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Wikström, Johan
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Publications (10 of 57) Show all publications
Nelander, M., Weis, J., Bergman, L., Larsson, A., Wikström, A.-K. & Wikström, J. (2017). Cerebral Magnesium Levels in Preeclampsia; A Phosphorus Magnetic Resonance Spectroscopy Study. American Journal of Hypertension, 30(7), 667-672.
Open this publication in new window or tab >>Cerebral Magnesium Levels in Preeclampsia; A Phosphorus Magnetic Resonance Spectroscopy Study
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2017 (English)In: American Journal of Hypertension, ISSN 0895-7061, E-ISSN 1941-7225, Vol. 30, no 7, 667-672 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Magnesium sulfate (MgSO4) is used as a prophylaxis for eclamptic seizures. The exact mechanism of action is not fully established. We used phosphorus magnetic resonance spectroscopy (31P-MRS) to investigate if cerebral magnesium (Mg2+) levels differ between women with preeclampsia, normal pregnant, and nonpregnant women.

METHODS: This cross-sectional study comprised 28 women with preeclampsia, 30 women with normal pregnancies in corresponding gestational week (range: 23-41 weeks) and 11 nonpregnant healthy controls. All women underwent 31P-MRS from the parieto-occipital region of the brain and were interviewed about cerebral symptoms. Differences between groups were assessed by analysis of variance and Tukey's post-hoc test. Correlations between Mg2+ levels and specific neurological symptoms were estimated with Spearman's rank test.

RESULTS: Mean maternal cerebral Mg2+ levels were lower in women with preeclampsia (0.12 mM ± 0.02) compared to normal pregnant controls (0.14 mM ± 0.03) (P = 0.04). Nonpregnant and normal pregnant women did not differ in Mg2+ levels. Among women with preeclampsia, lower Mg2+ levels correlated with presence of visual disturbances (P = 0.04). Plasma levels of Mg2+ did not differ between preeclampsia and normal pregnancy.

CONCLUSIONS: Women with preeclampsia have reduced cerebral Mg2+ levels, which could explain the potent antiseizure prophylactic properties of MgSO4. Within the preeclampsia group, women with visual disturbances have lower levels of Mg2+ than those without such symptoms.

Keyword
31P-magnetic resonance spectroscopy, blood pressure, eclampsia, hypertension, magnesium, magnetic resonance, preeclampsia.
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-319608 (URN)10.1093/ajh/hpx022 (DOI)000407115100009 ()28338765 (PubMedID)
Funder
Swedish Research Council, 2014-3561
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2017-12-06Bibliographically approved
Marusik, C., Frykholm, C., Ericson, K., Wikström, J. & Axelsson, O. (2017). Diagnosis of Placental Mesenchymal Dysplasia with a focus on magnetic resonance imaging (MRI) [Letter to the editor]. Ultrasound in Obstetrics and Gynecology, 49(3), 410-412.
Open this publication in new window or tab >>Diagnosis of Placental Mesenchymal Dysplasia with a focus on magnetic resonance imaging (MRI)
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2017 (English)In: Ultrasound in Obstetrics and Gynecology, ISSN 0960-7692, E-ISSN 1469-0705, Vol. 49, no 3, 410-412 p.Article in journal, Letter (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-312400 (URN)10.1002/uog.15930 (DOI)27062337 (PubMedID)
Available from: 2017-01-09 Created: 2017-01-09 Last updated: 2017-11-29Bibliographically approved
Abu Hamdeh, S., Marklund, N., Lannsjö, M., Howells, T., Raininko, R., Wikström, J. & Enblad, P. (2017). Extended anatomical grading in diffuse axonal injury using MRI: Hemorrhagic lesions in the substantia nigra and mesencephalic tegmentum indicate poor long-term outcome. Journal of Neurotrauma, 5(34), 341-352.
Open this publication in new window or tab >>Extended anatomical grading in diffuse axonal injury using MRI: Hemorrhagic lesions in the substantia nigra and mesencephalic tegmentum indicate poor long-term outcome
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2017 (English)In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 5, no 34, 341-352 p.Article in journal (Refereed) Published
Abstract [en]

Clinical outcome after traumatic diffuse axonal injury (DAI) is difficult to predict. In this study, three magnetic resonance imaging (MRI) sequences were used to quantify the anatomical distribution of lesions, to grade DAI according to the Adams grading system, and to evaluate the value of lesion localization in combination with clinical prognostic factors to improve outcome prediction. Thirty patients (mean 31.2 years ±14.3 standard deviation) with severe DAI (Glasgow Motor Score [GMS] <6) examined with MRI within 1 week post-injury were included. Diffusion-weighted (DW), T2*-weighted gradient echo and susceptibility-weighted (SWI) sequences were used. Extended Glasgow outcome score was assessed after 6 months. Number of DW lesions in the thalamus, basal ganglia, and internal capsule and number of SWI lesions in the mesencephalon correlated significantly with outcome in univariate analysis. Age, GMS at admission, GMS at discharge, and low proportion of good monitoring time with cerebral perfusion pressure <60 mm Hg correlated significantly with outcome in univariate analysis. Multivariate analysis revealed an independent relation with poor outcome for age (p = 0.005) and lesions in the mesencephalic region corresponding to substantia nigra and tegmentum on SWI (p  = 0.008). We conclude that higher age and lesions in substantia nigra and mesencephalic tegmentum indicate poor long-term outcome in DAI. We propose an extended MRI classification system based on four stages (stage I—hemispheric lesions, stage II—corpus callosum lesions, stage III—brainstem lesions, and stage IV—substantia nigra or mesencephalic tegmentum lesions); all are subdivided by age (≥/<30 years).

Keyword
adult brain injury, axonal injury, head trauma, MRI, susceptibility weighted imaging
National Category
Clinical Medicine Neurology
Identifiers
urn:nbn:se:uu:diva-309038 (URN)10.1089/neu.2016.4426 (DOI)000391754800009 ()27356857 (PubMedID)
Available from: 2016-12-01 Created: 2016-12-01 Last updated: 2017-11-29Bibliographically approved
Vågberg, M., Axelsson, M., Birgander, R., Burman, J., Cananau, C., Forslin, Y., . . . Wikström, J. (2017). Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society. Acta Neurologica Scandinavica, 135(1), 17-24.
Open this publication in new window or tab >>Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society
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2017 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 135, no 1, 17-24 p.Article, review/survey (Refereed) Published
Abstract [en]

Multiple sclerosis (MS) is associated with inflammatory lesions in the brain and spinal cord. The detection of such inflammatory lesions using magnetic resonance imaging (MRI) is important in the consideration of the diagnosis and differential diagnoses of MS, as well as in the monitoring of disease activity and predicting treatment efficacy. Although there is strong evidence supporting the use of MRI for both the diagnosis and monitoring of disease activity, there is a lack of evidence regarding which MRI protocols to use, the frequency of examinations, and in what clinical situations to consider MRI examination. A national workshop to discuss these issues was held in Stockholm, Sweden, in August 2015, which resulted in a Swedish consensus statement regarding the use of MRI in the care of individuals with MS. The aim of this consensus statement is to provide practical advice for the use of MRI in this setting. The recommendations are based on a review of relevant literature and the clinical experience of workshop attendees. It is our hope that these recommendations will benefit individuals with MS and guide healthcare professionals responsible for their care.

National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-302738 (URN)10.1111/ane.12667 (DOI)000389421400002 ()27558404 (PubMedID)
Available from: 2016-09-08 Created: 2016-09-08 Last updated: 2017-11-21Bibliographically approved
Wikström, J., Isacsson, U., Bengt, J. & Lennernäs, B. (2017). Magnetic Resonance Compatibility of a Transponder Aimed for Radiotherapy Positioning – A Phantom Study. Anticancer Research, 37(9), 4993-4996.
Open this publication in new window or tab >>Magnetic Resonance Compatibility of a Transponder Aimed for Radiotherapy Positioning – A Phantom Study
2017 (English)In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 37, no 9, 4993-4996 p.Article in journal (Refereed) Published
Abstract [en]

Background/Aim: Electromagnetic Positioning Systems (EMP) is a new position-ing technique in four-dimensional radiotherapy. Patients with implanted transponders may be referred for magnetic resonance imaging (MRI) making it important to establish the MR safety.

Materials and Methods: Oranges were prepared with transponders and imaged on a 3T MR scanner with different sequences. Computed tomography (CT) was performed as comparison. MR artifacts were assessed. An estimation of the maximum transponder de-flection force and heating was made.

Results: The mean measured displacement of transponders was 0.1 mm (range=0.03-0.3 mm). Artifacts were observed adjacent to transponders using all sequences. The deflection force on the transponder in the gantry was less than 38 mN. No heating was observed.

Conclusion: The absence of any substantial movement, the weak measured deflection force and absence of observed heating speaks for the safe use of MR imaging with transponder 3T. Local artefacts makes evaluation impossible adjacent to transponders.

Keyword
Prostate cancer, electromagnetic positioning, four dimensional radiotherapy
National Category
Medical and Health Sciences Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-333690 (URN)10.21873/anticanres.11911 (DOI)000412578200034 ()28870923 (PubMedID)
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-01-12Bibliographically approved
Rostami, E., Nyström, P. W., Libard, S., Wikström, J., Casar Borota, O. & Gudjonsson, O. (2017). Recurrent papillary craniopharyngioma with BRAFV600E mutation treated with neoadjuvant-targeted therapy.. Acta Neurochirurgica, 159(11), 2217-2221.
Open this publication in new window or tab >>Recurrent papillary craniopharyngioma with BRAFV600E mutation treated with neoadjuvant-targeted therapy.
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2017 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 159, no 11, 2217-2221 p.Article in journal (Refereed) Published
Abstract [en]

Craniopharyngiomas are histologically benign but locally aggressive tumors in the sellar region that may cause devastating neurological and endocrine deficits. They tend to recur following surgery with high morbidity; hence, postoperative radiotherapy is recommended following sub-total resection. BRAFV600E mutation is the principal oncogenic driver in the papillary variant of craniopharyngiomas. Recently, a dramatic tumor reduction has been reported in a patient with BRAFV600E mutated, multiply recurrent papillary craniopharyngioma using a combination therapy of BRAF inhibitor dabrafenib and MEK inhibitor trametinib. Here, we report on near-radical reduction of a growing residual BRAFV600E craniopharyngioma using the same neoadjuvant therapy.

Keyword
BRAFV600E, Craniopharyngioma, RAF-inhibitor
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-333691 (URN)10.1007/s00701-017-3311-0 (DOI)000412754600027 ()28918496 (PubMedID)
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-01-08Bibliographically approved
Correia de Verdier, M. & Wikström, J. (2016). Normal ranges and test-retest reproducibility of flow and velocity parameters in intracranial arteries measured with phase-contrast magnetic resonance imaging. Neuroradiology, 58(5), 521-531.
Open this publication in new window or tab >>Normal ranges and test-retest reproducibility of flow and velocity parameters in intracranial arteries measured with phase-contrast magnetic resonance imaging
2016 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 58, no 5, 521-531 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The purpose of the present study was to investigate normal ranges and test-retest reproducibility of phase-contrast MRI (PC-MRI)-measured flow and velocity parameters in intracranial arteries.

METHODS: Highest flow (HF), lowest flow (LF), peak systolic velocity (PSV), and end diastolic velocity (EDV) were measured at two dates in the anterior (ACA), middle (MCA), and posterior (PCA) cerebral arteries of 30 healthy volunteers using two-dimensional PC-MRI at 3 T. Least detectable difference (LDD) was calculated.

RESULTS: In the left ACA, HF was (mean (range, LDD)) 126 ml/min (36-312, 59 %), LF 61 ml/min (0-156, 101 %), PSV 64 cm/s (32-141, 67 %), and EDV 35 cm/s (18-55, 42 %); in the right ACA, HF was 154 ml/min (42-246, 49 %), LF 77 ml/min (0-156, 131 %), PSV 75 cm/s (26-161, 82 %), and EDV 39 cm/s (7-59, 67 %). In the left MCA, HF was 235 ml/min (126-372, 35 %), LF 116 ml/min (42-186, 48 %), PSV 90 cm/s (55-183, 39 %), and EDV 46 cm/s (20-66, 28 %); in the right MCA, HF was 238 ml/min (162-342, 44 %), LF 120 ml/min (72-216, 48 %), PSV 88 cm/s (55-141, 35 %), and EDV 45 cm/s (26-67, 23 %). In the left PCA, HF was 108 ml/min (42-168, 54 %), LF 53 ml/min (18-108, 64 %), PSV 50 cm/s (24-77, 63 %), and EDV 28 cm/s (14-40, 45 %); in the right PCA, HF was 98 ml/min (30-162, 49 %), LF 49 ml/min (12-84, 55 %), PSV 47 cm/s (27-88, 59 %), and EDV 27 cm/s (16-41, 45 %).

CONCLUSION: PC-MRI-measured flow and velocity parameters in the main intracranial arteries have large normal ranges. Reproducibility is highest in MCA.

Keyword
Magnetic resonance imaging; Phase-contrast MRI; Cerebral arteries; Hemodynamics; Bloodflow velocity
National Category
Neurology Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:uu:diva-278953 (URN)10.1007/s00234-016-1661-6 (DOI)000374972100011 ()26882908 (PubMedID)
Available from: 2016-02-26 Created: 2016-02-26 Last updated: 2017-11-30Bibliographically approved
Nelander, M., Cnattingius, S., Åkerud, H., Wikström, J., Pedersen, N. L. & Wikström, A.-K. (2016). Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older: a cohort study. BMJ Open, 6(1), Article ID e009880.
Open this publication in new window or tab >>Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older: a cohort study
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2016 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 1, e009880Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The primary aim was to study pregnancy hypertensive disease and subsequent risk of dementia. The second aim was to study if the increased risks of cardiovascular disease (CVD) and stroke after pregnancy hypertensive disease persist in an elderly population.

DESIGN: Cohort study.

SETTING: Sweden.

POPULATION OR SAMPLE: 3232 women 65 years or older (mean 71 years) at inclusion.

METHODS: Cox proportional hazards regression analyses were used to calculate risks of dementia, CVD and/or stroke for women exposed to pregnancy hypertensive disease. Exposure data were collected from an interview at inclusion during the years 1998-2002. Outcome data were collected from the National Patient Register and Cause of Death Register from the year of inclusion until the end of 2010. Age at inclusion was set as a time-dependent variable, and adjustments were made for body mass index, education and smoking.

MAIN OUTCOME MEASURES: Dementia, CVD, stroke.

RESULTS: During the years of follow-up, 7.6% of the women exposed to pregnancy hypertensive disease received a diagnosis of dementia, compared with 7.4% among unexposed women (HR 1.19; 95% CI 0.79 to 1.73). The corresponding rates for CVD were 22.9% for exposed women and 19.0% for unexposed women (HR 1.29; 95% CI 1.02 to 1.61), and for stroke 13.4% for exposed women and 10.7% for unexposed women (HR 1.36; 95% CI 1.00 to 1.81).

CONCLUSIONS: There was no increased risk of dementia after self-reported pregnancy hypertensive disease in our cohort. We found that the previously reported increased risk of CVD and stroke after pregnancy hypertensive disease persists in an older population.

National Category
General Practice Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-278956 (URN)10.1136/bmjopen-2015-009880 (DOI)000369993900137 ()26801467 (PubMedID)
Funder
EU, European Research Council, 259679Swedish Research Council, 2014-3561
Available from: 2016-02-26 Created: 2016-02-26 Last updated: 2018-01-10Bibliographically approved
Wikström, J. (2016). Re: Placental magnetic resonance imaging T2*measurements in normal pregnancies and in those complicated by fetal growth restriction. M. Sinding, D. A. Peters, J. B. Frokjaer, O. B. Christiansen, A. Petersen, N. Uldbjerg and A. Sorensen. Ultrasound Obstet Gynecol 2016; 47: 748-754.. Ultrasound in Obstetrics and Gynecology, 47(6), 673-673.
Open this publication in new window or tab >>Re: Placental magnetic resonance imaging T2*measurements in normal pregnancies and in those complicated by fetal growth restriction. M. Sinding, D. A. Peters, J. B. Frokjaer, O. B. Christiansen, A. Petersen, N. Uldbjerg and A. Sorensen. Ultrasound Obstet Gynecol 2016; 47: 748-754.
2016 (English)In: Ultrasound in Obstetrics and Gynecology, ISSN 0960-7692, E-ISSN 1469-0705, Vol. 47, no 6, 673-673 p.Article in journal, Editorial material (Other academic) Published
National Category
Radiology, Nuclear Medicine and Medical Imaging Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-300628 (URN)10.1002/uog.15952 (DOI)000378535100003 ()27256657 (PubMedID)
Available from: 2016-08-10 Created: 2016-08-10 Last updated: 2017-11-28Bibliographically approved
Gingnell, M., Bannbers, E., Engman, J., Frick, A., Moby, L., Wikström, J. & Sundström-Poromaa, I. (2016). The effect of combined hormonal contraceptives use on brain reactivity during response inhibition. European journal of contraception & reproductive health care, 21(2), 150-157.
Open this publication in new window or tab >>The effect of combined hormonal contraceptives use on brain reactivity during response inhibition
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2016 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 21, no 2, 150-157 p.Article in journal (Refereed) Published
Abstract [en]

Objectives Cognitive control, which can be described as the ability to moderate impulses, has not previously been investigated in users of combined hormonal contraception (CHC). Given the suggested modulatory role of ovarian steroids in prefrontal dopaminergic function, which in turn taps into cognitive control, this randomised, double-blinded, placebo-controlled oral contraceptive trial set out to investigate the brain activity pattern during response inhibition in CHC users. Methods Thirty-four women were randomised to one treatment cycle with a levonorgestrel-containing CHC or placebo. The women performed a Go/NoGo task to measure brain activity during response inhibition by use of event-related functional magnetic resonance imaging (fMRI) prior to and during the CHC/placebo treatment cycle. Results No differences between CHC and placebo users in number of correct inhibitions were found during treatment, but only women on CHC significantly improved their performance between the baseline and treatment assessments. During the treatment cycle CHC users displayed decreased activity in the right middle frontal gyrus in comparison with placebo users. No other significant activations were evident between treatment groups or within groups. Conclusion Overall, CHC use had marginal effects on brain activity during response inhibition. If anything, the findings of the study may suggest reduced effort or increased efficiency in maintaining orbitofrontal cortex inhibitory cognitive control when using a combined oral contraceptive.

Keyword
Functional magnetic resonance imaging; Go/NoGo; Oestrogen; Oral contraceptives; Progestagen; Randomised clinical trial; Response inhibition
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-265145 (URN)10.3109/13625187.2015.1077381 (DOI)000375025700006 ()26291330 (PubMedID)
Funder
Swedish Research Council
Available from: 2015-10-23 Created: 2015-10-23 Last updated: 2017-12-01Bibliographically approved
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