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Li Y, Liu Y, Zhao W, An X, Zhang F, Zhang TX, Liu Y, Du C, Zeng P, Yuan M, Zhang N, Zhang C. Serum neurofilament light chain predicts spinal cord atrophy in neuromyelitis optica spectrum disorder. J Neuroimmunol 2023; 384:578218. [PMID: 37801952 DOI: 10.1016/j.jneuroim.2023.578218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/06/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023]
Abstract
Levels of serum neurofilament light chain (sNfL) and serum glial fibrillary acidic protein (sGFAP) are useful biomarkers of disease activity and disability in neuromyelitis optica spectrum disorder (NMOSD). Here we investigated the association of sNfL and sGFAP levels with brain and spinal cord volumes in patients with NMOSD. Fifteen patients with NMOSD were enrolled in this prospective study. The median baseline level of sNfL was 42.2 (IQR, 16.1-72.6) pg/mL and decreased to 8.5 (IQR, 7.4-16.6) pg/mL at the end of the study. The reduction in sNfL was associated with a 7.5% loss of cervical spinal cord volume (CSCV) (p = 0.001). The levels of sGFAP reduced from 239.2 (IQR, 139.0-3393.3) pg/mL at baseline to 108.5 (IQR, 74.2-154.6) pg/mL. However, there was no strong correlation between sGFAP levels and CSCV changes during the follow-up period. Our data suggested that sNfL level is a useful biomarker for predicting spinal cord atrophy in patients with NMOSD.
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Affiliation(s)
- Yulin Li
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yanyan Liu
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenjin Zhao
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China; Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xueting An
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Fenghe Zhang
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tian-Xiang Zhang
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ye Liu
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Chen Du
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Pei Zeng
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Meng Yuan
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ningnannan Zhang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China.
| | - Chao Zhang
- Department of Neurology and Institute of Neuroimmunology, Tianjin Medical University General Hospital, Tianjin, China; Centers of Neuroimmunology and Neurological Diseases, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
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Peng Z, Deng H. Correlation of IgH-CDR3 Immune Repertoire Diversity Test in Peripheral Blood of Neuromyelitis Spectrum Diseases. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6790145. [PMID: 36262966 PMCID: PMC9576374 DOI: 10.1155/2022/6790145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/06/2022] [Accepted: 09/19/2022] [Indexed: 11/18/2022]
Abstract
Neuroretinitis spectrum disorder (NMOSD) is generally regarded as an acute or subacute inflammatory demyelinating disease of the central nervous system, mainly involving the optic nerve and spinal cord, mediated by humoral immunity. To address these questions, this work established an immunomic library of the heavy chain complementarity determinant 3 (gHI-CDR3) of peripheral blood lymphocyte B cell receptors. The library was established in patients with a spectrum of neurosyphilis-retinitis disorders. Six NMOSD patients and six healthy volunteers were recruited, and the NMOSD group was divided into an early-onset group and a stable group according to treatment conditions. The IgH-CDR3 gene fragment cultured in vitro was amplified by multiplex PCR technology, and the gene was sequenced by the second-generation high-throughput sequencing technology, and the statistical analysis was carried out by the method without reference. The quantity, type, and diversity of IgH-CDR3 in peripheral blood B lymphocytes of NMOSD patients were significantly lower than those of normal group (P > 0.05); the variation of IgH-CDR3 sequence in the initial stage of treatment was higher than that in the stable stage (P > 0.05); the replication frequency of the characteristic gene "CASSICLGSGCGGYYYGMDVW" was significantly increased in patients at the initial stage of NMOSD treatment (P < 0.05). The conclusion was that the gene expression and gene expression analysis of NMOSD patients could accurately judge the condition of NMOSD patients, evaluate their efficacy, and provide new molecular targets and new theoretical basis for clinical application.
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Affiliation(s)
- Zhihui Peng
- Internal Neurology, Shaoyang University Affiliated Second Hospital, Shaoyang, 422000 Hunan, China
| | - Hongfei Deng
- Precision Medicine Center, First People's Hospital, Chenzhou, 423000 Hunan, China
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Lersy F, Bund C, Anheim M, Mondino M, Noblet V, Lazzara S, Phillipps C, Collange O, Oulehri W, Mertes PM, Helms J, Merdji H, Schenck M, Schneider F, Pottecher J, Giraudeau C, Chammas A, Ardellier FD, Baloglu S, Ambarki K, Namer IJ, Kremer S. Evolution of Neuroimaging Findings in Severe COVID-19 Patients with Initial Neurological Impairment: An Observational Study. Viruses 2022; 14:949. [PMID: 35632691 PMCID: PMC9145920 DOI: 10.3390/v14050949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cerebral complications related to the COVID-19 were documented by brain MRIs during the acute phase. The purpose of the present study was to describe the evolution of these neuroimaging findings (MRI and FDG-PET/CT) and describe the neurocognitive outcomes of these patients. METHODS During the first wave of the COVID-19 outbreak between 1 March and 31 May 2020, 112 consecutive COVID-19 patients with neurologic manifestations underwent a brain MRI at Strasbourg University hospitals. After recovery, during follow-up, of these 112 patients, 31 (initially hospitalized in intensive care units) underwent additional imaging studies (at least one brain MRI). RESULTS Twenty-three men (74%) and eight women (26%) with a mean age of 61 years (range: 18-79) were included. Leptomeningeal enhancement, diffuse brain microhemorrhages, acute ischemic strokes, suspicion of cerebral vasculitis, and acute inflammatory demyelinating lesions were described on the initial brain MRIs. During follow-up, the evolution of the leptomeningeal enhancement was discordant, and the cerebral microhemorrhages were stable. We observed normalization of the vessel walls in all patients suspected of cerebral vasculitis. Four patients (13%) demonstrated new complications during follow-up (ischemic strokes, hypoglossal neuritis, marked increase in the white matter FLAIR hyperintensities with presumed vascular origin, and one suspected case of cerebral vasculitis). Concerning the grey matter volumetry, we observed a loss of volume of 3.2% during an average period of approximately five months. During follow-up, the more frequent FDG-PET/CT findings were hypometabolism in temporal and insular regions. CONCLUSION A minority of initially severe COVID-19 patients demonstrated new complications on their brain MRIs during follow-up after recovery.
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Affiliation(s)
- François Lersy
- Service d’Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (F.L.); (A.C.); (F.-D.A.); (S.B.)
| | - Caroline Bund
- ICANS, Service de Médecine Nucléaire, 67000 Strasbourg, France; (C.B.); (I.J.N.)
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France; (M.M.); (V.N.); (S.L.)
| | - Mathieu Anheim
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, CEDEX, 67200 Strasbourg, France; (M.A.); (C.P.)
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67400 Illkirch, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), UR 3072, Université de Strasbourg, 67000 Strasbourg, France;
| | - Mary Mondino
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France; (M.M.); (V.N.); (S.L.)
| | - Vincent Noblet
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France; (M.M.); (V.N.); (S.L.)
| | - Shirley Lazzara
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France; (M.M.); (V.N.); (S.L.)
| | - Clelie Phillipps
- Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, CEDEX, 67200 Strasbourg, France; (M.A.); (C.P.)
| | - Olivier Collange
- Service d’Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (O.C.); (W.O.); (P.-M.M.)
| | - Walid Oulehri
- Service d’Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (O.C.); (W.O.); (P.-M.M.)
| | - Paul-Michel Mertes
- Service d’Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (O.C.); (W.O.); (P.-M.M.)
| | - Julie Helms
- Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (J.H.); (H.M.)
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), CRBS (Centre de Recherche en Biomédecine de Strasbourg), FMTS (Fédération de Médecine Translationnelle de Strasbourg), Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France
| | - Hamid Merdji
- Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (J.H.); (H.M.)
| | - Maleka Schenck
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires de Strasbourg, Hautepierre, 67000 Strasbourg, France; (M.S.); (F.S.)
| | - Francis Schneider
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires de Strasbourg, Hautepierre, 67000 Strasbourg, France; (M.S.); (F.S.)
| | - Julien Pottecher
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), UR 3072, Université de Strasbourg, 67000 Strasbourg, France;
- Service d’Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Céline Giraudeau
- Department of Radiology, IHU Strasbourg, 67000 Strasbourg, France;
| | - Agathe Chammas
- Service d’Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (F.L.); (A.C.); (F.-D.A.); (S.B.)
| | - François-Daniel Ardellier
- Service d’Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (F.L.); (A.C.); (F.-D.A.); (S.B.)
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France; (M.M.); (V.N.); (S.L.)
| | - Seyyid Baloglu
- Service d’Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (F.L.); (A.C.); (F.-D.A.); (S.B.)
| | - Khalid Ambarki
- Siemens Healthcare, Siemens Healthcare SAS, 67200 Saint Denis, France;
| | - Izzie Jacques Namer
- ICANS, Service de Médecine Nucléaire, 67000 Strasbourg, France; (C.B.); (I.J.N.)
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France; (M.M.); (V.N.); (S.L.)
| | - Stéphane Kremer
- Service d’Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France; (F.L.); (A.C.); (F.-D.A.); (S.B.)
- Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France; (M.M.); (V.N.); (S.L.)
- Department of Radiology, IHU Strasbourg, 67000 Strasbourg, France;
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Bautin P, Cohen-Adad J. Minimum detectable spinal cord atrophy with automatic segmentation: Investigations using an open-access dataset of healthy participants. NEUROIMAGE: CLINICAL 2021; 32:102849. [PMID: 34624638 PMCID: PMC8503570 DOI: 10.1016/j.nicl.2021.102849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/07/2021] [Accepted: 09/28/2021] [Indexed: 11/20/2022] Open
Abstract
Evaluate the robustness of an automated analysis pipeline for detecting SC atrophy. Simulate spinal cord atrophy and scan-rescan variability. Fully automated analysis method available on an open access database. Evaluation of sample size and inter/intra-subject variability for T1w and T2w images.
Spinal cord atrophy is a well-known biomarker in multiple sclerosis (MS) and other diseases. It is measured by segmenting the spinal cord on an MRI image and computing the average cross-sectional area (CSA) over a few slices. Introduced about 25 years ago, this procedure is highly sensitive to the quality of the segmentation and is prone to rater-bias. Recently, fully-automated spinal cord segmentation methods, which remove the rater-bias and enable the automated analysis of large populations, have been introduced. A lingering question related to these automated methods is: How reliable are they at detecting atrophy? In this study, we evaluated the precision and accuracy of automated atrophy measurements by simulating scan-rescan experiments. Spinal cord MRI data from the open-access spine-generic project were used. The dataset aggregates 42 sites worldwide and consists of 260 healthy subjects and includes T1w and T2w contrasts. To simulate atrophy, each volume was globally rescaled at various scaling factors. Moreover, to simulate patient repositioning, random rigid transformations were applied. Using the DeepSeg algorithm from the Spinal Cord Toolbox, the spinal cord was segmented and vertebral levels were identified. Then, the average CSA between C3-C5 vertebral levels was computed for each Monte Carlo sample, allowing us to derive measures of atrophy, intra/inter-subject variability, and sample-size calculations. The minimum sample size required to detect an atrophy of 2% between unpaired study arms, commonly seen in MS studies, was 467 +/− 13.9 using T1w and 467 +/− 3.2 using T2w images. The minimum sample size to detect a longitudinal atrophy (between paired study arms) of 0.8% was 60 +/− 25.1 using T1w and 10 +/− 1.2 using T2w images. At the intra-subject level, the estimated CSA, observed in this study, showed good precision compared to other studies with COVs (across Monte Carlo transformations) of 0.8% for T1w and 0.6% for T2w images. While these sample sizes seem small, we would like to stress that these results correspond to a “best case” scenario, in that the dataset used here was of particularly good quality and the model for simulating atrophy does not encompass all the variability met in real-life datasets. The simulated atrophy and scan-rescan variability may over-simplify the biological reality. The proposed framework is open-source and available at https://csa-atrophy.readthedocs.io/.
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Affiliation(s)
- Paul Bautin
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada; Mila - Quebec AI Institute, Montreal, QC, Canada.
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