Claudia AM Wheeler-Kingshott, Ph.D.
University Reader in Magnetic Resonance Physics, Department of Neuroinflammation, UCL Institute of Neurology, London, UK
Abstract
Detecting neuronal activity in vivo non-invasively is possible with a number of techniques. Amongst these, in 1990 functional magnetic resonance imaging (fMRI) was proposed as a technique that has a great ability to spatially map brain activity by exploiting the blood oxygenation level dependent (BOLD) contrast mechanism [1, 2]. In fact, neuronal activation triggers a demand for oxygen and induces a localised increase in blood flow and blood volume, which actually exceeds the metabolic needs. This in turns causes an increase of oxyhaemoglobin in the venous compartment, which is a transient phenomenon and is accompanied by a transient change (decrease) in the concentration of deoxyhaemoglobin. Due to its paramagnetic properties, the amount of deoxyhaemoglobin present in the venous blood affects the local magnetic field seen by the spins (protons) and determines the local properties of the MR signal. A decrease in deoxyhaemoglobin during neuronal activity, therefore, induces local variations of this magnetic field that increases the average transverse relaxation time of tissue, measured via the T2* parameter [3]. This means that there is an increase of the MR signal (of the order of a few %, typically <5%) linked to metabolic changes happening during brain function. Activation can be inferred at different brain locations by performing tasks while acquiring the MR signal and comparing periods of rest to periods of activity.
The macroscopic changes of the BOLD signal are well characterised, while the reason for the increased blood supply, exceeding demands, needs further thoughts. Here we will discuss two approaches for explaining the BOLD phenomenon, one that links it to adenosine triphosphate production [4] and enzyme saturation, the other that relates it to the very slow diffusion of oxygen through the blood-brain-barrier with a consequent compensatory high demand of oxygen [5]. Some evidence of restricted oxygen diffusion has been shown by means of hypercapnia [6], although it is not excluded that both mechanisms may be present.
Overall, the BOLD signal changes theory and its physiological basis will be presented and discussed.
References
- Ogawa, S., et al., Brain magnetic resonance imaging with contrast dependent on blood oxygenation. Proc Natl Acad Sci U S A, 1990. 87(24): p. 9868-72.
- Kwong, K.K., et al., Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation. Proc Natl Acad Sci U S A, 1992. 89(12): p. 5675-9.
- Bandettini PA, et al. Spin-echo and gradient-echo EPI of human brain activation using BOLD contrast: a comparative study at 1.5 T. NMR Biomed. 1994 Mar;7(1-2):12-20
- Fox, P.T., et al., Nonoxidative glucose consumption during focal physiologic neural activity. Science, 1988. 241(4864): p. 462-4.
- Gjedde, A., et al. Reduction of functional capillary density in human brain after stroke. J Cereb Blood Flow Metab, 1990. 10(3): p. 317-26.
- Hoge, R.D., et al., Linear coupling between cerebral blood flow and oxygen consumption in activated human cortex. Proc Natl Acad Sci U S A, 1999. 96(16): p. 9403-8.
Jaydeep Unni, Ph.D.
Sr. Project Manager, Robert Bosch Healthcare Systems, Palo Alto, CA
Remote Patient Monitoring – Challenges and Opportunities
Remote Patient Monitoring (RPM) is gaining importance and acceptance with rising number of chronic disease conditions and with increase in the aging population. As instances of Heart diseases, Diabetes etc are increasing the demand for these technologies are increasing. RPM devices typically collect patient vital sign data and in some case also patient responses to health related questions. Thus collected data is then transmitted through various modalities (wireless/Bluetooth/cellular) to Hospitals/Doctor’s office for clinical evaluation. With these solutions Doctors are able to access patient’s vital data ‘any time any where’ thus enabling them to intervene on a timely and effective manner. For older adult population chronic disease management, post-acute care management and safety monitoring are areas were RPM finds application. That said, there are significant challenges in adoption of Remote Patient Monitoring including patient willingness and compliance for adoption, affordability, availability of simpler/smarter technology to mention a few. But experts contend that if implemented correctly Remote Patient Monitoring can contain healthcare expenditure by reducing avoidable hospitalization while greatly improving quality of care.
John Stanley, Satheesh Babu, Ramacahandran T and Bipin Nair
Pt-Pd decorated TiO2 nanotube array for the non-enzymatic determination of glucose in neutral medium
Rapidly expanding diabetic population and the complications associated with elevated glycemic levels necessitates the need for a highly sensitive, selective and stable blood glucose measurement strategy. The high sensitivity and selectivity of enzymatic sensors together with viable manufacturing technologies such as screen-printing have made a great social and economic impact. However, the intrinsic nature of the enzymes leads to lack of stability and consequently reduces shelf life and imposes the need for stringent storage conditions. As a result much effort has been directed towards the development of ‘enzyme-free’ glucose sensors (Park et al. 2006). In this paper, a non-enzymatic amperometric sensor for selective and sensitive direct electrooxidation of glucose in neutral medium was fabricated based on Platinum-Palladium (Pt–Pd) nanoparticle decorated titanium dioxide (TiO2) nanotube arrays. Highly ordered TiO2 nanotube arrays were obtained using a single step anodization process (Grimes C A and Mor G K 2009) over which Pt–Pd nanoparticles where electrochemically deposited. Scanning Electron Microscopy (SEM) analysis revealed the diameter of the TiO2 nanotubes to be approximately 40 nm. Elemental analysis after electrochemical deposition confirms the presence of Pt–Pd. Electrochemical characterization of the sensor was carried out using cyclic voltammetry technique (−1.0 to +1.0V) in phosphate buffer saline (PBS) pH 7.4. All further glucose oxidation studies were performed in PBS (pH 7.4). The sensor exhibited good linear response towards glucose for a concentration range of 1 μM to 20mM with a linear regression coefficient of R = 0.998. The electrodes are found to be selective in the presence of other commonly interfering molecules such as ascorbic acid, uric acid, dopamine and acetamidophenol. Thus a nonenzymatic sensor with good selectivity and sensitivity towards glucose in neutral medium has been developed.