Cortical mapping with navigated transcranial magnetic stimulation in low-grade glioma surgery

Transcranial magnetic stimulation (TMS) is a promising method for both investigation and therapeutic treatment of psychiatric and neurologic disorders and, more recently, for brain mapping. This study describes the application of navigated TMS for motor cortex mapping in patients with a brain tumor located close to the precentral gyrus. Materials and methods: In this prospective study, six patients with low-grade gliomas in or near the precentral gyrus underwent TMS, and their motor responses were correlated to locations in the cortex around the lesion, generating a functional map overlaid on three-dimensional magnetic resonance imaging (MRI) scans of the brain. To determine the accuracy of this new method, we compared TMS mapping with the gold standard mapping with direct cortical electrical stimulation in surgery. The same navigation system and TMS-generated map were used during the surgical resection procedure. Results: The motor cortex could be clearly mapped using both methods. The locations corresponding to the hand and forearm, found during intraoperative mapping, showed a close spatial relationship to the homotopic areas identified by TMS mapping. The mean distance between TMS and direct cortical electrical stimulation (DES) was 4.16 +/- 1.02 mm (range: 2.56-5.27 mm). Conclusion: Preoperative mapping of the motor cortex with navigated TMS prior to brain tumor resection is a useful presurgical planning tool with good accuracy.

A Homonuclear Rotational Echo Double-Resonance Method for Measuring Site-Resolved Distance Distributions in I=1/2 Spin Pairs, Clusters, and Multispin Systems

Deutsche Forschungsgemeinschaft [SFB 858]

Encapsulation of small magnetic clusters in fullerene cages: A density functional theory investigation within van der Waals corrections

The encapsulation of magnetic transition-metal (TM) clusters inside carbon cages (fullerenes, nanotubes) has been of great interest due to the wide range of applications, which spread from medical sensors in magnetic resonance imaging to photonic crystals. Several theoretical studies have been reported; however, our atomistic understanding of the physical properties of encapsulated magnetic TM 3d clusters is far from satisfactory. In this work, we will report general trends, derived from density functional theory within the generalized gradient approximation proposed by Perdew, Burke, and Ernzerhof (PBE), for the encapsulation properties of the TMm@C-n (TM = Fe, Co, Ni; m = 2-6, n = 60,70,80,90) systems. Furthermore, to understand the role of the van der Waals corrections to the physical properties, we employed the empirical Grimme's correction (PBE + D2). We found that both PBE and PBE + D2 functionals yield almost the same geometric parameters, magnetic and electronic properties, however, PBE + D2 strongly enhances the encapsulation energy. We found that the center of mass of the TMm clusters is displaced towards the inside C-n surfaces, except for large TMm clusters (m = 5 and 6). For few cases, e. g., Co-4 and Fe-4, the encapsulation changes the putative lowest-energy structure compared to the isolated TMm clusters. We identified few physical parameters that play an important role in the sign and magnitude of the encapsulation energy, namely, cluster size, fullerene equatorial diameter, shape, curvature of the inside C-n surface, number of TM atoms that bind directly to the inside C-n surface, and the van der Waals correction. The total magnetic moment of encapsulated TMm clusters decreases compared with the isolated TMm clusters, which is expected due to the hybridization of the d-p states, and strongly depends on the size and shape of the fullerene cages.

A simple analysis of the influence of the solvent-induced electronic polarization on the N-15 magnetic shielding of pyridine in water

Electronic polarization induced by the interaction of a reference molecule with a liquid environment is expected to affect the magnetic shielding constants. Understanding this effect using realistic theoretical models is important for proper use of nuclear magnetic resonance in molecular characterization. In this work, we consider the pyridine molecule in water as a model system to briefly investigate this aspect. Thus, Monte Carlo simulations and quantum mechanics calculations based on the B3LYP/6-311++G (d,p) are used to analyze different aspects of the solvent effects on the N-15 magnetic shielding constant of pyridine in water. This includes in special the geometry relaxation and the electronic polarization of the solute by the solvent. The polarization effect is found to be very important, but, as expected for pyridine, the geometry relaxation contribution is essentially negligible. Using an average electrostatic model of the solvent, the magnetic shielding constant is calculated as -58.7 ppm, in good agreement with the experimental value of -56.3 ppm. The explicit inclusion of hydrogen-bonded water molecules embedded in the electrostatic field of the remaining solvent molecules gives the value of -61.8 ppm.

Design of multifunctional magnetic nanomaterials for biomedical applications

Diese Arbeit ist ein Beitrag zu den schnell wachsenden Forschungsgebieten der Nano-Biotechnologie und Nanomedizin. Sie behandelt die spezifische Gestaltung magnetischer Nanomaterialien für verschiedene biomedizinische Anwendungsgebiete, wie beispielsweise Kontrastmittel für die magnetische Resonanztomographie (MRT) oder "theragnostische" Agenzien für simultane optische/MR Detektion und Behandlung mittels photodynamischer Therapie (PDT).rnEine Vielzahl magnetischer Nanopartikel (NP) mit unterschiedlichsten magnetischen Eigenschaften wurden im Rahmen dieser Arbeit synthetisiert und erschöpfend charakterisiert. Darüber hinaus wurde eine ganze Reihe von Oberflächenmodifizierungsstrategien entwickelt, um sowohl die kolloidale als auch die chemische Stabilität der Partikel zu verbessern, und dadurch den hohen Anforderungen der in vitro und in vivo Applikation gerecht zu werden. Diese Strategien beinhalteten nicht nur die Verwendung bi-funktionaler und multifunktioneller Polymerliganden, sondern auch die Kondensation geeigneter Silanverbindungen, um eine robuste, chemisch inerte und hydrophile Siliziumdioxid- (SiO2) Schale um die magnetischen NP auszubilden.rnGenauer gesagt, der Bildungsmechanismus und die magnetischen Eigenschaften monodisperser MnO NPs wurden ausgiebig untersucht. Aufgrund ihres einzigartigen magnetischen Verhaltens eignen sich diese NPs besonders als (positive) Kontrastmittel zur Verkürzung der longitudinalen Relaxationszeit T1, was zu einer Aufhellung im entsprechenden MRT-Bild führt. Tatsächlich wurde dieses kontrastverbessernde Potential in mehreren Studien mit unterschiedlichen Oberflächenliganden bestätigt. Au@MnO „Nanoblumen“, auf der anderen Seite, sind Vertreter einer weiteren Klasse von Nanomaterialien, die in den vergangenen Jahren erhebliches Interesse in der wissenschaftlichen Welt geweckt hat und oft „Nano-hetero-Materialien“ genannt wird. Solche Nano-hetero-partikel vereinen die individuellen physikalischen und chemischen Eigenschaften der jeweiligen Komponenten in einem nanopartikulärem System und erhöhen dadurch die Vielseitigkeit der möglichen Anwendungen. Sowohl die magnetischen Merkmale von MnO, als auch die optischen Eigenschaften von Au bieten die Möglichkeit, diese „Nanoblumen“ für die kombinierte MRT und optische Bildgebung zu verwenden. Darüber hinaus erlaubt das Vorliegen zweier chemisch unterschiedlicher Oberflächen die gleichzeitige selektive Anbindung von Katecholliganden (auf MnO) und Thiolliganden (auf Au). Außerdem wurde das therapeutische Potential von magnetischen NPs anhand von MnO NPs demonstriert, die mit dem Photosensibilisator Protoporhyrin IX (PP) funktionalisiert waren. Bei Bestrahlung mit sichtbarem Licht initiiert PP die Produktion von zytotoxisch-reaktivem Sauerstoff. Wir zeigen, dass Nierenkrebszellen, die mit PP-funktionalisierten MnO NPs inkubiert wurden nach Bestrahlung mit Laserlicht verenden, während sie ohne Bestrahlung unverändert bleiben. In einem ähnlichen Experiment untersuchten wir die Eigenschaften von SiO2 beschichteten MnO NPs. Dafür wurde eigens eine neuartige SiO2-Beschichtungsmethode entwickelt, die einer nachfolgende weitere Anbindung verschiedenster Liganden und die Einlagerung von Fluoreszenzfarbstoffen durch herkömmliche Silan- Sol-Gel Chemie erlaubt. Die Partikel zeigten eine ausgezeichnete Stabilität in einer ganzen Reihe wässriger Lösungen, darunter auch physiologische Kochsalzlösung, Pufferlösungen und humanes Blutserum, und waren weniger anfällig gegenüber Mn-Ionenauswaschung als einfache PEGylierte MnO NPs. Des Weiteren konnte bewiesen werden, dass die dünne SiO2 Schicht nur einen geringen Einfluss auf das magnetische Verhalten der NPs hatte, so dass sie weiterhin als T1-Kontrastmittel verwendet werden können. Schließlich konnten zusätzlich FePt@MnO NPs hergestellt werden, welche die individuellen magnetischen Merkmale eines ferromagnetischen (FePt) und eines antiferromagnetischen (MnO) Materials vereinen. Wir zeigen, dass wir die jeweiligen Partikelgrößen, und damit das resultierende magnetische Verhalten, durch Veränderung der experimentellen Parameter variieren können. Die magnetische Wechselwirkung zwischen beiden Materialien kann dabei auf Spinkommunikation an der Grenzfläche zwischen beiden NP-Sorten zurückgeführt werden.rn

Smart magnetic dispersions - from switchable release to well-defined hybrid nanofibers

The synthesis, characterization and application of aqueous dispersions of superparamagnetic/polymer hybrid nanoparticles and capsules is described. Implementation of the superparamagnetic moiety into the polymer matrix enables a response of the nanomaterials towards an external magnetic field. Application of the external field is used for two main purposes: i) As heat generator, when an alternating magnetic field is applied. ii) As structuring agent to self-assemble superparamagnetic nanoparticles in the external field.rnIn the first part, superparamagnetic nanoparticles were used as heat generators in order to achieve a magnetic field induced release of an active compound from nanocontainers. To achieve such a release in remote-controlled fashion, the encapsulation of superparamagnetic nanoparticles into polymer nanocapsules was combined with the integration of a thermolabile compound into the shell of the nanocontainers. The magnetic nanoparticles acted as generators for heat, which decomposed the thermolabile compound. Pores were created in the degrading shell and an active substance was released.rn Additionally, the self-assembly of polymer nanoparticles, which were labeled with a superparamagnetic moiety as structuring agent, could be demonstrated. A combination of a magnetic field induced self-assembly and a sintering of neighboring particles upon an increase in temperature above the glass transition temperature of the polymer was used to form stable architectures. Various structures with tunable periodicity could be obtained ranging from smooth linear nanofibers to zigzag fibers. Besides solely creating linear architectures, the frugal process additionally allowed the creation of arrangements in analogy to more complex polymer architectures: By the introduction of defined junction points, the generation of branched structures and networks was demonstrated. Additionally, by tailoring the interaction of differently sized particles, the preparation of nanoparticle arrangements in statistical or block copolymer fashion was shown. Moreover, a reversible linear assembly and linkage of the nanoparticles was demonstrated following a lock/unlock mechanism. Therefore, the particles were locked in their linear assembly by a stable iron(III) hydroxamato-complex and unlocked by addition of a reducing agent and formation of a less stable iron(II)-complex.Further, in various projects with collaboration partners, nanoparticles and nanocapsules were labeled with a superparamagnetic moiety for their use as contrast agents in magnetic resonance imaging or as magnetically separable dispersions.

Ideal site for ventricular anchoring of artificial chordae in mitral regurgitation

Surgical treatment of mitral leaflet prolapse using artificial neochordae shows excellent outcomes. Upcoming devices attempt the same treatment in a minimally invasive way but target the left ventricular apex as an anchoring point, rather than the tip of the corresponding papillary muscle. In this study, cine cardiac magnetic resonance imaging was used to compare these 2 different anchoring positions and their dynamic relationship with the mitral leaflets.

Novel magnetic iron oxide nanoparticles coated with poly(ethylene imine)-g-poly(ethylene glycol) for potential biomedical application: synthesis, stability, cytotoxicity and MR imaging

Magnetic iron oxide nanoparticles have found application as contrast agents for magnetic resonance imaging (MRI) and as switchable drug delivery vehicles. Their stabilization as colloidal carriers remains a challenge. The potential of poly(ethylene imine)-g-poly(ethylene glycol) (PEGPEI) as stabilizer for iron oxide (γ-Fe₂O₃) nanoparticles was studied in comparison to branched poly(ethylene imine) (PEI). Carrier systems consisting of γ-Fe₂O₃-PEI and γ-Fe₂O₃-PEGPEI were prepared and characterized regarding their physicochemical properties including magnetic resonance relaxometry. Colloidal stability of the formulations was tested in several media and cytotoxic effects in adenocarcinomic epithelial cells were investigated. Synthesized γ-Fe₂O₃ cores showed superparamagnetism and high degree of crystallinity. Diameters of polymer-coated nanoparticles γ-Fe₂O₃-PEI and γ-Fe₂O₃-PEGPEI were found to be 38.7 ± 1.0 nm and 40.4 ± 1.6 nm, respectively. No aggregation tendency was observable for γ-Fe₂O₃-PEGPEI over 12 h even in high ionic strength media. Furthermore, IC₅₀ values were significantly increased by more than 10-fold when compared to γ-Fe₂O₃-PEI. Formulations exhibited r₂ relaxivities of high numerical value, namely around 160 mM⁻¹ s⁻¹. In summary, novel carrier systems composed of γ-Fe₂O₃-PEGPEI meet key quality requirements rendering them promising for biomedical applications, e.g. as MRI contrast agents.

Cerebral blood flow identifies responders to transcranial magnetic stimulation in auditory verbal hallucinations

Auditory hallucinations comprise a critical domain of psychopathology in schizophrenia. Repetitive transcranial magnetic stimulation (TMS) has shown promise as an intervention with both positive and negative reports. The aim of this study was to test resting-brain perfusion before treatment as a possible biological marker of response to repetitive TMS. Twenty-four medicated patients underwent resting-brain perfusion magnetic resonance imaging with arterial spin labeling (ASL) before 10 days of repetitive TMS treatment. Response was defined as a reduction in the hallucination change scale of at least 50%. Responders (n=9) were robustly differentiated from nonresponders (n=15) to repetitive TMS by the higher regional cerebral blood flow (CBF) in the left superior temporal gyrus (STG) (P<0.05, corrected) before treatment. Resting-brain perfusion in the left STG predicted the response to repetitive TMS in this study sample, suggesting this parameter as a possible bio-marker of response in patients with schizophrenia and auditory hallucinations. Being noninvasive and relatively easy to use, resting perfusion measurement before treatment might be a clinically relevant way to identify possible responders and nonresponders to repetitive TMS.

Reduced neuronal activity in language-related regions after transcranial magnetic stimulation therapy for auditory verbal hallucinations

Transcranial magnetic stimulation (TMS) is a novel therapeutic approach, used in patients with pharmacoresistant auditory verbal hallucinations (AVH). To investigate the neurobiological effects of TMS on AVH, we measured cerebral blood flow with pseudo-continuous magnetic resonance-arterial spin labeling 20 ± 6 hours before and after TMS treatment.

Time course of blood oxygenation level-dependent signal response after theta burst transcranial magnetic stimulation of the frontal eye field

The aim of the current study was to examine the effect of theta burst repetitive transcranial magnetic stimulation (rTMS) on the blood oxygenation level-dependent (BOLD) activation during repeated functional magnetic resonance imaging (fMRI) measurements. Theta burst rTMS was applied over the right frontal eye field in seven healthy subjects. Subsequently, repeated fMRI measurements were performed during a saccade-fixation task (block design) 5, 20, 35, and 60 min after stimulation. We found that theta burst rTMS induced a strong and long-lasting decrease of the BOLD signal response of the stimulated frontal eye field at 20 and 35 min. Furthermore, less pronounced alterations of the BOLD signal response with different dynamics were found for remote oculomotor areas such as the left frontal eye field, the pre-supplementary eye field, the supplementary eye field, and both parietal eye fields. Recovery of the BOLD signal changes in the anterior remote areas started earlier than in the posterior remote areas. These results show that a) the major inhibitory impact of theta burst rTMS occurs directly in the stimulated area itself, and that b) a lower effect on remote, oculomotor areas can be induced.

Differentiation between active and chronic Crohn's disease using MRI small-bowel motility examinations — Initial experience

AIM: To evaluate the influence of locally active Crohn's disease on systemic small-bowel motility in patients with chronic Crohn's disease compared to healthy individuals. MATERIAL AND METHODS: Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn's disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn's disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student's t-test and one-way analysis of variance (ANOVA). RESULTS: Three randomly chosen segments were analysed in each participant. Patients with active Crohn's disease had significantly (p < 0.05) reduced contraction frequencies (active Crohn's disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn's disease. Contraction amplitudes were significantly reduced during active Crohn's disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn's disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn's disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn's disease (13.68). CONCLUSION: The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with active Crohn's disease alters small-bowel motility in distant, non-affected segments. The motility patterns revealed reduced contraction-wave frequencies, amplitudes, and decreased luminal occlusion rates. Thus evaluation of these characteristics potentially helps to differentiate between chronic and active Crohn's disease.

A g-factor metric for k-t-GRAPPA- and PEAK-GRAPPA-based parallel imaging.

PURPOSE The aim of this work is to derive a theoretical framework for quantitative noise and temporal fidelity analysis of time-resolved k-space-based parallel imaging methods. THEORY An analytical formalism of noise distribution is derived extending the existing g-factor formulation for nontime-resolved generalized autocalibrating partially parallel acquisition (GRAPPA) to time-resolved k-space-based methods. The noise analysis considers temporal noise correlations and is further accompanied by a temporal filtering analysis. METHODS All methods are derived and presented for k-t-GRAPPA and PEAK-GRAPPA. A sliding window reconstruction and nontime-resolved GRAPPA are taken as a reference. Statistical validation is based on series of pseudoreplica images. The analysis is demonstrated on a short-axis cardiac CINE dataset. RESULTS The superior signal-to-noise performance of time-resolved over nontime-resolved parallel imaging methods at the expense of temporal frequency filtering is analytically confirmed. Further, different temporal frequency filter characteristics of k-t-GRAPPA, PEAK-GRAPPA, and sliding window are revealed. CONCLUSION The proposed analysis of noise behavior and temporal fidelity establishes a theoretical basis for a quantitative evaluation of time-resolved reconstruction methods. Therefore, the presented theory allows for comparison between time-resolved parallel imaging methods and also nontime-resolved methods. Magn Reson Med, 2014. © 2014 Wiley Periodicals, Inc.