• Investigative Magnetic Resonance Imaging
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• v.18 no.4
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• pp.341-351
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• 2014

Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.

• Sleep Medicine and Psychophysiology
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• v.28 no.1
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• pp.18-26
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• 2021

Sleep is essential to brain function and mental health. Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders, and are major public health concerns. Proton magnetic resonance spectroscopy (¹H-MRS) is a non-invasive method of quantifying neurometabolite concentrations. Therefore, ¹H-MRS studies on individuals with sleep disorders may enhance our understanding of the pathophysiology of these disorders. In this article, we reviewed ¹H-MRS studies in insomnia and OSA that reported changes in neurometabolite concentrations. Previous studies have consistently reported insomnia-related reductions in γ-aminobutyric acid (GABA) levels in the frontal and occipital regions, which suggest that changes in GABA are important to the etiology of insomnia. These results may support the hyperarousal theory that insomnia is associated with increased cognitive and physiological arousal. In addition, the severity of insomnia was associated with low glutamate and glutamine levels. Previous studies of OSA have consistently reported reduced N-acetylaspartate (NAA) levels in the frontal, parieto-occipital, and temporal regions. In addition, OSA was associated with increased myo-inositol levels. These results may provide evidence that intermittent hypoxia induced by OSA may result in neuronal damage in the brain, which can be related to neurocognitive dysfunction in patients with OSA. The current review summarizes findings related to neurochemical changes in insomnia and OSA. Future well-designed studies using ¹H-MRS have the potential to enhance our understanding of the pathophysiology of sleep disorders including insomnia and OSA.

• Investigative Magnetic Resonance Imaging
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• v.9 no.1
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• pp.16-23
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• 2005

Purpose : In order to investigate the functional brain anatomy associated with mental calculation, functional magnetic resonance imaging was performed. Materials and Methods : In six normal right handed subjects, functional MR images were obtained using a 1.57 MR scanner and the EPI BOLD technique. The study included experiment I and experiment II. Each experiment consisted of five resting and four activation periods with each period of 30 seconds. During the activation period of both experiment I and II, calculation equations[an example: $(4+5)\times8=72$] were presented and the subjects were instructed to decide true or false of them. During the resting period of experiment I, the subjects were instructed to visually fixate on a crosshair. During the resting period of experiment II, two diagrams (an example: $(\bullet,\;\blacksquare)$)were presented and the subjects were instructed to decide they are same or not. For the post-processing of images, the SPM program was used, with the threshold of significance set at p<0.00001. The activated areas during the tasks were assessed. Results : In experiment 1, the inferior frontal gyrus, prefrontal cortex, promoter area, supplementary motor area, and intraparietal sulcus including superior parietal cortex were activated bilaterally. Although these areas were also activated in experiment II, the activated signals in the right frontal and parietal lobes were lessened. Conclusion : The left inferior frontal gyrus and prefrontal cortex and bilateral intraparietal sulci were activated during mental calculation. The right frontal and parietal lobes might be related to attention and decision making.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.522-527
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• 2001

We present a case of recurrent extraventricular neurocytoma with malignant glial differentiation in left temporoparietal area. A 37-year-old man with presentation of generalized seizure had undergone biopsy of brain tumor in left parietal area in 1987, which revealed extraventricular neurocytoma and radiotherapy was followed. Postoperative course was uneventful until eleven years after biopsy, when he became gradually aphasic and right hemiplegic. Brain CT and MRI revealed enlargement of tumor with peritumoral edema and calcifications. He underwent subtotal tumor removal in 1998. Microscopic examination of second biopsy specimen revealed presence of large areas composed of anaplastic glial cells with frequent mitosis, nuclear pleomorphism, large eosinophilic cytoplasm and eccentric nuclei, resembling gemistocytes, which were strongly immunoreactive to glial fibrillary acidic protein(GFAP) but not to synaptophysin(SNP). Also focal areas of neuronal cells were found, which were immunoreactive to SNP but not to GFAP. These histologic findings imply that this recurred tumor was a high grade, mixed tumor with divergent differentiation of neuronal and astrocyte lineage. We report a rare case of extraventricular cerebral neurocytoma with malignant glial differentiation with review of the literature.

• Proceedings of the IEEK Conference
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• 1999.11a
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• pp.525-528
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• 1999

Abstract - In this paper, a segmentation method for brain Magnetic Resonance(MR) image using region clustering technique with statistical distribution of gradient image and fuzzy rules is described. The brain MRI consists of gray matter and white matter, cerebrospinal fluid. But due to noise, overlap, vagueness, and various parameters, segmentation of MR image is a very difficult task. We use gradient information rather than intensity directly from the MR images and find appropriate thresholds for region classification using gradient approximation, rayleigh distribution function, region clustering, and merging techniques. And then, we propose the adaptive fuzzy rules in order to extract anatomical structures and diseases from brain MR image data. The experimental results shows that the proposed segmentation algorithm given better performance than traditional segmentation techniques.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.91-96
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• 2005

Cyclosporin A-induced central neurotoxicity has been rarely reported in patients with nephrotic syndrome. We report a pediatric patient who developed acute leukoencephalopathy diagnosed by MRI during CsA therapy for nephrotic syndrome.

• Neonatal Medicine
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• v.15 no.2
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• pp.160-165
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• 2008

Purpose : Cephalhematomas rarely lead to serious complications, such as skull fractures and intracranial hematomas, so CT and/or MRI scans are indicated only in cases in which depressed fractures are suspected or neurologic symptoms develop. Nevertheless, we have experienced several cases of cephalhematomas associated with intracranial hematomas in the absence of remarkable neurologic symptoms. The aim of this study was to evaluate the correlation between cephalhematomas and intracranial hematomas and determine the need for neuroimaging in infants with cephalhematomas. Methods : Infants who were admitted to the NICU with cephalhematomas and underwent neuroimaging (CT and/or MRI) between January 2002 and July 2006 were evaluated. Neuroimaging was done when the symptoms suggested the development of an intracranial hematoma. Results : Among 54 infants with cephalhematomas, 18 infants underwent neuroimaging. Six of 18 infants (33.3%) had intracranial hematomas, 4 infants had epidural hematomas, and 2 infants had subdural hematomas. Four of these 6 infants had neurologic symptoms or depressed skull fractures; 2 infants had no neurologic symptoms or depressed skull fractures. The neuroimaging was done to evaluate the cause of an excessive elevation of serum bilirubin and unexplained anemia. There were no remarkable differences between the infants with and without intracranial hematomas with respect to gestational age, birth weight, head circumference, diameter of the cephalhematoma, neurologic symptoms, and other clinical signs and symptoms. Conclusion : Based on this study, intracranial hematomas are common complications of cephalhematomas, thus more careful inspection and neuroimaging may be needed in cases of cephalhematomas in newborns.

• Investigative Magnetic Resonance Imaging
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• v.5 no.1
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• pp.24-32
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• 2001

Purpose : We investigated the reproducibility of language lateralization by 4 different word generation paradigms or the rest contents in each paradigm using functional magnetic resonance imaging in normal volunteers Materials and Methods Nine normal volunteers with left-handedness (mean age: 25 yrs) were examined on a 1.57 MR unit using a single-shot gradient echo epibold sequence. Four different word generation paradigms of noun, verb, adjective and adverb were used in each normal volunteer for investigating language system. In each paradigm, two different rest contents consisted of only seeing the " +" symbol or reading the meaningless letters. Each task consisted of 96 phases including 3 activations and 6 rests of 2 different contents. Two activation maps in one task were obtained under two different rest contents using the correlation method. We evaluated the detection rates of Broca and Wernicke areas and the differences of language lateralization among four different word generation paradigms, or between the rest contents. Results : The detection rates of Broca and Wernicke areas were over 67 % in 4 different language paradigms and there was no significant difference of them among language paradigms, or between two different rest contents. Language dominances, in all 4 different language paradigms, were shown to be consistent in 66 %, but were contrary with language paradigms in some subjects. The rest contents made no significant effect on dominant language dominance determination, but the success rates of the dominant language dominances determined from 4 language paradigms were higher in reading the meaningless letter (100%, n=9) than in only seeing "+" on screen at the rest task (78%, n=7).

• Investigative Magnetic Resonance Imaging
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• v.9 no.1
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• pp.24-29
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• 2005

Purpose : Instead of conventional two-dimensional (2-D) visual stimuli, three-dimensional (3-D) visual stimuli with stereoscopic vision were employed for the study of functional Magnetic Resonance Imaging (f-MRI). In this paper f-MRI with 3-D visual stimuli is investigated in comparison with f-MRI with 2-D visual stimuli. Materials and Methods : The anaglyph which generates stereoscopic vision by viewing color coded images with red-blue glasses is used for 3-D visual stimuli. Two-dimensional visual stimuli are also used for comparison. For healthy volunteers, f-MRI experiments were performed with 2-D and 3-D visual stimuli at 3.0 Tesla MRI system. Results : Occipital lobes were activated by the 3-D visual stimuli similarly as in the f-MRI with the conventional 2-D visual stimuli. The activated regions by the 3-D visual stimuli were, however, larger than those by the 2-D visual stimuli by $18\%$. Conclusion : Stereoscopic vision is the basis of the three-dimensional human perception. In this paper 3-D visual stimuli were applied using the anaglyph. Functional MRI was performed with 2-D and 3-D visual stimuli at 3.0 Tesla whole body MRI system. The occipital lobes activated by the 3-D visual stimuli appeared larger than those by the 2-D visual stimuli by about $18\%$. This is due to the more complex character of the 3-D human vision compared to 2-D vision. The f-MRI with 3-D visual stimuli may be useful in various fields using 3-D human vision such as virtual reality, 3-D display, and 3-D multimedia contents.

• Journal of the Korean Society of Radiology
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• v.10 no.4
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• pp.279-284
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• 2016

Single-shot echo planar imaging(SS-EPI) is well established as high sensitivity for ischemic stroke. However, it is prone to susceptibility artifact in brain stem that diminish the image quality. single-shot turbo spin echo(SS-TSE) is a new DWI technique that can reduce susceptibility artifact. Thus, this research was conducted so as to reduce geometric distortion in brain stem by using single-shot turbo spin echo technique. Thirty patients without brain disease underwent diffusion MR on a 3T scanner with SS-EPI and SS-TSE. Obtained images with both sequences were analyzed for geometric distortion and error percentage as well. Image quality in terms of geometric distortion of SS-TSE were found to be significantly better than those for SS-EPI. And error percentage was considerably reduced for 2.4% of b0 image(from 11.1% to 8.7%), 1.2% of b1000 image(from 11.4% to 10.1%), respectively. In summary, diffusion MR using SS-TSE significantly reduce geometric distortion compared to SS-EPI in brain stem and may provide improved diagnostic performance.