3T Group Research Articles

Latent diffusion model-based MRI superresolution enhances mild cognitive impairment prognostication and Alzheimer's disease classification

IntroductionTimely diagnosis and prognostication of Alzheimer's disease (AD) and mild cognitive impairment (MCI) are pivotal for effective intervention. Artificial intelligence (AI) in neuroradiology may aid in such appropriate diagnosis and prognostication. This study aimed to evaluate the potential of novel diffusion model-based AI for enhancing AD and MCI diagnosis through superresolution (SR) of brain magnetic resonance (MR) images. Methods1.5T brain MR scans of patients with AD or MCI and healthy controls (NC) from Alzheimer's Disease Neuroimaging Initiative 1 (ADNI1) were superresolved to 3T using a novel diffusion model-based generative AI (d3T*) and a convolutional neural network-based model (c3T*). Comparisons of image quality to actual 1.5T and 3T MRI were conducted based on signal-to-noise ratio (SNR), naturalness image quality evaluator (NIQE), and Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE). Voxel-based volumetric analysis was then conducted to study whether 3T* images offered more accurate volumetry than 1.5T images. Binary and multiclass classifications of AD, MCI, and NC were conducted to evaluate whether 3T* images offered superior AD classification performance compared to actual 1.5T MRI. Moreover, CNN-based classifiers were used to predict conversion of MCI to AD, to evaluate the prognostication performance of 3T* images. The classification performances were evaluated using accuracy, sensitivity, specificity, F1 score, Matthews correlation coefficient (MCC), and area under the receiver-operating curves (AUROC). ResultsAnalysis of variance (ANOVA) detected significant differences in image quality among the 1.5T, c3T*, d3T*, and 3T groups across all metrics. Both c3T* and d3T* showed superior image quality compared to 1.5T MRI in NIQE and BRISQUE with statistical significance. While the hippocampal volumes measured in 3T* and 3T images were not significantly different, the hippocampal volume measured in 1.5T images showed significant difference. 3T*-based AD classifications showed superior performance across all performance metrics compared to 1.5T-based AD classification. Classification performance between d3T* and actual 3T was not significantly different. 3T* images offered superior accuracy in predicting the conversion of MCI to AD than 1.5T images did. ConclusionsThe diffusion model-based MRI SR enhances the resolution of brain MR images, significantly improving diagnostic and prognostic accuracy for AD and MCI. Superresolved 3T* images closely matched actual 3T MRIs in quality and volumetric accuracy, and notably improved the prediction performance of conversion from MCI to AD.

Pilot Study on Evaluating the Impact of Tetanus, Diphtheria, and Pertussis (Tdap), Influenza, and COVID-19 Vaccinations on Antibody Responses in Pregnant Women.

This study assessed IgG levels to influenza/pertussis and neutralizing antibody (Nab) responses of COVID-19 vaccines in blood of pregnant women following immunization with pertussis (Tdap), influenza, and COVID-19 vaccines. We prospectively collected 71 participants categorized by the following vaccine combinations: 3TI, 4TI, 3T, and 4T groups (three and four doses of COVID-19 vaccines plus Tdap/influenza or Tdap vaccines alone). Our findings have indicated that the 3TI group exhibited elevated IgG levels for influenza B compared to the 3T group (12.90 vs. 7.75 U, p = 0.001); this pattern was not observed for influenza A. Pertussis IgG levels remained uniform across all groups. The 4TI group demonstrated a greater Nab inhibition rate from COVID-19 vaccines compared to both the 3TI and 3T groups (61.34% vs. 22.5% and 15.16%, respectively, p = 0.001). We observed no correlation between Nab inhibition rate and IgG levels for Tdap/influenza, with the exception of a moderate correlation with influenza B in the 3TI group. The efficacy of Tdap vaccine in pregnant women remained consistent, regardless of the administration of COVID-19 or influenza vaccines. Interestingly, without the influenza vaccine, both three and four doses of the COVID-19 vaccine still offered protection against influenza A, but not B. Hence, co-administering COVID-19, influenza, and Tdap vaccines during prenatal care maintains immunogenicity and is highly advised to safeguard pregnant women fully.

Maternal SARS-CoV-2 infection in pregnancy disrupts gene expression in Hofbauer cells with limited impact on cytotrophoblasts.

Hofbauer cells (HBCs) and cytotrophoblasts (CTBs) are major cell populations in placenta. The indirect impact of maternal SARS-CoV-2 disease on these cells that are not directly infected has not been extensively studied. Herein, we profiled gene expression in HBCs and CTBs isolated from placentae of recovered pregnant subjects infected with SARS-CoV-2 during all trimesters of pregnancy, placentae from subjects with active infection, SARS-CoV-2 vaccinated subjects, and those who were unexposed to the virus. Placentae were collected within 4 h post-delivery and membrane-free tissues were enzymatically digested for the isolation of HBCs and CTBs. RNA extracted from HBCs and CTBs were sequenced using 150bp paired-end reads. Differentially expressed genes (DEGs) were identified by DESeq2 package in R and enriched in GO Biological Processes, KEGG Pathway, Reactome Gene Sets, Hallmark Gene Sets, and Canonical Pathways. Protein-protein interactions among the DEGs were modelled using STRING and BioGrid. Pregnant subjects (n = 30) were recruited and categorized into six groups: infected with SARS-CoV-2 in i) the first (1T, n = 4), ii) second (2T, n = 5), iii) third (3T, n = 5) trimester, iv) tested positive at delivery (Delivery, n = 5), v) never infected (Control, n = 6), and vi) fully mRNA-vaccinated by delivery (Vaccinated, n = 5). Compared to the Control group, gene expression analysis showed that HBCs from infected subjects had significantly altered gene expression profiles, with the 2T group having the highest number of DEGs (1,696), followed by 3T and 1T groups (1,656 and 958 DEGs, respectively). These DEGs were enriched for pathways involved in immune regulation for host defense, including production of cytokines, chemokines, antimicrobial proteins, ribosomal assembly, neutrophil degranulation inflammation, morphogenesis, and cell migration/adhesion. Protein-protein interaction analysis mapped these DEGs with oxidative phosphorylation, translation, extracellular matrix organization, and type I interferon signaling. Only 95, 23, and 8 DEGs were identified in CTBs of 1T, 2T, and 3T groups, respectively. Similarly, 11 and 3 DEGs were identified in CTBs and HBCs of vaccinated subjects, respectively. Reassuringly, mRNA vaccination did not induce an inflammatory response in placental cells. Our studies demonstrate a significant impact of indirect SARS-CoV-2 infection on gene expression of inner mesenchymal HBCs, with limited effect on lining CTB cells isolated from pregnant subjects infected and recovered from SARS-CoV-2. The pathways associated with these DEGs identify potential targets for therapeutic intervention.

Enhancing outcomes in deep brain stimulation: a comparative study of direct targeting using 7T versus 3T MRI.

The aim of this study was to compare outcomes of direct targeting in deep brain stimulation (DBS) for essential tremor using 7T MRI versus 3T MRI. The authors hypothesized that 7T MRI direct targeting would be noninferior to 3T MRI in early tremor outcomes. A retrospective study was conducted on patients undergoing unilateral thalamic DBS for essential tremor between 2021 and 2023. Two matched cohorts were assessed, one using 7T MRI and the other using 3T MRI for surgical planning. The primary endpoint was the percentage improvement in the Fahn-Tolosa-Marin Tremor Rating Scale (TRS) scores. Additionally, the authors assessed optimized programming settings and variance in electrode position on postoperative imaging. Demographic and clinical data were compared using the nonparametric Mann-Whitney U-test. The squared Euclidean distance of each contact from the group mean centroid was calculated and averaged across the entire cohort to provide the variance (i.e., the mean squared distance) of electrode contact position. A total of 34 patients were analyzed, with 17 in each cohort. There were no significant differences in demographic information or mean surgical dates between the groups. There were no differences in intraoperative target repositioning or adverse events. The 7T group had a significantly greater TRS improvement than the 3T group (64.9% ± 11.4% vs 50.9% ± 16.4%, p = 0.004). Patients in the 7T cohort also had a lower mean stimulation current compared with those in the 3T cohort (2.0 ± 0.8 mA vs 2.7 ± 0.9 mA, p = 0.01). Image evaluation revealed that although the mean electrode position was comparable between 7T and 3T, the 7T electrode positioning was more clustered, indicating a lower variance in the final electrode location. The mean Euclidean distance between the individual electrode tips and the group centroid was significantly less at 7T than at 3T (1.82 ± 0.68 mm vs 2.75 ± 0.81 mm, p = 0.001). Despite concerns for increased artifacts and distortions at 7T, the authors show that these effects can be mitigated with an appropriate workflow, leading to improved surgical outcomes with direct targeting using 7T MRI. Their results suggest similar accuracy but greater precision in targeting with 7T MRI compared with 3T MRI, resulting in lower stimulation currents and improved tremor reduction. Future studies are needed to assess outcomes related to 7T MRI in targeting other subcortical structures.

A multicenter study on the quantification of liver iron concentration in thalassemia patients by means of the MRI T2* technique.

To investigate the feasibility and accuracy of quantifying liver iron concentration (LIC) in patients with thalassemia (TM) using 1.5T and 3T T2* MRI. 1.5T MRI T2* values were measured in 391 TM patients from three medical centers: the T2* values of the test group were combined with the LIC (LICF) provided by FerriScan to construct the curve equation. In addition, the liver 3T MRI liver T2* data of 55 TM patients were measured as the 3T group: the curve equation of 3T T2* value and LICF was constructed. Based on the test group LICF (0.6-43 mg/g dw) and the corresponding 1.5T T2* value, the equation was LICF = 37.393(-1.22) (R2 = 0.971; P < 0.001). There was no significant difference between LICe - 1.5T and LICF in each validation group (Z = -1.269, -0.977, -1.197; P = 0.204, 0.328, 0.231). There was significant consistency (Kendall's W = 0.991, 0.985, 0.980; all P < 0.001) and high correlation (rs = 0.983, 0.971, 0.960; all P < 0.001) between the two methods. There was no significant difference between the clinical grading results of LICe - 1.5T and LICF in each validation group (χ2 = 3.0, 4.0, 2.0; P = 0.083, 0.135, 0.157), and there was significant consistency between the clinical grading results (Kappa's K = 0.943, 0.891, 0.953; P < 0.001). There was no statistical correlation between the LICF (≥14 mg/g dw) and the 3T T2* value of severe iron overload (P = 0.085). The LICF (2-14 mg/g dw) in mild and moderate iron overload was significantly correlated with the corresponding T2* value (rs = -0.940; P < 0.001). The curve equation constructed from LICF and corresponding 3T T2* values in this range is LICF = 18.463T2*∧(-1.142) (R2 = 0.889; P < 0.001). There was no significant difference between LICF and LICe - 3T in the mild to moderate range (Z = -0.523; P = 0.601), and there was a significant correlation (rs = 0.940; P < 0.001) and significant consistency (Kendall's W = 0.970; P = 0.008) between them. LICe - 3T had high diagnostic efficiency in the diagnosis of severe, moderate, and mild liver iron overload (specificity = 1.000, 0.909; sensitivity = 0.972, 1.000). The liver iron concentration can be accurately quantified based on the 1.5T T2* value of the liver and the specific LIC-T2* curve equation. 3T T2* technology can accurately quantify mild-to-moderate LIC, but it is not recommended to use 3T T2* technology to quantify higher iron concentrations.

Лабораторні маркери алергічних та токсико-алергічних реакцій на медикаменти у хворих на туберкульоз легень

Abstract. The purpose of the study was to determine the laboratory markers of allergic reactions (AR) and toxic-allergic adverse reactions (TAR) to medications in patients with active pulmonary tuberculosis (TB) to predict their development. Methods and materials. There are the results of examination of 68 patients with TB, average age (38.2 ± 1.8) years, who were divided into 4 groups depending on the presence of adverse reactions to medications. 1A group included 12 patients with clinical signs of allergy (A) and nonelevated indicators of liver function in the blood; 2nd group included 16 people with signs of allergy with the increased liver function indicators that developed during treatment (TAR); 3T group included 25 people with the only elevated liver function indicators (toxic (T) reactions); 4BP group included 15 patients without adverse reactions to medications. All patients were examined with standard clinical, radiological, laboratory, biochemical, microbiological, and immunological methods with subsequent computer statistical processing using ranked data series. Conclusions. There were determined the laboratory markers (lymphocyte coefficient — LC and lymphocyte-hepatic coefficient — LHC) of AR and TAR in patients with TB. Decrease in LC (calculated for CD3+, CD8+) below 1 unit and in LC (for CD4+ or CD19+) below 0.5 unit confirmed an allergic reaction in patients with clinical manifestations of allergy. The absence of LC decrease made it possible to diagnose TAR at the presence of allergy clinical signs in patient. The growth of LC for CD 16+56+ above 1.0 unit was the evidence of toxic reactions. Decrease in LHK (calculated for CD3+, CD4+, CD8+ or CD19+) below 2.5 units is possible to use as a TAR marker.

OS08.4.A Retrospective analysis of in vivo 1H-magnetic resonance spectroscopy based on a machine learning approach enables reliable prediction of IDH mutation in patients with glioma

Abstract BACKGROUND Mutation of isocitrate dehydrogenase (IDH) is not only an important landmark in the development of low-grade gliomas, but also has prognostic significance and is a potential therapeutic target. There is a high need to determinate IDH mutation status at diagnosis and during the course of therapy in a non-invasive and reliable manner. We established a machine learning approach based on a support vector machine to detect IDH mutation status in in vivo standard 1H-magnetic resonance spectroscopy (1H-MRS) at 3T with an accuracy of 88.2%, a sensitivity of 95.5% (95% CI, 77.2–99.9%), and a specificity of 75% (95% CI, 42.85–94.5%) in a prospective monocentric clinical trial. Here, the same method is applied in a retrospective cohort at 1.5T and tested for transferability. MATERIAL AND METHODS Validation cohort. The validation cohort comprised 100 patients with glioma for which standard in vivo 1H-MRS spectra had been acquired between 2002 and 2007. Standard single voxel spectroscopy had been measured at 1.5T using a PRESS sequence with a TR of 1500ms and a TE of 30ms. One sample had to be excluded due to non-malignant histology and for 15 samples the IDH mutation status was not available. Therefore, the validation cohort comprised 84 samples, of which 35 were bearing an IDH mutation in immunohistochemistry (sequencing for confirmation is outstanding). Machine learning. To transfer our method to an independent validation cohort our previously established machine learning approach was first trained on all samples of the 3T group. The trained algorithm was then applied to the data of the validation cohort. Here, among other factors the different field strengths, with which the spectra were acquired (3T vs. 1.5T) had to be considered. RESULTS 27 samples of the validation cohort had to be excluded due to poor spectra quality. Our approach correctly detected IDH mutation status in 47 of 62 patients (75.8%), although the technical conditions were significantly different from our published prospective cohort. 17 of 30 patients bearing an IDH mutation were correctly identified, while 30 of 32 wild type patients were determined successfully. CONCLUSION Our approach to detect IDH mutation status has promising application in an unselected retrospective cohort, demonstrating transferability across different technical conditions. Further investigations to improve our technique and an advanced neuropathological processing of the samples are planned.

Abstract TMP23: Shades of White: Correlation of Hyperacute DWI Intensity With Last Known Well Time

Background: Identifying a last known well (LKW) time surrogate for acute stroke is vital to increase stroke treatment. Previous research have used an MRI DWI vs. FLAIR mismatch to estimate LKW time to within 6 hours. DWI signal intensity initially increases from onset of stroke, but mapping a reliable time course to the signal intensity has not been demonstrated. Methods: We retrospectively reviewed stroke code patients between 1/2016 and 6/2017 from the prospective, IRB approved UCSD Stroke Registry. Patients who had MRI brain from onset, with or without intervention, are included. All ischemic strokes were confirmed with ADC correlation and timing from onset to MRI was calculated. Raw DWI intensity was measured in grays (Gy) using IMPAX software and compared to contralateral side for control, for a relative DWI intensity (rDWI). LKW and MRI time were collected by chart review. Correlation was assessed using Pearson correlation coefficient between DWI intensity, rDWI, and time to MRI imaging. 1.5T, 3T, and combined modalities were examined. Results: 97 patients were included in this analysis. Overall, there is a good correlation (0.39, p&lt;0.001) for minutes from onset to MRI and DWI intensity. There was good correlation with the 1.5T group (0.39, p=0.001) and very good correlation with the 3T group (0.60, p=0.001). There were no significant differences in demographic or time interval between the two MRI types. Conclusions: There is good correlation between DWI intensity and minutes from onset to MRI. This suggests a time-dependent DWI intensity response and supports the potential use of DWI intensity measurements to extrapolate a LKW time in unknown cases. Further studies in a larger dataset within the hyperacute period are being pursued to increase both experience and generalizability.

Performance decline by search dogs in repetitive tasks, and mitigation strategies

Differences between training and working contexts have the potential to be a major cause of deficits in performance of searching animals. Detection responses of individuals trained with high rates of target stimulus presentation tend to extinguish when moved to a new context where their rate of target encountering is low. This problem is acute with some contraband and people detection dogs where the rate of target encountering in the work context is significantly lower than during training. While the rate of extinction can be mitigated by planting known targets in the working contexts, this is often logistically difficult, dangerous, or impractical; an alternative solution would therefore be beneficial. Here, we explore the novel approach of adding non-contraband target stimuli to the training set and then presenting these innocuous targets periodically in the work context, thereby avoiding the logistic difficulties attached to the use of real contraband targets. Our rationale is that the search persistence caused by the innocuous targets could generalise to the real targets, thus increasing resistance to extinction in the latter. The potential problem with this approach is that dogs may learn to focus on the innocuous targets in the work context to the detriment of the real targets. In our experiments, 21 dogs were trained with three contraband (explosive) and one innocuous (non-explosive) odours. When they were transferred to a “work” context, they were separated into three groups, as follows: Group “0T” (zero target) were not exposed to any targets in the work environment; Group 1T (one target) were exposed to and rewarded on one innocuous target in the work environment; and Group 3T (three target) were exposed to and rewarded on three contraband targets in the work location. These regimens continued for six weeks during which time all dogs received two refresher training days away from their work location, where they were rewarded on all four target odours. Following this work phase, search and detection performance was tested in the work location for all stimuli. In the work phase, search vigilance in the 0T group dropped considerably compared with the 1T and 3T groups. Critically, when dogs were re-exposed to all four targets in the work location at the end of the work phase, detection rates were significantly reduced for the 0T group, but were maintained on all targets for the 1T and 3T group. Our results show that rewarding search persistence with innocuous stimuli is potentially a successful strategy to maintain detection-dog performance across a range of trained contraband odours.

Upregulation of the rostral anterior cingulate cortex can alter the perception of emotions: fMRI-based neurofeedback at 3 and 7 T.

Recent advances in real-time functional magnetic resonance imaging (rt-fMRI) techniques enable online feedback about momentary brain activity from a localized region of interest. The anterior cingulate cortex (ACC) as a central hub for cognitive and emotional networks and its modulation has been suggested to elicit mood changes. In the presented real-time fMRI neurofeedback experiment at a 3 and a 7T scanner we enabled participants to regulate ACC activity within one training session. The session consisted of three training runs of 8.5min where subjects received online feedback about their current ACC activity. Before and after each run we presented emotional prosody. Subjects rated these stimuli according to their emotional valence and arousal, which served as an implicit mood measure. We found increases in ACC activation at 3T (n=15) and at 7T (n=9) with a higher activation success for the 3T group. FMRI signal control of the rostral ACC depended on signal quality and predicted a valence bias in the rating of emotional prosody. Real-time fMRI neurofeedback of the ACC is feasible at different magnetic field strengths and can modulate localized ACC activity and emotion perception. It promises non-invasive therapeutic approaches for different psychiatric disorders characterized by impaired self-regulation.

1.5T versus 3T MRI for targeting subthalamic nucleus for deep brain stimulation

Background. Accurate stereotactic placement of the electrode into the subthalamic nucleus (STN) is imperative to the therapeutic efficacy of deep brain stimulation (DBS). However, it is not always possible to directly visualize the very small STN using 1.5T MR imaging. Objective. To evaluate whether 3T MR imaging can provide better identification of the STN and clinical outcome than 1.5T MR imaging. Methods. Thirty-nine patients with advanced Parkinson's disease underwent 1.5T (n = 16) or 3T (n = 23) fast spin echo T2-weighted (FSE-T2WI) MR imaging for targeting the STN. A semi-quantitative 3-point scoring system was proposed to rank the clearness of STN contour: Score “0” if non-visible; Score “1” if visible but with blurred margin; and “2” if visible with clear margin. The unified Parkinson's disease rating scale (UPDRS) was also compared before operation and post-operation. Results. The STN score was 2 in all the patients of the 3T group, whereas it was relatively blurred (mean score, 1.19) in the 1.5T group (P < 0.001). The number of microelectrode trajectories (1.2 versus 1.5; P < 0.05) was lower in the 3T group; consequently, the operative time was also less (P < 0.05) as compared with that in the 1.5T group. The outcome of UPDRS motor examination showed no significant difference in two groups. Conclusion. 3T MR imaging is a reliable and more accurate method for direct targeting of the STN for DBS surgery. However, the technique of high-sequence MR imaging may not influence the clinical outcome significantly.

Triple-Target Treatment Versus Low-Frequency Electrostimulation for Anal Incontinence

In the nonsurgical treatment of anal incontinence, the combination of amplitude-modulated medium-frequency stimulation and electromyographic biofeedback (EMG-BF), known as triple-target treatment (3T), is superior to EMG-BF alone. The aim of this trial is to compare 3T with the standard treatment, low-frequency stimulation (LFS). 80 patients with anal incontinence of Grade I or higher who presented to physicians or centers specialized in coloproctology were enrolled in this multicenter randomized trial with blinded observer. The trial had an open parallel-group design. Randomization was performed centrally by telephone. The primary endpoint was the Cleveland Clinic Score (CCS) after self-training at home with either 3T or LFS in two 20-minute sessions per day for 6 months. The secondary endpoints included the proportion of patients regaining continence, and the patients' quality of life (QoL). On completion of the trial as planned, the results were evaluated with an intention-to-treat analysis. DRKS00000138 (http://register.germanctr.de). 39 patients were randomized to 3T, and 41 to LFS. After 6 months of treatment, the CCS (mean ± standard deviation) was 3.1 ± 4.2 in the 3T group and 9.6 ± 3.9 in the LFS group. The median improvement in the CCS at 6 months compared to baseline was 7 points greater in the 3T group than in the LFS group (95% CI: 5-9, p<0.001). Anal continence was regained by 54% of the 3T patients, but none of the LFS patients (95% CI for the difference: 37.18% - 69.91%, p<0.001). QoL scores were higher in all dimensions in the 3T group than in the LFS group. No major adverse effects occurred in either group. 3T is superior to LFS in the treatment of anal incontinence. The available evidence suggests that the success of 3T is based on the combined effect of biofeedback and medium-frequency stimulation. LFS of the type applied in this trial has no effect. 3T should be used in routine clinical practice instead of LFS.

3T-AI: Ein neuer, mit höherer Evidenz versehener Behandlungsalgorithmus bei analer Inkontinenz

The evidence for conservative treatment of anal incontinence is poor. In our first publication [Schwandner et al. Dis Colon Rectum 2010; 53: 1007-1016] we demonstrated that a novel therapeutic concept, termed triple target treatment (3T), combining amplitude-modulated medium frequency stimulation and electromyography biofeedback (EMG-BF) was superior to EMG-BF alone. Questions about the required treatment duration and the relevant subgroups of patients with sphincter damage and damaged anal sensibility were not addressed. We enrolled 158 patients with anal incontinence in this randomized study. Here, we -report on the important subgroup analyses of patients with and without sphincter damage and damaged anal sensibility for the endpoints Cleveland Clinic Score (CCS) and success record. Using the results of this study we propose a novel treatment algorithm which is open for discussion. In patients with sphincter damage, the median difference on the CCS from baseline to 9 months was 5 points higher for 3T than for EMG-BF (95 % confidence interval 0-8; p = 0.0168). While 47 % of the patients with sphincter damage became continent with 3T, only 18 % did with EMG-BF (p = 0.0036). Ten of 17 patients in the 3T group regained anal sensibility after 3 months stimulation. There was tendency towards improved continence in patients with neuropathy upon 3T treatment (p = 0.1219). 3T is superior to EMG-BF alone for patients with sphincter damage and neuropathic anal incontinence. It is a successful key element within our treatment algorithm, even in patients with sphincter damage and neuropathic anal incontinence.

Comparação dos padrões da frequência cardíaca fetal no segundo e terceiro trimestres da gestação

to compare the patterns of fetal heart rate (FHR) in the second and third trimesters of pregnancy. a prospective and comparative study performed between January 2008 and July 2009. The inclusion criteria were: singleton pregnancy, live fetus, pregnant women without clinical or obstetrical complications, no fetal malformation, gestational age between 24 and 27 weeks (2nd trimester - 2T) or between 36 and 40 weeks (3rd trimester - 3T). Computerized cardiotocography (System 8002 - Sonicaid) was performed for 30 minutes and the fetal biophysical profile was obtained. System 8002 analyzes the FHR tracings for periods of 3.75 seconds (1/16 minutes). During each period, the mean duration of the time intervals between successive fetal heart beats is determined in milliseconds (ms); the mean FHR and also the differences between adjacent periods are calculated for each period. The parameters included: basal FHR, FHR accelerations, duration of high variation episodes, duration of low variation episodes and short-term variation. The dataset was analyzed by the Student t test, chi-square test and Fisher's exact test. Statistical significance was set at p<0.05. eighteen pregnancies on the second trimester were compared to 25 pregnancies on the third trimester. There was a significant difference in the FHR parameters evaluated by computerized cardiotocography between the 2T and 3T groups, regarding the following results: mean basal FHR (mean, 143.8 bpm versus 134.0 bpm, p=0.009), mean number of transitory FHR accelerations > 10 bpm (3.7 bpm versus 8.4 bpm, p <0.001) and >15 bpm (mean, 0.9 bpm versus 5.4 bpm, p <0.001), mean duration of high variation episodes (8.4 min versus 15.4 min, p=0.008) and mean short - term variation (8.0 ms versus 10.9 ms, p=0.01). The fetal biophysical profile showed normal results in all pregnancies. the present study shows significant differences in the FHR characteristics when the 2nd and 3rd trimesters of pregnancy are compared and confirms the influence of autonomic nervous system maturation on FHR regulation.

Caudate asymmetry: A neurobiological marker of moderate prenatal alcohol exposure in young adults

This study identified structural changes in the caudate nucleus in offspring of mothers who drank moderate levels of alcohol during pregnancy. In addition, the effect of duration of alcohol use during pregnancy was assessed. Young adults were recruited from the Maternal Health Practices and Child Development Project. Three groups were evaluated: prenatal alcohol exposure (PAE) during all three trimesters (3T), PAE during the first trimester only (1T), and controls with no PAE (0T). Magnetic resonance images were processed using the automated labeling pathway technique. Volume was measured as the number (gray + white) and relative percentage (caudate count/whole brain count × 100) of voxels. Asymmetry was calculated by subtracting the caudate volume on the left from the right and dividing by the total (L − R/L + R). Data analyses controlled for gender, handedness, and prenatal tobacco and marijuana exposures. There were no significant differences between the groups for whole brain, left, or right volumes. There was a dose–response effect across the three exposure groups both in terms of magnitude and direction of asymmetry. In the 3T group, the left caudate was larger relative to the right caudate compared to the 0T group. The average magnitude of caudate asymmetry for the 1T group was intermediate between the 0T and 3T groups. Subtle anatomical changes in the caudate are detected at the moderate end of the spectrum of prenatal alcohol exposure.