MRI-Analysis of Neurodevelopmental Inversion of Allocortex for Fast Screening of Seizure Patients: A Clinical Informatics Approach
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National Brain Research Centre, Manesar (Delhi NCR), India
INTRODUCTION:
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As the world population grows, there is demographic explosion of chronic diseases, as disorders of the developing or ageing brain, especially neurodevelopmental or neurodegenerative diseases. Among the neurodevelopmental disorders is Epilepsy, the most common chronic brain dysfunction with the largest global neurological disease burden. There is 50 million people having epileptic involvement, double than the population of Alzheimer’s disease (Newton and Garcia, 2012). The percentage of patients without proper treatment (“treatment-gap”) is considerable, viz. 95% and 60% in India and Spain respectively. Much common is psychomotor or temporal lobe epilepsy (TLE), which needs to be identified or screened rapidly in a mass-scale setting at district-hospital level where there is facility of only plain brain scans (MRI/CT), without availability of customary time-consuming 3-D image analysis or morphometry. Thus the need of speedy single-slice methodology for screening, robustly implementable multicentrically.
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METHODS:
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The cortical expansion of the growing cerebrum is analyzed from a neurodevelopmental perspective of germinal neurogenesis and pruning, whereby epileptic temporal lobe dysfunction is formulated in terms of geometric malrotation of the inversion of allocortex. Possible neurodevelopmental biomarkers of TLE are deduced, in terms of 2-D rotational angles and 1-D ratiometry of the allocortex regions, which we can swiftly measure in a single MRI slice using FLASH T1 pulse sequence, with the pertinent allocortex being amygdala, hippocampus and parahippocampus. To test for large-scale multicentric applicability, our topographic analysis (Dutta et al, 2015) is implemented as an India Brain Grid initiative, with 57 patients of TLE, the grid being the national-level multicentric neuroinformatics analysis platform across different regions: North (Delhi NCR), East (Calcutta), West (Bombay), South (Bangalore). We develop the architecture via Linux-Apache-MySQL-PHP bundle, using Indian National Knowledge Network connectivity and C-Brain MNI prototype system. For this study, the investigating centres are Delhi (NBRC) and Calcutta (IPGMER).
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RESULTS:
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We form a model of neurogenesis from germinal subventricular/subgranular zone and show how neuro-developmental impediment induces cortical dysgenesis, reduced allocortex inversion and torsion effect on paleocortex/archicortex (amygdala/hippocampus/parahippocampus). Torsion alters the ratiometry and angulation of parahippocampus and hippocampus respectively, which we can accurately delineate in single-slice brain MRI scan readily. In neurodevelopmental phase of infants, one knows that left cerebrum has higher haemodynamic stress, as left common carotid artery is a direct branch of aorta, unlike right artery (Arditi et al, 2007). So the neurodevelopmental inversion will be more retarded on left side in TLE. Thereby, hippocampal angular rotation is to be less on left than right in TLE, and we confirm this prediction by MRI analysis. Via the Brain Grid, we enable fast standardized accession of imaging data across distant regions (40-50 sec), whilst ratiometric and angulation thresholds can be delineated for characterizing TLE patients.
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CONCLUSION:
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Feasibility of an affordable country-wide Indian Brain Grid is enabled, for rapid multi-centric collaboration and analysis, e.g. fast epilepsy screening via neurodevelopmental distortion analysis. This neuroinformatics infrastructure is expandable to other neurological and psychiatric disorders for national-level imaging trials.
Acknowledgements
Appreciation is extended for sponsorship of the work by Office of Principal Scientific Adviser and National Knowledge Network Initiative, Government of India, and by the Clinical Glue-Grant Scheme, Dept. of Biotechnology, Govt. of India. Furthermore, support has been obtained from the Perception Engineering Program, Ministry of Information Technology, Govt. of India. Additional provision was obtained from Tata Innovation Project Fund (DBT), Ministry of Science & Technology, Govt. of India.
References
Arditi, H., Feldman, R., Hammerman, C. and Eidelman, A. (2007).Cerebral bood-flow asymmetry, neurobehavioral maturation and cognitive development of premature infants across first two years. J Dev Behav Pediatr 28, 362-368.
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Datta, S., Chakraborty, S, Mulpuru, S., Basu, S., Tiwary,B., Chakrabarti, N., and Roy, P. K. (2015). MRI characteristics of temporal lobe epilepsy using rapidly-measurable spatial indices with hemispheric asymmetry and gender features. Neuroradiology [journal in press].
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Newton, C., and Garcia, H. (2012). Epilepsy in poor regions of the world. Lancet 380, 1193-1201.
Keywords:
neurodevelopmental disorder,
MRI,
Hippocampus,
Amygdala,
Brain grid,
Epilepsy screening,
Embryonic inversion of allocortex,
parahippocampus
Conference:
Neuroinformatics 2015, Cairns, Australia, 20 Aug - 22 Aug, 2015.
Presentation Type:
Poster, to be considered for oral presentation
Topic:
Clinical neuroscience
Citation:
Roy
PK
(2015). MRI-Analysis of Neurodevelopmental Inversion of Allocortex for Fast Screening of Seizure Patients: A Clinical Informatics Approach.
Front. Neurosci.
Conference Abstract:
Neuroinformatics 2015.
doi: 10.3389/conf.fnins.2015.91.00006
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Received:
13 May 2015;
Published Online:
05 Aug 2015.
*
Correspondence:
Prof. Prasun K Roy, National Brain Research Centre, Manesar (Delhi NCR), Haryana, 122051, India, prasunkumarroy@gmail.com