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Gilmartin CG, Hoyle N, Garjani A, Dixon T, Jos H, Paling D, Brownlee W, Tench C, Evangelou N. Real-world data on siponimod-related lymphopenia among people with secondary progressive multiple sclerosis. Mult Scler 2024; 30:600-604. [PMID: 38323423 DOI: 10.1177/13524585231225711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND Siponimod-related lymphopenia in real-world clinical practice has implications for dose adjustment and infection risk. OBJECTIVE To characterise siponimod-related lymphopenia in people with secondary progressive multiple sclerosis (pwSPMS). METHODS This is a retrospective cohort of 188 pwSPMS. The development of grade 4 lymphopenia was interrogated with Kaplan-Meier survival analysis and binary logistic regression. RESULTS Lymphopenia develops soon after commencing siponimod. In total, 15 (8.5%) of 176 experienced grade 4 lymphopenia at 1 month after initiation. There were no clinically significant associations between patient characteristics and development of grade 4 lymphopenia. CONCLUSION Grade 4 lymphopenia can occur soon after siponimod initiation and cannot be predicted.
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Affiliation(s)
- Christopher Gs Gilmartin
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Natasha Hoyle
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Afagh Garjani
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Terri Dixon
- Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Helena Jos
- University College London Medical School, London, UK
| | - David Paling
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Wallace Brownlee
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Institute for Health and Care Research (NIHR) University College London Hospitals Biomedical Research Centre, London, UK
| | - Christopher Tench
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Nikos Evangelou
- Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK
- Clinical Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
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Xing Y, Sapuan AH, Martín-Bastida A, Naidu S, Tench C, Evans J, Sare G, Schwarz ST, Al-Bachari S, Parkes LM, Kanavou S, Raw J, Silverdale M, Bajaj N, Pavese N, Burn D, Piccini P, Grosset DG, Auer DP. Neuromelanin-MRI to Quantify and Track Nigral Depigmentation in Parkinson's Disease: A Multicenter Longitudinal Study Using Template-Based Standardized Analysis. Mov Disord 2022; 37:1028-1039. [PMID: 35165920 PMCID: PMC9303322 DOI: 10.1002/mds.28934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 11/24/2021] [Accepted: 01/09/2022] [Indexed: 12/15/2022] Open
Abstract
Background Clinical diagnosis and monitoring of Parkinson's disease (PD) remain challenging because of the lack of an established biomarker. Neuromelanin‐magnetic resonance imaging (NM‐MRI) is an emerging biomarker of nigral depigmentation indexing the loss of melanized neurons but has unknown prospective diagnostic and tracking performance in multicenter settings. Objectives The aim was to investigate the diagnostic accuracy of NM‐MRI in early PD in a multiprotocol setting and to determine and compare serial NM‐MRI changes in PD and controls. Methods In this longitudinal case–control 3 T MRI study, 148 patients and 97 controls were included from six UK clinical centers, of whom 140 underwent a second scan after 1.5 to 3 years. An automated template‐based analysis was applied for subregional substantia nigra NM‐MRI contrast and volume assessment. A point estimate of the period of prediagnostic depigmentation was computed. Results All NM metrics performed well to discriminate patients from controls, with receiver operating characteristic showing 85% accuracy for ventral NM contrast and 83% for volume. Generalizability using a priori volume cutoff was good (79% accuracy). Serial MRI demonstrated accelerated NM loss in patients compared to controls. Ventral NM contrast loss was point estimated to start 5 to 6 years before clinical diagnosis. Ventral nigral depigmentation was greater in the most affected side, more severe cases, and nigral NM volume change correlated with change in motor severity. Conclusions We demonstrate that NM‐MRI provides clinically useful diagnostic information in early PD across protocols, platforms, and sites. It provides methods and estimated depigmentation rates that highlight the potential to detect preclinical PD and track progression for biomarker‐enabled clinical trials. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Yue Xing
- School of Medicine, Mental Health & Clinical Neurosciences, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Abdul Halim Sapuan
- School of Medicine, Mental Health & Clinical Neurosciences, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Antonio Martín-Bastida
- Division of Neurology, Imperial College London, London, United Kingdom.,Department of Neurology and Neurosciences, Clínica Universidad de Navarra, Pamplona-Madrid, Spain
| | - Saadnah Naidu
- School of Medicine, Mental Health & Clinical Neurosciences, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,Neurology, Nottingham University Hospital Trust, Nottingham, United Kingdom
| | - Christopher Tench
- School of Medicine, Mental Health & Clinical Neurosciences, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Jonathan Evans
- Neurology, Nottingham University Hospital Trust, Nottingham, United Kingdom
| | - Gillian Sare
- Neurology, Nottingham University Hospital Trust, Nottingham, United Kingdom
| | - Stefan T Schwarz
- School of Medicine, Mental Health & Clinical Neurosciences, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,Department of Radiology, Cardiff and Vale University Health Board, Cardiff, United Kingdom
| | - Sarah Al-Bachari
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.,Lancaster Medical School, Lancaster University, Lancaster, United Kingdom.,Department of Neurology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, United Kingdom
| | - Laura M Parkes
- Division of Neuroscience & Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Sofia Kanavou
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jason Raw
- Pennine Acute Hospitals NHS Trust, Oldham, United Kingdom
| | - Monty Silverdale
- Division of Neurology, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Nin Bajaj
- School of Medicine, Mental Health & Clinical Neurosciences, Nottingham, United Kingdom.,Spire Nottingham Hospital, Nottingham, United Kingdom
| | - Nicola Pavese
- Newcastle Magnetic Resonance Centre & Positron Emission Tomography Centre and Clinical Ageing Research Unit, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - David Burn
- Faculty of Medical Sciences, The Medical School, Framlington Place, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Paola Piccini
- Division of Neurology, Imperial College London, London, United Kingdom.,Department of Brain Science, Imperial College London, London, United Kingdom
| | - Donald G Grosset
- Institute for Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Dorothee P Auer
- School of Medicine, Mental Health & Clinical Neurosciences, Nottingham, United Kingdom.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, United Kingdom
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3
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Alyami A, Hoad CL, Tench C, Bannur U, Clarke C, Latief K, Argyriou K, Lobo A, Lung P, Baldwin-Cleland R, Sahnan K, Hart A, Limdi JK, Mclaughlin J, Atkinson D, Parker GJM, O’Connor JPB, Little RA, Gowland PA, Moran GW. Quantitative Magnetic Resonance Imaging in Perianal Crohn's Disease at 1.5 and 3.0 T: A Feasibility Study. Diagnostics (Basel) 2021; 11:2135. [PMID: 34829482 PMCID: PMC8624877 DOI: 10.3390/diagnostics11112135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 01/06/2023] Open
Abstract
Perianal Crohn's Disease (pCD) is a common manifestation of Crohn's Disease. Absence of reliable disease measures makes disease monitoring unreliable. Qualitative MRI has been increasingly used for diagnosing and monitoring pCD and has shown potential for assessing response to treatment. Quantitative MRI sequences, such as diffusion-weighted imaging (DWI), dynamic contrast enhancement (DCE) and magnetisation transfer (MT), along with T2 relaxometry, offer opportunities to improve diagnostic capability. Quantitative MRI sequences (DWI, DCE, MT and T2) were used in a cohort of 25 pCD patients before and 12 weeks after biological therapy at two different field strengths (1.5 and 3 T). Disease activity was measured with the Perianal Crohn's Disease Activity index (PDAI) and serum C-reactive protein (CRP). Diseased tissue areas on MRI were defined by a radiologist. A baseline model to predict outcome at 12 weeks was developed. No differences were seen in the quantitative MR measured in the diseased tissue regions from baseline to 12 weeks; however, PDAI and CRP decreased. Baseline PDAI, CRP, T2 relaxometry and surgical history were found to have a moderate ability to predict response after 12 weeks of biological treatment. Validation in larger cohorts with MRI and clinical measures are needed in order to further develop the model.
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Affiliation(s)
- Ali Alyami
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia;
- Translational Medical Sciences Academic Unit, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK;
- National Institute of Health Research Nottingham Biomedical Research Centre at the Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (C.T.); (P.A.G.)
| | - Caroline L. Hoad
- National Institute of Health Research Nottingham Biomedical Research Centre at the Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (C.T.); (P.A.G.)
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2QX, UK
| | - Christopher Tench
- National Institute of Health Research Nottingham Biomedical Research Centre at the Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (C.T.); (P.A.G.)
- Division of Clinical Neurosciences, Clinical Neurology, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK
| | - Uday Bannur
- Department of Radiology, Queens Medical Centre Campus, Nottingham University Hospitals, Nottingham NG7 2UH, UK; (U.B.); (C.C.); (K.L.)
| | - Christopher Clarke
- Department of Radiology, Queens Medical Centre Campus, Nottingham University Hospitals, Nottingham NG7 2UH, UK; (U.B.); (C.C.); (K.L.)
| | - Khalid Latief
- Department of Radiology, Queens Medical Centre Campus, Nottingham University Hospitals, Nottingham NG7 2UH, UK; (U.B.); (C.C.); (K.L.)
| | - Konstantinos Argyriou
- Translational Medical Sciences Academic Unit, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Alan Lobo
- Department of Gastroenterology, Sheffield Teaching Hospitals NHS Trust, Sheffield S10 2JF, UK;
| | - Philip Lung
- Department of Radiology, St Mark’s Hospital and Academic Institute, London North West Healthcare NHS Trust, London HA1 3UJ, UK; (P.L.); (R.B.-C.)
| | - Rachel Baldwin-Cleland
- Department of Radiology, St Mark’s Hospital and Academic Institute, London North West Healthcare NHS Trust, London HA1 3UJ, UK; (P.L.); (R.B.-C.)
| | - Kapil Sahnan
- Fistula Research Unit, St Mark’s Hospital and Academic Institute, London North West Healthcare NHS Trust, London HA1 3UJ, UK; (K.S.); (A.H.)
| | - Ailsa Hart
- Fistula Research Unit, St Mark’s Hospital and Academic Institute, London North West Healthcare NHS Trust, London HA1 3UJ, UK; (K.S.); (A.H.)
| | - Jimmy K. Limdi
- Department of Gastroenterology, The Pennine Acute Hospitals NHS Trust, Greater Manchester, Crumpsall M8 5RB, UK;
| | - John Mclaughlin
- Department of Gastroenterology, Salford Royal NHS Foundation Trust, Manchester Academic Health Sciences Centre, Salford M6 8HD, UK;
| | - David Atkinson
- Centre for Medical Imaging, University College London, London W1W 7TS, UK;
| | - Geoffrey J. M. Parker
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London WC1V 6LJ, UK;
- Bioxydyn Limited, Manchester M15 6SZ, UK
| | - James P. B. O’Connor
- Quantitative Biomedical Imaging Laboratory, Division of Cancer Science, University of Manchester, Manchester M13 9PL, UK (R.A.L.)
| | - Ross A. Little
- Quantitative Biomedical Imaging Laboratory, Division of Cancer Science, University of Manchester, Manchester M13 9PL, UK (R.A.L.)
| | - Penny A. Gowland
- National Institute of Health Research Nottingham Biomedical Research Centre at the Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (C.T.); (P.A.G.)
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2QX, UK
| | - Gordon W. Moran
- Translational Medical Sciences Academic Unit, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham NG7 2UH, UK;
- National Institute of Health Research Nottingham Biomedical Research Centre at the Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham NG7 2UH, UK; (C.L.H.); (C.T.); (P.A.G.)
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Alotaibi A, Tench C, Stevenson R, Felmban G, Altokhis A, Aldhebaib A, Dineen RA, Constantinescu CS. Investigating Brain Microstructural Alterations in Type 1 and Type 2 Diabetes Using Diffusion Tensor Imaging: A Systematic Review. Brain Sci 2021; 11:brainsci11020140. [PMID: 33499073 PMCID: PMC7911883 DOI: 10.3390/brainsci11020140] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 12/13/2022] Open
Abstract
Type 1 and type 2 diabetes mellitus have an impact on the microstructural environment and cognitive functions of the brain due to its microvascular/macrovascular complications. Conventional Magnetic Resonance Imaging (MRI) techniques can allow detection of brain volume reduction in people with diabetes. However, conventional MRI is insufficiently sensitive to quantify microstructural changes. Diffusion Tensor Imaging (DTI) has been used as a sensitive MRI-based technique for quantifying and assessing brain microstructural abnormalities in patients with diabetes. This systematic review aims to summarise the original research literature using DTI to quantify microstructural alterations in diabetes and the relation of such changes to cognitive status and metabolic profile. A total of thirty-eight published studies that demonstrate the impact of diabetes mellitus on brain microstructure using DTI are included, and these demonstrate that both type 1 diabetes mellitus and type 2 diabetes mellitus may affect cognitive abilities due to the alterations in brain microstructures.
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Affiliation(s)
- Abdulmajeed Alotaibi
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
- Correspondence: ; Tel.: +44-115-823-1443; Fax: +44-115-9709738
| | - Christopher Tench
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
| | - Rebecca Stevenson
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
| | - Ghadah Felmban
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
| | - Amjad Altokhis
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- School of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Ali Aldhebaib
- School of Applied Medical Sciences, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
| | - Rob A. Dineen
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
- NIHR Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
| | - Cris S. Constantinescu
- Division of Clinical Neuroscience, Nottingham University Hospitals NHS Trust, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK; (C.T.); (R.S.); (G.F.); (A.A.); (R.A.D.); (C.S.C.)
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5
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Xing Y, Tench C, Wongwandee M, Schwarz ST, Bajaj N, Auer DP. Coordinate based meta-analysis of motor functional imaging in Parkinson's: disease-specific patterns and modulation by dopamine replacement and deep brain stimulation. Brain Imaging Behav 2020; 14:1263-1280. [PMID: 30809759 PMCID: PMC7381438 DOI: 10.1007/s11682-019-00061-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate factors affecting the pattern of motor brain activation reported in people with Parkinson's (PwP), aiming to differentiate disease-specific features from treatment effects. METHODS A co-ordinate-based-meta-analysis (CBMA) of functional motor neuroimaging studies involving patients with Parkinson's (PwP), and healthy controls (HC) identified 126 suitable articles. The experiments were grouped based on subject feature, medication status (onMed/offMed), deep brain stimulation (DBS) status (DBSon/DBSoff) and type of motor initiation. RESULTS HC and PwP shared similar neural networks during upper extremity motor tasks but with differences of reported frequency in mainly bilateral putamen, insula and ipsilateral inferior parietal and precentral gyri. The activation height was significantly reduced in the bilateral putamen, left SMA, left subthalamus nucleus, right thalamus and right midial global pallidum in PwPoffMed (vs. HC), and pre-SMA hypoactivation correlated with disease severity. These changes were not found in patients on dopamine replacement therapy (PwPonMed vs. HC) in line with a restorative function. By contrast, left SMA and primary motor cortex showed hyperactivation in the medicated state (vs. HC) suggesting dopaminergic overcompensation. Deep-brain stimulation (PwP during the high frequency subthalamus nucleus (STN) DBS vs. no stimulation) induced a decrease in left SMA activity and the expected increase in the left subthalamic/thalamic region regardless of hand movement. We further demonstrated a disease related effect of motor intention with only PwPoffMed showing increased activation in the medial frontal lobe in self-initiated studies. CONCLUSION We describe a consistent disease-specific pattern of putaminal hypoactivation during motor tasks that appears reversed by dopamine replacement. Inconsistent reports of altered SMA/pre-SMA activation can be explained by task- and medication-specific variation in intention. Moreover, SMA activity was reduced during STN-DBS, while dopamine-induced hyperactivation of SMA which might underpin hyperdynamic L-dopa related overcompensation.
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Affiliation(s)
- Yue Xing
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK.
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- Radiological Sciences, Sir Peter Mansfield Imaging Centre, NIHR Nottingham BRC, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Christopher Tench
- Division of Clinical Neurology, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - Monton Wongwandee
- Department of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Stefan T Schwarz
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK
- Department of Radiology, Cardiff and Vale University Health Board, Cardiff, Wales
| | - Nin Bajaj
- Department of Neurology, Nottingham University Hospitals, Nottingham, NG7 2UH, UK
| | - Dorothee P Auer
- Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, NG7 2UH, UK.
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
- Radiological Sciences, Sir Peter Mansfield Imaging Centre, NIHR Nottingham BRC, University of Nottingham, Nottingham, NG7 2UH, UK.
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Morandi E, Tanasescu R, Tarlinton RE, Constantinescu CS, Zhang W, Tench C, Gran B. The association between human endogenous retroviruses and multiple sclerosis: A systematic review and meta-analysis. PLoS One 2017; 12:e0172415. [PMID: 28207850 PMCID: PMC5313176 DOI: 10.1371/journal.pone.0172415] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 02/03/2017] [Indexed: 11/18/2022] Open
Abstract
Background The interaction between genetic and environmental factors is crucial to multiple sclerosis (MS) pathogenesis. Human Endogenous Retroviruses (HERVs) are endogenous viral elements of the human genome whose expression is associated with MS. Objective To perform a systematic review and meta-analysis and to assess qualitative and quantitative evidence on the expression of HERV families in MS patients. Methods Medline, Embase and the Cochrane Library were searched for published studies on the association of HERVs and MS. Meta-analysis was performed on the HERV-W family. Odds Ratio (OR) and 95% confidence interval (CI) were calculated for association. Results 43 reports were extracted (25 related to HERV-W, 13 to HERV-H, 9 to HERV-K, 5 to HRES-1 and 1 to HER-15 family). The analysis showed an association between expression of all HERV families and MS. For HERV-W, adequate data was available for meta-analysis. Results from meta-analyses of HERV-W were OR = 22.66 (95%CI 6.32 to 81.20) from 4 studies investigating MSRV/HERV-W (MS-associated retrovirus) envelope mRNA in peripheral blood mononuclear cells, OR = 44.11 (95%CI 12.95 to 150.30) from 6 studies of MSRV/HERV-W polymerase mRNA in serum/plasma and OR = 6.00 (95%CI 3.35 to 10.74) from 4 studies of MSRV/HERV-W polymerase mRNA in CSF. Conclusions This systematic review and meta-analysis shows an association between expression of HERVs, and in particular the HERV-W family, and MS.
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Affiliation(s)
- Elena Morandi
- Division of Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, Nottingham, United Kingdom
| | - Radu Tanasescu
- Division of Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, Nottingham, United Kingdom
- Division of Clinical Neurosciences, University of Medicine and Pharmacy Carol Davila, Department of Neurology, Colentina Hospital, Bucharest, Romania
| | - Rachael E. Tarlinton
- University of Nottingham School of Veterinary Medicine and Science, Nottingham, United Kingdom
| | - Cris S. Constantinescu
- Division of Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, Nottingham, United Kingdom
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Weiya Zhang
- Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham School of Medicine, Nottingham, United Kingdom
| | - Christopher Tench
- Division of Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, Nottingham, United Kingdom
| | - Bruno Gran
- Division of Clinical Neuroscience, University of Nottingham School of Medicine, Nottingham, Nottingham, United Kingdom
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
- * E-mail:
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Mistry N, Abdel-Fahim R, Samaraweera A, Mougin O, Tallantyre E, Tench C, Jaspan T, Morris P, Morgan PS, Evangelou N. Imaging central veins in brain lesions with 3-T T2*-weighted magnetic resonance imaging differentiates multiple sclerosis from microangiopathic brain lesions. Mult Scler 2016; 22:1289-96. [DOI: 10.1177/1352458515616700] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 09/23/2015] [Indexed: 11/17/2022]
Abstract
Background: White matter lesions are frequently detected using brain magnetic resonance imaging (MRI) performed for various indications. Most are microangiopathic, but demyelination, including multiple sclerosis (MS), is an important cause; conventional MRI cannot always distinguish between these pathologies. The proportion of lesions with a central vein on 7-T T2*-weighted MRI prospectively distinguishes demyelination from microangiopathic lesions. Objective: To test whether 3-T T2*-weighted MRI can differentiate MS from microangiopathic brain lesions. Methods: A total of 40 patients were studied. Initially, a test cohort of 10 patients with MS and 10 patients with microangiopathic white matter lesions underwent 3-T T2*-weighted brain MRI. Anonymised scans were analysed blind to clinical data, and simple diagnostic rules were devised. These rules were applied to a validation cohort of 20 patients (13 with MS and 7 with microangiopathic lesions) by a blinded observer. Results: Within the test cohort, all patients with MS had central veins visible in >45% of brain lesions, while the rest had central veins visible in <45% of lesions. By applying diagnostic rules to the validation cohort, all remaining patients were correctly categorised. Conclusion: 3-T T2*-weighted brain MRI distinguishes perivenous MS lesions from microangiopathic lesions. Clinical application of this technique could supplement existing diagnostic algorithms.
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Affiliation(s)
- Niraj Mistry
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Rasha Abdel-Fahim
- Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Amal Samaraweera
- Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Olivier Mougin
- Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, UK
| | - Emma Tallantyre
- Department of Neurology, University Hospital of Wales, Cardiff, UK
| | - Christopher Tench
- Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Tim Jaspan
- Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Morris
- Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, UK
| | - Paul S Morgan
- Department of Medical Physics, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Nikos Evangelou
- Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
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8
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Duan J, Lu W, Tench C, Gottlob I, Proudlock F, Samani NN, Bai L. Denoising optical coherence tomography using second order total generalized variation decomposition. Biomed Signal Process Control 2016. [DOI: 10.1016/j.bspc.2015.09.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Duan J, Tench C, Gottlob I, Proudlock F, Bai L. New variational image decomposition model for simultaneously denoising and segmenting optical coherence tomography images. Phys Med Biol 2015; 60:8901-22. [PMID: 26553577 DOI: 10.1088/0031-9155/60/22/8901] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Optical coherence tomography (OCT) imaging plays an important role in clinical diagnosis and monitoring of diseases of the human retina. Automated analysis of optical coherence tomography images is a challenging task as the images are inherently noisy. In this paper, a novel variational image decomposition model is proposed to decompose an OCT image into three components: the first component is the original image but with the noise completely removed; the second contains the set of edges representing the retinal layer boundaries present in the image; and the third is an image of noise, or in image decomposition terms, the texture, or oscillatory patterns of the original image. In addition, a fast Fourier transform based split Bregman algorithm is developed to improve computational efficiency of solving the proposed model. Extensive experiments are conducted on both synthesised and real OCT images to demonstrate that the proposed model outperforms the state-of-the-art speckle noise reduction methods and leads to accurate retinal layer segmentation.
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Affiliation(s)
- Jinming Duan
- School of Computer Science, University of Nottingham, Nottingham NG7 2RD, UK
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Mistry N, Abdel-Fahim R, Samaraweera A, Mougin O, Tallantyre E, Tench C, Jaspan T, Morgan P, Evangelou N. 3T T2* MRI DISTINGUISHES MS FROM MICROANGIOPATHIC LESIONS. J Neurol Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309236.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mistry N, Abdel-Fahim R, Mougin O, Tench C, Gowland P, Evangelou N. Cortical lesion load correlates with diffuse injury of multiple sclerosis normal appearing white matter. Mult Scler 2013; 20:227-33. [PMID: 23858017 DOI: 10.1177/1352458513496344] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Degeneration of central nervous system normal appearing white matter (NAWM) underlies disability and progression in multiple sclerosis (MS). Axon loss typifies NAWM degeneration. OBJECTIVE The objective of this paper is to assess correlation between cortical lesion load and magnetisation transfer ratio (MTR) of the NAWM in MS. This was in order to test the hypothesis that cortical lesions cause NAWM degeneration. METHODS Nineteen patients with MS underwent 7 Tesla magnetisation-prepared-rapid-acquisition-gradient-echo (MPRAGE), and magnetisation transfer ratio (MTR) brain magnetic resonance imaging (MRI). Cortical lesions were identified using MPRAGE and MTR images of cortical ribbons. White matter lesions (WMLs) were segmented using MPRAGE images. WML maps were subtracted from white matter volumes to produce NAWM masks. Pearson correlation was calculated for NAWM MTR vs cortical lesion load, and WML volumes. RESULTS Cortical lesion volumes and counts all had significant correlation with NAWM mean MTR. The strongest correlation was with cortical lesion volumes obtained using MTR images (r = -0.6874, p = 0.0006). WML volume had no significant correlation with NAWM mean MTR (r = -0.08706, p = 0.3615). CONCLUSION Our findings are consistent with the hypothesis that cortical lesions cause NAWM degeneration. This implicates cortical lesions in the pathogenesis of NAWM axon loss, which underpins long-term disability and progression in MS.
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Affiliation(s)
- Niraj Mistry
- Division of Clinical Neurology, University of Nottingham, Queen's Medical Centre, UK
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Mistry N, Dixon J, Tallantyre E, Tench C, Abdel-Fahim R, Jaspan T, Morgan PS, Morris P, Evangelou N. Central Veins in Brain Lesions Visualized With High-Field Magnetic Resonance Imaging. JAMA Neurol 2013; 70:623-8. [DOI: 10.1001/jamaneurol.2013.1405] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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13
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Kasivisvanathan V, Connell DW, Molyneaux PL, Singanayagam A, George PM, Tench C, Kon OM. A presentation of Poncet's disease identified following immunosuppressive steroid therapy [Correspondence]. Int J Tuberc Lung Dis 2012; 16:708-9. [DOI: 10.5588/ijtld.11.0749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- V. Kasivisvanathan
- Department of Chest and Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - D. W. Connell
- Department of Chest and Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - P. L. Molyneaux
- Department of Chest and Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - A. Singanayagam
- Department of Chest and Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - P. M. George
- Department of Chest and Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - C. Tench
- Department of Rheumatology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - O. M. Kon
- Department of Chest and Allergy, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
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Constantinescu C, Manouchehrinia A, Tench C, Bibani R, Britton J. Cigarette Smoking and Disease Progression in Patients with Multiple Sclerosis: A Study of a Large United Kingdom Cohort (P05.097). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mistry N, Dixon J, Tallantyre E, Tench C, Abdel-Fahim R, Jaspan T, Morgan P, Morris P, Evangelou N. A Single 7 Tesla MRI Brain Scan Predicts Multiple Sclerosis in Cases with Initial Diagnostic Uncertainty (S10.004). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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