Multiexponential T2 and magnetization transfer MRI of demyelination and remyelination in murine spinal cord

A multicomponent T2 relaxometry algorithm for myelin water imaging of the brain

PURPOSE

Models based on a sum of damped exponentials occur in many applications, particularly in multicomponent T2 relaxometry. The problem of estimating the relaxation parameters and the corresponding amplitudes is known to be difficult, especially as the number of components increases. In this article, the commonly used non-negative least squares spectrum approach is compared to a recently published estimation algorithm abbreviated as Exponential Analysis via System Identification using Steiglitz-McBride.

METHODS

The two algorithms are evaluated via simulation, and their performance is compared to a statistical benchmark on precision given by the Cramér-Rao bound. By applying the algorithms to an in vivo brain multi-echo spin-echo dataset, containing 32 images, estimates of the myelin water fraction are computed.

RESULTS

Exponential Analysis via System Identification using Steiglitz-McBride is shown to have superior performance when applied to simulated T2 relaxation data. For the in vivo brain, Exponential Analysis via System Identification using Steiglitz-McBride gives an myelin water fraction map with a more concentrated distribution of myelin water and less noise, compared to non-negative least squares.

CONCLUSION

The Exponential Analysis via System Identification using Steiglitz-McBride algorithm provides an efficient and user-parameter-free alternative to non-negative least squares for estimating the parameters of multiple relaxation components and gives a new way of estimating the spatial variations of myelin in the brain.

Multiparametric MRI reveals dynamic changes in molecular signatures of injured spinal cord in monkeys

PURPOSE

To monitor the spontaneous recovery of cervical spinal cord injury (SCI) using longitudinal multiparametric MRI methods.

METHODS

Quantitative MRI imaging including diffusion tensor imaging, magnetization transfer (MT), and chemical exchange saturation transfer (CEST) were conducted in anesthetized squirrel monkeys at 9.4T. The structural, cellular, and molecular features of the spinal cord were examined before and at different time points after a dorsal column lesion in each monkey.

RESULTS

Images with MT contrast enhanced visualization of the gray and white matter boundaries and the lesion and permitted differentiation of core and rim compartments within an abnormal volume (AV). In the early weeks after SCI, both core and rim exhibited low cellular density and low protein content, with high levels of exchanging hydroxyl, amine, and amide protons, as evidenced by increased apparent diffusion coefficient, decreased fractional anisotropy, decreased MT ratio, decreased nuclear Overhauser effect, and large CEST effects. Over time, cellular density and fiber density increased, whereas amide, amine, and hydroxyl levels dropped significantly, but at differing rates. Histology confirmed the nature of the AV to be a cyst.

CONCLUSION

Multiparametric MRI offers a novel method to quantify the spontaneous changes in structure and cellular and molecular compositions of SC during spontaneous recovery from injury.

Model-based MR parameter mapping with sparsity constraints: parameter estimation and performance bounds

Magnetic resonance parameter mapping (e.g., T1 mapping, T2 mapping, T*2 mapping) is a valuable tool for tissue characterization. However, its practical utility has been limited due to long data acquisition time. This paper addresses this problem with a new model-based parameter mapping method. The proposed method utilizes a formulation that integrates the explicit signal model with sparsity constraints on the model parameters, enabling direct estimation of the parameters of interest from highly undersampled, noisy k-space data. An efficient greedy-pursuit algorithm is described to solve the resulting constrained parameter estimation problem. Estimation-theoretic bounds are also derived to analyze the benefits of incorporating sparsity constraints and benchmark the performance of the proposed method. The theoretical properties and empirical performance of the proposed method are illustrated in a T2 mapping application example using computer simulations.

A histogram-based similarity measure for quantitative magnetic resonance imaging: application in acute mild traumatic brain injury

OBJECTIVES

The most commonly used summary metric in neuroimaging is the mean value, but this pays little attention to the shape of the data distribution and can therefore be insensitive to subtle changes that alter the data distribution.

METHODS

We propose a distributional-based metric called the normalized histogram similarity measure (HSM) for characterization of quantitative images. We applied HSM to quantitative magnetic resonance imaging T1 relaxation data of 44 patients with mild traumatic brain injury and compared with data of 43 age-matched controls.

RESULTS

Significant differences were found between the patients and the controls in 8 gray matter regions using the HSM whereas in only 1 gray matter region based on the mean values.

CONCLUSIONS

Our results show that HSM is more sensitive than the standard mean values in detecting brain tissue changes. Future studies on brain tissue properties using quantitative magnetic resonance imaging should consider the use of HSM to properly capture any tissue changes.

A framework for accurate determination of the T₂ distribution from multiple echo magnitude MRI images

Measurement of the T2 distribution in tissues provides biologically relevant information about normal and abnormal microstructure and organization. Typically, the T2 distribution is obtained by fitting the magnitude MR images acquired by a multi-echo MRI pulse sequence using an inverse Laplace transform (ILT) algorithm. It is well known that the ideal magnitude MR signal follows a Rician distribution. Unfortunately, studies attempting to establish the validity and efficacy of the ILT algorithm assume that these input signals are Gaussian distributed. Violation of the normality (or Gaussian) assumption introduces unexpected artifacts, including spurious cerebrospinal fluid (CSF)-like long T2 components; bias of the true geometric mean T2 values and in the relative fractions of various components; and blurring of nearby T2 peaks in the T2 distribution. Here we apply and extend our previously proposed magnitude signal transformation framework to map noisy Rician-distributed magnitude multi-echo MRI signals into Gaussian-distributed signals with high accuracy and precision. We then perform an ILT on the transformed data to obtain an accurate T2 distribution. Additionally, we demonstrate, by simulations and experiments, that this approach corrects the aforementioned artifacts in magnitude multi-echo MR images over a large range of signal-to-noise ratios.

Understanding disease processes in multiple sclerosis through magnetic resonance imaging studies in animal models

There are exciting new advances in multiple sclerosis (MS) resulting in a growing understanding of both the complexity of the disorder and the relative involvement of grey matter, white matter and inflammation. Increasing need for preclinical imaging is anticipated, as animal models provide insights into the pathophysiology of the disease. Magnetic resonance (MR) is the key imaging tool used to diagnose and to monitor disease progression in MS, and thus will be a cornerstone for future research. Although gadolinium-enhancing and T₂ lesions on MRI have been useful for detecting MS pathology, they are not correlative of disability. Therefore, new MRI methods are needed. Such methods require validation in animal models. The increasing necessity for MRI of animal models makes it critical and timely to understand what research has been conducted in this area and what potential there is for use of MRI in preclinical models of MS. Here, we provide a review of MRI and magnetic resonance spectroscopy (MRS) studies that have been carried out in animal models of MS that focus on pathology. We compare the MRI phenotypes of animals and patients and provide advice on how best to use animal MR studies to increase our understanding of the linkages between MR and pathology in patients. This review describes how MRI studies of animal models have been, and will continue to be, used in the ongoing effort to understand MS.

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MRI studies of pathology in various animal models of MS are reviewed.

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MRI phenotypes in animal models of MS and MS patients are compared.

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Animal MRI can increase understanding of links between MR and pathology in patients.

Effect of treatment with interferon beta-1a on changes in voxel-wise magnetization transfer ratio in normal appearing brain tissue and lesions of patients with relapsing-remitting multiple sclerosis: a 24-week, controlled pilot study

Background

This pilot study investigated changes in remyelinating and demyelinating activity in normal appearing brain tissue (NABT) and lesions, by using voxel-wise magnetization transfer ratio (VW-MTR), in patients with relapsing–remitting multiple sclerosis (RRMS) receiving interferon beta-1a 44 mcg subcutaneously (IFN β-1a SC) three times weekly versus healthy controls (HCs) (NCT01085318).

Methods

Increasing (suggestive of remyelination) and decreasing (suggestive of demyelination) VW-MTR changes in NABT and in T2, T1 and gadolinium (Gd)-enhancing lesion volume were measured over 24 weeks in 23 patients treated with IFN β-1a SC and in 15 HCs (where applicable). VW-MTR changes were tested using the Wilcoxon signed–rank or Wilcoxon rank–sum test.

Results

A trend for greater volume of NABT with increasing VW-MTR at 24 weeks was observed for patients versus HCs (median [range] 1206 [0–15278]; 342 [0–951] mm³; p = 0.061). NABT volume with increasing VW-MTR at 12 weeks was significantly greater in patients than in HCs (852 [6–11577]; 360 [0–1755] mm³; p = 0.028). Similar findings were detected for lesion volumes. Two patients with notably high numbers of Gd-enhancing lesions at baseline had a markedly greater volume of tissue with increasing VW-MTR compared with other patients. Volume of NABT tissue with decreasing VW-MTR was significantly greater in patients versus HCs at 24 weeks (942 [0–6141]; 297 [0–852] mm³; p<0.001).

Conclusions

The significant change in NABT volume with increasing VW-MTR at 12 weeks suggests that active remyelination in patients with RRMS may occur during treatment with IFN β-1a SC. Findings from two patients with the highest number of Gd-enhancing lesions at baseline suggest that extensive remyelination in NABT may occur in patients with high disease activity. Tissue volume with decreasing VW-MTR was greater in patients than in HCs, despite treatment, validating the sensitivity of this technique for detecting MS disease activity.

Trial Registration

ClinicalTrials.gov NCT01085318.

MRI-based myelin water imaging: A technical review

Multiexponential T2 relaxation time measurement in the central nervous system shows a component that originates from water trapped between the lipid bilayers of myelin. This myelin water component is of significant interest as it provides a myelin-specific MRI signal of value in assessing myelin changes in cerebral white matter in vivo. In this article, the various acquisition and analysis strategies proposed to date for myelin water imaging are reviewed and research conducted into their validity and clinical applicability is presented. Comparisons between the imaging methods are made with a discussion regarding potential difficulties and model limitations.

In vivo longitudinal Myelin Water Imaging in rat spinal cord following dorsal column transection injury

Longitudinal Myelin Water Imaging was carried out in vivo to characterize white matter damage following dorsal column transection (DC Tx) injury at the lumbar level L1 of rat spinal cords. A transmit-receive implantable coil system was used to acquire multiple spin-echo (MSE) quantitative T2 data from the lumbar spinal cords of 16 rats at one week pre-injury as well as 3 and 8weeks post-injury (117 microns in-plane resolution and 1.5mm slice thickness). In addition, ex vivo MSE and DTI data were acquired from cords fixed and excised at 3 or 8weeks post injury using a solenoid coil. The MSE data were used to generate Myelin Water Fractions (MWFs) as a surrogate measure of myelin content, while DTI data were acquired to study damage to the axons. Myelin damage was assessed histologically with Eriochrome cyanine (EC) and Myelin Basic Protein in degenerated myelin (dgen-MBP) staining, and axonal damage was assessed by neurofilament-H in combination with neuron specific beta-III-tubulin (NF/Tub) staining. These MRI and histological measures of injury were studied in the dorsal column at 5mm cranial and 5mm caudal to injury epicenter. MWF increased significantly at 3weeks post-injury at both the cranial and caudal sites, relative to baseline. The values on the cranial side of injury returned to baseline at 8weeks post-injury but remained elevated on the caudal side. This trend was found in both in vivo and ex vivo data. This MWF increase was likely due to the presence of myelin debris, which were cleared by 8 weeks on the cranial, but not the caudal, side. Both EC and dgen-MBP stains displayed similar trends. MWF showed significant correlation with EC staining (R=0.63, p=0.005 in vivo and R=0.74, p=0.0001 ex vivo). MWF also correlated strongly with the dgen-MBP stain, but only on the cranial side (R=0.64, p=0.05 in vivo; R=0.63, p=0.038 ex vivo). This study demonstrates that longitudinal MWI in vivo can accurately characterize white matter damage in DC Tx model of injury in the rat spinal cord.

Using magnetic resonance imaging in animal models to guide drug development in multiple sclerosis

Major advances are taking place in the development of therapeutics for multiple sclerosis (MS), with a move past traditional immunomodulatory/immunosuppressive therapies toward medications aimed at promoting remyelination or neuroprotection. With an increase in diversity of MS therapies comes the need to assess the effectiveness of such therapies. Magnetic resonance imaging (MRI) is one of the main tools used to evaluate the effectiveness of MS therapeutics in clinical trials. As all new therapeutics for MS are tested in animal models first, it is logical that MRI be incorporated into preclinical studies assessing therapeutics. Here, we review key papers showing how MR imaging has been combined with a range of animal models to evaluate potential therapeutics for MS. We also advise on how to maximize the potential for incorporating MRI into preclinical studies evaluating possible therapeutics for MS, which should improve the likelihood of discovering new medications for the condition.

Quantitative MRI and ultrastructural examination of the cuprizone mouse model of demyelination

The cuprizone mouse model of demyelination was used to investigate the influence that white matter changes have on different magnetic resonance imaging results. In vivo T2 -weighted and magnetization transfer images (MTIs) were acquired weekly in control (n = 5) and cuprizone-fed (n = 5) mice, with significant increases in signal intensity in T2 -weighted images (p < 0.001) and lower magnetization transfer ratio (p < 0.001) in the corpus callosum of the cuprizone-fed mice starting at 3 weeks and peaking at 4 and 5 weeks, respectively. Diffusion tensor imaging (DTI), quantitative MTI (qMTI), and T1/T2 measurements were used to analyze freshly excised tissue after 6 weeks of cuprizone administration. In multicomponent T2 analysis with 10 ms echo spacing, there was no visible myelin water component associated with the short T2 value. Quantitative MTI metrics showed significant differences in the corpus callosum and external capsule of the cuprizone-fed mice, similar to previous studies of multiple sclerosis in humans and animal models of demyelination. Fractional anisotropy was significantly lower and mean, axial, and radial diffusivity were significantly higher in the cuprizone-fed mice. Cellular distributions measured in electron micrographs of the corpus callosum correlated strongly to several different quantitative MRI metrics. The largest Spearman correlation coefficient varied depending on cellular type: T1 versus the myelinated axon fraction (ρ = -0.90), the bound pool fraction (ƒ) versus the myelin sheath fraction (ρ = 0.93), and axial diffusivity versus the non-myelinated cell fraction (ρ = 0.92). Using Pearson's correlation coefficient, ƒ was strongly correlated to the myelin sheath fraction (r = 0.98) with a linear equation predicting myelin content (5.37ƒ - 0.25). Of the calculated MRI metrics, ƒ was the strongest indicator of myelin content, while longitudinal relaxation rates and diffusivity measurements were the strongest indicators of changes in tissue structure.

A new magnetic resonance imaging approach for discriminating Sardinian sheep milk cheese made from heat-treated or raw milk

The evaluation of milk heat treatment on dairy products via reliable analytical methods is a challenging issue that involves both industrial and fundamental research. We describe a new magnetic resonance imaging (MRI) protocol for discriminating Sardinian sheep milk cheese originating from heat-treated or raw milk. Thirty-six samples (18 pecorino cheeses manufactured from heat-treated milk and 18 Fiore Sardo cheeses made from raw milk) were investigated by means of MRI and bi-exponential signal decay analysis. The protocol is capable of discerning cheeses by virtue of the different distribution of the transversal (T2) relaxation time constant. Cheeses from heat-treated milk showed a significantly higher area fraction (≈70-80%), corresponding to the fast relaxing water protons (T2 ≈ 9 ms), compared with raw milk cheeses, whereas the opposite was observed for the long T2 (T2 ≈ 35 ms) proton population. The MRI protocol described is rapid and nondestructive, and it provides statistically significant discrimination between ewe milk cheeses made from heat-treated and raw milk.

Diffusion tensor imaging of the mouse brainstem and cervical spinal cord

Concurrent and/or progressive degeneration of upper and lower motor neurons (LMNs) causes neurological symptoms and dysfunctions in motor neuron diseases (MNDs) such as amyotrophic lateral sclerosis (ALS). Although brain lesions are readily detected, magnetic resonance imaging of the brainstem and cervical spinal cord lesions resulting from damage to LMNs has proven to be difficult. With the development of mouse models of MNDs, a noninvasive neuroimaging modality capable of detecting lesions resulting from axonal and neuronal injury in mouse brainstem and cervical spinal cord could improve our understanding of the underlying mechanism of MNDs and aid in the development of effective treatments. Here we present a protocol that allows the concomitant acquisition of high-quality in vivo full-diffusion tensor magnetic resonance images from the mouse brainstem and cervical spinal cord using the actively decoupled, anatomically shaped pair of coils--the surface-receive coil and the minimized volume-transmit coil. To improve the data quality, we used a custom-made nose cone to monitor respiratory motion for synchronizing data acquisition and assuring physiological stability of mice under examination. The protocol allows the acquisition of in vivo diffusion tensor imaging of the mouse brainstem and cervical spinal cord at 117 μm × 117 μm in-plane resolution with a 500-μm slice thickness in 1 h on a 4.7-T horizontal small animal imaging scanner equipped with an actively shielded gradient coil capable of pulsed gradient strengths up to 18 G cm(−1) with a gradient rise time of ≤295 μs.

Temporal phase correction of multiple echo T2 magnetic resonance images

Typically, magnetic resonance imaging (MRI) analysis is performed on magnitude data, and multiple echo T2 data consist of numerous images of the same slice taken with different echo spacing, giving voxel-wise temporal sampling of the noise as the signals decay according to T2 relaxation. Magnitude T2 decay data has Rician distributed noise which is characterized by a change in the noise distribution from Gaussian, through a transitional region, to Rayleigh as the signal to noise ratio decreases with increasing echo time. Non-Gaussian noise distributions may produce errors in the commonly applied non-negative least squares (NNLS) algorithm that is used to assess multiple echo decays for compartmentalized water environments through the creation of T2 distributions. Typically, Gaussian noise is sought by performing spatial-based phase correction on the MRI data however, these methods cannot capitalize on the temporal information available from multiple echo T2 acquisitions. Here we describe a temporal phase correction (TPC) algorithm that utilizes the temporal noise information available in multiple echo T2 acquisitions to put the relevant decay information in the Real portion of the decay data and leave only noise in the Imaginary portion. We apply this TPC algorithm to create real-valued multiple echo T2 data from human subjects measured at 1.5 T. We show that applying TPC causes changes in the T2 distribution estimates; notably the possible resolution of separate extracellular and intracellular water environments, and the disappearance of the commonly labeled cerebrospinal fluid peak, which might be an artefact observed in many previously published multiple echo T2 analyses.

The current state-of-the-art of spinal cord imaging: methods

A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small cross-sectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research.

Apolipoprotein E Mimetic Promotes Functional and Histological Recovery in Lysolecithin-Induced Spinal Cord Demyelination in Mice

Objective

Considering demyelination is the pathological hallmark of multiple sclerosis (MS), reducing demyelination and/or promoting remyelination is a practical therapeutic strategy to improve functional recovery for MS. An apolipoprotein E (apoE)-mimetic peptide COG112 has previously demonstrated therapeutic efficacy on functional and histological recovery in a mouse experimental autoimmune encephalomyelitis (EAE) model of human MS. In the current study, we further investigated whether COG112 promotes remyelination and improves functional recovery in lysolecithin induced focal demyelination in the white matter of spinal cord in mice.

Methods

A focal demyelination model was created by stereotaxically injecting lysolecithin into the bilateral ventrolateral funiculus (VLF) of T8 and T9 mouse spinal cords. Immediately after lysolecithin injection mice were treated with COG112, prefix peptide control or vehicle control for 21 days. The locomotor function of the mice was measured by the beam walking test and Basso Mouse Scale (BMS) assessment. The nerve transmission of the VLF of mice was assessed in vivo by transcranial magnetic motor evoked potentials (tcMMEPs). The histological changes were also examined by by eriochrome cyanine staining, immunohistochemistry staining and electron microscopy (EM) method.

Results

The area of demyelination in the spinal cord was significantly reduced in the COG112 group. EM examination showed that treatment with COG112 increased the thickness of myelin sheaths and the numbers of surviving axons in the lesion epicenter. Locomotor function was improved in COG112 treated animals when measured by the beam walking test and BMS assessment compared to controls. TcMMEPs also demonstrated the COG112-mediated enhancement of amplitude of evoked responses.

Conclusion

The apoE-mimetic COG112 demonstrates a favorable combination of activities in suppressing inflammatory response, mitigating demyelination and in promoting remyelination and associated functional recovery in animal model of CNS demyelination. These data support that apoE-mimetic strategy may represent a promising therapy for MS and other demyelination disorders.

Imaging techniques in spinal cord injury

BACKGROUND

Spinal imaging plays a critical role in the diagnosis, treatment, and rehabilitation of patients with spinal cord injury (SCI). In recent years there has been increasing interest in the development of advanced imaging techniques to provide pertinent microstructural and metabolic information that is not provided by conventional modalities.

METHODS

This review details the pathophysiological structural changes that accompany SCI, as well as their imaging correlates. The potential clinical applications of novel spinal cord imaging techniques to SCI are presented.

RESULTS

There are a variety of novel advanced imaging techniques that are principally focused on the microstructural and/or biochemical function of the spinal cord, and can potentially be applied to traumatic SCI, including diffusion tensor imaging, magnetic resonance spectroscopy, positron emission tomography, single-photon emission computed tomography, and functional magnetic resonance imaging. These techniques are presently in various stages of development, including some whose applications are primarily limited to laboratory investigation, whereas others are being actively used in clinical practice.

CONCLUSION

Advanced imaging of the spinal cord has tremendous potential to provide patient-specific physiological information about the status of cord integrity and health. Advanced spinal cord imaging is still at early stages of development and clinical implementation but is likely to play an increasingly important role in the management of spinal cord health in the foreseeable future.

Cervical spinal cord injection of epidural corticosteroids: comprehensive longitudinal study including multiparametric magnetic resonance imaging

Despite widespread use, the efficacy of epidural corticosteroid injections (ESI) for osteoarthritis-associated neck or radicular pain remains uncertain, so even rare serious complications enter into discussions about use. However, various factors impede investigation and publication of serious adverse events. To that end, we developed new magnetic resonance imaging (MRI) techniques for spinal cord white matter quantification and used the best available physiological tests to characterize a cervical spinal cord lesion caused by inadvertent intramedullary injection of Depo-Medrol. A 29-year-old woman with mild cervical osteoarthritis had 2 years of headache and neck pain (concussion and whiplash) after 2 minor motor vehicle accidents. During C5-6 ESI, she developed new left-sided motor and sensory symptoms, and MRI demonstrated a new left dorsal spinal cord cavity. Mild left-sided motor and sensory symptoms have persisted for more than 2.5 years, during which time we performed serial neurological examinations, standard electrodiagnostics, somatosensory evoked potentials, and transcranial measurement of corticospinal central motor conduction time (CMCT). We used 3-Tesla MRI with a 32-channel coil developed for high-resolution cervical spinal cord structural imaging, diffusion tensor imaging (DTI), and magnetization transfer (MT). T(2)(∗)-weighted signal and DTI and MT metrics showed delayed spread of the lesion across 4 vertebral levels rostrally, consistent with Wallerian degeneration within the ascending left dorsal columns. However, only CMCT metrics detected objective correlates of her left hemiparesis and bilateral hyperreflexia. DTI and MT metrics may better distinguish between post-traumatic demyelination and axonal degeneration than conventional MRI. These tests should be considered to better characterize similar spinal cord injuries.

Involvement of spinal sensory pathway in ALS and specificity of cord atrophy to lower motor neuron degeneration

Our objective was to demonstrate that ALS patients have sensory pathway involvement and that local cord atrophy reflects segmental lower motor neuron involvement. Twenty-nine ALS patients with spinal onset and twenty-one healthy controls were recruited. Diffusion tensor imaging (DTI), magnetization transfer and atrophy index were measured in the spinal cord, complemented with transcranial magnetic stimulations. Metrics were quantified within the lateral corticospinal and the dorsal segments of the cervical cord. Significant differences were detected between patients and controls for DTI and magnetization transfer metrics in the lateral and dorsal segments of the spinal cord. Fractional anisotropy correlated with ALSFRS-R (p = 0.04) and motor threshold (p = 0.02). Stepwise linear regression detected local spinal cord atrophy associated with weakness in the corresponding muscle territory, i.e. C4 level for deltoid and C7 level for hand muscles. In conclusion, impairment of spinal sensory pathways was detected at an early stage of the disease. Our data also demonstrate an association between muscle deficits and local spinal cord atrophy, suggesting that atrophy is a sensitive biomarker for lower motor neurons degeneration.

Spontaneous ocular and neurologic deficits in transgenic mouse models of multiple sclerosis and noninvasive investigative modalities: a review

Multiple sclerosis (MS) is an autoimmune, inflammatory, neurodegenerative, demyelinating disease of the central nervous system, predominantly involving myelinated neurons of the brain, spinal cord, and optic nerve. Optic neuritis is frequently associated with MS and often precedes other neurologic deficits associated with MS. A large number of patients experience visual defects and have abnormalities concomitant with neurologic abnormalities. Transgenic mice manifesting spontaneous neurologic and ocular disease are unique models that have revolutionized the study of MS. Spontaneous experimental autoimmune encephalomyelitis (sEAE) presents with spontaneous onset of demyelination, without the need of an injectable immunogen. This review highlights the various models of sEAE, their disease characteristics, and applicability for future research. The study of optic neuropathy and neurologic manifestations of demyelination in sEAE will expand our understanding of the pathophysiological mechanisms underlying MS. Early and precise diagnosis of MS with different noninvasive methods has opened new avenues in managing symptoms, reducing morbidity, and limiting disease burden. This review discusses the spectrum of available noninvasive techniques, such as electrophysiological and behavioral assessment, optical coherence tomography, scanning laser polarimetry, confocal scanning laser ophthalmoscopy, pupillometry, magnetic resonance imaging, positron emission tomography, gait, and cardiovascular monitoring, and their clinical relevance.

Mouse phenotyping with MRI

The field of mouse phenotyping with magnetic resonance imaging (MRI) is rapidly growing, motivated by the need for improved tools for characterizing and evaluating mouse models of human disease. Image results can provide important comparisons of human conditions with mouse disease models, evaluations of treatment, development or disease progression, as well as direction for histological or other investigations. Effective mouse MRI studies require attention to many aspects of experiment design. In this chapter, we provide details and discussion of important practical considerations: hardware requirements, mouse handling for in vivo imaging, specimen preparation for ex vivo imaging, sequence and contrast agent selection, study size, and quantitative image analysis. We focus particularly on anatomical phenotyping, an important and accessible application that has shown a high potential for impact in many mouse models at our imaging center.

Algebraic T2 estimation improves detection of right temporal lobe epilepsy by MR T2 relaxometry

Seizure related abnormalities may be detected with T2 relaxometry, which involves quantitative estimation of T2 values. Accounting for the partial-volume effect of cerebrospinal fluid (CSF) is important, especially for voxel-based relaxometry, VBR. With a mono-exponential decay model, this can be accomplished by including a baseline constant. An algebraic calculation, which accommodates this constant, offers improved T2 estimation speed over the commonly used non-linear fitting approach. Our objective was to compare the algebraic approach against three fitting approaches for the detection of seizure related abnormalities. We tested the performance of the four methods in the presence of noise using simulated data as well as real data acquired at 3 T with a Carr-Purcell-Meiboom-Gill sequence from 45 healthy subjects and 24 patients with confirmed right temporal lobe epilepsy. A quantitative analysis was performed on spatially normalized data by measuring T2 in various regions and with a whole brain tissue segmentation analysis. The detection rate of hippocampal T2 changes in patients was assessed by comparing the regional T2 measurements from each patient against the control data with a z-score threshold of 2.33. The algebraic method yielded high sensitivity for detection of hippocampal abnormalities in the epileptic patients in regional assessment and in follow-up single-subject VBR. This can be attributed to the relatively small variance across healthy subjects and improved precision in the presence of CSF and noise in simulation. In conclusion, the algebraic method is better than fitting based on faster calculation speed and better sensitivity for detecting seizure-related T2 changes.

Demyelination and degeneration in the injured human spinal cord detected with diffusion and magnetization transfer MRI

Characterizing demyelination/degeneration of spinal pathways in traumatic spinal cord injured (SCI) patients is crucial for assessing the prognosis of functional rehabilitation. Novel techniques based on diffusion-weighted (DW) magnetic resonance imaging (MRI) and magnetization transfer (MT) imaging provide sensitive and specific markers of white matter pathology. In this paper we combined for the first time high angular resolution diffusion-weighted imaging (HARDI), MT imaging and atrophy measurements to evaluate the cervical spinal cord of fourteen SCI patients and age-matched controls. We used high in-plane resolution to delineate dorsal and ventrolateral pathways. Significant differences were detected between patients and controls in the normal-appearing white matter for fractional anisotropy (FA, p<0.0001), axial diffusivity (p<0.05), radial diffusivity (p<0.05), generalized fractional anisotropy (GFA, p<0.0001), magnetization transfer ratio (MTR, p<0.0001) and cord area (p<0.05). No significant difference was detected in mean diffusivity (p=0.41), T1-weighted (p=0.76) and T2-weighted (p=0.09) signals. MRI metrics were remarkably well correlated with clinical disability (Pearson's correlations, FA: p<0.01, GFA: p<0.01, radial diffusivity: p=0.01, MTR: p=0.04 and atrophy: p<0.01). Stepwise linear regressions showed that measures of MTR in the dorsal spinal cord predicted the sensory disability whereas measures of MTR in the ventro-lateral spinal cord predicted the motor disability (ASIA score). However, diffusion metrics were not specific to the sensorimotor scores. Due to the specificity of axial and radial diffusivity and MT measurements, results suggest the detection of demyelination and degeneration in SCI patients. Combining HARDI with MT imaging is a promising approach to gain specificity in characterizing spinal cord pathways in traumatic injury.

MR oximetry

MR oximetry includes methods for assessing tissue oxygenation. This chapter focuses on direct measurements of oxygenation. These can be divided into three methods. The first and most common has been termed BOLD MRI and relates to the quantification of deoxyhemoglobin. The second method uses an injected fluorinated agent which has a T (1) that is sensitive to tissue oxygen levels. The third is a direct measurement of T (1) under conditions where the variation in T (1) can be limited to that caused by changes in pO(2). These conditions can be met in the vitreous of the eye or the cerebrospinal fluids. Such changes in the eye have been called the retinal oxygenation response.

GAS6 enhances repair following cuprizone-induced demyelination

Growth arrest-specific protein 6 (gas6) activities are mediated through the Tyro3, Axl, and Mer family of receptor tyrosine kinases. Gas6 is expressed and secreted by a wide variety of cell types, including cells of the central nervous system (CNS). In this study, we tested the hypothesis that administration of recombinant human Gas6 (rhGas6) protein into the CNS improves recovery following cuprizone withdrawal. After a 4-week cuprizone diet, cuprizone was removed and PBS or rhGas6 (400 ng/ml, 4 µg/ml and 40 µg/ml) was delivered by osmotic mini-pump into the corpus callosum of C57Bl6 mice for 14 days. Nine of 11 (82%) PBS-treated mice had abundant lipid-associated debris in the corpus callosum by Oil-Red-O staining while only 4 of 19 (21%) mice treated with rhGas6 had low Oil-Red-O positive droplets. In rhGas6-treated mice, SMI32-positive axonal spheroids and APP-positive deposits were reduced in number relative to PBS-treated mice. Compared to PBS, rhGas6 enhanced remyelination as revealed by MBP immunostaining and electron microscopy. The rhGas6-treated mice had more oligodendrocytes expressing Olig1 in the cytoplasm, indicative of oligodendrocyte progenitor cell maturation. Relative to PBS-treated mice, rhGas6-treated mice had fewer activated microglia in the corpus callosum by Iba1 immunostaining. The data show that rhGas6 treatment resulted in more efficient repair following cuprizone-induced injury.

The contributions of myelin and axonal caliber to transverse relaxation time in shiverer and neurofilament-deficient mouse models

White matter disorders can involve injury to myelin or axons but the respective contribution of each to clinical course is difficult to evaluate non-invasively. Here, to develop a paradigm for further investigations of axonal pathology by MRI, we compared two genetic mouse models exhibiting relatively selective axonal or myelin deficits using quantitative MRI relaxography of the transverse relaxation times (T2) in vivo and ultrastructural morphometry. In HM-DKO mice, which lack genes encoding the heavy (NF-H) and medium (NF-M) subunits of neurofilaments, neurofilament content of large myelinated axons of the central nervous system (CNS) is markedly reduced in the absence of changes in myelin thickness and volume. In shiverer mutant mice, which lack functional myelin basic protein, CNS myelin sheath formation is markedly reduced but neurofilament content is normal. We observed increases in T2 in nearly all white matter in shiverer mice compared to their wild type, while more subtle increases in T2 were observed in HM-DKO in the corpus callosum. White matter T2 was generally greater in shiverer mice than HM-DKO mice. Ultrastructural morphometry of the corpus callosum, which exhibited the greatest T2 differences, confirmed that total cross-sectional area occupied by axons was similar in the two mouse models and that the major ultrastructural differences, determined by morphometry, were an absence of myelin and larger unmyelinated axons in shiverer mice and absence of neurofilaments in HM-DKO mice. Our findings indicate that T2 is strongly influenced by myelination state and axonal volume, while neurofilament structure within the intra-axonal compartment has a lesser effect upon single compartment T2 estimates.