1
|
Wang L, Ji Y, Ding H, Tian Q, Fan K, Shi D, Yu C, Qin W. Abnormal cerebral blood flow in patients with Leber's hereditary optic neuropathy. Brain Imaging Behav 2023; 17:471-480. [PMID: 37368154 DOI: 10.1007/s11682-023-00775-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The study aimed to unravel abnormal cerebral blood flow (CBF) in patients with Leber's hereditary optic neuropathy (LHON) using arterial spin labeling (ASL) and to investigate the associations among disrupted CBF, disease duration, and neuro-ophthalmological impairment. METHODS ASL perfusion imaging data was collected from 20 patients with acute LHON, 29 patients with chronic LHON, and 37 healthy controls. We used a one-way analysis of covariance to test the intergroup differences in CBF. Linear and nonlinear curve fit models were applied to explore the associations among CBF, disease duration, and neuro-ophthalmological metrics. RESULTS Brain regions differed in LHON patients, including the left sensorimotor and bilateral visual areas (p < 0.05, cluster-wise family-wise error correction). Acute and chronic LHON patients demonstrated lower CBF in bilateral calcarine than the healthy controls. Chronic LHON had lower CBF in the left middle frontal gyrus and sensorimotor cortex, and temporal-partial junction than the healthy controls and acute LHON. A significant logarithmic negative correlation was shown between CBF of left middle frontal gyrus and disease duration. A significant linear positive correlation was found between retinal nerve fiber layer thickness and CBF in left middle frontal gyrus, and negative correlations between loss of variance and CBF in left middle frontal gyrus and sensorimotor cortex (p < 0.05, Bonferroni correction). CONCLUSION LHON patients exhibited reduced CBF in the visual pathway, sensorimotor and higher-tier cognitive areas. Disease duration and neuro-ophthalmological impairments can influence the metabolism of non-visual areas.
Collapse
Affiliation(s)
- Ling Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Yi Ji
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Hao Ding
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China
- School of Medical Imaging, Tianjin Medical University, Tianjin, 300070, China
| | - Qin Tian
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Ke Fan
- Henan Eye Institute, Henan Eye Hospital, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Dapeng Shi
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, 450003, China.
- Department of Medical Imaging, Henan Provincial People's Hospital, Sanquan College of Xinxiang Medical University, Weiwu Road No. 7, Jinshui District, ZhengZhou, Henan Province, China.
| | - Chunshui Yu
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China.
- Department of Radiology, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China.
| | - Wen Qin
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, 300052, China.
- Department of Radiology, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin, 300052, China.
| |
Collapse
|
2
|
Thomas-Black G, Altmann DR, Crook H, Solanky N, Carrasco FP, Battiston M, Grussu F, Yiannakas MC, Kanber B, Jolly JK, Brett J, Downes SM, Moran M, Chan PK, Adewunmi E, Gandini Wheeler-Kingshott CAM, Németh AH, Festenstein R, Bremner F, Giunti P. Multimodal Analysis of the Visual Pathways in Friedreich's Ataxia Reveals Novel Biomarkers. Mov Disord 2023; 38:959-969. [PMID: 36433650 DOI: 10.1002/mds.29277] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Optic neuropathy is a near ubiquitous feature of Friedreich's ataxia (FRDA). Previous studies have examined varying aspects of the anterior and posterior visual pathways but none so far have comprehensively evaluated the heterogeneity of degeneration across different areas of the retina, changes to the macula layers and combined these with volumetric MRI studies of the visual cortex and frataxin level. METHODS We investigated 62 genetically confirmed FRDA patients using an integrated approach as part of an observational cohort study. We included measurement of frataxin protein levels, clinical evaluation of visual and neurological function, optical coherence tomography to determine retinal nerve fibre layer thickness and macular layer volume and volumetric brain MRI. RESULTS We demonstrate that frataxin level correlates with peripapillary retinal nerve fibre layer thickness and that retinal sectors differ in their degree of degeneration. We also shown that retinal nerve fibre layer is thinner in FRDA patients than controls and that this thinning is influenced by the AAO and GAA1. Furthermore we show that the ganglion cell and inner plexiform layers are affected in FRDA. Our MRI data indicate that there are borderline correlations between retinal layers and areas of the cortex involved in visual processing. CONCLUSION Our study demonstrates the uneven distribution of the axonopathy in the retinal nerve fibre layer and highlight the relative sparing of the papillomacular bundle and temporal sectors. We show that thinning of the retinal nerve fibre layer is associated with frataxin levels, supporting the use the two biomarkers in future clinical trials design. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Gilbert Thomas-Black
- The Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals Foundation NHS Trust, London, UK
| | - Daniel R Altmann
- Medical Statistics Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Harry Crook
- The Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Nita Solanky
- The Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ferran Prados Carrasco
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing, UCL, London, UK
- e-Health Centre, Open University of Catalonia, Barcelona, Spain
| | - Marco Battiston
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK
| | - Francesco Grussu
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
- Radiomics Group, Vall d'Hebron Institute of Oncology, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Marios C Yiannakas
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK
| | - Baris Kanber
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing, UCL, London, UK
| | - Jasleen K Jolly
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Jon Brett
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Susan M Downes
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Marni Moran
- NIHR Clinical Research Network, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ping K Chan
- Gene Control Mechanisms and Disease Group, Department of Medicine, Division of Brain Sciences and MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, UK
| | - Emmanuel Adewunmi
- Gene Control Mechanisms and Disease Group, Department of Medicine, Division of Brain Sciences and MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, UK
| | - Claudia A M Gandini Wheeler-Kingshott
- Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, University College London (UCL) Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, UK
- Brain MRI 3T Research Center, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Andrea H Németh
- NIHR Clinical Research Network, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Richard Festenstein
- Gene Control Mechanisms and Disease Group, Department of Medicine, Division of Brain Sciences and MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, UK
| | - Fion Bremner
- National Hospital for Neurology and Neurosurgery, University College London Hospitals Foundation NHS Trust, London, UK
| | - Paola Giunti
- The Ataxia Centre, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
- National Hospital for Neurology and Neurosurgery, University College London Hospitals Foundation NHS Trust, London, UK
| |
Collapse
|
3
|
Ji Y, Wang L, Ding H, Tian Q, Fan K, Shi D, Yu C, Qin W. Aberrant neurovascular coupling in Leber's hereditary optic neuropathy: Evidence from a multi-model MRI analysis. Front Neurosci 2023; 16:1050772. [PMID: 36703998 PMCID: PMC9871937 DOI: 10.3389/fnins.2022.1050772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
The study aimed to investigate the neurovascular coupling abnormalities in Leber's hereditary optic neuropathy (LHON) and their associations with clinical manifestations. Twenty qualified acute Leber's hereditary optic neuropathy (A-LHON, disease duration ≤ 1 year), 29 chronic Leber's hereditary optic neuropathy (C-LHON, disease duration > 1 year), as well as 37 healthy controls (HCs) were recruited. The neurovascular coupling strength was quantified as the ratio between regional homogeneity (ReHo), which represents intrinsic neuronal activity and relative cerebral blood flow (CBF), representing microcirculatory blood supply. A one-way analysis of variance was used to compare intergroup differences in ReHo/CBF ratio with gender and age as co-variables. Pearson's Correlation was used to clarify the association between ReHo, CBF, and neurovascular coupling strength. Furthermore, we applied linear and exponential non-linear regression models to explore the associations among ReHo/CBF, disease duration, and neuro-ophthalmological metrics. Compared with HCs, A_LHON, and C_LHON patients demonstrated a higher ReHo/CBF ratio than the HCs in the bilateral primary visual cortex (B_CAL), which was accompanied by reduced CBF while preserved ReHo. Besides, only C_LHON had a higher ReHo/CBF ratio and reduced CBF in the left middle temporal gyrus (L_MTG) and left sensorimotor cortex (L_SMC) than the HCs, which was accompanied by increased ReHo in L_MTG (p < 1.85e-3, Bonferroni correction). A-LHON and C-LHON showed a negative Pearson correlation between ReHo/CBF ratio and CBF in B_CAL, L_SMC, and L_MTG. Only C_LHON showed a weak positive correlation between ReHo/CBF ratio and ReHo in L_SMC and L_MTG (p < 0.05, uncorrected). Finally, disease duration was positively correlated with ReHo/CBF ratio of L_SMC (Exponential: Radj2 = 0.23, p = 8.66e-4, Bonferroni correction). No statistical correlation was found between ReHo/CBF ratio and neuro-ophthalmological metrics (p > 0.05, Bonferroni correction). Brain neurovascular "dyscoupling" within and outside the visual system might be an important neurological mechanism of LHON.
Collapse
Affiliation(s)
- Yi Ji
- Tianjin Key Lab of Functional Imaging, Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ling Wang
- Department of Medical Imaging, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Hao Ding
- Tianjin Key Lab of Functional Imaging, Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China,School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Qin Tian
- Department of Medical Imaging, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Ke Fan
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Dapeng Shi
- Department of Medical Imaging, Henan Provincial People’s Hospital, Zhengzhou, China,*Correspondence: Dapeng Shi,
| | - Chunshui Yu
- Tianjin Key Lab of Functional Imaging, Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China,Chunshui Yu,
| | - Wen Qin
- Tianjin Key Lab of Functional Imaging, Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China,Wen Qin,
| |
Collapse
|
4
|
Tian Q, Wang L, Zhang Y, Fan K, Liang M, Shi D, Qin W, Ding H. Brain Gray Matter Atrophy and Functional Connectivity Remodeling in Patients With Chronic LHON. Front Neurosci 2022; 16:885770. [PMID: 35645726 PMCID: PMC9135140 DOI: 10.3389/fnins.2022.885770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to investigate the brain gray matter volume (GMV) and spontaneous functional connectivity (FC) changes in patients with chronic Leber's hereditary optic neuropathy (LHON), and their relations with clinical measures. Methods A total of 32 patients with chronic LHON and matched sighted healthy controls (HC) underwent neuro-ophthalmologic examinations and multimodel magnetic resonance imaging (MRI) scans. Voxel-based morphometry (VBM) was used to detect the GMV differences between the LHON and HC. Furthermore, resting-state FC analysis using the VBM-identified clusters as seeds was carried out to detect potential functional reorganization in the LHON. Finally, the associations between the neuroimaging and clinical measures were performed. Results The average peripapillary retinal nerve fiber layer (RNFL) thickness of the chronic LHON was significantly thinner (T = −16.421, p < 0.001), and the mean defect of the visual field was significantly higher (T = 11.28, p < 0.001) than the HC. VBM analysis demonstrated a significantly lower GMV of bilateral calcarine gyri (CGs) in the LHON than in the HC (p < 0.05). Moreover, in comparison with the HC, the LHON had significantly lower FC between the centroid of the identified left CG and ipsilateral superior occipital gyrus (SOG) and higher FC between this cluster and the ipsilateral posterior cingulate gyrus (p < 0.05, corrected). Finally, the GMV of the left CG was negatively correlated with the LHON duration (r = −0.535, p = 0.002), and the FC between the left CG and the ipsilateral posterior cingulate gyrus of the LHON was negatively correlated with the average peripapillary RNFL thickness (r = −0.522, p = 0.003). Conclusion The atrophied primary visual cortex of the chronic LHON may be caused by transneuronal degeneration following the retinal damage. Moreover, our findings suggest that the functional organization of the atrophied primary visual cortex has been reshaped in the chronic LHON.
Collapse
Affiliation(s)
- Qin Tian
- Department of Medical Imaging, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China
| | - Ling Wang
- Department of Medical Imaging, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China
| | - Yu Zhang
- Department of Radiology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Ke Fan
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Meng Liang
- Department of Radiology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
- School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Dapeng Shi
- Department of Medical Imaging, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China
- *Correspondence: Dapeng Shi
| | - Wen Qin
- Department of Radiology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
- Wen Qin
| | - Hao Ding
- Department of Radiology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
- School of Medical Imaging, Tianjin Medical University, Tianjin, China
- Hao Ding
| |
Collapse
|
5
|
Chow-Wing-Bom HT, Callaghan MF, Wang J, Wei S, Dick F, Yu-Wai-Man P, Dekker TM. Neuroimaging in Leber Hereditary Optic Neuropathy: State-of-the-art and future prospects. Neuroimage Clin 2022; 36:103240. [PMID: 36510411 PMCID: PMC9668671 DOI: 10.1016/j.nicl.2022.103240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 06/14/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
Leber Hereditary Optic Neuropathy (LHON) is an inherited mitochondrial retinal disease that causes the degeneration of retinal ganglion cells and leads to drastic loss of visual function. In the last decades, there has been a growing interest in using Magnetic Resonance Imaging (MRI) to better understand mechanisms of LHON beyond the retina. This is partially due to the emergence of gene-therapies for retinal diseases, and the accompanying expanded need for reliably quantifying and monitoring visual processing and treatment efficiency in patient populations. This paper aims to draw a current picture of key findings in this field so far, the challenges of using neuroimaging methods in patients with LHON, and important open questions that MRI can help address about LHON disease mechanisms and prognoses, including how downstream visual brain regions are affected by the disease and treatment and why, and how scope for neural plasticity in these pathways may limit or facilitate recovery.
Collapse
Affiliation(s)
- Hugo T Chow-Wing-Bom
- Institute of Ophthalmology, University College London (UCL), London, United Kingdom; Birkbeck/UCL Centre for NeuroImaging, London, United Kingdom.
| | - Martina F Callaghan
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Junqing Wang
- Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, The Chinese People's Liberation Army Medical School, Beijing, China
| | - Shihui Wei
- Department of Ophthalmology, The Chinese People's Liberation Army General Hospital, The Chinese People's Liberation Army Medical School, Beijing, China
| | - Frederic Dick
- Birkbeck/UCL Centre for NeuroImaging, London, United Kingdom; Department of Psychological Sciences, Birkbeck, University of London, United Kingdom; Department of Experimental Psychology, UCL, London, United Kingdom
| | - Patrick Yu-Wai-Man
- Institute of Ophthalmology, University College London (UCL), London, United Kingdom; John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom; Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, United Kingdom; Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Tessa M Dekker
- Institute of Ophthalmology, University College London (UCL), London, United Kingdom; Birkbeck/UCL Centre for NeuroImaging, London, United Kingdom; Department of Experimental Psychology, UCL, London, United Kingdom
| |
Collapse
|
6
|
Evangelisti S, La Morgia C, Testa C, Manners DN, Brizi L, Bianchini C, Carbonelli M, Barboni P, Sadun AA, Tonon C, Carelli V, Vandewalle G, Lodi R. Brain functional MRI responses to blue light stimulation in Leber’s hereditary optic neuropathy. Biochem Pharmacol 2021; 191:114488. [DOI: 10.1016/j.bcp.2021.114488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/20/2022]
|
7
|
Wang L, Ding H, Chen BT, Fan K, Tian Q, Long M, Liang M, Shi D, Yu C, Qin W. Occult primary white matter impairment in Leber hereditary optic neuropathy. Eur J Neurol 2021; 28:2871-2881. [PMID: 34166558 DOI: 10.1111/ene.14995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/17/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Leber hereditary optic neuropathy (LHON) is a disease maternally inherited from mitochondria that predominantly impairs the retinal ganglion cells and their axons. To identify whether occult brain white matter (WM) impairment is involved, a voxel-based analysis (VBA) of diffusion metrics was carried out in LHON patients with normal-appearing brain parenchyma. METHODS Fifty-four symptomatic LHON patients (including 22 acute LHON with vision loss for ≤12 months, and 32 chronic LHON) without any visible brain lesions and 36 healthy controls (HCs) were enrolled in this study. VBA was applied to quantify the WM microstructural changes of LHON patients. Finally, the associations of the severity of WM impairment with disease duration and ophthalmologic deficits were assessed. RESULTS Compared with the HCs, the average retinal nerve fiber layer (RNFL) thickness was significantly reduced in patients with chronic LHON, whereas it was increased in patients with acute LHON (p < 0.05, corrected). VBA identified significantly decreased fractional anisotropy widely in WM in both the acute and chronic LHON patients, including the left anterior thalamic radiation and superior longitudinal fasciculus, and bilateral corticospinal tract, dentate nuclei, inferior longitudinal fasciculus, forceps major, and optic radiation (OR; p < 0.05, corrected). The integrity of most WM structures (except for the OR) was correlated with neither disease duration nor RNFL thickness (p > 0.05, corrected). CONCLUSIONS Occult primary impairment of widespread brain WM is present in LHON patients. The coexisting primary and secondary WM impairment may jointly contribute to the pathological process of LHON.
Collapse
Affiliation(s)
- Ling Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
| | - Hao Ding
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China.,School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, California, USA
| | - Ke Fan
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Qin Tian
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
| | - Miaomiao Long
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Meng Liang
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China.,School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Dapeng Shi
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
| | - Chunshui Yu
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Wen Qin
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
8
|
Saruta W, Shibahara I, Handa H, Inukai M, Kanayama S, Yasumoto R, Sakurai K, Akiyama H, Ishikawa H, Sato S, Hide T, Kumabe T. Leber’s hereditary optic neuropathy with diffuse white matter changes mimicking gliomatosis cerebri: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2021; 1:CASE21161. [PMID: 35854899 PMCID: PMC9245756 DOI: 10.3171/case21161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/12/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUIND
Leber’s hereditary optic neuropathy (LHON) is a mitochondrial disease characterized by bilateral severe subacute central vision loss and a mutation in the mitochondrial DNA (mtDNA). The findings on cranial magnetic resonance imaging of patients with LHON vary from subtle to multiple white matter changes. However, they rarely present with diffuse infiltrative white matter changes.
OBSERVATIONS
The authors reported a case with diffuse white matter changes mimicking gliomatosis cerebri (GC). The histological findings included only mild glial hyperplasia without immunohistochemical positivity, supporting the diagnosis of glial tumors. Analysis of mtDNA obtained from the blood and brain tissue revealed mutation of m.11778G>A in the NADH dehydrogenase 4 gene, which confirmed the case as LHON. Immunohistochemistry of the brain tissue revealed 8-hydroxy-2′-deoxyguanosine positivity, suggesting the presence of oxidative stress.
LESSONS
LHON is extremely difficult to diagnose unless one suspects or knows the disease. The present case brings attention not only to LHON but also to other mtDNA-mutated diseases that need to be considered with diffuse white matter changes or GC.
Collapse
Affiliation(s)
| | | | | | | | - Shunsuke Kanayama
- Ophthalmology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Ryoma Yasumoto
- Department of Clinical Laboratory, Kitasato University Hospital, Sagamihara, Kanagawa, Japan; and
| | - Keizo Sakurai
- Department of Clinical Laboratory, Kitasato University Hospital, Sagamihara, Kanagawa, Japan; and
| | - Hisanao Akiyama
- Department of Neurology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Hitoshi Ishikawa
- Ophthalmology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | | | | | | |
Collapse
|
9
|
Trans-synaptic degeneration in the visual pathway: Neural connectivity, pathophysiology, and clinical implications in neurodegenerative disorders. Surv Ophthalmol 2021; 67:411-426. [PMID: 34146577 DOI: 10.1016/j.survophthal.2021.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
There is a strong interrelationship between eye and brain diseases. It has been shown that neurodegenerative changes can spread bidirectionally in the visual pathway along neuronal projections. For example, damage to retinal ganglion cells in the retina leads to degeneration of the visual cortex (anterograde degeneration) and vice versa (retrograde degeneration). The underlying mechanisms of this process, known as trans-synaptic degeneration (TSD), are unknown, but TSD contributes to the progression of numerous neurodegenerative disorders, leading to clinical and functional deterioration. The hierarchical structure of the visual system comprises of a strong topographic connectivity between the retina and the visual cortex and therefore serves as an ideal model to study the cellular effect, clinical manifestations, and deterioration extent of TSD. With this review we provide comprehensive information about the neural connectivity, synapse function, molecular changes, and pathophysiology of TSD in visual pathways. We then discuss its bidirectional nature and clinical implications in neurodegenerative diseases. A thorough understanding of TSD in the visual pathway can provide insights into progression of neurodegenerative disorders and its potential as a therapeutic target.
Collapse
|
10
|
Zhang J, Wang L, Ding H, Fan K, Tian Q, Liang M, Sun Z, Shi D, Qin W. Abnormal large-scale structural rich club organization in Leber's hereditary optic neuropathy. NEUROIMAGE-CLINICAL 2021; 30:102619. [PMID: 33752075 PMCID: PMC8010853 DOI: 10.1016/j.nicl.2021.102619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 12/24/2022]
Abstract
LHON patients suffered large-scale structural network disruption. Non-rich club connections may be more vulnerable in the LHON. Both primary and secondary connectivity damage may coexist in the LHON.
Objective The purpose of this study was to investigate whether the large-scale structural rich club organization was abnormal in patients with Leber's hereditary optic neuropathy (LHON) using diffusion tensor imaging (DTI), and the associations among disrupted brain structural connectivity, disease duration, and neuro-ophthalmological impairment. Methods Nineteen acute, 34 chronic LHON patients, and 36 healthy controls (HC) underwent DTI and neuro-ophthalmological measurements. The brain structural network and rich club organization were constructed based on deterministic fiber tracking at the individual level. Then intergroup differences among the acute, chronic LHON patients and healthy controls (HC) in three types of structural connections, including rich club, feeder, and local ones, were compared. Network-based Statistics (NBS) was also used to test the intergroup connectivity differences for each fiber. Several linear and nonlinear curve fit models were applied to explore the associations among large-scale brain structural connectivity, disease duration, and neuro-ophthalmological metrics. Results Compared to the HC, both the acute and chronic LHON patients had consistently significantly lower fractional anisotropy (FA) and higher radial diffusion (RD) for feeder connections (p < 0.05, FDR correction). Acute LHON patients had significantly lower FA and higher RD for local connections (p < 0.05, FDR correction). There was no significant difference in large-scale brain structural connectivity between acute and chronic LHON (p > 0.05, FDR correction). NBS also identified reduced FA of three feeder connections and five local ones linking visual, auditory, and basal ganglia areas in LHON patients (p < 0.05, FDR correction). No structural connections showed linear or nonlinear association with either disease duration or neuro-ophthalmological indicators (p > 0.05, FDR correction). A significant negative correlation was shown between the retinal nerve fiber layer (RNFL) thickness and disease duration (p < 0.05, FDR correction). Conclusions Abnormal rich club organization of the structural network was identified in both the acute and chronic LHON. Furthermore, our findings suggest the coexistence of both primary and secondary connectivity damage in the LHON.
Collapse
Affiliation(s)
- Jiahui Zhang
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ling Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Hao Ding
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China; School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Ke Fan
- Henan Eye Institute, Henan Eye Hospital, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Qin Tian
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - Meng Liang
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China; School of Medical Imaging, Tianjin Medical University, Tianjin 300070, China
| | - Zhihua Sun
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
| | - Dapeng Shi
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou 450003, China.
| | - Wen Qin
- Department of Radiology & Tianjin Key Lab of Functional Imaging, Tianjin Medical University General Hospital, Tianjin 300052, China.
| |
Collapse
|
11
|
Jonak K, Krukow P, Karakuła-Juchnowicz H, Rahnama-Hezavah M, Jonak KE, Stępniewski A, Niedziałek A, Toborek M, Podkowiński A, Symms M, Grochowski C. Aberrant Structural Network Architecture in Leber's Hereditary Optic Neuropathy. Minimum Spanning Tree Graph Analysis Application into Diffusion 7T MRI. Neuroscience 2020; 455:128-140. [PMID: 33359657 DOI: 10.1016/j.neuroscience.2020.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/08/2020] [Accepted: 12/14/2020] [Indexed: 11/15/2022]
Abstract
Examining individuals with Leber's hereditary optic neuropathy (LHON) provides a rare opportunity to understand how changes in mitochondrial DNA and loss of vision can be related to changes in organization of the whole-brain structural network architecture. In comparison with the previous neuroimaging studies with LHON participants, which were focused mainly on analyzing changes which occur in different areas of the patient's brain, network analysis not only makes it possible to observe single white matter fibers' aberrations but also the whole-brain nature of these changes. The purpose of our study was to better understand whole-brain neural network changes in LHON participants and see the correlation between the clinical data and the changes. To achieve this, we examined fifteen LHON patients and seventeen age-matched healthy subjects with the usage of ultra-high filed 7T magnetic resonance imaging (MRI). Basing on the analysis on MRI diffusion tensor imaging (DTI) data, whole-brain structural neural networks were reconstructed with the use of the minimum spanning tree algorithm (MST) for every participant. Our results revealed that the structural network in LHON participants was altered at both the local and the global level. The global network structures of LHON subjects were less centralized with path-like organization and there was an imbalance in the main hub centrality. Moreover, the inspection of nodes and hubs in terms of their anatomical placement revealed that in the LHON participants the prominent hubs were located within the basal ganglia (i.e. bilateral caudate, left pallidum), which differed them from healthy controls. An analysis of the relationships between the global MST metrics and LHON participants' clinical characteristics revealed significant correlations between the global network metrics and the duration of illness. Furthermore, the nodal parameters of the optic chiasm were significantly correlated with the duration of illness and the averaged thickness of the right retinal nerve fiber layer (RNFL). These findings clearly showed that the progression of the disease is accompanied by alterations within the brain network structure and its efficiency.
Collapse
Affiliation(s)
- Kamil Jonak
- Department of Clinical Neuropsychiatry, Medical University of Lublin, 20-439 Lublin, Poland; Department of Biomedical Engineering, Lublin University of Technology, 20-618 Lublin, Poland
| | - Paweł Krukow
- Department of Clinical Neuropsychiatry, Medical University of Lublin, 20-439 Lublin, Poland
| | - Hanna Karakuła-Juchnowicz
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland
| | | | - Katarzyna E Jonak
- Department of Foreign Languages, Medical University of Lublin, Jaczewskiego 4, 20-090 Lublin, Poland
| | | | - Anna Niedziałek
- Department of Radiography, Medical University of Lublin, 20-081 Lublin, Poland
| | - Michał Toborek
- Department of Radiography, Medical University of Lublin, 20-081 Lublin, Poland
| | | | - Mark Symms
- GE Healthcare, Amersham Place, Amersham HP7 9NA, UK
| | - Cezary Grochowski
- Laboratory of Virtual Man, Chair of Anatomy, Medical University of Lublin, Poland.
| |
Collapse
|
12
|
Decreased Volume of Lateral and Medial Geniculate Nuclei in Patients with LHON Disease-7 Tesla MRI Study. J Clin Med 2020; 9:jcm9092914. [PMID: 32927622 PMCID: PMC7565643 DOI: 10.3390/jcm9092914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 11/17/2022] Open
Abstract
Leber’s hereditary optic neuropathy (LHON) is a maternally inherited genetic disorder leading to severe and bilateral loss of central vision, with a young male predilection. In recent years, multiple studies examined structural abnormalities in visual white matter tracts such as the optic tract and optic radiation. However, it is still unclear if the disease alters only some parts of the white matter architecture or whether the changes also affect grey matter parts of the visual pathway. This study aimed at improving our understanding of morphometric changes in the lateral (LGN) and medial (MGN) geniculate nuclei and their associations with the clinical picture in LHON by the application of a submillimeter surface-based analysis approach to the ultra-high-field 7T magnetic resonance imaging data. To meet these goals, fifteen LHON patients and fifteen age-matched healthy subjects were examined. A quantitative analysis of the LGN and MGN volume was performed for all individuals. Additionally, morphometric results of LGN and MGN were correlated with variables covering selected aspects of the clinical picture of LHON. In comparison with healthy controls (HC), LHON participants showed a significantly decreased volume of the right LGN and the right MGN. Nevertheless, the volume of the right LGN was strongly correlated with the averaged thickness value of the right retinal nerve fiber layer (RNFL). The abnormalities in the volume of the LHON patients’ thalamic nuclei indicate that the disease can cause changes not only in the white matter areas constituting visual tracts but also in the grey matter structures. Furthermore, the correlation between the changes in the LGN volume and the RNFL, as well as the right optic nerve surface area located proximally to the eyeball, suggest some associations between the atrophy of these structures. However, to fully confirm this observation, longitudinal studies should be conducted.
Collapse
|
13
|
Widespread Reductions of Spontaneous Neurophysiological Activity in Leber’s Disease—An Application of EEG Source Current Density Reconstruction. Brain Sci 2020; 10:brainsci10090622. [PMID: 32911650 PMCID: PMC7563180 DOI: 10.3390/brainsci10090622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 11/16/2022] Open
Abstract
Leber’s hereditary optic neuropathy (LHON) is a rare, maternally inherited genetic disease caused by a mutation of mitochondrial DNA. Classical descriptions have highlighted structural abnormalities in various parts of patients’ optic tracts; however, current studies have proved that changes also affect many cortical and subcortical structures, not only these belonging to the visual system. This study aimed at improving our understanding of neurophysiological impairments in LHON. First of all, we wanted to know if there were any differences between the health control and LHON subjects in the whole-brain source electroencephalography (EEG) analysis. Second, we wanted to investigate the associations between the observed results and some selected aspects of Leber’s disease’s clinical picture. To meet these goals, 20 LHON patients and 20 age-matched healthy control (HC) subjects were examined. To investigate the electrophysiological differences between the HC and LHON groups, a quantitative analysis of the whole-brain current source density was performed. The signal analysis method was based on scalp EEG data and an inverse solution method called low-resolution brain electromagnetic tomography (eLORETA). In comparison with the healthy subjects, LHON participants showed significantly decreased neuronal activity in the alpha and gamma bands; more specifically, in the alpha band, the decrease was mainly found in the occipital lobes and secondary visual cortex, whereas, in the gamma band, the reduced activity occurred in multiple cortical areas. Additionally, a correlation was found between the alpha band activity of the right secondary visual cortex and the averaged thickness of the right retinal nerve fiber layer in the LHON participants. Our study suggests that LHON is associated with widespread cortical de-activation, rather than simply abnormalities of structures constituting the visual system.
Collapse
|
14
|
Neuroanatomical Changes in Leber's Hereditary Optic Neuropathy: Clinical Application of 7T MRI Submillimeter Morphometry. Brain Sci 2020; 10:brainsci10060359. [PMID: 32526981 PMCID: PMC7348858 DOI: 10.3390/brainsci10060359] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 12/31/2022] Open
Abstract
Leber’s hereditary optic neuropathy (LHON) is one of the mitochondrial diseases that causes loss of central vision, progressive impairment and subsequent degeneration of retinal ganglion cells (RGCs). In recent years, diffusion tensor imaging (DTI) studies have revealed structural abnormalities in visual white matter tracts, such as the optic tract, and optic radiation. However, it is still unclear if the disease alters only some parts of the white matter architecture or whether the changes also affect other subcortical areas of the brain. This study aimed to improve our understanding of morphometric changes in subcortical brain areas and their associations with the clinical picture in LHON by the application of a submillimeter surface-based analysis approach to the ultra-high-field 7T magnetic resonance imaging data. To meet these goals, fifteen LHON patients and fifteen age-matched healthy subjects were examined. For all individuals, quantitative analysis of the morphometric results was performed. Furthermore, morphometric characteristics which differentiated the groups were correlated with variables covering selected aspects of the LHON clinical picture. Compared to healthy controls (HC), LHON carriers showed significantly lower volume of both palladiums (left p = 0.023; right p = 0.018), the right accumbens area (p = 0.007) and the optic chiasm (p = 0.014). Additionally, LHON patients have significantly higher volume of both lateral ventricles (left p = 0.034; right p = 0.02), both temporal horns of the lateral ventricles (left p = 0.016; right p = 0.034), 3rd ventricle (p = 0.012) and 4th ventricle (p = 0.002). Correlation between volumetric results and clinical data showed that volume of both right and left lateral ventricles significantly and positively correlated with the duration of the illness (left R = 0.841, p = 0.002; right R = 0.755, p = 0.001) and the age of the LHON participants (left R = 0.656, p = 0.007; right R = 0.691, p = 0.004). The abnormalities in volume of the LHON patients’ subcortical structures indicate that the disease can cause changes not only in the white matter areas constituting visual tracts, but also in the other subcortical brain structures. Furthermore, the correlation between those results and the illness duration suggests that the disease might have a neurodegenerative nature; however, to fully confirm this observation, longitudinal studies should be conducted.
Collapse
|
15
|
Jorge L, Canário N, Quental H, Bernardes R, Castelo-Branco M. Is the Retina a Mirror of the Aging Brain? Aging of Neural Retina Layers and Primary Visual Cortex Across the Lifespan. Front Aging Neurosci 2020; 11:360. [PMID: 31998115 PMCID: PMC6961569 DOI: 10.3389/fnagi.2019.00360] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 12/10/2019] [Indexed: 01/13/2023] Open
Abstract
How aging concomitantly modulates the structural integrity of the brain and retina in healthy individuals remains an outstanding question. Given the strong bottom-up retinocortical connectivity, it is important to study how these structures co-evolve during healthy aging in order to unravel mechanisms that may affect the physiological integrity of both structures. For the 56 participants in the study, primary visual cortex (BA17), as well as frontal, parietal and temporal regions thicknesses were measured in T1-weighted magnetic resonance imaging (MRI), and retinal macular thickness (10 neuroretinal layers) was measured by optical coherence tomography (OCT) imaging. We investigated the statistical association of these measures and their age dependence. We found an age-related decay of primary visual cortical thickness that was significantly correlated with a decrease in global and multiple layer retinal thicknesses. The atrophy of both structures might jointly account for the decline of various visual capacities that accompany the aging process. Furthermore, associations with other cortical regions suggest that retinal status may index cortical integrity in general.
Collapse
Affiliation(s)
- Lília Jorge
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Nádia Canário
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Hugo Quental
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Rui Bernardes
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
16
|
Long M, Wang L, Tian Q, Ding H, Qin W, Shi D, Yu C. Brain white matter changes in asymptomatic carriers of Leber’s hereditary optic neuropathy. J Neurol 2019; 266:1474-1480. [DOI: 10.1007/s00415-019-09284-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/13/2019] [Accepted: 03/15/2019] [Indexed: 10/27/2022]
|
17
|
Adaptation of visual cortex to damage of visual pathways in suprasellar tumors before and after gamma knife radiosurgery. J Neurooncol 2019; 142:275-282. [PMID: 30637609 DOI: 10.1007/s11060-019-03092-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/05/2019] [Indexed: 01/28/2023]
Abstract
PURPOSE To demonstrate that lesions of the visual pathways due to suprasellar tumors are accompanied by alterations of the visual cortex and to see if these alterations are reversible after treatment of tumors by gamma knife radiosurgery. MATERIALS AND METHODS In 36 patients with peri-optic tumors and defects of their visual fields and in an age-matched control group, magnetic resonance imaging was performed before and after treatment. T1 weighted images were evaluated by voxel-based morphometry and correlated to the degree of visual field defects. RESULTS In patients, grey matter density and cortical thickness were reduced in all parts of the occipital cortex, reaching significance (p < 0.05) in the left superior and middle occipital gyri, with correlation to visual field defects. Follow-up scans showed further reduction in all occipital areas. CONCLUSION As in other peripheral lesions of the optic system, damage of the optic pathways affects the visual cortex. A prospective follow-up study is needed to determine if these alterations are reversible after successful tumor treatment.
Collapse
|
18
|
Alves CAPF, Gonçalves FG, Grieb D, Lucato LT, Goldstein AC, Zuccoli G. Neuroimaging of Mitochondrial Cytopathies. Top Magn Reson Imaging 2018; 27:219-240. [PMID: 30086109 DOI: 10.1097/rmr.0000000000000173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Mitochondrial diseases are a complex and heterogeneous group of genetic disorders that occur as a result of either nuclear DNA or mitochondrial DNA pathogenic variants, leading to a decrease in oxidative phosphorylation and cellular energy (ATP) production. Increasing knowledge about molecular, biochemical, and genetic abnormalities related to mitochondrial dysfunction has expanded the neuroimaging phenotypes of mitochondrial disorders. As a consequence of this growing field, the imaging recognition patterns of mitochondrial cytopathies are continually evolving. In this review, we describe the main neuroimaging characteristics of pediatric mitochondrial diseases, ranging from classical to more recent and challenging features. Due to the increased knowledge about the imaging findings of mitochondrial cytopathies, the pediatric neuroradiologist plays a crucial role in the diagnosis and evaluation of these patients.
Collapse
Affiliation(s)
| | | | - Dominik Grieb
- Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Germany
| | - Leandro Tavares Lucato
- Neuroradiology Section, Hospital das Clínicas- HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Amy C Goldstein
- Division of Human Genetics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA
| | - Giulio Zuccoli
- Department of Radiology, University of Pittsburgh School of Medicine, Director of Pediatric Neuroradiology, Children Hospital of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
19
|
Yoshimine S, Ogawa S, Horiguchi H, Terao M, Miyazaki A, Matsumoto K, Tsuneoka H, Nakano T, Masuda Y, Pestilli F. Age-related macular degeneration affects the optic radiation white matter projecting to locations of retinal damage. Brain Struct Funct 2018; 223:3889-3900. [PMID: 29951918 DOI: 10.1007/s00429-018-1702-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 06/17/2018] [Indexed: 12/16/2022]
Abstract
We investigated the impact of age-related macular degeneration (AMD) on visual acuity and the visual white matter. We combined an adaptive cortical atlas and diffusion-weighted magnetic resonance imaging (dMRI) and tractography to separate optic radiation (OR) projections to different retinal eccentricities in human primary visual cortex. We exploited the known anatomical organization of the OR and clinically relevant data to segment the OR into three primary components projecting to fovea, mid- and far-periphery. We measured white matter tissue properties-fractional anisotropy, linearity, planarity, sphericity-along the aforementioned three components of the optic radiation to compare AMD patients and controls. We found differences in white matter properties specific to OR white matter fascicles projecting to primary visual cortex locations corresponding to the location of retinal damage (fovea). Additionally, we show that the magnitude of white matter properties in AMD patients' correlates with visual acuity. In sum, we demonstrate a specific relation between visual loss, anatomical location of retinal damage and white matter damage in AMD patients. Importantly, we demonstrate that these changes are so profound that can be detected using magnetic resonance imaging data with clinical resolution. The conserved mapping between retinal and white matter damage suggests that retinal neurodegeneration might be a primary cause of white matter degeneration in AMD patients. The results highlight the impact of eye disease on brain tissue, a process that may become an important target to monitor during the course of treatment.
Collapse
Affiliation(s)
- Shoyo Yoshimine
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Shumpei Ogawa
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.,Department of Ophthalmology, Atsugi City Hospital, Kanagawa, Japan
| | - Hiroshi Horiguchi
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masahiko Terao
- Research Institute for Time Studies, Yamaguchi University, Yamaguchi, Japan
| | | | - Kenji Matsumoto
- Tamagawa University Brain Science Institute, Machida, Tokyo, Japan
| | - Hiroshi Tsuneoka
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoichiro Masuda
- Department of Ophthalmology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Franco Pestilli
- Department of Psychological and Brain Sciences, Indiana Network Science Institute, Indiana University, Bloomington, IN, 47405, USA. .,Department of Computer Science, Indiana University, Bloomington, USA. .,Department of Intelligent Systems Engineering, Indiana University, Bloomington, USA. .,Program in Neuroscience, Indiana University, Bloomington, USA. .,Program in Cognitive Science, Indiana University, Bloomington, USA. .,School of Optometry, Indiana University, Bloomington, USA.
| |
Collapse
|
20
|
Mutlu U, Ikram MK, Roshchupkin GV, Bonnemaijer PWM, Colijn JM, Vingerling JR, Niessen WJ, Ikram MA, Klaver CCW, Vernooij MW. Thinner retinal layers are associated with changes in the visual pathway: A population-based study. Hum Brain Mapp 2018; 39:4290-4301. [PMID: 29935103 DOI: 10.1002/hbm.24246] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/26/2018] [Accepted: 05/29/2018] [Indexed: 01/23/2023] Open
Abstract
Increasing evidence shows that thinner retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL), assessed on optical coherence tomography (OCT), are reflecting global brain atrophy. Yet, little is known on the relation of these layers with specific brain regions. Using voxel-based analysis, we aimed to unravel specific brain regions associated with these retinal layers. We included 2,235 persons (mean age: 67.3 years, 55% women) from the Rotterdam Study (2007-2012) who had gradable retinal OCT images and brain magnetic resonance imaging (MRI) scans, including diffusion tensor (DT) imaging. Thicknesses of peripapillary RNFL and perimacular GCL were measured using an automated segmentation algorithm. Voxel-based morphometry protocols were applied to process DT-MRI data. We investigated the association between retinal layer thickness with voxel-wise gray matter density and white matter microstructure by performing linear regression models. We found that thinner RNFL and GCL were associated with lower gray matter density in the visual cortex, and with lower fractional anisotropy and higher mean diffusivity in white matter tracts that are part of the optic radiation. Furthermore, thinner GCL was associated with lower gray matter density of the thalamus. Thinner RNFL and GCL are associated with gray and white matter changes in the visual pathway suggesting that retinal thinning on OCT may be specifically associated with changes in the visual pathway rather than with changes in the global brain. These findings may serve as a basis for understanding visual symptoms in elderly patients, patients with Alzheimer's disease, or patients with posterior cortical atrophy.
Collapse
Affiliation(s)
- Unal Mutlu
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Mohammad K Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Gennady V Roshchupkin
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Pieter W M Bonnemaijer
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Johanna M Colijn
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Johannes R Vingerling
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Wiro J Niessen
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Imaging Science and Technology, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands
| | - Mohammad A Ikram
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Caroline C W Klaver
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
| |
Collapse
|
21
|
Lawlor M, Danesh-Meyer H, Levin LA, Davagnanam I, De Vita E, Plant GT. Glaucoma and the brain: Trans-synaptic degeneration, structural change, and implications for neuroprotection. Surv Ophthalmol 2017; 63:296-306. [PMID: 28986311 DOI: 10.1016/j.survophthal.2017.09.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 09/11/2017] [Accepted: 09/22/2017] [Indexed: 01/20/2023]
Abstract
A recent hypothesis to enter the literature suggests that glaucoma is a neurodegenerative disease. The basis for this has been the finding of central nervous system changes in glaucoma patients on histology and neuroimaging. It is known that retinal ganglion cell pathology of any cause leads to anterograde and retrograde retinal ganglion cell degeneration, as well as trans-synaptic (transneuronal) anterograde degeneration. Trans-synaptic degeneration has been demonstrated in a range of optic neuropathies including optic nerve transection, optic neuritis, and hereditary optic neuropathies. More recently, similar changes have been confirmed in glaucoma patients using the neuroimaging techniques of voxel-based morphometry and diffusion tensor imaging. Some studies have reported brain changes in glaucoma outside the retino-geniculo-cortical pathway; however, these are preliminary and exploratory in nature. Further research is required to identify whether the degenerative brain changes in glaucoma are entirely secondary to the optic neuropathy or whether there is additional primary central nervous system pathology. This has critical implications for neuroprotective and regenerative treatment strategies and our basic understanding of glaucoma.
Collapse
Affiliation(s)
- Mitchell Lawlor
- Save Sight Institute, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South Wales, Australia; Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, United Kingdom.
| | - Helen Danesh-Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand; University of Melbourne, Parkville, Victoria, Australia
| | - Leonard A Levin
- Departments of Ophthalmology and Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada; Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Indran Davagnanam
- Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; Academic Neuroradiological Unit, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology, London, United Kingdom; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCL Hospitals Foundation Trust, London, United Kingdom
| | - Enrico De Vita
- Academic Neuroradiological Unit, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology, London, United Kingdom; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, UCL Hospitals Foundation Trust, London, United Kingdom; Department of Biomedical Engineering, King's College London, London, United Kingdom
| | - Gordon T Plant
- Department of Neuro-Ophthalmology, Moorfields Eye Hospital, London, United Kingdom; Department of Neuro-Ophthalmology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; The Medical Eye Unit, St Thomas' Hospital, London, United Kingdom
| |
Collapse
|
22
|
Structure-function correlations in Retinitis Pigmentosa patients with partially preserved vision: a voxel-based morphometry study. Sci Rep 2017; 7:11411. [PMID: 28900214 PMCID: PMC5596003 DOI: 10.1038/s41598-017-11317-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/22/2017] [Indexed: 11/08/2022] Open
Abstract
Retinitis Pigmentosa is a group of hereditary retinal dystrophy disorders associated with progressive peripheral visual field loss. The impact of this retinal loss in cortical gray matter volume has not been addressed before in Retinitis Pigmentosa patients with low vision. Voxel-based morphometry was applied to study whole brain gray matter volume changes in 27 Retinitis Pigmentosa patients with partially preserved vision and 38 age- and gender-matched normally sighted controls to determine whether peripheral visual loss can lead to changes in gray matter volume. We found significant reductions in gray matter volume that were restricted to the occipital cortex of patients. The anteromedial pattern of reduced gray matter volume in visual primary and association cortices was significantly correlated with the extent of the peripheral visual field deficit in this cohort. Moreover, this pattern was found to be associated with the extent of visual field loss. In summary, we found specific visual cortical gray matter loss in Retinitis Pigmentosa patients associated with their visual function profile. The spatial pattern of gray matter loss is consistent with disuse-driven neuronal atrophy which may have clinical implications for disease management, including prosthetic restoration strategies.
Collapse
|
23
|
Ferreira FS, Pereira JMS, Reis A, Sanches M, Duarte JV, Gomes L, Moreno C, Castelo-Branco M. Early visual cortical structural changes in diabetic patients without diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 2017; 255:2113-2118. [PMID: 28779362 DOI: 10.1007/s00417-017-3752-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/25/2017] [Accepted: 07/10/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND It is known that diabetic patients have changes in cortical morphometry as compared to controls, but it remains to be clarified whether the visual cortex is a disease target, even when diabetes complications such as retinopathy are absent. Therefore, we compared type 2 diabetes patients without diabetic retinopathy with control subjects using magnetic resonance imaging to assess visual cortical changes when retinal damage is not yet present. METHODS We performed T1-weighted imaging in 24 type 2 diabetes patients without diabetic retinopathy and 27 age- and gender-matched controls to compare gray matter changes in the occipital cortex between groups using voxel based morphometry. RESULTS Patients without diabetic retinopathy showed reduced gray matter volume in the occipital lobe when compared with controls. CONCLUSIONS Reduced gray matter volume in the occipital cortex was found in diabetic patients without retinal damage. We conclude that cortical early visual processing regions may be affected in diabetic patients even before retinal damage occurs.
Collapse
Affiliation(s)
- Fábio S Ferreira
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal
| | - João M S Pereira
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal
- Laboratory of Biostatistics and Medical Informatics, Institute for Biomedical Imaging in Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal
| | - Aldina Reis
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal
| | - Mafalda Sanches
- CiBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal
| | - João V Duarte
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal
- CiBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal
| | - Leonor Gomes
- Department of Endocrinology, Coimbra Hospital and Universitary Centre (CHUC), Coimbra, Portugal
| | - Carolina Moreno
- Department of Endocrinology, Coimbra Hospital and Universitary Centre (CHUC), Coimbra, Portugal
| | - Miguel Castelo-Branco
- Institute for Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal.
- Laboratory of Biostatistics and Medical Informatics, Institute for Biomedical Imaging in Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal.
- CiBIT, Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Azinhaga Santa Comba, Celas, 3000-548, Coimbra, Portugal.
| |
Collapse
|
24
|
Quantitative assessment of optic nerve in patients with Leber’s hereditary optic neuropathy using reduced field-of-view diffusion tensor imaging. Eur J Radiol 2017; 93:24-29. [DOI: 10.1016/j.ejrad.2017.05.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/21/2017] [Indexed: 11/22/2022]
|
25
|
Bryukhov VV, Krotenkova IA, Morozova SN, Krotenkova MV. [A current view on the MRI diagnosis of multiple sclerosis: an update of 2016 revised MRI criteria]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:66-73. [PMID: 28617364 DOI: 10.17116/jnevro20171172266-73] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Magnetic resonance imaging (MRI) is the primary method for confirming the clinical diagnosis of multiple sclerosis (MS). The article presents the current data on using MRI of the brain and spinal cord for diagnosis in suspected MS. Special attention is paid to the MRI criteria of McDonald and MAGNIMS for relapsing-remitting MS (RRMS) and primary-progressive MS (PPMS) in the latest revisions of 2010 and 2016. The information provided can help radiologists and neurologists to optimize the use of MRI in clinical practice for diagnosis of MS.
Collapse
|
26
|
Identification and functional characterization of a novel MTFMT mutation associated with selective vulnerability of the visual pathway and a mild neurological phenotype. Neurogenetics 2017; 18:97-103. [PMID: 28058511 DOI: 10.1007/s10048-016-0506-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/18/2016] [Indexed: 10/20/2022]
Abstract
Mitochondrial protein synthesis is initiated by formylated tRNA-methionine, which requires the activity of MTFMT, a methionyl-tRNA formyltransferase. Mutations in MTFMT have been associated with Leigh syndrome, early-onset mitochondrial leukoencephalopathy, microcephaly, ataxia, and cardiomyopathy. We identified compound heterozygous MTFMT mutations in a patient with a mild neurological phenotype and late-onset progressive visual impairment. MRI studies documented a progressive and selective involvement of the retrochiasmatic visual pathway. MTFMT was undetectable by immunoblot analysis of patient fibroblasts, resulting in specific defects in mitochondrial protein synthesis and assembly of the oxidative phosphorylation complexes. This report expands the clinical and MRI phenotypes associated with MTFMT mutations, illustrating the complexity of genotype-phenotype relationships in mitochondrial translation disorders.
Collapse
|
27
|
A neurodegenerative perspective on mitochondrial optic neuropathies. Acta Neuropathol 2016; 132:789-806. [PMID: 27696015 PMCID: PMC5106504 DOI: 10.1007/s00401-016-1625-2] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 09/24/2016] [Accepted: 09/25/2016] [Indexed: 12/15/2022]
Abstract
Mitochondrial optic neuropathies constitute an important cause of chronic visual morbidity and registrable blindness in both the paediatric and adult population. It is a genetically heterogeneous group of disorders caused by both mitochondrial DNA (mtDNA) mutations and a growing list of nuclear genetic defects that invariably affect a critical component of the mitochondrial machinery. The two classical paradigms are Leber hereditary optic neuropathy (LHON), which is a primary mtDNA disorder, and autosomal dominant optic atrophy (DOA) secondary to pathogenic mutations within the nuclear gene OPA1 that encodes for a mitochondrial inner membrane protein. The defining neuropathological feature is the preferential loss of retinal ganglion cells (RGCs) within the inner retina but, rather strikingly, the smaller calibre RGCs that constitute the papillomacular bundle are particularly vulnerable, whereas melanopsin-containing RGCs are relatively spared. Although the majority of patients with LHON and DOA will present with isolated optic nerve involvement, some individuals will also develop additional neurological complications pointing towards a greater vulnerability of the central nervous system (CNS) in susceptible mutation carriers. These so-called “plus” phenotypes are mechanistically important as they put the loss of RGCs within the broader perspective of neuronal loss and mitochondrial dysfunction, highlighting common pathways that could be modulated to halt progressive neurodegeneration in other related CNS disorders. The management of patients with mitochondrial optic neuropathies still remains largely supportive, but the development of effective disease-modifying treatments is now within tantalising reach helped by major advances in drug discovery and delivery, and targeted genetic manipulation.
Collapse
|
28
|
Jančić J, Dejanović I, Radovanović S, Ostojić J, Kozić D, Đurić-Jovičić M, Samardžić J, Ćetković M, Kostić V. White Matter Changes in Two Leber's Hereditary Optic Neuropathy Pedigrees: 12-Year Follow-Up. Ophthalmologica 2015; 235:49-56. [DOI: 10.1159/000441089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/14/2015] [Indexed: 11/19/2022]
Abstract
We are presenting two Leber's hereditary optic neuropathy (LHON) pedigrees with abnormal magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (H-MRS) findings but without neurological manifestation associated with LHON. The study included 14 LHON patients and 41 asymptomatic family members from 12 genealogically unrelated families. MRI showed white matter involvement and H-MRS exhibited metabolic anomalies within 12 LHON families. Main outcome measures were abnormal MRI and H-MRS findings in two pedigrees. MRI of the proband of the first pedigree showed a single demyelinating lesion in the right cerebellar hemisphere, while the proband of the second family displayed multiple supratentorial and infratentorial lesions, compatible with the demyelinating process, and both the absolute choline (Cho) concentration and Cho/creatinine ratio were increased. MRI and H-MRS profiles of both affected and unaffected mitochondrial DNA mutation carriers suggest more widespread central nervous involvement in LHON. Although even after 12 years our patients did not develop neurological symptoms, MRI could still be used to detect possible changes during the disease progression.
Collapse
|
29
|
Zhang P, Wen W, Sun X, He S. Selective reduction of fMRI responses to transient achromatic stimuli in the magnocellular layers of the LGN and the superficial layer of the SC of early glaucoma patients. Hum Brain Mapp 2015; 37:558-69. [PMID: 26526339 DOI: 10.1002/hbm.23049] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/24/2015] [Indexed: 11/07/2022] Open
Abstract
Glaucoma is now viewed not just a disease of the eye but also a disease of the brain. The prognosis of glaucoma critically depends on how early the disease can be detected. However, early glaucomatous loss of the laminar functions in the human lateral geniculate nucleus (LGN) and superior colliculus (SC) remains difficult to detect and poorly understood. Using functional MRI, we measured neural signals from different layers of the LGN and SC, as well as from the early visual cortices (V1, V2 and MT), in patients with early-stage glaucoma and normal controls. Compared to normal controls, early glaucoma patients showed more reduction of response to transient achromatic stimuli than to sustained chromatic stimuli in the magnocellular layers of the LGN, as well as in the superficial layer of the SC. Magnocellular responses in the LGN were also significantly correlated with the degree of behavioral deficits to the glaucomatous eye. Finally, early glaucoma patients showed no reduction of fMRI response in the early visual cortex. These findings demonstrate that 'large cells' in the human LGN and SC suffer selective loss of response to transient achromatic stimuli at the early stage of glaucoma. Hum Brain Mapp 37:558-569, 2016. © 2015 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Peng Zhang
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Wen Wen
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Sheng He
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| |
Collapse
|
30
|
Rovira À, Wattjes MP, Tintoré M, Tur C, Yousry TA, Sormani MP, De Stefano N, Filippi M, Auger C, Rocca MA, Barkhof F, Fazekas F, Kappos L, Polman C, Miller D, Montalban X. Evidence-based guidelines: MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis-clinical implementation in the diagnostic process. Nat Rev Neurol 2015; 11:471-82. [PMID: 26149978 DOI: 10.1038/nrneurol.2015.106] [Citation(s) in RCA: 305] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal experience of the members of the MAGNIMS (Magnetic Resonance Imaging in MS) network. We address the indications, timing, coverage, reporting and interpretation of MRI studies in patients with suspected MS. Our recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.
Collapse
Affiliation(s)
- Àlex Rovira
- Magnetic Resonance Unit, Cemcat, Hospital Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Mike P Wattjes
- MS Centre Amsterdam, VU University Medical Centre, Netherlands
| | - Mar Tintoré
- Neurology/Neuroimmunology Unit, Cemcat, Hospital Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Carmen Tur
- Neurology/Neuroimmunology Unit, Cemcat, Hospital Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Tarek A Yousry
- Lysholm Department of Neuroradiology, UCLH National Hospital for Neurology and Neurosurgery, University College London Institute of Neurology, UK
| | - Maria P Sormani
- Biostatistics Unit, Department of Health Sciences, University of Genoa, Italy
| | - Nicola De Stefano
- Department of Neurological and Behavioural Sciences, University of Siena, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy
| | - Cristina Auger
- Magnetic Resonance Unit, Cemcat, Hospital Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy
| | | | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Austria
| | - Ludwig Kappos
- Department of Neurology, University of Basel, Switzerland
| | - Chris Polman
- MS Centre Amsterdam, VU University Medical Centre, Netherlands
| | - David Miller
- NMR Research Unit, Queen Square MS Centre, University College London Institute of Neurology, UK
| | - Xavier Montalban
- Magnetic Resonance Unit, Cemcat, Hospital Vall d'Hebron, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
| | | |
Collapse
|
31
|
Pilat A, Sibley D, McLean RJ, Proudlock FA, Gottlob I. High-Resolution Imaging of the Optic Nerve and Retina in Optic Nerve Hypoplasia. Ophthalmology 2015; 122:1330-9. [PMID: 25939636 PMCID: PMC4518044 DOI: 10.1016/j.ophtha.2015.03.020] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To investigate the optic nerve and macular morphology in patients with optic nerve hypoplasia (ONH) using spectral-domain optical coherence tomography (SD OCT). DESIGN Prospective, cross-sectional, observational study. SUBJECTS A total of 16 participants with ONH (10 female and 6 male; mean age, 17.2 years; 6 bilateral involvement) and 32 gender-, age-, ethnicity-, and refraction-matched healthy controls. METHODS High-resolution SD OCT (Copernicus [Optopol Technology S.A., Zawiercie, Poland], 3 μm resolution) and handheld SD OCT (Bioptigen Inc [Research Triangle Park, NC], 2.6 μm resolution) devices were used to acquire horizontal scans through the center of the optic disc and macula. MAIN OUTCOME MEASURES Horizontal optic disc/cup and rim diameters, cup depth, peripapillary retinal nerve fiber layer (RNFL), and thickness of individual retinal layers in participants with ONH and in controls. RESULTS Patients with ONH had significantly smaller discs (P < 0.03 and P < 0.001 compared with unaffected eye and healthy controls, respectively), horizontal cup diameter (P < 0.02 for both), and cup depth (P < 0.02 and P < 0.01, respectively). In the macula, significantly thinner RNFL (nasally), ganglion cell layer (GCL) (nasally and temporally), inner plexiform layer (IPL) (nasally), outer nuclear layer (ONL) (nasally), and inner segment (centrally and temporally) were found in patients with ONH compared with the control group (P < 0.05 for all comparisons). Continuation of significantly thicker GCL, IPL, and outer plexiform layer in the central retinal area (i.e., foveal hypoplasia) was found in more than 80% of patients with ONH. Clinically unaffected fellow eyes of patients with ONH showed mild features of underdevelopment. Visual acuity and presence of septo-optic dysplasia were associated with changes in GCL and IPL. Sensitivity and specificity for the detection of ONH based on disc and retinal optical coherence tomography (OCT) parameters were >80%. CONCLUSIONS Our study provides evidence of retinal changes in ONH. In addition to thinning of retina layers mainly involving the RNFL and GCL, signs reminiscent of foveal hypoplasia were observed in patients with ONH. Optic nerve and foveal parameters measured using OCT showed high sensitivity and specificity for detecting ONH, demonstrating their useful for clinical diagnosis.
Collapse
Key Words
- gcl, ganglion cell layer
- inl, inner nuclear layer
- ipl, inner plexiform layer
- is, inner segment
- logmar, logarithm of the minimum angle of resolution
- oct, optical coherence tomography
- onh, optic nerve hypoplasia
- onhd, optic nerve head drusen
- opl, outer plexiform layer
- os, outer segment
- rnfl, retinal nerve fiber layer
- rpe, retinal pigment epithelium
- sd oct, spectral-domain optical coherence tomography
- sod, septo-optic-dysplasia
Collapse
Affiliation(s)
- Anastasia Pilat
- Ophthalmology Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Daniel Sibley
- Ophthalmology Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Rebecca J McLean
- Ophthalmology Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Frank A Proudlock
- Ophthalmology Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom
| | - Irene Gottlob
- Ophthalmology Group, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, United Kingdom.
| |
Collapse
|
32
|
Distributed abnormalities of brain white matter architecture in patients with dominant optic atrophy and OPA1 mutations. J Neurol 2015; 262:1216-27. [DOI: 10.1007/s00415-015-7696-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 01/08/2023]
|
33
|
Manners DN, Rizzo G, La Morgia C, Tonon C, Testa C, Barboni P, Malucelli E, Valentino ML, Caporali L, Strobbe D, Carelli V, Lodi R. Diffusion Tensor Imaging Mapping of Brain White Matter Pathology in Mitochondrial Optic Neuropathies. AJNR Am J Neuroradiol 2015; 36:1259-65. [PMID: 25792533 DOI: 10.3174/ajnr.a4272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/05/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE Brain white matter is frequently affected in mitochondrial diseases; optic atrophy gene 1-autosomal dominant optic atrophy and Leber hereditary optic neuropathy are the most frequent mitochondrial monosymptomatic optic neuropathies. In this observational study, brain white matter microstructure was characterized by DTI in patients with optic atrophy gene 1-autosomal dominant optic atrophy and Leber hereditary optic neuropathy, in relation to clinical and genetic features. MATERIALS AND METHODS Nineteen patients with optic atrophy gene 1-autosomal dominant optic atrophy and 17 with Leber hereditary optic neuropathy older than 18 years of age, all genetically diagnosed, and 19 healthy volunteers underwent DTI by using a 1.5T MR imaging scanner and neurologic and ophthalmologic assessments. Brain white matter DTI metrics were calculated for all participants, and, in patients, their correlations with genetics and clinical findings were calculated. RESULTS Compared with controls, patients with optic atrophy gene 1-autosomal dominant optic atrophy had an increased mean diffusivity in 29.2% of voxels analyzed within major white matter tracts distributed throughout the brain, while fractional anisotropy was reduced in 30.3% of voxels. For patients with Leber hereditary optic neuropathy, the proportion of altered voxels was only 0.5% and 5.5%, respectively, of which half was found within the optic radiation and 3.5%, in the smaller acoustic radiation. In almost all regions, fractional anisotropy diminished with age in patients with optic atrophy gene 1-autosomal dominant optic atrophy and correlated with average retinal nerve fiber layer thickness in several areas. Mean diffusivity increased in those with a missense mutation. Patients with Leber hereditary optic neuropathy taking idebenone had slightly milder changes. CONCLUSIONS Patients with Leber hereditary optic neuropathy had preferential involvement of the optic and acoustic radiations, consistent with trans-synaptic degeneration, whereas patients with optic atrophy gene 1-autosomal dominant optic atrophy presented with widespread involvement suggestive of a multisystemic, possibly a congenital/developmental, disorder. White matter changes in Leber hereditary optic neuropathy and optic atrophy gene 1-autosomal dominant optic atrophy may be exploitable as biomarkers.
Collapse
Affiliation(s)
- D N Manners
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
| | - G Rizzo
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.) Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences
| | - C La Morgia
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - C Tonon
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
| | - C Testa
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
| | - P Barboni
- Studio Oculistico d'Azeglio (P.B.), Bologna, Italy
| | - E Malucelli
- Department of Pharmacy and Biotechnology (E.M.), University of Bologna, Bologna, Italy
| | - M L Valentino
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - L Caporali
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - D Strobbe
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - V Carelli
- Neurology Unit (G.R., C.L.M., M.L.V., L.C., D.S., V.C.), Department of Biomedical and NeuroMotor Sciences "Istituto di Ricovero e Cura a Carattere Scientifico Istituto delle Scienze Neurologiche di Bologna" (C.L.M., M.L.V., L.C., D.S., V.C.), Bologna, Italy
| | - R Lodi
- From the Functional MR Unit (D.N.M., G.R., C.Tonon, C.Testa, R.L.)
| |
Collapse
|
34
|
Genetically induced impairment of retinal ganglion cells at the axonal level is linked to extrastriate cortical plasticity. Brain Struct Funct 2015; 221:1767-80. [PMID: 25680704 DOI: 10.1007/s00429-015-1002-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 02/04/2015] [Indexed: 10/24/2022]
Abstract
Leber hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disorder, which leads to initially silent visual loss due to retinal ganglion cell (RGC) degeneration. We aimed to establish a link between features of retinal progressive impairment and putative cortical changes in a cohort of 15 asymptomatic patients harboring the 11778G>A mutation with preserved visual acuity and normal ocular examination. To study plasticity evoked by clinically silent degeneration of RGC we only studied mutation carriers. We phenotyped pre-clinical silent degeneration from the psychophysical, neurophysiological and structural points of view to understand whether retinal measures could be related to cortical reorganization, using pattern electrophysiology, chromatic contrast sensitivity and high-resolution optical coherence tomography to measure macular, RGC nerve fiber layer as well as inner/outer retinal layer thickness. We then performed correlation analysis of these measures with cortical thickness estimates in functionally mapped retinotopic visual cortex. We found that compensatory cortical plasticity occurring in V2/V3 is predicted by the swelling (indicating deficits of axonal transport and intracellular edema) of the macular RGC axonal layer. Increased cortical thickness (CT) in V2 and V3 was observed in peripheral regions, like visual field loss, in these mutation carriers. CT was a very discriminative measure between carriers and controls, as revealed by ROC analysis. Importantly, the substantial cortical reorganization that occurs in the carrier state can be used to provide statistical discrimination between carriers and controls to a level that is similar to measures of retinal dysfunction. We conclude that peripheral cortical compensatory plasticity in early visual areas V2/V3 may be triggered by pathology in peripheral RGC axons in combination with potential developmental changes.
Collapse
|
35
|
Nucci C, Martucci A, Cesareo M, Garaci F, Morrone LA, Russo R, Corasaniti MT, Bagetta G, Mancino R. Links among glaucoma, neurodegenerative, and vascular diseases of the central nervous system. PROGRESS IN BRAIN RESEARCH 2015; 221:49-65. [DOI: 10.1016/bs.pbr.2015.04.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
36
|
Ogawa S, Takemura H, Horiguchi H, Terao M, Haji T, Pestilli F, Yeatman JD, Tsuneoka H, Wandell BA, Masuda Y. White matter consequences of retinal receptor and ganglion cell damage. Invest Ophthalmol Vis Sci 2014; 55:6976-86. [PMID: 25257055 DOI: 10.1167/iovs.14-14737] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Patients with Leber hereditary optic neuropathy (LHON) and cone-rod dystrophy (CRD) have central vision loss; but CRD damages the retinal photoreceptor layer, and LHON damages the retinal ganglion cell (RGC) layer. Using diffusion MRI, we measured how these two types of retinal damage affect the optic tract (ganglion cell axons) and optic radiation (geniculo-striate axons). METHODS Adult onset CRD (n = 5), LHON (n = 6), and healthy controls (n = 14) participated in the study. We used probabilistic fiber tractography to identify the optic tract and the optic radiation. We compared axial and radial diffusivity at many positions along the optic tract and the optic radiation. RESULTS In both types of patients, diffusion measures within the optic tract and the optic radiation differ from controls. The optic tract change is principally a decrease in axial diffusivity; the optic radiation change is principally an increase in radial diffusivity. CONCLUSIONS Both photoreceptor layer (CRD) and retinal ganglion cell (LHON) retinal disease causes substantial change in the visual white matter. These changes can be measured using diffusion MRI. The diffusion changes measured in the optic tract and the optic radiation differ, suggesting that they are caused by different biological mechanisms.
Collapse
Affiliation(s)
- Shumpei Ogawa
- Department of Psychology, Stanford University, Stanford, California, United States Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromasa Takemura
- Department of Psychology, Stanford University, Stanford, California, United States Department of Psychology, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Horiguchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Masahiko Terao
- Department of Psychology, The University of Tokyo, Tokyo, Japan Tamagawa University Brain Science Institute, Machida, Japan
| | - Tomoki Haji
- Department of Ophthalmology, Atsugi City Hospital, Kanagawa, Japan
| | - Franco Pestilli
- Department of Psychology, Stanford University, Stanford, California, United States
| | - Jason D Yeatman
- Department of Psychology, Stanford University, Stanford, California, United States
| | - Hiroshi Tsuneoka
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Brian A Wandell
- Department of Psychology, Stanford University, Stanford, California, United States
| | - Yoichiro Masuda
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan The Japan Society for the Promotion of Science, Tokyo, Japan
| |
Collapse
|
37
|
Mitochondrial dysfunction affecting visual pathways. Rev Neurol (Paris) 2014; 170:344-54. [DOI: 10.1016/j.neurol.2014.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/08/2014] [Accepted: 03/26/2014] [Indexed: 01/08/2023]
|
38
|
Zhang Y, Huang H, Wei S, Qiu H, Gong Y, Li H, Dai Y, Jiang Z, Liu Z. Characterization of retinal nerve fiber layer thickness changes associated with Leber's hereditary optic neuropathy by optical coherence tomography. Exp Ther Med 2013; 7:483-487. [PMID: 24396430 PMCID: PMC3881063 DOI: 10.3892/etm.2013.1430] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 11/12/2013] [Indexed: 01/01/2023] Open
Abstract
In the present study, the changes in the retinal nerve fiber layer (RNFL) thickness associated with Leber’s hereditary optic neuropathy (LHON) were examined by Cirrus high definition-optical coherence tomography (OCT), and the correlation between the RNFL thickness and the best corrected visual acuity (BCVA) was evaluated. A cross-sectional study was performed. Sixty-eight eyes from patients with LHON and 30 eyes from healthy individuals were scanned. Affected eyes were divided into 5 groups according to disease duration: Group 1, ≤3 months; group 2, 4–6 months; group 3, 7–9 months; group 4, 10–12 months; and group 5, >12 months. The RNFL thickness of the temporal, superior, nasal and inferior quadrants and the 360° average were compared between the LHON groups and the control group. The eyes in groups 1 and 2 were observed to have a thicker RNFL in the superior, nasal and inferior quadrants and a higher 360°-average RNFL thickness compared with those of the control group (P<0.05), the RNFL was observed to be thinner in the temporal quadrant in groups 1 and 2. The eyes in groups 3 and 4 showed a thinner RNFL in the temporal (P=0.001), superior and inferior (both P<0.05) quadrants, and a lower 360°-average RNFL thickness as compared with controls (P=0.001). No significant correlation was identified between BCVA and RNFL thickness. RNFL thickness was observed to undergo a unique process from thickening to thinning in the patients with LHON. Changes in different quadrants occurred at different time periods and the BCVA was not found to be correlated with RNFL thickness.
Collapse
Affiliation(s)
- Yixin Zhang
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Houbin Huang
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Shihui Wei
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Huaiyu Qiu
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Yan Gong
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Hongyang Li
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Yanli Dai
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Zhaocai Jiang
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Zihao Liu
- Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| |
Collapse
|
39
|
d'Almeida OC, Mateus C, Reis A, Grazina MM, Castelo-Branco M. Long term cortical plasticity in visual retinotopic areas in humans with silent retinal ganglion cell loss. Neuroimage 2013; 81:222-230. [DOI: 10.1016/j.neuroimage.2013.05.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 04/27/2013] [Accepted: 05/05/2013] [Indexed: 01/29/2023] Open
|
40
|
Rocca MA, Mesaros S, Preziosa P, Pagani E, Stosic-Opincal T, Dujmovic-Basuroski I, Drulovic J, Filippi M. Wallerian and trans-synaptic degeneration contribute to optic radiation damage in multiple sclerosis: a diffusion tensor MRI study. Mult Scler 2013; 19:1610-7. [DOI: 10.1177/1352458513485146] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Optic radiation (OR) damage occurs in multiple sclerosis (MS). Objectives: The purpose of this study was to explore the contribution of local and distant mechanisms associated with OR damage in MS. Methods: Diffusion tensor (DT) magnetic resonance imaging (MRI) tractography probability maps of the ORs were derived from 102 MS patients and 11 controls. Between-group differences of OR normal-appearing white matter (NAWM) damage and topographical distribution of OR damage were assessed using quantitative and voxel-wise analyses, considering the influence of previous optic neuritis (ON+) and T2 OR lesions (T2 OR+). Results: OR NAWM diffusivity abnormalities were more severe in ON+ patients vs patients without previous optic neuritis (ON–) and T2 OR+ vs T2 OR– patients. Damage to the anterior portions of the ORs was more severe in ON+ vs ON– patients. Compared to controls and T2 OR– patients, T2 OR+ patients experienced a more distributed pattern of DT MRI abnormalities along the ORs, with an increased axial diffusivity limited to the anterior portions of the ORs. In T2 OR+ group, ON+ vs ON– patients showed DT MRI abnormalities in the middle portion of the ORs, in correspondence with focal lesions. OR damage correlated with OR T2 lesion volume, visual dysfunction and optic nerve atrophy. Conclusions: Both trans-synaptic degeneration secondary to optic nerve damage and Wallerian degeneration due to local T2 lesions contribute to OR damage in MS.
Collapse
Affiliation(s)
- Maria A Rocca
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
- Department of Neurology, Vita-Salute San Raffaele University, Italy
| | - Sarlota Mesaros
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Serbia
| | - Paolo Preziosa
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
- Department of Neurology, Vita-Salute San Raffaele University, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
| | | | | | - Jelena Drulovic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Serbia
| | - Massimo Filippi
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
- Department of Neurology, Vita-Salute San Raffaele University, Italy
| |
Collapse
|
41
|
Secondary post-geniculate involvement in Leber's hereditary optic neuropathy. PLoS One 2012; 7:e50230. [PMID: 23209682 PMCID: PMC3507727 DOI: 10.1371/journal.pone.0050230] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 10/22/2012] [Indexed: 11/19/2022] Open
Abstract
Leber’s hereditary optic neuropathy (LHON) is characterized by retinal ganglion cell (RGC) degeneration with the preferential involvement of those forming the papillomacular bundle. The optic nerve is considered the main pathological target for LHON. Our aim was to investigate the possible involvement of the post-geniculate visual pathway in LHON patients. We used diffusion-weighted imaging for in vivo evaluation. Mean diffusivity maps from 22 LHON visually impaired, 11 unaffected LHON mutation carriers and 22 healthy subjects were generated and compared at level of optic radiation (OR). Prefrontal and cerebellar white matter were also analyzed as internal controls. Furthermore, we studied the optic nerve and the lateral geniculate nucleus (LGN) in post-mortem specimens obtained from a severe case of LHON compared to an age-matched control. Mean diffusivity values of affected patients were higher than unaffected mutation carriers (P<0.05) and healthy subjects (P<0.01) in OR and not in the other brain regions. Increased OR diffusivity was associated with both disease duration (B = 0.002; P<0.05) and lack of recovery of visual acuity (B = 0.060; P<0.01). Post-mortem investigation detected atrophy (41.9% decrease of neuron soma size in the magnocellular layers and 44.7% decrease in the parvocellular layers) and, to a lesser extent, degeneration (28.5% decrease of neuron density in the magnocellular layers and 28.7% decrease in the parvocellular layers) in the LHON LGN associated with extremely severe axonal loss (99%) in the optic nerve. The post-geniculate involvement in LHON patients is a downstream post-synaptic secondary phenomenon, reflecting de-afferentation rather than a primary neurodegeneration due to mitochondrial dysfunction of LGN neurons.
Collapse
|
42
|
Idebenone protects against retinal damage and loss of vision in a mouse model of Leber's hereditary optic neuropathy. PLoS One 2012; 7:e45182. [PMID: 23028832 PMCID: PMC3445472 DOI: 10.1371/journal.pone.0045182] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 08/14/2012] [Indexed: 11/24/2022] Open
Abstract
Leber’s hereditary optic neuropathy (LHON) is an inherited disease caused by mutations in complex I of the mitochondrial respiratory chain. The disease is characterized by loss of central vision due to retinal ganglion cell (RGC) dysfunction and optic nerve atrophy. Despite progress towards a better understanding of the disease, no therapeutic treatment is currently approved for this devastating disease. Idebenone, a short-chain benzoquinone, has shown promising evidence of efficacy in protecting vision loss and in accelerating recovery of visual acuity in patients with LHON. It was therefore of interest to study suitable LHON models in vitro and in vivo to identify anatomical correlates for this protective activity. At nanomolar concentrations, idebenone protected the rodent RGC cell line RGC-5 against complex I dysfunction in vitro. Consistent with the reported dosing and observed effects in LHON patients, we describe that in mice, idebenone penetrated into the eye at concentrations equivalent to those which protected RGC-5 cells from complex I dysfunction in vitro. Consequently, we next investigated the protective effect of idebenone in a mouse model of LHON, whereby mitochondrial complex I dysfunction was caused by exposure to rotenone. In this model, idebenone protected against the loss of retinal ganglion cells, reduction in retinal thickness and gliosis. Furthermore, consistent with this protection of retinal integrity, idebenone restored the functional loss of vision in this disease model. These results support the pharmacological activity of idebenone and indicate that idebenone holds potential as an effective treatment for vision loss in LHON patients.
Collapse
|
43
|
Finsterer J, Zarrouk Mahjoub S. Leukoencephalopathies in Mitochondrial Disorders: Clinical and MRI Findings. J Neuroimaging 2012; 22:e1-11. [DOI: 10.1111/j.1552-6569.2011.00693.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
|
44
|
Milesi J, Rocca MA, Bianchi-Marzoli S, Petrolini M, Pagani E, Falini A, Comi G, Filippi M. Patterns of white matter diffusivity abnormalities in Leber’s hereditary optic neuropathy: a tract-based spatial statistics study. J Neurol 2012; 259:1801-7. [PMID: 22249289 DOI: 10.1007/s00415-011-6406-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 12/21/2011] [Accepted: 12/28/2011] [Indexed: 11/25/2022]
Affiliation(s)
- Jacopo Milesi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Abstract
A previously healthy 34-year-old man sustained multiple skull fractures in a traffic accident. Radiological findings and visual field examination did not detect any abnormality. Shortly after the accident, he noticed blurred vision in both eyes. Six months after the accident, he gradually developed disturbance of visual acuity in the right eye. His best corrected visual acuity (BCVA) was 0.8 OD and 1.2 OS and brain MRI did not show any abnormality, while Humphrey visual field analysis demonstrated right homonymous hemianopsia. Two months after the initial presentation, his BCVA showed 0.1 OD and 0.08 OS. Visual field examination suggested that both right homonymous hemianopsia and left blind spot had become enlarged. Mitochondrial DNA analysis demonstrated G11,778A mutation and a diagnosis of Leber's hereditary optic neuropathy (LHON) was made. A few reports have documented mild acute insult to the head or blunt optic trauma as triggers of optic neuropathy in subjects with LHON. Although, the precise mechanism of LHON following trauma remains unknown, it appears that an acute insult may be sufficient to precipitate neuropathy in the optic nerve already compromised by mitochondrial dysfunction. Asymptomatic carriers should be advised to avoid possible precipitating factors such as head trauma.
Collapse
Affiliation(s)
- Shintaro Hayashi
- Department of Neurology, Gunma University Graduate School of Medicine
| | | |
Collapse
|
46
|
Extra-visual functional and structural connection abnormalities in Leber's hereditary optic neuropathy. PLoS One 2011; 6:e17081. [PMID: 21347331 PMCID: PMC3037402 DOI: 10.1371/journal.pone.0017081] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 01/21/2011] [Indexed: 11/19/2022] Open
Abstract
We assessed abnormalities within the principal brain resting state networks (RSNs) in patients with Leber's hereditary optic neuropathy (LHON) to define whether functional abnormalities in this disease are limited to the visual system or, conversely, tend to be more diffuse. We also defined the structural substrates of fMRI changes using a connectivity-based analysis of diffusion tensor (DT) MRI data. Neuro-ophthalmologic assessment, DT MRI and RS fMRI data were acquired from 13 LHON patients and 13 healthy controls. RS fMRI data were analyzed using independent component analysis and SPM5. A DT MRI connectivity-based parcellation analysis was performed using the primary visual and auditory cortices, bilaterally, as seed regions. Compared to controls, LHON patients had a significant increase of RS fluctuations in the primary visual and auditory cortices, bilaterally. They also showed decreased RS fluctuations in the right lateral occipital cortex and right temporal occipital fusiform cortex. Abnormalities of RS fluctuations were correlated significantly with retinal damage and disease duration. The DT MRI connectivity-based parcellation identified a higher number of clusters in the right auditory cortex in LHON vs. controls. Differences of cluster-centroid profiles were found between the two groups for all the four seeds analyzed. For three of these areas, a correspondence was found between abnormalities of functional and structural connectivities. These results suggest that functional and structural abnormalities extend beyond the visual network in LHON patients. Such abnormalities also involve the auditory network, thus corroborating the notion of a cross-modal plasticity between these sensory modalities in patients with severe visual deficits.
Collapse
|