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Song XY, Puyang Z, Chen AH, Zhao J, Li XJ, Chen YY, Tang WJ, Zhang YY. Diffusion Tensor Imaging Detects Microstructural Differences of Visual Pathway in Patients With Primary Open-Angle Glaucoma and Ocular Hypertension. Front Hum Neurosci 2018; 12:426. [PMID: 30459581 PMCID: PMC6232882 DOI: 10.3389/fnhum.2018.00426] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/01/2018] [Indexed: 02/01/2023] Open
Abstract
Ocular hypertension (OHT), the common situation in adult patients in the outpatients, occurs ∼5% worldwide. However, there are still some practical problems in differentiation of OHT with early primary open-angle glaucoma (POAG) using current standard methods. Application of high resolution diffusion tensor imaging (DTI) enables us to the differentiate axonal architecture of visual pathway between POAG and OHT subjects. Among 32 POAG patients recruited (15 OHT and 14 control subjects), 62.5% of glaucoma were in early stage for the current study. All subjects underwent ophthalmological assessments with standard automated perimetry and optical coherence tomography (OCT). DTI was applied to measure fraction anisotropy (FA) and mean diffusivity (MD) of optic tract (OT), lateral geniculate body (LGN) and optic radiation (OR) using voxel-based analysis. Our data demonstrated that FA values of bilateral OR in POAG were significantly lower in the right or left than that of OHT patients (left OR: 0.51 ± 0.04 vs. 0.54 ± 0.03, p < 0.05; right OR: 0.51 ± 0.05 vs. 0.54 ± 0.03, p < 0.05). In right LGN, MD values were higher in POAG patients compared with OHT subjects (9.81 ± 1.45 vs. 8.23 ± 0.62, p < 0.05). However, no significant difference of all of the DTI parameters was observed between OHT and control subjects. DTI parameters in POAG patients were positively correlated with morphological and functional measurements (p < 0.05). Vertical cup to disc ratio (VCDR) was correlated with ipsilateral FA of OT (p < 0.05), ipsilateral MD of OT (p < 0.05), ipsilateral MD of LGN (p < 0.05), and contralateral MD of OT (p < 0.05). Mean deviation of visual field (MDVF) was correlated with ipsilateral FA of OT (p < 0.05), ipsilateral MD of OT (p < 0.05), and ipsilateral FA of LGN (p < 0.05). Our study demonstrated that DTI can differentiate POAG from OHT subjects in optic pathway, particularly in early POAG, and DTI parameters can quantify the progression of POAG.
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Affiliation(s)
- Xiang-Yuan Song
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhen Puyang
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, Shanghai, China
| | - Ai-Hua Chen
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, Shanghai, China
| | - Jin Zhao
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao-Jiao Li
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ya-Ying Chen
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei-Jun Tang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yu-Yan Zhang
- Department of Ophthalmology, Huashan Hospital, Fudan University, Shanghai, China
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Aojula A, Botfield H, McAllister JP, Gonzalez AM, Abdullah O, Logan A, Sinclair A. Diffusion tensor imaging with direct cytopathological validation: characterisation of decorin treatment in experimental juvenile communicating hydrocephalus. Fluids Barriers CNS 2016; 13:9. [PMID: 27246837 PMCID: PMC4888658 DOI: 10.1186/s12987-016-0033-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 05/20/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In an effort to develop novel treatments for communicating hydrocephalus, we have shown previously that the transforming growth factor-β antagonist, decorin, inhibits subarachnoid fibrosis mediated ventriculomegaly; however decorin's ability to prevent cerebral cytopathology in communicating hydrocephalus has not been fully examined. Furthermore, the capacity for diffusion tensor imaging to act as a proxy measure of cerebral pathology in multiple sclerosis and spinal cord injury has recently been demonstrated. However, the use of diffusion tensor imaging to investigate cytopathological changes in communicating hydrocephalus is yet to occur. Hence, this study aimed to determine whether decorin treatment influences alterations in diffusion tensor imaging parameters and cytopathology in experimental communicating hydrocephalus. Moreover, the study also explored whether diffusion tensor imaging parameters correlate with cellular pathology in communicating hydrocephalus. METHODS Accordingly, communicating hydrocephalus was induced by injecting kaolin into the basal cisterns in 3-week old rats followed immediately by 14 days of continuous intraventricular delivery of either human recombinant decorin (n = 5) or vehicle (n = 6). Four rats remained as intact controls and a further four rats served as kaolin only controls. At 14-days post-kaolin, just prior to sacrifice, routine magnetic resonance imaging and magnetic resonance diffusion tensor imaging was conducted and the mean diffusivity, fractional anisotropy, radial and axial diffusivity of seven cerebral regions were assessed by voxel-based analysis in the corpus callosum, periventricular white matter, caudal internal capsule, CA1 hippocampus, and outer and inner parietal cortex. Myelin integrity, gliosis and aquaporin-4 levels were evaluated by post-mortem immunohistochemistry in the CA3 hippocampus and in the caudal brain of the same cerebral structures analysed by diffusion tensor imaging. RESULTS Decorin significantly decreased myelin damage in the caudal internal capsule and prevented caudal periventricular white matter oedema and astrogliosis. Furthermore, decorin treatment prevented the increase in caudal periventricular white matter mean diffusivity (p = 0.032) as well as caudal corpus callosum axial diffusivity (p = 0.004) and radial diffusivity (p = 0.034). Furthermore, diffusion tensor imaging parameters correlated primarily with periventricular white matter astrocyte and aquaporin-4 levels. CONCLUSIONS Overall, these findings suggest that decorin has the therapeutic potential to reduce white matter cytopathology in hydrocephalus. Moreover, diffusion tensor imaging is a useful tool to provide surrogate measures of periventricular white matter pathology in communicating hydrocephalus.
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Affiliation(s)
- Anuriti Aojula
- />Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
- />Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH UK
- />Neurotrauma, College of Medicine and Dentistry, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Hannah Botfield
- />Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
- />Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH UK
- />Neurotrauma, College of Medicine and Dentistry, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - James Patterson McAllister
- />Department of Neurosurgery, Division of Pediatric Neurosurgery at the Washington University School of Medicine and the Saint Louis Children’s Hospital, St. Louis, MO 63110 USA
| | - Ana Maria Gonzalez
- />Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
- />Neurotrauma, College of Medicine and Dentistry, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Osama Abdullah
- />Department of Bioengineering, University of Utah, Salt Lake City, UT 84112 USA
| | - Ann Logan
- />Department of Bioengineering, University of Utah, Salt Lake City, UT 84112 USA
- />Neurotrauma, College of Medicine and Dentistry, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Alexandra Sinclair
- />Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
- />Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, B15 2TH UK
- />Neurotrauma, College of Medicine and Dentistry, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
- />Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH UK
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Pickard JD, Pena A. Biomechanical modeling of hydrocephalus and idiopathic intracranial hypertension. J Neurosurg 2016; 124:879-80. [PMID: 26722862 DOI: 10.3171/2015.7.jns151726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- John D Pickard
- University of Cambridge, Cambridge, United Kingdom; and ,SDA Bocconi School of Management, Milan, Italy
| | - Alonso Pena
- University of Cambridge, Cambridge, United Kingdom; and ,SDA Bocconi School of Management, Milan, Italy
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Galgano MA, Deshaies EM. An update on the management of pseudotumor cerebri. Clin Neurol Neurosurg 2013; 115:252-9. [DOI: 10.1016/j.clineuro.2012.11.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/19/2012] [Accepted: 11/25/2012] [Indexed: 11/28/2022]
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Abstract
Idiopathic intracranial hypertension (IIH) is a disease of unknown etiology associated with increased intracranial pressure, predominantly affecting obese females of childbearing age. The history of IIH is quite unique, featuring only limited advancements in evidenced-based treatments, but boasting literally countless changes in nomenclature, proposed etiology, and conceptual approach. Despite its elusive pathogenesis, an evolution of our approach to IIH can be traced sequentially through identifiable periods. Contemporary research suggests that we are approaching a new phase in IIH, redefining it as a global neurologic syndrome with more far-reaching effects than previously realized.
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Affiliation(s)
- Kapil G Kapoor
- Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77550, USA.
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Abstract
Benign intracranial hypertension (BIH) is a rare condition in which the pathophysiology remains unclear. Multiple theories have been proposed in the past to explain BIH. Today it is widely accepted that the condition occurs in situations where alteration of cerebrospinal fluid (CSF) reabsorption is encountered. The venous system is therefore involved and may be the common denominator of the pathophysiological theories. A distinction must be made between idiopathic benign intracranial hypertension and BIH resulting from drugs, other pathological conditions, or toxics (secondary BIH), which are reported in this paper. We emphasize the crucial role of exhaustive clinical, biological, and neuroradiological investigations aiming to establish the diagnosis of BIH.
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Affiliation(s)
- J Chazal
- Service de neurochirurgie A, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, BP 69, 63003 Clermont-Ferrand cedex, France.
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Hasan KM, Sankar A, Halphen C, Kramer LA, Ewing-Cobbs L, Dennis M, Fletcher JM. Quantitative diffusion tensor imaging and intellectual outcomes in spina bifida: laboratory investigation. J Neurosurg Pediatr 2008; 2:75-82. [PMID: 18590401 PMCID: PMC3046025 DOI: 10.3171/ped/2008/2/7/075] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Patients with spina bifida (SB) have variable intellectual outcomes. The authors used diffusion tensor (DT) imaging to quantify whole-brain volumes of gray matter, white matter, and cerebrospinal fluid (CSF), and perform regional quantitative microstructural assessments of gray matter nuclei and white matter tracts in relation to intellectual outcomes in patients with SB. METHODS Twenty-nine children with myelomeningoceles and 20 age- and sex-matched children with normal neural tube development underwent MR imaging with DT image acquisition and assessments of intelligence. The DT imaging-derived metrics were the fractional anisotropy (FA), axial (parallel), and transverse (perpendicular) diffusivities. These metrics were also used to segment the brain into white matter, gray matter, and CSF. A region-of-interest analysis was conducted of the white and gray matter structures implicated in hydrocephalus. RESULTS The amount of whole-brain gray matter was decreased in patients with SB, with a corresponding increase in CSF (p < 0.0001). Regional transverse diffusivity in the caudate nucleus was decreased (p < 0.0001), and the corresponding FA was increased (p < 0.0001), suggesting reduced dendritic branching and connectivity. Fractional anisotropy in the posterior limb of the internal capsule increased in the myelomeningocele group (p = 0.02), suggesting elimination of some divergent fascicles; in contrast, the FA in several white matter structures (such as the corpus callosum genu [p < 0.001] and arcuate fasciculus) was reduced, suggesting disruption of myelination. Diffusion tensor imaging-metrics involving gray matter volume and the caudate nucleus, but not other structures, predicted variations in IQ (r = 0.37-0.50; p < 0.05). CONCLUSIONS Diffusion tensor imaging-derived metrics provide noninvasive neuronal surrogate markers of the pathogenesis of SB and predict variations in general intellectual outcomes in children with this condition.
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Affiliation(s)
- Khader M. Hasan
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston
| | - Ambika Sankar
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston
| | - Christopher Halphen
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston
| | - Larry A. Kramer
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston
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Hasan KM, Halphen C, Boska MD, Narayana PA. Diffusion tensor metrics,T2 relaxation, and volumetry of the naturally aging human caudate nuclei in healthy young and middle-aged adults: Possible implications for the neurobiology of human brain aging and disease. Magn Reson Med 2007; 59:7-13. [DOI: 10.1002/mrm.21434] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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