Magnetic resonance imaging (MRI) measurements of atrophy in an important area of the brain are an accurate predictor of multiple sclerosis (MS). According to the researchers, these atrophy measurements offer an improvement over current methods for evaluating patients at risk for MS.

MS develops as the body’s immune system attacks and damages myelin, the protective layer of fatty tissue that surrounds nerve cells within the brain and spinal cord. Symptoms include visual disturbances, muscle weakness and trouble with co-ordination and balance. People with severe cases can lose the ability to speak or walk.
Approximately 85 percent of people with MS suffer an initial, short-term neurological episode known as clinically isolated syndrome (CIS). A definitive MS diagnosis is based on a combination of factors, including medical history, neurological exams, development of a second clinical attack and detection of new and enlarging lesions with contrast-enhanced or T2-weighted MRI.
‘For some time we’ve been trying to understand MRI biomarkers that predict MS development from the first onset of the disease,’ said Robert Zivadinov, M.D., Ph.D., FAAN, from the Buffalo Neuroimaging Analysis Center of the University at Buffalo in Buffalo, N.Y. ‘In the last couple of years, research has become much more focused on the thalamus.’
The thalamus is a structure of gray matter deep within the brain that acts as a kind of relay centre for nervous impulses. Recent studies found atrophy of the thalamus in all different MS disease types and detected thalamic volume loss in pediatric MS patients.
‘Thalamic atrophy may become a hallmark of how we look at the disease and how we develop drugs to treat it,’ Dr. Zivadinov said.

For this study, Dr. Zivadinov and colleagues investigated the association between the development of thalamic atrophy and conversion to clinically definite MS.
‘One of the most important reasons for the study was to understand which regions of the brain are most predictive of a second clinical attack,’ he said. ‘No one has really looked at this over the long term in a clinical trial.’

The researchers used contrast-enhanced MRI for initial assessment of 216 CIS patients. They performed follow-up scans at six months, one year and two years. Over two years, 92 of 216 patients, or 42.6 percent, converted to clinically definite MS. Decreases in thalamic volume and increase in lateral ventricle volumes were the only MRI measures independently associated with the development of clinically definite MS.
‘First, these results show that atrophy of the thalamus is associated with MS,’ Dr. Zivadinov said. ‘Second, they show that thalamic atrophy is a better predictor of clinically definite MS than accumulation of T2-weighted and contrast-enhanced lesions.’
The findings suggest that measurement of thalamic atrophy and increase in ventricular size may help identify patients at high risk for conversion to clinically definite MS in future clinical trials involving CIS patients.

‘Thalamic atrophy is an ideal MRI biomarker because it’s detectable at very early stage,’ Dr. Zivadinov said. ‘It has very good predictive value, and you will see it used more and more in the future.’
‘The next step is to look at where the lesions develop over two years with respect to the location of the atrophy,’ Dr. Zivadinov said. ‘Thalamic atrophy cannot be explained entirely by accumulation of lesions; there must be an independent component that leads to loss of thalamus.’ Radiological Society of North America

Identifying the "smell" of different types of lung bacteria could lead to a simple breath test to diagnose infections, a study on mice suggests. Breath analysis could reduce lung infection diagnosis times from weeks to minutes, the Vermont researchers said. Scientists have already researched breath tests to diagnose asthma and cancer. An expert said breath analysis was "an important and emerging field".

Diagnosing bacterial infections traditionally means collecting a sample that is used to grow bacteria in the lab. This bacteria is then tested to classify it and see how it responds to antibiotics, which can take time. Doctors see breath analysis, in contrast, as a fast and non-invasive method of diagnosing diseases.
For the study, researchers from the University of Vermont analysed volatile organic compounds (VOCs) given off in exhaled breath by different bacteria as well as different strains of the same bacterium.

They infected mice with two bacteria that are both common in lung infections – Pseudomonas aeruginosa and Staphylococcus aureus – and sampled their breath after 24 hours.  The compounds in their breath were analysed using a technique called secondary electrospray ionisation mass spectrometry (SESI-MS), which is capable of detecting extremely small elements of the chemicals present in their breath.

The researchers said they found a "statistically significant" difference between the breath profiles of the mice infected with the bacteria and the mice that were uninfected.  They also said they were able to differentiate between two species of bacteria and two different strains of the same P. aeruginosa bacterium.

But Jane Hill, co-author of the study, from the University of Vermont College of Medicine, said there were still some challenges to overcome with "breath-prints".

"We are now collaborating with colleagues to sample patients in order to demonstrate the strengths, as well as limitations, of breath analysis more comprehensively," she said.

Richard Hubbard, professor of respiratory epidemiology at Nottingham City Hospital and a spokesman for the British Lung Foundation, said breath analysis was already being used to diagnose children with asthma.

"Breath analysis is an emerging field and is likely to take off across the board. It could be a very useful tool for children with cystic fibrosis, for example, as a guide on how to treat them," he said.
BBC

A new functional magnetic resonance imaging (fMRI) technique may provide neurosurgeons with a non-invasive tool to help in mapping critical areas of the brain before surgery.
Evaluating brain fMRI responses to a ‘single, short auditory language task’ can reliably localise critical language areas of the brain

Hearts previously rejected due to donors’ age or other risk factors can now be declared viable for transplantation using pharmacological stress echo, according to research presented at EUROECHO and other Imaging Modalities 2012. The study was presented by Dr Tonino Bombardini from Pisa, Italy.
Heart transplantation is an established procedure in patients with end-stage heart failure but it is limited by a severe donor organ shortage. The average age of organ donors has increased and the donor is frequently a patient who died of a stroke. Every year in Europe a pool of