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Niazi M, Karaman M, Das S, Zhou XJ, Yushkevich P, Cai K. Quantitative MRI of Perivascular Spaces at 3T for Early Diagnosis of Mild Cognitive Impairment. AJNR Am J Neuroradiol 2018; 39:1622-1628. [PMID: 30093484 DOI: 10.3174/ajnr.a5734] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/02/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The limitations inherent in the current methods of diagnosing mild cognitive impairment have constrained the use of early therapeutic interventions to delay the progression of mild cognitive impairment to dementia. This study evaluated whether quantifying enlarged perivascular spaces observed on MR imaging can help differentiate those with mild cognitive impairment from cognitively healthy controls and, thus, have an application in the diagnosis of mild cognitive impairment. MATERIALS AND METHODS We automated the identification of enlarged perivascular spaces in brain MR Images using a custom quantitative program designed with Matlab. We then quantified the densities of enlarged perivascular spaces for patients with mild cognitive impairment (n = 14) and age-matched cognitively healthy controls (n = 15) and compared them to determine whether the density of enlarged perivascular spaces can serve as an imaging surrogate for mild cognitive impairment diagnosis. RESULTS Quantified as a percentage of volume fraction (v/v%), densities of enlarged perivascular spaces were calculated to be 2.82 ± 0.40 v/v% for controls and 4.17 ± 0.57 v/v% for the mild cognitive impairment group in the subcortical brain (P < .001), and 2.74 ± 0.57 v/v% for the controls and 3.90 ± 0.62 v/v% for the mild cognitive impairment cohort in the basal ganglia (P < .001). Maximum intensity projections exhibited a visually conspicuous difference in the distributions of enlarged perivascular spaces for a patient with mild cognitive impairment and a control patient. By means of receiver operating characteristic curve analysis, we determined the sensitivity and specificity of using enlarged perivascular spaces as a differentiating biomarker between mild cognitive impairment and controls to be 92.86% and 93.33%, respectively. CONCLUSIONS The density of enlarged perivascular spaces was found to be significantly higher in those with mild cognitive impairment compared with age-matched healthy control subjects. The density of enlarged perivascular spaces, therefore, may be a useful imaging biomarker for the diagnosis of mild cognitive impairment.
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Affiliation(s)
- M Niazi
- From the Department of Radiology (M.N., X.J.Z., K.C.).,Chicago College of Osteopathic Medicine (M.N.), Midwestern University, Downers Grove, Illinois
| | - M Karaman
- Center for MR Research (M.K., X.J.Z., K.C.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - S Das
- Department of Radiology (S.D., P.Y.), School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - X J Zhou
- From the Department of Radiology (M.N., X.J.Z., K.C.).,Center for MR Research (M.K., X.J.Z., K.C.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - P Yushkevich
- Department of Radiology (S.D., P.Y.), School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - K Cai
- From the Department of Radiology (M.N., X.J.Z., K.C.) .,Center for MR Research (M.K., X.J.Z., K.C.), College of Medicine, University of Illinois at Chicago, Chicago, Illinois
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Lundgaard I, Wang W, Eberhardt A, Vinitsky HS, Reeves BC, Peng S, Lou N, Hussain R, Nedergaard M. Beneficial effects of low alcohol exposure, but adverse effects of high alcohol intake on glymphatic function. Sci Rep 2018; 8:2246. [PMID: 29396480 PMCID: PMC5797082 DOI: 10.1038/s41598-018-20424-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 01/18/2018] [Indexed: 12/16/2022] Open
Abstract
Prolonged intake of excessive amounts of ethanol is known to have adverse effects on the central nervous system (CNS). Here we investigated the effects of acute and chronic ethanol exposure and withdrawal from chronic ethanol exposure on glymphatic function, which is a brain-wide metabolite clearance system connected to the peripheral lymphatic system. Acute and chronic exposure to 1.5 g/kg (binge level) ethanol dramatically suppressed glymphatic function in awake mice. Chronic exposure to 1.5 g/kg ethanol increased GFAP expression and induced mislocation of the astrocyte-specific water channel aquaporin 4 (AQP4), but decreased the levels of several cytokines. Surprisingly, glymphatic function increased in mice treated with 0.5 g/kg (low dose) ethanol following acute exposure, as well as after one month of chronic exposure. Low doses of chronic ethanol intake were associated with a significant decrease in GFAP expression, with little change in the cytokine profile compared with the saline group. These observations suggest that ethanol has a J-shaped effect on the glymphatic system whereby low doses of ethanol increase glymphatic function. Conversely, chronic 1.5 g/kg ethanol intake induced reactive gliosis and perturbed glymphatic function, which possibly may contribute to the higher risk of dementia observed in heavy drinkers.
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Affiliation(s)
- Iben Lundgaard
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA.
| | - Wei Wang
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Allison Eberhardt
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Hanna Sophia Vinitsky
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Benjamin Cameron Reeves
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Sisi Peng
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Nanhong Lou
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Rashad Hussain
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester, Rochester, NY, 14642, USA
- Center for Basic and Translational Neuroscience, University of Copenhagen, 2200, Copenhagen, Denmark
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Cai K, Tain R, Das S, Damen FC, Sui Y, Valyi-Nagy T, Elliott MA, Zhou XJ. The feasibility of quantitative MRI of perivascular spaces at 7T. J Neurosci Methods 2015; 256:151-6. [PMID: 26358620 DOI: 10.1016/j.jneumeth.2015.09.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/05/2015] [Accepted: 09/01/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Dilated brain perivascular spaces (PVSs) are found to be associated with many conditions, including aging, dementia, and Alzheimer's disease (AD). Conventionally, PVS assessment is mainly based on subjective observations of the number, size and shape of PVSs in MR images collected at clinical field strengths (≤3T). This study tests the feasibility of imaging and quantifying brain PVS with an ultra-high 7T whole-body MRI scanner. NEW METHOD 3D high resolution T2-weighted brain images from healthy subjects (n=3) and AD patients (n=5) were acquired on a 7T whole-body MRI scanner. To automatically segment the small hyperintensive fluid-filling PVS structures, we also developed a quantitative program based on algorithms for spatial gradient, component connectivity, edge-detection, k-means clustering, etc., producing quantitative results of white matter PVS volume densities. RESULTS The 3D maps of automatically segmented PVS show an apparent increase in PVS density in AD patients compared to age-matched healthy controls due to the PVS dilation (8.0±2.1 v/v% in AD vs. 4.9±1.3 v/v% in controls, p<0.05). COMPARISON WITH EXISTING METHOD We demonstrated that 7T provides sufficient SNR and resolution for quantitatively measuring PVSs in deep white matter that is challenging with clinical MRI systems (≤3T). Compared to the conventional visual counting and rating for the PVS assessment, the quantitation method we developed is automatic and objective. CONCLUSIONS Quantitative PVS MRI at 7T may serve as a non-invasive and endogenous imaging biomarker for diseases with PVS dilation.
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Affiliation(s)
- Kejia Cai
- Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA.
| | - Rongwen Tain
- Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Sandhitsu Das
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Frederick C Damen
- Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Yi Sui
- Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Tibor Valyi-Nagy
- Department of Neuropathology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Mark A Elliott
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xiaohong J Zhou
- Department of Radiology, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA; Center for MR Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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Spencer PS, Palmer VS. Interrelationships of undernutrition and neurotoxicity: food for thought and research attention. Neurotoxicology 2012; 33:605-16. [PMID: 22394483 PMCID: PMC3437940 DOI: 10.1016/j.neuro.2012.02.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 02/13/2012] [Accepted: 02/13/2012] [Indexed: 12/25/2022]
Abstract
The neurotoxic actions of chemical agents on humans and animals are usually studied with little consideration of the subject's nutritional status. States of protein-calorie, vitamin and/or mineral undernutrition are associated with a range of neurodevelopmental, neurological and psychiatric disorders, commonly with involvement of both the central and the peripheral nervous system. Undernutrition can modify risk for certain chemical-induced neurologic diseases, and in some cases undernutrition may be a prerequisite for neurotoxicity to surface. In addition, neurologic disease associated with undernutrition or neurotoxicity may show similarities in clinical and neuropathological expression, especially in the peripheral nervous system. The combined effects of undernutrition and chemical neurotoxicity are most relevant to people with low incomes who experience chronic hunger, parasitism and infectious disease, monotonous diets of plants with neurotoxic potential (notably cassava), environmental pollution from rapid industrial development, chronic alcohol abuse, or prolonged treatment with certain therapeutic drugs. Undernutrition alone or in combination with chemical exposure is also important in high-income societies in the setting of drug and alcohol abuse, old age, food faddism, post-bariatric surgery, and drug treatment for certain medical conditions, including cancer and tuberculosis. The nutritional demands of pregnancy and lactation increase the risk of fetal and infant undernutrition and chemical interactions therewith.
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Affiliation(s)
- Peter S Spencer
- Global Health Center, Center for Research on Occupational and Environmental Toxicology, and Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR 97239, United States.
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