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Reiländer A, Pilatus U, Schüre JR, Shrestha M, Deichmann R, Nöth U, Hattingen E, Gracien RM, Wagner M, Seiler A. Impaired oxygen extraction and adaptation of intracellular energy metabolism in cerebral small vessel disease. Cereb Circ Cogn Behav 2023; 4:100162. [PMID: 36851996 PMCID: PMC9957754 DOI: 10.1016/j.cccb.2023.100162] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/25/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND We aimed to investigate whether combined phosphorous (31P) magnetic resonance spectroscopic imaging (MRSI) and quantitative T 2 ' mapping are able to detect alterations of the cerebral oxygen extraction fraction (OEF) and intracellular pH (pHi) as markers the of cellular energy metabolism in cerebral small vessel disease (SVD). MATERIALS AND METHODS 32 patients with SVD and 17 age-matched healthy control subjects were examined with 3-dimensional 31P MRSI and oxygenation-sensitive quantitative T 2 ' mapping (1/ T 2 ' = 1/T2* - 1/T2) at 3 Tesla (T). PHi was measured within the white matter hyperintensities (WMH) in SVD patients. Quantitative T 2 ' values were averaged across the entire white matter (WM). Furthermore, T 2 ' values were extracted from normal-appearing WM (NAWM) and the WMH and compared between patients and controls. RESULTS Quantitative T 2 ' values were significantly increased across the entire WM and in the NAWM in patients compared to control subjects (149.51 ± 16.94 vs. 138.19 ± 12.66 ms and 147.45 ± 18.14 vs. 137.99 ± 12.19 ms, p < 0.05). WM T 2 ' values correlated significantly with the WMH load (ρ=0.441, p = 0.006). Increased T 2 ' was significantly associated with more alkaline pHi (ρ=0.299, p < 0.05). Both T 2 ' and pHi were significantly positively correlated with vascular pulsatility in the distal carotid arteries (ρ=0.596, p = 0.001 and ρ=0.452, p = 0.016). CONCLUSIONS This exploratory study found evidence of impaired cerebral OEF in SVD, which is associated with intracellular alkalosis as an adaptive mechanism. The employed techniques provide new insights into the pathophysiology of SVD with regard to disease-related consequences on the cellular metabolic state.
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Key Words
- BBB, blood-brain barrier
- CBF, cerebral blood flow
- CBV, cerebral blood volume
- CMRO2, Cerebral metabolic rate of oxygen
- Cellular energy metabolism
- DTI, diffusion tensor imaging
- GE, gradient echo
- Hb, hemoglobin
- ICA, internal carotid artery
- MR spectroscopy
- MRI, magnetic resonance imaging
- MRS, magnetic resonance spectroscopy
- MRSI, magnetic resonance spectroscopic imaging
- Microstructural impairment
- NAWM, normal-appearing white matter
- OEF, oxygen extraction fraction
- Oxygen extraction fraction
- PI, Pulsatility index
- RF, radio frequency
- SVD, cerebral small vessel disease
- Small vessel disease
- TR, repetition time
- WM, white matter
- WMH, white matter hyperintensities
- pHi, intracellular pH
- quantitative MRI
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Affiliation(s)
- Annemarie Reiländer
- Department of Neurology, Goethe University Hospital Frankfurt, Schleusenweg 2-16, Frankfurt 60528, Germany
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Ulrich Pilatus
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Jan-Rüdiger Schüre
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Manoj Shrestha
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Hospital Frankfurt, Schleusenweg 2-16, Frankfurt 60528, Germany
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Marlies Wagner
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University Hospital Frankfurt, Schleusenweg 2-16, Frankfurt 60528, Germany
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
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Mellander H, Fransson V, Ydström K, Lätt J, Ullberg T, Wassélius J, Ramgren B. Metal artifact reduction by virtual monoenergetic reconstructions from spectral brain CT. Eur J Radiol Open 2023; 10:100479. [PMID: 36819113 DOI: 10.1016/j.ejro.2023.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose Conventional computed tomography (CT) images are severely affected by metal artifacts in patients with intracranial coils. Monoenergetic images have been suggested to reduce metal artifacts.The aim of this study was to assess metal artifacts in virtual monoenergetic images (VMIs) reconstructed from spectral brain CT. Methods Thirty-two consecutive patients with intracranial coils examined by spectral non contrast brain CT (NCCT) at our center between November 2017 and April 2019 were included. Attenuation and standard deviations were measured in regions of interest (ROIs) at predefined areas in artifact-free and artifact-affected areas. Measurements were performed in conventional polyenergetic images (CIs) and the corresponding data for VMIs were retrieved through spectral diagrams for the each ROI. Subjective analysis was performed by visual grading of CIs and specific VMIs by two neuroradiologists, independently. Results In artefact-affected image areas distal from the metal objects, the attenuation values decreased with higher energy level VMIs. The same effect was not seen for artefact-affected image areas close to the metal.Subjective rating of the artefact severity was significantly better in VMIs at 50 keV for one of the two reviewers compared to the CIs. Overall image quality and tissue differentiation scores were significantly higher for both reviewers in VMIs at 60 and 70 keV compared to CIs. Conclusion Our quantitative and qualitative image analysis shown that there is a small significant reduction of intracranial coils artifacts severity by all monoenergetic reconstructions from 50 to 200 keV with preserved or increased overall subjective image quality compared to conventional images.
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Key Words
- Aneurysm
- CIs, conventional images
- CSF, cerebrospinal fluid
- CT, computed tomography
- DECT, dual energy computed tomography
- DLP, dose length product
- DSA, digital subtraction angiography
- Diagnostic imaging
- HU, Hounsfield units
- IQR, interquartile range
- MRI, magnetic resonance imaging
- Metal artifacts
- Monoenergetic imaging
- PACS, Picture Archiving and Communication System
- ROI, region of interest
- SD, standard deviation
- SNR, signal-to-noise ratio
- VMIs, virtual monoenergetic images
- WM, white matter
- X-ray computed tomography
- keV, kiloelectron volt
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Lacalle-Aurioles M, Iturria-Medina Y. Fornix degeneration in risk factors of Alzheimer's disease, possible trigger of cognitive decline. Cereb Circ Cogn Behav 2023; 4:100158. [PMID: 36703699 PMCID: PMC9871745 DOI: 10.1016/j.cccb.2023.100158] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023]
Abstract
Risk factors of late-onset Alzheimer's disease (AD) such as aging, type 2 diabetes, obesity, heart failure, and traumatic brain injury can facilitate the appearance of cognitive decline and dementia by triggering cerebrovascular pathology and neuroinflammation. White matter (WM) microstructure and function are especially vulnerable to these conditions. Microstructural WM changes, assessed with diffusion weighted magnetic resonance imaging, can already be detected at preclinical stages of AD, and in the presence of the aforementioned risk factors. Particularly, the limbic system and cortico-cortical association WM tracts, which myelinate late during brain development, degenerate at the earliest stages. The fornix, a C-shaped WM tract that originates from the hippocampus, is one of the limbic tracts that shows early microstructural changes. Fornix integrity is necessary for ensuring an intact executive function and memory performance. Thus, a better understanding of the mechanisms that cause fornix degeneration is critical in the development of therapeutic strategies aiming to prevent cognitive decline in populations at risk. In this literature review, i) we deepen the idea that partial loss of forniceal integrity is an early event in AD, ii) we describe the role that common risk factors of AD can play in the degeneration of the fornix, and iii) we discuss some potential cellular and physiological mechanisms of WM degeneration in the scenario of cerebrovascular disease and inflammation.
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Affiliation(s)
- María Lacalle-Aurioles
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC H3A 2B4, Canada,Corresponding author at: Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4, Canada.
| | - Yasser Iturria-Medina
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montréal, QC H3A 2B4, Canada,Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montreal, Canada,McConnell Brain Imaging Centre, McGill University, Montreal, Canada
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Blair GW, Stringer MS, Thrippleton MJ, Chappell FM, Shuler K, Hamilton I, Garcia DJ, Doubal FN, Kopczak A, Duering M, Ingrisch M, Kerkhofs D, Staals J, van den Brink H, Arts T, Backes WH, van Oostenbrugge R, Biessels GJ, Dichgans M, Wardlaw JM. Imaging neurovascular, endothelial and structural integrity in preparation to treat small vessel diseases. The INVESTIGATE-SVDs study protocol. Part of the SVDs@Target project. Cereb Circ Cogn Behav 2021; 2:100020. [PMID: 36324725 DOI: 10.1016/j.cccb.2021.100020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/25/2021] [Accepted: 06/20/2021] [Indexed: 12/30/2022]
Abstract
Background Sporadic cerebral small vessel disease (SVD) and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) share clinical and neuroimaging features and possibly vascular dysfunction(s). However few studies have included both conditions, assessed more than one vascular dysfunction simultaneously, or included more than one centre. The INVESTIGATE-SVDs study will assess several cerebrovascular dysfunctions with MRI in participants with sporadic SVD or CADASIL at three European centres. Methods We will recruit participants with sporadic SVDs (ischaemic stroke or vascular cognitive impairment) and CADASIL in Edinburgh, Maastricht and Munich. We will perform detailed clinical and neuropsychological phenotyping of the participants, and neuroimaging including structural MRI, cerebrovascular reactivity MRI (CVR: using carbon dioxide challenge), phase contrast MRI (arterial, venous and CSF flow and pulsatility), dynamic contrast-enhanced MRI (blood brain barrier (BBB) leakage) and multishell diffusion imaging. Participants will measure their blood pressure (BP) and its variability over seven days using a telemetric device. Discussion INVESTIGATE-SVDs will assess the relationships of BBB integrity, CVR, pulsatility and CSF flow in sporadic SVD and CADASIL using a multisite, multimodal MRI protocol. We aim to establish associations between these measures of vascular function, risk factors particularly BP and its variability, and brain parenchymal lesions in these two SVD phenotypes. Additionally we will test feasibility of complex multisite MRI, provide reliable intermediary outcome measures and sample size estimates for future trials.
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Key Words
- BBB, blood brain barrier
- BOLD, blood oxygen level dependent
- BP, blood pressure
- BPv, blood pressure variability
- Blood-brain barrier permeability
- CADASIL
- CADASIL, cerebral autosomal dominant arteriopathy with leukoencephalopathy and subcortical infarcts
- CBF, cerebral blood flow
- CERAD+, consortium to establish a disease registry for Alzheimer's disease plus battery
- CO2, carbon dioxide
- CSF, cerebrospinal fluid
- CVR, cerebrovascular reactivity
- Cerebral small vessel disease
- Cerebrovascular reactivity
- DCE, dynamic contrast enhanced
- EtCO2, end-tidal carbon dioxide
- GM, grey matter
- MMSE, mini-mental state examination
- MRI
- MoCA, Montreal cognitive exam
- NIHSS, national institute for health stroke scale
- PI, pulsatility index
- PVS, perivascular space
- RSSI, recent small subcortical infarct
- SVDs, small vessel diseases
- WM, white matter
- WMH, white matter hyperintensity
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Yamashita K, Kuwashiro T, Ishikawa K, Furuya K, Harada S, Shin S, Wada N, Hirakawa C, Okada Y, Noguchi T. Identification of predictors for mini-mental state examination and revised Hasegawa's Dementia Scale scores using MR-based brain morphometry. Eur J Radiol Open 2021; 8:100359. [PMID: 34095357 PMCID: PMC8167144 DOI: 10.1016/j.ejro.2021.100359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose The early detection of cognitive function decline is crucial to help manage or slow the progression of symptoms. The Mini-Mental State Examination (MMSE) and revised Hasegawa's Dementia Scale (HDS-R) are widely used in screening for cognitive impairment. The purpose of this study was to explore common predictors of the two different cognitive testing systems using MR-based brain morphometry. Materials and Methods This retrospective study included 200 subjects with clinical suspicion of cognitive impairment who underwent 3D T1-weighted MRI at our institution between February 2019 and August 2020. Variables related to the volume of deep gray matter and 70 cortical thicknesses were obtained from the MR images using voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) and FreeSurfer software. The correlation between each variable including age and MMSE/HDS-R scores was evaluated using uni- and multi-variate logistic regression analyses. Results In univariate analysis, parameters include hippocampal volume and bilateral entorhinal cortex (ERC) thickness showed moderate correlation coefficients with both MMSE and HDS-R scores. Multivariate analysis demonstrated the right ERC thickness was the common parameter which significantly correlates with both MMSE and HDS-R scores (p < 0.05). Conclusion Right ERC thickness appears to offer a useful predictive biomarker for both MMSE and HDS-R scores.
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Key Words
- 3D, 3-dimensional
- AD, Alzheimer’s disease
- ApoE, apolipoprotein E
- Cerebral cortex
- ERC, entorhinal cortex
- GM, gray matter
- HDS-R, revised Hasegawa's Dementia Scale
- MMSE, Mini-Mental State Examination
- MPRAGE, magnetization-prepared rapid gradient-echo
- Magnetic resonance imaging
- Mini-Mental State examination
- VOI, voxel of interest
- VSRAD, Voxel-based specific regional analysis system for Alzheimer’s disease
- WM, white matter
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Affiliation(s)
- Koji Yamashita
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Takahiro Kuwashiro
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Kensuke Ishikawa
- Department of Psychiatry, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Kiyomi Furuya
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Shino Harada
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Seitaro Shin
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Noriaki Wada
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Chika Hirakawa
- Department of Medical Technology, Division of Radiology, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Yasushi Okada
- Department of Cerebrovascular Medicine and Neurology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
| | - Tomoyuki Noguchi
- Department of Radiology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka, 810-0065, Japan
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Waters ES, Kaiser EE, Yang X, Fagan MM, Scheulin KM, Jeon JH, Shin SK, Kinder HA, Kumar A, Platt SR, Duberstein KJ, Park HJ, Xie J, West FD. Intracisternal administration of tanshinone IIA-loaded nanoparticles leads to reduced tissue injury and functional deficits in a porcine model of ischemic stroke. IBRO Neurosci Rep 2021; 10:18-30. [PMID: 33842909 DOI: 10.1016/j.ibneur.2020.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background The absolute number of new stroke patients is annually increasing and there still remains only a few Food and Drug Administration (FDA) approved treatments with significant limitations available to patients. Tanshinone IIA (Tan IIA) is a promising potential therapeutic for ischemic stroke that has shown success in pre-clinical rodent studies but lead to inconsistent efficacy results in human patients. The physical properties of Tan-IIA, including short half-life and low solubility, suggests that Poly (lactic-co-glycolic acid) (PLGA) nanoparticle-assisted delivery may lead to improve bioavailability and therapeutic efficacy. The objective of this study was to develop Tan IIA-loaded nanoparticles (Tan IIA-NPs) and to evaluate their therapeutic effects on cerebral pathological changes and consequent motor function deficits in a pig ischemic stroke model. Results Tan IIA-NP treated neural stem cells showed a reduction in SOD activity in in vitro assays demonstrating antioxidative effects. Ischemic stroke pigs treated with Tan IIA-NPs showed reduced hemispheric swelling when compared to vehicle only treated pigs (7.85 ± 1.41 vs. 16.83 ± 0.62%), consequent midline shift (MLS) (1.72 ± 0.07 vs. 2.91 ± 0.36 mm), and ischemic lesion volumes (9.54 ± 5.06 vs. 12.01 ± 0.17 cm3) when compared to vehicle-only treated pigs. Treatment also lead to lower reductions in diffusivity (-37.30 ± 3.67 vs. -46.33 ± 0.73%) and white matter integrity (-19.66 ± 5.58 vs. -30.11 ± 1.19%) as well as reduced hemorrhage (0.85 ± 0.15 vs 2.91 ± 0.84 cm3) 24 h post-ischemic stroke. In addition, Tan IIA-NPs led to a reduced percentage of circulating band neutrophils at 12 (7.75 ± 1.93 vs. 14.00 ± 1.73%) and 24 (4.25 ± 0.48 vs 5.75 ± 0.85%) hours post-stroke suggesting a mitigated inflammatory response. Moreover, spatiotemporal gait deficits including cadence, cycle time, step time, swing percent of cycle, stride length, and changes in relative mean pressure were less severe post-stroke in Tan IIA-NP treated pigs relative to control pigs. Conclusion The findings of this proof of concept study strongly suggest that administration of Tan IIA-NPs in the acute phase post-stroke mitigates neural injury likely through limiting free radical formation, thus leading to less severe gait deficits in a translational pig ischemic stroke model. With stroke as one of the leading causes of functional disability in the United States, and gait deficits being a major component, these promising results suggest that acute Tan IIA-NP administration may improve functional outcomes and the quality of life of many future stroke patients.
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Key Words
- ADC, Apparent Diffusion Coefficient
- ANOVA, analysis of variance
- AU, arbitrary units
- BBB, blood brain barrier
- Baic, Baicalin
- CNS, central nervous system
- CSF, cerebral spinal fluid
- DAMPS, damaged-associated molecular patterns
- DLS, dynamic light scattering
- DTI, Diffusion Tensor Imaging
- DWI, Diffusion-Weighted Imaging
- Edar, Edaravone
- FA, fractional anisotropy
- FDA, Food and Drug Administration
- GABA, γ-aminobutyric acid
- GM, gray matter
- IC, inhibitory concentration
- ICH, intracerebral hemorrhage
- IL-6, interleukin 6
- IM, intramuscular
- Ischemic stroke
- LPS, lipopolysaccharide
- MCA, middle cerebral artery
- MCAO, middle cerebral artery occlusion
- MLS, midline shift
- NP, nanoparticle
- NSCs, neural stem cells
- Nanomedicine
- PBS, phosphate buffered saline
- PEG–PLGA, polyethyleneglycol–polylactic-co-glycolic acid
- PLGA nanoparticle
- PLGA, Poly (lactic-co-glycolic acid)
- PLGA-b-PEG-OH, poly (lactide-co-glycolide)-b-poly (ethylene glycol)-maleimide
- Pig stroke model
- Piog, Pioglitazone
- Puer, Puerarin
- ROS, reactive oxygen species
- Resv, Resveratrol
- SOD, superoxide dismutase
- STAIR, Stroke Therapy Academic and Industry Roundtable
- T2*, T2Star
- T2FLAIR, T2 Fluid Attenuated Inversion Recovery
- T2W, T2Weighted
- TD, transdermal
- TEM, transmission electron microscopy
- TNF-α, tumor necrosis factor α
- Tan IIA, Tanshinone IIA
- Tan IIA-NPs, Tan IIA PLGA NPs
- Tan IIA-NPs, Tan IIA-loaded nanoparticles
- Tanshinone IIA
- UGA, University of Georgia
- WM, white matter
- ddH2O, double-distilled water
- tPA, Tissue plasminogen activator
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Ammirati E, Moroni F, Magnoni M, Rocca MA, Messina R, Anzalone N, De Filippis C, Scotti I, Besana F, Spagnolo P, Rimoldi OE, Chiesa R, Falini A, Filippi M, Camici PG. Extent and characteristics of carotid plaques and brain parenchymal loss in asymptomatic patients with no indication for revascularization. Int J Cardiol Heart Vasc 2020; 30:100619. [PMID: 32904369 PMCID: PMC7452655 DOI: 10.1016/j.ijcha.2020.100619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/26/2020] [Revised: 08/01/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Extent of subclinical atherosclerosis has been associated with brain parenchymal loss in community-dwelling aged subjects. Identification of patient-related and plaque-related markers could identify subjects at higher risk of brain atrophy, independent of cerebrovascular accidents. Aim of the study was to investigate the relation between extent and characteristics of carotid plaques and brain atrophy in asymptomatic patients with no indication for revascularization. METHODS AND RESULTS Sixty-four patients (aged 69 ± 8 years, 45% females) with carotid stenosis <70% based on Doppler flow velocity were enrolled in the study. Potential causes of cerebral damage other than atherosclerosis, including history of atrial fibrillation, heart failure, previous cardiac or neurosurgery and neurological disorders were excluded. All subjects underwent carotid computed tomography angiography, contrast enhanced ultrasound for assessment of plaque neovascularization and brain magnetic resonance imaging for measuring brain volumes. On multivariate regression analysis, age and fibrocalcific plaques were independently associated with lower total brain volumes (β = -3.13 and β = -30.7, both p < 0.05). Fibrocalcific plaques were also independently associated with lower gray matter (GM) volumes (β = -28.6, p = 0.003). On the other hand, age and extent of carotid atherosclerosis were independent predictors of lower white matter (WM) volumes. CONCLUSIONS WM and GM have different susceptibility to processes involved in parenchymal loss. Contrary to common belief, our results show that presence of fibrocalcific plaques is associated with brain atrophy.
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Affiliation(s)
- Enrico Ammirati
- Vita-Salute University and San Raffaele Hospital, Milan, Italy
- De Gasperis Cardio Center, Niguarda Ca’ Granda Hospital, Milan, Italy
| | | | - Marco Magnoni
- Vita-Salute University and San Raffaele Hospital, Milan, Italy
| | - Maria A Rocca
- Vita-Salute University and Neuroimaging Research Unit, Institute of Experimental Neurology, and Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Roberta Messina
- Vita-Salute University and Neuroimaging Research Unit, Institute of Experimental Neurology, and Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Nicoletta Anzalone
- Vita-Salute University and Department of Neuroradiology, San Raffaele Scientific Institute, Milan, Italy
| | - Costantino De Filippis
- Vita-Salute University and Department of Neuroradiology, San Raffaele Scientific Institute, Milan, Italy
| | - Isabella Scotti
- Department of Rheumatology, Istituto Ortopedico Gaetano Pini, Milan, Italy
| | - Francesca Besana
- Cardiovascular Prevention Center, San Raffaele Institute, Milan, Italy
| | - Pietro Spagnolo
- Cardiovascular Prevention Center, San Raffaele Institute, Milan, Italy
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | - Roberto Chiesa
- Vita-Salute University and San Raffaele Hospital, Milan, Italy
| | - Andrea Falini
- Vita-Salute University and Department of Neuroradiology, San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Vita-Salute University and Neuroimaging Research Unit, Institute of Experimental Neurology, and Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy
| | - Paolo G Camici
- Vita-Salute University and San Raffaele Hospital, Milan, Italy
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Rydhög A, Pasternak O, Ståhlberg F, Ahlgren A, Knutsson L, Wirestam R. Estimation of diffusion, perfusion and fractional volumes using a multi-compartment relaxation-compensated intravoxel incoherent motion (IVIM) signal model. Eur J Radiol Open 2019; 6:198-205. [PMID: 31193664 PMCID: PMC6538803 DOI: 10.1016/j.ejro.2019.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/14/2019] [Accepted: 05/14/2019] [Indexed: 12/12/2022] Open
Abstract
Compartmental diffusion MRI models that account for intravoxel incoherent motion (IVIM) of blood perfusion allow for estimation of the fractional volume of the microvascular compartment. Conventional IVIM models are known to be biased by not accounting for partial volume effects caused by free water and cerebrospinal fluid (CSF), or for tissue-dependent relaxation effects. In this work, a three-compartment model (tissue, free water and blood) that includes relaxation terms is introduced. To estimate the model parameters, in vivo human data were collected with multiple echo times (TE), inversion times (TI) and b-values, which allowed a direct relaxation estimate alongside estimation of perfusion, diffusion and fractional volume parameters. Compared to conventional two-compartment models (with and without relaxation compensation), the three-compartment model showed less effects of CSF contamination. The proposed model yielded significantly different volume fractions of blood and tissue compared to the non-relaxation-compensated model, as well as to the conventional two-compartment model, suggesting that previously reported parameter ranges, using models that do not account for relaxation, should be reconsidered.
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Key Words
- CSF, cerebrospinal fluid
- Diffusion
- GM, grey matter
- IR, inversion recovery
- IVIM, intravoxel incoherent motion
- Intravoxel incoherent motion
- PVE, partial volume effect
- Perfusion fraction
- Pseudo-diffusion
- ROI, region of interest
- Relaxation
- SNR, signal-to-noise ratio
- T1, longitudinal relaxation time
- T2, transverse relaxation time
- TE, echo time
- TI, inversion time
- TR, repetition time
- WM, white matter
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Affiliation(s)
- Anna Rydhög
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Freddy Ståhlberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,Department of Diagnostic Radiology, Lund University, Lund, Sweden.,Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - André Ahlgren
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ronnie Wirestam
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
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9
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Abstract
Brain edema is a common feature associated with hepatic encephalopathy (HE). In patients with acute HE, brain edema has been shown to play a crucial role in the associated neurological deterioration. In chronic HE, advanced magnetic resonance imaging (MRI) techniques have demonstrated that low-grade brain edema appears also to be an important pathological feature. This review explores the different methods used to measure brain edema ex vivo and in vivo in animal models and in humans with chronic HE. In addition, an in-depth description of the main studies performed to date is provided. The role of brain edema in the neurological alterations linked to HE and whether HE and brain edema are the manifestations of the same pathophysiological mechanism or two different cerebral manifestations of brain dysfunction in liver disease are still under debate. In vivo MRI/magnetic resonance spectroscopy studies have allowed insight into the development of brain edema in chronic HE. However, additional in vivo longitudinal and multiparametric/multimodal studies are required (in humans and animal models) to elucidate the relationship between liver function, brain metabolic changes, cellular changes, cell swelling, and neurological manifestations in chronic HE.
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Key Words
- 1H MRS, proton magnetic resonance spectroscopy
- ADC, apparent diffusion coefficient
- ALF, acute liver failure
- AQP, aquaporins
- BBB, blood-brain barrier
- BDL, bile duct ligation
- CNS, central nervous system
- CSF, cerebrospinal fluid
- Cr, creatine
- DTI, diffusion tensor imaging
- DWI, diffusion-weighted imaging
- FLAIR, fluid-attenuated inversion recovery
- GM, gray matter
- Gln, glutamine
- Glx, sum of glutamine and glutamate
- HE, hepatic encephalopathy
- Ins, inositol
- LPS, lipopolysaccharide
- Lac, lactate
- MD, mean diffusivity
- MRI, magnetic resonance imaging
- MRS, magnetic resonance spectroscopy
- MT, magnetization transfer
- MTR, MT ratio
- NMR, nuclear magnetic resonance
- PCA, portocaval anastomosis
- TE, echo time
- WM, white matter
- brain edema
- chronic hepatic encephalopathy
- in vivo magnetic resonance imaging
- in vivo magnetic resonance spectroscopy
- liver cirrhosis
- mIns, myo-inositol
- tCho, total choline
- tCr, total creatine
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Affiliation(s)
- Cristina Cudalbu
- Centre d'Imagerie Biomedicale (CIBM), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland,Address for correspondence: Cristina Cudalbu, Centre d'Imagerie Biomedicale (CIBM), Ecole Polytechnique Fédérale de Lausanne (EPFL), EPFL-CIBM, Office F3 628, Station 6, CH-1015 Lausanne, Switzerland.
| | - Simon D. Taylor-Robinson
- Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and Cancer, St Mary's Hospital Campus, Imperial College London, London, United Kingdom
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10
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Chen L, Wang Y, Niu C, Zhong S, Hu H, Chen P, Zhang S, Chen G, Deng F, Lai S, Wang J, Huang L, Huang R. Common and distinct abnormal frontal-limbic system structural and functional patterns in patients with major depression and bipolar disorder. Neuroimage Clin 2018; 20:42-50. [PMID: 30069426 PMCID: PMC6067086 DOI: 10.1016/j.nicl.2018.07.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [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: 03/14/2018] [Revised: 06/02/2018] [Accepted: 07/03/2018] [Indexed: 12/16/2022]
Abstract
Major depressive disorder (MDD) and bipolar disorder (BD) are common severe affective diseases. Although previous neuroimaging studies have investigated brain abnormalities in MDD or BD, the structural and functional differences between these two disorders remain unclear. In this study, we adopted a multimodal approach, combining voxel-based morphometry (VBM) and functional connectivity (FC), to study the common and distinct structural and functional alterations in unmedicated MDD and BD patients. The VBM analysis revealed that both the MDD and BD patients showed decreased gray matter volume (GMV) in the left anterior cingulate cortex (ACC_L) and right hippocampus (HIP_R) compared with the healthy controls, and the MDD patients showed decreased GMV in the left superior frontal gyrus (SFG_L) and ACC_L compared with the BD patients. Furthermore, we took these clusters as seed regions to analyze the abnormal resting-state functional connectivity (RSFC) in the patients. We found that both the MDD and BD groups had decreased RSFC between the ACC_L and the left orbitofrontal cortex (OFC_L) and that the MDD group had decreased RSFC between the SFG_L and the HIP_L, compared with the healthy controls. Our results revealed that the MDD and BD patients were more similar than different in GMV and RSFC. These findings indicate that investigating the frontal-limbic system could be useful for understanding the underlying mechanisms of these two disorders. Both MDD and BD patients had reduced GMV in the ACC_L and HIP_R compared with HC. MDD patients had decreased GMV in the ACC_L and SFG_L compared with BD patients. Both BD and MDD patients had decreased ACC-OFC RSFC compared with HC. The MDD and BD patients were more similar than different in GMV and RSFC.
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Key Words
- ACC, anterior cingulate cortex
- Affective disorder
- CSF, cerebrospinal fluid
- DLPFC, dorsolateral prefrontal cortex
- Functional connectivity
- GM, gray matter
- GMV, gray matter volume
- HDRS, Hamilton Depression Rating Scale
- HIP, hippocampus
- Multimodal
- OFC, orbitofrontal cortex
- ORBmid, orbital part middle frontal gyrus
- ORBsup, orbital part superior frontal gyrus
- R-fMRI, Resting-state fMRI
- RSFC, resting-state functional connectivity
- SFG, superior frontal gyrus
- THA, thalamus
- VBM, voxel-based morphometry
- VLPFC, ventrolateral prefrontal cortex
- Voxel-based morphometry
- WM, white matter
- YMRS, Young Mania Rating Scale
- dmPFC, dorsomedial prefrontal cortex
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Affiliation(s)
- Lixiang Chen
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China.
| | - Chen Niu
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Huiqing Hu
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Ping Chen
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Shufei Zhang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Feng Deng
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China
| | - Sunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Junjing Wang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou 510006, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ruiwang Huang
- Center for the Study of Applied Psychology, Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou 510631, China.
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11
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Faber I, Martinez ARM, de Rezende TJR, Martins CR, Martins MP, Lourenço CM, Marques W, Montecchiani C, Orlacchio A, Pedroso JL, Barsottini OGP, Lopes-Cendes Í, França MC. SPG11 mutations cause widespread white matter and basal ganglia abnormalities, but restricted cortical damage. Neuroimage Clin 2018; 19:848-857. [PMID: 29946510 PMCID: PMC6008284 DOI: 10.1016/j.nicl.2018.05.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 05/20/2018] [Accepted: 05/22/2018] [Indexed: 12/12/2022]
Abstract
SPG11 mutations are the major cause of autosomal recessive Hereditary Spastic Paraplegia. The disease has a wide phenotypic variability indicating many regions of the nervous system besides the corticospinal tract are affected. Despite this, anatomical and phenotypic characterization is restricted. In the present study, we investigate the anatomical abnormalities related to SPG11 mutations and how they relate to clinical and cognitive measures. Moreover, we aim to depict how the disease course influences the regions affected, unraveling different susceptibility of specific neuronal populations. We performed clinical and paraclinical studies encompassing neuropsychological, neuroimaging, and neurophysiological tools in a cohort of twenty-five patients and age matched controls. We assessed cortical thickness (FreeSurfer software), deep grey matter volumes (T1-MultiAtlas tool), white matter microstructural damage (DTI-MultiAtlas) and spinal cord morphometry (Spineseg software) on a 3 T MRI scan. Mean age and disease duration were 29 and 13.2 years respectively. Sixty-four percent of the patients were wheelchair bound while 84% were demented. We were able to unfold a diffuse pattern of white matter integrity loss as well as basal ganglia and spinal cord atrophy. Such findings contrasted with a restricted pattern of cortical thinning (motor, limbic and parietal cortices). Electromyography revealed motor neuronopathy affecting 96% of the probands. Correlations with disease duration pointed towards a progressive degeneration of multiple grey matter structures and spinal cord, but not of the white matter. SPG11-related hereditary spastic paraplegia is characterized by selective neuronal vulnerability, in which a precocious and widespread white matter involvement is later followed by a restricted but clearly progressive grey matter degeneration.
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Key Words
- ACE-R, Addenbrooke's Cognitive Examination Revised
- ALS, amyotrophic lateral sclerosis
- CA, cord area
- CE, cord eccentricity
- CMAP, compound muscle action potential
- CST, corticospinal tract
- Complicated hereditary spastic paraplegia
- DTI, diffusion tensor imaging
- FA, fractional anisotropy
- GM, grey matter
- Grey matter
- HSP, hereditary spastic paraplegia
- LH, left hemisphere
- MD, mean diffusivity
- MOCA, Montreal cognitive assessment
- Motor neuron disorder
- NPI, neuropsychiatric inventory
- PNP, sensory-motor polyneuropathy
- PNS, peripheral nervous system
- RH, right hemisphere
- ROI, region of interest
- SC, spinal cord
- SNAP, sensory nerve action potential
- SPG11
- SPRS, Spastic Paraplegia Rating Scale
- STS, cortex adjacent to the superior temporal sulcus
- Spinal cord
- Thinning of the corpus callosum
- WES, whole exome sequencing
- WM, white matter
- White matter
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Affiliation(s)
- Ingrid Faber
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | | | | | | | | - Wilson Marques
- Department of Neurology, University of São Paulo (USP-RP), Ribeirão Preto, Brazil
| | - Celeste Montecchiani
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC) - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia, Rome, Italy
| | - Antonio Orlacchio
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC) - Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia, Rome, Italy; Dipartimento di Scienze Chirurgiche e Biomediche, Università di Perugia, Perugia, Italy
| | - Jose Luiz Pedroso
- Department of Neurology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | - Íscia Lopes-Cendes
- Department of Medical Genetics, University of Campinas (UNICAMP), Campinas, Brazil
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12
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Olm CA, McMillan CT, Irwin DJ, Van Deerlin VM, Cook PA, Gee JC, Grossman M. Longitudinal structural gray matter and white matter MRI changes in presymptomatic progranulin mutation carriers. Neuroimage Clin 2018; 19:497-506. [PMID: 29984158 PMCID: PMC6029561 DOI: 10.1016/j.nicl.2018.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Received: 08/15/2017] [Revised: 03/29/2018] [Accepted: 05/13/2018] [Indexed: 11/21/2022]
Abstract
Introduction Mutations in the progranulin (GRN) gene are a major source of inherited frontotemporal degeneration (FTD) spectrum disorders associated with TDP-43 proteinopathy. We use structural MRI to identify regions of baseline differences and longitudinal changes in gray matter (GM) and white matter (WM) in presymptomatic GRN mutation carriers (pGRN+) compared to young controls (yCTL). Methods Cognitively intact first-degree relatives of symptomatic GRN+ FTD patients with identified GRN mutations (pGRN+; N = 11, mean age = 41.4) and matched yCTL (N = 11, mean age = 53.6) were identified. They completed a MRI session with T1-weighted imaging to assess GM density (GMD) and diffusion-weighted imaging (DWI) to assess fractional anisotropy (FA). Participants completed a follow-up session with T1 and DWI imaging (pGRN+ mean interval 2.20 years; yCTL mean interval 3.27 years). Annualized changes of GMD and FA were also compared. Results Relative to yCTL, pGRN+ individuals displayed reduced GMD at baseline in bilateral orbitofrontal, insular, and anterior temporal cortices. pGRN+ also showed greater annualized GMD changes than yCTL at follow-up in right orbitofrontal and left occipital cortices. We also observed reduced FA at baseline in bilateral superior longitudinal fasciculus, left corticospinal tract, and frontal corpus callosum in pGRN+ relative to yCTL, and pGRN+ displayed greater annualized longitudinal FA change in right superior longitudinal fasciculus and frontal corpus callosum. Conclusions Longitudinal MRI provides evidence of progressive GM and WM changes in pGRN+ participants relative to yCTL. Structural MRI illustrates the natural history of presymptomatic GRN carriers, and may provide an endpoint during disease-modifying treatment trials for pGRN+ individuals at risk for FTD.
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Key Words
- AD, axial diffusivity
- BA, Brodmann area
- CST, corticospinal tract
- DWI, diffusion-weighted imaging
- FA, fractional anisotropy
- FTD, frontotemporal degeneration
- Frontotemporal lobar degeneration
- GM, gray matter
- GMD, gray matter density
- GRN+, symptomatic progranulin mutation carriers
- GRN, progranulin
- IFO, inferior fronto-occipital fasciculus
- ILF, inferior longitudinal fasciculus
- Longitudinal
- MD, mean diffusivity
- Magnetic resonance imaging
- Neuroimaging
- Presymptomatic
- Progranulin
- RD, radial diffusivity
- ROI, region of interest
- SLF, superior longitudinal fasciculus
- WM, white matter
- eCTL, elderly healthy controls
- pGRN+, presymptomatic progranulin mutation carriers
- yCTL, young healthy controls
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Affiliation(s)
- Christopher A Olm
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States; Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Corey T McMillan
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - David J Irwin
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States; Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Vivianna M Van Deerlin
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip A Cook
- Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - James C Gee
- Penn Image Computing and Science Laboratory, Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States.
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13
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Amiri H, de Sitter A, Bendfeldt K, Battaglini M, Gandini Wheeler-Kingshott CAM, Calabrese M, Geurts JJG, Rocca MA, Sastre-Garriga J, Enzinger C, de Stefano N, Filippi M, Rovira Á, Barkhof F, Vrenken H. Urgent challenges in quantification and interpretation of brain grey matter atrophy in individual MS patients using MRI. Neuroimage Clin 2018; 19:466-475. [PMID: 29984155 PMCID: PMC6030805 DOI: 10.1016/j.nicl.2018.04.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/28/2018] [Accepted: 04/22/2018] [Indexed: 01/18/2023]
Abstract
Atrophy of the brain grey matter (GM) is an accepted and important feature of multiple sclerosis (MS). However, its accurate measurement is hampered by various technical, pathological and physiological factors. As a consequence, it is challenging to investigate the role of GM atrophy in the disease process as well as the effect of treatments that aim to reduce neurodegeneration. In this paper we discuss the most important challenges currently hampering the measurement and interpretation of GM atrophy in MS. The focus is on measurements that are obtained in individual patients rather than on group analysis methods, because of their importance in clinical trials and ultimately in clinical care. We discuss the sources and possible solutions of the current challenges, and provide recommendations to achieve reliable measurement and interpretation of brain GM atrophy in MS.
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Key Words
- BET, brain extraction tool
- Brain atrophy
- CNS, central nervous system
- CTh, cortical thickness
- DGM, deep grey matter
- DTI, diffusion tensor imaging
- FA, fractional anisotropy
- GM, grey matter
- Grey matter
- MRI, magnetic resonance imaging
- MS, multiple sclerosis
- Magnetic resonance imaging
- Multiple sclerosis
- TE, echo time
- TI, inversion time
- TR, repetition time
- VBM, voxel-based morphometry
- WM, white matter
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Affiliation(s)
- Houshang Amiri
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Alexandra de Sitter
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
| | | | - Marco Battaglini
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | - Massimiliano Calabrese
- Multiple Sclerosis Centre, Neurology Section, Department of Neurosciences, Biomedicine and Movements, University of Verona, Italy
| | - Jeroen J G Geurts
- Anatomy & Neurosciences, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Jaume Sastre-Garriga
- Servei de Neurologia/Neuroimmunologia, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Christian Enzinger
- Department of Neurology & Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
| | - Nicola de Stefano
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Álex Rovira
- Unitat de Ressonància Magnètica (Servei de Radiologia), Hospital universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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14
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Falcon C, Tucholka A, Monté-Rubio GC, Cacciaglia R, Operto G, Rami L, Gispert JD, Molinuevo JL; Alzheimer's Disease Neuroimaging Initiative. Longitudinal structural cerebral changes related to core CSF biomarkers in preclinical Alzheimer's disease: A study of two independent datasets. Neuroimage Clin 2018; 19:190-201. [PMID: 30023169 DOI: 10.1016/j.nicl.2018.04.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/08/2018] [Accepted: 04/14/2018] [Indexed: 12/21/2022]
Abstract
Alzheimer's disease (AD) is characterized by an accumulation of β-amyloid (Aβ42) accompanied by brain atrophy and cognitive decline. Several recent studies have shown that Aβ42 accumulation is associated with gray matter (GM) changes prior to the development of cognitive impairment, in the so-called preclinical stage of the AD (pre-AD). It also has been proved that the GM atrophy profile is not linear, both in normal ageing but, especially, on AD. However, several other factors may influence this association and may have an impact on the generalization of results from different samples. In this work, we estimate differences in rates of GM volume change in cognitively healthy elders in association with baseline core cerebrospinal fluid (CSF) AD biomarkers, and assess to what these differences are sample dependent. We report the dependence of atrophy rates, measured in a two-year interval, on Aβ42, computed both over continuous and categorical values of Aβ42, at voxel-level (p < 0.001; k < 100) and corrected for sex, age and education. Analyses were performed jointly and separately, on two samples. The first sample was formed of 31 individuals (22 Ctrl and 9 pre-AD), aged 60–80 and recruited at the Hospital Clinic of Barcelona. The second sample was a replica of the first one with subjects selected from the ADNI dataset. We also investigated the dependence of the GM atrophy rate on the basal levels of continuous p-tau and on the p-tau/Aβ42 ratio. Correlation analyses on the whole sample showed a dependence of GM atrophy rates on Aβ42 in medial and orbital frontal, precuneus, cingulate, medial temporal regions and cerebellum. Correlations with p-tau were located in the left hippocampus, parahippocampus and striatal nuclei whereas correlation with p-tau/Aβ42 was mainly found in ventral and medial temporal areas. Regarding analyses performed separately, we found a substantial discrepancy of results between samples, illustrating the complexities of comparing two independent datasets even when using the same inclusion criteria. Such discrepancies may lead to significant differences in the sample size needed to detect a particular reduction on cerebral atrophy rates in prevention trials. Higher cognitive reserve and more advanced pathological progression in the ADNI sample could partially account for the observed discrepancies. Taken together, our findings in these two samples highlight the importance of comparing and merging independent datasets to draw more robust and generalizable conclusions on the structural changes in the preclinical stages of AD. GM atrophy rates depends differently on values of CSF Aβ42 than on CSF p-tau in the preclinical stage of AD. Discrepant results were obtained. Although nominally equivalent, samples might reflect different time-windows in the AD continuum. It is necessary a further effort to standardize CSF-biomarkers measures and thresholds to make different samples to be directly comparable.
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Key Words
- AD, Alzheimer's disease
- ADNI, Alzheimer's Disease Neuroimaging Initiative
- Alzheimer's disease
- Aβ42, amyloid beta
- CDR, Clinical Dementia Rating
- CSF biomarkers
- CSF, Cerebro-Spinal Fluid
- Ctrl, control
- DI, divergences of the longitudinal deformations
- ELISA, Enzyme-Linked ImmunoSorbent Assay
- FWE, Family Wise Error
- GM, gray matter
- HCB, Hospital Clinic Barcelona
- L, left
- Longitudinal VBM
- MMSE, Mini Mental State examination
- PLR, pairwise longitudinal registration
- Preclinical Alzheimer's disease
- R, right
- ROI, region of interest
- TIV, total intracranial volume
- VBM, voxel-based morphometry
- WM, white matter
- p-tau, phosphorylated tau
- preAD, preclinical Alzheimer's disease
- t-tau, total tau
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15
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de Moura MTM, Zanetti MV, Duran FLS, Schaufelberger MS, Menezes PR, Scazufca M, Busatto GF, Serpa MH. Corpus callosum volumes in the 5 years following the first-episode of schizophrenia: Effects of antipsychotics, chronicity and maturation. Neuroimage Clin 2018; 18:932-42. [PMID: 29876278 DOI: 10.1016/j.nicl.2018.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 02/19/2018] [Accepted: 03/14/2018] [Indexed: 01/27/2023]
Abstract
Background White matter (WM) structural changes, particularly affecting the corpus callosum (CC), seem to be critically implicated in psychosis. Whether such abnormalities are progressive or static is still a matter of debate in schizophrenia research. Aberrant maturation processes might also influence the longitudinal trajectory of age-related CC changes in schizophrenia patients. We investigated whether patients with first-episode schizophrenia-related psychoses (FESZ) would present longitudinal CC and whole WM volume changes over the 5 years after disease onset. Method Thirty-two FESZ patients and 34 controls recruited using a population-based design completed a 5-year assessment protocol, including structural MRI scanning at baseline and follow-up. The linear effects of disease duration, clinical outcome and antipsychotic (AP) use over time on WM and CC volumes were studied using both voxelwise and volume-based morphometry analyses. We also examined maturation/aging abnormalities through cross-sectional analyses of age-related trajectories of total WM and CC volume changes. Results No interaction between diagnosis and time was observed, and clinical outcome did not influence CC volumes in patients. On the other hand, FESZ patients continuously exposed to AP medication showed volume increase over time in posterior CC. Curve-estimation analyses revealed a different aging pattern in FESZ patients versus controls: while patients displayed a linear decline of total WM and anterior CC volumes with age, a non-linear trajectory of total WM and relative preservation of CC volumes were observed in controls. Conclusions Continuous AP exposure can influence CC morphology during the first years after schizophrenia onset. Schizophrenia is associated with an abnormal pattern of total WM and anterior CC aging during non-elderly adulthood, and this adds complexity to the discussion on the static or progressive nature of structural abnormalities in psychosis.
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Key Words
- AP, antipsychotics
- CC, corpus callosum
- Corpus callosum
- FEP, first episode of psychosis
- FESZ, First-episode of schizophrenia-related psychoses
- GM, gray matter
- MEM, mixed-effects model
- Magnetic resonance imaging
- Psychosis
- ROI, region-of-interest
- Schizophrenia
- VBM, voxel-based morphometry
- VolBM, volume-based morphometry
- WM, white matter
- White matter
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16
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Rijpma A, van der Graaf M, Meulenbroek O, Olde Rikkert MGM, Heerschap A. Altered brain high-energy phosphate metabolism in mild Alzheimer's disease: A 3-dimensional 31P MR spectroscopic imaging study. Neuroimage Clin 2018; 18:254-261. [PMID: 29876246 PMCID: PMC5987799 DOI: 10.1016/j.nicl.2018.01.031] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [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: 06/30/2017] [Revised: 12/15/2017] [Accepted: 01/24/2018] [Indexed: 12/20/2022]
Abstract
In Alzheimer's disease (AD), defects in essential metabolic processes for energy supply and phospholipid membrane function have been implicated in the pathological process. However, post-mortem investigations are generally limited to late stage disease and prone to tissue decay artifacts. In vivo assessments of high energy phosphates, tissue pH and phospholipid metabolites are possible by phosphorus MR spectroscopy (31P–MRS), but so far only small studies, mostly focusing on single brain regions, have been performed. Therefore, we assessed phospholipid and energy metabolism in multiple brain regions of 31 early stage AD patients and 31 age- and gender-matched controls using 31P–MRS imaging. An increase of phosphocreatine (PCr) was found in AD patients compared with controls in the retrosplenial cortex, and both hippocampi, but not in the anterior cingulate cortex. While PCr/inorganic phosphate and pH were also increased in AD, no changes were found for phospholipid metabolites. This study showed that PCr levels are specifically increased in regions that show early degeneration in AD. Together with an increased pH, this indicates an altered energy metabolism in mild AD. Phosphocreatine and pH are increased in mild Alzheimer's disease. Phosphocreatine increase occurs in early affected brain regions. Brain energy metabolism may be altered in mild Alzheimer's disease. Phospholipid and energy metabolites as well as pH, differ across brain regions.
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Key Words
- 1H, proton
- 31P–MRS, phosphorus magnetic resonance spectroscopy
- AC, anterior commissure
- ACC, anterior cingulate cortex
- AD, Alzheimer's disease
- ADP, adenosine diphosphate
- ATP, adenosine triphosphate
- Alzheimer's disease
- CK, creatine kinase
- CSF, cerebrospinal fluid
- Cr, creatine
- Dementia
- Energy metabolism
- GM, grey matter
- GPCh, glycerophosphocholine
- GPEth, glycerophosphoethanolamine
- HL, left hippocampus
- HR, right hippocampus
- LS, least square
- MCI, mild cognitive impairment
- MMSE, Mini Mental State Examination
- MRSI, magnetic resonance spectroscopic imaging
- NAD(H), nicotinamide adenine dinucleotide
- OXPHOS, oxidative phosphorylation
- PC, posterior commissure
- PCh, phosphocholine
- PCr, phosphocreatine
- PDE, phosphodiesters
- PEth, phosphoethanolamine
- PME, phosphomonoesters
- Phospholipid metabolism
- Phosphorus magnetic resonance spectroscopic imaging
- Pi, inorganic phosphate
- ROI, region of interest
- RSC, retrosplenial cortex
- WM, white matter
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Affiliation(s)
- Anne Rijpma
- Department of Geriatric Medicine, Radboud university medical center, Nijmegen, The Netherlands; Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.
| | - Marinette van der Graaf
- Department of Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, The Netherlands; Department of Paediatrics, Radboud university medical center, Nijmegen, The Netherlands
| | - Olga Meulenbroek
- Department of Geriatric Medicine, Radboud university medical center, Nijmegen, The Netherlands; Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Marcel G M Olde Rikkert
- Department of Geriatric Medicine, Radboud university medical center, Nijmegen, The Netherlands; Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Arend Heerschap
- Department of Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, The Netherlands
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Abstract
Prader-Willi syndrome (PWS) is a neurodevelopmental disorder of genomic imprinting, presenting with a characteristic overeating disorder, mild to moderate intellectual disability, and a variable range of social and behavioral difficulties. Consequently, widespread alterations in neural structure and developmental and maturational trajectory would be expected. To date, there have been few quantitative and systematic studies of brain morphology in PWS, although alterations of volume and of cortical organisation have been reported. This study aimed to investigate, in detail, the structure of grey matter and cortex in the brain in a sample of young adults with PWS in a well-matched case-controlled analysis. 20 young adults with PWS, aged 19–27 years, underwent multiparameter mapping magnetic resonance imaging sequences, from which measures of grey matter volume, cortical thickness and magnetisation transfer saturation, as a proxy measure of myelination, were examined. These variables were investigated in comparison to a control group of 40 typically developing young adults, matched for age and sex. A voxel-based morphometry analysis identified large and widespread bilateral clusters of both increased and decreased grey matter volume in the brain in PWS. In particular, widespread areas of increased volume encompassed parts of the prefrontal cortex, especially medially, the majority of the cingulate cortices, from anterior to posterior aspects, insula cortices, and areas of the parietal and temporal cortices. Increased volume was also reported in the caudate, putamen and thalamus. The most ventromedial prefrontal areas, in contrast, showed reduced volume, as did the parts of the medial temporal lobe, bilateral temporal poles, and a small cluster in the right lateral prefrontal cortex. Analysis of cortical structure revealed that areas of increased volume in the PWS group were largely driven by greater cortical thickness. Conversely, analysis of myelin content using magnetisation transfer saturation indicated that myelination of the cortex was broadly similar in the PWS and control groups, with the exception of highly localised areas, including the insula. The bilateral nature of these abnormalities suggests a systemic biological cause, with possible developmental and maturational mechanisms discussed, and may offer insight into the contribution of imprinted genes to neural development. Twenty young adults with PWS and forty age and sex-matched control participants underwent multiparameter mapping MRI. Large and widespread bilateral clusters of both increased and decreased grey matter volume were identified in PWS. Volumetric increases in PWS were largely driven by greater cortical thickness. Myelination of the cortex in PWS was broadly similar to the typically-developing control group. Potential developmental and maturational explanations are considered, including insights into the of the role of imprinted genes.
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Key Words
- ACC, anterior cingulate cortex
- ANTS, Advanced Normalisation Tools Software
- BMI, body mass index
- CamBA, Cambridge Brain Analysis software
- Cortical thickness
- FA, flip angle
- GLM, general linear model
- GM, grey matter
- Genomic imprinting
- Grey matter
- IQ, intelligence quotient
- MPM, multiparameter mapping
- MRI, magnetic resonance imaging
- MT, magnetisation transfer
- Multiparameter mapping
- Myelination
- NHS, National Health Service
- NSPN, NeuroScience in Psychiatry Network
- OFC, orbitofrontal cortex
- PD, proton density
- PFC, prefrontal cortex
- PWS, Prader-Willi syndrome
- PWSA UK, Prader-Willi Syndrome Association UK
- Prader-Willi syndrome
- TE, echo time
- TIV, total intracranial volume
- TR, repetition time
- UPD, uniparental disomy
- WM, white matter
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Affiliation(s)
| | - Roger Tait
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anthony J Holland
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, UK; National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Care Research and Care (CLAHRC), East of England, UK
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18
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Sollmann N, Echlin PS, Schultz V, Viher PV, Lyall AE, Tripodis Y, Kaufmann D, Hartl E, Kinzel P, Forwell LA, Johnson AM, Skopelja EN, Lepage C, Bouix S, Pasternak O, Lin AP, Shenton ME, Koerte IK. Sex differences in white matter alterations following repetitive subconcussive head impacts in collegiate ice hockey players. Neuroimage Clin 2017; 17:642-649. [PMID: 29204342 PMCID: PMC5709295 DOI: 10.1016/j.nicl.2017.11.020] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [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: 07/29/2017] [Revised: 11/08/2017] [Accepted: 11/18/2017] [Indexed: 12/31/2022]
Abstract
Objective Repetitive subconcussive head impacts (RSHI) may lead to structural, functional, and metabolic alterations of the brain. While differences between males and females have already been suggested following a concussion, whether there are sex differences following exposure to RSHI remains unknown. The aim of this study was to identify and to characterize sex differences following exposure to RSHI. Methods Twenty-five collegiate ice hockey players (14 males and 11 females, 20.6 ± 2.0 years), all part of the Hockey Concussion Education Project (HCEP), underwent diffusion-weighted magnetic resonance imaging (dMRI) before and after the Canadian Interuniversity Sports (CIS) ice hockey season 2011-2012 and did not experience a concussion during the season. Whole-brain tract-based spatial statistics (TBSS) were used to compare pre- and postseason imaging in both sexes for fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Pre- and postseason neurocognitive performance were assessed by the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). Results Significant differences between the sexes were primarily located within the superior longitudinal fasciculus (SLF), the internal capsule (IC), and the corona radiata (CR) of the right hemisphere (RH). In significant voxel clusters (p < 0.05), decreases in FA (absolute difference pre- vs. postseason: 0.0268) and increases in MD (0.0002), AD (0.00008), and RD (0.00005) were observed in females whereas males showed no significant changes. There was no significant correlation between the change in diffusion scalar measures over the course of the season and neurocognitive performance as evidenced from postseason ImPACT scores. Conclusions The results of this study suggest sex differences in structural alterations following exposure to RSHI. Future studies need to investigate further the underlying mechanisms and association with exposure and clinical outcomes.
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Key Words
- AD, axial diffusivity
- CIS, Canadian Interuniversity Sports
- CR, corona radiata
- Diffusion tensor imaging
- EC, external capsule
- FA, fractional anisotropy
- HCEP, Hockey Concussion Education Project
- IC, internal capsule
- Ice hockey
- ImPACT, Immediate Post-Concussion Assessment and Cognitive Test
- LH, left hemisphere
- MD, mean diffusivity
- MRI, magnetic resonance imaging
- NCAA, National Collegiate Athletic Association
- RD, radial diffusivity
- RH, right hemisphere
- RSHI, repetitive subconcussive head impacts
- Repetitive subconcussive head impacts
- SD, standard deviation
- SLF, superior longitudinal fasciculus
- Sex difference
- TBI, traumatic brain injury
- TBSS, tract-based spatial statistics
- Traumatic brain injury
- WM, white matter
- White matter
- dMRI, diffusion magnetic resonance imaging
- rs, Spearman's rank correlation coefficient
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Affiliation(s)
- Nico Sollmann
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
| | - Paul S Echlin
- Elliott Sports Medicine Clinic, Burlington, ON, Canada.
| | - Vivian Schultz
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.
| | - Petra V Viher
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Translational Research Center, University Hospital of Psychiatry, Bern, Switzerland.
| | - Amanda E Lyall
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA; Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, MA, USA.
| | - David Kaufmann
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany; Department of Radiology, Charité Universitätsmedizin, Berlin, Germany.
| | - Elisabeth Hartl
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, Epilepsy Center, Ludwig-Maximilians-Universität, Munich, Germany.
| | - Philipp Kinzel
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.
| | - Lorie A Forwell
- 3M Centre, The University of Western Ontario, London, ON, Canada.
| | - Andrew M Johnson
- School of Health Studies, The University of Western Ontario, London, ON, Canada.
| | - Elaine N Skopelja
- Ruth Lilly Medical Library, Indiana University, Indianapolis, IN, USA.
| | - Christian Lepage
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; School of Psychology, University of Ottawa, Ottawa, ON, Canada.
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Alexander P Lin
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; VA Boston Healthcare System, Brockton Division, Brockton, MA, USA.
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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19
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Kamagata K, Zalesky A, Hatano T, Di Biase MA, El Samad O, Saiki S, Shimoji K, Kumamaru KK, Kamiya K, Hori M, Hattori N, Aoki S, Pantelis C. Connectome analysis with diffusion MRI in idiopathic Parkinson's disease: Evaluation using multi-shell, multi-tissue, constrained spherical deconvolution. Neuroimage Clin 2017; 17:518-529. [PMID: 29201640 PMCID: PMC5700829 DOI: 10.1016/j.nicl.2017.11.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 06/09/2017] [Revised: 10/16/2017] [Accepted: 11/07/2017] [Indexed: 01/08/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects extensive regions of the central nervous system. In this work, we evaluated the structural connectome of patients with PD, as mapped by diffusion-weighted MRI tractography and a multi-shell, multi-tissue (MSMT) constrained spherical deconvolution (CSD) method to increase the precision of tractography at tissue interfaces. The connectome was mapped with probabilistic MSMT-CSD in 21 patients with PD and in 21 age- and gender-matched controls. Mapping was also performed by deterministic single-shell, single tissue (SSST)-CSD tracking and probabilistic SSST-CSD tracking for comparison. A support vector machine was trained to predict diagnosis based on a linear combination of graph metrics. We showed that probabilistic MSMT-CSD could detect significantly reduced global strength, efficiency, clustering, and small-worldness, and increased global path length in patients with PD relative to healthy controls; by contrast, probabilistic SSST-CSD only detected the difference in global strength and small-worldness. In patients with PD, probabilistic MSMT-CSD also detected a significant reduction in local efficiency and detected clustering in the motor, frontal temporoparietal associative, limbic, basal ganglia, and thalamic areas. The network-based statistic identified a subnetwork of reduced connectivity by MSMT-CSD and probabilistic SSST-CSD in patients with PD, involving key components of the cortico–basal ganglia–thalamocortical network. Finally, probabilistic MSMT-CSD had superior diagnostic accuracy compared with conventional probabilistic SSST-CSD and deterministic SSST-CSD tracking. In conclusion, probabilistic MSMT-CSD detected a greater extent of connectome pathology in patients with PD, including those with cortico–basal ganglia–thalamocortical network disruptions. Connectome analysis based on probabilistic MSMT-CSD may be useful when evaluating the extent of white matter connectivity disruptions in PD. Connectomes mapped in Parkinson's disease (PD) using multi-shell tractography. Multi-shell tractography provided improved sensitivity to connectome pathology. Machine learning accurately predicted PD diagnosis based on connectome. Connectome pathology in PD was localized to basal ganglia-thalamocortical circuits.
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Key Words
- CSD, constrained spherical deconvolution
- CSF, cerebrospinal fluid
- Connectome
- DW-MRI, diffusion-weighted magnetic resonance imaging
- Diffusion MRI
- Diffusion tensor imaging
- GM, gray matter
- Lewy bodies
- MSMT-CSD, multi-shell, multi-tissue CSD
- Neurodegenerative disorders
- PD, Parkinson's disease
- SVM, support vector machine
- Support vector machine
- UPDRS, Unified Idiopathic Parkinson's Disease Rating Scale
- WM, white matter
- fODF, fiber orientation distribution function
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Affiliation(s)
- Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC, Australia.
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC, Australia; Melbourne School of Engineering, University of Melbourne, Melbourne, Australia
| | - Taku Hatano
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Maria Angelique Di Biase
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC, Australia
| | - Omar El Samad
- Department of Computing and Information Systems, University of Melbourne, Parkville, Australia
| | - Shinji Saiki
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Keigo Shimoji
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Kanako K Kumamaru
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kouhei Kamiya
- Department of Radiology, The University of Tokyo, Bunkyo, Tokyo, Japan
| | - Masaaki Hori
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Parkville, VIC, Australia; Melbourne School of Engineering, University of Melbourne, Melbourne, Australia; Centre for Neural Engineering, Department of Electrical and Electronic Engineering, The University of Melbourne, Carlton, VIC, Australia
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20
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Wood ET, Ercan E, Sati P, Cortese ICM, Ronen I, Reich DS. Longitudinal MR spectroscopy of neurodegeneration in multiple sclerosis with diffusion of the intra-axonal constituent N-acetylaspartate. Neuroimage Clin 2017; 15:780-788. [PMID: 28702353 PMCID: PMC5496488 DOI: 10.1016/j.nicl.2017.06.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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] [Received: 03/28/2017] [Revised: 06/08/2017] [Accepted: 06/20/2017] [Indexed: 11/19/2022]
Abstract
Multiple sclerosis (MS) is a pathologically complex CNS disease: inflammation, demyelination, and neuroaxonal degeneration occur concurrently and may depend on one another. Current therapies are aimed at the immune-mediated, inflammatory destruction of myelin, whereas axonal degeneration is ongoing and not specifically targeted. Diffusion-weighted magnetic resonance spectroscopy can measure the diffusivity of metabolites in vivo, such as the axonal/neuronal constituent N-acetylaspartate, allowing compartment-specific assessment of disease-related changes. Previously, we found significantly lower N-acetylaspartate diffusivity in people with MS compared to healthy controls (Wood et al., 2012) suggesting that this technique can measure axonal degeneration and could be useful in developing neuroprotective agents. In this longitudinal study, we found that N-acetylaspartate diffusivity decreased by 8.3% (p < 0.05) over 6 months in participants who were experiencing clinical or MRI evidence of inflammatory activity (n = 13), whereas there was no significant change in N-acetylaspartate diffusivity in the context of clinical and radiological stability (n = 6). As N-acetylaspartate diffusivity measurements are thought to more specifically reflect the intra-axonal space, these data suggest that N-acetylaspartate diffusivity can report on axonal health on the background of multiple pathological processes in MS, both cross-sectionally and longitudinally.
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Key Words
- Axonopathy
- DW-MRS, diffusion-weighted magnetic resonance spectroscopy
- Diffusion-weighted magnetic resonance spectroscopy
- EDSS, Expanded Disability Scale Score
- HV, healthy volunteer
- ICV, intracranial volume
- MS, multiple sclerosis
- Multiple sclerosis
- NAA, N-acetylaspartate
- PASAT, Paced Auditory Symbol Addition Test
- T, Tesla
- VOI, volume of interest
- WM, white matter
- White matter
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Affiliation(s)
- Emily Turner Wood
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Ece Ercan
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Pascal Sati
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Irene C M Cortese
- Neuroimmunology Clinic, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Itamar Ronen
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Daniel S Reich
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA; Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
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21
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Lee YJ, Yum MS, Kim MJ, Shim WH, Yoon HM, Yoo IH, Lee J, Lim BC, Kim KJ, Ko TS. Large-scale structural alteration of brain in epileptic children with SCN1A mutation. Neuroimage Clin 2017; 15:594-600. [PMID: 28664031 PMCID: PMC5479971 DOI: 10.1016/j.nicl.2017.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 02/14/2017] [Revised: 05/01/2017] [Accepted: 06/01/2017] [Indexed: 01/03/2023]
Abstract
Objective Mutations in SCN1A gene encoding the alpha 1 subunit of the voltage gated sodium channel are associated with several epilepsy syndromes including genetic epilepsy with febrile seizures plus (GEFS +) and severe myoclonic epilepsy of infancy (SMEI). However, in most patients with SCN1A mutation, brain imaging has reported normal or non-specific findings including cerebral or cerebellar atrophy. The aim of this study was to investigate differences in brain morphometry in epileptic children with SCN1A mutation compared to healthy control subjects. Methods We obtained cortical morphology (thickness, and surface area) and brain volume (global, subcortical, and regional) measurements using FreeSurfer (version 5.3.0, https://surfer.nmr.mgh.harvard.edu) and compared measurements of children with epilepsy and SCN1A gene mutation (n = 21) with those of age and gender matched healthy controls (n = 42). Results Compared to the healthy control group, children with epilepsy and SCN1A gene mutation exhibited smaller total brain, total gray matter and white matter, cerebellar white matter, and subcortical volumes, as well as mean surface area and mean cortical thickness. A regional analysis revealed significantly reduced gray matter volume in the patient group in the bilateral inferior parietal, left lateral orbitofrontal, left precentral, right postcentral, right isthmus cingulate, right middle temporal area with smaller surface area and white matter volume in some of these areas. However, the regional cortical thickness was not significantly different in two groups. Significance This study showed large-scale developmental brain changes in patients with epilepsy and SCN1A gene mutation, which may be associated with the core symptoms of the patients. Further longitudinal MRI studies with larger cohorts are required to confirm the effect of SCN1A gene mutation on structural brain development. Surface-based morphometry was performed in epileptic children with SCN1A mutation. Cortical GM and WM volumes, cerebellar WM volume and surface area are smaller. Patients group showed similar age effect on total brain volume and GM volume. No significant difference were obtained in regional cortical thickness.
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Affiliation(s)
- Yun-Jeong Lee
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Mi-Sun Yum
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min-Jee Kim
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo-Hyun Shim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee Mang Yoon
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Il Han Yoo
- Department of Pediatrics, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Republic of Korea
| | - Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byung Chan Lim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Ki Joong Kim
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.
| | - Tae-Sung Ko
- Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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22
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Canu E, Agosta F, Mandic-Stojmenovic G, Stojković T, Stefanova E, Inuggi A, Imperiale F, Copetti M, Kostic VS, Filippi M. Multiparametric MRI to distinguish early onset Alzheimer's disease and behavioural variant of frontotemporal dementia. Neuroimage Clin 2017; 15:428-438. [PMID: 28616383 PMCID: PMC5458769 DOI: 10.1016/j.nicl.2017.05.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/12/2017] [Accepted: 05/25/2017] [Indexed: 12/11/2022]
Abstract
This prospective study explored whether an approach combining structural [cortical thickness and white matter (WM) microstructure] and resting state functional MRI can aid differentiation between 62 early onset Alzheimer's disease (EOAD) and 27 behavioural variant of frontotemporal dementia (bvFTD) patients. Random forest and receiver operator characteristic curve analyses assessed the ability of MRI in classifying the two clinical syndromes. All patients showed a distributed pattern of brain alterations relative to controls. Compared to bvFTD, EOAD patients showed bilateral inferior parietal cortical thinning and decreased default mode network functional connectivity. Compared to EOAD, bvFTD patients showed bilateral orbitofrontal and temporal cortical thinning, and WM damage of the corpus callosum, bilateral uncinate fasciculus, and left superior longitudinal fasciculus. Random forest analysis revealed that left inferior parietal cortical thickness (accuracy 0.78, specificity 0.76, sensitivity 0.83) and WM integrity of the right uncinate fasciculus (accuracy 0.81, specificity 0.96, sensitivity 0.43) were the best predictors of clinical diagnosis. The combination of cortical thickness and DT MRI measures was able to distinguish patients with EOAD and bvFTD with accuracy 0.82, specificity 0.76, and sensitivity 0.96. The diagnostic ability of MRI models was confirmed in a subsample of patients with biomarker-based clinical diagnosis. Multiparametric MRI is useful to identify brain alterations which are specific to EOAD and bvFTD. A severe cortical involvement is suggestive of EOAD, while a prominent WM damage is indicative of bvFTD. Multimodal MRI distinguishes in vivo EOAD and bvFTD patients EOAD and bvFTD show a distributed pattern of structural brain alterations A severe cortical involvement is suggestive of EOAD relative to bvFTD A prominent WM damage is indicative of bvFTD relative to EOAD
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Key Words
- ACE-R, Addenbrooke's Cognitive Examination-revised
- Behavioural variant of frontotemporal dementia
- CC, corpus callosum
- CSF, cerebrospinal fluid
- Cortical thickness
- DMN, default mode network
- DT, diffusion tensor
- Diagnosis
- EOAD, early onset Alzheimer's disease
- Early onset Alzheimer's disease
- GM, grey matter
- IC, independent component
- ILF, inferior longitudinal fasciculus
- LOAD, late onset Alzheimer's disease
- MNI, Montreal Neurological Institute
- NVI, Normalized Variable Importance
- RS fMRI, resting state functional MRI
- RSN, resting state network
- Resting state functional MRI
- SLF, superior longitudinal fasciculus
- TFCE, threshold-free cluster enhancement
- WM, white matter
- White matter (WM) damage
- bvFTD, behavioural variant frontotemporal dementia
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Affiliation(s)
- Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy
| | - Gorana Mandic-Stojmenovic
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy; Clinic of Neurology, Faculty of Medicine, University of Belgrade, Dr Subotića 6, PO Box 12, 11129 Belgrade 102, Serbia
| | - Tanja Stojković
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Dr Subotića 6, PO Box 12, 11129 Belgrade 102, Serbia
| | - Elka Stefanova
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Dr Subotića 6, PO Box 12, 11129 Belgrade 102, Serbia
| | - Alberto Inuggi
- Unit of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Via Morego, 30, 16163 Genoa, Italy
| | - Francesca Imperiale
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy
| | - Massimiliano Copetti
- Biostatistics Unit, IRCCS-Ospedale Casa Sollievo della Sofferenza, Viale Cappuccini, San Giovanni Rotondo, 71013 Foggia, Italy
| | - Vladimir S Kostic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Dr Subotića 6, PO Box 12, 11129 Belgrade 102, Serbia
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, via Olgettina 60, 20132 Milan, Italy.
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23
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Choi S, Bush AM, Borzage MT, Joshi AA, Mack WJ, Coates TD, Leahy RM, Wood JC. Hemoglobin and mean platelet volume predicts diffuse T1-MRI white matter volume decrease in sickle cell disease patients. Neuroimage Clin 2017; 15:239-246. [PMID: 28540180 PMCID: PMC5430155 DOI: 10.1016/j.nicl.2017.04.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 01/26/2017] [Revised: 04/13/2017] [Accepted: 04/25/2017] [Indexed: 02/01/2023]
Abstract
Sickle cell disease (SCD) is a life-threatening genetic condition. Patients suffer from chronic systemic and cerebral vascular disease that leads to early and cumulative neurological damage. Few studies have quantified the effects of this disease on brain morphometry and even fewer efforts have been devoted to older patients despite the progressive nature of the disease. This study quantifies global and regional brain volumes in adolescent and young adult patients with SCD and racially matched controls with the aim of distinguishing between age related changes associated with normal brain maturation and damage from sickle cell disease. T1 weighted images were acquired on 33 clinically asymptomatic SCD patients (age = 21.3 ± 7.8; F = 18, M = 15) and 32 racially matched control subjects (age = 24.4 ± 7.5; F = 22, M = 10). Exclusion criteria included pregnancy, previous overt stroke, acute chest, or pain crisis hospitalization within one month. All brain volume comparisons were corrected for age and sex. Globally, grey matter volume was not different but white matter volume was 8.1% lower (p = 0.0056) in the right hemisphere and 6.8% (p = 0.0068) in the left hemisphere in SCD patients compared with controls. Multivariate analysis retained hemoglobin (β = 0.33; p = 0.0036), sex (β = 0.35; p = 0.0017) and mean platelet volume (β = 0.27; p = 0.016) as significant factors in the final prediction model for white matter volume for a combined r2 of 0.37 (p < 0.0001). Lower white matter volume was confined to phylogenetically younger brain regions in the anterior and middle cerebral artery distributions. Our findings suggest that there are diffuse white matter abnormalities in SCD patients, especially in the frontal, parietal and temporal lobes, that are associated with low hemoglobin levels and mean platelet volume. The pattern of brain loss suggests chronic microvascular insufficiency and tissue hypoxia as the causal mechanism. However, longitudinal studies of global and regional brain morphometry can help us give further insights on the pathophysiology of SCD in the brain. Total white matter brain volume is decreased in sickle cell disease patients. Global white matter decrease is found to be due to anemia. Diffuse WM volume decrease is found especially in watershed areas. Diffuse WM volume decrease spatially colocalize with silent stroke in SCD patients.
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Key Words
- ACA, anterior cerebral artery
- GM, grey matter
- Hemoglobin
- HgB, hemoglobin
- MCA, middle cerebral artery
- MPV, mean platelet volume
- MRI, magnetic resonance imaging
- Mean platelet volume
- PCA, posterior cerebral artery
- ROI, region of interest
- SCD, sickle cell disease
- Sickle cell disease
- Structural MRI
- WM, white matter
- WMHI, white matter hyperintensities
- White matter
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Affiliation(s)
- Soyoung Choi
- Neuroscience Graduate Program, University of Southern California, 3641 Watt Way, HNB 120, Los Angeles, CA 90089-2520, USA; Signal and Image Processing Institution, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, CA 90089-2560, USA; Department of Pediatrics and Radiology, Children's Hospital Los Angeles USC, 4650 Sunset Blvd., MS #81, Los Angeles, CA 90027, USA.
| | - Adam M Bush
- Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, CA 90089, USA.
| | - Matthew T Borzage
- Department of Pediatrics and Radiology, Children's Hospital Los Angeles USC, 4650 Sunset Blvd., MS #81, Los Angeles, CA 90027, USA.
| | - Anand A Joshi
- Signal and Image Processing Institution, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, CA 90089-2560, USA.
| | - William J Mack
- Department of Neurosurgery, University of Southern California Keck School of Medicine, 1200 North State St., Suite 3300, Los Angeles, CA 90033, USA.
| | - Thomas D Coates
- Hematology/Oncology, Children's Hospital Los Angeles, 4650 Sunset Blvd. MS #54, Los Angeles, CA 90027, USA.
| | - Richard M Leahy
- Signal and Image Processing Institution, University of Southern California, 3740 McClintock Avenue, EEB 400, Los Angeles, CA 90089-2560, USA; Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, CA 90089, USA.
| | - John C Wood
- Department of Pediatrics and Radiology, Children's Hospital Los Angeles USC, 4650 Sunset Blvd., MS #81, Los Angeles, CA 90027, USA; Biomedical Engineering, University of Southern California, 1042 Downey Way, Los Angeles, CA 90089, USA.
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24
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Lin J, Lv X, Niu M, Liu L, Chen J, Xie F, Zhong M, Qiu S, Li L, Huang R. Radiation-induced abnormal cortical thickness in patients with nasopharyngeal carcinoma after radiotherapy. Neuroimage Clin 2017; 14:610-621. [PMID: 28348952 PMCID: PMC5357686 DOI: 10.1016/j.nicl.2017.02.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 09/18/2016] [Revised: 02/02/2017] [Accepted: 02/28/2017] [Indexed: 01/08/2023]
Abstract
Conventional MRI studies showed that radiation-induced brain necrosis in patients with nasopharyngeal carcinoma (NPC) in years after radiotherapy (RT) could involve brain gray matter (GM) and impair brain function. However, it is still unclear the radiation-induced brain morphological changes in NPC patients with normal-appearing GM in the early period after RT. In this study, we acquired high-resolution brain structural MRI data from three groups of patients, 22 before radiotherapy (pre-RT) NPC patients with newly diagnosed but not yet medically treated, 22 NPC patients in the early-delayed stage after radiotherapy (post-RT-ED), and 20 NPC patients in the late-delayed stage after radiotherapy (post-RT-LD), and then analyzed the radiation-induced cortical thickness alteration in NPC patients after RT. Using a vertex-wise surface-based morphometry (SBM) approach, we detected significantly decreased cortical thickness in the precentral gyrus (PreCG) in the post-RT-ED group compared to the pre-RT group. And the post-RT-LD group showed significantly increased cortical thickness in widespread brain regions, including the bilateral inferior parietal, left isthmus of the cingulate, left bank of the superior temporal sulcus and left lateral occipital regions, compared to the pre-RT group, and in the bilateral PreCG compared to the post-RT-ED group. Similar analysis with ROI-wise SBM method also found the consistent results. These results indicated that radiation-induced brain injury mainly occurred in the post-RT-LD group and the cortical thickness alterations after RT were dynamic in different periods. Our findings may reflect the pathogenesis of radiation-induced brain injury in NPC patients with normal-appearing GM and an early intervention is necessary for protecting GM during RT.
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Key Words
- 2D-CRT, conventional two-dimensional radiotherapy
- AJCC, American Joint Committee on Cancer
- ANOVA, analysis of variance
- Brain injury
- CMBs, cerebral microbleeds
- CT, cortical thickness
- Cortical thickness
- DMN, default mode network
- FDR, false discovery rate
- FWHM, full width at half maximum
- GLM, general linear model
- GM, gray matter
- ICC, isthmus of the cingulate cortex
- IMRT, intensity-modulated radiation therapy
- IPC, inferior parietal cortex
- KPS, Karnofsky performance status scale
- LOC, lateral occipital cortex
- MTC, middle temporal cortex
- NPC, nasopharyngeal carcinoma
- PoCG, postcentral gyrus
- PreCG, precentral gyrus
- PreCUN, precuneus
- RA, relative alteration
- RT, radiotherapy
- Radiotherapy
- SBM, surface-based morphometry
- STC, superior temporal cortex
- Structural MRI
- Surface-based morphometry
- VBM, voxel-based morphometry
- WM, white matter
- bSTS, bank of the superior temporal sulcus
- cMFC, caudal middle frontal cortex
- post-RT-ED, in the early-delayed stage after radiotherapy
- post-RT-LD, in the late-delayed stage after radiotherapy
- pre-RT, before radiotherapy
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Affiliation(s)
- Jiabao Lin
- Center for the Study of Applied Psychology, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou 510631, PR China
| | - Xiaofei Lv
- Department of Medical Imaging, Collaborative Innovation Centre for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Centre, Guangzhou 510060, PR China
| | - Meiqi Niu
- Center for the Study of Applied Psychology, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou 510631, PR China
| | - Lizhi Liu
- Department of Medical Imaging, Collaborative Innovation Centre for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Centre, Guangzhou 510060, PR China
| | - Jun Chen
- Center for the Study of Applied Psychology, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou 510631, PR China
| | - Fei Xie
- Department of Medical Imaging, Collaborative Innovation Centre for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Centre, Guangzhou 510060, PR China
| | - Miao Zhong
- Center for the Study of Applied Psychology, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou 510631, PR China
| | - Shijun Qiu
- Department of Medical Imaging, The First Affiliated Hospital of Guangzhou University of Chinese Traditional Medicine, Guangzhou 510405, PR China
| | - Li Li
- Department of Medical Imaging, Collaborative Innovation Centre for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Centre, Guangzhou 510060, PR China
| | - Ruiwang Huang
- Center for the Study of Applied Psychology, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou 510631, PR China
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Shepherd TM, Kirov II, Charlson E, Bruno M, Babb J, Sodickson DK, Ben-Eliezer N. New rapid, accurate T 2 quantification detects pathology in normal-appearing brain regions of relapsing-remitting MS patients. Neuroimage Clin 2017; 14:363-70. [PMID: 28239545 DOI: 10.1016/j.nicl.2017.01.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/18/2017] [Accepted: 01/25/2017] [Indexed: 01/22/2023]
Abstract
Introduction Quantitative T2 mapping may provide an objective biomarker for occult nervous tissue pathology in relapsing-remitting multiple sclerosis (RRMS). We applied a novel echo modulation curve (EMC) algorithm to identify T2 changes in normal-appearing brain regions of subjects with RRMS (N = 27) compared to age-matched controls (N = 38). Methods The EMC algorithm uses Bloch simulations to model T2 decay curves in multi-spin-echo MRI sequences, independent of scanner, and scan-settings. T2 values were extracted from normal-appearing white and gray matter brain regions using both expert manual regions-of-interest and user-independent FreeSurfer segmentation. Results Compared to conventional exponential T2 modeling, EMC fitting provided more accurate estimations of T2 with less variance across scans, MRI systems, and healthy individuals. Thalamic T2 was increased 8.5% in RRMS subjects (p < 0.001) and could be used to discriminate RRMS from healthy controls well (AUC = 0.913). Manual segmentation detected both statistically significant increases (corpus callosum & temporal stem) and decreases (posterior limb internal capsule) in T2 associated with RRMS diagnosis (all p < 0.05). In healthy controls, we also observed statistically significant T2 differences for different white and gray matter structures. Conclusions The EMC algorithm precisely characterizes T2 values, and is able to detect subtle T2 changes in normal-appearing brain regions of RRMS patients. These presumably capture both axon and myelin changes from inflammation and neurodegeneration. Further, T2 variations between different brain regions of healthy controls may correlate with distinct nervous tissue environments that differ from one another at a mesoscopic length-scale. EMC technique provides accurate and scanner-invariant T2 mapping in MS subjects. Thalamus T2 differences distinguish relapsing-remitting MS subjects from controls. Normal-appearing brain regions demonstrate T2 changes in MS patients compared to controls. T2 values reflect anatomic and function-specific differences in healthy controls.
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Key Words
- AUC, area under the curve
- B1 +, transmit field
- Biomarkers
- Demyelination
- EMC, echo modulation curve
- FLAIR, fluid-attenuated inversion recovery
- GM, gray matter
- MPRAGE, magnetization-prepared rapid gradient-echo
- MSE, multi-spin echo
- MWF, myelin water fraction
- Mesoscopic
- Neurodegeneration
- ROI, Region of Interest
- RRMS, relapsing-remitting multiple sclerosis
- Relaxation
- SPACE, sampling perfection with application-optimized contrasts using different flip angle evolution
- SSE, single spin echo
- WM, white matter
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Louapre C, Govindarajan ST, Giannì C, Madigan N, Nielsen AS, Sloane JA, Kinkel RP, Mainero C. The association between intra- and juxta-cortical pathology and cognitive impairment in multiple sclerosis by quantitative T 2* mapping at 7 T MRI. Neuroimage Clin 2016; 12:879-886. [PMID: 27872810 PMCID: PMC5107649 DOI: 10.1016/j.nicl.2016.11.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 08/18/2016] [Revised: 10/09/2016] [Accepted: 11/01/2016] [Indexed: 12/18/2022]
Abstract
Using quantitative T2* at 7 Tesla (T) magnetic resonance imaging, we investigated whether impairment in selective cognitive functions in multiple sclerosis (MS) can be explained by pathology in specific areas and/or layers of the cortex. Thirty-one MS patients underwent neuropsychological evaluation, acquisition of 7 T multi-echo T2* gradient-echo sequences, and 3 T anatomical images for cortical surfaces reconstruction. Seventeen age-matched healthy subjects served as controls. Cortical T2* maps were sampled at various depths throughout the cortex and juxtacortex. Relation between T2*, neuropsychological scores and a cognitive index (CI), calculated from a principal component analysis on the whole battery, was tested by a general linear model. Cognitive impairment correlated with T2* increase, independently from white matter lesions and cortical thickness, in cortical areas highly relevant for cognition belonging to the default-mode network (p < 0.05 corrected). Dysfunction in different cognitive functions correlated with longer T2* in selective cortical regions, most of which showed longer T2* relative to controls. For most tests, this association was strongest in deeper cortical layers. Executive dysfunction, however, was mainly related with pathology in juxtameningeal cortex. T2* explained up to 20% of the variance of the CI, independently of conventional imaging metrics (adjusted-R2: 52–67%, p < 5.10− 4). Location of pathology across the cortical width and mantle showed selective correlation with impairment in differing cognitive domains. These findings may guide studies at lower field strength designed to develop surrogate markers of cognitive impairment in MS. Cognitive deficit in multiple sclerosis is associated with cortical T2* increase. Location of clusters of correlation varies upon affected cognitive domains. Global cognitive deficit was associated with T2* increase in deepest cortical layers. Executive dysfunction was associated with T2* increase in outer cortical layers. Regional T2* explained up to 20% of the variance of cognitive performance in MS.
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Key Words
- 7 Tesla MRI
- BVMT - DR, brief visuo-spatial memory test delayed recall
- BVMT, brief visual memory test
- CI, cognitive index
- CVLT, California verbal learning test
- Cognitive impairment
- DB, digit span backward
- DF, digit span forward
- DR, delayed recall
- EDSS, expanded disability status score
- JLOT, judgment of line orientation test
- LDCR, long delayed cued recall
- LDFR, long delayed free recall
- Laminar cortical pathology
- MRI, magnetic resonance imaging
- MS, multiple sclerosis
- Multiple sclerosis
- NP, neuropsychological
- PCA, principal component analysis
- SDMT, symbol digit modalities test
- T2*
- TMT, trail making test
- TOT, total recall
- WCST, Wisconsin card sorting test
- WM, white matter
- WMLV, white matter lesion volume
- q-T2*, quantitative T2*
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Affiliation(s)
- Céline Louapre
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Sindhuja T Govindarajan
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Costanza Giannì
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Nancy Madigan
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Jacob A Sloane
- Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Revere P Kinkel
- University of California San Diego, Department of Neuroscience, San Diego, CA, USA
| | - Caterina Mainero
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
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Kopitzki K, Oldag A, Sweeney-Reed CM, Machts J, Veit M, Kaufmann J, Hinrichs H, Heinze HJ, Kollewe K, Petri S, Mohammadi B, Dengler R, Kupsch AR, Vielhaber S. Interhemispheric connectivity in amyotrophic lateral sclerosis: A near-infrared spectroscopy and diffusion tensor imaging study. Neuroimage Clin 2016; 12:666-72. [PMID: 27761397 DOI: 10.1016/j.nicl.2016.09.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 11/22/2022]
Abstract
PURPOSE Aim of the present study was to investigate potential impairment of non-motor areas in amyotrophic lateral sclerosis (ALS) using near-infrared spectroscopy (NIRS) and diffusion tensor imaging (DTI). In particular, we evaluated whether homotopic resting-state functional connectivity (rs-FC) of non-motor associated cortical areas correlates with clinical parameters and disease-specific degeneration of the corpus callosum (CC) in ALS. MATERIAL AND METHODS Interhemispheric homotopic rs-FC was assessed in 31 patients and 30 healthy controls (HCs) for 8 cortical sites, from prefrontal to occipital cortex, using NIRS. DTI was performed in a subgroup of 21 patients. All patients were evaluated for cognitive dysfunction in the executive, memory, and visuospatial domains. RESULTS ALS patients displayed an altered spatial pattern of correlation between homotopic rs-FC values when compared to HCs (p = 0.000013). In patients without executive dysfunction a strong correlation existed between the rate of motor decline and homotopic rs-FC of the anterior temporal lobes (ATLs) (ρ = - 0.85, p = 0.0004). Furthermore, antero-temporal homotopic rs-FC correlated with fractional anisotropy in the central corpus callosum (CC), corticospinal tracts (CSTs), and forceps minor as determined by DTI (p < 0.05). CONCLUSIONS The present study further supports involvement of non-motor areas in ALS. Our results render homotopic rs-FC as assessed by NIRS a potential clinical marker for disease progression rate in ALS patients without executive dysfunction and a potential anatomical marker for ALS-specific degeneration of the CC and CSTs.
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Key Words
- AC, anterior commissure
- ALS, amyotrophic lateral sclerosis
- ALS-EX, ALS with executive impairment
- ALS-NECI, ALS with non-executive cognitive impairment
- ALSFRS-R, revised ALS functional rating scale
- ATL, anterior temporal lobe
- Amyotrophic lateral sclerosis
- CC, corpus callosum
- CST, corticospinal tract
- Corpus callosum
- DD, disease duration
- DPR, disease progression rate
- DTI, diffusion tensor imaging
- Diffusion tensor imaging
- FA, fractional anisotropy
- FTD, frontotemporal dementia
- HC, healthy control
- Hb, hemoglobin
- Interhemispheric connectivity
- NIRS, near-infrared spectroscopy
- Near-infrared spectroscopy
- TBSS, tract based spatial statistics
- WM, white matter
- fMRI, functional magnetic resonance imaging
- pALS, pure ALS no cognitive impairment
- rs-FC, resting-state functional connectivity
- rs-fNIRS, resting-state functional NIRS
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Fourati H, Ellouze E, Ahmadi M, Chaari D, Kamoun F, Hsairi I, Triki C, Mnif Z. MRI features in 17 patients with l2 hydroxyglutaric aciduria. Eur J Radiol Open 2016; 3:245-250. [PMID: 27709120 PMCID: PMC5043405 DOI: 10.1016/j.ejro.2016.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 07/21/2016] [Revised: 08/30/2016] [Accepted: 09/24/2016] [Indexed: 11/17/2022] Open
Abstract
l-2-Hydroxyglutaric (l-2-HG) aciduria is a rare inherited metabolic disease usually observed in children. Patients present a very slowly progressive deterioration with cerebellar ataxia, mild or severe mental retardation, and various other clinical signs including extrapyramidal and pyramidal symptoms, and seizures Goffette et al. [1]. This leukencephalopathy was first described in 1980 Duran et al. [2]. Brain magnetic resonance imaging (MRI) demonstrates nonspecific subcortical white matter (WM) loss, cerebellar atrophy and changes in dentate nuclei and putamen Steenweg et al. [3]. The diagnosis is highlighted by increased levels of l-2-HG in body fluids such as urine and cerebrospinal fluid. The purpose of this study is to retrospectively describe the brain MRI features in l-2-HG aciduria.
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Affiliation(s)
- Héla Fourati
- Radiology Departement Hedi Chaker Hospital, EL Ain Road, 3002 3089 Sfax, Tunisia; Neuropediaty Reaserch Unit (UR12ES16), Faculty of Medecine at Sfax university Tunisia, Boulevard Majida Boulila 3089 Sfax Tunisia
| | - Emna Ellouze
- Neuropediaty Reaserch Unit (UR12ES16), Faculty of Medecine at Sfax university Tunisia, Boulevard Majida Boulila 3089 Sfax Tunisia; Pediatric Neurology department Hedi Chaker Hospital, EL Ain Road, 3089 Sfax, Tunisia
| | - Mourad Ahmadi
- Radiology Departement Hedi Chaker Hospital, EL Ain Road, 3002 3089 Sfax, Tunisia
| | - Dhouha Chaari
- Neuropediaty Reaserch Unit (UR12ES16), Faculty of Medecine at Sfax university Tunisia, Boulevard Majida Boulila 3089 Sfax Tunisia
| | - Fatma Kamoun
- Neuropediaty Reaserch Unit (UR12ES16), Faculty of Medecine at Sfax university Tunisia, Boulevard Majida Boulila 3089 Sfax Tunisia; Pediatric Neurology department Hedi Chaker Hospital, EL Ain Road, 3089 Sfax, Tunisia
| | - Ines Hsairi
- Neuropediaty Reaserch Unit (UR12ES16), Faculty of Medecine at Sfax university Tunisia, Boulevard Majida Boulila 3089 Sfax Tunisia; Pediatric Neurology department Hedi Chaker Hospital, EL Ain Road, 3089 Sfax, Tunisia
| | - Chahnez Triki
- Neuropediaty Reaserch Unit (UR12ES16), Faculty of Medecine at Sfax university Tunisia, Boulevard Majida Boulila 3089 Sfax Tunisia; Pediatric Neurology department Hedi Chaker Hospital, EL Ain Road, 3089 Sfax, Tunisia
| | - Zeineb Mnif
- Neuropediaty Reaserch Unit (UR12ES16), Faculty of Medecine at Sfax university Tunisia, Boulevard Majida Boulila 3089 Sfax Tunisia; Pediatric Neurology department Hedi Chaker Hospital, EL Ain Road, 3089 Sfax, Tunisia
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Wenz H, Maros ME, Meyer M, Gawlitza J, Förster A, Haubenreisser H, Kurth S, Schoenberg SO, Groden C, Henzler T. Intra-individual diagnostic image quality and organ-specific-radiation dose comparison between spiral cCT with iterative image reconstruction and z-axis automated tube current modulation and sequential cCT. Eur J Radiol Open 2016; 3:182-90. [PMID: 27504476 PMCID: PMC4969238 DOI: 10.1016/j.ejro.2016.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 05/31/2016] [Accepted: 05/31/2016] [Indexed: 11/16/2022] Open
Abstract
Superiority of spiral versus sequential cCT in image quality and organ-specific-radiation dose. Spiral cCT: lower organ-specific-radiation-dose in eye lense compared to tilted sequential cCT. State-of-the-art IR spiral cCT techniques has significant advantages over sequential cCT techniques.
Objectives To prospectively evaluate image quality and organ-specific-radiation dose of spiral cranial CT (cCT) combined with automated tube current modulation (ATCM) and iterative image reconstruction (IR) in comparison to sequential tilted cCT reconstructed with filtered back projection (FBP) without ATCM. Methods 31 patients with a previous performed tilted non-contrast enhanced sequential cCT aquisition on a 4-slice CT system with only FBP reconstruction and no ATCM were prospectively enrolled in this study for a clinical indicated cCT scan. All spiral cCT examinations were performed on a 3rd generation dual-source CT system using ATCM in z-axis direction. Images were reconstructed using both, FBP and IR (level 1–5). A Monte-Carlo-simulation-based analysis was used to compare organ-specific-radiation dose. Subjective image quality for various anatomic structures was evaluated using a 4-point Likert-scale and objective image quality was evaluated by comparing signal-to-noise ratios (SNR). Results Spiral cCT led to a significantly lower (p < 0.05) organ-specific-radiation dose in all targets including eye lense. Subjective image quality of spiral cCT datasets with an IR reconstruction level 5 was rated significantly higher compared to the sequential cCT acquisitions (p < 0.0001). Consecutive mean SNR was significantly higher in all spiral datasets (FBP, IR 1–5) when compared to sequential cCT with a mean SNR improvement of 44.77% (p < 0.0001). Conclusions Spiral cCT combined with ATCM and IR allows for significant-radiation dose reduction including a reduce eye lens organ-dose when compared to a tilted sequential cCT while improving subjective and objective image quality.
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Key Words
- ASPECTS, Alberta Stroke Program Early CT score
- ATCM, automated tube current modulation
- Automatic tube current modulation
- DSCT, dual-source computed tomography
- FBP, filtered back projection
- HU, hounsfield units
- ICRP, International Commission on Radiological Protection
- IR, iterative image reconstruction
- Iterative reconstruction
- MDCT, multi-detector computed tomography
- NC, caudate nucleus
- ND, normally distributed data
- NI, non-inferiority analysis
- Organ-specific-radiation dose
- SNR, signal-to-noise ratios
- Sequential cranial CT
- Spiral cranial CT
- WM, white matter
- cCT, cranial CT
- cCT, cranial computed tomography
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Affiliation(s)
- Holger Wenz
- Department of Neuroradiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Máté E Maros
- Department of Neuroradiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Mathias Meyer
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Joshua Gawlitza
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Alex Förster
- Department of Neuroradiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Holger Haubenreisser
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Stefan Kurth
- Department of Neuroradiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Stefan O Schoenberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Christoph Groden
- Department of Neuroradiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Thomas Henzler
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
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Barnden LR, Kwiatek R, Crouch B, Burnet R, Del Fante P. Autonomic correlations with MRI are abnormal in the brainstem vasomotor centre in Chronic Fatigue Syndrome. Neuroimage Clin 2016; 11:530-537. [PMID: 27114901 PMCID: PMC4833047 DOI: 10.1016/j.nicl.2016.03.017] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [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: 11/21/2015] [Revised: 03/21/2016] [Accepted: 03/23/2016] [Indexed: 11/25/2022]
Abstract
Autonomic changes are often associated with the chronic fatigue syndrome (CFS), but their pathogenetic role is unclear and brain imaging investigations are lacking. The vasomotor centre and, through it, nuclei in the midbrain and hypothalamus play a key role in autonomic nervous system regulation of steady state blood pressure (BP) and heart rate (HR). In this exploratory cross-sectional study, BP and HR, as indicators of autonomic function, were correlated with volumetric and T1- and T2-weighted spin-echo (T1w and T2w) brain MRI in 25 CFS subjects and 25 normal controls (NC). Steady state BP (systolic, diastolic and pulse pressure) and HR in two postures were extracted from 24 h blood pressure monitoring. We performed (1) MRI versus autonomic score interaction-with-group regressions to detect locations where regression slopes differed in the CFS and NC groups (collectively indicating abnormality in CFS), and (2) MRI regressions in the CFS and NC groups alone to detect additional locations with abnormal correlations in CFS. Significant CFS regressions were repeated controlling for anxiety and depression (A&D). Abnormal regressions were detected in nuclei of the brainstem vasomotor centre, midbrain reticular formation and hypothalamus, but also in limbic nuclei involved in stress responses and in prefrontal white matter. Group comparisons of CFS and NC did not find MRI differences in these locations. We propose therefore that these regulatory nuclei are functioning correctly, but that two-way communication between them is impaired in CFS and this affects signalling to/from peripheral effectors/sensors, culminating in inverted or magnified correlations. This single explanation for the diverse abnormal correlations detected here consolidates the conclusion for a brainstem/midbrain nerve conduction deficit inferred earlier (Barnden et al., 2015). Strong correlations were also detected in isolated NC regressions. For the first time in CFS, we performed MRI regressions with steady state BP and HR. Vasomotor centre, midbrain and hypothalamus correlations were abnormal in CFS. MRI group comparisons between CFS and controls detected no differences. Regulatory nuclei and peripheral effectors/sensors appear to function correctly. Signalling between brainstem/midbrain regulatory nuclei appears to be impaired.
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Key Words
- 1s, 1 sample
- 2s, 2 sample
- A&D, anxiety and depression
- Anxiety and depression
- Autonomic
- BA, Brodmann Area
- BP, blood pressure
- Blood pressure
- CFS, chronic fatigue syndrome
- Cb, cerebellum
- Chronic fatigue syndrome
- CnF, cuneiform nucleus of the reticular formation
- DLPF, dorsolateral prefrontal
- FDR, false discovery rate
- FWE, family wise error
- GM, grey matter
- HADS, Hospital Anxiety and Depression Scale
- HR, heart rate
- Heart rate
- Hypothalamus
- MRI
- Midbrain
- NC, normal controls
- Nerve conduction
- PCC, posterior cingulate cortex
- PHg, parahippocampal gyrus
- POTS, postural orthostatic tachycardia syndrome
- PP, pulse pressure
- Posture
- RAS, reticular activation system
- Regression
- SS, symptom score
- VBIS, voxel based iterative sensitivity
- Vasomotor centre
- WM, white matter
- ccP, corrected cluster P statistic
- diaBP, diastolic blood pressure
- sysBP, systolic Blood pressure
- uvP, uncorrected voxel P statistic
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Affiliation(s)
- Leighton R Barnden
- Department of Nuclear Medicine, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia; National Centre for NeuroImmunology and Emerging Diseases, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Richard Kwiatek
- Division of Medical Subspecialities, Lyell McEwin Hospital, Elizabeth, SA 5112, Australia.
| | - Benjamin Crouch
- Department of Nuclear Medicine, The Queen Elizabeth Hospital, Woodville, SA 5011, Australia.
| | - Richard Burnet
- Endocrinology Department, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
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Kini LG, Gee JC, Litt B. Computational analysis in epilepsy neuroimaging: A survey of features and methods. Neuroimage Clin 2016; 11:515-29. [PMID: 27114900 DOI: 10.1016/j.nicl.2016.02.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 02/11/2016] [Accepted: 02/22/2016] [Indexed: 12/15/2022]
Abstract
Epilepsy affects 65 million people worldwide, a third of whom have seizures that are resistant to anti-epileptic medications. Some of these patients may be amenable to surgical therapy or treatment with implantable devices, but this usually requires delineation of discrete structural or functional lesion(s), which is challenging in a large percentage of these patients. Advances in neuroimaging and machine learning allow semi-automated detection of malformations of cortical development (MCDs), a common cause of drug resistant epilepsy. A frequently asked question in the field is what techniques currently exist to assist radiologists in identifying these lesions, especially subtle forms of MCDs such as focal cortical dysplasia (FCD) Type I and low grade glial tumors. Below we introduce some of the common lesions encountered in patients with epilepsy and the common imaging findings that radiologists look for in these patients. We then review and discuss the computational techniques introduced over the past 10 years for quantifying and automatically detecting these imaging findings. Due to large variations in the accuracy and implementation of these studies, specific techniques are traditionally used at individual centers, often guided by local expertise, as well as selection bias introduced by the varying prevalence of specific patient populations in different epilepsy centers. We discuss the need for a multi-institutional study that combines features from different imaging modalities as well as computational techniques to definitively assess the utility of specific automated approaches to epilepsy imaging. We conclude that sharing and comparing these different computational techniques through a common data platform provides an opportunity to rigorously test and compare the accuracy of these tools across different patient populations and geographical locations. We propose that these kinds of tools, quantitative imaging analysis methods and open data platforms for aggregating and sharing data and algorithms, can play a vital role in reducing the cost of care, the risks of invasive treatments, and improve overall outcomes for patients with epilepsy. We introduce common epileptogenic lesions encountered in patients with drug resistant epilepsy. We discuss state of the art computational techniques used to detect lesions. There is a need for multi-institutional studies that combine these techniques. Clinically validated pipelines alongside the advances in imaging and electrophysiology will improve outcomes.
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Key Words
- DRE, drug resistant epilepsy
- DTI, diffusion tensor imaging
- DWI, diffusion weighted imaging
- Drug resistant epilepsy
- Epilepsy
- FCD, focal cortical dysplasia
- FLAIR, fluid-attenuated inversion recovery
- Focal cortical dysplasia
- GM, gray matter
- GW, gray-white junction
- HARDI, high angular resolution diffusion imaging
- MEG, magnetoencephalography
- MRS, magnetic resonance spectroscopy imaging
- Machine learning
- Malformations of cortical development
- Multimodal neuroimaging
- PET, positron emission tomography
- PNH, periventricular nodular heterotopia
- SBM, surface-based morphometry
- T1W, T1-weighted MRI
- T2W, T2-weighted MRI
- VBM, voxel-based morphometry
- WM, white matter
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Klosinski LP, Yao J, Yin F, Fonteh AN, Harrington MG, Christensen TA, Trushina E, Brinton RD. White Matter Lipids as a Ketogenic Fuel Supply in Aging Female Brain: Implications for Alzheimer's Disease. EBioMedicine 2015; 2:1888-904. [PMID: 26844268 PMCID: PMC4703712 DOI: 10.1016/j.ebiom.2015.11.002] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [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: 08/19/2015] [Revised: 10/24/2015] [Accepted: 11/02/2015] [Indexed: 01/28/2023] Open
Abstract
White matter degeneration is a pathological hallmark of neurodegenerative diseases including Alzheimer's. Age remains the greatest risk factor for Alzheimer's and the prevalence of age-related late onset Alzheimer's is greatest in females. We investigated mechanisms underlying white matter degeneration in an animal model consistent with the sex at greatest Alzheimer's risk. Results of these analyses demonstrated decline in mitochondrial respiration, increased mitochondrial hydrogen peroxide production and cytosolic-phospholipase-A2 sphingomyelinase pathway activation during female brain aging. Electron microscopic and lipidomic analyses confirmed myelin degeneration. An increase in fatty acids and mitochondrial fatty acid metabolism machinery was coincident with a rise in brain ketone bodies and decline in plasma ketone bodies. This mechanistic pathway and its chronologically phased activation, links mitochondrial dysfunction early in aging with later age development of white matter degeneration. The catabolism of myelin lipids to generate ketone bodies can be viewed as a systems level adaptive response to address brain fuel and energy demand. Elucidation of the initiating factors and the mechanistic pathway leading to white matter catabolism in the aging female brain provides potential therapeutic targets to prevent and treat demyelinating diseases such as Alzheimer's and multiple sclerosis. Targeting stages of disease and associated mechanisms will be critical. Mitochondrial dysfunction activates mechanisms for catabolism of myelin lipids to generate ketone bodies for ATP production. Mechanisms leading to ketone body driven energy production in brain coincide with stages of reproductive aging in females. Sequential activation of myelin catabolism pathway during aging provides multiple therapeutic targets and windows of efficacy.
The mechanisms underlying white matter degeneration, a hallmark of multiple neurodegenerative diseases including Alzheimer's, remain unclear. Herein we provide a mechanistic pathway, spanning multiple transitions of aging, that links mitochondrial dysfunction early in aging with later age white matter degeneration. Catabolism of myelin lipids to generate ketone bodies can be viewed as an adaptive survival response to address brain fuel and energy demand. Women are at greatest risk of late-onset-AD, thus, our analyses in female brain address mechanisms of AD pathology and therapeutic targets to prevent, delay and treat AD in the sex most affected with potential relevance to men.
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Key Words
- ABAD, Aβ-binding alcohol dehydrogenase
- ABAD, Aβ-binding-alcohol-dehydrogenase
- ACER3, alkaline ceramidase
- AD, Alzheimer's disease
- APO-ε4, apolipoprotein ε4
- APP, amyloid precursor protein
- Aging oxidative stress
- Alzheimer's disease
- BACE1, beta-secretase 1
- BBB, blood brain barrier
- CC, corpus callosum
- CMRglu, cerebral glucose metabolic rate
- COX, complex IV cytochrome c oxidase
- CPT1, carnitine palmitoyltransferase 1
- Cldn11, claudin 11
- Cyp2j6, arachidonic acid epoxygenase
- Cytosolic phospholipase A2
- DHA, docosahexaesnoic acid
- Erbb3, Erb-B2 receptor tyrosine kinase 3
- FDG-PET, 2-[18F]fluoro-2-deoxy-d-glucose
- GFAP, glial fibrillary acidic protein
- H2O2, hydrogen peroxide
- HADHA, hydroxyacyl-CoA dehydrogenase
- HK, hexokinase
- Ketone bodies
- LC MS, liquid chromatography mass spectrometer
- MAG, myelin associated glycoprotein
- MBP, myelin basic protein
- MCT1, monocarboxylate transporter 1
- MIB, mitochondrial isolation buffer
- MOG, myelin oligodendrocyte glycoprotein
- MTL, medial temporal lobe
- Mitochondria
- NEFA, nonesterified fatty acids
- Neurodegeneration
- OCR, oxygen consumption rate
- Olig2, oligodendrocyte transcription factor
- PB, phosphate buffer
- PCC, posterior cingulate
- PCR, polymerase chain reaction
- PDH, pyruvate dehydrogenase
- PEI, polyethyleneimine
- RCR, respiratory control ratio
- ROS, reactive oxygen species
- S1P, sphingosine
- TLDA, TaqMan low density array
- WM, white matter
- WT, wild type
- White matter
- cPLA2, cytosolic phospholipase A2
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Affiliation(s)
- Lauren P Klosinski
- Department of Neuroscience, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jia Yao
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Fei Yin
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Eugenia Trushina
- Department of Neurology, Mayo Clinic Rochester, MN, USA; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA
| | - Roberta Diaz Brinton
- Department of Neuroscience, Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA; Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Scheck SM, Pannek K, Raffelt DA, Fiori S, Boyd RN, Rose SE. Structural connectivity of the anterior cingulate in children with unilateral cerebral palsy due to white matter lesions. Neuroimage Clin 2015; 9:498-505. [PMID: 26640762 DOI: 10.1016/j.nicl.2015.09.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 09/08/2015] [Accepted: 09/22/2015] [Indexed: 12/13/2022]
Abstract
In this work we investigate the structural connectivity of the anterior cingulate cortex (ACC) and its link with impaired executive function in children with unilateral cerebral palsy (UCP) due to periventricular white matter lesions. Fifty two children with UCP and 17 children with typical development participated in the study, and underwent diffusion and structural MRI. Five brain regions were identified for their high connectivity with the ACC using diffusion MRI fibre tractography: the superior frontal gyrus, medial orbitofrontal cortex, rostral middle frontal gyrus, precuneus and isthmus cingulate. Structural connectivity was assessed in pathways connecting these regions to the ACC using three diffusion MRI derived measures: fractional anisotropy (FA), mean diffusivity (MD) and apparent fibre density (AFD), and compared between participant groups. Furthermore we investigated correlations of these measures with executive function as assessed by the Flanker task. The ACC-precuneus tract had significantly different MD (p < 0.0001) and AFD (p = 0.0072) between groups, with post-hoc analysis showing significantly increased MD in the right hemisphere of children with left hemiparesis compared with controls. The ACC-superior frontal gyrus tract had significantly different FA (p = 0.0049) and MD (p = 0.0031) between groups. AFD in this tract (contralateral to side of hemiparesis; right hemisphere in controls) showed a significant relationship with Flanker task performance (p = 0.0045, β = -0.5856), suggesting that reduced connectivity correlates with executive dysfunction. Reduced structural integrity of ACC tracts appears to be important in UCP, in particular the connection to the superior frontal gyrus. Although damage to this area is heterogeneous it may be important in early identification of children with impaired executive function.
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Key Words
- ACC, anterior cingulate cortex
- AFD, apparent fibre density
- CP, cerebral palsy
- CTD, children with typical development
- DTI, diffusion tensor imaging
- FA, fractional anisotropy
- FOD, fibre orientation distribution
- HARDI, high angular resolution diffusion imaging
- MD, mean diffusivity
- MRI, magnetic resonance imaging
- ROI, region of interest
- SIFT, spherical deconvolution informed filtering of tractograms
- UCP, unilateral cerebral palsy
- WM, white matter
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Daamen M, Bäuml JG, Scheef L, Meng C, Jurcoane A, Jaekel J, Sorg C, Busch B, Baumann N, Bartmann P, Wolke D, Wohlschläger A, Boecker H. Neural correlates of executive attention in adults born very preterm. Neuroimage Clin 2015; 9:581-91. [PMID: 26640769 PMCID: PMC4633838 DOI: 10.1016/j.nicl.2015.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 05/17/2015] [Revised: 08/31/2015] [Accepted: 09/07/2015] [Indexed: 01/16/2023]
Abstract
Very preterm birth is associated with an increased prevalence of attention problems and may especially impair executive attention, i.e., top-down control of attentional selection in situations where distracting information interferes with the processing of task-relevant stimuli. While there are initial findings linking structural brain alterations in preterm-born individuals with attention problems, the functional basis of these problems are not well understood. The present study used an fMRI adaptation of the Attentional Network Test to examine the neural correlates of executive attention in a large sample of N = 86 adults born very preterm and/or with very low birth weight (VP/VLBW), and N = 100 term-born controls. Executive attention was measured by comparing task behavior and brain activations associated with the processing of incongruent vs. congruent arrow flanker stimuli. Consistent with subtle impairments of executive attention, the VP/VLBW group showed lower accuracy and a tendency for increased response times during the processing of incongruent stimuli. Both groups showed similar activation patters, especially within expected fronto-cingulo-parietal areas, but no significant between-group differences. Our results argue for a maintained attention-relevant network organization in high-functioning preterm born adults in spite of subtle deficits in executive attention. Gestational age and neonatal treatment variables showed associations with task behavior, and brain activation in the dorsal ACC and lateral occipital areas, suggesting that the degree of prematurity (and related neonatal complications) has subtle modulatory influences on executive attention processing. fMRI study examines neural correlates of executive attention in preterm-born adults. Preterm-born adults show subtle behavioral deficits. Preterm-born adults show maintained organization of attention-related networks. Modulatory effects of gestational age and neonatal treatment variables are observed.
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Key Words
- ACC, anterior cingulate cortex
- ANT, Attentional Network Test
- Anterior cingulate
- Attentional Network Test
- BLS, Bavarian Longitudinal Study
- BW, birth weight
- CSF, cerebrospinal fluid
- DLPFC, dorsolateral prefrontal cortex
- DNTI, duration of neonatal intensive treatment
- EHI, Edinburgh Handedness Inventory
- ELBW, extremely low birth weight
- EP, extremely preterm
- Executive attention
- FWE, familywise error
- GA, gestational age
- GM, gray matter
- Gestational age
- ICV, intracranial volume
- INTI, intensity of neonatal intensive treatment
- IVH, intraventricular hemorrhage
- PFC, prefrontal cortex
- Preterm birth
- VLBW, very low birth weight
- VP, very preterm
- WM, white matter
- fMRI, functional magnetic resonance imaging
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Affiliation(s)
- Marcel Daamen
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany ; Department of Neonatology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Josef G Bäuml
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany
| | - Lukas Scheef
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Chun Meng
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany ; Graduate School of Systemic Neurosciences GSN, Ludwig Maximilians Universität, Biocenter, Department Biology II Neurobiology, Großhaderner Str. 2, D-82152 Planegg-Martinsried, Germany
| | - Alina Jurcoane
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany ; Department of Neonatology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Julia Jaekel
- Department of Developmental Psychology, Ruhr-University Bochum, Universitätsstraße 150, Bochum 44801, Germany ; Department of Psychology, University of Warwick, University Road, Coventry CV4 7AL, UK
| | - Christian Sorg
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; Department of Psychiatry, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany
| | - Barbara Busch
- Department of Neonatology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Nicole Baumann
- Department of Psychology, University of Warwick, University Road, Coventry CV4 7AL, UK
| | - Peter Bartmann
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, University Road, Coventry CV4 7AL, UK ; Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Afra Wohlschläger
- Department of Neuroradiology, Klinikum Rechts der Isar, Technische Universität München, Ismaninger str. 22, 81664 Munich, Germany ; TUM-Neuroimaging Center of Klinikum rechts der Isar, Technische Universität München, Ismaninger str. 22, Munich 81664, Germany ; Graduate School of Systemic Neurosciences GSN, Ludwig Maximilians Universität, Biocenter, Department Biology II Neurobiology, Großhaderner Str. 2, D-82152 Planegg-Martinsried, Germany
| | - Henning Boecker
- Department of Radiology, University Hospital Bonn, Sigmund Freud-Str. 25, 53105 Bonn, Germany
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Wen J, Yablonskiy DA, Luo J, Lancia S, Hildebolt C, Cross AH. Detection and quantification of regional cortical gray matter damage in multiple sclerosis utilizing gradient echo MRI. Neuroimage Clin 2015; 9:164-75. [PMID: 27330979 DOI: 10.1016/j.nicl.2015.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 12/29/2022]
Abstract
Cortical gray matter (GM) damage is now widely recognized in multiple sclerosis (MS). The standard MRI does not reliably detect cortical GM lesions, although cortical volume loss can be measured. In this study, we demonstrate that the gradient echo MRI can reliably and quantitatively assess cortical GM damage in MS patients using standard clinical scanners. High resolution multi-gradient echo MRI was used for regional mapping of tissue-specific MRI signal transverse relaxation rate values (R2(*)) in 10 each relapsing-remitting, primary-progressive and secondary-progressive MS subjects. A voxel spread function method was used to correct artifacts induced by background field gradients. R2(*) values from healthy controls (HCs) of varying ages were obtained to establish baseline data and calculate ΔR2(*) values - age-adjusted differences between MS patients and HC. Thickness of cortical regions was also measured in all subjects. In cortical regions, ΔR2(*) values of MS patients were also adjusted for changes in cortical thickness. Symbol digit modalities (SDMT) and paced auditory serial addition (PASAT) neurocognitive tests, as well as Expanded Disability Status Score, 25-foot timed walk and nine-hole peg test results were also obtained on all MS subjects. We found that ΔR2(*) values were lower in multiple cortical GM and normal appearing white matter (NAWM) regions in MS compared with HC. ΔR2(*) values of global cortical GM and several specific cortical regions showed significant (p < 0.05) correlations with SDMT and PASAT scores, and showed better correlations than volumetric measures of the same regions. Neurological tests not focused on cognition (Expanded Disability Status Score, 25-foot timed walk and nine-hole peg tests) showed no correlation with cortical GM ΔR2(*) values. The technique presented here is robust and reproducible. It requires less than 10 min and can be implemented on any MRI scanner. Our results show that quantitative tissue-specific R2(*) values can serve as biomarkers of tissue injury due to MS in the brain, including the cerebral cortex, an area that has been difficult to evaluate using standard MRI.
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Key Words
- 25FTW, 25-foot timed walk
- 9HPT, Nine-hole peg test
- Cognitive disability
- Cortical gray matter
- EDSS, expanded disability status scale
- GEPCI, gradient echo plural contrast imaging
- GM, gray matter
- HC, healthy control
- MPRAGE, magnetization prepared rapid gradient echo
- MS, multiple sclerosis
- Multiple sclerosis
- NAWM, normal appearing white matter
- NCGMV, normalized cortical gray matter volume
- PASAT, paced auditory serial addition test
- PPMS, primary-progressive multiple sclerosis
- Quantitative
- R2*
- ROI, region of interest
- RRMS, relapsing–remitting multiple sclerosis
- SDMT, symbol digit modalities test
- SPMS, secondary-progressive multiple sclerosis
- WM, white matter
- WMLL, white matter lesion load
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Ercan E, Ingo C, Tritanon O, Magro-Checa C, Smith A, Smith S, Huizinga T, van Buchem MA, Ronen I. A multimodal MRI approach to identify and characterize microstructural brain changes in neuropsychiatric systemic lupus erythematosus. Neuroimage Clin 2015; 8:337-44. [PMID: 26106559 DOI: 10.1016/j.nicl.2015.05.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/08/2015] [Accepted: 05/13/2015] [Indexed: 01/09/2023]
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune disease with multi-organ involvement and results in neurological and psychiatric (NP) symptoms in up to 40% of the patients. To date, the diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) poses a challenge due to the lack of neuroradiological gold standards. In this study, we aimed to better localize and characterize normal appearing white matter (NAWM) changes in NPSLE by combining data from two quantitative MRI techniques, diffusion tensor imaging (DTI) and magnetization transfer imaging (MTI). 9 active NPSLE patients (37 ± 13 years, all females), 9 SLE patients without NP symptoms (44 ± 11 years, all females), and 14 healthy controls (HC) (40 ± 9 years, all females) were included in the study. MTI, DTI and fluid attenuated inversion recovery (FLAIR) images were collected from all subjects on a 3 T MRI scanner. Magnetization transfer ratio (MTR), mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD) maps and white matter lesion maps based on the FLAIR images were created for each subject. MTR and DTI data were then co-analyzed using tract-based spatial statistics and a cumulative lesion map to exclude lesions. Significantly lower MTR and FA and significantly higher AD, RD and MD were found in NPSLE compared to HC in NAWM regions. The differences in DTI measures and in MTR, however, were only moderately co-localized. Additionally, significant differences in DTI measures, but not in MTR, were found between NPSLE and SLE patients, suggesting that the underlying microstructural changes detected by MD are linked to the onset of NPSLE. The co-analysis of the anatomical distribution of MTI and DTI measures can potentially improve the diagnosis of NPSLE and contribute to the understanding of the underlying microstructural damage. NAWM is investigated in NPSLE and SLE using MTI and DTI. Differences in DTI and MTR between NPSLE and HC are widespread but only moderately co-localized. Significant differences in MD between SLE and NPSLE suggest link to onset of NPSLE.
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Key Words
- ACR, American College of Rheumatology
- AD, axial diffusivity
- DTI, diffusion tensor imaging
- Diffusion tensor imaging
- FA, fractional anisotropy
- FLAIR, fluid attenuated inversion recovery
- HC, healthy controls
- MD, mean diffusivity
- MTI, magnetization transfer imaging
- MTR, magnetization transfer ratio
- Magnetic resonance imaging
- Magnetization transfer imaging
- NAWM, normal appearing white matter
- NP, neurological and psychiatric
- NPSLE, neuropsychiatric systemic lupus erythematosus
- Neuropsychiatric systemic lupus erythematosus
- Normal appearing white matter
- RD, radial diffusivity
- SLE, systemic lupus erythematosus
- Systemic lupus erythematosus
- TBSS, tract based spatial statistics
- WM, white matter
- WMH, white matter hyperintensities
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Asaf A, Evan S, Anat A. Injury to white matter tracts in relapsing-remitting multiple sclerosis: A possible therapeutic window within the first 5 years from onset using diffusion-tensor imaging tract-based spatial statistics. Neuroimage Clin 2015; 8:261-6. [PMID: 26106550 PMCID: PMC4474176 DOI: 10.1016/j.nicl.2015.04.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 02/22/2015] [Revised: 04/15/2015] [Accepted: 04/28/2015] [Indexed: 11/23/2022]
Abstract
DTI studies in multiple sclerosis (MS) reveal white matter (WM) injury that occurs with disease progression. In the present study we aimed to elucidate the relationship of microstructural WM damage in patients with varying periods of disease duration. DTI scans were acquired from 90 MS patients and 25 healthy controls. Patients were grouped to short (<1 year), moderate (1 up to 6 years) and long (6–10 years) disease duration periods. Statistical analyses of the fractional anisotropy (FA) data were performed using tract-based spatial statistics (TBSS). Whole-brain skeletal FA measurements showed a significant decrease between healthy controls and the short MS disease duration group, as well as between moderate disease duration and long disease duration groups, but failed to show a significant difference between short and moderate disease duration groups. Voxelwise analysis revealed clusters of diffuse FA reductions in 40 WM tracts when comparing healthy controls and MS short disease duration group, with the point of maximal significant difference located in the left inferior longitudinal fasciculus. Comparing short with long disease duration groups, progressive FA reduction was demonstrated across 30 WM tracts, with the point of maximal significant difference migrating to the body of the corpus callosum. A non-linear pattern of WM microstructure disruption occurs in RRMS. Alterations are seen early in the disease course within 1 year from onset, reach a plateau within the next 5 years, and only later additional WM changes are detected. An important period of a possible therapeutic window therefore exists within the early disease stage. A non-linear pattern of WM microstructure disruption occurs in patients with RRMS. WM disruption is identified within 1 year from disease onset. FA reduction is similar in patients with early and moderate disease duration periods. Different patterns of WM disruption occur in patients with longer disease duration.
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Affiliation(s)
- Achiron Asaf
- Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Stone Evan
- Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Achiron Anat
- Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
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Yuan W, Holland SK, Shimony JS, Altaye M, Mangano FT, Limbrick DD, Jones BV, Nash T, Rajagopal A, Simpson S, Ragan D, McKinstry RC. Abnormal structural connectivity in the brain networks of children with hydrocephalus. Neuroimage Clin 2015; 8:483-92. [PMID: 26106573 DOI: 10.1016/j.nicl.2015.04.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 03/18/2015] [Accepted: 04/26/2015] [Indexed: 12/21/2022]
Abstract
Increased intracranial pressure and ventriculomegaly in children with hydrocephalus are known to have adverse effects on white matter structure. This study seeks to investigate the impact of hydrocephalus on topological features of brain networks in children. The goal was to investigate structural network connectivity, at both global and regional levels, in the brains in children with hydrocephalus using graph theory analysis and diffusion tensor tractography. Three groups of children were included in the study (29 normally developing controls, 9 preoperative hydrocephalus patients, and 17 postoperative hydrocephalus patients). Graph theory analysis was applied to calculate the global network measures including small-worldness, normalized clustering coefficients, normalized characteristic path length, global efficiency, and modularity. Abnormalities in regional network parameters, including nodal degree, local efficiency, clustering coefficient, and betweenness centrality, were also compared between the two patients groups (separately) and the controls using two tailed t-test at significance level of p < 0.05 (corrected for multiple comparison). Children with hydrocephalus in both the preoperative and postoperative groups were found to have significantly lower small-worldness and lower normalized clustering coefficient than controls. Children with hydrocephalus in the postoperative group were also found to have significantly lower normalized characteristic path length and lower modularity. At regional level, significant group differences (or differences at trend level) in regional network measures were found between hydrocephalus patients and the controls in a series of brain regions including the medial occipital gyrus, medial frontal gyrus, thalamus, cingulate gyrus, lingual gyrus, rectal gyrus, caudate, cuneus, and insular. Our data showed that structural connectivity analysis using graph theory and diffusion tensor tractography is sensitive to detect abnormalities of brain network connectivity associated with hydrocephalus at both global and regional levels, thus providing a new avenue for potential diagnosis and prognosis tool for children with hydrocephalus.
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Haris M, Yadav SK, Rizwan A, Singh A, Cai K, Kaura D, Wang E, Davatzikos C, Trojanowski JQ, Melhem ER, Marincola FM, Borthakur A. T1rho MRI and CSF biomarkers in diagnosis of Alzheimer's disease. Neuroimage Clin 2015; 7:598-604. [PMID: 25844314 PMCID: PMC4375645 DOI: 10.1016/j.nicl.2015.02.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [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: 09/29/2014] [Revised: 02/22/2015] [Accepted: 02/23/2015] [Indexed: 01/14/2023]
Abstract
In the current study, we have evaluated the performance of magnetic resonance (MR) T1rho (T1ρ) imaging and CSF biomarkers (T-tau, P-tau and Aβ-42) in characterization of Alzheimer's disease (AD) patients from mild cognitive impairment (MCI) and control subjects. With informed consent, AD (n = 27), MCI (n = 17) and control (n = 17) subjects underwent a standardized clinical assessment and brain MRI on a 1.5-T clinical-scanner. T1ρ images were obtained at four different spin-lock pulse duration (10, 20, 30 and 40 ms). T1ρ maps were generated by pixel-wise fitting of signal intensity as a function of the spin-lock pulse duration. T1ρ values from gray matter (GM) and white matter (WM) of medial temporal lobe were calculated. The binary logistic regression using T1ρ and CSF biomarkers as variables was performed to classify each group. T1ρ was able to predict 77.3% controls and 40.0% MCI while CSF biomarkers predicted 81.8% controls and 46.7% MCI. T1ρ and CSF biomarkers in combination predicted 86.4% controls and 66.7% MCI. When comparing controls with AD, T1ρ predicted 68.2% controls and 73.9% AD, while CSF biomarkers predicted 77.3% controls and 78.3% for AD. Combination of T1ρ and CSF biomarkers improved the prediction rate to 81.8% for controls and 82.6% for AD. Similarly, on comparing MCI with AD, T1ρ predicted 35.3% MCI and 81.9% AD, whereas CSF biomarkers predicted 53.3% MCI and 83.0% AD. Collectively CSF biomarkers and T1ρ were able to predict 59.3% MCI and 84.6% AD. On receiver operating characteristic analysis T1ρ showed higher sensitivity while CSF biomarkers showed greater specificity in delineating MCI and AD from controls. No significant correlation between T1ρ and CSF biomarkers, between T1ρ and age, and between CSF biomarkers and age was observed. The combined use of T1ρ and CSF biomarkers have promise to improve the early and specific diagnosis of AD. Furthermore, disease progression form MCI to AD might be easily tracked using these two parameters in combination. Increased T1rho was observed in MCI and AD compared to controls. Increased T-tau and P-tau and decreased Aβ1-42 were observed in MCI and AD. Combined biomarkers have promise to improve early and specific diagnosis of AD. MCI to AD progression might be tracked using these two biomarkers in combination.
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Key Words
- AD, Alzheimer's disease
- Alzheimer's disease
- Aβ1-42, amyloid beta 42
- CSF biomarkers
- CSF, cerebrospinal fluid
- FOV, field of view
- GM, gray matter
- MCI, mild cognitive impairment
- MMSE, Mini-Mental State Examination
- MPRAGE, magnetization prepared rapid acquisition gradient-echo
- MRI, magnetic resonance imaging
- MTL, medial temporal lobe
- Medial temporal lobe
- Mild cognitive impairment
- PET, positron emission tomography
- ROC, receiver operating characteristic.
- T-tau, total tau
- T1rho
- T1ρ, T1rho
- TE, echo time
- TI, inversion time
- TR, repetition time
- TSL, total spin lock
- WM, white matter
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Affiliation(s)
- Mohammad Haris
- Research Branch, Sidra Medical and Research Center, Doha, Qatar ; Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Santosh K Yadav
- Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Arshi Rizwan
- All India Institute of Medical Science, Ansari Nagar East, New Delhi, Delhi 110029, India
| | - Anup Singh
- Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA ; Center for Biomedical Engineering, Indian institute of Technology, New Delhi, India
| | - Kejia Cai
- Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA ; Center for Magnetic Resonance Research, Radiology Department, University of Illinois at Chicago, IL, USA
| | - Deepak Kaura
- Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Ena Wang
- Research Branch, Sidra Medical and Research Center, Doha, Qatar
| | - Christos Davatzikos
- Section of Biomedical Image Analysis, University of Pennsylvania, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology & Lab Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elias R Melhem
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Arijitt Borthakur
- Center for Magnetic Resonance and Optical Imaging, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
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van Rooij D, Hartman CA, Mennes M, Oosterlaan J, Franke B, Rommelse N, Heslenfeld D, Faraone SV, Buitelaar JK, Hoekstra PJ. Altered neural connectivity during response inhibition in adolescents with attention-deficit/hyperactivity disorder and their unaffected siblings. Neuroimage Clin 2015; 7:325-35. [PMID: 25610797 PMCID: PMC4297885 DOI: 10.1016/j.nicl.2015.01.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/06/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Response inhibition is one of the executive functions impaired in attention-deficit/hyperactivity disorder (ADHD). Increasing evidence indicates that altered functional and structural neural connectivity are part of the neurobiological basis of ADHD. Here, we investigated if adolescents with ADHD show altered functional connectivity during response inhibition compared to their unaffected siblings and healthy controls. METHODS Response inhibition was assessed using the stop signal paradigm. Functional connectivity was assessed using psycho-physiological interaction analyses applied to BOLD time courses from seed regions within inferior- and superior frontal nodes of the response inhibition network. Resulting networks were compared between adolescents with ADHD (N = 185), their unaffected siblings (N = 111), and controls (N = 125). RESULTS Control subjects showed stronger functional connectivity than the other two groups within the response inhibition network, while subjects with ADHD showed relatively stronger connectivity between default mode network (DMN) nodes. Stronger connectivity within the response inhibition network was correlated with lower ADHD severity, while stronger connectivity with the DMN was correlated with increased ADHD severity. Siblings showed connectivity patterns similar to controls during successful inhibition and to ADHD subjects during failed inhibition. Additionally, siblings showed decreased connectivity with the primary motor areas as compared to both participants with ADHD and controls. DISCUSSION Subjects with ADHD fail to integrate activation within the response inhibition network and to inhibit connectivity with task-irrelevant regions. Unaffected siblings show similar alterations only during failed stop trials, as well as unique suppression of motor areas, suggesting compensatory strategies. These findings support the role of altered functional connectivity in understanding the neurobiology and familial transmission of ADHD.
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Key Words
- ADHD
- ADHD, attention deficit/hyperactivity disorder
- CD, conduct disorder
- Connectivity
- DMN, default mode network
- GEE, generalized estimating equations
- ICV, intraindividual coefficient of variance
- ODD, oppositional defiant disorder
- PPI
- RD, reading disorder
- ROI, region of interest
- Response inhibition
- SI, supplementary information
- SSRT, stop-signal reaction time
- SST, Stop-signal task
- Siblings
- WM, white matter
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Affiliation(s)
- Daan van Rooij
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Centre for Cognitive Neuroimaging, Donders Institute for Brain Cognition and Behavior, Nijmegen, The Netherlands
| | - Catharina A. Hartman
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maarten Mennes
- Centre for Cognitive Neuroimaging, Donders Institute for Brain Cognition and Behavior, Nijmegen, The Netherlands
| | - Jaap Oosterlaan
- Department of Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nanda Rommelse
- Karakter Child and Adolescent Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dirk Heslenfeld
- Department of Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jan K. Buitelaar
- Karakter Child and Adolescent Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain Cognition and Behavior, Nijmegen, The Netherlands
| | - Pieter J. Hoekstra
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Kerbler GM, Fripp J, Rowe CC, Villemagne VL, Salvado O, Rose S, Coulson EJ. Basal forebrain atrophy correlates with amyloid β burden in Alzheimer's disease. Neuroimage Clin 2014; 7:105-13. [PMID: 25610772 PMCID: PMC4299972 DOI: 10.1016/j.nicl.2014.11.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [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: 02/10/2014] [Revised: 06/11/2014] [Accepted: 11/18/2014] [Indexed: 12/11/2022]
Abstract
The brains of patients suffering from Alzheimer's disease (AD) have three classical pathological hallmarks: amyloid-beta (Aβ) plaques, tau tangles, and neurodegeneration, including that of cholinergic neurons of the basal forebrain. However the relationship between Aβ burden and basal forebrain degeneration has not been extensively studied. To investigate this association, basal forebrain volumes were determined from magnetic resonance images of controls, subjects with amnestic mild cognitive impairment (aMCI) and AD patients enrolled in the longitudinal Alzheimer's Disease Neuroimaging Initiative (ADNI) and Australian Imaging, Biomarkers and Lifestyle (AIBL) studies. In the AIBL cohort, these volumes were correlated within groups to neocortical gray matter retention of Pittsburgh compound B (PiB) from positron emission tomography images as a measure of Aβ load. The basal forebrain volumes of AD and aMCI subjects were significantly reduced compared to those of control subjects. Anterior basal forebrain volume was significantly correlated to neocortical PiB retention in AD subjects and aMCI subjects with high Aβ burden, whereas posterior basal forebrain volume was significantly correlated to neocortical PiB retention in control subjects with high Aβ burden. Therefore this study provides new evidence for a correlation between neocortical Aβ accumulation and basal forebrain degeneration. In addition, cluster analysis showed that subjects with a whole basal forebrain volume below a determined cut-off value had a 7 times higher risk of having a worse diagnosis within ~18 months. The link between amyloid (Aβ) and basal forebrain degeneration in AD is unclear. We find that basal forebrain volumes are correlated with neocortical Aβ burden. Basal forebrain volume correlates with Aβ burden in at-risk control subjects. Basal forebrain atrophy delineates subjects at increased risk of progressing to AD.
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Key Words
- 3D, 3-dimensional
- AD, Alzheimer's disease
- ADNI, Alzheimer's Disease Neuroimaging Initiative
- AIBL, Australian Imaging, Biomarkers and Lifestyle Flagship Study of Aging
- Alzheimer's disease
- Amyloid
- Aβ, amyloid-beta
- Basal forebrain
- CSF, cerebrospinal fluid
- GM, gray matter
- HC, healthy control
- MCI, mild cognitive impairment
- MNI, Montreal Neurological Institute
- MPM, maximum probability maps
- MPRAGE, magnetization prepared rapid gradient echo
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- OR, odds ratio
- PET
- PET, positron emission tomography
- PiB, Pittsburgh compound B
- SPSS, statistics software package for the social sciences
- SUVR, standard uptake value ratio
- SyN, symmetric normalization
- T1W, T1-weighted
- TG-ROC, two-graph receiver operating characteristic
- WM, white matter
- aMCI, amnestic mild cognitive impairment
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Affiliation(s)
- Georg M Kerbler
- Queensland Brain Institute, Clem Jones Centre for Ageing Dementia Research, The University of Queensland, Brisbane, Qld 4072, Australia
| | - Jürgen Fripp
- Commonwealth Scientific and Industrial Research Organisation, Computational Informatics, Brisbane, Qld 4029, Australia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Vic. 3084, Australia
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Vic. 3084, Australia ; Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Vic. 3084, Australia
| | - Olivier Salvado
- Commonwealth Scientific and Industrial Research Organisation, Computational Informatics, Brisbane, Qld 4029, Australia
| | - Stephen Rose
- Commonwealth Scientific and Industrial Research Organisation, Computational Informatics, Brisbane, Qld 4029, Australia
| | - Elizabeth J Coulson
- Queensland Brain Institute, Clem Jones Centre for Ageing Dementia Research, The University of Queensland, Brisbane, Qld 4072, Australia
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Mole TB, MacIver K, Sluming V, Ridgway GR, Nurmikko TJ. Specific brain morphometric changes in spinal cord injury with and without neuropathic pain. Neuroimage Clin 2014; 5:28-35. [PMID: 24936434 PMCID: PMC4055864 DOI: 10.1016/j.nicl.2014.05.014] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [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: 03/13/2014] [Revised: 05/17/2014] [Accepted: 05/21/2014] [Indexed: 12/04/2022]
Abstract
Why only certain patients develop debilitating pain after spinal chord injury and whether structural brain changes are implicated remain unknown. The aim of this study was to determine if patients with chronic, neuropathic below-level pain have specific cerebral changes compared to those who remain pain-free. Voxel-based morphometry of high resolution, T1-weighted images was performed on three subject groups comprising patients with pain (SCI-P, n = 18), patients without pain (SCI-N, n = 12) and age- and sex-matched controls (n = 18). The SCI-P group was first compared directly with the SCI-N group and then subsequently with controls. Overall, grey and white matter changes dependent on the presence of pain were revealed. Significant changes were found within the somatosensory cortex and also in corticospinal tracts and visual-processing areas. When the SCI-P group was directly compared with the SCI-N group, reduced grey matter volume was found in the deafferented leg area of the somatosensory cortex bilaterally. This region negatively correlated with pain intensity. Relative to controls, grey matter in this paracentral primary sensory cortex was decreased in SCI-P but conversely increased in SCI-N. When compared with controls, discrepant corticospinal tract white matter reductions were found in SCI-P and in SCI-N. In the visual cortex, SCI-N showed increased grey matter, whilst the SCI-N showed reduced white matter. In conclusion, structural changes in SCI are related to the presence and degree of below-level pain and involve but are not limited to the sensorimotor cortices. Pain-related structural plasticity may hold clinical implications for the prevention and management of refractory neuropathic pain. Voxel-based morphometry was performed on spinal cord injury patients and controls. Patients with below-level neuropathic pain had reduced somatosensory cortex volume. Patients without pain had increased somatosensory cortex volume. Other structural changes were also found outside the sensorimotor cortices. Structural brain changes showed associations with the degree of neuropathic pain.
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Affiliation(s)
- Tom B Mole
- Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, Level E4, Box 189, Hills Road, Cambridge CB2 2QQ, UK
| | - Kate MacIver
- Unit of Neuroscience, School of Clinical Sciences, Pain Research Institute, Lower Lane, Liverpool L9 7AL, UK
| | - Vanessa Sluming
- Department of Molecular and Cellular Physiology, Institute of Translational Medicine (PGR), University of Liverpool, Whelan Building, Liverpool L69 3GB, UK
| | - Gerard R Ridgway
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Turo J Nurmikko
- Walton Centre for Neurology and Neurosurgery NHS Trust, Lower Lane, Fazakerley, Liverpool L9 7JL, UK
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Newbould RD, Nicholas R, Thomas CL, Quest R, Lee JSZ, Honeyfield L, Colasanti A, Malik O, Mattoscio M, Matthews PM, Sormani MP, Waldman AD, Muraro PA. Age independently affects myelin integrity as detected by magnetization transfer magnetic resonance imaging in multiple sclerosis. Neuroimage Clin 2014; 4:641-8. [PMID: 24936415 PMCID: PMC4053639 DOI: 10.1016/j.nicl.2014.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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: 11/29/2013] [Revised: 01/23/2014] [Accepted: 02/14/2014] [Indexed: 11/25/2022]
Abstract
Background Multiple sclerosis (MS) is a heterogeneous disorder with a progressive course that is difficult to predict on a case-by-case basis. Natural history studies of MS have demonstrated that age influences clinical progression independent of disease duration. Objective To determine whether age would be associated with greater CNS injury as detected by magnetization transfer MRI. Materials and methods Forty MS patients were recruited from out-patient clinics into two groups stratified by age but with similar clinical disease duration as well as thirteen controls age-matched to the older MS group. Images were segmented by automated programs and blinded readers into normal appearing white matter (NAWM), normal appearing gray matter (NAGM), and white matter lesions (WMLs) and gray matter lesions (GMLs) in the MS groups. WML and GML were delineated on T2-weighted 3D fluid-attenuated inversion recovery (FLAIR) and T1 weighted MRI volumes. Mean magnetization transfer ratio (MTR), region volume, as well as MTR histogram skew and kurtosis were calculated for each region. Results All MTR measures in NAGM and MTR histogram metrics in NAWM differed between MS subjects and controls, as expected and previously reported by several studies, but not between MS groups. However, MTR measures in the WML did significantly differ between the MS groups, in spite of no significant differences in lesion counts and volumes. Conclusions Despite matching for clinical disease duration and recording no significant WML volume difference, we demonstrated strong MTR differences in WMLs between younger and older MS patients. These data suggest that aging-related processes modify the tissue response to inflammatory injury and its clinical outcome correlates in MS. Magnetization transfer MRI was used in a cohort of 40 MS subjects differing by age. MTR metrics were different between MS groups and controls, as expected. MTR in normal appearing tissue did not differ between age-stratified MS groups. MTR in white matter lesions was strongly different between age-stratified MS groups. Results imply an age-related effect in tissue integrity in MR-visible lesions.
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Affiliation(s)
- R D Newbould
- Imanova Centre for Imaging Sciences, London, UK ; Division of Experimental Medicine, Imperial College London, UK
| | - R Nicholas
- Division of Brain Sciences, Imperial College London, UK
| | - C L Thomas
- Division of Brain Sciences, Imperial College London, UK
| | - R Quest
- Department of Imaging, Imperial College Healthcare NHS Trust, UK
| | - J S Z Lee
- Division of Brain Sciences, Imperial College London, UK
| | - L Honeyfield
- Department of Imaging, Imperial College Healthcare NHS Trust, UK
| | - A Colasanti
- Imanova Centre for Imaging Sciences, London, UK ; Division of Brain Sciences, Imperial College London, UK
| | - O Malik
- Division of Brain Sciences, Imperial College London, UK
| | - M Mattoscio
- Division of Brain Sciences, Imperial College London, UK
| | - P M Matthews
- Division of Brain Sciences, Imperial College London, UK ; Neurosciences, GlaxoSmithKline Research and Development, UK
| | - M P Sormani
- Department of Health Sciences (DISSAL), University of Genoa, Italy
| | - A D Waldman
- Division of Brain Sciences, Imperial College London, UK ; Department of Imaging, Imperial College Healthcare NHS Trust, UK
| | - P A Muraro
- Division of Brain Sciences, Imperial College London, UK ; Department of Clinical Neurosciences, Imperial College Healthcare NHS Trust, UK
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Deppe M, Marinell J, Krämer J, Duning T, Ruck T, Simon OJ, Zipp F, Wiendl H, Meuth SG. Increased cortical curvature reflects white matter atrophy in individual patients with early multiple sclerosis. Neuroimage Clin 2014; 6:475-87. [PMID: 25610761 PMCID: PMC4299934 DOI: 10.1016/j.nicl.2014.02.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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: 01/18/2014] [Revised: 02/14/2014] [Accepted: 02/19/2014] [Indexed: 11/21/2022]
Abstract
Objective White matter atrophy occurs independently of lesions in multiple sclerosis. In contrast to lesion detection, the quantitative assessment of white matter atrophy in individual patients has been regarded as a major challenge. We therefore tested the hypothesis that white matter atrophy (WMA) is present at the very beginning of multiple sclerosis (MS) and in virtually each individual patient. To find a new sensitive and robust marker for WMA we investigated the relationship between cortical surface area, white matter volume (WMV), and whole-brain-surface-averaged rectified cortical extrinsic curvature. Based on geometrical considerations we hypothesized that cortical curvature increases if WMV decreases and the cortical surface area remains constant. Methods In total, 95 participants were enrolled: 30 patients with early and advanced relapsing–remitting MS; 30 age-matched control subjects; 30 patients with Alzheimer's disease (AD) and 5 patients with clinically isolated syndrome (CIS). Results 29/30 MS and 5/5 CIS patients showed lower WMV than expected from their intracranial volume (average reduction 13.0%, P < 10− 10), while the cortical surface area showed no significant differences compared with controls. The estimated WMV reductions were correlated with an increase in cortical curvature (R = 0.62, P = 0.000001). Discriminant analysis revealed that the curvature increase was highly specific for the MS and CIS groups (96.7% correct assignments between MS and control groups) and was significantly correlated with reduction of white matter fractional anisotropy, as determined by diffusion tensor imaging and the Expanded Disability Status Scale. As expected by the predominant gray and WM degeneration in AD, no systematic curvature increase was observed in AD. Conclusion Whole-brain-averaged cortical extrinsic curvature appears to be a specific and quantitative marker for a WMV–cortex disproportionality and allows us to assess “pure” WMA without being confounded by intracranial volume. WMA seems to be a characteristic symptom in early MS and can already occur in patients with CIS and should thus be considered in future MS research and clinical studies. We suggest cortical curvature as marker for selective white matter atrophy (WMA). This geometric marker is more specific and sensitive than volumetric measures. It is not confounded by intra-cranial volume, age, and gender. WMA seems to be a characteristic symptom in early multiple sclerosis. WMA can be also detected in patients with a clinical isolated symptom.
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Key Words
- 3D, three-dimensional
- CI, confidence interval
- CIS, clinically isolated syndrome
- Cortex
- Cortical curvature
- DTI, diffusion tensor imaging
- EDSS, Expanded Disability Status Scale
- EVAL, Münster Neuroimaging Evaluation System
- FA, fractional anisotropy
- FOV, field of view
- GM, gray matter
- GMV, gray matter volume
- GRAPPA, generalized autocalibrating partially parallel acquisition
- ICV, intracranial volume
- Imaging
- MRI
- Multiple sclerosis
- ROI, region of interest
- SD, standard deviation
- TE, echo time
- TR, repetition time
- TSE, turbo spin-echo
- WM, white matter
- WMV, white matter volume
- eWMV, estimated white matter volume
- ΔWMV, WMV − eWMV
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Affiliation(s)
- Michael Deppe
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
| | - Jasmin Marinell
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
| | - Julia Krämer
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
| | - Thomas Duning
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
| | - Tobias Ruck
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
| | - Ole J Simon
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
| | - Frauke Zipp
- Department of Neurology, Rhine Main Neuroscience Network, Johannes Gutenberg University Medical Centre Mainz, Germany
| | - Heinz Wiendl
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
| | - Sven G Meuth
- Department of Neurology, Westfälische Wilhelms University, Münster, Germany
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Racine AM, Adluru N, Alexander AL, Christian BT, Okonkwo OC, Oh J, Cleary CA, Birdsill A, Hillmer AT, Murali D, Barnhart TE, Gallagher CL, Carlsson CM, Rowley HA, Dowling NM, Asthana S, Sager MA, Bendlin BB, Johnson SC. Associations between white matter microstructure and amyloid burden in preclinical Alzheimer's disease: A multimodal imaging investigation. Neuroimage Clin 2014; 4:604-14. [PMID: 24936411 PMCID: PMC4053642 DOI: 10.1016/j.nicl.2014.02.001] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [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: 12/02/2013] [Revised: 01/29/2014] [Accepted: 02/10/2014] [Indexed: 10/30/2022]
Abstract
Some cognitively healthy individuals develop brain amyloid accumulation, suggestive of incipient Alzheimer's disease (AD), but the effect of amyloid on other potentially informative imaging modalities, such as Diffusion Tensor Imaging (DTI), in characterizing brain changes in preclinical AD requires further exploration. In this study, a sample (N = 139, mean age 60.6, range 46 to 71) from the Wisconsin Registry for Alzheimer's Prevention (WRAP), a cohort enriched for AD risk factors, was recruited for a multimodal imaging investigation that included DTI and [C-11]Pittsburgh Compound B (PiB) positron emission tomography (PET). Participants were grouped as amyloid positive (Aβ+), amyloid indeterminate (Aβi), or amyloid negative (Aβ-) based on the amount and pattern of amyloid deposition. Regional voxel-wise analyses of four DTI metrics, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), and radial diffusivity (Dr), were performed based on amyloid grouping. Three regions of interest (ROIs), the cingulum adjacent to the corpus callosum, hippocampal cingulum, and lateral fornix, were selected based on their involvement in the early stages of AD. Voxel-wise analysis revealed higher FA among Aβ+ compared to Aβ- in all three ROIs and in Aβi compared to Aβ- in the cingulum adjacent to the corpus callosum. Follow-up exploratory whole-brain analyses were consistent with the ROI findings, revealing multiple regions where higher FA was associated with greater amyloid. Lower fronto-lateral gray matter MD was associated with higher amyloid burden. Further investigation showed a negative correlation between MD and PiB signal, suggesting that Aβ accumulation impairs diffusion. Interestingly, these findings in a largely presymptomatic sample are in contradistinction to relationships reported in the literature in symptomatic disease stages of Mild Cognitive Impairment and AD, which usually show higher MD and lower FA. Together with analyses showing that cognitive function in these participants is not associated with any of the four DTI metrics, the present results suggest an early relationship between PiB and DTI, which may be a meaningful indicator of the initiating or compensatory mechanisms of AD prior to cognitive decline.
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Key Words
- AD risk
- ANCOVA, Analysis of Covariance
- ANTs, Advanced Normalization Tools
- APOE4, apolipoprotein E gene ε4
- Alzheimer's disease
- Amyloid imaging
- Aβ+, amyloid positive
- Aβi, amyloid indeterminate
- Aβ−, amyloid negative
- BET, Brain Extraction Tool
- Cingulum–CC, cingulum adjacent to corpus callosum
- Cingulum–HC, hippocampal cingulum (projecting to medial temporal lobe)
- DTI, Diffusion Tensor Imaging
- DTI-TK, Diffusion Tensor Imaging Toolkit
- DVR, distribution volume ratio
- Da, axial diffusivity
- Dr, radial diffusivity
- FA, fractional anisotropy
- FH, (parental) family history
- FSL, FMRIB Software Library
- FUGUE, FMRIB's utility for geometrically unwarping EPIs
- FWE, family wise error
- GM, gray matter
- HARDI, high angular resolution diffusion imaging
- ICBM, International Consortium for Brain Mapping
- MD, mean diffusivity
- PCC, posterior cingulate cortex
- PIB, Pittsburgh compound B
- PRELUDE, phase region expanding labeler for unwrapping discrete estimates
- RAVLT, Rey Auditory Verbal Learning Test
- SPM, Statistical Parametric Mapping
- TMT, Trail Making Test
- WASI, Wechsler Abbreviated Scale of Intelligence
- WM, white matter
- WRAP, Wisconsin Registry for Alzheimer's Prevention
- WRAT, Wide Range Achievement Test
- White matter
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Affiliation(s)
- Annie M Racine
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Nagesh Adluru
- Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Andrew L Alexander
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53705, USA ; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI 53719, USA
| | - Bradley T Christian
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Ozioma C Okonkwo
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Jennifer Oh
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Caitlin A Cleary
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Alex Birdsill
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Ansel T Hillmer
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI 53719, USA
| | - Dhanabalan Murali
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Todd E Barnhart
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Catherine L Gallagher
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Cynthia M Carlsson
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Howard A Rowley
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - N Maritza Dowling
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Sanjay Asthana
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Mark A Sager
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Barbara B Bendlin
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
| | - Sterling C Johnson
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI 53705, USA ; Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA ; Waisman Laboratory for Brain Imaging and Behavior, University of Wisconsin-Madison, Madison, WI 53705, USA
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Cordina R, Grieve S, Barnett M, Lagopoulos J, Malitz N, Celermajer DS. Brain volumetric, regional cortical thickness and radiographic findings in adults with cyanotic congenital heart disease. Neuroimage Clin 2014; 4:319-25. [PMID: 24501700 PMCID: PMC3913831 DOI: 10.1016/j.nicl.2013.12.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [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: 09/24/2013] [Revised: 12/22/2013] [Accepted: 12/24/2013] [Indexed: 11/28/2022]
Abstract
Background Chronic cyanosis in adults with congenital heart disease (CHD) may cause structural brain changes that could contribute to impaired neurological functioning. The extent of these changes has not been adequately characterized. Hypothesis We hypothesized that adults with cyanotic CHD would have widespread changes including abnormal brain volumetric measures, decreased cortical thickness and an increased burden of small and large vessel ischemic changes. Methods Ten adults with chronic cyanosis from CHD (40 ± 4 years) and mean oxygen saturations of 82 ± 2% were investigated using quantitative MRI. Hematological and biochemical parameters were also assessed. All subjects were free from major physical or intellectual impairment. Brain volumetric results were compared with randomly selected age- and sex-matched controls from our database of normal subjects. Results Five of 10 cyanotic subjects had cortical lacunar infarcts. The white matter (WM) hyperintensity burden was also abnormally high (Scheltens Scale was 8 ± 2). Quantitative MRI revealed evidence of extensive generalized WM and gray matter (GM) volumetric loss; global GM volume was reduced in cyanosed subjects (630 ± 16 vs. 696 ± 14 mL in controls, p = 0.01) as was global WM volume (471 ± 10 vs. 564 ± 18 mL, p = 0.003). Ventricular cerebrospinal fluid volume was increased (35 ± 10 vs. 26 ± 5 mL, p = 0.002). There were widespread regions of local cortical thickness reduction observed across the brain. These changes included bilateral thickness reductions in the frontal lobe including the dorsolateral prefrontal cortex and precentral gyrus, the posterior parietal lobe and the middle temporal gyrus. Sub-cortical volume changes were observed in the caudate, putamen and in the thalamus (p ≤ 0.005 for all regions). Cortical GM volume negatively correlated with brain natriuretic peptide (R = − 0.89, p = 0.009), high sensitivity C-reactive protein (R = − 0.964, p < 0.0001) and asymmetric dimethylarginine (R = − 0.75, p = 0.026) but not with oxygen saturations, packed cell volume or viscosity. Conclusions We present the first comprehensive analysis of brain structure in adults with chronic neurocyanosis due to congenital heart disease. We demonstrate clear evidence for marked macro- and microvascular injury. Cyanotic patients show global evidence for reduced brain volume as well as specific foci of cortical thickness reduction. The GM volume loss correlated with hsCRP, BNP and ADMA suggesting that inflammation, neurohormonal activation and endothelial dysfunction may have important roles in its pathogenesis. A high burden of cerebral small and large vessel ischemic injury. Extensive white and gray matter (GM) volumetric loss. Regions of bilateral local cortical thickness reduction within the frontal, parietal and temporal lobes.
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Affiliation(s)
- Rachael Cordina
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia ; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Stuart Grieve
- Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Sydney, Australia ; The Brain Dynamics Center, Sydney Medical School, The University of Sydney, NSW, Australia ; Department of Radiology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Michael Barnett
- Sydney Neuroimaging Analysis Centre, Brain & Mind Research Institute, Sydney, Australia ; Department of Neurology, Royal Prince Alfred Hospital, Sydney, Australia
| | - Jim Lagopoulos
- Sydney Neuroimaging Analysis Centre, Brain & Mind Research Institute, Sydney, Australia
| | | | - David S Celermajer
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia ; Sydney Translational Imaging Laboratory, Sydney Medical School, University of Sydney, Sydney, Australia
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Mutsaerts HJ, Richard E, Heijtel DF, van Osch MJ, Majoie CB, Nederveen AJ. Gray matter contamination in arterial spin labeling white matter perfusion measurements in patients with dementia. Neuroimage Clin 2014; 4:139-44. [PMID: 24371796 DOI: 10.1016/j.nicl.2013.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 11/05/2013] [Accepted: 11/06/2013] [Indexed: 01/28/2023]
Abstract
Introduction White matter (WM) perfusion measurements with arterial spin labeling can be severely contaminated by gray matter (GM) perfusion signal, especially in the elderly. The current study investigates the spatial extent of GM contamination by comparing perfusion signal measured in the WM with signal measured outside the brain. Material and methods Four minute 3T pseudo-continuous arterial spin labeling scans were performed in 41 elderly subjects with cognitive impairment. Outward and inward geodesic distance maps were created, based on dilations and erosions of GM and WM masks. For all outward and inward geodesic distances, the mean CBF was calculated and compared. Results GM contamination was mainly found in the first 3 subcortical WM voxels and had only minor influence on the deep WM signal (distances 4 to 7 voxels). Perfusion signal in the WM was significantly higher than perfusion signal outside the brain, indicating the presence of WM signal. Conclusion These findings indicate that WM perfusion signal can be measured unaffected by GM contamination in elderly patients with cognitive impairment. GM contamination can be avoided by the erosion of WM masks, removing subcortical WM voxels from the analysis. These results should be taken into account when exploring the use of WM perfusion as micro-vascular biomarker. A single slice distance analysis was performed. Perfusion signal in the white matter was compared with signal outside the brain. The application of erosion was compared with removal of partial volume voxels. White matter perfusion signal can be distinguished from gray matter contamination. The erosion of three voxels is warranted to avoid gray matter contamination.
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Benitez A, Fieremans E, Jensen JH, Falangola MF, Tabesh A, Ferris SH, Helpern JA. White matter tract integrity metrics reflect the vulnerability of late-myelinating tracts in Alzheimer's disease. Neuroimage Clin 2013; 4:64-71. [PMID: 24319654 PMCID: PMC3853114 DOI: 10.1016/j.nicl.2013.11.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [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: 08/27/2013] [Revised: 11/01/2013] [Accepted: 11/03/2013] [Indexed: 12/21/2022]
Abstract
Post-mortem and imaging studies have observed that white matter (WM) degenerates in a pattern inverse to myelin development, suggesting preferential regional vulnerabilities influencing cognitive decline in AD. This study applied novel WM tract integrity (WMTI) metrics derived from diffusional kurtosis imaging (DKI) to examine WM tissue properties in AD within this framework. Using data from amnestic mild cognitive impairment (aMCI, n = 12), AD (n = 14), and normal control (NC; n = 15) subjects, mixed models revealed interaction effects: specific WMTI metrics of axonal density and myelin integrity (i.e. axonal water fraction, radial extra-axonal diffusivity) in late-myelinating tracts (i.e. superior and inferior longitudinal fasciculi) changed in the course of disease, but were stable in the initial stages for early-myelinating tracts (i.e. posterior limb of the internal capsule, cerebral peduncles). WMTI metrics in late-myelinating tracts correlated with semantic verbal fluency, a cognitive function known to decline in AD. These findings corroborate the preferential vulnerability of late-myelinating tracts, and illustrate an application of WMTI metrics to characterizing the regional course of WM changes in AD. We investigated the vulnerability of late-myelinating tracts in AD using WMTI metrics. WMTI metrics are derived from the biophysical modeling of the DKI signal. These metrics indicate pathological features like axonal density and myelin integrity. WMTI metrics were largely stable in early-myelinating tracts through the course of AD. Axonal density loss & myelin breakdown were observed in late-myelinating tracts.
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Key Words
- AD, Alzheimer's disease
- AWF, axonal water fraction
- Alzheimer's disease
- CP, cerebral peduncle
- DKI, diffusional kurtosis imaging
- DTI, diffusion tensor imaging
- Daxon, intrinsic axonal diffusivity
- De,∥, axial extra-axonal diffusivity
- De,⊥, radial extra-axonal diffusivity
- Diffusion MRI
- Diffusional kurtosis imaging
- FA, fractional anisotropy
- ILF, inferior longitudinal fasciculus
- NC, normal control
- PLIC, posterior limb of the internal capsule
- SLF, superior longitudinal fasciculus
- Verbal fluency
- WM, white matter
- WMTI, white matter tract integrity
- White matter
- aMCI, amnestic mild cognitive impairment
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Affiliation(s)
- Andreana Benitez
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29425, USA ; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC 29425, USA
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Sarma MK, Nagarajan R, Keller MA, Kumar R, Nielsen-Saines K, Michalik DE, Deville J, Church JA, Thomas MA. Regional brain gray and white matter changes in perinatally HIV-infected adolescents. Neuroimage Clin 2013; 4:29-34. [PMID: 24380059 PMCID: PMC3874468 DOI: 10.1016/j.nicl.2013.10.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [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: 08/13/2013] [Revised: 10/03/2013] [Accepted: 10/19/2013] [Indexed: 01/22/2023]
Abstract
Despite the success of antiretroviral therapy (ART), perinatally infected HIV remains a major health problem worldwide. Although advance neuroimaging studies have investigated structural brain changes in HIV-infected adults, regional gray matter (GM) and white matter (WM) volume changes have not been reported in perinatally HIV-infected adolescents and young adults. In this cross-sectional study, we investigated regional GM and WM changes in 16 HIV-infected youths receiving ART (age 17.0 ± 2.9 years) compared with age-matched 14 healthy controls (age 16.3 ± 2.3 years) using magnetic resonance imaging (MRI)-based high-resolution T1-weighted images with voxel based morphometry (VBM) analyses. White matter atrophy appeared in perinatally HIV-infected youths in brain areas including the bilateral posterior corpus callosum (CC), bilateral external capsule, bilateral ventral temporal WM, mid cerebral peduncles, and basal pons over controls. Gray matter volume increase was observed in HIV-infected youths for several regions including the left superior frontal gyrus, inferior occipital gyrus, gyrus rectus, right mid cingulum, parahippocampal gyrus, bilateral inferior temporal gyrus, and middle temporal gyrus compared with controls. Global WM and GM volumes did not differ significantly between groups. These results indicate WM injury in perinatally HIV-infected youths, but the interpretation of the GM results, which appeared as increased regional volumes, is not clear. Further longitudinal studies are needed to clarify if our results represent active ongoing brain infection or toxicity from HIV treatment resulting in neuronal cell swelling and regional increased GM volume. Our findings suggest that assessment of regional GM and WM volume changes, based on VBM procedures, may be an additional measure to assess brain integrity in HIV-infected youths and to evaluate success of current ART therapy for efficacy in the brain. First time investigation of gray/white matter changes in HIV-infected youths Brain white matter atrophy observed in the HIV-infected youths Significantly increased gray matter volume emerged in several regions. Pilot findings indicate white matter injury in perinatally HIV-infected youths.
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Affiliation(s)
- Manoj K Sarma
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Rajakumar Nagarajan
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Margaret A Keller
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Pediatrics, Torrance, CA 90502, USA
| | - Rajesh Kumar
- Department of Anesthesiology, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Karin Nielsen-Saines
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, CA 90095, USA
| | - David E Michalik
- Department of Pediatrics, Miller Children's Hospital of Long Beach, Long Beach, CA 90806, USA
| | - Jaime Deville
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, CA 90095, USA
| | - Joseph A Church
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - M Albert Thomas
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
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Kim DJ, Bolbecker AR, Howell J, Rass O, Sporns O, Hetrick WP, Breier A, O'Donnell BF. Disturbed resting state EEG synchronization in bipolar disorder: A graph-theoretic analysis. Neuroimage Clin 2013; 2:414-23. [PMID: 24179795 PMCID: PMC3777715 DOI: 10.1016/j.nicl.2013.03.007] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [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: 01/28/2013] [Revised: 03/11/2013] [Accepted: 03/13/2013] [Indexed: 01/24/2023]
Abstract
Disruption of functional connectivity may be a key feature of bipolar disorder (BD) which reflects disturbances of synchronization and oscillations within brain networks. We investigated whether the resting electroencephalogram (EEG) in patients with BD showed altered synchronization or network properties. Resting-state EEG was recorded in 57 BD type-I patients and 87 healthy control subjects. Functional connectivity between pairs of EEG channels was measured using synchronization likelihood (SL) for 5 frequency bands (δ, θ, α, β, and γ). Graph-theoretic analysis was applied to SL over the electrode array to assess network properties. BD patients showed a decrease of mean synchronization in the alpha band, and the decreases were greatest in fronto-central and centro-parietal connections. In addition, the clustering coefficient and global efficiency were decreased in BD patients, whereas the characteristic path length increased. We also found that the normalized characteristic path length and small-worldness were significantly correlated with depression scores in BD patients. These results suggest that BD patients show impaired neural synchronization at rest and a disruption of resting-state functional connectivity. Global synchronization of BD patients was reduced in the alpha-band at resting. De-synchronized connectivity was localized in fronto-centro-parietal connections. Global topology of BD had decreased network clustering and increased path length. BD showed the less efficient network processing. Network characteristics of BD patients were associated with depression severity.
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Key Words
- BD, bipolar disorder
- Bipolar disorder
- C, clustering coefficients
- DSM-IV, diagnostic and statistical manual of mental disorders, the 4th-edition
- DTI, diffusion tensor imaging (image)
- EEG, electroencephalogram
- EOG, electrooculogram
- Eg, global efficiency
- El, local efficiency
- Electroencephalogram
- FA, fractional anisotropy
- FDR, false discovery rate
- Functional connectivity
- GABA, gamma-amino butyric acid
- Graph theory
- L, characteristic path length
- MADRS, Montgomery–Asberg Depression Rating Scale
- MEG, magnetoencephalogram
- MRI, magnetic resonance imaging
- NBS, network-based statistics
- NC, normal healthy control
- PLI, phase lag index
- Resting state
- SCID, Structured Clinical Interview for DSM Disorders
- SL, synchronization likelihood
- Synchronization likelihood
- WASI, Wechsler Abbreviated Scale of Intelligence
- WM, white matter
- YMRS, Young Mania Rating Scale
- b, node betweenness centrality
- fMRI, functional magnetic resonance imaging
- s, node strength
- γ, normalized clustering coefficients
- λ, normalized characteristic path length
- σ, small-worldness
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Affiliation(s)
- Dae-Jin Kim
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN 47405, USA
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