inherit;">Lobe/Gyrus Cortical Gray Matter: yrR#CGMA, where # is the name of the Lobe/Gyrus</span></li>
<li><span style="font-family: inherit;">Hippocampus: <a href="http://brainatrophyindices.blogspot.com.es/2013/10/concept.html">yrRHA</a></span></li>
<li><span style="font-family: inherit;">Amygdala: yrRAmyA</span></li>
<li><span style="font-family: inherit;">Caudate: yrRCauA</span></li>
<li><span style="font-family: inherit;">Putamen: yrRPuA</span></li>
<li><span style="font-family: inherit;">Striatum (Caudate+Putamen): yrRStA</span></li>
<li><span style="font-family: inherit;">Pallidum: yrRPaA</span></li>
<li><span style="font-family: inherit;">Lenticularis (Putamen+Pallidum): yrRLenA</span></li>
</ul>
Most useful diencephalic ROI:<br />
<ul>
<li><span style="font-family: inherit;">Thalamus: <a href="http://brainatrophyindices.blogspot.com.es/2014/08/the-yearly-rate-of-relative-thalamic.html">yrRTA</a> </span></li>
</ul>
Most useful ROI in the <i>posterior fossa</i>:</div>
<div>
<ul>
<li><span style="font-family: inherit;">Whole Cerebellum: yrRwCerA</span></li>
<li><span style="font-family: inherit;">Left Hemispheric Cerebellum: yrRlHCerA</span></li>
<li><span style="font-family: inherit;">Right Hemispheric Cerebellum: yrRrHCerA</span></li>
<li>Mesencephalon/Midbrain: yrRMidA</li>
<li>Pons: yrRPonsA</li>
<li>Medulla: yrRMedA</li>
</ul>
<div>
<span id="docs-internal-guid-61b7a3a5-f5d2-a7e3-b593-be1036a6b039"></span><br />
<h4 style="line-height: 1.15; margin-bottom: 0pt; margin-top: 0pt;">
<span id="docs-internal-guid-61b7a3a5-f5d2-a7e3-b593-be1036a6b039">
<span style="color: #333333; font-family: "arial"; font-size: 13px; vertical-align: baseline; white-space: pre-wrap;"><br /></span></span></h4>
<span id="docs-internal-guid-61b7a3a5-f5d2-a7e3-b593-be1036a6b039">
</span>
<h4 style="line-height: 1.15; margin-bottom: 0pt; margin-top: 0pt;">
<span id="docs-internal-guid-61b7a3a5-f5d2-a7e3-b593-be1036a6b039">
<span style="color: #333333; font-family: "arial"; font-size: 13px; vertical-align: baseline; white-space: pre-wrap;">References</span></span></h4>
<span id="docs-internal-guid-61b7a3a5-f5d2-a7e3-b593-be1036a6b039">
<span style="background-color: white; color: #404040; font-family: "arial"; font-size: 13px; line-height: 1.15; white-space: pre-wrap;"><ol>
<li><span style="line-height: 1.15;">Menéndez-González M. Volumetric indices and rates of atrophy for the assessment of medial temporal lobe atrophy. Journal of Neurology and Neuroscience 2014;5:2(4)</span></li>
<li><span style="line-height: 1.15;">Menéndez-González M, Salas-Pacheco JM and Arias-Carrión O (2014). The yearly rate of Relative Thalamic Atrophy (yrRTA): a simple 2D/3D method for estimating deep gray matter atrophy in Multiple Sclerosis. Frontiers in Aging Neuroscience 6:219</span></li>
</ol>
</span></span></div>
</div>
</div>
Anonymoushttp://www.blogger.com/profile/04796162963517707328noreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-32008416214898819712014-08-05T03:18:00.003-07:002014-08-05T03:25:53.577-07:00The yearly rate of Relative Thalamic Atrophy (yrRTA): a simple 2D/3D method for estimating deep gray matter atrophy in Multiple Sclerosis<div style="text-align: justify;">
Despite a strong correlation to outcome, the measurement of gray matter (GM) atrophy is not being used in daily clinical practice as a prognostic factor and monitor the effect of treatments in Multiple Sclerosis (MS). This is mainly because the volumetric methods available to date are sophisticated and difficult to implement for routine use in most hospitals. In addition, the meaning of raw results from volumetric studies on regions of interest are not always easy to understand. Thus, there is a huge need of a methodology suitable to be applied in daily clinical practice in order to estimate GM atrophy in a convenient and comprehensive way. Given the thalamus is the brain structure found to be more consistently implied in MS both in terms of extent of atrophy and in terms of prognostic value, we propose a solution based in this structure. In particular, we propose to compare the extent of thalamus atrophy (TA) with the extent of unspecific, global brain atrophy, represented by ventricular enlargement. We name this ratio the “yearly rate of Relative Thalamic Atrophy” (yrRTA). In this report we aim to describe the concept of yrRTA and the guidelines for computing it under 2D and 3D approaches and explain the rationale behind this method. We have also conducted a very short crossectional retrospective study to proof the concept of yrRTA. However, we do not seek to describe here the validity of this parameter since these researches are being conducted currently and results will be addressed in future publications.<br />
<br />
<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQEAbcd4fcrI-uh6VPo_VMW1PYoZl1Nu8XRsnFqCMu7HBG60_KPdGC4mexnumre-XBtE5KcceIUx9zPmLUIUQZwQftegyhbxuDbpa2Qe4tLboC2DY1sL9LZ7wM1ZLz12iGQBp0xUTBrg-I/s1600/Figure+1.tiff" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgQEAbcd4fcrI-uh6VPo_VMW1PYoZl1Nu8XRsnFqCMu7HBG60_KPdGC4mexnumre-XBtE5KcceIUx9zPmLUIUQZwQftegyhbxuDbpa2Qe4tLboC2DY1sL9LZ7wM1ZLz12iGQBp0xUTBrg-I/s1600/Figure+1.tiff" height="400" width="303" /></a></td></tr>
<tr><td class="tr-caption"><span style="font-size: x-small;"><br /></span>
<span style="font-size: xx-small;">yrRTA= (A1+A’1)-(A2+A’2) x 120 / (B2-B1) x </span><br />
<span style="font-size: xx-small;">(#months between MRI studies) </span></td></tr>
</tbody></table>
<div style="text-align: center;">
<br /></div>
</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<a href="http://journal.frontiersin.org/Journal/10.3389/fnagi.2014.00219/full" target="_blank">Full text</a></div>
<span style="background-color: white; color: #3e3d40; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; line-height: 22px;"><br /></span>Anonymoushttp://www.blogger.com/profile/04796162963517707328noreply@blogger.com0tag:blogger.com,1999:blog-4110790349320800299.post-38501951562437213602014-04-16T05:19:00.001-07:002015-01-31T02:05:33.876-08:00Gray matter imaging in multiple sclerosis: the role of thalamus<h4 style="background-color: white; border: none; clear: both; color: #4e4e4e; line-height: 1.2em; margin: 0px; outline: 0px; padding: 4px 0px; vertical-align: baseline;">
<span style="font-family: inherit;">
Key points: </span></h4>
<div class="xfullindent1" style="background-color: white; border: 0px; clear: both; line-height: 17.600000381469727px; margin-bottom: 1em; outline: 0px; overflow: visible; padding: 0px 0px 0px 0.6em; vertical-align: baseline;">
<div style="text-align: justify;">
<br />
<ul>
<li><span style="font-family: inherit;">GM damage in MS is common and widespread, especially in chronic MS;</span></li>
<li><span style="font-family: inherit;">The underlying pathological correlates of GM damage in MS are different from WM damage;</span></li>
<li><span style="font-family: inherit;">GM pathology is present in all stages of the disease, but is more prominent in SPMS and PPMS compared to RRMS;</span></li>
<li><span style="font-family: inherit;">Although a relatively non-specific measure of overall pathology, GM atrophy measurements are reliable and robust and correlate strongly with disability and cognitive impairment (more so than WM atrophy);</span></li>
<li><span style="font-family: inherit;">Non-neocortical GM damage is frequently detected in histopathological studies as well as on MRI; </span></li>
<li><span style="font-family: inherit;">Thalamic abnormalities have been studied most extensively and were shown to correlate with clinical parameters;</span></li>
</ul>
</div>
</div>
<div class="xfullindent1" style="background-color: white; border: 0px; clear: both; line-height: 17.600000381469727px; margin-bottom: 1em; outline: 0px; overflow: visible; padding: 0px 0px 0px 0.6em; vertical-align: baseline;">
<div style="text-align: justify;">
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.biomedcentral.com/content/figures/1471-2377-11-153-1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.biomedcentral.com/content/figures/1471-2377-11-153-1.jpg" height="467" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><strong style="background-color: #f7f7f7; border: 0px; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; margin: 0px; outline: 0px; padding: 0px; text-align: left; vertical-align: baseline;">Timeline of GM imaging in MS</strong><span style="background-color: #f7f7f7; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;">. A schematic overview of developments in the field of GM imaging in MS from the beginning of the 20</span><sup style="background-color: #f7f7f7; font-family: Verdana, Arial, Helvetica, sans-serif; line-height: 17.600000381469727px; margin: 0px; padding: 0px; text-align: left;">th </sup><span style="background-color: #f7f7f7; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;">century until now. Taken from </span><em style="background-color: white; border: 0px; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; margin: 0px; outline: 0px; padding: 0px; text-align: left; vertical-align: baseline;">BMC Neurology</em><span style="background-color: white; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;"> 2011, </span><span style="background-color: white; border: 0px; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; margin: 0px; outline: 0px; padding: 0px; text-align: left; vertical-align: baseline;">11</span><span style="background-color: white; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;">:153 </span></td></tr>
</tbody></table>
</div>
</div>
<div class="xfullindent1" style="background-color: white; border: 0px; clear: both; line-height: 17.600000381469727px; margin-bottom: 1em; outline: 0px; overflow: visible; padding: 0px 0px 0px 0.6em; vertical-align: baseline;">
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<tr><td style="text-align: center;"><a href="http://www.biomedcentral.com/content/figures/1471-2377-11-153-3.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.biomedcentral.com/content/figures/1471-2377-11-153-3.jpg" height="640" width="499" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><strong style="background-color: #f7f7f7; border: 0px; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; margin: 0px; outline: 0px; padding: 0px; text-align: left; vertical-align: baseline;">Subcortical GM damage in MS</strong><span style="background-color: #f7f7f7; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;">. Subcortical atrophy in HC and MS</span><span style="background-color: #f7f7f7; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;">. Above: Effect sizes of subcortical atrophy in a cohort of 120 early RRMS patients, six years post-diagnosis. Below: Two examples of segmented subcortical structures in a healthy control (HC, above) and an age-matched RRMS patient (MS, below). </span><span style="background-color: #f7f7f7; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;">Taken from </span><em style="background-color: white; border: 0px; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; margin: 0px; outline: 0px; padding: 0px; text-align: left; vertical-align: baseline;">BMC Neurology</em><span style="background-color: white; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;"> 2011, </span><span style="background-color: white; border: 0px; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; margin: 0px; outline: 0px; padding: 0px; text-align: left; vertical-align: baseline;">11</span><span style="background-color: white; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 11px; line-height: 17.600000381469727px; text-align: left;">:153</span><br />
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<tr><td style="text-align: center;"><a href="http://www.ajnr.org/content/33/8/1573/F1.medium.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.ajnr.org/content/33/8/1573/F1.medium.gif" height="400" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><b>Representative FIRST segmentation</b> in a 47-year-old female patient with CIS (EDSS 1.5) on the left and a 47-year-old female patient with RRMS (EDSS 2.0) on the right. The colored regions represent thalamus (green), globus pallidus (dark blue), caudate (light blue), and putamen (magenta). <span style="font-family: inherit; font-size: x-small;">Taken from <abbr class="slug-jnl-abbrev" style="background-color: white; border: 0px; color: #333300; line-height: 9.21349811553955px; margin: 0px; outline-style: none; padding: 0px; text-align: start; vertical-align: baseline;" title="American Journal of Neuroradiology">AJNR</abbr><span class="slug-pub-date" itemprop="datePublished" style="background-color: white; border: 0px; color: #333300; line-height: 9.21349811553955px; margin: 0px; outline-style: none; padding: 0px; text-align: start; vertical-align: baseline;"> 2012 </span><span style="background-color: white; color: #333300; line-height: 9.21349811553955px; text-align: start;"></span><span class="slug-vol" style="background-color: white; border: 0px; color: #333300; line-height: 9.21349811553955px; margin: 0px; outline-style: none; padding: 0px; text-align: start; vertical-align: baseline;">33: </span><span class="slug-pages" style="background-color: white; border: 0px; color: #333300; line-height: 9.21349811553955px; margin: 0px; outline-style: none; padding: 0px; text-align: start; vertical-align: baseline;">1573-1578</span></span></td></tr>
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More info:</div>
<h6 id="TracingGuidelinesDocumentsandManuals-thalamus.pdfThalamusTracingGuidelines-W.Ooteman,K.Cretsinger" style="background-color: white; font-family: Arial, Helvetica, FreeSans, sans-serif; margin: 21px 0px 4px; padding: 0px; text-align: left;">
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<li style="font-size: 10pt;"><span style="font-weight: normal;"><span style="color: blue; font-size: 10pt;"><a href="https://www.icts.uiowa.edu/confluence/download/attachments/72385476/thalamus.pdf?version=1&modificationDate=1370624466752&api=v2" style="color: #326ca6; outline: none;"><span style="color: blue;">thalamus.pdf</span></a> </span><span style="font-size: 10pt;"> Thalamus Tracing Guidelines - W. Ooteman, K. Cretsinger</span></span></li>
<li style="font-size: 10pt;"><span style="font-weight: normal;"><span style="color: blue; font-size: 10pt;"><a href="https://www.icts.uiowa.edu/confluence/download/attachments/72385476/Mediodorsal_nucleus_tracing_thalamus.pdf?version=1&modificationDate=1370625537284&api=v2" style="color: #326ca6; outline: none;"><span style="color: blue;">Mediodorsal_nucleus_tracing_thalamus.pdf</span></a> </span><span style="font-size: 10pt;"> Mediodorsal Nucleus Tracing Guidelines - S. Ziebel, K. Cretsinger</span></span></li>
<li><span style="font-weight: normal;"><div style="color: #222222; font-family: arial, sans-serif;">
<span style="font-size: x-small;"><a href="http://www.neurology.org/content/early/2015/01/28/WNL.0000000000001281.abstract" target="_blank">Correlation between brain volume loss and clinical and MRI outcomes in multiple sclerosis</a></span></div>
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