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Multiple Sclerosis: White and Gray Matter Damage Associated with Balance Deficit Detected at Static Posturography

Prosperini, Luca; Sbardella, Emilia; Raz, Eytan; Cercignani, Mara; Tona, Francesca; Bozzali, Marco; Petsas, Nikolaos; Pozzilli, Carlo; Pantano, Patrizia
Purpose:To combine two unbiased (ie, without any a priori hypothesis) magnetic resonance (MR) imaging processing approaches, tract-based spatial statistics and voxel-based morphometry, to investigate the relationship between white matter and gray matter damage and computer-based measures of balance impairment assessed at static posturography in patients with multiple sclerosis (MS).Materials and Methods:Institutional review board approval and written informed consent were obtained. Forty-five ambulatory patients with MS (34 women, 11 men) and 25 sex- and age-matched healthy control subjects were assessed by using a force platform to compute the displacement (in millimeters) of the body center of pressure in 30 seconds. In a separate session, patients underwent MR imaging at 3 T, including a dual-echo fast spin-echo sequence, a T1-weighted volume sequence, and a diffusion-tensor imaging sequence. T2 lesion volumes were assessed by using a semiautomated technique. Tract-based spatial statistics and voxel-based morphometry were used for the white and gray matter analyses, respectively, to correlate force platform measures with diffusion-tensor imaging parameters and regional gray matter volumes, adjusting for the patients' sex, age, disease duration, and lesion volume.Results:Patients with MS had worse postural stability, widespread alterations in most white matter bundles, and gray matter atrophy in several brain regions compared with control subjects. In patients with MS, balance impairment was correlated with worse diffusion-tensor imaging parameters along the cerebellar connections and supratentorial associative white matter bundles (P < .05, threshold-free cluster enhancement corrected). Gray matter atrophy of the superior lobules of the cerebellum (IV, V, VI), and lobules VIII also correlated with worse posturometric values (P < .05, family-wise error corrected).Conclusion:Imbalance due to MS appears to be related to the disconnection between the spinal cord, cerebellum, and cerebral cortex, which in turn produces atrophy of the sensory motor cerebellar regions that are functionally connected with specific cortical areas.(c) RSNA, 2013.
PMID: 23533287
ISSN: 0033-8419
CID: 379212

MR and CT of Brain's Cava

Saba, Luca; Anzidei, Michele; Raz, Eytan; Suri, Jasjit; Piga, Mario; Grassi, Roberto; Catalano, Carlo
The Cavum Septi Pellucidi (CSP), Cavum Vergae (CV) and Cavum Veli Interpositi, are anatomical variants located in the midline of the brain. It is important to identify these conditions to distinguish them from other entities that may require treatment. In this paper, our purpose is to describe MR and CT findings of CSP, CV and Cavum Veli Interpositi, explaining the differential diagnosis.
PMID: 23320830
ISSN: 1051-2284
CID: 379222

Parotid gland atrophy in patients with chronic trigeminal nerve denervation

Raz, E; Saba, L; Hagiwara, M; Hygino de Cruz, L C Jr; Som, P M; Fatterpekar, G M
BACKGROUND AND PURPOSE: Trigeminal nerve injury or dysfunction is associated with denervation atrophy of muscles innervated by the mandibular branch of the trigeminal nerve. The purpose of our study was to evaluate the association between chronic CN V denervation and parotid gland atrophy. MATERIALS AND METHODS: Twenty-six patients with chronic masticator muscle atrophy were retrospectively identified and evaluated for the presence of ipsilateral parotid gland atrophy. Twenty-six age-matched control subjects with no clinical or imaging evidence of chronic masticator space atrophy were also identified. Segmentation of the parotid gland was performed to calculate a parotid asymmetry index. The Fisher exact test and t test were respectively used to determine the correlation between parotid gland atrophy and ipsilateral masticator muscle atrophy and to evaluate any difference in the size of the involved parotid gland when compared with that in the control subjects. RESULTS: Ipsilateral parotid gland atrophy was seen in 9/26 (42.8%) patients with fatty replacement of the masticator group of muscles, suggesting a correlation between parotid gland atrophy and CN V denervation (P < .001). The parotid asymmetry index was significantly different in patients with CN V denervation (0.59 +/- 0.25) compared with control subjects (0.92 +/- 0.03) (P < .001). CONCLUSIONS: Ipsilateral parotid gland atrophy can accompany chronic CN V denervation change, and its clinical significance remains to be determined.
PMID: 23042921
ISSN: 0195-6108
CID: 287112

Case 186: Dysembrioplastic neuroepithelial tumor [Case Report]

Raz, Eytan; Kapilamoorthy, Tirur R; Gupta, Arun K; Fiorelli, Marco
PMID: 22993223
ISSN: 0033-8419
CID: 379232

ERG AS A RELIABLE MARKER OF VASCULAR CELLS IN BRAIN TUMORS [Meeting Abstract]

Iranmahboob, Amir; Haber, Matthew; Esencay, Mine; Fatterpekar, Girish; Raz, Eytan; Placantonakis, Dimitris; Zagzag, David
ISI:000310971300012
ISSN: 1522-8517
CID: 204932

USE OF MULTIVOXEL DSC-MRI PERFUSION DATA IN STEREOTACTIC-GUIDED GLIOMA SURGERY AND CORRELATION WITH TUMOR PATHOLOGY [Meeting Abstract]

Parker, Erik; Fatterpekar, Girish; Raz, Eytan; Narayana, Ashwatha; Johnson, Glyn; Placantonakis, Dimitris; Zagzag, David
ISI:000310971300496
ISSN: 1522-8517
CID: 204992

INTRINSIC ENHANCEMENT FROM THE NECROTIC COMPONENT OF RING-ENHANCING LESIONS: A KEY IMAGING FEATURE TO DISTINGUISH NECROTIC TUMORS FROM ABSCESSES [Meeting Abstract]

Fatterpekar, Girish; Raz, Eytan; Knopp, Edmond; Gruber, Michael; Parker, Erik; Golfinos, John; Zagzag, David
ISI:000310971300495
ISSN: 1522-8517
CID: 205012

Mystery Case: Idiopathic bilateral stenosis of the foramina of Monro

Raz, Eytan; Fatterpekar, Girish; Davis, Adam J; Huang, Paul P; Loh, John P; Nita, Dragos A
PMID: 23109660
ISSN: 0028-3878
CID: 180902

Cyst with a mural nodule tumor of the brain

Raz, Eytan; Zagzag, David; Saba, Luca; Mannelli, Lorenzo; Di Paolo, Pier Luigi; D'Ambrosio, Ferdinando; Knopp, Edmond
The purpose of this article is to illustrate the imaging findings of lesions that present as cyst with a mural nodule tumor (CMNT). CMNT is a subtype pattern of intra-axial enhancement in central nervous system tumors, typical of a variety of brain neoplasms, including, as the most common, hemangioblastoma, pilocytic astrocytoma, ganglioglioma and pleomorphic xanthoastrocytoma and as less common tanycytic ependymoma, intraparenchymal schwannoma, desmoplastic infantile ganglioglioma and cystic metastasis. A retrospective design was chosen given the rarity of CMNT. Relevant cases were obtained retrospectively to review the different lesions that can present with the appearance of CMNT.
PMCID:3458787
PMID: 22935908
ISSN: 1470-7330
CID: 177154

Periependymal Abnormalities in Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis: A Case-Control Study [Meeting Abstract]

Raz, Eytan; Kister, Ilya; Omari, Mirza; Herbert, Joseph; Lui, Yvonne; Loh, John
ISI:000303204804208
ISSN: 0028-3878
CID: 166859