Apple Computers - Streamlining Neuroimaging
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At a Glance

Radiologist Nouchine Hadjikhani studies migraines and the way the
brain perceives body language at the Martinos Center for Biomedical
Imaging at Massachusetts General Hospital, a teaching hospital
affiliated Harvard Medical School. She uses NeuroLens, a powerful Mac-
only 3D neuroimaging program, to view and analyze MRI scans before
using UNIX programs like FS-FAST and Freesurfer for detailed data
analysis. With the application running on a dual-processor Power Mac
G5, she now has a quick, reliable way to preview her scans.

Using QUOSA to Track Down Research Materials
When Hadjikhani wants to know what her contemporaries are up to, she
turns to QUOSA. The program enables her to quickly search and
download full journal articles in PDF form. She searches directly in
PubMed, and with one click QUOSA retrieves all of the full articles
she has selected, automatically integrating with Harvard Medical
School's vast library of research publications.

QUOSA can also automate full-article retrieval from OVID and other
databases. Once the articles have been downloaded, QUOSA
automatically indexes them for further searching. From there,
Hadjikhani can use Boolean and proximity search to pinpoint the
information she needs.

With one click, she can also create records for all of these articles
in EndNote, including an automatically inserted link to the saved PDF
retrieved by QUOSA. "It's a very valuable tool for research," says
Hadjikhani. "I don't know what I would do without it."

QUOSA's new integration of Mac OS X Tiger's Spotlight functionality
allows users to search the full text of any documents on their
computer — including PDF, html, email, Word, PowerPoint, etc. — as
well as to do automatic highlighting and one-click navigation to the
most relevant sections of a document, rapid screening and drag and
drop organization into fully indexed folders.



Nouchine Hadjikhani
Streamlining Neuroimaging
By Dustin Driver


Dr. Nouchine Hadjikhani reads minds. As a radiologist at the Martinos
Center for Biomedical Imaging at Massachusetts General Hospital
(MGH), a teaching hospital affiliated with the Harvard Medical School
(HMS), she seeks through the use of MRI to unravel the mystery of
migraines and to understand how people perceive and process body
language.

Hadjikhani recently started using NeuroLens, a powerful Mac-only 3D
neuroimaging application, which she runs on a Power Mac G5 desktop
system and which has become a vital tool for her research. "I look at
everything I do with NeuroLens," she says. She currently uses
NeuroLens to get an almost instant preview of her functional MRI
results before doing additional analyses using established UNIX
packages like FS-FAST and Freesurfer.

"The first time I saw NeuroLens on the Mac I was so shocked. Normally
it would take several days before I could look at the results. Now I
come back from the scanner with a CD loaded with files and put it in
the Power Mac computer and click on NeuroLens and in less than 10
minutes I have the results."

From Positron Emission to MRI
During her post-doctoral work in Sweden, Hadjikhani used positron
emission tomography to scan the visual cortex of the brain. It was
the first time she got to peek into someone's head. "I was trying to
understand how vision and touch are connected," she says. "When you
put your hand in your pocket and you feel your key, you know which
one it is even though you don't see it. The question was, how can you
visualize what you feel with your hand?"

In 1995, she had her first encounter with MRI. "That was quite
something," she says. "I was in the magnet myself and they showed me
an image of my own brain. It was a very impressive moment. Suddenly
you can have somebody alive and look at different things in the
brain. There's no danger and you can repeatedly get data about how
the brain is organized."

She now uses her skills in her role as an assistant professor in
radiology at HMS, where she has been working since 1996. Her
knowledge of the visual cortex and expertise with MRI machines would
lead her to one of the most mundane, yet mysterious, of human
ailments: the migraine.

Using MRI to Study Migraines
Most migraines arise without warning, but about 10 percent of
migraine victims see flickering lights, called scintillations or
aura, 20 minutes before an attack. Hadjikhani's task was to capture
some of these auras using MRI. Luckily, she had a patient who could
reliably induce an aura and the following migraine — by playing
basketball. "We have a little court next to the lab," says
Hadjikhani. "He agreed to play for us. We rushed him into the magnet
and started to image. It was one of the first times that anybody had
seen a migraine in an MRI."

The image was surprising. Hadjikhani and her peers now think that
migraines with aura are triggered by a phenomenon called cortical
spreading depression. Essentially, something lights a fuse that sets
off a cascade of neural fireworks in and around the visual cortex.
Hadjikhani and others believe that cortical spreading depression
leaves chemical fallout that aggravates the meninges, which contain a
network of nerves and blood vessels that surround the brain. This
fallout may trigger migraine pain.

In the future, Hadjikhani's migraine work could lead to drugs that
squelch cortical spreading depression. "There's evidence that if you
use drugs that stabilize the neural membrane you can actually
diminish migraine with aura," she says. "Right now they are anti-
epileptic drugs, but they're a bit too strong and may have many side
effects. Now the way is open to develop drugs that really look at the
source of the problem and not the consequences of it."


Reading Bodies
Hadjikhani also studies the brain's perception of facial and body
expressions. What part of the brain recognizes fear, aggravation or
anger in someone's stance? Hadjikhani and Dr. Beatrice de Gelder, a
colleague at Tilburg University in the Netherlands, are trying to
find out.

"There are more people looking at faces now and the amount of
literature is amazing," says Hadjikhani. "But you don't normally see
a face alone, you see whole bodies."

Hadjikhani and de Gelder compiled a complex library of body
expressions — the first one ever — to use in their experiment. Using
MRI, they discovered that the same chunks of gray matter — the
amygdala and fusiform cortex — are responsible for processing both
facial and body expressions.

The information will come in handy for doctors who are studying
autism, Williams syndrome, Huntington's disease or Parkinson's
disease — patients with those ailments have trouble telling the
difference between a grimace and a coy smile. "If you can't recognize
facial expressions, how bad are you at looking at body expressions?"
asks Hadjikhani. She doesn't have the answer yet, but she hopes that
her research will lead to new treatments and therapies.

Next page: Accelerating Time to Results