Name: dti of the visual pathway - white matter tracts and cerebral lesions
Uploaded: 2014-08-26T15:00:00
Description: Watch this Scientific Journal Video about DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions at JoVE.com

We would like to thank the whole Service of Neuroradiology. We would like to thank Lis Prussen for her work in the library.

注：此协议遵循中心医院去卢森堡在卢森堡的准则。 1，准备弥散张量成像的视觉通路的神经外科及跟进<ol style="margin-left: 40px;"><li>至少有一天在手术前严格轴向采用32梯度方向，一个B0图像进行核磁共振成像扫描。请随时与神经放射学单位保持密切联系。 注意：请明确的神经放射手术后的图像是相同的操作之前。 </li><li>使用3特斯拉MRI检查，执行3DT1加权和DTI序列扫描。...

<ol>
	<li>Fernandez-Miranda, J. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=High-Definition+Fiber+Tractography+of+the+Human+Brain:+Neuroanatomical+Validation+and+Neurosurgical+Applications.">High-Definition Fiber Tractography of the Human Brain: Neuroanatomical Validation and Neurosurgical Applications.</a> Neurosurgery. 71 (2), 430-453 (2012).</li><li>Alexander, D. C., Barker, G. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimal+imaging+parameters+for+fiber-orientation+estimation+in+diffusion+MRI.">Optimal imaging parameters for fiber-orientation estimation in diffusion MRI.</a> Neuroimage. 27 (2), 357-367 (2005).</li><li>Le Bihan, D., Poupon, C., Amadon, A., Lethimonnier, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Artifacts+and+pitfalls+in+diffusion+MRI.">Artifacts and pitfalls in diffusion MRI.</a> J Magn Reson Imaging. 24 (3), 478-488 (2006).</li><li>Abdullah, K. G., Lubelski, D., Nucifora, P. G., Brem, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+diffusion+tensor+imaging+in+glioma+resection.">Use of diffusion tensor imaging in glioma resection.</a> Neurosurg Focus. 34 (4), (2013).</li><li>Ota, T., Kawai, K., Kamada, K., Kin, T., Saito, N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraoperative+monitoring+of+cortically+recorded+visual+response+for+posterior+visual+pathway.">Intraoperative monitoring of cortically recorded visual response for posterior visual pathway.</a> J Neurosurg. 112, 285-294 (2010).</li><li>Gras-Combe, G., Moritz-Gasser, S., Herbet, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraoperative+subcortical+electrical+mapping+of+optic+radiations+in+awake+surgery+for+glioma+involving+visual+pathways.">Intraoperative subcortical electrical mapping of optic radiations in awake surgery for glioma involving visual pathways.</a> J Neurosurg. 117 (3), 466-473 (2012).</li><li>Maruyama, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optic+radiation+tractography+integrated+into+simulated+treatment+planning+for+Gamma+Knife+surgery.">Optic radiation tractography integrated into simulated treatment planning for Gamma Knife surgery.</a> J Neurosurg. 107, 721-726 (2007).</li><li>Bérubé, J., McLaughlin, N., Bourgouin, P., Beaudoin, G., Bojanowski, M. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diffusion+tensor+imaging+analysis+of+long+association+bundles+in+the+presence+of+an+arteriovenous+malformation.">Diffusion tensor imaging analysis of long association bundles in the presence of an arteriovenous malformation.</a> J Neurosurg. 107 (3), 509-514 (2007).</li><li>Sun, G. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intraoperative+High-Field+Magnetic+Resonance+Imaging+Combined+With+Fiber+Tract+Neuronavigation-Guided+Resection+of+Cerebral+Lesions+Involving+Optic+Radiation.">Intraoperative High-Field Magnetic Resonance Imaging Combined With Fiber Tract Neuronavigation-Guided Resection of Cerebral Lesions Involving Optic Radiation.</a> Neurosurgery. 69 (5), 1070-1084 (2011).</li><li>Kamada, K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Functional+Monitoring+For+Visual+Pathway+Using+Real-Time+Visual+Evoked+Potentials+Aand+Optic-Radiation+Tractography.">Functional Monitoring For Visual Pathway Using Real-Time Visual Evoked Potentials Aand Optic-Radiation Tractography.</a> Neurosurgery. 57 (1 Suppl), 121-127 (2005).</li><li>Wu, W., Rigolo, L., O'Donnell, L. J., Norton, I., Shriver, S., Golby, A. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Visual+Pathway+Study+Using+In+Vivo+Diffusion+Tensor+Imaging+Tractography+to+Complement+Classic+Anatomy.">Visual Pathway Study Using In Vivo Diffusion Tensor Imaging Tractography to Complement Classic Anatomy.</a> Neurosurgery. 70 (1 Suppl Operative), 145-156 (2012).</li><li>Stieglitz, L. H., L&#252;demann, W. O., Giordano, M., Raabe, A., Fahlbusch, R., Samii, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optic+Radiation+Fiber+Tracking+Using+Anteriorly+Angulated+Diffusion+Tensor+Imaging:+A+Tested+Algorithm+for+Quick+Application.">Optic Radiation Fiber Tracking Using Anteriorly Angulated Diffusion Tensor Imaging: A Tested Algorithm for Quick Application.</a> Neurosurgery. 68 (5), 1239-1251 (2011).</li><li>Hodaie, M., Quan, J., Chen, D. Q. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+Vivo+Visualization+of+Cranial+Nerve+Pathways+in+Humans+Using+Diffusion-Based+Tractography.">In Vivo Visualization of Cranial Nerve Pathways in Humans Using Diffusion-Based Tractography.</a> Neurosurgery. 66 (4), 788-795 (2010).</li><li>Perrin, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fiber+tracking+in+Q-ball+fields+using+regularized+particle+trajectories.">Fiber tracking in Q-ball fields using regularized particle trajectories.</a> Inf Process Med Imaging. 19, 52-63 (2005).</li><li>Wedeen, V. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diffusion+spectrum+magnetic+resonance+imaging+(DSI)+tractography+of+crossing+fibers.">Diffusion spectrum magnetic resonance imaging (DSI) tractography of crossing fibers.</a> Neuroimage. 41 (4), 1267-1277 (2008).</li><li>Yamamoto, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diffusion+Tensor+Fiber+Tractography+of+the+Optic+Radiation:+Analysis+with+6-,+12-,+40-,+and+81-+Directional+Motion-Probing+Gradients,+a+Preliminary+Study.">Diffusion Tensor Fiber Tractography of the Optic Radiation: Analysis with 6-, 12-, 40-, and 81- Directional Motion-Probing Gradients, a Preliminary Study.</a> AJNR Am J Neuroradiol. 28 (1), 92-96 (2007).</li><li>Okada, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diffusion+Tensor+Fiber+Tractography+for+Arteriovenous+Malformations:+Quantitative+Analyses+to+Evaluate+the+Corticospinal+Tract+and+Optic+Radiation.">Diffusion Tensor Fiber Tractography for Arteriovenous Malformations: Quantitative Analyses to Evaluate the Corticospinal Tract and Optic Radiation.</a> AJNR Am J Neuroradiol. 28 (6), 1107-1113 (2007).</li><li>Kuhnt, D., Bauer, M. H., Sommer, J., Merhof, D., Nimsky, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optic+Radiation+Fiber+Tractography+in+Glioma+Patients+Based+on+High+Angular+Resolution+Diffusion+Imaging+with+Compressed+Sensing+Compared+with+Diffusion+Tensor+Imaging+-+Initial+Experience.">Optic Radiation Fiber Tractography in Glioma Patients Based on High Angular Resolution Diffusion Imaging with Compressed Sensing Compared with Diffusion Tensor Imaging - Initial Experience.</a> PLoS One. 8 (7), e70973 (2013).</li><li>Basser, P. J., Pajevic, S., Pierpaoli, C., Duda, J., Aldroubi, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vivo+fiber+tractography+using+DT-MRI+data.">In vivo fiber tractography using DT-MRI data.</a> Magn Reson Med. 44 (4), 625-632 (2000).</li><li>Friman, O., Farneback, G., Westin, C. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Bayesian+approach+for+stochastic+white+matter+tractography.">A Bayesian approach for stochastic white matter tractography.</a> IEEE Trans Med Imaging. 25 (8), 965-978 (2006).</li><li>Mori, S., van Zijl, P. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fiber+tracking:+principles+and+strategies+-+a+technical+review.">Fiber tracking: principles and strategies - a technical review.</a> NMR Biomed. 15 (7-8), 468-480 (2002).</li><li>Alexander, D. C., Barker, G. J., Arridge, S. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Detection+and+modeling+of+non-Gaussian+apparent+diffusion+coefficient+profiles+in+human+brain+data.">Detection and modeling of non-Gaussian apparent diffusion coefficient profiles in human brain data.</a> Magn Reson Med. 48 (2), 331-340 (2002).</li><li>Mori, S., Crain, B. J., Chacko, V. P., van Zijl, P. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Three-dimensional+tracking+of+axonal+projections+in+the+brain+by+magnetic+resonance+imaging.">Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging.</a> Ann Neurol. 45, 265-269 (1999).</li><li>Conturo, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tracking+neuronal+fiber+pathways+in+the+living+human+brain.">Tracking neuronal fiber pathways in the living human brain.</a> Proc Natl Acad Sci U S A. 96, 10422-10427 (1999).</li><li>Poupon, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Regularization+of+diffusion-based+direction+maps+for+the+tracking+of+brain+white+matter+fascicles.">Regularization of diffusion-based direction maps for the tracking of brain white matter fascicles.</a> Neuroimage. 12, 184-195 (2000).</li><li>Parker, G. J., Haroon, H. A., Wheeler-Kingshott, C. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+framework+for+a+streamline-based+probabilistic+index+of+connectivity+(PICo)+using+a+structural+interpretation+of+MRI+diffusion+measurements.">A framework for a streamline-based probabilistic index of connectivity (PICo) using a structural interpretation of MRI diffusion measurements.</a> J Magn Reson Imaging. 18, 242-254 (2003).</li><li>Behrens, T. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Non-invasive+mapping+of+connections+between+human+thalamus+and+cortex+using+diffusion+imaging.">Non-invasive mapping of connections between human thalamus and cortex using diffusion imaging.</a> Nat Neurosci. 6, 750-757 (2003).</li><li>Reinges, M. H., Schoth, F., Coenen, V. A., Krings, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Imaging+of+postthalamic+visual+fiber+tracts+by+anisotropic+diffusion+weighted+MRI+and+diffusion+tensor+imaging:+principles+and+applications.">Imaging of postthalamic visual fiber tracts by anisotropic diffusion weighted MRI and diffusion tensor imaging: principles and applications.</a> European Journal of Radiology. 49, 91-104 (2004).</li><li>Sherbondy, A. J., Dougherty, R. F., Napel, S., Wandell, B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Identifying+the+human+optic+radiation+using+diffusion+imaging+and+fiber.">Identifying the human optic radiation using diffusion imaging and fiber.</a> J. Vis. 8 (10), (2008).</li></ol>

DTI是一种技术，使神经外科医生形象化白质在体内 8。视觉通路是这些大片之一。虽然这种方法为医生提供关于病人有关的大脑，我们不得不说，这种技术的一些局限性做还存在雄辩区病变的治疗提供新的可能性。第一个也是最明显的挑战是脑转移，其中正在调查4仍然是一个问题。之后通过除去肿瘤或我们`吨有相同的条件下在手术前的脑脊液损失打开硬脑膜和操纵后在脑?...

弥散张量成像（DTI）用于在人脑中1描绘WMT非侵入。它已被用于在过去的十年中，以减少手术1期间伤及大脑口才方面的风险。 英国贸工部在50例患者行2012年3月和2014年1月间，以塑造视觉通路。贸工部可能通过提供关于白质束的解剖位置的重要信息保存完善的大脑雄辩地区在手术过程中。它已被纳入战略规划切除复杂的脑部病变1。然而，视觉通路的写照仍然是一个挑战，因为没有标准，英国贸工部，放置种子数量和效果12诠释的参数。 不同的算法已经被至今19-21实现。一些方法集中在确定性方法19，22-25。另一些人用概率方法，26,27,29。最近，采用Q-球张量场，扩散光谱成像和高角分辨率弥散成像（HARDI）正在使用的技术来描绘等等的视觉通路1,13-15,18白质。然而，在必要时对HARDI是显著长45分钟，该软件是不能商购获得，并强调科学应用18。教学期间为HARDI似乎是长于DTI 18。 所提出的协议是容易可行的，可以避免发病率和改善术后结果用于神经外科手术的日常例程。额外的时间用于该协议是小于9分钟，比其他协议1,9,12,16显著更快。承认许多复杂的算法近来已经开发出了纸张限制的事实本身的使用可商购的和FDA批准的软件。然而它是强制性的，以顾及它们上面提到了这种技术的局限性。

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			<td height="42" style="height:42px;width:216px;">3-Tesla-MRI</td>
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			<td height="42" style="height:42px;width:216px;">Surgical Navigation System Srogram</td>
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dti of the visual pathway - white matter tracts and cerebral lesions

<html> DTI是标识白质（WMT）非侵入性地在使用扩散测量健康和非健康患者的技术。类似的视觉通路（VP），WMT不与古典MRI或显微镜手术中可见。 DIT将有助于神经外科医生，以防止破坏的副总裁，同时消除邻近该WMT病变。我们已经进行了英国贸工部对50例患者手术前后2012年3月至2014年1月要浏览我们使用了3DT1加权序列。此外，我们进行了T2加权和DTI序列。所使用的参数为，FOV：20​​0×200毫米，切片厚度：2毫米，并采集矩阵：96×96得到的2×2×2mm的几乎各向同性的体素。轴向核磁共振进行了使用32梯度方向，一个B0形象。我们使用回波平面-成像（EPI）和资产并行成像中的2的加速度因子和为800秒/平方毫米的b值。扫描时间小于9分钟。 ENT“&gt;获得使用FDA批准它使用被称为连续跟踪（事实）光纤分配一个简单的纤维跟踪方法的手术导航系统的程序进行处理的贸工部的数据，这是基于对感兴趣的区域间线的传输（投资回报率），这是由医生确定。50的最大角度，足协启动0.10的值，为0.20平方毫米/停止的ADC值S被用于跟踪技术参数。 有一些限制这种技术。在有限的捕获时间帧强制折衷的图像质量。另一个重要的一点不容忽视的是在手术中的脑转移。至于后者术中MRI检查可能会有帮助。另外需要的假阳性或假阴性束的风险要考虑到这可能会危及最终结果。

<html>该协议使医生能够充分地描绘了​​VP的主要部分。它可以随着时间稍微量，以防止损害患者旁边口​​才区域脑病变使用。术后控制也显示出了良好的效果。 VP是描绘在图7中后，病人从胶质母细胞瘤手术。 图2给出了副总裁复发胶质母细胞瘤后。作者承认提出该协议描绘迈耶环这仍然是一个重大挑战困难的事实。 <im...

Watch this Scientific Journal Video about DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions at JoVE.com

DTI of the Visual Pathway - White Matter Tracts and Cerebral Lesions

弥散张量成像（DTI）进行尝试描绘视觉通路的主要部件。该目标是利用一种FDA批准的标准商业工作站可能被用于日常例程以试图减少在病人的视觉通路的手术损伤。

贸工部视觉通路的 - 白质及脑病变

DTI is a technique that identifies white matter tracts (WMT) non-invasively in healthy and non-healthy patients using diffusion measurements. Similar to ...

dti-of-the-visual-pathway-white-matter-tracts-and-cerebral-lesions

Research

JoVE Journal

Medicine

The Application Of Permanent Middle Cerebral Artery Ligation in the Mouse

Focal cerebral ischemia is among the most common type of stroke seen in patients. Due to the clinical significance there has been a prolonged effort to develop suitable animal models to study the events that unfold during ischemic insult. These techniques include transient or permanent, focal or global ischemia models using many different animal models, with the most common being rodents.
The permanent MCA ligation method which is also referred as pMCAo in the literature is used extensively as a focal ischemia model in rodents 1-6. This method was originally described for rats by Tamura et al. in 1981 7. In this protocol a craniotomy was used to access the MCA and the proximal regions were occluded by electrocoagulation. The infarcts involve mostly cortical and sometimes striatal regions depending on the location of the occlusion. This technique is now well established and used in many laboratories 8-13. Early use of this technique led to the definition and description of &#x201C;infarct core&#x201D; and &#x201C;penumbra&#x201D; 14-16, and it is often used to evaluate potential neuroprotective compounds 10, 12, 13, 17. Although the initial studies were performed in rats, permanent MCA ligation has been used successfully in mice with slight modifications 18-20 .
This model yields reproducible infarcts and increased post-survival rates. Approximately 80% of the ischemic strokes in humans happen in the MCA area 21 and thus this is a very relevant model for stroke studies. Currently, there is a paucity of effective treatments available to stroke patients, and thus there is a need for good models to test potential pharmacological compounds and evaluate physiological outcomes. This method can also be used for studying intracellular hypoxia response mechanisms in vivo. 
Here, we present the MCA ligation surgery in a C57/BL6 mouse. We describe the pre-surgical preparation, MCA ligation surgery and 2,3,5 Triphenyltetrazolium chloride (TTC) staining for quantification of infarct volumes.

Middle cerebral artery (MCA) ligation is a technique to study focal cerebral ischemia in animal models. In this method, the middle cerebral artery is exposed by craniotomy and ligated by cauterization. This method gives highly reproducible infarct volumes and increased post-operative survival rates compared to other methods available.

在小鼠永久性大脑中动脉结扎术中的应用

Focal cerebral ischemia is among the most common type of stroke seen in patients. Due to the clinical significance there has been a prolonged effort to ...

科研

医学

Driving Simulation in the Clinic: Testing Visual Exploratory Behavior in Daily Life Activities in Patients with Visual Field Defects

Patients suffering from homonymous hemianopia after infarction of the posterior cerebral artery (PCA) report different degrees of constraint in daily life, despite similar visual deficits. We assume this could be due to variable development of compensatory strategies such as altered visual scanning behavior. Scanning compensatory therapy (SCT) is studied as part of the visual training after infarction next to vision restoration therapy. SCT consists of learning to make larger eye movements into the blind field enlarging the visual field of search, which has been proven to be the most useful strategy1, not only in natural search tasks but also in mastering daily life activities2. Nevertheless, in clinical routine it is difficult to identify individual levels and training effects of compensatory behavior, since it requires measurement of eye movements in a head unrestrained condition. Studies demonstrated that unrestrained head movements alter the visual exploratory behavior compared to a head-restrained laboratory condition3. Martin et al.4 and Hayhoe et al.5 showed that behavior demonstrated in a laboratory setting cannot be assigned easily to a natural condition. Hence, our goal was to develop a study set-up which uncovers different compensatory oculomotor strategies quickly in a realistic testing situation: Patients are tested in the clinical environment in a driving simulator. SILAB software (Wuerzburg Institute for Traffic Sciences GmbH (WIVW)) was used to program driving scenarios of varying complexity and recording the driver's performance. The software was combined with a head mounted infrared video pupil tracker, recording head- and eye-movements (EyeSeeCam, University of Munich Hospital, Clinical Neurosciences).
The positioning of the patient in the driving simulator and the positioning, adjustment and calibration of the camera is demonstrated. Typical performances of a patient with and without compensatory strategy and a healthy control are illustrated in this pilot study. Different oculomotor behaviors (frequency and amplitude of eye- and head-movements) are evaluated very quickly during the drive itself by dynamic overlay pictures indicating where the subjects gaze is located on the screen, and by analyzing the data. Compensatory gaze behavior in a patient leads to a driving performance comparable to a healthy control, while the performance of a patient without compensatory behavior is significantly worse. The data of eye- and head-movement-behavior as well as driving performance are discussed with respect to different oculomotor strategies and in a broader context with respect to possible training effects throughout the testing session and implications on rehabilitation potential.

Patients with visual deficits after stroke report about different constraints in daily life most likely due to variable compensatory strategies, which are difficult to differentiate in clinical routine. We present a clinical set-up which allows measurement of different compensatory head- and eye-movement-strategies and evaluating their effects on driving performance.

驾驶模拟诊所：测试视觉与视野缺损的患者在日常活动中的探索行为

Patients suffering from homonymous hemianopia after infarction of the posterior cerebral artery (PCA) report different degrees of constraint in daily ...

Optimized System for Cerebral Perfusion Monitoring in the Rat Stroke Model of Intraluminal Middle Cerebral Artery Occlusion

The translational potential of pre-clinical stroke research depends on the accuracy of experimental modeling. Cerebral perfusion monitoring in animal models of acute ischemic stroke allows to confirm successful arterial occlusion and exclude subarachnoid hemorrhage. Cerebral perfusion monitoring can also be used to study intracranial collateral circulation, which is emerging as a powerful determinant of stroke outcome and a possible therapeutic target. Despite a recognized role of Laser Doppler perfusion monitoring as part of the current guidelines for experimental cerebral ischemia, a number of technical difficulties exist that limit its widespread use. One of the major issues is obtaining a secure and prolonged attachment of a deep-penetration Laser Doppler probe to the animal skull. In this video, we show our optimized system for cerebral perfusion monitoring during transient middle cerebral artery occlusion by intraluminal filament in the rat. We developed in-house a simple method to obtain a custom made holder for twin-fibre (deep-penetration) Laser Doppler probes, which allow multi-site monitoring if needed. A continuous and prolonged monitoring of cerebral perfusion could easily be obtained over the intact skull.

Cerebral perfusion monitoring has been demonstrated to improve accuracy in ischemic stroke models. Technical difficulties often limit the use of this essential tool for cerebrovascular research. In this video, an optimized system is shown to obtain a single or multi-site hemodynamic monitoring during intraluminal middle cerebral artery occlusion in rats.

优化系统的脑灌注监测在中风模型大鼠的大脑中动脉闭塞腔内

The translational potential of pre-clinical stroke research depends on the accuracy of experimental modeling. Cerebral perfusion monitoring in animal ...

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

Stroke is a leading cause of death, disability, and socioeconomic loss worldwide. The majority of all strokes result from an interruption in blood flow (ischemia) 1. Middle cerebral artery (MCA) delivers a great majority of blood to the lateral surface of the cortex 2, is the most common site of human stroke 3, and ischemia within its territory can result in extensive dysfunction or death 1,4,5. Survivors of ischemic stroke often suffer loss or disruption of motor capabilities, sensory deficits, and infarct. In an effort to capture these key characteristics of stroke, and thereby develop effective treatment, a great deal of emphasis is placed upon animal models of ischemia in MCA.
Here we present a method of permanently occluding a cortical surface blood vessel. We will present this method using an example of a relevant vessel occlusion that models the most common type, location, and outcome of human stroke, permanent middle cerebral artery occlusion (pMCAO). In this model, we surgically expose MCA in the adult rat and subsequently occlude via double ligature and transection of the vessel. This pMCAO blocks the proximal cortical branch of MCA, causing ischemia in all of MCA cortical territory, a large portion of the cortex. This method of occlusion can also be used to occlude more distal portions of cortical vessels in order to achieve more focal ischemia targeting a smaller region of cortex. The primary disadvantages of pMCAO are that the surgical procedure is somewhat invasive as a small craniotomy is required to access MCA, though this results in minimal tissue damage. The primary advantages of this model, however, are: the site of occlusion is well defined, the degree of blood flow reduction is consistent, functional and neurological impairment occurs rapidly, infarct size is consistent, and the high rate of survival allows for long-term chronic assessment.

Permanent Cerebral Vessel Occlusion via Double Ligature and Transection

We describe a highly reproducible method for the permanent occlusion of a rodent major cerebral blood vessel. This technique can be accomplished with very little peripheral damage, minimal blood loss, a high rate of long-term survival, and consistent infarct volume commensurate with the human clinical population.

永久性脑血管闭塞<em&gt;通过</em&gt;双人结扎横断

Stroke is a leading cause of death, disability, and socioeconomic loss worldwide. The majority of all strokes result from an interruption in blood flow ...

Generation and 3-Dimensional Quantitation of Arterial Lesions in Mice Using Optical Projection Tomography

The generation and analysis of vascular lesions in appropriate animal models is a cornerstone of research into cardiovascular disease, generating important information on the pathogenesis of lesion formation and the action of novel therapies. Use of atherosclerosis-prone mice, surgical methods of lesion induction, and dietary modification has dramatically improved understanding of the mechanisms that contribute to disease development and the potential of new treatments.
Classically, analysis of lesions is performed ex vivo using 2-dimensional histological techniques. This article describes application of optical projection tomography (OPT) to 3-dimensional quantitation of arterial lesions. As this technique is non-destructive, it can be used as an adjunct to standard histological and immunohistochemical analyses.
Neointimal lesions were induced by wire-insertion or ligation of the mouse femoral artery whilst atherosclerotic lesions were generated by administration of an atherogenic diet to apoE-deficient mice.
Lesions were examined using OPT imaging of autofluorescent emission followed by complementary histological and immunohistochemical analysis. OPT clearly distinguished lesions from the underlying vascular wall. Lesion size was calculated in 2-dimensional sections using planimetry, enabling calculation of lesion volume and maximal cross-sectional area. Data generated using OPT were consistent with measurements obtained using histology, confirming the accuracy of the technique and its potential as a complement (rather than alternative) to traditional methods of analysis.
This work demonstrates the potential of OPT for imaging atherosclerotic and neointimal lesions. It provides a rapid, much needed ex vivo technique for the routine 3-dimensional quantification of vascular remodelling.

Ex vivo analysis of arterial lesions from animal models of cardiovascular disease classically relies on histological and immunohistochemical techniques. These provide 2-dimensional measurements in 3-dimensional lesions. This manuscript describes the generation of arterial lesions for quantitative analysis in 3-dimensions using optical projection tomography.

生成和动脉病变的小鼠的三维定量使用光学投影层析成像

The generation and analysis of vascular lesions in appropriate animal models is a cornerstone of research into cardiovascular disease, generating ...

Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus

Atherosclerosis is a disease of the large arteries and a major underlying cause of myocardial infarction and stroke. Several different mouse models have been developed to facilitate the study of the molecular and cellular pathophysiology of this disease. In this manuscript we describe specific techniques for the quantification and characterization of atherosclerotic lesions in the murine aortic sinus and ascending aorta. The advantage of this procedure is that it provides an accurate measurement of the cross-sectional area and total volume of the lesion, which can be used to compare atherosclerotic progression across different treatment groups. This is possible through the use of the valve leaflets as an anatomical landmark, together with careful adjustment of the sectioning angle. We also describe basic staining methods that can be used to begin to characterize atherosclerotic progression. These can be further modified to investigate antigens of specific interest to the researcher. The described techniques are generally applicable to a wide variety of existing and newly created dietary and genetically-induced models of atherogenesis.

We describe procedures to quantify and characterize atherosclerotic lesions in mouse models using precision sectioning of the aortic sinus and ascending aorta combined with histochemical and immunohistochemical analysis.

Atherosclerosis is a disease of the large arteries and a major underlying cause of myocardial infarction and stroke. Several different mouse models have ...

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients

In order to follow optic neuritis patients and evaluate the effectiveness of their treatment, a handy, accurate and quantifiable tool is required to assess changes in myelination at the central nervous system (CNS). However, standard measurements, including routine visual tests and MRI scans, are not sensitive enough for this purpose. We present two visual tests addressing dynamic monocular and binocular functions which may closely associate with the extent of myelination along visual pathways. These include Object From Motion (OFM) extraction and Time-constrained stereo protocols. In the OFM test, an array of dots compose an object, by moving the dots within the image rightward while moving the dots outside the image leftward or vice versa. The dot pattern generates a camouflaged object that cannot be detected when the dots are stationary or moving as a whole. Importantly, object recognition is critically dependent on motion perception. In the Time-constrained Stereo protocol, spatially disparate images are presented for a limited length of time, challenging binocular 3-dimensional integration in time. Both tests are appropriate for clinical usage and provide a simple, yet powerful, way to identify and quantify processes of demyelination and remyelination along visual pathways. These protocols may be efficient to diagnose and follow optic neuritis and multiple sclerosis patients.
In the diagnostic process, these protocols may reveal visual deficits that cannot be identified via current standard visual measurements. Moreover, these protocols sensitively identify the basis of the currently unexplained continued visual complaints of patients following recovery of visual acuity. In the longitudinal follow up course, the protocols can be used as a sensitive marker of demyelinating and remyelinating processes along time. These protocols may therefore be used to evaluate the efficacy of current and evolving therapeutic strategies, targeting myelination of the CNS.

Object From Motion (OFM) and Time-constrained stereo protocols are sensitive tools to identify monocular and binocular dynamic visual function deficits, which are uniquely affected in optic neuritis patients. Furthermore, these tests may be used as quantitative noninvasive tools to assess the extent of myelination along visual pathways.

动态视觉测试，以确定和量化视觉损伤与修复继脱髓鞘视神经炎患者

In order to follow optic neuritis patients and evaluate the effectiveness of their treatment, a handy, accurate and quantifiable tool is required to ...

A Versatile Murine Model of Subcortical White Matter Stroke for the Study of Axonal Degeneration and White Matter Neurobiology

Stroke affecting white matter accounts for up to 25% of clinical stroke presentations, occurs silently at rates that may be 5-10 fold greater, and contributes significantly to the development of vascular dementia. Few models of focal white matter stroke exist and this lack of appropriate models has hampered understanding of the neurobiologic mechanisms involved in injury response and repair after this type of stroke. The main limitation of other subcortical stroke models is that they do not focally restrict the infarct to the white matter or have primarily been validated in non-murine species. This limits the ability to apply the wide variety of murine research tools to study the neurobiology of white matter stroke. Here we present a methodology for the reliable production of a focal stroke in murine white matter using a local injection of an irreversible eNOS inhibitor. We also present several variations on the general protocol including two unique stereotactic variations, retrograde neuronal tracing, as well as fresh tissue labeling and dissection that greatly expand the potential applications of this technique. These variations allow for multiple approaches to analyze the neurobiologic effects of this common and understudied form of stroke.

Here we present methodology for the production of a focal stroke in murine white matter by local injection of an irreversible endothelial nitric oxide synthase (eNOS) inhibitor (L-Nio). Presented are two stereotactic variations, retrograde neuronal tracing, and fresh tissue labeling and dissection that expand the potential applications of this technique.

皮层下的多功能小鼠模型白质行程轴索变性和白质神经生物学的研究

Stroke affecting white matter accounts for up to 25% of clinical stroke presentations, occurs silently at rates that may be 5-10 fold greater, and ...

Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus

In recent years, regenerative techniques have been increasingly studied and used to treat osteochondral lesions of the talus. In particular, several studies have focused their attention on mesenchymal stem cells derived from adipose tissue. Adipose-derived stem cells (ADSCs) exhibit morphological characteristics and properties similar to other mesenchymal cells, and are able to differentiate into several cellular lines. Moreover, these cells are also widely available in the subcutaneous tissue, representing 10 - 30% of the normal body weight, with a concentration of 5,000 cells per gram of tissue.
In the presented technique, the first step involves harvesting ADSCs from the abdomen and a process of microfracture and purification; next, the surgical procedure is performed entirely arthroscopically, with less soft tissue dissection, better joint visualization, and a faster recovery compared with standard open procedures. Arthroscopy is characterized by a first phase in which the lesion is identified, isolated, and prepared with microperforations; the second step, performed dry, involves injection of adipose tissue at the level of the lesion.
Between January 2016 and September 2016, four patients underwent arthroscopic treatment of osteochondral lesion of the talus with microfractured and purified adipose tissue. All patients reported clinical improvement six months after surgery with no reported complications. Functional scores at the latest follow-up are encouraging and confirm that the technique provides reliable pain relief and improvements in patients with osteochondral lesion of the talus.

The aim of this study is to report a protocol for the arthroscopic treatment of osteochondral lesions of the talus using microfractured and purified adipose-derived stem cells.

自体 Microfractured 与纯化脂肪组织在关节镜下治疗距骨软骨病变

In recent years, regenerative techniques have been increasingly studied and used to treat osteochondral lesions of the talus. In particular, several ...

Assessment of Static Graviceptive Perception in the Roll-Plane using the Subjective Visual Vertical Paradigm

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow the examination of all semicircular canals in the clinical setting. Assessment methods of the otolithic system, which is responsible for the perception of linear acceleration and perception of gravity, are far less in clinical use. There are several experimental approaches for measuring the perception of gravity. The most frequently used method is the determination of the subjective visual vertical. This is usually measured with the head in an upright position. We present here an assessment method for testing otolith function in the roll plane. The subjective visual vertical is measured in the head upright position as well as with head inclination of &#177; 15&#176; and &#177; 30&#176; in the roll plane. This extended functional paradigm is an easy-to-perform clinical test of otolith function and ensures increased information content for the detection of impaired graviceptive perception.

The perception of gravity is commonly determined by the subjective visual vertical in the head upright position. The additional assessment at head tilts of &#177; 15&#176; and &#177; 30&#176; in the roll plane ensures increased information content for the detection of impaired graviceptive perception.

使用主观视觉垂直范式对卷平面中的静态视觉感知的评估

Vestibular disorders are among the most common syndromes in medicine. In recent years, new vestibular diagnostic systems have been introduced that allow ...