scholarly journals Characterizing the relationship between functional MRI–derived measures and clinical outcomes in patients with vascular lesions

2013 ◽  
Vol 34 (4) ◽  
pp. E8 ◽  
Author(s):  
Thomas A. Gallagher ◽  
Veena A. Nair ◽  
Michael F. Regner ◽  
Brittany M. Young ◽  
Andrew Radtke ◽  
...  
Keyword(s):  
Functional Mri ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Motor Deficits ◽  
Sample Population ◽  
Relevant Parameter ◽  
Language Deficits ◽  
Lesion Type ◽  
The Impact ◽  
The Relationship

Object Functional MRI (fMRI) has proven to be an effective component of pretreatment planning in patients harboring a variety of different brain lesions. The authors have recently reported significant relationships concerning distances between brain tumor borders and areas of functional activation (lesion-to-activation distance; LAD) with regard to patient morbidity and mortality. This study further examines the relationship between LAD, focusing on a host of vascular lesions and pre- and posttreatment morbidity. Methods This study included a sample population of patients with vascular lesions (n = 106), primarily arteriovenous malformations (AVMs) and cavernomas. These patients underwent pretreatment fMRI-based motor mapping (n = 72) or language mapping (n = 84). The impact of LAD and other variables derived from the patient medical record were analyzed with respect to functional deficits in terms of morbidity (weakness and/or aphasia). Results In patients with no pretreatment deficits, there was trend for a significant relationship between the Wernicke area LAD and posttreatment language deficits. In patients with or without pretreatment deficits, a trend toward significance was observed between sensorimotor LAD and posttreatment motor deficits. Additionally, lesion type (AVMs or cavernomas) affected posttreatment deficits, with more patients with cavernomas showing posttreatment language deficits than patients with AVMs. However, this difference was not observed for posttreatment motor deficits. Conclusions These findings suggest that the proximity of a vascular lesion to sensorimotor and language areas is a relevant parameter in estimating patient prognosis in the perioperative period. Additionally, vascular lesion type and existence of pretreatment deficits play a significant role in outcomes.

scholarly journals The role of secondary motor and language cortices in morbidity and mortality: a retrospective functional MRI study of surgical planning for patients with intracranial tumors

2013 ◽  
Vol 34 (4) ◽  
pp. E7 ◽  
Author(s):  
Jed Voss ◽  
Timothy B. Meier ◽  
Robert Freidel ◽  
Bornali Kundu ◽  
Veena A. Nair ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Functional Mri ◽  
Brain Regions ◽  
Motor Area ◽  
Morbidity And Mortality ◽  
Motor Deficits ◽  
Language Mapping ◽  
Language Deficits ◽  
The Impact ◽  
The Relationship

Object Functional MRI (fMRI) is commonly used by neurosurgeons preoperatively to identify brain regions associated with essential behaviors, such as language and motor abilities. In this study the authors investigated the relationship between patient morbidity and mortality and the distance from the tumor border area to functional activations in secondary motor and language cortices. Methods Patients with primary or metastatic brain tumors who underwent preoperative fMRI motor and language mapping were selected from a large database of patients with tumors. The lesion-to-activation distance (LAD) was measured in each patient relative to the supplementary motor area (SMA) for motor tasks and the presupplementary motor area (pSMA) for language tasks. The association between LAD and the incidence of deficits was investigated using the Fisher exact tests of significance. The impact of other variables, including age, handedness, sex, and tumor grade, was also investigated. In a subset of patients, logistic regression was performed to identify the likelihood of deficits based on the LAD to primary and secondary regions. Finally, Mantel-Cox log-rank tests were performed to determine whether survival time was significantly related to the LAD to secondary motor and language areas. Results A significant association was observed between the LAD to the SMA and the incidence of motor deficits, with the percentage of patients with deficits dropping for those in the LAD > 2 cm group. The relationship between the LAD to the pSMA and the incidence of language deficits was not significant. Logistic regression demonstrated that the LAD to primary sensorimotor cortex does affect the incidence of motor deficits, but that the LAD to SMA does not. Finally, the authors observed no relationship between the LAD to secondary regions and patient mortality rates. Conclusions These results demonstrate that the LAD to SMA structures does affect morbidity, although not to the extent of LAD to primary structures. In addition, motor deficits are significantly associated with LAD to secondary structures, but language deficits are not. This should be considered by neurosurgeons for patient consultation and preoperative planning.

Abstract 3734: Presurgical fMRI and Morbidity Outcomes in Patients with Vascular Lesions

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Andrew C Radtke ◽  
Joshua Pankratz ◽  
Ryan Holdsworth ◽  
Dovile Baniulis ◽  
Nicole Kornder ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preoperative Planning ◽  
Binary Logistic Regression ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Motor Deficits ◽  
Binary Logistic Regression Analysis ◽  
Language Mapping ◽  
Motor Mapping ◽  
The Relationship

Background fMRI is being increasingly used as an adjunct imaging technique for preoperative planning for patients with various brain lesions. The proximity of the lesion to eloquent cortex is a major factor in guiding surgical planning. Our group has previously reported significant association between the distance between brain tumor periphery and area of fMRI activation (Lesion-Activation Distance; LAD) and morbidity and mortality outcomes. This study investigated the relationship between vascular lesion LAD and morbidity. Methods This study was a retrospective analysis of data from patients with vascular lesions [arteriovenous malformations (AVMs) (n=49), and cavernomas (n=57)], who had received fMRI as part of their preoperative planning. The preoperative fMRI included motor mapping (n=87) and/or language mapping (n=102). The fMRI paradigms were chosen based on observed preoperative weakness (aphasia, paresis) and anticipated functional areas of the brain that may be affected by treatment. Results Multiple logistic regression analyses showed that a model that combines Age and Language LAD was a significant predictor of postoperative deficits (p= 0.04). Broca’s LAD(1-2 cm) X Age was a significant predictor of postoperative deficits (change in odds ratio (OR) =0.82, CI:0.68-0.98). The relationship between Brocas’s LAD and postoperative aphasia and Broca’s LAD and pre and postoperative aphasia trended towards significance (p = .08 and p =.07 respectively). Wernicke’s LAD, independently or combined with Age, was not a significant predictor of postoperative deficits. Binary logistic regression analysis for SMC LAD and postop deficits did not reach significance (p =.10). There were no significant differences in postoperative language or motor deficits as a function of gender or handedness. Conclusions These results suggest that both age and the proximity of a vascular lesion to language LAD are factors that can help predict postoperative outcomes, especially for Broca’s LAD. The lack of similar results when investigating the relationship between Wernicke’s LAD and postoperative deficits suggests potential brain reorganization and/or robustness of this brain region. These results have implications for the potential use of fMRI as a presurgical tool for language mapping in patients with vascular lesions.

Impact of chocolate liquor on vascular lesions in apoE-knockout mice

2017 ◽  
Vol 131 (20) ◽  
pp. 2549-2560
Author(s):  
Narges Yazdekhasti ◽  
Corinna Brandsch ◽  
Frank Hirche ◽  
Julia Kühn ◽  
Anke Schloesser ◽  
...  
Keyword(s):  
Knockout Mice ◽  
Tissue Level ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Control Group ◽  
Aortic Tissue ◽  
Lesion Development ◽  
Chocolate Liquor ◽  
Apoe Knockout Mice ◽  
The Impact

Cocoa polyphenols are thought to reduce the risk of cardiovascular diseases. Thus, cocoa-containing foods may have significant health benefits. Here, we studied the impact of chocolate liquor on vascular lesion development and plaque composition in a mouse model of atherosclerosis. Apolipoprotein E (apoE)-knockout mice were assigned to two groups and fed a Western diet that contained 250 g/kg of either chocolate liquor or a polyphenol-free isoenergetic control paste for 16 weeks. In addition to fat, protein, and fibers, the chocolate liquor contained 2 g/kg of polyphenols. Compared with the control group, mice fed the chocolate liquor had larger plaque areas in the descending aorta and aortic root, which were attributed to a higher mass of vascular smooth muscle cells (VSMCs) and collagen. Vascular lipid deposits and calcification areas did not differ between the two groups. The aortic tissue level of interleukin-6 (IL-6) mRNA was 5-fold higher in the mice fed chocolate liquor than in the control mice. Chocolate-fed mice exhibited an increased hepatic saturated to polyunsaturated fatty acid ratio than the controls. Although the chocolate liquor contained 14 µg/kg of vitamin D2, the chocolate liquor-fed mice did not have measurable 25-hydroxyvitamin D2 in the serum. These mice even showed a 25% reduction in the level of 25-hydroxyvitamin D3 compared with the control mice. Overall, present data may contribute to our understanding how chocolate constituents can impact vascular lesion development.

scholarly journals The Moderating Effect of the Economic Situation on Relationship between Problem-Solving Skills and Mental Health in Working Women and Housewives

2017 ◽  
Vol 7 (3) ◽  
pp. 1
Author(s):  
Goldis Garmsari ◽  
Maryam Safara
Keyword(s):  
Mental Health ◽  
Problem Solving ◽  
Working Women ◽  
Moderating Effect ◽  
Economic Situation ◽  
Sample Population ◽  
Problem Solving Skills ◽  
Independent Contribution ◽  
The Impact ◽  
The Relationship

Women as an important stratum of society play a fundamental role in the creation, establishment and strengthening of families. So, paying attention to their mental health as the family guides has direct effects on the mental health of children, families and consequently the whole of society. Thus, the present study was performed to investigate the moderating effect of the economic situation on the relationship between problem solving skills and mental health in two groups of working women and housewives referring to Welfare Centers in the city of Karaj. Based on Morgan’s sampling table, 199 working women and 192 housewives (totally 391) were selected by simple random sampling method. Then, Cassidy and Long (1996) Problem-Solving Style Questionnaire and Goldberg (1989) General Health Questionnaire were administered on the sample group, and data were analyzed using SPSS software (ver. 17). The results showed that the economy had an independent contribution in predicting the mental health of working women, but it was not capable to act as a moderating variable in relationship between problem-solving skill and mental health of working women. In addition, according to the results obtained from the housewife population, not only the economy does not have an independent contribution in the prediction of their mental health, but also it cannot act as a moderating variable in this relationship. But the problem-solving skill alone explains 23.8% of the variance of mental health in the sample population. In other words, problem-solving ability was effective in increasing the level of mental health. But the impact of economy as a moderating variable in the relationship between problem-solving skill and mental health of housewives and working women was not significant.

Functional MRI in Neurosurgery and Neurology

2018 ◽  
pp. 49-63
Author(s):  
S. Kathleen Bandt ◽  
Dennis D. Spencer
Keyword(s):  
Functional Mri ◽  
Neurological Disorders ◽  
Clinical Medicine ◽  
Functional Neuroimaging ◽  
Brain Activity ◽  
Clinical Care ◽  
Rehabilitation Potential ◽  
Magnetic Resonance Imaging Mri ◽  
The Impact ◽  
The Relationship

The relationship between neuroimaging and the care of patients with neurosurgical and neurological disorders has long been a close one. The integration of these fields dates back to neuroimaging’s earliest days in the 20th century. However, no single imaging technique has had the enduring impact on clinical medicine that magnetic resonance imaging (MRI) has. The impact of MRI has resulted not only from an enhanced understanding of structural abnormalities but also the functional implications of those abnormalities. Beyond this, advances in functional neuroimaging have improved our understanding not only of the functional correlates of lesion disorders but also of non-lesion conditions including developmental, degenerative and movement disorders as well as predicting rehabilitation potential following stroke or traumatic brain injury. The advent of functional MRI (fMRI), which capitalizes on the relationship between cerebral blood flow and neuronal activity, combines all of these advantages together with the ability to define regions of brain activity, or function, and has further revolutionized the clinical care of patients with neurosurgical and neurological disorders. Here, we discuss current fMRI techniques as well as their clinical application to the care of patients with neurosurgical and neurological disorders. We also briefly review other functional imaging modalities beyond fMRI.

scholarly journals The Impact of Pregnancy on Hemorrhagic Stroke in Young Women

2018 ◽  
Vol 46 (1-2) ◽  
pp. 10-15 ◽  
Author(s):  
Eliza C. Miller ◽  
Kathryn M. Sundheim ◽  
Joshua Z. Willey ◽  
Amelia K. Boehme ◽  
Dritan Agalliu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Women ◽  
Hemorrhagic Stroke ◽  
Patient Characteristics ◽  
Vascular Lesion ◽  
Vascular Lesions ◽  
Lower Odds ◽  
Cerebral Vasoconstriction ◽  
The Impact ◽  
Prior Stroke

Background: Pregnancy is a sex-specific risk factor for causing hemorrhagic stroke (HS) in young adults. Unique physiological characteristics during pregnancy may alter the relative risk for HS in pregnant/postpartum (PP) women compared to HS in other young women. We compared patient characteristics and HS subtypes between young non-pregnant and PP women. Methods: We reviewed the medical records of all women 18–45 years old admitted to our center with HS from October 15, 2008 through March 31, 2015, and compared patient characteristics and stroke mechanisms using logistic regression. Results: Of the 130 young women with HS during the study period, 111 were non-PP women, and 19 PP women. PP women had lower proportions of vascular risk factors such as hypertension, prior stroke, and smoking, and a higher proportion of migraine (36.8 vs. 14.4%, p = 0.01). After adjusting for hypertension, smoking, migraine, prior stroke and prior myocardial infarction, PP women had lower odds of having an underlying vascular lesion (OR 0.14, 95% CI 0.04–0.44, p = 0.0009) and a higher proportion of the reversible cerebral vasoconstriction syndrome (RCVS) as cause of their HS. Conclusions: Women with pregnancy-associated HS had fewer cerebrovascular risk factors, lower odds of having ­underlying vascular lesions, and higher proportion of ­migraine and RCVS compared with similar-aged non-­pregnant women. Pregnancy-associated HS appears to represent a unique pathophysiological process, requiring targeted study.

Accent Policy and Accent Modification Enterprises as Potential Indicators of Intercultural Power Relations: A Call for an Updated Research Agenda

2013 ◽  
Vol 3 (1) ◽  
pp. 22-33 ◽  
Author(s):  
Brynne D. Ovalle ◽  
Rahul Chakraborty
Keyword(s):  
International Relations ◽  
Identity Construction ◽  
Social Theory ◽  
Power Relations ◽  
Linguistic Diversity ◽  
Cultural Organization ◽  
Using Data ◽  
The Individual ◽  
The Impact ◽  
The Relationship

This article has two purposes: (a) to examine the relationship between intercultural power relations and the widespread practice of accent discrimination and (b) to underscore the ramifications of accent discrimination both for the individual and for global society as a whole. First, authors review social theory regarding language and group identity construction, and then go on to integrate more current studies linking accent bias to sociocultural variables. Authors discuss three examples of intercultural accent discrimination in order to illustrate how this link manifests itself in the broader context of international relations (i.e., how accent discrimination is generated in situations of unequal power) and, using a review of current research, assess the consequences of accent discrimination for the individual. Finally, the article highlights the impact that linguistic discrimination is having on linguistic diversity globally, partially using data from the United Nations Educational, Scientific and Cultural Organization (UNESCO) and partially by offering a potential context for interpreting the emergence of practices that seek to reduce or modify speaker accents.

Business: Making Cents of Coding Systems: Billing for Professional Services

2010 ◽  
Vol 20 (1) ◽  
pp. 3-8
Author(s):  
Dee Adams Nikjeh
Keyword(s):  
Professional Services ◽  
Speech Language Pathology ◽  
Coding Systems ◽  
Language Pathology ◽  
Program Funding ◽  
Fee Schedule ◽  
Procedure Codes ◽  
Relationship Of ◽  
The Impact ◽  
The Relationship

Abstract Administrators and supervisors face daily challenges over issues such as program funding, service fees, correct coding procedures, and the ever-changing healthcare regulations. Receiving equitable reimbursement for speech-language pathology and audiology services necessitates an understanding of federal coding and reimbursement systems. This tutorial provides information pertaining to two major healthcare coding systems and explains the relationship of these systems to clinical documentation, the Medicare Physician Fee Schedule and equitable reimbursement. An explanation of coding edits and coding modifiers is provided for use in those occasional atypical situations when the standard use of procedural coding may not be appropriate. Also included in this tutorial is a brief discussion of the impact that the Medicare Improvements for Patients and Providers Act of 2008 (HR 6331 Medicare Improvements for Patients and Providers Act [MIPPA], 2008) has had on the valuation of speech-language pathology procedure codes.

The Need to Belong and the Relationship Between Loneliness and Health

2014 ◽  
Vol 22 (4) ◽  
pp. 194-201 ◽  
Author(s):  
Freda-Marie Hartung ◽  
Britta Renner
Keyword(s):  
Individual Differences ◽  
Social Isolation ◽  
Social Situation ◽  
First Year ◽  
Health State ◽  
Need To Belong ◽  
First Year University ◽  
Perceived Social Isolation ◽  
The Impact ◽  
The Relationship

Humans are social animals; consequently, a lack of social ties affects individuals’ health negatively. However, the desire to belong differs between individuals, raising the question of whether individual differences in the need to belong moderate the impact of perceived social isolation on health. In the present study, 77 first-year university students rated their loneliness and health every 6 weeks for 18 weeks. Individual differences in the need to belong were found to moderate the relationship between loneliness and current health state. Specifically, lonely students with a high need to belong reported more days of illness than those with a low need to belong. In contrast, the strength of the need to belong had no effect on students who did not feel lonely. Thus, people who have a strong need to belong appear to suffer from loneliness and become ill more often, whereas people with a weak need to belong appear to stand loneliness better and are comparatively healthy. The study implies that social isolation does not impact all individuals identically; instead, the fit between the social situation and an individual’s need appears to be crucial for an individual’s functioning.

Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Meshan Lehmann ◽  
Matthew R. Hilimire ◽  
Lawrence H. Yang ◽  
Bruce G. Link ◽  
Jordan E. DeVylder
Keyword(s):  
Young Adults ◽  
Suicide Attempts ◽  
Self Esteem ◽  
High Risk Population ◽  
High Functioning ◽  
People With Mental Illness ◽  
History Of ◽  
The Individual ◽  
The Impact ◽  
The Relationship

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

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