Ventricle-to-brain Ratio Research Articles

Ventricular volume, white matter alterations and outcome of major depression and their relationship to endocrine parameters – A pilot study

Objectives Brain morphology and its relation to endocrine parameters were examined, in order to determine the link of these parameters to treatment outcome to psychopharmacological treatment in depressed patients. Methods We examined the potentially predictive value of Magnetic Resonance Imaging (MRI) parameters related to mineralocorticoid receptor (MR) function on the treatment outcome of depression. 16 inpatients with a major depressive episode (MDE) were studied at baseline and 14 of them approximately six weeks later. Physiological biomarkers and 3-T-structural MRI based volume measures, using FreeSurfer 6.0 software, were determined. Results Non-responders (<50% reduction of HAMD-21; n = 6) had a significantly smaller volume of the right anterior cingulate cortex, a significantly larger ventricle to brain ratio (VBR) and third ventricle volume, and smaller volumes of the central and central-anterior corpus callosum (CC) in comparison to responders (n = 7; all p ≤ 0.05). Correlational analysis (Spearman) demonstrated that larger ventricle volume was correlated to a worse treatment outcome, higher body mass index (BMI) and smaller CC segment volume, whereas the total CC volume was negatively correlated to the saliva aldosterone/cortisol concentration ratio (AC-ratio). Conclusion Large ventricular volume may be a predictive marker for worse treatment response to standard antidepressant treatment, potentially via compression of white matter structures. A mediating role of the previously identified markers BMI and the AC-ratio, is suggested.

Volume estimation of brain ventricles using Cavalieri’s principle and Atlas-based methods in Alzheimer disease: Consistency between methods

Automatic estimations of brain ventricles are needed to assess disease progression in neurodegenerative disorders such as Alzheimer Disease (AD). The objectives of this study are to evaluate the diagnostic performances of an automated volumetric assessment tool in estimating lateral ventricle volumes in AD and to compare this with Cavalieri’s principle, which is accepted as the gold standard method. This is across-sectional volumetric study including 25 Alzheimer patients and 25 healthy subjects undergoing magnetic resonance images (MRI) with a 3D turbo spin echo sequence at 1.5 Tesla. The Atlas-based method incorporated MRIStudio software to automatically measure he volumes of brain ventricles. To compare the corresponding measurements, we used manual point-counting and semi-automatic planimetry methods based on Cavalieri’s principle. Bland–Altman test results indicated an excellent agreement between Cavalieri’s principle and the Atlas-based method in all volumetric measurements (p < 0.05). We obtained a 64% sensitivity and 92% specificity for lateral ventricular volumes according to the Atlas-based method. AD subjects had significantly larger left and right lateral ventricle volume (LVV) when compared to control subjects in respect to three volumetric methods (p < 0.01). Lateral ventricle-to-brain ratio (VBR) statistically increased 49.23% in measurements done with the point-counting method, 45.12% with the planimetry method, and 45.49% with the Atlas-based method in AD patients (p < 0.01). As a result, the Atlas-based method may be used instead of manual volumetry to estimate brain volumes. Additionally, this method provides rapid and accurate estimations of brain ventricular volumes in-vivo examination of MRI.

Brain ventricular dimensions and relationship to outcome in adult patients with bacterial meningitis.

BackgroundExperimental studies suggest that changes in brain ventricle size are key events in bacterial meningitis. This study investigated the relationship between ventricle size, clinical condition and risk of poor outcome in patients with bacterial meningitis.MethodsAdult patients diagnosed with bacterial meningitis admitted to two departments of infectious diseases from 2003 through 2010 were identified. Clinical and biochemical data as well as cerebral computed tomographic images were collected. The size of the brain ventricles were presented as a Ventricle to Brain Ratio (VBR). Normal range of VBR was defined from an age matched control group. A multivariate analysis was performed to identify predictors of 30-day mortality.ResultsOne hundred and seven patients were included. Eighty-one patients had a CT scan at the time of diagnosis. VBR was identified as an independent risk factor of 30-day mortality, Mortality Rate Ratio: 6.03 (95 % confidence interval: 1.61-22.64, p = 0.008) for highest versus lowest tertile. A VBR deviating more than 2 standard deviations from the normal range was associated with increased mortality.ConclusionsBrain ventricles are commonly subject to marked changes in size as a consequence of meningitis. Increased brain ventricle size in the acute phase of bacterial meningitis was associated with increased mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1097-3) contains supplementary material, which is available to authorized users.

Importance of ventricle-to-brain ratio (VBR) and volume of CSF drainage in the treatment of very low pressure hydrocephalus

Introduction: Low pressure hydrocephalus is a known complication of prolonged hydrocephalus sometimes treatable with continued low-pressure drainage at subatmospheric pressures. Clarke et. al. and Filipidis et. al. have reported poor outcomes when treating very low pressure hydrocephalus (VLPH). We present 4 cases of very low pressure hydrocephalus (VLPH) following transnasal endoscopic resection of suprasellar lesions and hypothesize that poor prognostic cases can be identified thereby avoiding prolonged futile treatments. Methods: We performed a retrospective chart review of 4 cases of VLPH and tried to identify metrics contributing to successful treatment. We examined the Pearson correlations between Glasgow Coma Scale and ventricle-to-brain ratio (VBR); volume of CSF drained; net fluids; and serum sodium, urea, and creatinine. Results: Our investigation reveals that Glasgow Coma Score is positively correlated with increased CSF drainage and negatively correlated with increased ventricle-to-brain ratio. The most important determinant of good outcome is brain compliance as measured by the brain’s ability to maintain a good GCS score in the face of wide ranges in ventricle-to-brain ratio (VBR). Conclusion: We propose that futile prolonged subatmospheric drainage be avoided by declining treatment in patients who have ventriculitis and patients who have a narrow range of ventricle-to-brain ratio (VBR) concurrent with a good neurological examination.

Analysis of intracranial volume ratios by means of cerebrospinal fluid deployment indicators.

Imaging studies make it possible not only to visualize the general structure of the brain but also to take precise measurements of brain tissue volume and the size of individual lobes and their structure. The aim of this study was to determine the ratio of cerebrospinal fluid (CSF) volume contained in the intracranial ventricular system to the brain tissue volume and the ratio of CSF volume in the subarachnoid space and basal cisterns to the brain tissue volume. The evaluation of volumetric measurements of computed tomographic (CT) images was undertaken on 23 male and female patients (average age 56.9 ± 6.1) diagnosed with normal pressure hydrocephalus (NPH) and 27 male and female patients (average age 70.6 ± 5.2) diagnosed with brain atrophy (BA). In the CT imaging studies, the total brain tissue volume and CSF volume collected in the intracranial fluid cavities were mapped to a colour scale. The VisNow software was used for volumetric evaluation. The groups were compared by means of the non-parametric Kolmogorov-Smirnov test (K-S) for independent samples. Paired data were compared by means of the nonparametric Wilcoxon test. The volumes of brain (brain volume - BV) and cerebrospinal fluid (fluid volume - FV) differ greatly from each other in both groups BA and NPH. The SBR (subarachnoid space and basal cisterns-to-brain ratio) and VBR (ventricle-to-brain ratio) indicators differ significantly and very much within the NPH group as well as within the BA group. In the NPH group a clearly higher value of VBR can be observed in comparison with the BA group. There was a higher value of SBR in the BA than the NPH group. The simultaneous use of two indicators, VBR and SBR, on a study group of 50 patients enabled the total separation of NPH and BA groups. This differentiation can have real diagnostic value. Thus the volumetric assessment of the volume of CSF and brain tissue based on CT of the head can become an important part of the differential diagnosis of hydrocephalus and brain atrophy.

Heterogeneity of brain lesions in pediatric traumatic brain injury.

Magnetic resonance imaging (MRI) provides a method to identify and quantify abnormalities resulting from traumatic brain injury (TBI). MRI abnormalities in children with TBI have not been fully characterized according to the frequency, location, and quantitative measurement of a range of pathologies critical for studies of neuropsychological outcome. Here, we report MRI findings from a large, multicenter study of childhood TBI, the Social Outcomes of Brain Injury in Kids (SOBIK) study, which compared qualitative and quantitative neuroimaging findings in 72 children with complicated mild-to-severe TBI to 52 children with orthopedic injury (OI). Qualitative analyses of MRI scans coded white matter hyperintensities (WMHs), hemosiderin deposits reflecting prior hemorrhagic lesions, regions of encephalomalacia and/or atrophy, and corpus callosum atrophy and traumatic shear lesions. Two automated quantitative analyses were conducted: (a) FreeSurfer methods computed volumes for total brain, white matter (WM), gray matter (GM), corpus callosum, ventricles, amygdala, hippocampus, basal ganglia, and thalamus along with a ventricle-to-brain ratio (VBR); and (b) voxel-based morphometry (VBM) to identify WM, GM, and cerebrospinal fluid. We also examined performance on the Processing Speed Index (PSI) from the Wechsler Intelligence Scale for Children, Fourth Edition, in relation to the above-mentioned neuroimaging variables. WMHs, hemosiderin deposits, and focal areas of encephalomalacia or atrophy were common in children with TBI, were related to injury severity, and were mostly observed within a frontotemporal distribution. Quantitative analyses showed volumetric changes related to injury severity, especially ventricular enlargement and reduced corpus callosum volume. VBM demonstrated similar findings, but, in addition, GM reductions in the inferior frontal, basal forebrain region, especially in the severe TBI group. The complicated mild TBI group showed few differences from the OI group. PSI was significantly associated with global atrophy, as measured by VBR. MRI findings after childhood TBI are diverse and particularly influenced by injury severity, and they involve common features, group heterogeneity, and individual variability.

New stereological approach for the evaluation of patients with schizophrenia using computer tomography images: Ventricle to brain volume fraction

There are several studies that have proposed different criteria for evaluating the volumes of the cerebral hemispheres, the lateral and third ventricles in patients with schizophrenia seen on routine computed tomography (CT) images. These approaches use solely the volume of the cerebrum and/or lateral ventricles, length and width measurements of the ventricles, and ventricle to brain ratio (VBR). In the present study, we proposed a new unbiased approach namely ventricle to brain volume fraction (VBF). CT scans of 23 patients with schizophrenia and 23 matched controls were blindly assessed by three independent observers. VBF, total brain volume and ventricle volumes were calculated and compared. The subjects with schizophrenia showed higher VBF than the control subjects (P =0.000) with mean (±SEM) VBF values of 2.71±0.16 and 1.62±0.10%, respectively. No gender difference was found. Older subjects had a higher VBF than those younger in controls but not patients. Correlation was observed for VBF estimations made by three independent observers (r = 0.979; P = 0.000). The studies measuring VBR on schizophrenia revealed inconsistent findings. Comparing solely the brain volumes or ventricle volumes between two groups, instead of using volume fraction method, will not provide reliable data. VBF described here easily could be used for the analysis of the brain structures of schizophrenia using standard CT scans not requiring any additional expense. In addition; evaluation of the whole section series gives real ventricular and cerebral volumes. Key words: Cavalieri method, computed tomography (CT), schizophrenia.

Cerebral atrophy, apolipoprotein E ɛ4, and rate of decline in everyday function among patients with amnestic mild cognitive impairment

Background Patients with amnestic mild cognitive impairment (MCI) demonstrate decline in everyday function. In this study, we investigated whether whole brain atrophy and apolipoprotein E ( APOE) genotype are associated with the rate of functional decline in MCI. Methods Participants were 164 healthy controls, 258 MCI patients, and 103 patients with mild Alzheimer's disease (AD), enrolled in the Alzheimer's Disease Neuroimaging Initiative. They underwent brain MRI scans, APOE genotyping, and completed up to six biannual Functional Activities Questionnaire (FAQ) assessments. Random effects regressions were used to examine trajectories of decline in FAQ across diagnostic groups, and to test the effects of ventricle-to-brain ratio (VBR) and APOE genotype on FAQ decline among MCI patients. Results Rate of decline in FAQ among MCI patients was intermediate between that of controls and mild AD patients. Patients with MCI who converted to mild AD declined faster than those who remained stable. Among MCI patients, increased VBR and possession of any APOE ɛ4 allele were associated with faster rate of decline in FAQ. In addition, there was a significant VBR by APOE ɛ4 interaction such that patients who were APOE ɛ4 positive and had increased atrophy experienced the fastest decline in FAQ. Conclusions Functional decline occurs in MCI, particularly among patients who progress to mild AD. Brain atrophy and APOE ɛ4 positivity are associated with such declines, and patients who have elevated brain atrophy and are APOE ɛ4 positive are at greatest risk of functional degradation. These findings highlight the value of genetic and volumetric MRI information as predictors of functional decline, and thus disease progression, in MCI.

Magnetic resonance imaging reveals no ventriculomegaly in polydrug abusers.

Previous studies of cerebral structure in substance abusers yielded controversial results, largely due to issues of subject selection and/or limitations of experimental techniques. The purpose of the present study was to assess whether the ventricle-to-brain ratio (VBR), determined volumetrically by magnetic resonance imaging (MRI), differed in polysubstance abusers (n = 10), as compared with age-matched controls (n = 10). Subjects were male volunteers 21-39 years of age. The values of VBR in the polydrug abuse group were not larger than those in control group, nor was there any tendency toward relative ventriculomegaly in the substance abusers. Therefore, the present findings provide no evidence that polysubstance abuse produces abnormalities of gross brain structure in relatively young and physically healthy men.

The relation between Glasgow Coma Scale score and later cerebral atrophy in paediatric traumatic brain injury

Primary objective: To examine initial Glasgow Coma Scale (GCS) score and its relationship with later cerebral atrophy in children with traumatic brain injury (TBI) using Quantitative Magnetic Resonance Imaging (QMRI) at 4 months post-injury. It was hypothesized that a lower GCS score would predict later generalized atrophy. As a guide in assessing paediatric TBI patients, the probability of developing chronic cerebral atrophy was determined based on the initial GCS score.Methods and procedures: The probability model used data from 45 paediatric patients (mean age = 13.6) with mild-to-severe TBI and 41 paediatric (mean age = 12.4) orthopaedically-injured children.Results: This study found a 24% increase in the odds of developing an abnormal ventricle-to-brain ratio (VBR) and a 27% increase in the odds of developing reduced white matter percentage on neuroimaging with each numerical drop in GCS score. Logistic regression models with cut-offs determined by normative QMRI data confirmed that a lower initial GCS score predicts later atrophy.Conclusion: GCS is a commonly used measure of injury severity. It has proven to be a prognostic indicator of cognitive recovery and functional outcome and is also predictive of later parenchymal change.

Cerebral Ventricular Changes Associated With Transitions Between Normal Cognitive Function, Mild Cognitive Impairment, and Dementia

Expansion of the cerebral ventricles may occur at an accelerated rate in subjects with dementia, but the time course of expansion during transitions between normal cognitive function, mild cognitive impairment (MCI), and dementia is not well understood. Furthermore, the effects of cardiovascular risk factors on rate of ventricular expansion are unclear. We used a fully automated segmentation technique to measure change rate in lateral ventricle-to-brain ratio (VBR) on 145 longitudinal pairs of magnetic resonance images of subjects in the Cardiovascular Health Study Cognition Study from the Pittsburgh Center. A multivariate model analyzed VBR change rate, accounting for dementia statuses at both imaging times (normal, MCI, or dementia), age, sex, education, race, magnetic resonance-defined infarcts, Center for Epidemiology Studies Depression Scale, baseline ventricular volume, and cardiovascular risk factors. VBR change was faster in subjects who were demented or transitioned from MCI to dementia, compared with subjects normal at both images and subjects who transitioned from normal to MCI or dementia. Patients with diabetes had faster VBR change. Ventricular expansion may accelerate late in the progression from normal cognitive function to dementia, and may be modulated by diabetes.

Day-of-Injury Computerized Tomography, Rehabilitation Status, and Development of Cerebral Atrophy in Persons with Traumatic Brain Injury

To compare day-of-injury (DOI) computerized tomography (CT) findings with acute injury severity markers, disability at acute hospital admission and discharge from inpatient rehabilitation, injury severity markers, and degree of postacute cerebral atrophy on magnetic resonance imaging (MRI). Retrospective chart review of 240 consecutive traumatic brain injury (TBI) admissions (mean age 31.7 +/- 15.8 yrs) with moderate-to-severe initial brain injury. All DOI CT abnormalities were qualitatively rated. Disability was assessed using the Disability Rating Scale (DRS) and the FIM measure. In a representative subset, cerebral atrophy was determined by the ventricle-to-brain ratio (VBR) method and quantified from MRI scans 25 or more days postinjury. CT classification resulted in nonsignificant differences in DRS and FIM ratings at the time of discharge from the rehabilitation unit, except in brainstem injury subjects who had significantly higher DRS and lower FIM scores at rehabilitation discharge. At 25 or more days postinjury, presence of any DOI CT abnormality was associated with larger VBR. Increased VBR, as an index of cerebral atrophy, was associated with worse rehabilitation discharge DRS and FIM ratings. Other than brainstem injury, DOI CT findings relate poorly to rehabilitation outcome. Presence of DOI CT abnormalities were associated with the development of cerebral atrophy, which was associated with poorer rehabilitation discharge DRS and FIM scores.

Structural brain abnormalities in early-onset schizophrenia

Few studies investigated brain abnormalities in early onset schizophrenia. To assess computed tomography (CT) abnormalities in patients with childhood or adolescence onset schizophrenia. CT scans of patients with childhood (6 to 11 years old) (N=6) or adolescence (12-17 years old) (N=9) schizophrenia were compared to normal controls. Patients were diagnosed based on the DSM-III-R criteria. Ventricular enlargement was measured by the Ventricle to Brain Ratio (VBR) and Cortical Atrophy (pre-frontal prominence) was measured by the Pre-Frontal Atrophy Index (PFAI). There was a significant difference in VBR, but not in PFAI, between subjects and controls [8.26+/-2.79, and 5.71+/-3.26 (p=0.029)], and [2.72+/-1.77, and 3.21+/-1.53 (p=0.424)], respectively. There were no differences of VBR and PFAI between children and adolescents with schizophrenia. Compared to controls, patients with child or adolescent onset schizophrenia exhibit more pronounced ventricular enlargement. There were no differences regarding prefrontal atrophy.

Post-traumatic amnesia predicts long-term cerebral atrophy in traumatic brain injury

Primary objective: To examine post-traumatic amnesia (PTA) and its relation to long-term cerebral atrophy in persons with traumatic brain injury (TBI) using objective indicators of PTA duration and Quantitative Magnetic Resonance Imaging (QMRI). It was hypothesized that longer PTA would predict later generalized atrophy (increased ventricle-to-brain ratio (VBR)). As a guide in assessing patients with TBI, this study determined the probability of developing chronic cerebral atrophy based on PTA duration.Research design: Probability model using 60 adult patients with mild-to-severe TBI.Main outcomes and results: A logistic regression model with a cut-off determined by normative QMRI data confirmed that longer PTA duration predicts increased VBR. A probability model demonstrated a 6% increase in the odds of developing later atrophy on neuroimaging with each additional day of PTA.Conclusions: PTA has previously proven to be a good indicator of later cognitive recovery and functional outcome and also predicts long-term parenchymal change.

Frontal and Temporal Morphometric Findings on MRI in Children after Moderate to Severe Traumatic Brain Injury

In vivo MRI volumetric analysis enables investigators to evaluate the extent of tissue loss following traumatic brain injury (TBI). However, volumetric studies of pediatric TBI are sparse, and there have been no volumetric studies to date in children examining specific subregions of the prefrontal and temporal lobes. In this study, MRI volumetry was used to evaluate brain volume differences in the whole brain, and prefrontal, temporal, and posterior regions of children following moderate to severe TBI as compared to uninjured children of similar age and demographic characteristics. The TBI group had significantly reduced whole brain, and prefrontal and temporal regional tissue volumes as well as increased cerebrospinal fluid (CSF). Confidence interval testing further revealed group differences on gray matter (GM) and white matter (WM) in the superior medial and ventromedial prefrontal regions, WM in the lateral frontal region, and GM, WM, and CSF in the temporal region. Whole brain volume and total brain GM were reduced, and total ventricular volume, total CSF volume, and ventricle-to-brain ratio (VBR) were increased in the TBI group. Additional analyses comparing volumetric data from typically developing children and subgroups of TBI patients with and without regional focal lesions suggested that GM loss in the frontal areas was primarily attributable to focal injury, while WM loss in the frontal and temporal lobes was related to both diffuse and focal injury. Finally, volumetric measures of preserved frontotemporal tissue were related to functional recovery as measured by the Glasgow Outcome Scale (adapted for children) with greater tissue preservation predicting better recovery.

Premorbid Intellectual Functioning, Education, and Brain Size in Traumatic Brain Injury: An Investigation of the Cognitive Reserve Hypothesis

Cognitive reserve theories have been postulated in an attempt to explain individual differences in functional outcome following cerebral insult or disease. These theories suggest that higher education and psychometric intelligence may preserve functional capacity regardless of injury or disease severity. This study investigated cognitive reserve in 25 participants with traumatic brain injury (TBI) using high-resolution magnetic resonance imaging (MRI) analyses. We examined the relationships between total intracranial volume (TICV), ventricle-to-brain ratio (VBR), education level, and standardized testing obtained prior to injury with post-injury cognitive outcome. Participants with lower post-injury IQ scores had significantly lower TICV values, irrespective of injury severity, and experienced significantly greater change in IQ from pre- to post-injury. TICV and education correctly predicted participants' post-injury IQ category (≥ 90 or < 90). However, premorbid standardized testing (PST) scores did not predict cognitive outcome. The results of this study suggest that larger premorbid brain volume and higher education level may decrease vulnerability to cognitive deficits following TBI, consistent with the notion of a cognitive reserve.

White matter lesions, quantitative magnetic resonance imaging, and dementia.

The authors performed quantitative and qualitative image analysis on a sample of the elderly population of Cache County, Utah, relating neuroimaging findings to Mini-Mental Status Examination (MMSE) scores and the presence of the apolipoprotein E epsilon4 allele. Neuroimaging measures included white, gray, and hippocampal volumes; a ventricle-to-brain ratio (VBR); and qualitative ratings of white matter lesions (WMLs) in the periventricular (PV) and centrum semiovale (CS) regions. Subjects included 85 persons with possible and probable Alzheimer disease (AD), 21 with vascular dementia (VaD), 30 with cognitive symptoms classified as mild/ambiguous (M/A), a heterogenous group of 39 non-AD or VaD subjects but diagnosed with some form of neuropsychiatric disorder ("Mixed Neuropsychiatric" group), and 20 normal control subjects aged 65 years or older. Controlling for age, sex, and length of disease, the authors found that AD and VaD subjects differed significantly from control subjects on WMLs, but only the VaD subjects significantly differed from M/A subjects. The two dementia groups also displayed, as expected, significant cerebral atrophy. The WMLs generally increased with age and severity of dementia. PV WMLs were significantly but only modestly associated with white matter volume loss and greater impairment on the MMSE. Modest correlations were also present between the quantitative measures of cerebral structure and MMSE performance. However, when degree of cerebral atrophy was controlled by using the VBR measure, WML effects on MMSE performance became nonsignificant, with the only significant relationship remaining being that between hippocampal volume and MMSE performance. There were no significant qualitative or quantitative findings related to presence of the epsilon4 allele and MMSE performance. The role of WMLs in aging and dementia is discussed.

Determinants of Benton Facial Recognition Test performance in normal adults.

Clinical investigations have found that lesions of the right cerebral hemisphere can disrupt face perception. Much less is known about the determinants of facial discrimination in healthy adults, although age-related differences in many cognitive abilities have been shown to correlate with simple processing speed and variation in regional brain volumes. In this study, 174 healthy adults between the ages of 20 and 92 were asked to match pictures of unfamiliar faces. After their performance was regressed on age, sex, education, and perceptual comparison speed, adding terms for frontal lobe volume, nonfrontal volume, and ventricle-to-brain ratio (VBR) derived from magnetic resonance imaging improved the model and accounted for 35% of the variance in facial discrimination. VBR and processing speed alone accounted for nearly 34% of the variance. These findings suggest that both normal atrophic brain changes and decreases in processing speed contribute to individual differences in facial discrimination.

Computed tomography image analyzer: 3D reconstruction and segmentation applying active contour models — ‘snakes’

Many diagnostic and therapeutic procedures depend on medical images. In order to overcome imperfections of the obtained images, which are due to the acquisition process, and to extract new information from the available images, many techniques have been developed. In this study, a new method of image segmentation and 3D reconstruction based on active contour models (‘snakes’) was applied in analyzing computed tomography (CT) images in patients with acute head trauma. Using this method, lesion to brain (LBR) and ventricle to brain ratio (VBR) parameters, as well as 3D reconstruction of traumatic lesion, was obtained accurately. In our study group, 215 patients (mean age 42.4±23.5 years, 138/215 (64.2%) males) were included. Among them, 72 (33.5%) did not survive during hospitalisation in the Emergency Department. LBR correlated with the Glasgow Coma Score and the intrahospital outcome ( r=−0.457 and r=0.515, respectively). Besides, non-survivors had greater LTB values (0.042±0.034) than survivors (0.005±0.011). However, VBR did not correlate with these clinical parameters. In addition, LBR was significantly higher in the patients with other pathologic CT findings. The proposed methodology, based on extracting maximum information from available CT scans, could be a basis for further medical decision making in patients with acute head trauma.

Frontal lobe membrane phospholipid metabolism and ventricle to brain ratio in schizophrenia: preliminary 31P-MRS and CT studies.

A number of studies employing in vivo phosphorous-31 magnetic resonance spectroscopy (31P-MRS) have demonstrated altered measurements of frontal phospholipid and high energy phosphorus metabolism in schizophrenia. Enlargement of both the cerebroventricular system and the cortical sulci also has been reported as the most consistent pathological finding in schizophrenia by several investigators. To our knowledge, however, only two studies have simultaneously examined structural and functional aspects of the biological substrate of schizophrenia in the same patients. Moreover, they may have failed to find a significant correlation between these variables because of small sample sizes. The possible relationship between frontal lobe membrane phospholipid metabolism and ventricle-to-brain ratio (VBR) in patients with schizophrenia was investigated. In 31 schizophrenic patients, frontal lobe membrane phospholipid metabolism was measured by 31P-MRS, and VBR was measured by computed tomography (CT). Stepwise multiple regression analysis disclosed that VBR positively correlated only with increased phosphodiester (PDE) level (beta = 0.381, p = 0.0345), but with no other metabolites. This finding may provide evidence for an association between structural brain abnormality and altered frontal lobe membrane metabolism in schizophrenic patients, although the p-value of the finding is not high.