16 results
Supraglacial lakes on the Larsen B ice shelf, Antarctica, and at Paakitsoq, West Greenland: a comparative study
- Alison F. Banwell, Martamaria Caballero, Neil S. Arnold, Neil F. Glasser, L. Mac Cathles, Douglas R. MacAyeal
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- Journal:
- Annals of Glaciology / Volume 55 / Issue 66 / 2014
- Published online by Cambridge University Press:
- 26 July 2017, pp. 1-8
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Supraglacial meltwater lakes trigger ice-shelf break-up and modulate seasonal ice-sheet flow, and are thus agents by which warming is transmitted to the Antarctic and Greenland ice sheets. To characterize supraglacial lake variability we perform a comparative analysis of lake geometry and depth in two distinct regions, one on the pre-collapse (2002) Larsen B ice shelf, Antarctica, and the other in the ablation zone of Paakitsoq, a land-terminating region of the Greenland ice sheet. Compared to Paakitsoq, lakes on the Larsen B ice shelf cover a greater proportion of surface area (5.3% cf. 1%), but are shallower and more uniform in area. Other aspects of lake geometry (e.g. eccentricity, degree of convexity (solidity) and orientation) are relatively similar between the two regions. We attribute the notable difference in lake density and depth between ice-shelf and grounded ice to the fact that ice shelves have flatter surfaces and less distinct drainage basins. Ice shelves also possess more stimuli to small-scale, localized surface elevation variability, due to the various structural features that yield small variations in thickness and which float at different levels by Archimedes’ principle.
Cognitive and Behavioral Functioning in Childhood Acquired Demyelinating Syndromes
- Christine Till, Austin Noguera, Leonard H. Verhey, Julia O’Mahony, E. Ann Yeh, Jean K. Mah, Katia J. Sinopoli, Brian L. Brooks, Berengere Aubert-Broche, D. Louis Collins, Sridar Narayanan, Douglas L. Arnold, Brenda L. Banwell
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- Journal:
- Journal of the International Neuropsychological Society / Volume 22 / Issue 10 / November 2016
- Published online by Cambridge University Press:
- 01 December 2016, pp. 1050-1060
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Objectives: The aim of this study was to describe cognitive, academic, and psychosocial outcomes after an incident demyelinating event (acquired demyelinating syndromes, ADS) in childhood and to investigate the contribution of brain lesions and confirmed MS diagnosis on outcome. Methods: Thirty-six patients with ADS (mean age=12.2 years, SD=2.7, range: 7–16 years) underwent brain MRI scans at presentation and at 6-months follow-up. T2-weighted lesions on MRI were assessed using a binary classification. At 6-months follow-up, patients underwent neuropsychological evaluation and were compared with 42 healthy controls. Results: Cognitive, academic, and behavioral outcomes did not differ between the patients with ADS and controls. Three of 36 patients (8.3%) were identified with cognitive impairment, as determined by performance falling ≤1.5 SD below normative values on more than four independent tests in the battery. Poor performance on a visuomotor integration task was most common, observed among 6/32 patients, but this did not differ significantly from controls. Twelve of 36 patients received a diagnosis of MS within 3 years post-ADS. Patients with MS did not differ from children with monophasic ADS in terms of cognitive performance at the 6-months follow-up. Fatigue symptoms were reported in 50% of patients, irrespective of MS diagnosis. Presence of brain lesions at onset and 6 months post-incident demyelinating event did not associate with cognitive outcome. Conclusions: Children with ADS experience a favorable short-term neurocognitive outcome, even those confirmed to have MS. Longitudinal evaluations of children with monophasic ADS and MS are required to determine the possibility of late-emerging sequelae and their time course. (JINS, 2016, 22, 1050–1060)
Axonal Damage in Multiple Sclerosis Patients with High versus Low Expanded Disability Status Scale Score
- Steven D. Brass, Sridar Narayanan, Jack P. Antel, Yves Lapierre, Louis Collins, Douglas L. Arnold
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 31 / Issue 2 / May 2004
- Published online by Cambridge University Press:
- 16 February 2016, pp. 225-228
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Background:
The pathophysiological basis for differences in disability in patients with multiple sclerosis is unclear.
Methods:We used magnetic resonance imaging to examine whether differences in disability in cohorts of multiple sclerosis patients with similar T2-weighted lesion volume and disease duration were associated with a more destructive disease process in the more disabled patients.
Results:The benign and severely disabled groups had similar brain atrophy metrics and similar decreases of the neuronal marker, N-acetylaspartate, in the normal appearing white matter of the cerebrum on magnetic resonance spectroscopy examination in vivo. The severely disabled cohort had more spinal cord atrophy.
Conclusion:The dissociation of spinal cord atrophy and cerebral atrophy between these two groups suggests that the difference between the more benign and more disabled groups cannot be explained by a more aggressive pathological process that is affecting the entire neuroaxis in a homogeneous fashion.
Metabolic Changes in Cerebral Gliomas Within Hours of Treatment With Intra-Arterial BCNU Demonstrated by Phosphorus Magnetic Resonance Spectroscopy
- Douglas L. Arnold, Eric A. Shoubridge, William Feindel, Jean-Guy Villemure
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- Canadian Journal of Neurological Sciences / Volume 14 / Issue 4 / November 1987
- Published online by Cambridge University Press:
- 18 September 2015, pp. 570-575
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A 40-year-old female with a recurrent mixed astrocytoma/oligodendroglioma was treated with intraarterial BCNU at six week intervals. Phosphorus magnetic resonance spectroscopy was performed before, and on two occasions after her third treatment.
Before treatment, phosphodiesters were 25% less than normal and intracellular pH was 7.14 (normal 6.97 ± 0.02). Eight hours following treatment phosphocreatine and phosphodiesters were reduced by ∼40% and pHi increased to 7.24. Thirty-two hours after treatment, phosphocreatine and phosphodiesters had reversed their decline, but pHi had increased further to 7.35. MRI and x-ray CT scans did not show any change during this period.
This study demonstrates that chemical changes can be observed in a glioma by magnetic resonance spectroscopy shortly after chemotherapy in a clinical setting and before changes are observable by imaging modalities. This approach evidently offers a possible means of monitoring the acute metabolic response of tumours to chemotherapy or other forms of treatment by a non-invasive repeatable quantitative method.
Magnetic Resonance Spectroscopy Guided Brain Tumor Resection: Differentiation Between Recurrent Glioma and Radiation Change in Two Diagnostically Difficult Cases
- Mark C. Preul, Richard Leblanc, Zografos Caramanos, Reza Kasrai, Sridar Narayanan, Douglas L. Arnold
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 25 / Issue 1 / February 1998
- Published online by Cambridge University Press:
- 18 September 2015, pp. 13-22
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Background:
It is often difficult to differentiate a recurrent glioma from the effects of post-operative radiotherapy by means of conventional neurodiagnostic imaging. Proton magnetic resonance spectroscopic imaging (1H-MRSI), that allows in vivo measurements of the concentration of brain metabolites such as choline-containing phospholipids (Cho), may provide in vivo biochemical information helpful in distinguishing areas of tumor recurrence from areas of radiation effect.
Patients and Methods:Two patients who had undergone resection and post-operative radiotherapy for a cerebral glioma became newly symptomatic. Computed tomographic (CT) and magnetic resonance imaging (MRI) performed after the intravenous infusion of contrast material, and in one case, [18F] fluorodeoxyglucose positron emission tomography (PET), could not differentiate between the possibilities of recurrent glioma and radiation effect. The patients underwent 1H-MRSI prior to reoperation and the 1H-MRSI results were compared to histological findings originating from the same locations.
Results:A high Cho signal measured by 1H-MRSI was seen in areas of histologicallyproven dense tumor recurrence, while low Cho signal was present where radiation changes predominated.
Conclusions:The differentiation between the recurrence of a cerebral glioma and the effects of post-operative irradiation was achieved using 1H-MRSI in these two patients whose conventional neurodiagnostic imaging was equivocal for such a distinction. Where these two conditions are present, metabolite images from 1H-MRSI, such as that based on Cho, can be co-registered with other imaging modalities such as MRI and may also be integrated with functional MRI or functional PET within a multimodal imaging-guided surgical navigation system to assure maximal resection of recurrent tumor while minimizing the risk of added neurological damage.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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The Metabolic Epicenter of Supratentorial Gliomas: A 1H-MRSI Study
- Tejas Sankar, Yevgeniy E. Kuznetsov, Robert W. Ryan, Zografos Caramanos, Samson B. Antel, Douglas L. Arnold, Mark C. Preul
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- Canadian Journal of Neurological Sciences / Volume 36 / Issue 6 / November 2009
- Published online by Cambridge University Press:
- 02 December 2014, pp. 696-706
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Background:
Assessing the impact of glioma location on prognosis remains elusive. We approached the problem using multivoxel proton magnetic resonance spectroscopic imaging (1H-MRSI) to define a tumor “metabolic epicenter”, and examined the relationship of metabolic epicenter location to survival and histopathological grade.
Methods:We studied 54 consecutive patients with a supratentorial glioma (astrocytoma or oligodendroglioma, WHO grades II-IV). The metabolic epicenter in each tumor was defined as the 1H-MRSI voxel containing maximum intra-tumoral choline on preoperative imaging. Tumor location was considered the X-Y-Z coordinate position, in a standardized stereotactic space, of the metabolic epicenter. Correlation between epicenter location and survival or grade was assessed.
Results:Metabolic epicenter location correlated significantly with patient survival for all tumors (r2 = 0.30, p = 0.0002) and astrocytomas alone (r2 = 0.32, p = 0.005). A predictive model based on both metabolic epicenter location and histopathological grade accounted for 70% of the variability in survival, substantially improving on histology alone to predict survival. Location also correlated significantly with grade (r2 = 0.25, p = 0.001): higher grade tumors had a metabolic epicenter closer to the midpoint of the brain.
Conclusions:The concept of the metabolic epicenter eliminates several problems related to existing methods of classifying glioma location. The location of the metabolic epicenter is strongly correlated with overall survival and histopathological grade, suggesting that it reflects biological factors underlying glioma growth and malignant dedifferentiation. These findings may be clinically relevant to predicting patterns of local glioma recurrence, and in planning resective surgery or radiotherapy.
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- By Sofya Abazyan, Saskia S. Arndt, Jonathon C. Arnold, Sandra Beeské, Odd-Geir Berge, Valerie J. Bolivar, David Borchelt, Marie-Françoise Chesselet, Yoon H. Cho, Angelo Contarino, John C. Crabbe, Wim E. Crusio, Bianca De Filippis, Mara Dierssen, Stephanie C. Dulawa, Emily C. Eastwood, Haim Einat, Raul R. Gainetdinov, David Gordon, Guy Griebel, F. Scott Hall, John H. Harkness, Christopher Janus, Zhengping Jia, Nirit Kara, Tim Karl, Martien J. H. Kas, Federica Klaus, Robert Lalonde, Glenda Lassi, Giovanni Laviola, Iddo Magen, Stephen C. Maxson, Douglas Ashley Monks, Rebecca E. Nordquist, Lucy R. Osborne, Tamara J. Phillips, Alisdair R. Philp, Marina R. Picciotto, Susanna Pietropaolo, Mikhail V. Pletnikov, Christopher R. Pryce, James L. Resnick, Laura Ricceri, Frans Sluyter, Emily Y. Smith, Ichiro Sora, Tatyana D. Sotnikova, Rebecca C. Steiner, Ortrud K. Steinlein, Catherine Strazielle, Enejda Subashi, Ashlyn Swift-Gallant, Aki Takahashi, Kevin Talbot, Stewart Thompson, Valter Tucci, F. Josef van der Staay, Gertjan van Dijk, Nancy S. Woehrle
- Edited by Susanna Pietropaolo, Centre National de la Recherche Scientifique (CNRS), Paris, Frans Sluyter, University of Portsmouth, Wim E. Crusio, Centre National de la Recherche Scientifique (CNRS), Paris
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- Behavioral Genetics of the Mouse
- Published online:
- 05 October 2014
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- 25 September 2014, pp ix-xii
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Treatment Optimization in MS: Canadian MS Working Group Updated Recommendations
- Mark S. Freedman, Daniel Selchen, Douglas L. Arnold, Alexandre Prat, Brenda Banwell, Michael Yeung, David Morgenthau, Yves Lapierre,
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- Canadian Journal of Neurological Sciences / Volume 40 / Issue 3 / May 2013
- Published online by Cambridge University Press:
- 23 September 2014, pp. 307-323
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The Canadian Multiple Sclerosis Working Group (CMSWG) developed practical recommendations in 2004 to assist clinicians in optimizing the use of disease-modifying therapies (DMT) in patients with relapsing multiple sclerosis. The CMSWG convened to review how disease activity is assessed, propose a more current approach for assessing suboptimal response, and to suggest a scheme for switching or escalating treatment. Practical criteria for relapses, Expanded Disability Status Scale (EDSS) progression and MRI were developed to classify the clinical level of concern as Low, Medium and High. The group concluded that a change in treatment may be considered in any RRMS patient if there is a high level of concern in any one domain (relapses, progression or MRI), a medium level of concern in any two domains, or a low level of concern in all three domains. These recommendations for assessing treatment response should assist clinicians in making more rational choices in their management of relapsing MS patients.
First Global Consensus for Evidence-Based Management of the Hematopoietic Syndrome Resulting From Exposure to Ionizing Radiation
- Nicholas Dainiak, Robert Nicolas Gent, Zhanat Carr, Rita Schneider, Judith Bader, Elena Buglova, Nelson Chao, C. Norman Coleman, Arnold Ganser, Claude Gorin, Martin Hauer-Jensen, L. Andrew Huff, Patricia Lillis-Hearne, Kazuhiko Maekawa, Jeffrey Nemhauser, Ray Powles, Holger Schünemann, Alla Shapiro, Leif Stenke, Nelson Valverde, David Weinstock, Douglas White, Joseph Albanese, Viktor Meineke
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- Disaster Medicine and Public Health Preparedness / Volume 5 / Issue 3 / October 2011
- Published online by Cambridge University Press:
- 08 April 2013, pp. 202-212
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Objective: Hematopoietic syndrome (HS) is a clinical diagnosis assigned to people who present with ≥1 new-onset cytopenias in the setting of acute radiation exposure. The World Health Organization convened a panel of experts to evaluate the evidence and develop recommendations for medical countermeasures for the management of HS in a hypothetical scenario involving the hospitalization of 100 to 200 individuals exposed to radiation. The objective of this consultancy was to develop recommendations for treatment of the HS based upon the quality of evidence.
Methods: English-language articles were identified in MEDLINE and PubMed. Reference lists of retrieved articles were distributed to panel members before the meeting and updated during the meeting. Published case series and case reports of individuals with HS, published randomized controlled trials of relevant interventions used to treat nonirradiated individuals, reports of studies in irradiated animals, and prior recommendations of subject matter experts were selected. Studies were extracted using the Grading of Recommendations Assessment Development and Evaluation (GRADE) system. In cases in which data were limited or incomplete, a narrative review of the observations was made. No randomized controlled trials of medical countermeasures have been completed for individuals with radiation-associated HS. The use of GRADE analysis of countermeasures for injury to hematopoietic tissue was restricted by the lack of comparator groups in humans. Reliance on data generated in nonirradiated humans and experimental animals was necessary.
Results: Based upon GRADE analysis and narrative review, a strong recommendation was made for the administration of granulocyte colony-stimulating factor or granulocyte macrophage colony-stimulating factor and a weak recommendation was made for the use of erythropoiesis-stimulating agents or hematopoietic stem cell transplantation.
Conclusions: Assessment of therapeutic interventions for HS in humans exposed to nontherapeutic radiation is difficult because of the limits of the evidence.
(Disaster Med Public Health Preparedness. 2011;5:202-212)
Literature Review and Global Consensus on Management of Acute Radiation Syndrome Affecting Nonhematopoietic Organ Systems
- Nicholas Dainiak, Robert Nicolas Gent, Zhanat Carr, Rita Schneider, Judith Bader, Elena Buglova, Nelson Chao, C. Norman Coleman, Arnold Ganser, Claude Gorin, Martin Hauer-Jensen, L. Andrew Huff, Patricia Lillis-Hearne, Kazuhiko Maekawa, Jeffrey Nemhauser, Ray Powles, Holger Schünemann, Alla Shapiro, Leif Stenke, Nelson Valverde, David Weinstock, Douglas White, Joseph Albanese, Viktor Meineke
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 5 / Issue 3 / October 2011
- Published online by Cambridge University Press:
- 08 April 2013, pp. 183-201
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Objectives: The World Health Organization convened a panel of experts to rank the evidence for medical countermeasures for management of acute radiation syndrome (ARS) in a hypothetical scenario involving the hospitalization of 100 to 200 victims. The goal of this panel was to achieve consensus on optimal management of ARS affecting nonhematopoietic organ systems based upon evidence in the published literature.
Methods: English-language articles were identified in MEDLINE and PubMed. Reference lists of retrieved articles were distributed to conferees in advance of and updated during the meeting. Published case series and case reports of ARS, publications of randomized controlled trials of relevant interventions used to treat nonirradiated individuals, reports of studies in irradiated animals, and prior recommendations of subject matter experts were selected. Studies were extracted using the Grading of Recommendations Assessment Development and Evaluation system. In cases in which data were limited or incomplete, a narrative review of the observations was made.
Results: No randomized controlled trials of medical countermeasures have been completed for individuals with ARS. Reports of countermeasures were often incompletely described, making it necessary to rely on data generated in nonirradiated humans and in experimental animals. A strong recommendation is made for the administration of a serotonin-receptor antagonist prophylactically when the suspected exposure is >2 Gy and topical steroids, antibiotics, and antihistamines for radiation burns, ulcers, or blisters; excision and grafting of radiation ulcers or necrosis with intractable pain; provision of supportive care to individuals with neurovascular syndrome; and administration of electrolyte replacement therapy and sedatives to individuals with significant burns, hypovolemia, and/or shock. A strong recommendation is made against the use of systemic steroids in the absence of a specific indication. A weak recommendation is made for the use of fluoroquinolones, bowel decontamination, loperamide, and enteral nutrition, and for selective oropharyngeal/digestive decontamination, blood glucose maintenance, and stress ulcer prophylaxis in critically ill patients.
Conclusions: High-quality studies of therapeutic interventions in humans exposed to nontherapeutic radiation are not available, and because of ethical concerns regarding the conduct of controlled studies in humans, such studies are unlikely to emerge in the near future.
(Disaster Med Public Health Preparedness. 2011;5:183–201)
Memory Performance and Normalized Regional Brain Volumes in Patients with Pediatric-Onset Multiple Sclerosis
- Amanda Fuentes, Donald Louis Collins, Daniel Garcia-Lorenzo, John G. Sled, Sridar Narayanan, Douglas L. Arnold, Brenda L. Banwell, Christine Till
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- Journal:
- Journal of the International Neuropsychological Society / Volume 18 / Issue 3 / May 2012
- Published online by Cambridge University Press:
- 10 February 2012, pp. 471-480
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Studies in adults with multiple sclerosis (MS) have associated regional brain abnormalities with memory impairment. While memory problems in children with MS are often reported, little is known about the neural correlates that may contribute to these difficulties. We measured verbal and nonverbal memory using the Test of Memory and Learning (TOMAL-2) in 32 children and adolescents with MS and 26 age- and sex-matched healthy controls. Memory performance was correlated with volumetric measures of the whole brain, hippocampus, amygdala, and thalamus. Brain volumes were normalized for age and sex using magnetic resonance imaging (MRI) data from the National Institutes of Health MRI Study of Normal Brain development. With the exception of story recall, performance on memory tests was similar to that of the control group. Relative to controls, patient with MS showed reduced volume in the whole brain (p < .001), amygdala (p < .005), and thalamus (p < .001), but not the hippocampus. In the patient group, word-list learning correlated with whole brain volume (r = .53) and hippocampal volume (r = .43), whereas visual recognition memory correlated with thalamic volume (r = .48). Findings are consistent with the well-established role of the hippocampus in learning and consolidation and also highlight the importance of diffuse brain pathology on memory function. (JINS, 2012, 18, 471–480)
12 - Axonal pathology in patients with multiple sclerosis
- from Section II - Clinical trial methodology
- Edited by Jeffrey A. Cohen, Richard A. Rudick
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- Book:
- Multiple Sclerosis Therapeutics
- Published online:
- 05 December 2011
- Print publication:
- 20 October 2011, pp 150-164
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Summary
The Expanded Disability Status Scale (EDSS) represents the most widely accepted measure of disease progression in multiple sclerosis (MS), and is used in many natural history studies. This chapter discusses natural history of relapsing onset MS, primary progressive MS, changes in natural history and impact on clinical trial design, traditional prognostic factors, and other factors which may influence prognosis such as race, comorbid diseases, and health behaviors. Pharmacoepidemiological studies using real world data derived from clinical practice represent a cost-effective means of evaluating the long-term effectiveness of immunomodulatory drug treatments for MS. Along with evidence from the basic sciences, epidemiological studies can provide insights into potentially novel treatments, as well as the rationale and hypotheses for testing these treatments in clinical trials. For example, vitamin D and estrogen are being evaluated in clinical trials based partly on epidemiological observations. Heterogeneity remains the hallmark of MS.
Contributors
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- By Douglas L. Arnold, Laura J. Balcer, Amit Bar-Or, Sergio E. Baranzini, Frederik Barkhof, Robert A. Bermel, Francois A. Bethoux, Dennis N. Bourdette, Richard K. Burt, Peter A. Calabresi, Zografos Caramanos, Tanuja Chitnis, Stacey S. Cofield, Jeffrey A. Cohen, Nadine Cohen, Alasdair J. Coles, Devon Conway, Stuart D. Cook, Gary R. Cutter, Peter J. Darlington, Ann Dodds-Frerichs, Ranjan Dutta, Gilles Edan, Michelle Fabian, Franz Fazekas, Massimo Filippi, Elizabeth Fisher, Paulo Fontoura, Corey C. Ford, Robert J. Fox, Natasha Frost, Alex Z. Fu, Siegrid Fuchs, Kazuo Fujihara, Kristin M. Galetta, Jeroen J.G. Geurts, Gavin Giovannoni, Nada Gligorov, Ralf Gold, Andrew D. Goodman, Myla D. Goldman, Jenny Guerre, Stephen L. Hauser, Peter B. Imrey, Douglas R. Jeffery, Stephen E. Jones, Adam I. Kaplin, Michael W. Kattan, B. Mark Keegan, Kyle C. Kern, Zhaleh Khaleeli, Samia J. Khoury, Joep Killestein, Soo Hyun Kim, R. Philip Kinkel, Stephen C. Krieger, Lauren B. Krupp, Emmanuelle Le Page, David Leppert, Scott Litwiller, Fred D. Lublin, Henry F. McFarland, Joseph C. McGowan, Don Mahad, Jahangir Maleki, Ruth Ann Marrie, Paul M. Matthews, Francesca Milanetti, Aaron E. Miller, Deborah M. Miller, Xavier Montalban, Charity J. Morgan, Ichiro Nakashima, Sridar Narayanan, Avindra Nath, Paul W. O’Connor, Jorge R. Oksenberg, A. John Petkau, Michael D. Phillips, J. Theodore Phillips, Tammy Phinney, Sean J. Pittock, Sarah M. Planchon, Chris H. Polman, Alexander Rae-Grant, Stephen M. Rao, Stephen C. Reingold, Maria A. Rocca, Richard A. Rudick, Amber R. Salter, Paula Sandler, Jaume Sastre-Garriga, John R. Scagnelli, Dana J. Serafin, Lynne Shinto, Nancy L. Sicotte, Jack H. Simon, Per Soelberg Sørensen, Ryan E. Stagg, James M. Stankiewicz, Lael A. Stone, Amy Sullivan, Matthew Sutliff, Jessica Szpak, Alan J. Thompson, Bruce D. Trapp, Helen Tremlett, Maria Trojano, Orla Tuohy, Rhonda R. Voskuhl, Marc K. Walton, Mike P. Wattjes, Emmanuelle Waubant, Martin S. Weber, Howard L Weiner, Brian G. Weinshenker, Bianca Weinstock-Guttman, Jeffrey L. Winters, Jerry S. Wolinsky, Vijayshree Yadav, E. Ann Yeh, Scott S. Zamvil
- Edited by Jeffrey A. Cohen, Richard A. Rudick
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- Book:
- Multiple Sclerosis Therapeutics
- Published online:
- 05 December 2011
- Print publication:
- 20 October 2011, pp viii-xii
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DIVISION XII / COMMISSON 5 / WORKING GROUP: FITS
- William D. Pence, François Ochsenbein, Donald C. Wells, Steven L. Allen, Mark R. Calabretta, Lucio Chiappetti, Daniel Durand, Thierry Forveille, Carlos Gabriel, Eric Greisen, Preben J. Grosbol, Robert J. Hanisch, Walter J. Jaffe, Osamu Kanamitsu, Oleg Yu. Malkov, Clive G. Page, Arnold H. Rots, Richard A. Shaw, Elizabeth Stobie, William T. Thompson, Douglas C. Tody, Andreas Wicenec
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- Journal:
- Proceedings of the International Astronomical Union / Volume 3 / Issue T26B / December 2007
- Published online by Cambridge University Press:
- 18 November 2008, p. 218
- Print publication:
- December 2007
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The business meeting began with a brief review of the current rules and procedures of the WG, which are documented on the WG web page. Four regional FITS committees have been established by the WG, covering North American, Europe, Japan, and Australian/New Zealand, to provide advice to the WG on pending proposals. While it is recognized that this committee structure might need to be revised to provide representation to other regions, the current system is working well, and there were no motions to make any changes at this time.
11 - Windows on the working brain: magnetic resonance spectroscopy
- from PART I - INTRODUCTION AND GENERAL PRINCIPLES
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- By James W. Prichard, Department of Neurology, Yale Medical School, New Haven, CT, USA, Jeffrey R. Alger, Department of Radiology, University of California at Los Angeles, CA, USA, Douglas Arnold, Department of Neurology, Montreal Neurological Institute, Canada, Ognen A.C. Petroff, Department of Neurology, Yale Medical School, New Haven, CT, USA, Douglas L. Rothman, Department of Diagnostic Radiology, Yale Medical School, New Haven, CT, USA
- Edited by Arthur K. Asbury, University of Pennsylvania School of Medicine, Guy M. McKhann, The Johns Hopkins University School of Medicine, W. Ian McDonald, University College London, Peter J. Goadsby, University College London, Justin C. McArthur, The Johns Hopkins University School of Medicine
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- Book:
- Diseases of the Nervous System
- Published online:
- 05 August 2016
- Print publication:
- 11 November 2002, pp 146-159
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Summary
Nuclear magnetic resonance (NMR) spectroscopy is an observational technique based on detection of signals from magnetic atomic nuclei such as 1H, 31P, 13C, 15N, and 17O. It is most familiar to physicians and the public as magnetic resonance imaging (MRI), which uses the strong signal from water protons to make the most highly detailed pictures of living tissue available from any non-invasive method. In consequence, MRI, including its special forms magnetic resonance angiography, diffusion-weighted imaging, and magnetization transfer imaging – quickly became a major tool for medical diagnosis and research on living creatures. Its applications to neurological disease are described in several other chapters of this book.
Magnetic resonance spectroscopy (MRS) is the designation used in the biomedical world for measurement of NMR signals from non-water protons and other magnetic nuclei. The usage is not accurate, MRI is the MRS of water, but it is convenient. MRS signals detectable in living brain are thousands of times weaker than the water proton signal; hence observing them requires extra time and special procedures. The reward for the effort is an abundance of chemically specific information which can be acquired as often as necessary, since the measurement process is non-invasive. In the living human brain, 1H signals can be obtained from N-acetyl aspartate, creatine, choline moieties, glutamate, glutamine, lactate, and several other small molecules. Phosphocreatine, adenosine triphosphate, and inorganic phosphate can be measured directly by their 31P signals, and intracellular pH calculated from its effect on these signals. Information from the 31P spectrum allows calculation of the rate of the creatine kinase reaction. The spectra of 13C, 15N, 17O, and other magnetic nuclei contain many more small signals from a variety of molecules which will become detectable as technology advances.
This unprecedented measurement capability provides an opportunity for characterization of human neurological diseases along several axes of chemical variation throughout their natural histories. The data are obtained without hazard to the patient, are free from artefacts of tissue preparation, and can be compared in as much detail as necessary to identically acquired information from normal subjects. As MRS matures technically over the first decades of the twenty-first century, it can be expected to take a place among the principal technologies contributing to illumination of disease processes and evaluation of new treatments.