Multiexponential T2, magnetization transfer, and quantitative histology in white matter tracts of rat spinal cord

Testing quantitative magnetization transfer models with membrane lipids

PURPOSE

Quantitative magnetization transfer (qMT) models aim to quantify the contributions of lipids and macromolecules to the MRI signal. Hence, a model system that relates qMT parameters and their molecular sources may improve the interpretation of the qMT parameters. Here we used membrane lipid phantoms as a meaningful tool to study qMT models. By controlling the fraction and type of membrane lipids, we could test the accuracy, reliability, and interpretability of different qMT models.

METHODS

We formulated liposomes with various lipid types and water-to-lipids fractions and measured their signals with spoiled gradient-echo MT. We fitted three known qMT models and estimated six parameters for every model. We tested the accuracy and reproducibility of the models and compared the dependency among the qMT parameters. We compared the samples' qMT parameters with their water-to-lipid fractions and with a simple MTnorm (= MTon/MToff) calculation.

RESULTS

We found that the three qMT models fit the membrane lipids signals well. We also found that the estimated qMT parameters are highly interdependent. Interestingly, the estimated qMT parameters are a function of the membrane lipid type and also highly related to the water-to-lipid fraction. Finally, we find that most of the lipid sample's information can be captured using the common and easy to estimate MTnorm analysis.

CONCLUSION

qMT parameters are sensitive to both the water-to-lipid fraction and to the lipid type. Estimating the water-to-lipid fraction can improve the characterization of membrane lipids' contributions to qMT parameters. Similar characterizations can be obtained using the MTnorm analysis.

Multimodal imaging with magnetization transfer and diffusion tensor imaging reveals evidence of myelin damage in children and youth treated for a brain tumor

Background

The microstructural damage underlying compromise of white matter following treatment for pediatric brain tumors is unclear. We use multimodal imaging employing advanced diffusion tensor imaging (DTI) and magnetization transfer imaging (MTI) MRI methods to examine chronic microstructural damage to white matter in children and adolescents treated for pediatric brain tumor. Notably, MTI may be more sensitive to macromolecular content, including myelin, than DTI.

Methods

Fifty patients treated for brain tumors (18 treated with surgery ± chemotherapy and 32 treated with surgery followed by cranial-spinal radiation; time from diagnosis to scan ~6 years) and 45 matched healthy children completed both MTI and DTI scans. Voxelwise and region-of-interest approaches were employed to compare white matter microstructure metrics (magnetization transfer ratio (MTR); DTI- fractional anisotropy [FA], radial diffusivity [RD], axial diffusivity [AD], mean diffusivity [MD]) between patients and healthy controls.

Results

MTR was decreased across multiple white matter tracts in patients when compared to healthy children, P < .001. These differences were observed for both patients treated with radiation and those treated with only surgery, P < .001. We also found that children and adolescents treated for brain tumors exhibit decreased FA and increased RD/AD/MD compared to their healthy counterparts in several white matter regions, Ps < .02. Finally, we observed that MTR and DTI metrics were related to multiple white matter tracts in patients, Ps < .01, but not healthy control children.

Conclusions

Our findings provide evidence that the white matter damage observed in patients years after treatment of pediatric posterior fossa tumors, likely reflects myelin disruption.

Rapid Whole-Knee Quantification of Cartilage Using T1, T2*, and TRAFF2 Mapping With Magnetic Resonance Fingerprinting

OBJECTIVE

Quantitative Magnetic Resonance Imaging (MRI) holds great promise for the early detection of cartilage deterioration. Here, a Magnetic Resonance Fingerprinting (MRF) framework is proposed for comprehensive and rapid quantification of T1, T2*, and TRAFF2 with whole-knee coverage.

METHODS

A MRF framework was developed to achieve quantification of Relaxation Along a Fictitious Field in the 2nd rotating frame of reference ( TRAFF2) along with T1 and T2*. The proposed sequence acquires 65 measurements of 25 high-resolution slices, interleaved with 7 inversion pulses and 40 RAFF2 trains, for whole-knee quantification in a total acquisition time of 3:25 min. Comparison with reference T1, T2*, and TRAFF2 methods was performed in phantom and in seven healthy subjects at 3 T. Repeatability (test-retest) with and without repositioning was also assessed.

RESULTS

Phantom measurements resulted in good agreement between MRF and the reference with mean biases of -54, 2, and 5 ms for T1, T2*, and TRAFF2, respectively. Complete characterization of the whole-knee cartilage was achieved for all subjects, and, for the femoral and tibial compartments, a good agreement between MRF and reference measurements was obtained. Across all subjects, the proposed MRF method yielded acceptable repeatability without repositioning ( R2 ≥ 0.94) and with repositioning ( R2 ≥ 0.57) for T1, T2*, and TRAFF2.

SIGNIFICANCE

The short scan time combined with the whole-knee coverage makes the proposed MRF framework a promising candidate for the early assessment of cartilage degeneration with quantitative MRI, but further research may be warranted to improve repeatability after repositioning and assess clinical value in patients.

Empirical relationship between TEM-derived myelin volume fraction and MRI-R2 values in aging ex vivo rat corpus callosum

Ex vivo ratiometric measurements of short- and long-T2 components using the multiple spin echo sequence of MRI are often employed to evaluate alterations in myelin content in the white matter (WM) of the brain. However, the relationship between absolute MRI-T2 values (long-T2 component) and myelin volumetric information in aged ex vivo rodent WM appears to be influenced by factors such as animal species, field strength, and fixation durations/washing. Here, multiple spin echo sequence-based MRI-R2 (the reciprocal of T2) values were measured in the corpus callosum (CC) region in the post-mortem rat brains (n = 9) of different age groups with common fixation techniques without washing at 7 T. Transmission electron microscopy (TEM)-based quantification of myelin volume fraction (MVF) and corresponding Monte-Carlo simulation to estimate relaxation rates (R2,IE) due to diffusion in the presence of inhomogeneous magnetic field perturbation in intra- and extra-cellular (IE) spaces were respectively performed. To determine whether the short-T2 components originating from myelin water were mixed with long-T2 components from IE water or were undetectable, the MVF values obtained from TEM results were respectively compared with MRI-R2 and R2,IE values. A significant correlation (Pearson's correlation coefficient r = 0.8763; p < 0.01) of average MRI-R2 and MVF values was observed. Estimated R2,IE values from Monte-Carlo simulations in IE water signals were also positively correlated (r = 0.8281; p < 0.01) with MVF values. However, the magnitudes of R2,IE values were much smaller than those observed for MRI-R2 values, indicating that changes in R2 related MVF are likely dominated by myelin water components. Such comparisons between independent parameters from MRI, TEM, and simulations support the suggestion that myelin water signals were indistinguishably mixed to exhibit mono-exponential T2 relaxation, and multiple spin echo sequence-based MRI-R2 values in aging ex vivo rat CC without prolonged washing still reflect the volumetric information of myelin, likely due to enhanced water exchange across the myelin.

Fiber-orientation independent component of R2* obtained from single-orientation MRI measurements in simulations and a post-mortem human optic chiasm

The effective transverse relaxation rate (R2*) is sensitive to the microstructure of the human brain like the g-ratio which characterises the relative myelination of axons. However, the fibre-orientation dependence of R2* degrades its reproducibility and any microstructural derivative measure. To estimate its orientation-independent part (R2,iso*) from single multi-echo gradient-recalled-echo (meGRE) measurements at arbitrary orientations, a second-order polynomial in time model (hereafter M2) can be used. Its linear time-dependent parameter, β1, can be biophysically related to R2,iso* when neglecting the myelin water (MW) signal in the hollow cylinder fibre model (HCFM). Here, we examined the performance of M2 using experimental and simulated data with variable g-ratio and fibre dispersion. We found that the fitted β1 can estimate R2,iso* using meGRE with long maximum-echo time (TEmax ≈ 54 ms), but not accurately captures its microscopic dependence on the g-ratio (error 84%). We proposed a new heuristic expression for β1 that reduced the error to 12% for ex vivo compartmental R2 values. Using the new expression, we could estimate an MW fraction of 0.14 for fibres with negligible dispersion in a fixed human optic chiasm for the ex vivo compartmental R2 values but not for the in vivo values. M2 and the HCFM-based simulations failed to explain the measured R2*-orientation-dependence around the magic angle for a typical in vivo meGRE protocol (with TEmax ≈ 18 ms). In conclusion, further validation and the development of movement-robust in vivo meGRE protocols with TEmax ≈ 54 ms are required before M2 can be used to estimate R2,iso* in subjects.

Estimating axon radius using diffusion-relaxation MRI: calibrating a surface-based relaxation model with histology

Axon radius is a potential biomarker for brain diseases and a crucial tissue microstructure parameter that determines the speed of action potentials. Diffusion MRI (dMRI) allows non-invasive estimation of axon radius, but accurately estimating the radius of axons in the human brain is challenging. Most axons in the brain have a radius below one micrometer, which falls below the sensitivity limit of dMRI signals even when using the most advanced human MRI scanners. Therefore, new MRI methods that are sensitive to small axon radii are needed. In this proof-of-concept investigation, we examine whether a surface-based axonal relaxation process could mediate a relationship between intra-axonal T2 and T1 times and inner axon radius, as measured using postmortem histology. A unique in vivo human diffusion-T1-T2 relaxation dataset was acquired on a 3T MRI scanner with ultra-strong diffusion gradients, using a strong diffusion-weighting (i.e., b = 6,000 s/mm2) and multiple inversion and echo times. A second reduced diffusion-T2 dataset was collected at various echo times to evaluate the model further. The intra-axonal relaxation times were estimated by fitting a diffusion-relaxation model to the orientation-averaged spherical mean signals. Our analysis revealed that the proposed surface-based relaxation model effectively explains the relationship between the estimated relaxation times and the histological axon radius measured in various corpus callosum regions. Using these histological values, we developed a novel calibration approach to predict axon radius in other areas of the corpus callosum. Notably, the predicted radii and those determined from histological measurements were in close agreement.

Temporal trajectories of normal myelination and axonal development assessed by quantitative macromolecular and diffusion MRI: Ultrastructural and immunochemical validation in a rabbit model

INTRODUCTION

Quantitative and non-invasive measures of brain myelination and maturation during development are of great importance to both clinical and translational research communities. While the metrics derived from diffusion tensor imaging, are sensitive to developmental changes and some pathologies, they remain difficult to relate to the actual microstructure of the brain tissue. The advent of advanced model-based microstructural metrics requires histological validation. The purpose of the study was to validate novel, model-based MRI techniques, such as macromolecular proton fraction mapping (MPF) and neurite orientation and dispersion indexing (NODDI), against histologically derived indexes of myelination and microstructural maturation at various stages of development.

METHODS

New Zealand White rabbit kits underwent serial in-vivo MRI examination at postnatal days 1, 5, 11, 18, and 25, and as adults. Multi-shell, diffusion-weighted experiments were processed to fit NODDI model to obtain estimates, intracellular volume fraction (ICVF) and orientation dispersion index (ODI). Macromolecular proton fraction (MPF) maps were obtained from three source (MT-, PD-, and T1-weighted) images. After MRI sessions, a subset of animals was euthanized and regional samples of gray and white matter were taken for western blot analysis, to determine myelin basic protein (MBP), and electron microscopy, to estimate axonal, myelin fractions and g-ratio.

RESULTS

MPF of white matter regions showed a period of fast growth between P5 and P11 in the internal capsule, with a later onset in the corpus callosum. This MPF trajectory was in agreement with levels of myelination in the corresponding brain region, as assessed by western blot and electron microscopy. In the cortex, the greatest increase of MPF occurred between P18 and P26. In contrast, myelin, according to MBP western blot, saw the largest hike between P5 and P11 in the sensorimotor cortex and between P11 and P18 in the frontal cortex, which then seemingly plateaued after P11 and P18 respectively. G-ratio by MRI markers decreased with age in the white matter. However, electron microscopy suggest a relatively stable g-ratio throughout development.

CONCLUSION

Developmental trajectories of MPF accurately reflected regional differences of myelination rate in different cortical regions and white matter tracts. MRI-derived estimation of g-ratio was inaccurate during early development, likely due to the overestimation of axonal volume fraction by NODDI due to the presence of a large proportion of unmyelinated axons.

Temporal Diffusion Ratio (TDR) for imaging restricted diffusion: Optimisation and pre-clinical demonstration

Temporal Diffusion Ratio (TDR) is a recently proposed dMRI technique (Dell'Acqua et al., proc. ISMRM 2019) which provides contrast between areas with restricted diffusion and areas either without restricted diffusion or with length scales too small for characterisation. Hence, it has a potential for informing on pore sizes, in particular the presence of large axon diameters or other cellular structures. TDR employs the signal from two dMRI acquisitions obtained with the same, large, b-value but with different diffusion gradient waveforms. TDR is advantageous as it employs standard acquisition sequences, does not make any assumptions on the underlying tissue structure and does not require any model fitting, avoiding issues related to model degeneracy. This work for the first time introduces and optimises the TDR method in simulation for a range of different tissues and scanner constraints and validates it in a pre-clinical demonstration. We consider both substrates containing cylinders and spherical structures, representing cell soma in tissue. Our results show that contrasting an acquisition with short gradient duration, short diffusion time and high gradient strength with an acquisition with long gradient duration, long diffusion time and low gradient strength, maximises the TDR contrast for a wide range of pore configurations. Additionally, in the presence of Rician noise, computing TDR from a subset (50% or fewer) of the acquired diffusion gradients rather than the entire shell as proposed originally further improves the contrast. In the last part of the work the results are demonstrated experimentally on rat spinal cord. In line with simulations, the experimental data shows that optimised TDR improves the contrast compared to non-optimised TDR. Furthermore, we find a strong correlation between TDR and histology measurements of axon diameter. In conclusion, we find that TDR has great potential and is a very promising alternative (or potentially complement) to model-based approaches for informing on pore sizes and restricted diffusion in general.

Mapping myelin in white matter with T1-weighted/T2-weighted maps: discrepancy with histology and other myelin MRI measures

The ratio of T1-weighted/T2-weighted magnetic resonance images (T1w/T2w MRI) has been successfully applied at the cortical level since 2011 and is now one of the most used myelin mapping methods. However, no reports have explored the histological validity of T1w/T2w myelin mapping in white matter. Here we compare T1w/T2w with ex vivo postmortem histology and in vivo MRI methods, namely quantitative susceptibility mapping (QSM) and multi-echo T2 myelin water fraction (MWF) mapping techniques. We report a discrepancy between T1w/T2w myelin maps of the human corpus callosum and the histology and analyse the putative causes behind such discrepancy. T1w/T2w does not positively correlate with Luxol Fast Blue (LFB)-Optical Density but shows a weak to moderate, yet significant, negative correlation. On the contrary, MWF is strongly and positively correlated with LFB, whereas T1w/T2w and MWF maps are weakly negatively correlated. The discrepancy between T1w/T2w MRI maps, MWF and histological myelin maps suggests caution in using T1w/T2w as a white matter mapping method at the callosal level. While T1w/T2w imaging may correlate with myelin content at the cortical level, it is not a specific method to map myelin density in white matter.

T1w/FLAIR ratio standardization as a myelin marker in MS patients

INTRODUCTION

Calculation of a T1w/T2w ratio was introduced as a proxy for myelin integrity in the brain of multiple sclerosis (MS) patients. Since nowadays 3D FLAIR is commonly used for lesion detection instead of T2w images, we introduce a T1w/FLAIR ratio as an alternative for the T1w/T2w ratio.

OBJECTIVES

Bias and intensity variation are widely present between different scanners, between subjects and within subjects over time in T1w, T2w and FLAIR images. We present a standardized method for calculating a histogram calibrated T1w/FLAIR ratio to reduce bias and intensity variation in MR sequences from different scanners and at different time-points.

MATERIAL AND METHODS

207 Relapsing Remitting MS patients were scanned on 4 different 3 T scanners with a protocol including 3D T1w, 2D T2w and 3D FLAIR images. After bias correction, T1w/FLAIR ratio maps and T1w/T2w ratio maps were calculated in 4 different ways: without calibration, with linear histogram calibration as described by Ganzetti et al. (2014), and by using 2 methods of non-linear histogram calibration. The first nonlinear calibration uses a template of extra-cerebral tissue and cerebrospinal fluid (CSF) brought from Montreal Neurological Institute (MNI) space to subject space; for the second nonlinear method we used an extra-cerebral tissue and CSF template of our own subjects. Additionally, we segmented several brain structures such as Normal Appearing White Matter (NAWM), Normal Appearing Grey Matter (NAGM), corpus callosum, thalami and MS lesions using Freesurfer and Samseg.

RESULTS

The coefficient of variation of T1w/FLAIR ratio in NAWM for the no calibrated, linear, and 2 nonlinear calibration methods were respectively 24, 19.1, 9.5, 13.8. The nonlinear methods of calibration showed the best results for calculating the T1w/FLAIR ratio with a smaller dispersion of the data and a smaller overlap of T1w/FLAIR ratio in the different segmented brain structures. T1w/T2w and T1w/FLAIR ratios showed a wider range of values compared to MTR values.

CONCLUSIONS

Calibration of T1w/T2w and T1w/FLAIR ratio maps is imperative to account for the sources of variation described above. The nonlinear calibration methods showed the best reduction of between-subject and within-subject variability. The T1w/T2w and T1w/FLAIR ratio seem to be more sensitive to smaller changes in tissue integrity than MTR. Future work is needed to determine the exact substrate of T1w/FLAIR ratio and to obtain correlations with clinical outcome.

Role of Demyelination in the Persistence of Neurological and Mental Impairments after COVID-19

Long-term neurological and mental complications of COVID-19, the so-called post-COVID syndrome or long COVID, affect the quality of life. The most persistent manifestations of long COVID include fatigue, anosmia/hyposmia, insomnia, depression/anxiety, and memory/attention deficits. The physiological basis of neurological and psychiatric disorders is still poorly understood. This review summarizes the current knowledge of neurological sequelae in post-COVID patients and discusses brain demyelination as a possible mechanism of these complications with a focus on neuroimaging findings. Numerous reviews, experimental and theoretical studies consider brain demyelination as one of the mechanisms of the central neural system impairment. Several factors might cause demyelination, such as inflammation, direct effect of the virus on oligodendrocytes, and cerebrovascular disorders, inducing myelin damage. There is a contradiction between the solid fundamental basis underlying demyelination as the mechanism of the neurological injuries and relatively little published clinical evidence related to demyelination in COVID-19 patients. The reason for this probably lies in the fact that most clinical studies used conventional MRI techniques, which can detect only large, clearly visible demyelinating lesions. A very limited number of studies use specific methods for myelin quantification detected changes in the white matter tracts 3 and 10 months after the acute phase of COVID-19. Future research applying quantitative MRI assessment of myelin in combination with neurological and psychological studies will help in understanding the mechanisms of post-COVID complications associated with demyelination.

An in vivo implementation of the MEX MRI for myelin fraction of mice brain

OBJECTIVE

Magnetization EXchange (MEX) sequence measures a signal linearly dependent on the myelin proton fraction by selective suppression of water magnetization and a recovery period. Varying the recovery period enables extraction of the percentile fraction of myelin bound protons. We aim to demonstrate the MEX sequence sensitivity to the fraction of protons associated with myelin in mice brain, in vivo.

METHODS

The cuprizone mouse model was used to manipulate the myelin content. Mice fed cuprizone (n = 15) and normal chow (n = 8) were imaged in vivo using MEX sequence. MR images were segmented into corpus callosum and internal capsule (white matter) and cortical gray matter, and fitted to the recovery equation. Results were analyzed with correlation to MWF and histopathology.

RESULTS

The extracted parameters show significant differences in the corpus callosum between the cuprizone and control groups. The cuprizone group exhibited reduced myelin fraction 26.5% (P < 0.01). The gray matter values were less affected, with 13.5% reduction (P < 0.05); no changes were detected in the internal capsule. Results were validated by MWF scans and good correlation to the histology analysis (R² = 0.685).

CONCLUSION

The results of this first in vivo implementation of the MEX sequence provide a quantitative measure of demyelination in brain white matter.

Macromolecular Proton Fraction as a Myelin Biomarker: Principles, Validation, and Applications

Macromolecular proton fraction (MPF) is a quantitative MRI parameter describing the magnetization transfer (MT) effect and defined as a relative amount of protons bound to biological macromolecules with restricted molecular motion, which participate in magnetic cross-relaxation with water protons. MPF attracted significant interest during past decade as a biomarker of myelin. The purpose of this mini review is to provide a brief but comprehensive summary of MPF mapping methods, histological validation studies, and MPF applications in neuroscience. Technically, MPF maps can be obtained using a variety of quantitative MT methods. Some of them enable clinically reasonable scan time and resolution. Recent studies demonstrated the feasibility of MPF mapping using standard clinical MRI pulse sequences, thus substantially enhancing the method availability. A number of studies in animal models demonstrated strong correlations between MPF and histological markers of myelin with a minor influence of potential confounders. Histological studies validated the capability of MPF to monitor both demyelination and re-myelination. Clinical applications of MPF have been mainly focused on multiple sclerosis where this method provided new insights into both white and gray matter pathology. Besides, several studies used MPF to investigate myelin role in other neurological and psychiatric conditions. Another promising area of MPF applications is the brain development studies. MPF demonstrated the capabilities to quantitatively characterize the earliest stage of myelination during prenatal brain maturation and protracted myelin development in adolescence. In summary, MPF mapping provides a technically mature and comprehensively validated myelin imaging technology for various preclinical and clinical neuroscience applications.

Imaging and Electrophysiology for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 9]

STUDY DESIGN

Narrative review.

OBJECTIVE

The current review aimed to describe the role of existing techniques and emerging methods of imaging and electrophysiology for the management of degenerative cervical myelopathy (DCM), a common and often progressive condition that causes spinal cord dysfunction and significant morbidity globally.

METHODS

A narrative review was conducted to summarize the existing literature and highlight future directions.

RESULTS

Anatomical magnetic resonance imaging (MRI) is well established in the literature as the key imaging tool to identify spinal cord compression, disc herniation/bulging, and inbuckling of the ligamentum flavum, thus facilitating surgical planning, while radiographs and computed tomography (CT) provide complimentary information. Electrophysiology techniques are primarily used to rule out competing diagnoses. However, signal change and measures of cord compression on conventional MRI have limited utility to characterize the degree of tissue injury, which may be helpful for diagnosis, prognostication, and repeated assessments to identify deterioration. Early translational studies of quantitative imaging and electrophysiology techniques show potential of these methods to more accurately reflect changes in spinal cord microstructure and function.

CONCLUSION

Currently, clinical management of DCM relies heavily on anatomical MRI, with additional contributions from radiographs, CT, and electrophysiology. Novel quantitative assessments of microstructure, perfusion, and function have the potential to transform clinical practice, but require robust validation, automation, and standardization prior to uptake.

Serum neurofilament light chain correlates with myelin and axonal magnetic resonance imaging markers in multiple sclerosis

BACKGROUND

Neurofilaments are cytoskeletal proteins that are detectable in the blood after neuroaxonal injury. Multiple sclerosis (MS) disease progression, greater lesion volume, and brain atrophy are associated with higher levels of serum neurofilament light chain (NfL), but few studies have examined the relationship between NfL and advanced magnetic resonance imaging (MRI) measures related to myelin and axons. We assessed the relationship between serum NfL and brain MRI measures in a diverse group of MS participants.

METHODS AND MATERIALS

103 participants (20 clinically isolated syndrome, 33 relapsing-remitting, 30 secondary progressive, 20 primary progressive) underwent 3T MRI to obtain myelin water fraction (MWF), geometric mean T₂ (GMT₂), water content, T_1; high angular resolution diffusion imaging (HARDI)-derived axial diffusivity (AD), radial diffusivity (RD), fractional anisotropy (FA); diffusion basis spectrum imaging (DBSI)-derived AD, RD, FA; restricted, hindered, water and fiber fractions; and volume measurements of normalized brain, lesion, thalamic, deep gray matter (GM), and cortical thickness. Multiple linear regressions assessed the strength of association between serum NfL (dependent variable) and each MRI measure in whole brain (WB), normal appearing white matter (NAWM) and T₂ lesions (independent variables), while controlling for age, expanded disability status scale, and disease duration.

RESULTS

Serum NfL levels were significantly associated with metrics of axonal damage (FA: R²_WB-HARDI = 0.29, R²_NAWM-HARDI = 0.31, R²_NAWM-DBSI = 0.30, R²_Lesion-DBSI = 0.31; AD: R²_WB-HARDI=0.31), myelin damage (MWF: R²_WB = 0.29, R²_NAWM = 0.30, RD: R²_WB-HARDI = 0.32, R²_NAWM-HARDI = 0.34, R²_Lesion-DBSI = 0.30), edema and inflammation (T₁: R²_Lesion = 0.32; GMT₂: R²_WB = 0.31, R²_Lesion = 0.31), and cellularity (restricted fraction R²_WB = 0.30, R²_NAWM = 0.32) across the entire MS cohort. Higher serum NfL levels were associated with significantly higher T₂ lesion volume (R² = 0.35), lower brain structure volumes (thalamus R² = 0.31; deep GM R² = 0.33; normalized brain R² = 0.31), and smaller cortical thickness R² = 0.31).

CONCLUSION

The association between NfL and myelin MRI markers suggest that elevated serum NfL is a useful biomarker that reflects not only acute axonal damage, but also damage to myelin and inflammation, likely due to the known synergistic myelin-axon coupling relationship.

Temporal Progression of Acute Spinal Cord Injury Mechanisms in a Rat Model: Contusion, Dislocation, and Distraction

Traumatic spinal cord injuries (SCIs) occur due to different spinal column injury patterns, including burst fracture, dislocation, and flexion-distraction. Pre-clinical studies modeling different SCI mechanisms have shown distinct histological differences between these injuries both acutely (3 h and less) and chronically (8 weeks), but there remains a temporal gap. Different rates of injury progression at specific regions of the spinal cord may provide insight into the pathologies that are initiated by specific SCI mechanisms. Therefore, the objective of this study was to evaluate the temporal progression of injury at specific tracts within the white matter, for time-points of 3 h, 24 h, and 7 days, for three distinct SCI mechanisms. In this study, 96 male Sprague Dawley rats underwent one of three SCI mechanisms: contusion, dislocation, or distraction. Animals were sacrificed at one of three times post-injury: 3 h, 24 h, or 7 days. Histological analysis using eriochrome cyanide and immunostaining for MBP, SMI-312, neurofilament-H (NF-H), and β-III tubulin were used to characterize white matter sparing and axon and myelinated axon counts. The regions analyzed were the gracile fasciculus, cuneate fasciculus, dorsal corticospinal tract, and ventrolateral white matter. Contusion, dislocation, and distraction SCIs demonstrated distinct damage patterns that progressed differently over time. Myelinated axon counts were significantly reduced after dislocation and contusion injuries in most locations and time-points analyzed (compared with sham). This indicates early myelin damage often within 3 h. Myelinated axon counts after distraction dropped early and did not demonstrate any significant progression over the next 7 days. Important differences in white matter degeneration were identified between injury types, with distraction injuries showing the least variability across time-points These findings and the observation that white matter injury occurs early, and in many cases, without much dynamic change, highlight the importance of injury type in SCI research-both clinically and pre-clinically.

Temperature dependence and histological correlation of inhomogeneous magnetization transfer and myelin water imaging in ex vivo brain

PURPOSE

The promise of inhomogeneous magnetization transfer (ihMT) as a new myelin imaging method was studied in ex vivo human brain tissue and in relation to myelin water fraction (MWF). The temperature dependence of both methods was characterized, as well as their correspondence with a histological measure of myelin content. Unfiltered and filtered ihMT protocols were studied by adjusting the saturation scheme to preserve or attenuate signal from tissue with short dipolar relaxation time T_1D.

METHODS

ihMT ratio (ihMTR) and MWF maps were acquired at 7 T from formalin-fixed human brain samples at 22.5 °C, 30 °C and 37 °C. The impact of temperature on unfiltered ihMTR, filtered ihMTR and MWF was investigated and compared to myelin basic protein staining.

RESULTS

Unfiltered ihMTR exhibited no temperature dependence, whereas filtered ihMTR increased with increasing temperature. MWF decreased at higher temperature, with an increasing prevalence of areas where the myelin water signal was unreliably determined, likely related to a reduction in T₂ peak separability at higher temperatures ex vivo. MWF and ihMTR showed similar per-sample correlation with myelin staining at room temperature. At 37 ^°C, filtered ihMTR was more strongly correlated with myelin staining and had increased dynamic range compared to unfiltered ihMTR.

CONCLUSIONS

Given the temperature dependence of filtered ihMT, increased dynamic range, and strong myelin specificity that persists at higher temperatures, we recommend carefully controlled temperatures close to 37 °C for filtered ihMT acquisitions. Unfiltered ihMT may also be useful, due to its independence from temperature, higher amplitude values, and sensitivity to short T_1D components. Ex vivo myelin water imaging should be performed at room temperature, to avoid fitting issues found at higher temperatures.

RAFF-4, Magnetization Transfer and Diffusion Tensor MRI of Lysophosphatidylcholine Induced Demyelination and Remyelination in Rats

Remyelination is a naturally occurring response to demyelination and has a central role in the pathophysiology of multiple sclerosis and traumatic brain injury. Recently we demonstrated that a novel MRI technique entitled Relaxation Along a Fictitious Field (RAFF) in the rotating frame of rank n (RAFFn) achieved exceptional sensitivity in detecting the demyelination processes induced by lysophosphatidylcholine (LPC) in rat brain. In the present work, our aim was to test whether RAFF4, along with magnetization transfer (MT) and diffusion tensor imaging (DTI), would be capable of detecting the changes in the myelin content and microstructure caused by modifications of myelin sheets around axons or by gliosis during the remyelination phase after LPC-induced demyelination in the corpus callosum of rats. We collected MRI data with RAFF4, MT and DTI at 3 days after injection (demyelination stage) and at 38 days after injection (remyelination stage) of LPC (n = 12) or vehicle (n = 9). Cell density and myelin content were assessed by histology. All MRI metrics detected differences between LPC-injected and control groups of animals in the demyelination stage, on day 3. In the remyelination phase (day 38), RAFF4, MT parameters, fractional anisotropy, and axial diffusivity detected signs of a partial recovery consistent with the remyelination evident in histology. Radial diffusivity had undergone a further increase from day 3 to 38 and mean diffusivity revealed a complete recovery correlating with the histological assessment of cell density attributed to gliosis. The combination of RAFF4, MT and DTI has the potential to differentiate between normal, demyelinated and remyelinated axons and gliosis and thus it may be able to provide a more detailed assessment of white matter pathologies in several neurological diseases.

Identification of water compartments in spinal cords by 2 H double quantum filtered NMR

In ² H double quantum filtered (DQF) NMR, the various water compartments are characterized by their different residual quadrupolar interactions. The spectral separation between the different signals enables the measurement of the relaxation of each compartment and the magnetization transfer (MT) between them. In the current study, five water compartments were identified in the ² H DQF spectra of porcine spinal cord. The most prominent signal was the pair of satellites with a quadrupolar splitting of about 550 Hz. ² H DQF MRI optimized for the 550 Hz quadrupolar splitting indicated that this signal originated mainly from the white matter and it was assigned to the myelin water. This splitting does not change upon changing the orientation of the spinal cord relative to the magnetic field, indicating a liquid crystalline nature. Another site exhibiting splitting of about 1500 Hz was assigned to collagenous connective tissue. The narrow central peak was assigned to a combination of intra- and inter-axonal water. The assignment of the other two sites is not certain and requires further study. The rates of MT between the various sites were recorded.

Beyond the diffusion standard model in fixed rat spinal cord with combined linear and planar encoding

Information about tissue on the microscopic and mesoscopic scales can be accessed by modelling diffusion MRI signals, with the aim of extracting microstructure-specific biomarkers. The standard model (SM) of diffusion, currently the most broadly adopted microstructural model, describes diffusion in white matter (WM) tissues by two Gaussian components, one of which has zero radial diffusivity, to represent diffusion in intra- and extra-axonal water, respectively. Here, we reappraise these SM assumptions by collecting comprehensive double diffusion encoded (DDE) MRI data with both linear and planar encodings, which was recently shown to substantially enhance the ability to estimate SM parameters. We find however, that the SM is unable to account for data recorded in fixed rat spinal cord at an ultrahigh field of 16.4 T, suggesting that its underlying assumptions are violated in our experimental data. We offer three model extensions to mitigate this problem: first, we generalize the SM to accommodate finite radii (axons) by releasing the constraint of zero radial diffusivity in the intra-axonal compartment. Second, we include intracompartmental kurtosis to account for non-Gaussian behaviour. Third, we introduce an additional (third) compartment. The ability of these models to account for our experimental data are compared based on parameter feasibility and Bayesian information criterion. Our analysis identifies the three-compartment description as the optimal model. The third compartment exhibits slow diffusion with a minor but non-negligible signal fraction (∼12%). We demonstrate how failure to take the presence of such a compartment into account severely misguides inferences about WM microstructure. Our findings bear significance for microstructural modelling at large and can impact the interpretation of biomarkers extracted from the standard model of diffusion.

Understanding aqueous and non-aqueous proton T1 relaxation in brain

A full picture of longitudinal relaxation in complex heterogeneous environments like white matter brain tissue remains elusive. In tissue, successive approximations, from the solvation layer model to the two pool model, have highlighted how longitudinal magnetization evolution depends on both inter-compartmental exchange and spin-lattice relaxation. In white matter, however, these models fail to capture the behaviour of the two distinct aqueous pools, myelin water and intra/extra-cellular water. A challenge with testing more comprehensive multi-pool models lies in directly observing all pools, both aqueous and non-aqueous. In this work, we advance these efforts by integrating three main experimental and analytical elements: direct observation of the longitudinal relaxation of both the aqueous and the non-aqueous protons in white matter, a wide range of different initial conditions, and application of an analysis pipeline which includes lineshape, CPMG, and fitting of a four pool model. An eigenvector interpretation of the four pool model highlights how longitudinal relaxation in white matter depends on initial conditions. We find that a single set of model parameters is able to describe the entire range of relaxation behaviour observed in all the separable aqueous and non-aqueous pools in experiments involving six different initial conditions. Understanding of the nature and connectedness of the tissue components is crucial in the design and interpretation of many MRI measurements, especially those based on magnetization transfer and longitudinal relaxation. In particular, the dependency of relaxation behaviour on initial conditions is likely the basis for understanding method-dependent discrepancies in in vivo T₁.

Towards in vivo g-ratio mapping using MRI: Unifying myelin and diffusion imaging

BACKGROUND

The g-ratio, quantifying the comparative thickness of the myelin sheath encasing an axon, is a geometrical invariant that has high functional relevance because of its importance in determining neuronal conduction velocity. Advances in MRI data acquisition and signal modelling have put in vivo mapping of the g-ratio, across the entire white matter, within our reach. This capacity would greatly increase our knowledge of the nervous system: how it functions, and how it is impacted by disease.

NEW METHOD

This is the second review on the topic of g-ratio mapping using MRI.

RESULTS

This review summarizes the most recent developments in the field, while also providing methodological background pertinent to aggregate g-ratio weighted mapping, and discussing pitfalls associated with these approaches.

COMPARISON WITH EXISTING METHODS

Using simulations based on recently published data, this review reveals caveats to the state-of-the-art calibration methods that have been used for in vivo g-ratio mapping. It highlights the need to estimate both the slope and offset of the relationship between these MRI-based markers and the true myelin volume fraction if we are really to achieve the goal of precise, high sensitivity g-ratio mapping in vivo. Other challenges discussed in this review further evidence the need for gold standard measurements of human brain tissue from ex vivo histology.

CONCLUSIONS

We conclude that the quest to find the most appropriate MRI biomarkers to enable in vivo g-ratio mapping is ongoing, with the full potential of many novel techniques yet to be investigated.

Comparison of multi echo T2 relaxation and steady state approaches for myelin imaging in the central nervous system

The traditional approach for measuring myelin-associated water with quantitative magnetic resonance imaging (MRI) uses multi-echo T₂ relaxation data to calculate the myelin water fraction (MWF). A fundamentally different approach, abbreviated “mcDESPOT”, uses a more efficient steady-state acquisition to generate an equivalent metric (f_M). Although previous studies have demonstrated inherent instability and bias in the complex mcDESPOT analysis procedure, f_M has often been used as a surrogate for MWF. We produced and compared multivariate atlases of MWF and f_M in healthy human brain and cervical spinal cord (available online) and compared their ability to detect multiple sclerosis pathology. A significant bias was found in all regions (p < 10^–5), albeit reversed for spinal cord (f_M-MWF =  − 3.4%) compared to brain (+ 6.2%). MWF and f_M followed an approximately linear relationship for regions with MWF <  ~ 10%. For MWF >  ~ 10%, the relationship broke down and f_M no longer increased in tandem with MWF. For multiple sclerosis patients, MWF and f_M Z score maps showed overlapping areas of low Z score and similar trends between patients and brain regions, although those of f_M generally had greater spatial extent and magnitude of severity. These results will guide future choice of myelin-sensitive quantitative MRI and improve interpretation of studies using either myelin imaging approach.

Microstructure of Human Corpus Callosum across the Lifespan: Regional Variations in Axon Caliber, Density, and Myelin Content

The myeloarchitecture of the corpus callosum (CC) is characterized as a mosaic of distinct differences in fiber density of small- and large-diameter axons along the anterior-posterior axis; however, regional and age differences across the lifespan are not fully understood. Using multiecho T2 magnetic resonance imaging combined with multi-T2 fitting, the myelin water fraction (MWF) and geometric-mean of the intra-/extracellular water T2 (geomT2IEW) in 395 individuals (7-85 years; 41% males) were examined. The approach was validated where regional patterns along the CC closely resembled the histology; MWF matched mean axon diameter and geomT2IEW mirrored the density of large-caliber axons. Across the lifespan, MWF exhibited a quadratic association with age in all 10 CC regions with evidence of a positive linear MWF-age relationship among younger participants and minimal age differences in the remainder of the lifespan. Regarding geomT2IEW, a significant linear age × region interaction reflected positive linear age dependence mostly prominent in the regions with the highest density of small-caliber fibers-genu and splenium. In all, these two indicators characterize distinct attributes that are consistent with histology, which is a first. In addition, these results conform to rapid developmental progression of CC myelination leveling in middle age as well as age-related degradation of axon sheaths in older adults.

Multidimensional correlation MRI

Multidimensional correlation spectroscopy is emerging as a novel MRI modality that is well suited for microstructure and microdynamic imaging studies, especially of biological specimens. Conventional MRI methods only provide voxel-averaged and mostly macroscopically averaged information; these methods cannot disentangle intra-voxel heterogeneity on the basis of both water mobility and local chemical interactions. By correlating multiple MR contrast mechanisms and processing the data in an integrated manner, correlation spectroscopy is able to resolve the distribution of water populations according to their chemical and physical interactions with the environment. The use of a non-parametric, phenomenological representation of the multidimensional MR signal makes no assumptions about tissue structure, thereby allowing the study of microscopic structure and composition of complex heterogeneous biological systems. However, until recently, vast data requirements have confined these types of measurement to non-localized NMR applications and prevented them from being widely and successfully used in conjunction with imaging. Recent groundbreaking advancements have allowed this powerful NMR methodology to be migrated to MRI, initiating its emergence as a promising imaging approach. This review is not intended to cover the entire field of multidimensional MR; instead, it focuses on pioneering imaging applications and the challenges involved. In addition, the background and motivation that have led to multidimensional correlation MR development are discussed, along with the basic underlying mathematical concepts. The goal of the present work is to provide the reader with a fundamental understanding of the techniques developed and their potential benefits, and to provide guidance to help refine future applications of this technology.

Non-negative least squares computation for in vivo myelin mapping using simulated multi-echo spin-echo T2 decay data

Multi-compartment T₂ mapping has gained particular relevance for the study of myelin water in the brain. As a facilitator of rapid saltatory axonal signal transmission, myelin is a cornerstone indicator of white matter development and function. Regularized non-negative least squares fitting of multi-echo T₂ data has been widely employed for the computation of the myelin water fraction (MWF), and the obtained MWF maps have been histopathologically validated. MWF measurements depend upon the quality of the data acquisition, B₁⁺ homogeneity and a range of fitting parameters. In this special issue article, we discuss the relevance of these factors for the accurate computation of multi-compartment T₂ and MWF maps. We generated multi-echo spin-echo T₂ decay curves following the Carr-Purcell-Meiboom-Gill approach for various myelin concentrations and myelin T₂ scenarios by simulating the evolution of the magnetization vector between echoes based on the Bloch equations. We demonstrated that noise and imperfect refocusing flip angles yield systematic underestimations in MWF and intra-/extracellular water geometric mean T₂ (gmT₂ ). MWF estimates were more stable than myelin water gmT₂ time across different settings of the T₂ analysis. We observed that the lower limit of the T₂ distribution grid should be slightly shorter than TE₁ . Both TE₁ and the acquisition echo spacing also have to be sufficiently short to capture the rapidly decaying myelin water T₂ signal. Among all parameters of interest, the estimated MWF and intra-/extracellular water gmT₂ differed by approximately 0.13-4 percentage points and 3-4 ms, respectively, from the true values, with larger deviations observed in the presence of greater B₁⁺ inhomogeneities and at lower signal-to-noise ratio. Tailoring acquisition strategies may allow us to better characterize the T₂ distribution, including the myelin water, in vivo.

An interactive meta-analysis of MRI biomarkers of myelin

Several MRI measures have been proposed as in vivo biomarkers of myelin, each with applications ranging from plasticity to pathology. Despite the availability of these myelin-sensitive modalities, specificity and sensitivity have been a matter of discussion. Debate about which MRI measure is the most suitable for quantifying myelin is still ongoing. In this study, we performed a systematic review of published quantitative validation studies to clarify how different these measures are when compared to the underlying histology. We analyzed the results from 43 studies applying meta-analysis tools, controlling for study sample size and using interactive visualization (https://neurolibre.github.io/myelin-meta-analysis). We report the overall estimates and the prediction intervals for the coefficient of determination and find that MT and relaxometry-based measures exhibit the highest correlations with myelin content. We also show which measures are, and which measures are not statistically different regarding their relationship with histology.

Retaining information from multidimensional correlation MRI using a spectral regions of interest generator

Multidimensional correlation magnetic resonance imaging (MRI) is an emerging imaging modality that is capable of disentangling highly heterogeneous and opaque systems according to chemical and physical interactions of water within them. Using this approach, the conventional three dimensional MR scalar images are replaced with spatially resolved multidimensional spectra. The ensuing abundance in microstructural and chemical information is a blessing that incorporates a real challenge: how does one distill and refine it into images while retaining its significant components? In this paper we introduce a general framework that preserves the spectral information from spatially resolved multidimensional data. Equal weight is given to significant spectral components at the single voxel level, resulting in a summarized image spectrum. This spectrum is then used to define spectral regions of interest that are utilized to reconstruct images of sub-voxel components. Using numerical simulations we first show that, contrary to the conventional approach, the proposed framework preserves spectral resolution, and in turn, sensitivity and specificity of the reconstructed images. The retained spectral resolution allows, for the first time, to observe an array of distinct [Formula: see text]-[Formula: see text]-[Formula: see text] components images of the human brain. The robustly generated images of sub-voxel components overcome the limited spatial resolution of MRI, thus advancing multidimensional correlation MRI to fulfilling its full potential.

So You Want to Image Myelin Using MRI: An Overview and Practical Guide for Myelin Water Imaging

Myelin water imaging (MWI) is an MRI imaging biomarker for myelin. This method can generate an in vivo whole-brain myelin water fraction map in approximately 10 minutes. It has been applied in various applications including neurodegenerative disease, neurodevelopmental, and neuroplasticity studies. In this review we start with a brief introduction of myelin biology and discuss the contributions of myelin in conventional MRI contrasts. Then the MRI properties of myelin water and four different MWI methods, which are categorized as T₂ -, T₂ *-, T₁ -, and steady-state-based MWI, are summarized. After that, we cover more practical issues such as availability, interpretation, and validation of these methods. To illustrate the utility of MWI as a clinical research tool, MWI studies for two diseases, multiple sclerosis and neuromyelitis optica, are introduced. Additional topics about imaging myelin in gray matter and non-MWI methods for myelin imaging are also included. Although technical and physiological limitations exist, MWI is a potent surrogate biomarker of myelin that carries valuable and useful information of myelin. Evidence Level: 5 Technical Efficacy: 1 J. MAGN. RESON. IMAGING 2021;53:360-373.

White-matter microstructural properties of the corpus callosum: test-retest and repositioning effects in two parcellation schemes

We investigated test-retest reliability of two MRI-derived indices of white-matter microstructural properties in the human corpus callosum (CC): myelin water fraction (MWF) and geometric mean T₂ relaxation time of intra/extracellular water (geomT_2IEW), using a 3D gradient and multi spin-echo sequence in 20 healthy adults (aged 24-69 years, 10 men). For each person, we acquired two back-to-back acquisitions in a single session, and the third after a break and repositioning the participant in the scanner. We assessed the contribution of session-related variance to reliability, using intra-class effect decomposition (ICED) while comparing two CC parcellation schemes that divided the CC into five and ten regions. We found high construct-level reliability of MWF and geomT_2IEW in all regions of both schemes, except the posterior body-a slender region with a smaller number of large myelinated fibers. Only in that region, we observed significant session-specific variance in the MWF, interpreted as an effect of repositioning in the scanner. The geomT_2IEW demonstrated higher reliability than MWF across both parcellation schemes and all CC regions. Thus, in both CC parcellation approaches, MWF and geomT_2IEW have good test-retest reliability and are, therefore, suitable for longitudinal investigations in healthy adults. However, the five-region scheme appears more appropriate for MWF, whereas both schemes are suitable for geomT_2IEW studies. Given the lower reliability in the posterior body, which may reflect sensitivity to the repositioning of the participant in the scanner, caution should be exercised in interpreting differential findings in that region.

Construction of a rat spinal cord atlas of axon morphometry

Atlases of the central nervous system are essential for understanding the pathophysiology of neurological diseases, which remains one of the greatest challenges in neuroscience research today. These atlases provide insight into the underlying white matter microstructure and have been created from a variety of animal models, including rats. Although existing atlases of the rat spinal cord provide some details of axon microstructure, there is currently no histological dataset that quantifies axon morphometry exhaustively in the entire spinal cord. In this study, we created the first comprehensive rat spinal cord atlas of the white matter microstructure with quantifiable axon and myelin morphometrics. Using full-slice scanning electron microscopy images and state-of-the-art segmentation algorithms, we generated an atlas of microstructural metrics such as axon diameter, axonal density and g-ratio. After registering the Watson spinal cord white matter atlas to our template, we computed statistics across metrics, spinal levels and tracts. We notably found that g-ratio is relatively constant, whereas axon diameter showed the greatest variation. The atlas, data and full analysis code are freely available at: https://github.com/neuropoly/atlas-rat.

White matter tract myelin maturation and its association with general psychopathology in adolescence and early adulthood

Adolescence is a time period associated with marked brain maturation that coincides with an enhanced risk for onset of psychiatric disorder. White matter tract myelination, a process that continues to unfold throughout adolescence, is reported to be abnormal in several psychiatric disorders. Here, we ask whether psychiatric vulnerability is linked to aberrant developmental myelination trajectories. We assessed a marker of myelin maturation, using magnetisation transfer (MT) imaging, in 10 major white matter tracts. We then investigated its relationship to the expression of a general psychopathology "p-factor" in a longitudinal analysis of 293 healthy participants between the ages of 14 and 24. We observed significant longitudinal MT increase across the full age spectrum in anterior thalamic radiation, hippocampal cingulum, dorsal cingulum and superior longitudinal fasciculus. MT increase in the inferior fronto-occipital fasciculus, inferior longitudinal fasciculus and uncinate fasciculus was pronounced in younger participants but levelled off during the transition into young adulthood. Crucially, longitudinal MT increase in dorsal cingulum and uncinate fasciculus decelerated as a function of mean p-factor scores over the study period. This suggests that an increased expression of psychopathology is closely linked to lower rates of myelin maturation in selective brain tracts over time. Impaired myelin growth in limbic association fibres may serve as a neural marker for emerging mental illness during the course of adolescence and early adulthood.

Diffusion MRI microstructural models in the cervical spinal cord - Application, normative values, and correlations with histological analysis

Multi-compartment tissue modeling using diffusion magnetic resonance imaging has proven valuable in the brain, offering novel indices sensitive to the tissue microstructural environment in vivo on clinical MRI scanners. However, application, characterization, and validation of these models in the spinal cord remain relatively under-studied. In this study, we apply a diffusion "signal" model (diffusion tensor imaging, DTI) and two commonly implemented "microstructural" models (neurite orientation dispersion and density imaging, NODDI; spherical mean technique, SMT) in the human cervical spinal cord of twenty-one healthy controls. We first provide normative values of DTI, SMT, and NODDI indices in a number of white matter ascending and descending pathways, as well as various gray matter regions. We then aim to validate the sensitivity and specificity of these diffusion-derived contrasts by relating these measures to indices of the tissue microenvironment provided by a histological template. We find that DTI indices are sensitive to a number of microstructural features, but lack specificity. The microstructural models also show sensitivity to a number of microstructure features; however, they do not capture the specific microstructural features explicitly modelled. Although often regarded as a simple extension of the brain in the central nervous system, it may be necessary to re-envision, or specifically adapt, diffusion microstructural models for application to the human spinal cord with clinically feasible acquisitions - specifically, adjusting, adapting, and re-validating the modeling as it relates to both theory (i.e. relevant biology, assumptions, and signal regimes) and parameter estimation (for example challenges of acquisition, artifacts, and processing).

Monte Carlo Simulations of Water Exchange Through Myelin Wraps: Implications for Diffusion MRI

Diffusion magnetic resonance imaging (dMRI) yields parameters sensitive to brain tissue microstructure. A structurally important aspect of this microstructure is the myelin wrapping around the axons. This paper investigated the forward problem concerning whether water exchange via the spiraling structure of the myelin can meaningfully contribute to the signal in dMRI. Monte Carlo simulations were performed in a system with intra-axonal, myelin, and extra-axonal compartments. Diffusion in the myelin was simulated as a spiral wrapping the axon, with a custom number of wraps. Exchange (or intra-axonal residence) times were analyzed for various number of wraps and axon diameters. Pulsed gradient sequences were employed to simulate the dMRI signal, which was analyzed using different methods. Diffusional kurtosis imaging analysis yielded the radial diffusivity (RD) and radial kurtosis (RK), while the two-compartment Kärger model yielded estimates the intra-axonal volume fraction ( ν _ic ) and exchange time ( τ ). Results showed that τ was on the sub-second level for geometries with axon diameters below 1.0 μ m and less than eight wraps. Otherwise, exchange was negligible compared to typical experimental durations, with τ of seconds or longer. In situations where exchange influenced the signal, estimates of RK and ν _ic increased with the number of wraps, while RD decreased. τ estimates from simulated signals were in agreement with predicted ones. In conclusion, exchange through spiraling myelin permits sub-second τ for small diameters and low number of wraps. Such conditions may arise in the developing brain or in neurodegenerative disease, and thus the results could aid the interpretation of dMRI studies.

Formalin tissue fixation biases myelin-sensitive MRI

PURPOSE

Chemical fixatives such as formalin form cross-links between proteins and affect the relaxation times and diffusion properties of tissue. These fixation-induced changes likely also affect myelin density measurements produced by quantitative magnetization transfer and myelin water imaging. In this work, we evaluate these myelin-sensitive MRI methods for fixation-induced biases.

METHODS

We perform quantitative magnetization transfer, myelin water imaging, and deuterium oxide-exchanged zero TE imaging on unfixed human spinal cord tissue at 9.4 Tesla and repeat these measurements after 1 day and 31 days of formalin fixation.

RESULTS

The quantitative magnetization-transfer bound pool fraction increased by 30.7% ± 21.1% after 1 day of fixation and by 42.6% ± 33.9% after 31 days of fixation. Myelin water fraction increased by 39.7% ± 15.5% and 37.0% ± 15.9% at these same time points, and mean T₂ of the myelin water pool nearly doubled. Reference-normalized deuterium oxide-exchanged zero TE signal intensity increased by 8.17% ± 6.03% after 31 days of fixation but did not change significantly after 1 day of fixation. After fixation, specimen cross-sectional area decreased by approximately 5%; after correction for shrinkage, changes in deuterium oxide-exchanged zero TE intensity were nearly eliminated.

CONCLUSION

Bound pool fraction and myelin water fraction are significantly increased by formalin fixation, whereas deuterium oxide-exchanged zero TE intensity is minimally affected. Changes in quantitative magnetization transfer and myelin water imaging may be due in part to delamination and formation of vacuoles in the myelin sheath. Deuterium oxide-exchanged signal intensity may be altered by fixation-induced changes in myelin lipid solid-state ¹ H T₁ . We urge caution in the comparison of these measurements across subjects or specimens in different states, especially unfixed versus fixed tissue.

In vivo microscopic diffusional kurtosis imaging with symmetrized double diffusion encoding EPI

PURPOSE

Diffusional kurtosis imaging (DKI) measures the deviation of the displacement probability from a normal distribution, complementing the data commonly acquired by diffusion MRI. It is important to elucidate the sources of kurtosis contrast, particularly in biological tissues where microscopic kurtosis (intrinsic kurtosis) and diffusional heterogeneity may co-exist.

METHODS

We have developed a technique for microscopic kurtosis MRI, dubbed microscopic diffusional kurtosis imaging (µDKI), using a symmetrized double diffusion encoding (s-DDE) EPI sequence. We compared this newly developed µDKI to conventional DKI methods in both a triple compartment phantom and in vivo.

RESULTS

Our results showed that whereas conventional DKI and µDKI provided similar measurements in a compartment of monosphere beads, kurtosis measured by µDKI was significantly less than that measured by conventional DKI in a compartment of mixed Gaussian pools. For in vivo brain imaging, µDKI showed small yet significantly lower kurtosis measurement in regions of the cortex, CSF, and internal capsule compared to the conventional DKI approach.

CONCLUSIONS

Our study showed that µDKI is less susceptible than conventional DKI to sub-voxel diffusional heterogeneity. Our study also provided important preliminary demonstration of our technique in vivo, warranting future studies to investigate its diagnostic use in examining neurological disorders.

Measuring intra-axonal T2 in white matter with direction-averaged diffusion MRI

PURPOSE

To demonstrate how the T₂ relaxation time of intra-axonal water (T_2a ) in white matter can be measured with direction-averaged diffusion MRI.

METHODS

For b-values larger than about 4000 s/mm² , the direction-averaged diffusion MRI signal from white matter is dominated by the contribution from water within axons, which enables T_2a to be estimated by acquiring data for multiple TE values and fitting a mono-exponential decay curve. If given a value of the intra-axonal diffusivity, an extension of the method allows the extra-axonal relaxation time (T_2e ) to be calculated also. This approach was applied to estimate T_2a in white matter for 3 healthy subjects at 3 T, as well as T_2e for a selected set of assumed intra-axonal diffusivities.

RESULTS

The estimated T_2a values ranged from about 50 ms to 110 ms, with considerable variation among white matter regions. For white matter tracts with primarily collinear fibers, T_2a was found to depend on the angle of the tract relative to the main magnetic field, which is consistent with T_2a being affected by magnetic field inhomogeneities arising from spatial differences in magnetic susceptibility. The T_2e values were significantly smaller than the T_2a values across white matter regions for several plausible choices of the intra-axonal diffusivity.

CONCLUSION

The relaxation time for intra-axonal water in white matter can be determined in a straightforward manner by measuring the direction-averaged diffusion MRI signal with a large b-value for multiple TEs. In healthy brain, T_2a is greater than T_2e and varies considerably with anatomical region.

Two-dimensional magnetization-transfer - CPMG MRI reveals tract-specific signatures in fixed rat spinal cord

Multiexponential T₂ (MET₂) Relaxometry and Magnetization Transfer (MT) are among the most promising MRI-derived techniques for white matter (WM) characterization. Both techniques are shown to have histologically correlated sensitivity to myelin, but these correlations are not fully understood. Furthermore, MET₂ and MT report on different WM features, thus they can be considered specific to different (patho)physiological states. Two-dimensional studies potentially resolving interactions, such as those commonly used in NMR, have been rarely performed in this context. Here, we investigated how off-resonance irradiation affects different MET₂ components in fixed rat spinal cord white matter at 16.4 T. These 2D MT-MET₂ experiments reveal that MT affects both short and long T₂ components in a tract-specific fashion. The spatially distinct signal modulations enhanced contrast between microstructurally-distinct spinal cord tracts. Two hypotheses to explain these findings were proposed: either selective elimination of a short T₂ component through pre-saturation combines with intercompartmental water exchange effects occurring on the irradiation timescale; or, other macromolecular species that exist within the tissue - other than myelin - such as neurofilaments, may be involved in the apparent microstructural segregation of the spinal cord (SC) from MET₂. Though further investigation is required to elucidate the underlying mechanism, this phenomenon adds a new dimension for WM characterization.

Myelin volume fraction imaging with MRI

MRI is a valuable tool to assess myelin during development and demyelinating disease processes. While multiexponential T2 and quantitative magnetization transfer measures correlate with myelin content, neither provides the total myelin volume fraction. In many cases correlative measures are adequate; but to assess microstructure of myelin, (e.g. calculate the g-ratio using MRI), an accurate measure of myelin volume fraction is imperative. Using a volumetric model of white matter, we relate MRI measures of myelin to absolute measures of myelin volume fraction and compare them to quantitative histology. We assess our approach in control mice along with two models of hypomyelination and one model of hypermyelination and find strong agreement between MRI and histology amongst models. This work investigates the sensitivities of MRI myelin measures to changes in axon geometry and displays promise for estimating g-ratio from MRI.

Axons morphometry in the human spinal cord

Due to the technical challenges of large-scale microscopy and analysis, to date only limited knowledge has been made available about axon morphometry (diameter, shape, myelin thickness, volume fraction), thereby limiting our understanding of neuronal microstructure and slowing down research on neurodegenerative pathologies. This study addresses this knowledge gap by establishing a state-of-the-art acquisition and analysis framework for mapping axon morphometry, and providing the first comprehensive mapping of axon morphometry in the human spinal cord. We dissected, fixed and stained a human spinal cord with osmium tetroxide, and used a scanning electron microscope to image the entirety of 23 axial slices, covering C1 to L5 spinal levels. An automatic method based on deep learning was then used to segment each axon and myelin sheath to produce maps of axon morphometry. These maps were then registered to a standard spinal cord magnetic resonance imaging (MRI) template. Between 500,000 (lumbar) and 1 million (cervical) myelinated axons were segmented at each level of this human spinal cord. Morphometric features show a large disparity between tracts, but high right-left symmetry. Our results suggest a modality-based organization of the dorsal column in the human, as it has been observed in the rat. The generated axon morphometry template is publicly available at https://osf.io/8k7jr/ and could be used as a reference for quantitative MRI studies. The proposed framework for axon morphometry mapping could be extended to other parts of the central or peripheral nervous system that exhibit coherently-oriented axons.

White matter intercompartmental water exchange rates determined from detailed modeling of the myelin sheath

PURPOSE

Magnetization exchange (ME) between hydrogen protons of water and large molecules (semisolids [SS]) in lipid bilayers is an important factor in MRI signal generation and can be exploited to study white matter pathology. Current models used to quantify ME in white matter generally consider water to reside in 1 or 2 distinct compartments, ignoring the complexities of the myelin sheath's multicompartment structure of alternating myelin SS and myelin water (MW) layers. Here, we investigated the effect of this by fitting ME data obtained from human brain at 7 T with a multilayer model of myelin.

METHODS

A multi-echo acquisition for a T₂ ^* -based separation of MW from other water signals was combined with various preparation pulses to change the (relative) state of the SS and water pools and analyzed by fitting with a multilayer exchange model.

RESULTS

The estimated lifetime within a single MW layer was 260 µs, corresponding to a lipid bilayer permeability of 6.7 µm/s. The magnetization lifetime of the aggregate of all MW was estimated at 13 ms, shorter than previously reported values in the range of 40 to 140 ms.

CONCLUSION

Contrary to expectations and previous reports, ME between protons in myelin SS and water is not limited by the myelin sheath but rather by the exchange between SS and water protons. The analysis of ME contrast should account for the relatively short MW lifetime and affects the interpretation of tissue compartmentalization from MRI contrasts such as T₁ - and diffusion-weighting.

Myelin Measurement: Comparison Between Simultaneous Tissue Relaxometry, Magnetization Transfer Saturation Index, and T1w/T2w Ratio Methods

Magnetization transfer (MT) imaging has been widely used for estimating myelin content in the brain. Recently, two other approaches, namely simultaneous tissue relaxometry of R1 and R2 relaxation rates and proton density (SyMRI) and the ratio of T1-weighted to T2-weighted images (T1w/T2w ratio), were also proposed as methods for measuring myelin. SyMRI and MT imaging have been reported to correlate well with actual myelin by histology. However, for T1w/T2w ratio, such evidence is limited. In 20 healthy adults, we examined the correlation between these three methods, using MT saturation index (MTsat) for MT imaging. After calibration, white matter (WM) to gray matter (GM) contrast was the highest for SyMRI among these three metrics. Even though SyMRI and MTsat showed strong correlation in the WM (r = 0.72), only weak correlation was found between T1w/T2w and SyMRI (r = 0.45) or MTsat (r = 0.38) (correlation coefficients significantly different from each other, with p values < 0.001). In subcortical and cortical GM, these measurements showed moderate to strong correlations to each other (r = 0.54 to 0.78). In conclusion, the high correlation between SyMRI and MTsat indicates that both methods are similarly suited to measure myelin in the WM, whereas T1w/T2w ratio may be less optimal.

MRI gradient-echo phase contrast of the brain at ultra-short TE with off-resonance saturation

Larmor-frequency shift or image phase measured by gradient-echo sequences has provided a new source of MRI contrast. This contrast is being used to study both the structure and function of the brain. So far, phase images of the brain have been largely obtained at long echo times as maximum phase signal-to-noise ratio (SNR) is achieved at TE = T2* (∼40 ms at 3T). The structures of the brain, however, are compartmentalized and complex with a wide range of signal relaxation times. At such long TE, the short-T2 components are largely attenuated and contribute minimally to phase contrast. The purpose of this study was to determine whether proton gradient-echo images of the brain exhibit phase contrast at ultra-short TE (UTE). Our data showed that UTE images acquired at 7 T without off-resonance saturation do not contain significant phase contrast between gray and white matter. However, UTE images of the brain can attain strong phase contrast even at a nominal TE of 106 μs by using off-resonance RF saturation pulses, which provide direct saturation of ultra-short-T2 components and indirect saturation of longer-T2 components via magnetization transfer. In addition, phase contrast between gray and white matter acquired at UTE with off-resonance saturation is reversed compared to that of the long-T2 signals acquired at long TEs. This finding opens up a potential new way to manipulate image phase contrast of the brain. By accessing short and ultra-short-T2 species, MRI phase images may further improve the characterization of tissue microstructure in the brain.

Inferring brain tissue composition and microstructure via MR relaxometry

MRI relaxometry is sensitive to a variety of tissue characteristics in a complex manner, which makes it both attractive and challenging for characterizing tissue. This article reviews the most common water proton relaxometry measures, T₁, T₂, and T₂^*, and reports on their development and current potential to probe the composition and microstructure of brain tissue. The development of these relaxometry measures is challenged by the need for suitably accurate tissue models, as well as robust acquisition and analysis methodologies. MRI relaxometry has been established as a tool for characterizing neural tissue, particular with respect to myelination, and the potential for further development exists.

The role of magnetization transfer in the observed contrast in T1 weighted imaging under clinical setups

In T₁ weighted magnetic resonance imaging of brain and spinal cord in the clinical setting, the white matter (WM) appears with greater intensity than the gray matter (GM). This contrast has been assigned to differences in T₁ values. In these experiments the RF pulses are too long to excite both the water and the species with restricted motion of the protons (SRMP). In in vitro studies using short RF pulses, the contrast is reversed, with greater intensity for the GM. These results raise the question of whether magnetization transfer (MT) plays a role in the contrast observed in the T₁ weighting experiments. In the present work we implemented selective saturation recovery alone and together with the conventional magnetization transfer contrast (MTC) method. The results confirm that a major factor that determines the characteristic WM/GM averaged intensity ratio observed in T₁ weighted imaging under clinical conditions is MT between the SRMP and water. When selective saturation recovery is combined with MTC, the SRMP yields spectral widths ranging from a few to tens of kilohertz, indicating that more than one type of SRMP is involved in the MT. The z-spectrum obtained with this combination is free of the effect of direct saturation of the water peak. Selective saturation recovery enables an independent measurement of the exchange time and T₁ , while the combination with MTC with complete saturation of the SRMP enables measurement of T₁ without the effect of MT. The latter measurement can be carried out on a timescale much shorter than T_1.

Advances in noninvasive myelin imaging

Myelin is important for the normal development and healthy function of the nervous system. Recent developments in MRI acquisition and tissue modeling aim to provide a better characterization and more specific markers for myelin. This allows for specific monitoring of myelination longitudinally and noninvasively in the healthy brain as well as assessment of treatment and intervention efficacy. Here, we offer a nontechnical review of MRI techniques developed to specifically monitor myelin such as magnetization transfer (MT) and myelin water imaging (MWI). We further summarize recent studies that employ these methods to measure myelin in relation to development and aging, learning and experience, and neuropathology and psychiatric disorders. © 2017 The Authors. Developmental Neurobiology Published by Wiley Periodicals, Inc. Develop Neurobiol 78: 136–151, 2018

Towards quantification of myelin by solid-state MRI of the lipid matrix protons

PURPOSE

Direct assessment of myelin has the potential to reveal central nervous system abnormalities and serve as a means to follow patients with demyelinating disorders during treatment. Here, we investigated the feasibility of direct imaging and quantification of the myelin proton pool, without the many possible confounds inherent to indirect methods, via long-T₂ suppressed 3D ultra-short echo-time (UTE) and zero echo-time (ZTE) MRI in ovine spinal cord.

METHODS

ZTE and UTE experiments, with and without inversion-recovery (IR) preparation, were conducted in ovine spinal cords before and after D₂O exchange of tissue water, on a 9.4T vertical-bore micro-imaging system, along with some feasibility experiments on a 3T whole-body scanner. Myelin density was quantified relative to reference samples containing various mass fractions of purified myelin lipid, extracted via the sucrose gradient extraction technique, and reconstituted by suspension in water, where they spontaneously self-assemble into an ensemble of multi-lamellar liposomes, analogous to native myelin.

RESULTS

MR signal amplitudes from reference samples at 9.4T were linearly correlated with myelin concentration (R² = 0.98-0.99), enabling their use in quantification of myelin fraction in neural tissues. An adiabatic inversion-recovery preparation was found to effectively suppress long-T₂ water signal in white matter, leaving short-T₂ myelin protons to be imaged. Estimated myelin lipid fractions in white matter were 19.9%-22.5% in the D₂O-exchanged spinal cord, and 18.1%-23.5% in the non-exchanged spinal cord. Numerical simulations based on the myelin spectrum suggest that approximately 4.59% of the total myelin proton magnetization is observable by IR-ZTE at 3T due to T₂ decay and the inability to excite the shortest T₂* components. Approximately 380 μm of point-spread function blurring is predicted, and ZTE images of the spinal cord acquired at 3T were consistent with this estimate.

CONCLUSION

In the present implementation, IR-UTE at 9.4T produced similar estimates of myelin concentration in D₂O-exchanged and non-exchanged spinal cord white matter. 3T data suggest that direct myelin imaging is feasible, but remaining challenging on clinical MR systems.

Whole brain g-ratio mapping using myelin water imaging (MWI) and neurite orientation dispersion and density imaging (NODDI)

MR g-ratio, which measures the ratio of the aggregate volume of axons to that of fibers in a voxel, is a potential biomarker for white matter microstructures. In this study, a new approach for acquiring an in-vivo whole human brain g-ratio map is proposed. To estimate the g-ratio, myelin volume fraction and axonal volume fraction are acquired using multi-echo gradient echo myelin water imaging (GRE-MWI) and neurite orientation dispersion and density imaging (NODDI), respectively. In order to translate myelin water fraction measured in GRE-MWI into myelin volume fraction, a new scaling procedure is proposed and validated. This scaling approach utilizes geometric measures of myelin structure and, therefore, provides robustness over previous methods. The resulting g-ratio map reveals an expected range of g-ratios (0.71-0.85 in major fiber bundles) with a small inter-subject coefficient of variance (less than 2%). Additionally, a few fiber bundles (e.g. cortico-spinal tract and optic radiation) show different constituents of myelin volume fraction and axonal volume fraction, indicating potentials to utilize the measures for deciphering fiber tracking.

Promise and pitfalls of g-ratio estimation with MRI

The fiber g-ratio is the ratio of the inner to the outer diameter of the myelin sheath of a myelinated axon. It has a limited dynamic range in healthy white matter, as it is optimized for speed of signal conduction, cellular energetics, and spatial constraints. In vivo imaging of the g-ratio in health and disease would greatly increase our knowledge of the nervous system and our ability to diagnose, monitor, and treat disease. MRI based g-ratio imaging was first conceived in 2011, and expanded to be feasible in full brain white matter with preliminary results in 2013. This manuscript reviews the growing g-ratio imaging literature and speculates on future applications. It details the methodology for imaging the g-ratio with MRI, and describes the known pitfalls and challenges in doing so.