The effect of diffusion gradient direction number on corticospinal tractography in the human brain: an along-tract analysis

Objectives

We evaluated diffusion imaging measures of the corticospinal tract obtained with a probabilistic tractography algorithm applied to data of two acquisition protocols based on different numbers of diffusion gradient directions (NDGDs).

Materials and methods

The corticospinal tracts (CST) of 18 healthy subjects were delineated using 22 and 66-NDGD data. An along-tract analysis of diffusion metrics was performed to detect possible local differences due to NDGD.

Results

FA values at 22-NDGD showed an increase along the central portion of the CST. The mean of partial volume fraction of the orientation of the second fiber (f2) was higher at 66-NDGD bilaterally, because for 66-NDGD data the algorithm more readily detects dominant fiber directions beyond the first, thus the increase in FA at 22-NDGD is due to a substantially reduced detection of crossing fiber volume. However, the good spatial correlation between the tracts drawn at 22 and 66 NDGD shows that the extent of the tract can be successfully defined even at lower NDGD.

Conclusions

Given the spatial tract localization obtained even at 22-NDGD, local analysis of CST can be performed using a NDGD compatible with clinical protocols. The probabilistic approach was particularly powerful in evaluating crossing fibers when present.

     

Ultra-high field diffusion tensor imaging of articular cartilage correlated with histology and scanning electron microscopy

Object

To investigate the relationship of the different diffusion tensor imaging (DTI) parameters (ADC, FA, and first eigenvector (EV)) to the constituents (proteoglycans and collagen), the zonal arrangement of the collagen network, and mechanical loading of articular cartilage.

Material and methods

DTI of eight cartilage-on-bone samples of healthy human patellar cartilage was performed at 17.6 T. Three samples were additionally imaged under indentation loading. After DTI, samples underwent biomechanical testing, safranin-O staining for semiquantitative proteoglycan estimation, and scanning electron microscopy (SEM) for depicting collagen architecture.

Results

From the articular surface to the bone–cartilage interface, ADC continuously decreased and FA increased. Cartilage zonal heights calculated from EVs strongly correlated with SEM-derived zonal heights (P r ²=0.87). Compression reduced ADC in the superficial 30% of cartilage and increased FA in the superficial 5% of cartilage. Reorientation of the EVs indicative of collagen fiber reorientation under the indenter was observed. No significant correlation was found between ADC, FA, and compressive stiffness.

Conclusions

Correlating ADC and FA with proteoglycan and collagen content suggests that diffusion is dominated by different depth-dependent mechanisms within cartilage. Knowledge of the spatial distribution of the DTI parameters and their variation contributes to form a database for future analysis of defective cartilage.     

Diffusion property differences of the lower leg musculature between athletes and non-athletes using 1.5T MRI

Object

To compare the differences in diffusion properties—namely fractional anisotropy (FA), three eigenvalues of the diffusion tensor (λ1, λ2, and λ3), and apparent diffusion coefficient (ADC)—between athletically-trained and untrained lower leg musculature.

Materials and methods

Twelve athletes (Group A) and 11 non-athletes (Group B) were recruited. All were females in their 20s. We scanned diffusion tensor images of both calves and compared FA, the three eigenvalues, and ADC in the gastrocnemius medialis, gastrocnemius lateralis, soleus (SOL), and anterior tibialis muscles between Groups A and B, and between the right and left sides, using two-factor fractional ANOVA.

Results

In all muscles of bilateral calves, all three eigenvalues and ADC were lower in Group A than in Group B, with statistically significant differences in all muscles for λ1, λ2, and λ3 and ADC, with a P value of <0.01. Moreover, statistical differences were also found between right and left for λ1, λ2, and λ3 (P?P?Conclusions Our results indicate that training causes a decrease of the three eigenvalues and ADC, which we hypothesize is due to an increase of density of myofilaments in the intracellular space, and deformation of the cell induced by enlargement of extracellular components.     

Quantitative breast MRI: 2D histogram analysis of diffusion tensor parameters in normal tissue

Object

Diffusion tensor imaging (DTI) of the breast may provide a powerful new approach for the detection of intraductal processes. The aim of this investigation was to characterize the relation between diffusion tensor parameters [fractional anisotropy (FA), mean diffusivity (MD)] in normal breast tissue to obtain information on the microenvironment of the diffusing water molecules and to provide a systematic approach for DTI analysis.

Materials and methods

Seven female, healthy volunteers underwent prospective double-spin-echo prepared echo-planar diffusion-weighted sequence (TR/TE 8,250 ms/74 ms, b values 0 and 500 s/mm (2), six encoding directions, 12 averages, 35 slices) in 4 consecutive weeks (3.0 T). Quantitative maps of diffusion tensor parameters were computed offline with custom routines. The interdependence of MD and FA in different voxels was analysed by linear and exponential regression.

Results

All MD and FA maps were of excellent quality. A consistent pattern was observed in that lower fractional anisotropy values were more likely associated with higher mean diffusivity values. The dependence exhibited an exponential behavior with a correlation coefficient R = 0.60 (R linear = 0.57).

Conclusion

The likelihood with which FA and MD values are observed in a voxel within normal breast tissue is characterized by a specific pattern, which can be described by an exponential model. Moreover, we could show that the proposed technique does not depend on the menstrual cycle.     

An embedded optical tracking system for motion-corrected magnetic resonance imaging at 7T

Object

Prospective motion correction using data from optical tracking systems has been previously shown to reduce motion artifacts in MR imaging of the head. We evaluate a novel optical embedded tracking system.

Materials and methods

The home-built optical embedded tracking system performs image processing within a 7T scanner bore, enabling high speed tracking. Corrected and uncorrected in vivo MR volumes are acquired interleaved using a modified 3D FLASH sequence, and their image quality is assessed and compared.

Results

The latency between motion and correction of the slice position was measured to be (19?±?5)?ms, and the tracking noise has a standard deviation no greater than 10???m/0.005° during conventional MR scanning. Prospective motion correction improved the edge strength by 16?% on average, even though the volunteers were asked to remain motionless during the acquisitions.

Conclusion

Using a novel method for validating the effectiveness of in vivo prospective motion correction, we have demonstrated that prospective motion correction using motion data from the embedded tracking system considerably improved image quality.     

Spatial phase encoding exploiting the Bloch–Siegert shift effect

Objective

The present work introduces an alternative to the conventional \(B_{0}\) -gradient spatial phase encoding technique. By applying far off-resonant radiofrequency (RF) pulses, a spatially dependent phase shift is introduced to the on-resonant transverse magnetization. This so-called Bloch–Siegert (BS) phase shift has been recently used for \(B_{1}^{ + }\) -mapping. The current work presents the theoretical background for the BS spatial encoding technique (BS-SET) using RF-gradients.

Materials and methods

Since the BS-gradient leads to nonlinear encoding, an adapted reconstruction method was developed to obtain undistorted images. To replace conventional phase encoding gradients, BS-SET was implemented in a two-dimensional (2D) spin echo sequence on a 0.5 T portable MR scanner.

Results

A 2D spin echo (SE) measurement imaged along a single dimension using the BS-SET was compared to a conventional SE 2D measurement. The proposed reconstruction method yielded undistorted images.

Conclusions

BS-gradients were demonstrated as a feasible option for spatial phase encoding. Furthermore, undistorted BS-SET images could be obtained using the proposed reconstruction method.     

Assessment of diffusion tensor imaging indices in calf muscles following postural change from standing to supine position

Object

To investigate whether postural change from erect to recumbent position affects calf muscle water diffusivity.

Materials and methods

Ten healthy adults (27.2 ± 4.9 years, 3 females) were imaged at baseline (following assumption of recumbent position), and after 34 min (session 2) and 64 min (session 3) of laying supine within a 3T MRI scanner. Diffusion tensor imaging (DTI) eigenvalues, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were evaluated in five calf muscles (anterior and posterior tibialis and triceps surae) during each of the three imaging sessions.

Results

Significant decreases were observed in all of the eigenvalues and ADC in each of the muscles with postural change. These reductions ranged from 3.2 to 6.7 % and 3.4 to 7.5 % for the various DTI metrics, following 34 and 64 min of supine rest, respectively (P < 0.05). No significant differences were noted in ADC or eigenvalues between the second and third imaging sessions for any muscle. FA did not change significantly with postural manipulation in any muscle compartment.

Conclusion

Diffusion tensor imaging indices were altered with postural change. As differences were not apparent between the latter two imaging sessions, we suggest that a short supine resting period (~34 min) is sufficient for muscle diffusivity to stabilize prior to quantitative MR imaging in healthy young adults.     

Spatially resolved kinetics of skeletal muscle exercise response and recovery with multiple echo diffusion tensor imaging (MEDITI): a feasibility study

Objectives

We describe measurement of skeletal muscle kinetics with multiple echo diffusion tensor imaging (MEDITI). This approach allows characterization of the microstructural dynamics in healthy and pathologic muscle.

Materials and methods

In a Siemens 3-T Skyra scanner, MEDITI was used to collect dynamic DTI with a combination of rapid diffusion encoding, radial imaging, and compressed sensing reconstruction in a multi-compartment agarose gel rotation phantom and within in vivo calf muscle. An MR-compatible ergometer (Ergospect Trispect) was employed to enable in-scanner plantar flexion exercise. In a HIPAA-compliant study with written informed consent, post-exercise recovery of DTI metrics was quantified in eight volunteers. Exercise response of DTI metrics was compared with that of T2-weighted imaging and characterized by a gamma variate model.

Results

Phantom results show quantification of diffusivities in each compartment over its full dynamic rotation. In vivo calf imaging results indicate larger radial than axial exercise response and recovery in the plantar flexion-challenged gastrocnemius medialis (fractional response: nT2w?=?0.385?±?0.244, nMD?=?0.163?±?0.130, nλ₁?=?0.110?±?0.093, nλ_rad?=?0.303?±?0.185). Diffusion and T2-weighted response magnitudes were correlated (e.g., r?=?0.792, p?=?0.019 for nMD vs. nT2w).

Conclusion

We have demonstrated the feasibility of MEDITI for capturing spatially resolved diffusion tensor data in dynamic systems including post-exercise skeletal muscle recovery following in-scanner plantar flexion.

     

Practical considerations for in vivo MRI with higher dimensional spatial encoding

Object

This work seeks to examine practical aspects of in vivo imaging when spatial encoding is performed with three or more encoding channels for a 2D image.

Materials and methods

The recently developed 4-Dimensional Radial In/Out (4D-RIO) trajectory is compared in simulations to an alternative higher-order encoding scheme referred to as O-space imaging. Direct comparison of local k-space representations leads to the proposal of a modification to the O-space imaging trajectory based on a scheme of prephasing to improve the reconstructed image quality. Data were collected using a 4D-RIO acquisition in vivo in the human brain and several image reconstructions were compared, exploiting the property that the dense encoding matrix, after a 1D or 2D Fourier transform, can be approximated by a sparse matrix by discarding entries below a chosen magnitude.

Results

The proposed prephasing scheme for the O-space trajectory shows a marked improvement in quality in the simulated image reconstruction. In experiments, 4D-RIO data acquired in vivo in the human brain can be reconstructed to a reasonable quality using only 5?% of the encoding matrix??massively reducing computer memory requirements for a practical reconstruction.

Conclusion

Trajectory design and reconstruction techniques such as these may prove especially useful when extending generalized higher-order encoding methods to 3D images.     

Spatial analysis of diffusion tensor tractography statistics along the inferior fronto-occipital fasciculus with application in progressive supranuclear palsy

Background

The purpose of the study was to develop a method for analysis of diffusion parameters along white matter (WM) tracts, using spatial normalization based on anatomical landmarks, and to introduce the apparent area coefficient (AAC). The method’s applicability was tested in the inferior fronto-occipital fasciculus (IFO) in patients with progressive supranuclear palsy (PSP) and healthy controls (HCs).

Methods

A framework for analysis of diffusion parameters was developed. Spatial normalization of the tracts was performed using anatomical landmarks, to avoid deformations caused by cerebral atrophy. Initially, 38 HCs were used to optimize a threshold for the minimal size of regions that differ between groups. The fractional anisotropy, mean diffusivity, AAC, and the hemispheric asymmetry index (AI), were compared between 11 PSP patients and 15 HCs.

Results

The method was feasible for analysis of PSP patients and HCs. The AI showed that the observed hemispheric asymmetry of AAC was significantly larger in PSP patients compared with HCs in small regions of the IFO.

Conclusions

The method was successfully employed for analysis of diffusion parameters along the IFO in a patient group. This method can be potentially useful in studies of WM diseases, with or without cerebral atrophy.     

Iterative separation of transmit and receive phase contributions and B 1 + -based estimation of the specific absorption rate for transmit arrays

Object

The specific absorption rate (SAR) can be determined from radiofrequency transmit fields measured via magnetic resonance imaging.

Materials and methods

The proposed method estimates the SAR solely from the complex transmit field (B ₁ ⁺ ) by taking into account the particular properties of the electromagnetic field generated by an 8-channel transmit array. It is further based on an iterative consistency check between the measured B ₁ ⁺ magnitude and an appropriate field estimate fulfilling Maxwell’s equations. For testing the method, simulations and phantom experiments were performed for a multi-transmit array at 3T using a cylindrical phantom.

Results

The method’s robustness with respect to the assumptions made about electric tissue properties as well as its stability under different initial conditions regarding the signal phase was shown. A high sensitivity to signal noise was found. Robust reconstruction results were achieved including information from more than two transmit elements. The validity of the experimental results was confirmed by a qualitative comparison to simulated electromagnetic fields.

Conclusions

The method allows the determination of the SAR as well as the transmit phase of the individual channels of a multi-transmit array. With additional B₀ inhomogeneity measurements, a reconstruction of the receive phase is feasible independent of the receive coil type in use.     

Characterization of the impact to PET quantification and image quality of an anterior array surface coil for PET/MR imaging

Object

The aim of this study was to determine the impact to PET quantification, image quality and possible diagnostic impact of an anterior surface array used in a combined PET/MR imaging system.

Materials and methods

An extended oval phantom and 15 whole-body FDG PET/CT subjects were re-imaged for one bed position following placement of an anterior array coil at a clinically realistic position. The CT scan, used for PET attenuation correction, did not include the coil. Comparison, including liver SUV_mean, was performed between the coil present and absent images using two methods of PET reconstruction. Due to the time delay between PET scans, a model was used to account for average physiologic time change of SUV.

Results

On phantom data, neglecting the coil caused a mean bias of ?8.2 % for non-TOF/PSF reconstruction, and ?7.3 % with TOF/PSF. On clinical data, the liver SUV neglecting the coil presence fell by ?6.1 % (±6.5 %) for non-TOF/PSF reconstruction; respectively ?5.2 % (±5.3 %) with TOF/PSF. All FDG-avid features seen with TOF/PSF were also seen with non-TOF/PSF reconstruction.

Conclusion

Neglecting coil attenuation for this anterior array coil results in a small but significant reduction in liver SUV_mean but was not found to change the clinical interpretation of the PET images.     

High-resolution 3D whole-heart coronary MRA: a study on the combination of data acquisition in multiple breath-holds and 1D residual respiratory motion compensation

Object

To study a scan protocol for coronary magnetic resonance angiography based on multiple breath-holds featuring 1D motion compensation and to compare the resulting image quality to a navigator-gated free-breathing acquisition. Image reconstruction was performed using L1 regularized iterative SENSE.

Materials and methods

The effects of respiratory motion on the Cartesian sampling scheme were minimized by performing data acquisition in multiple breath-holds. During the scan, repetitive readouts through a k-space center were used to detect and correct the respiratory displacement of the heart by exploiting the self-navigation principle in image reconstruction. In vivo experiments were performed in nine healthy volunteers and the resulting image quality was compared to a navigator-gated reference in terms of vessel length and sharpness.

Results

Acquisition in breath-hold is an effective method to reduce the scan time by more than 30 % compared to the navigator-gated reference. Although an equivalent mean image quality with respect to the reference was achieved with the proposed method, the 1D motion compensation did not work equally well in all cases.

Conclusion

In general, the image quality scaled with the robustness of the motion compensation. Nevertheless, the featured setup provides a positive basis for future extension with more advanced motion compensation methods.     

Diffusion time dependence of magnetic resonance diffusion signal decays: an investigation of water exchange in human brain in vivo

Object

To understand the behavior of diffusion signal decays of water in white matter of human brain in vivo and to estimate tissue microstructure parameters such as exchange time of diffusing water molecules in human brain.

Materials and methods

Diffusion decays were measured over an extended range of diffusion weightings (b-values) up to a maximum of 12,500?s/mm² and diffusion times between 19.9 and 53.8?ms in eight healthy human subjects using MRI scans. The diffusion signal decays were all Rician noise corrected and then analyzed using multi-component non-negative least squares (NNLS) data analysis.

Results

Three diffusion coefficients including one at (0.930?±?0.003)?×?10^?3 (80?±?1%)?mm²/s, another at (0.067?±?0.002)?×?10^?3 (19?±?1%)?mm²/s and a small contribution at (1.20?±?0.02)?×?10^?2 (1.00?±?0.01%)?mm²/s were observed in the diffusion decay using the highest b-value. The diffusion decays show diffusion time dependence for the slow diffusion coefficient which has not previously been reported.

Conclusion

This study presents the accurate diffusion parameters by the use of very large b-values along with Rician noise correction and multi-component data analysis. The experimental results are consistent with the theoretical predictions used to estimate the exchange time of diffusing water molecules for a model of human brain tissue.     

Impact of number of channels on RF shimming at 3T

Object

At high-field strengths (≥3T) inhomogeneity of the radio frequency (RF) field and RF power deposition become increasingly problematic. Parallel Transmission (PTx)—the use of segmented transmission arrays with independently driven elements—affords the ability to combat both of these issues. There are a variety of existing designs for PTx coils, ranging from systems with two channels to systems with eight or more. In this work, we have investigated the impact of the number of independent channels on the achievable results for both homogeneity improvement and power reduction in vivo.

Materials and methods

A 3T Philips Achieva MRI system fitted with an 8-channel PTx body coil was driven so as to emulate configurations with 1, 2 4 and 8 independent channels. RF shimming was used in two different anatomies in order to assess improvements in RF homogeneity.

Results

Significant homogeneity improvements were observed when increasing from 1 to 2, 2 to 4, and 4 to 8 channel configurations. Reductions in RF power requirements and local SAR were predicted for increasing numbers of channels.

Conclusion

Increasing the number of RF transmit channels adds extra degrees of freedom which can be used to benefit homogeneity improvement or power reduction for body imaging at 3T.     

Magnetic resonance imaging in patients with granulomatosis with polyangiitis (Wegener’s) and subglottic stenosis

Objective

To evaluate the ability of MRI to detect subglottic stenosis and to differentiate between active and inactive subglottic inflammation in patients with granulomatosis with polyangiitis (GPA).

Materials and methods

MRI studies of the larynx of 18 GPA patients with suspected SGS were included. The MRI protocol included T1- and T2-weighted and STIR-sequences, dynamic contrast enhancement (DCE) and diffusion weighted imaging (DWI). Two independent observers reviewed the MR images. SGS were identified and quantified, inflammatory activity was assessed using edema imaging, DCE and DWI. Final MRI diagnoses were compared to the clinical, laryngoscopic and histopathologic results.

Results

MRI confirmed SGS in all GPA patients with significant narrowing of the airway lumen and thickening of subglottic wall. Assessing the subglottic inflammatory activity, MRI showed a sensitivity of 87.5 % and a specificity of 60.0 %. Interrater agreement was κ = 0.769. Of the different MR technical approaches tested, edema imaging was most sensitive and specific. DWI led to significant differences in the apparent diffusion coefficient between active and inactive subglottic inflammation. No significant differences were found with DCE imaging.

Conclusion

MR imaging has shown the ability to detect and grade SGS in patients with GPA. It non-invasively assesses the status of inflammatory activity utilizing edema sensitive sequences and DWI.     

Evaluation of an attenuation correction method for PET/MR imaging of the head based on substitute CT images

Object

The aim of this study was to evaluate MR-based attenuation correction of PET emission data of the head, based on a previously described technique that calculates substitute CT (sCT) images from a set of MR images.

Materials and methods

Images from eight patients, examined with ¹⁸F-FLT PET/CT and MRI, were included. sCT images were calculated and co-registered to the corresponding CT images, and transferred to the PET/CT scanner for reconstruction. The new reconstructions were then compared with the originals. The effect of replacing bone with soft tissue in the sCT-images was also evaluated.

Results

The average relative difference between the sCT-corrected PET images and the CT-corrected PET images was 1.6 % for the head and 1.9 % for the brain. The average standard deviations of the relative differences within the head were relatively high, at 13.2 %, primarily because of large differences in the nasal septa region. For the brain, the average standard deviation was lower, 4.1 %. The global average difference in the head when replacing bone with soft tissue was 11 %.

Conclusion

The method presented here has a high rate of accuracy, but high-precision quantitative imaging of the nasal septa region is not possible at the moment.     

Mapping fine-scale anatomy of gray matter,white matter,and trigeminal-root region applying spherical deconvolution to high-resolution 7-T diffusion MRI

Objectives

We assessed the use of high-resolution ultra-high-field diffusion magnetic resonance imaging (dMRI) to determine neuronal fiber orientation density functions (fODFs) throughout the human brain, including gray matter (GM), white matter (WM), and small intertwined structures in the cerebellopontine region.

Materials and methods

We acquired 7-T whole-brain dMRI data of 23 volunteers with 1.4-mm isotropic resolution; fODFs were estimated using constrained spherical deconvolution.

Results

High-resolution fODFs enabled a detailed view of the intravoxel distributions of fiber populations in the whole brain. In the brainstem region, the fODF of the extra- and intrapontine parts of the trigeminus could be resolved. Intrapontine trigeminal fiber populations were crossed in a network-like fashion by fiber populations of the surrounding cerebellopontine tracts. In cortical GM, additional evidence was found that in parts of primary somatosensory cortex, fODFs seem to be oriented less perpendicular to the cortical surface than in GM of motor, premotor, and secondary somatosensory cortices.

Conclusion

With 7-T MRI being introduced into clinical routine, high-resolution dMRI and derived measures such as fODFs can serve to characterize fine-scale anatomic structures as a prerequisite to detecting pathologies in GM and small or intertwined WM tracts.

     

Distribution and fibre field similarity mapping of the human anterior commissure fibres by diffusion tensor imaging

Object

The anterior commissure is a critical interhemispheric pathway in animals, yet its connections in humans are not clearly understood. Its distribution has shown to vary greatly between species, and it is thought that in humans it may convey axons from a larger territory than previously thought. The aim was to use an anatomical mapping tool to look at the anterior commissure fibres and to compare the distribution findings with published anatomical understanding.

Materials and methods

Two different diffusion-weighted imaging data sets were acquired from eight healthy subjects using a 3 Tesla MR scanner with 32 gradient directions. Diffusion tensor imaging tractography was performed, and the anterior commissure fibres were selected using three-dimensional regions of interest. Distribution of the fibres was observed by means of registration with T2-weighted images. The fibre field similarity maps were produced for five of the eight subjects by comparing each subject’s fibres to the combined map of the five data sets.

Results

Fibres were shown to lead into the temporal lobe and towards the orbitofrontal cortex in the majority of subjects. Fibres were also distributed to the parietal or occipital lobes in all five subjects in whom the anterior commissure was large enough for interhemispheric fibres to be tracked through. The fibre field similarity maps highlighted areas where the local distances of fibre tracts were displayed for each subject compared to the combined bundle map.

Conclusion

The anterior commissure may play a more important role in interhemispheric communication than currently presumed by conveying axons from a wider territory, and the fibre field similarity maps give a novel approach to quantifying and visualising characteristics of fibre tracts.     

A multimodal imaging approach to the evaluation of post-traumatic epilepsy

Object

Electroencephalography-functional magnetic resonance imaging (EEG-fMRI) coregistration and high-density EEG (hdEEG) can be combined to map noninvasively abnormal brain activation elicited by epileptic processes. By combining noninvasive imaging techniques in a multimodal approach, we sought to investigate pathophysiological mechanisms underlying epileptic activity in seven patients with severe traumatic brain injury.

Materials and methods

Standard EEG and fMRI data were acquired during a single scanning session. The EEG-fMRI data were analyzed using the general linear model and independent component analysis. Source localization of interictal epileptiform discharges (IEDs) was performed using 256-channel hdEEG. Blood oxygenation level dependent (BOLD) localizations were then compared to EEG source reconstruction.

Results

On hdEEG, focal source localization was detected in all seven patients; in six out of seven it was concordant with the expected epileptic activity as defined by EEG data and clinical evaluation; and in four out of seven in whom IEDs were recorded, BOLD signal changes were observed. These activities were partially concordant with the source localization.

Conclusion

Multimodal integration of EEG-fMRI and hdEEG combining two different methods to localize the same epileptic foci appears to be a promising tool to noninvasively map abnormal brain activation in patients with post-traumatic brain injury.