About

Laura Becerra is a Clinical Assistant Professor of Peridontology at the Henry M. Goldman School of Dental Medicine. She earned her DMD and MSD / CAGS in Periodontology from the Henry M. Goldman School of Dental Medicine in 2010 and 2004, respectively. Additionally, she holds a DDS from the European University of Madrid, obtained in 2000. Her academic and professional focus is on periodontology, and she is affiliated with the Department of Periodontology at Boston University. Her role involves teaching and clinical practice within the dental school's framework, contributing to the education of future dental professionals in the field of periodontology.

Research topics

• Internal medicine
• Neuroscience
• Medicine
• Anesthesia
• Psychology

Selected publications

• The QIBA Profile for Dynamic Susceptibility Contrast MRI Quantitative Imaging Biomarkers for Assessing Gliomas

  Radiology · 2024-12-01 · 8 citations

  reviewOpen access

  The dynamic susceptibility contrast (DSC) MRI measures of relative cerebral blood volume (rCBV) play a central role in monitoring therapeutic response and disease progression in patients with gliomas. Previous investigations have demonstrated promise of using rCBV in classifying tumor grade, elucidating tumor viability after therapy, and differentiating pseudoprogression and pseudoresponse. However, the quantification and reproducibility of rCBV measurements across patients, devices, and software remain a critical barrier to routine or clinical trial use of longitudinal DSC MRI in patients with gliomas. To address this limitation, the RSNA DSC MRI Biomarker Committee of the Quantitative Imaging Biomarkers Alliance developed a Profile that defines statistics-based claims for the precision of longitudinal measurements. Although rCBV is the clinical marker of interest, the Profile focused on the reproducibility of the measured quantitative imaging biomarker, which is the area under the contrast agent concentration-time curve (AUC) normalized by the mean value of normal-appearing contralateral white matter tissue (tissue-normalized AUC values). Based on previous reports of within-subject coefficient of variation (wCV) in the tissue-normalized AUC values for enhancing gliomas (wCV = 0.31), an increase of 182% or more with respect to the baseline tissue-normalized AUC value indicates that an increase has occurred with 95% confidence. In contrast, a decrease of 64% or more with respect to baseline suggests that a decrease has occurred with 95% confidence. Similarly, an increase of 399% or more in the tissue-normalized AUC values in normal brain gray matter tissue (wCV = 0.40) suggests that an increase has occurred with 95% confidence, whereas a decrease of 80% or more with respect to baseline suggests that a decrease has occurred with 95% confidence. This article provides the rationale for these claims and the compliance activities needed to achieve these claims. Potential updates to incorporate new data based on advances in technology and clinical care in the Profile are also discussed.

  PublisherOA PDFDOI

• Full spine 3D T2-weighted MRI with improved stitching for segmentation of the intrathecal space

  Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition · 2024-08-14

  articleSenior author

  Computational fluid dynamics (CFD) has been used to model the behavior of cerebral-spinal-fluid (CSF) flow along the spine in research of intrathecal drug delivery. However, the model geometry highly impacts the CFD-based prediction of CSF flow. Enhanced images of the spinal CSF can be obtained with T2-weighted MRI, typically collected in 3-4 stations. Here we present a method to stitch spine images for CSF segmentation and compare it to the scanner’s stitching technique. Our offline approach appears more robust to movement and field-of-view adjustments while scanning and presents acceptable CSF signal intensity homogeneity across the spine for tissue segmentation.

  PublisherDOI

• Anatomical Changes to the Rostral Neuroaxis After Spinal Cord Injury—A Multicenter Study (P7-11.016)

  Neurology · 2024-04-09

  article

  To investigate cerebral and cerebellar structural changes and cervical spinal cord cross-sectional area atrophy after human spinal cord injury (SCI).

  PublisherDOI

• 4D PC-MRI for CSF dynamics of the cervical, thoracic and lumbar spine: a feasibility study

  Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition · 2024-11-26

  articleSenior author

  Motivation: Understanding the fluid mechanics of the cerebrospinal (CSF) flow is important for creating more accurate models of flow dynamics in intrathecal drug delivery systems.Goal(s): We assess the feasibility of measuring with high-temporal resolution 3-directional CSF flow across all sections of the spine in healthy volunteers.Approach: We report peak-to-peak velocity, peak velocity, flow rate, total displacement, and display velocity vector fields for the CSF across the three spinal sections. Results: 3-directional CSF flow of the full spine can be measured with MRI. Our observations revealed varying CSF velocity profiles across three sections of the spine, indicating distinct pressure mechanisms along its length.Impact: Recent research have focused on the development of novel therapeutic strategies for CNS drug delivery though intrathecal space modelling. To achieve this and establish better boundary conditions, more precise measurements of spinal CSF flow through MRI are required.

  PublisherDOI

• Magnetic Resonance Imaging Data Phenotypes for the Parkinson’s Progression Markers Initiative

  medRxiv · 2024-09-24 · 3 citations

  preprintOpen access

  Abstract The Parkinson’s Progression Markers Initiative (PPMI) delivers multiple modality MRI (M3RI) and biomarker data for a comprehensive longitudinal study of Parkinson’s Disease (PD). These provide quantitative indices of deep brain and cortical structure (T1-weighted MRI), microstructural integrity of brain tissue (diffusion-weighted imaging) and resting brain function (resting state functional MRI). Integrating and uniformly analyzing M3RI alongside non-imaging biological and clinical data is challenging due to the distinct nature of each modality. This study systematically organizes these complex data into a structured format, provides a PD-focused evaluation of the methodologies and evidence for technical robustness of the approach. The cohort encompasses 841 idiopathic PD, 309 genetic PD, 1364 presymptomatic PD and 240 control subjects at baseline with followup at a mean of 1.83 years.

  PublisherOA PDFDOI

• MRI assessment of cerebral perfusion in clinical trials

  Drug Discovery Today · 2023-01-20 · 13 citations

  reviewOpen accessSenior authorCorresponding
  PublisherOA PDFDOI

• A clinical protocol for 3D imaging of the locus coeruleus with super-resolution at 3 Tesla

  Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition · 2023-08-03

  articleSenior author

  The locus coeruleus (LC) is the principal source of noradrenaline production in humans. Histology studies have shown that severe loss of neurons in the LC is associated with many neurodegenerative disorders. Damage is thought to be non-uniform and occurring in stages, hence there is a growing interest in imaging the LC in vivo in these patient populations. In this work we propose a protocol for imaging the LC at clinical field strengths using a 3D magnetization-transfer prepared imaging sequence strategy and the application of super-resolution techniques to increase the LC features within the brainstem region.

  PublisherDOI

• Brain-based measures of nociception during general anesthesia with remifentanil: A randomized controlled trial

  PLoS Medicine · 2022-04-22 · 13 citations

  articleOpen accessCorresponding

  BACKGROUND: Catheter radiofrequency (RF) ablation for cardiac arrhythmias is a painful procedure. Prior work using functional near-infrared spectroscopy (fNIRS) in patients under general anesthesia has indicated that ablation results in activity in pain-related cortical regions, presumably due to inadequate blockade of afferent nociceptors originating within the cardiac system. Having an objective brain-based measure for nociception and analgesia may in the future allow for enhanced analgesic control during surgical procedures. Hence, the primary aim of this study is to demonstrate that the administration of remifentanil, an opioid widely used during surgery, can attenuate the fNIRS cortical responses to cardiac ablation. METHODS AND FINDINGS: We investigated the effects of continuous remifentanil on cortical hemodynamics during cardiac ablation under anesthesia. In a randomized, double-blinded, placebo (PL)-controlled trial, we examined 32 pediatric patients (mean age of 15.8 years,16 females) undergoing catheter ablation for cardiac arrhythmias at the Cardiology Department of Boston Children's Hospital from October 2016 to March 2020; 9 received 0.9% NaCl, 12 received low-dose (LD) remifentanil (0.25 mcg/kg/min), and 11 received high-dose (HD) remifentanil (0.5 mcg/kg/min). The hemodynamic changes of primary somatosensory and prefrontal cortices were recorded during surgery using a continuous wave fNIRS system. The primary outcome measures were the changes in oxyhemoglobin concentration (NadirHbO, i.e., lowest oxyhemoglobin concentration and PeakHbO, i.e., peak change and area under the curve) of medial frontopolar cortex (mFPC), lateral prefrontal cortex (lPFC) and primary somatosensory cortex (S1) to ablation in PL versus remifentanil groups. Secondary measures included the fNIRS response to an auditory control condition. The data analysis was performed on an intention-to-treat (ITT) basis. Remifentanil group (dosage subgroups combined) was compared with PL, and a post hoc analysis was performed to identify dose effects. There were no adverse events. The groups were comparable in age, sex, and number of ablations. Results comparing remifentanil versus PL show that PL group exhibit greater NadirHbO in inferior mFPC (mean difference (MD) = 1.229, 95% confidence interval [CI] = 0.334, 2.124, p < 0.001) and superior mFPC (MD = 1.206, 95% CI = 0.303, 2.109, p = 0.001) and greater PeakHbO in inferior mFPC (MD = -1.138, 95% CI = -2.062, -0.214, p = 0.002) and superior mFPC (MD = -0.999, 95% CI = -1.961, -0.036, p = 0.008) in response to ablation. S1 activation from ablation was greatest in PL, then LD, and HD groups, but failed to reach significance, whereas lPFC activation to ablation was similar in all groups. Ablation versus auditory stimuli resulted in higher PeakHbO in inferior mFPC (MD = 0.053, 95% CI = 0.004, 0.101, p = 0.004) and superior mFPC (MD = 0.052, 95% CI = 0.013, 0.091, p < 0.001) and higher NadirHbO in posterior superior S1 (Pos. SS1; MD = -0.342, 95% CI = -0.680, -0.004, p = 0.007) during ablation of all patients. Remifentanil group had smaller NadirHbO in inferior mFPC (MD = 0.098, 95% CI = 0.009, 0.130, p = 0.003) and superior mFPC (MD = 0.096, 95% CI = 0.008, 0.116, p = 0.003) and smaller PeakHbO in superior mFPC (MD = -0.092, 95% CI = -0.680, -0.004, p = 0.007) during both the stimuli. Study limitations were small sample size, motion from surgery, indirect measure of nociception, and shallow penetration depth of fNIRS only allowing access to superficial cortical layers. CONCLUSIONS: We observed cortical activity related to nociception during cardiac ablation under general anesthesia with remifentanil. It highlights the potential of fNIRS to provide an objective pain measure in unconscious patients, where cortical-based measures may be more accurate than current evaluation methods. Future research may expand on this application to produce a real-time indication of pain that will aid clinicians in providing immediate and adequate pain treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT02703090.

  PublisherOA PDFDOI

• Dissecting Salience Network Responsivity to Evoked Nociception and Pain: Model Free Analyses

  Research Square · 2021-01-06

  preprintOpen access1st authorCorresponding

  Abstract Dissecting the responses of brain changes to acute nociceptive stimuli includes understanding networks that dynamically interact to produce the experience of pain. Among these networks the salience, default, sensory, and cognitive/central executive networks are known to interact in monitoring external stimuli, assigning salience and diverting activity from self-reflection (default mode) to cognitive integration and planning potential reaction to pain (executive). Several studies of acute evoked pain report a pattern of activity reflecting the involvement of these networks. However, it has also been proposed that much of the activity seems to reflect a response to the saliency of pain rather than pain/nociceptive processing itself. These results stem from the assumption that the evoked fMRI signal arises from a single, canonical hemodynamic response induced by the stimuli. Using a model-free analysis we demonstrate that the observed fMRI response has a complex, dynamic nature not captured by model-based analysis. We provide evidence that these and other networks have a distinct temporal response. Results presented here suggest that proper modeling and characterization of the brain response is fundamental for a correct interpretation of brain activity in response to phasic/evoked noxious stimuli.

  PublisherOA PDFDOI

• Rhythmic Change of Cortical Hemodynamic Signals Associated with Ongoing Nociception in Awake and Anesthetized Individuals: An Exploratory Functional Near Infrared Spectroscopy Study

  Anesthesiology · 2021-10-08 · 10 citations

  articleOpen access

  BACKGROUND: Patients undergoing surgical procedures are vulnerable to repetitive evoked or ongoing nociceptive barrage. Using functional near infrared spectroscopy, the authors aimed to evaluate the cortical hemodynamic signal power changes during ongoing nociception in healthy awake volunteers and in surgical patients under general anesthesia. The authors hypothesized that ongoing nociception to heat or surgical trauma would induce reductions in the power of cortical low-frequency hemodynamic oscillations in a similar manner as previously reported using functional magnetic resonance imaging for ongoing pain. METHODS: Cortical hemodynamic signals during noxious stimuli from the fontopolar cortex were evaluated in two groups: group 1, a healthy/conscious group (n = 15, all males) where ongoing noxious and innocuous heat stimulus was induced by a contact thermode to the dorsum of left hand; and group 2, a patient/unconscious group (n = 13, 3 males) receiving general anesthesia undergoing knee surgery. The fractional power of low-frequency hemodynamic signals was compared across stimulation conditions in the healthy awake group, and between patients who received standard anesthesia and those who received standard anesthesia with additional regional nerve block. RESULTS: A reduction of the total fractional power in both groups-specifically, a decrease in the slow-5 frequency band (0.01 to 0.027 Hz) of oxygenated hemoglobin concentration changes over the frontopolar cortex-was observed during ongoing noxious stimuli in the healthy awake group (paired t test, P = 0.017; effect size, 0.70), and during invasive procedures in the surgery group (paired t test, P = 0.003; effect size, 2.16). The reduction was partially reversed in patients who received a regional nerve block that likely diminished afferent nociceptive activity (two-sample t test, P = 0.002; effect size, 2.34). CONCLUSIONS: These results suggest common power changes in slow-wave cortical hemodynamic oscillations during ongoing nociceptive processing in conscious and unconscious states. The observed signal may potentially promote future development of a surrogate signal to assess ongoing nociception under general anesthesia.

  PublisherOA PDFDOI

Frequent coauthors

• David Borsook

  Massachusetts General Hospital

  1740 shared

• Eric A. Moulton

  Boston Children's Hospital

  211 shared

• Rami Burstein

  Beth Israel Deaconess Medical Center

  192 shared

• Gautam Pendse

  McLean Hospital

  189 shared

• Jaymin Upadhyay

  Boston Children's Hospital

  172 shared

• Christopher M. Aasted

  169 shared

• James H. Bishop

  Stanford University

  159 shared

• Clas Linnman

  Spaulding Rehabilitation Hospital

  149 shared

Education

• Other

  Henry M. Goldman School of Dental Medicine

  2010

• Other, Periodontology

  Henry M. Goldman School of Dental Medicine

  2004

• Other

  European University of Madrid (Spain)

  2000