Brain Pressure Study
Overview
Raised intracranial pressure (ICP) is a serious condition that can lead to brain injury, blindness, coma, stroke, or death. Unfortunately, current clinical practices for measuring ICP are invasive, which in-creases the risk of complications. In order to develop a non-invasive proxy measure of ICP, our team is working to create a computational model based on brain motion measurements obtained from advanced MRI.
By leveraging amplified Magnetic Resonance Imaging (aMRI), we can detect subtle motion variations in the brain and quantify these changes to estimate ICP non-invasively. Our team has recently demonstrated a link between ICP and intrinsic brain motion in a pilot study of five IIH patients. We believe that changes in ICP can predictably alter the motion of the brain, which can be visualised and quantified using aMRI.
To validate our computational model, we are acquiring MRI and physiological data from IIH patients before and after lumbar puncture, which reduces ICP to normal levels. By comparing the pre-and post-LP MRI features, we can produce and validate a computational model of brain pressure. Our ultimate goal is to develop a non-invasive method for identifying patients with elevated ICP, which could significantly improve the management of patients with suspected intracranial hypertension. By using non-invasive methods, we can reduce the risk of complications associated with invasive methods while providing accurate and reliable ICP measurements.
Volunteer Eligibility Criteria
We are recruiting Idiopathic Intracranial Hypertension (IIH) patients. As part of patients’ normal clinical work up, newly diagnosed IIH patients will undergo assessments as follows:
• An initial diagnostic MRI scan
• Optic nerve assessment and visual field testing
• Lumbar puncture (LP) with pressure reading
• Follow up MRI scan within 4 hours of LP
Inclusion criteria:
• Age of 16 years and older
• Ability to read and understand the information and tasks in this study
• Clinical signs of raised intracranial pressure as determined by the treating ophthalmologist
Exclusion criteria:
• Contraindications for MRI (such as metal implants)
• History of other drug and alcohol addictions
• History of other neurological disorders
• Any major structural brain abnormalities (e.g., due to surgery or traumatic brain injury)
Control participants will be recruited based on the following:
Inclusion Criteria:
• Age of 16 years and older
• Ability to read and understand the information and tasks in this study
Exclusion criteria:
• Contraindications for MRI
• Prior history of drug and alcohol addictions
• History of other neurological disorders
• Any major structural brain abnormalities (e.g., due to surgery or traumatic brain injury)
Participants will be invited to the Mātai Medical Research Institute in Gisborne for the study. After consultation with the research team, the consent form will be completed and the MRI scan, visual field testing, LP and follow-up MRI will be conducted.
This project is a collaboration between the Auckland Bioengineering Institute and the Auckland Eye Institute; the Faculty of Medical Health Sciences and Centre for Brain Research at the University of Auckland; GE Healthcare; UC San Diego, USA; and the Mātai Medical Research Institute, New Zealand.
Publications:
I. Terem, L. Dang, A. Champagne, J. Abderezaei, A. Pionteck, Z. Almadan, A. Lydon, M. Kurt,M. Scadeng, S.J. Holdsworth. 3D amplified MRI for visualizing pulsatile brain motion. MRM,86(3), 1674-1686;2021.
J. Abderezaei, A. Pionteck, I. Terem,L. Dang, M. Scadeng, P. Morgenstern, R. Shrivastava, S.J.Holdsworth, Y. Yang, M. Kurt. Development, calibration, and validation of 3D aMRI for thequantification of intrinsic brain motion. Brain Multiphysics, 2, 100022, 2021.
I Terem, WW Ni, M Goubran, M. Salmani Rahimi, G. Zaharchuk, KW Yeom, ME Moseley, MKurt, S.J. Holdsworth. Revealing sub-voxel motions of brain tissue using phase-based amplifiedMRI (aMRI). Magnetic Resonance in Medicine (2018).
S.J. Holdsworth, W. Ni, G. Zaharchuk, M. Rahimi, M. Moseley. Amplified Magnetic ResonanceImaging (aMRI), Magnetic Resonance in Medicine, 75(6):2245-54 (2016).
Book Chapter:
H. Kumar, I. Terem, M. Kurt, E. Kwon, S.J. Holdsworth, Amplified MRI and PhysiologicalBrain Tissue Motion; chapter 31, In Press.
Conferences:
1. A. Little, E. Kwon, S. Safaei, G. M Talou, D. Dubowitz, M. Scadeng, SJ Guild, S.J. Holdsworth. Correlating raised intracranial pressure with increased brain motion in a ovine model. ISMRM, London 2022.
2. H. Kumar, M. McDonald, A. Sharifzadeh, J. Wright, E. Kwon, L. Potter, P. Condron, T. Emsden, D. Cornfeld, G. Wilson, D. Freschini, H. Danesh-Meyer, D. Dubowitz, M. Scadeng, S.Holdsworth, SJ Guild, S. Safaei, G. Maso Talou. Alterations of brain motion in idiopathic intracranial hypertension (IIH) based on amplified MRI (aMRI). ISMRM 2023
3. A. Sharifzadeh-Kermani, F. Argus, J. Shen, SJ Guild, Miriam Scadeng, D. Dubowitz, P. Con- dron, E. Kwon, SJ Holdsworth, G. Maso Talou, S. Safaei. Toward a detailed subject-specific cerebrovascular model using Arterial Spin Labeling (ASL) Magnetic Resonance Imaging (MRI). ISMRM 2023
4. H. Kumar, H. Rodgers, Jet Wright, B. Bristow, P. Condron, T. Emsden, D. Taylor, SJ Holdsworth, S. Safaei, G. Maso Talou, J. McGeown, E. Maunder, E. Kwon. Changes in brain pulsatility as- sociated with heartrate elevation using amplified MRI and phase-contrast MRI. ISMRM 2023.
5. I. Terem, N. Wang, K. Younes, P. Condron, J. Abderezaei, M. Kurt, E. Mormino, S. Holdsworth, K Setsompop. 3D quantitative amplified Magnetic Resonance Imaging (3D-q-aMRI). ISMRM 2023.
6. S. Vandenbulcke, P. Condron, H. Kumar, S. Safaei, SJ Holdsworth, J. Degroote, P. Segers. Computational fluid dynamics study to investigate the impact of sudden physiological actions on CSF flow. SB3C2023 Summer Biomechanics, Bioengineering and Biotransport Conference, June 4-8, Vail, CO, USA.
Contact our team
Dr Samantha Holdsworth, Dr Sarah-Jane Guild, Dr Gonzalo Maso Talou, Dr Soroush Safaei, Dr Miriam Scadeng, Dr MatthewMcDonald, Dr Helen Danesh-Meyer, Dr David Dubowitz, Dr Graham Wilson, Alireza Sharif Zadeh-Kermani, Jet Wright, Dr Haribalan Kumar, Dr Eryn Kwon, Paul Condron, Dr Daniel Cornfeld, DrDavid Freschini, Professor Richard Buxton.
Principal Investigator
Dr Samantha Holdsworth
s.holdsworth@matai.org.nz or s.holdsworth@auckland.ac.nz
