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Adanyeguh IM, Perlbarg V, Henry PG, Rinaldi D, Petit E, Valabregue R, Brice A, Durr A, Mochel F. Autosomal dominant cerebellar ataxias: Imaging biomarkers with high effect sizes. Neuroimage Clin 2018; 19:858-867. [PMID: 29922574 PMCID: PMC6005808 DOI: 10.1016/j.nicl.2018.06.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/19/2018] [Accepted: 06/07/2018] [Indexed: 12/13/2022]
Abstract
Objective As gene-based therapies may soon arise for patients with spinocerebellar ataxia (SCA), there is a critical need to identify biomarkers of disease progression with effect sizes greater than clinical scores, enabling trials with smaller sample sizes. Methods We enrolled a unique cohort of patients with SCA1 (n = 15), SCA2 (n = 12), SCA3 (n = 20) and SCA7 (n = 10) and 24 healthy controls of similar age, sex and body mass index. We collected longitudinal clinical and imaging data at baseline and follow-up (mean interval of 24 months). We performed both manual and automated volumetric analyses. Diffusion tensor imaging (DTI) and a novel tractography method, called fixel-based analysis (FBA), were assessed at follow-up. Effect sizes were calculated for clinical scores and imaging parameters. Results Clinical scores worsened as atrophy increased over time (p < 0.05). However, atrophy of cerebellum and pons showed very large effect sizes (>1.2) compared to clinical scores (<0.8). FBA, applied for the first time to SCA, was sensitive to microstructural cross-sectional differences that were not captured by conventional DTI metrics, especially in the less studied SCA7 group. FBA also showed larger effect sizes than DTI metrics. Conclusion This study showed that volumetry outperformed clinical scores to measure disease progression in SCA1, SCA2, SCA3 and SCA7. Therefore, we advocate the use of volumetric biomarkers in therapeutic trials of autosomal dominant ataxias. In addition, FBA showed larger effect size than DTI to detect cross-sectional microstructural alterations in patients relative to controls. Biomarkers are needed to test upcoming therapies for spinocerebellar ataxia. As spinocerebellar ataxias are rare, biomarkers with high effect sizes are needed. We identified imaging biomarkers with higher effect sizes than clinical scores.
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Key Words
- Apparent fiber density
- CCFS, composite cerebellar functional severity score
- CFE, connectivity-based fixel enhancement
- CSD, constrained spherical deconvolution
- CST, corticospinal tract
- DTI, diffusion tensor imaging
- Diffusion imaging.
- FA, fractional anisotropy
- FBA, fixel-based analysis
- FC, fiber cross-section
- FD, fiber density
- FDC, fiber density and cross-section
- FOD, fiber orientation distribution
- FOV, Field of view
- Fixel analysis
- GRAPPA, generalized autocalibrating partial parallel acquisition
- Imaging biomarkers
- MPRAGE, magnetization-prepared rapid gradient-echo
- MRI, magnetic resonance imaging
- RD, radial diffusivity
- SARA, scale for the assessment and rating of ataxia
- SCA, spinocerebellar ataxias
- SNR, signal-to-noise ratio
- Spinocerebellar ataxia
- TBSS, tract-based spatial statistics
- TE, echo time
- TR, repetition time
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Affiliation(s)
- Isaac M Adanyeguh
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Vincent Perlbarg
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Bioinformatics and Biostatistics Core Facililty, iCONICS, Institut du Ceveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Pierre-Gilles Henry
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, United States
| | - Daisy Rinaldi
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Elodie Petit
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Romain Valabregue
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; Center for NeuroImaging Research (CENIR), Institut du Cerveau et de la Moelle épinière, 75013 Paris, France
| | - Alexis Brice
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France
| | - Alexandra Durr
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; AP-HP, Pitié-Salpêtrière University Hospital, Department of Genetics, Paris, France
| | - Fanny Mochel
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013 Paris, France; AP-HP, Pitié-Salpêtrière University Hospital, Department of Genetics, Paris, France; University Pierre and Marie Curie, Neurometabolic Research Group, Paris, France.
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Kuchling J, Backner Y, Oertel FC, Raz N, Bellmann-Strobl J, Ruprecht K, Paul F, Levin N, Brandt AU, Scheel M. Comparison of probabilistic tractography and tract-based spatial statistics for assessing optic radiation damage in patients with autoimmune inflammatory disorders of the central nervous system. Neuroimage Clin 2018; 19:538-550. [PMID: 29984162 PMCID: PMC6029567 DOI: 10.1016/j.nicl.2018.05.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/03/2018] [Accepted: 05/06/2018] [Indexed: 10/28/2022]
Abstract
Background Diffusion Tensor Imaging (DTI) can evaluate microstructural tissue damage in the optic radiation (OR) of patients with clinically isolated syndrome (CIS), early relapsing-remitting multiple sclerosis and neuromyelitis optica spectrum disorders (NMOSD). Different post-processing techniques, e.g. tract-based spatial statistics (TBSS) and probabilistic tractography, exist to quantify this damage. Objective To evaluate the capacity of TBSS-based atlas region-of-interest (ROI) combination with 1) posterior thalamic radiation ROIs from the Johns Hopkins University atlas (JHU-TBSS), 2) Juelich Probabilistic ROIs (JUEL-TBSS) and tractography methods using 3) ConTrack (CON-PROB) and 4) constrained spherical deconvolution tractography (CSD-PROB) to detect OR damage in patients with a) NMOSD with prior ON (NMOSD-ON), b) CIS and early RRMS patients with ON (CIS/RRMS-ON) and c) CIS and early RRMS patients without prior ON (CIS/RRMS-NON) against healthy controls (HCs). Methods Twenty-three NMOSD-ON, 18 CIS/RRMS-ON, 21 CIS/RRMS-NON, and 26 HCs underwent 3 T MRI. DTI data analysis was carried out using JUEL-TBSS, JHU-TBSS, CON-PROB and CSD-PROB. Optical coherence tomography (OCT) and visual acuity testing was performed in the majority of patients and HCs. Results Absolute OR fractional anisotropy (FA) values differed between all methods but showed good correlation and agreement in Bland-Altman analysis. OR FA values between NMOSD and HC differed throughout the methodologies (p-values ranging from p < 0.0001 to 0.0043). ROC-analysis and effect size estimation revealed higher AUCs and R2 for CSD-PROB (AUC = 0.812; R2 = 0.282) and JHU-TBSS (AUC = 0.756; R2 = 0.262), compared to CON-PROB (AUC = 0.742; R2 = 0.179) and JUEL-TBSS (AUC = 0.719; R2 = 0.161). Differences between CIS/RRMS-NON and HC were only observable in CSD-PROB (AUC = 0.796; R2 = 0.094). No significant differences between CIS/RRMS-ON and HC were detected by any of the methods. Conclusions All DTI post-processing techniques facilitated the detection of OR damage in patient groups with severe microstructural OR degradation. The comparison of distinct disease groups by use of different methods may lead to different - either false-positive or false-negative - results. Since different DTI post-processing approaches seem to provide complementary information on OR damage, application of distinct methods may depend on the relevant research question.
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Key Words
- AD, axial diffusivity
- AUC, area under the curve
- CIS, clinically isolated syndrome
- CON, Contrack
- CSD, constrained spherical deconvolution
- DTI
- DTI, diffusion tensor imaging
- DW-MRI, diffusion weighted magnetic resonance imaging
- DWI, diffusion weighted imaging
- FA, fractional anisotropy
- FOD, fiber orientation distribution
- HC, Healthy Control
- JHU, Johns Hopkins University DTI white matter atlas
- JUEL, Juelich histological atlas
- LGN, lateral geniculate nucleus
- MD, mean diffusivity
- MS, multiple sclerosis
- Multiple sclerosis
- NMOSD, neuromyelitis optica spectrum disorder
- Neuromyelitis optica
- OCT, optical coherence tomography
- ON, optic neuritis
- OR, optic radiation
- Optic radiation
- PROB, probabilistic tractography
- Probabilistic tractography
- RD, radial diffusivity
- RNFL, retinal nerve fiber layer thickness
- ROC, receiver operating characteristic
- ROI, region of interest
- RRMS, relapsing-remitting multiple sclerosis
- SD, standard deviation
- SEM, standard error of the mean
- TBSS
- TBSS, tract-based spatial statistics
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Affiliation(s)
- Joseph Kuchling
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, NeuroCure Clinical Research Center, NCRC Charité, Charitéplatz 1, 10117 Berlin, Germany; Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| | - Yael Backner
- Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah-Hebrew-University Medical Center, Kiryat Hadassah Ein kerem, Jerusalem 91120, Israel.
| | - Frederike C Oertel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, NeuroCure Clinical Research Center, NCRC Charité, Charitéplatz 1, 10117 Berlin, Germany.
| | - Noa Raz
- Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah-Hebrew-University Medical Center, Kiryat Hadassah Ein kerem, Jerusalem 91120, Israel.
| | - Judith Bellmann-Strobl
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, NeuroCure Clinical Research Center, NCRC Charité, Charitéplatz 1, 10117 Berlin, Germany; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| | - Klemens Ruprecht
- Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| | - Friedemann Paul
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, NeuroCure Clinical Research Center, NCRC Charité, Charitéplatz 1, 10117 Berlin, Germany; Department of Neurology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
| | - Netta Levin
- Department of Neurology, The Agnes Ginges Center for Human Neurogenetics, Hadassah-Hebrew-University Medical Center, Kiryat Hadassah Ein kerem, Jerusalem 91120, Israel.
| | - Alexander U Brandt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, NeuroCure Clinical Research Center, NCRC Charité, Charitéplatz 1, 10117 Berlin, Germany; Department of Neurology, University of California, 1001 Health Sciences Road, Irvine Hall, Irvine, CA 92697, USA.
| | - Michael Scheel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Neurocure Cluster of Excellence, NeuroCure Clinical Research Center, NCRC Charité, Charitéplatz 1, 10117 Berlin, Germany.
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Wirsich J, Perry A, Ridley B, Proix T, Golos M, Bénar C, Ranjeva JP, Bartolomei F, Breakspear M, Jirsa V, Guye M. Whole-brain analytic measures of network communication reveal increased structure-function correlation in right temporal lobe epilepsy. Neuroimage Clin 2016; 11:707-718. [PMID: 27330970 PMCID: PMC4909094 DOI: 10.1016/j.nicl.2016.05.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/15/2016] [Accepted: 05/18/2016] [Indexed: 12/13/2022]
Abstract
The in vivo structure-function relationship is key to understanding brain network reorganization due to pathologies. This relationship is likely to be particularly complex in brain network diseases such as temporal lobe epilepsy, in which disturbed large-scale systems are involved in both transient electrical events and long-lasting functional and structural impairments. Herein, we estimated this relationship by analyzing the correlation between structural connectivity and functional connectivity in terms of analytical network communication parameters. As such, we targeted the gradual topological structure-function reorganization caused by the pathology not only at the whole brain scale but also both in core and peripheral regions of the brain. We acquired diffusion (dMRI) and resting-state fMRI (rsfMRI) data in seven right-lateralized TLE (rTLE) patients and fourteen healthy controls and analyzed the structure-function relationship by using analytical network communication metrics derived from the structural connectome. In rTLE patients, we found a widespread hypercorrelated functional network. Network communication analysis revealed greater unspecific branching of the shortest path (search information) in the structural connectome and a higher global correlation between the structural and functional connectivity for the patient group. We also found evidence for a preserved structural rich-club in the patient group. In sum, global augmentation of structure-function correlation might be linked to a smaller functional repertoire in rTLE patients, while sparing the central core of the brain which may represent a pathway that facilitates the spread of seizures.
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Key Words
- CSD, constrained spherical deconvolution
- CSF, cerebrospinal fluid
- FA, fractional anisotropy
- FCA, analytic functional connectivity
- FCD, functional connectivity dynamics
- FOD, fiber orientation distribution
- Functional connectivity
- NBS, network based statistics
- Network based statistics
- Network communication
- Rich club
- Structural connectivity
- Temporal lobe epilepsy
- dMRI, diffusion magnetic resonance imaging
- rTLE, right temporal lobe epilepsy
- rsfMRI, resting state functional magnetic resonance imaging
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Affiliation(s)
- Jonathan Wirsich
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, 13385 Marseille, France; APHM, Hôpitaux de la Timone, Pôle d'imagerie Médicale, CEMEREM, 13005 Marseille, France; Aix-Marseille Université, Institut de Neurosciences des Systèmes, 13385 Marseille, France; INSERM, UMR_S 1106, 13385 Marseille, France.
| | - Alistair Perry
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia; Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia.
| | - Ben Ridley
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, 13385 Marseille, France; APHM, Hôpitaux de la Timone, Pôle d'imagerie Médicale, CEMEREM, 13005 Marseille, France.
| | - Timothée Proix
- Aix-Marseille Université, Institut de Neurosciences des Systèmes, 13385 Marseille, France; INSERM, UMR_S 1106, 13385 Marseille, France.
| | - Mathieu Golos
- Aix-Marseille Université, Institut de Neurosciences des Systèmes, 13385 Marseille, France; INSERM, UMR_S 1106, 13385 Marseille, France.
| | - Christian Bénar
- Aix-Marseille Université, Institut de Neurosciences des Systèmes, 13385 Marseille, France; INSERM, UMR_S 1106, 13385 Marseille, France.
| | - Jean-Philippe Ranjeva
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, 13385 Marseille, France; APHM, Hôpitaux de la Timone, Pôle d'imagerie Médicale, CEMEREM, 13005 Marseille, France.
| | - Fabrice Bartolomei
- Aix-Marseille Université, Institut de Neurosciences des Systèmes, 13385 Marseille, France; INSERM, UMR_S 1106, 13385 Marseille, France; APHM, Hôpitaux de la Timone, Pôle de Neurosciences Cliniques, Service de Neurophysiologie Clinique, 13005 Marseille, France.
| | - Michael Breakspear
- School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia; Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; Metro North Mental Health Services, Brisbane, QLD 4006, Australia.
| | - Viktor Jirsa
- Aix-Marseille Université, Institut de Neurosciences des Systèmes, 13385 Marseille, France; INSERM, UMR_S 1106, 13385 Marseille, France.
| | - Maxime Guye
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, 13385 Marseille, France; APHM, Hôpitaux de la Timone, Pôle d'imagerie Médicale, CEMEREM, 13005 Marseille, France.
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