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De Lury AD, Bisulca JA, Lee JS, Altaf MD, Coyle PK, Duong TQ. Magnetic resonance imaging detection of deep gray matter iron deposition in multiple sclerosis: A systematic review. J Neurol Sci 2023; 453:120816. [PMID: 37827008 DOI: 10.1016/j.jns.2023.120816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023]
Abstract
Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease involving immune-mediated damage. Iron deposition in deep gray matter (DGM) structures like the thalamus and basal ganglia have been suggested to play a role in MS pathogenesis. Magnetic Resonance Imaging (MRI) imaging methods like T2 and T2* imaging, susceptibility-weighted imaging, and quantitative susceptibility mapping can track iron deposition storage in the brain primarily from ferritin and hemosiderin (paramagnetic iron storage proteins) with varying levels of tissue contrast and sensitivity. In this systematic review, we evaluated the role of DGM iron deposition as detected by MRI techniques in relation to MS-related neuroinflammation and its potential as a novel therapeutic target. We searched through PubMed, Embase, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, against predetermined inclusion and exclusion criteria. We included 89 articles (n = 6630 patients), and then grouped them into different categories: i) methodological techniques to measure DGM iron, ii) cross-sectional and group comparison of DGM iron content, iii) longitudinal comparisons of DGM iron, iv) associations between DGM iron and other imaging and neurobiological markers, v) associations with disability, and vi) associations with cognitive impairment. The review revealed that iron deposition in DGM is independent yet concurrent with demyelination, and that these iron deposits contribute to MS-related cognitive impairment and disability. Variability in iron distributions appears to rely on a positive feedback loop between inflammation, and release of iron by oligodendrocytes. DGM iron seems to be a promising prognostic biomarker for MS pathophysiology.
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Affiliation(s)
- Amy D De Lury
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Joseph A Bisulca
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Jimmy S Lee
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Muhammad D Altaf
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Patricia K Coyle
- Department of Neurology, Stony Brook University Medical Center, Stony Brook, NY, USA.
| | - Tim Q Duong
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
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Shen X, Özen AC, Monsivais H, Susnjar A, Ilbey S, Zheng W, Du Y, Chiew M, Emir U. High-resolution 3D ultra-short echo time MRI with Rosette k-space pattern for brain iron content mapping. J Trace Elem Med Biol 2023; 77:127146. [PMID: 36871432 PMCID: PMC10107748 DOI: 10.1016/j.jtemb.2023.127146] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/10/2023] [Accepted: 01/31/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND The iron concentration increases during normal brain development and is identified as a risk factor for many neurodegenerative diseases, it is vital to monitor iron content in the brain non-invasively. PURPOSE This study aimed to quantify in vivo brain iron concentration with a 3D rosette-based ultra-short echo time (UTE) magnetic resonance imaging (MRI) sequence. METHODS A cylindrical phantom containing nine vials of different iron concentrations (iron (II) chloride) from 0.5 millimoles to 50 millimoles and six healthy subjects were scanned using 3D high-resolution (0.94 ×0.94 ×0.94 mm3) rosette UTE sequence at an echo time (TE) of 20 μs. RESULTS Iron-related hyperintense signals (i.e., positive contrast) were detected based on the phantom scan, and were used to establish an association between iron concentration and signal intensity. The signal intensities from in vivo scans were then converted to iron concentrations based on the association. The deep brain structures, such as the substantia nigra, putamen, and globus pallidus, were highlighted after the conversion, which indicated potential iron accumulations. CONCLUSION This study suggested that T1-weighted signal intensity could be used for brain iron mapping.
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Affiliation(s)
- Xin Shen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Ali Caglar Özen
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - Antonia Susnjar
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
| | - Serhat Ilbey
- Department of Radiology, Medical Physics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Wei Zheng
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Yansheng Du
- Department of Neurology, School of Medicine, Indiana University, Bloomington, IN, USA
| | - Mark Chiew
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Uzay Emir
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; School of Health Sciences, Purdue University, West Lafayette, IN, USA.
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Zachariou V, Bauer CE, Pappas C, Gold BT. High cortical iron is associated with the disruption of white matter tracts supporting cognitive function in healthy older adults. Cereb Cortex 2022; 33:4815-4828. [PMID: 36182267 PMCID: PMC10110441 DOI: 10.1093/cercor/bhac382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 01/25/2023] Open
Abstract
Aging is associated with brain iron accumulation, which has been linked to cognitive decline. However, how brain iron affects the structure and function of cognitive brain networks remains unclear. Here, we explored the possibility that iron load in gray matter is associated with disruption of white matter (WM) microstructure within a network supporting cognitive function, in a cohort of 95 cognitively normal older adults (age range: 60-86). Functional magnetic resonance imaging was used to localize a set of brain regions involved in working memory and diffusion tensor imaging based probabilistic tractography was used to identify a network of WM tracts connecting the functionally defined regions. Brain iron concentration within these regions was evaluated using quantitative susceptibility mapping and microstructural properties were assessed within the identified tracts using neurite orientation dispersion and density imaging. Results indicated that high brain iron concentration was associated with low neurite density (ND) within the task-relevant WM network. Further, regional associations were observed such that brain iron in cortical regions was linked with lower ND in neighboring but not distant WM tracts. Our results provide novel evidence suggesting that age-related increases in brain iron concentration are associated with the disruption of WM tracts supporting cognitive function in normal aging.
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Affiliation(s)
- Valentinos Zachariou
- Department of Neuroscience, University of Kentucky, Lexington, KY 40536-0298, United States.,College of Medicine, University of Kentucky, Lexington, KY 40536-0298, United States
| | - Christopher E Bauer
- Department of Neuroscience, University of Kentucky, Lexington, KY 40536-0298, United States.,College of Medicine, University of Kentucky, Lexington, KY 40536-0298, United States
| | - Colleen Pappas
- Department of Neuroscience, University of Kentucky, Lexington, KY 40536-0298, United States.,College of Medicine, University of Kentucky, Lexington, KY 40536-0298, United States
| | - Brian T Gold
- Department of Neuroscience, University of Kentucky, Lexington, KY 40536-0298, United States.,College of Medicine, University of Kentucky, Lexington, KY 40536-0298, United States.,Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY 40536-0298, United States.,Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY 40536-0298, United States
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A Preliminary Study of Alterations in Iron Disposal and Neural Activity in Ischemic Stroke. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4552568. [PMID: 35971446 PMCID: PMC9375706 DOI: 10.1155/2022/4552568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
Purpose The study aimed to evaluate the postrehabilitation changes in deep gray matter (DGM) nuclei, corticospinal tract (CST), and motor cortex area, involved in motor tasks in patients with ischemic stroke. Methods Three patients participated in this study, who had experienced an ischemic stroke on the left side of the brain. They underwent a standard rehabilitation program for four consecutive weeks, including transcranial direct current stimulation (tDCS), neuromuscular electrical stimulation (NMES), and occupational therapy. The patients' motor ability was evaluated by Fugl-Meyer assessment-upper extremity (FMA-UE) and Wolf motor function test (WMFT). Multimodal magnetic resonance imaging (MRI) was acquired from the patients by a 3 Tesla machine before and after the rehabilitation. The magnetic susceptibility changes were examined in DGM nuclei including the bilateral caudate (CA), putamen (PT), globus pallidus (GP), and thalamus (TH) using quantitative susceptibility mapping (QSM). Functional MRI (fMRI) in the motor cortex areas was acquired to evaluate the postrehab functional motor activity. The three-dimensional corticospinal tract (CST) was reconstructed using diffusion-weighted imaging (DWI) and diffusion tensor tractography (DTT), and the fractional anisotropy (FA) was measured along the tract. Ultimately, the relationship between the structural and functional changes was evaluated in CST and motor cortex. Results Postrehabilitation FMA-UE and WMFT scores increased for all patients compared to the prerehabilitation. QSM analysis revealed increasing in susceptibility values in GP and CA in all patients at the ipsilesional hemisphere. By fMRI analysis, the ipsilesional hemisphere demonstrated an increase in functional activity in motor areas for all 3 patients. In the ipsilesional hemisphere, the fractional anisotropy (FA) was increased in CST in two patients, while the mean diffusivity (MD) was decreased in CA in a patient, in PT and TH in another patient, and in PT in two patients. Conclusion This preliminary study demonstrates that the magnetic susceptibility may decrease at some ipsilesional DGM nuclei after tDCS, NMES, and occupational therapy for patients with ischemic stroke, suggesting a drop in the level of iron deposition, which may be associated with an increase in the level of activity in motor cortex after rehabilitation.
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Cho H, Lee H, Gong Y, Kim YR, Cho J, Cho HJ. Quantitative susceptibility mapping and R1 measurement: Determination of the myelin volume fraction in the aging ex vivo rat corpus callosum. NMR IN BIOMEDICINE 2022; 35:e4645. [PMID: 34739153 DOI: 10.1002/nbm.4645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 10/03/2021] [Accepted: 10/16/2021] [Indexed: 06/13/2023]
Abstract
In studies of the white matter (WM) in aging brains, both quantitative susceptibility mapping (QSM) and direct R1 measurement offer potentially useful ex vivo MRI tools that allow volumetric characterization of myelin content changes. Despite the technical importance of such MRI methods in numerous age-related diseases, the supposed linear relationship between the estimates of either the QSM or R1 method and age-affected myelin contents has not been validated. In this study, the absolute myelin volume fraction (MVF) was determined by transmission electron microscopy (TEM) as a gold standard measure for comparison with the values obtained by the aforementioned MR methods. To theoretically evaluate and understand the MR signal characteristics, QSM simulations were performed using the finite perturber method (FPM). Specifically, the simulation geometry modeling was based on TEM-derived structures aligned orthogonally to the main magnetic field, the construct of which was used to estimate the magnetic field shift (ΔB) changes arising from the conjectured myelin structures. Experimentally, ex vivo corpus callosum (CC) samples from rat brains obtained at 6 weeks (n = 3), 4 months (n = 3), and 20 months (n = 3) after birth were used to establish the relationship between changes quantified by either QSM or R1 with the absolute MVF by TEM. From the ex vivo brain samples, the scatterplot of mean MVF versus R1 was fitted to a linear equation, where R1mean = 0.7948 × MVFmean + 0.8118 (Pearson's correlation coefficient r = 0.9138; p < 0.01), while the scatterplot of mean MVF versus MRI-derived magnetic susceptibility (χ) was also fitted to a line where χmeasured,mean = -0.1218 × MVFmean - 0.006345 (r = -0.8435; p < 0.01). As a result of the FPM-based QSM simulations, a linearly proportional relationship between the simulated magnetic susceptibility, χsimulated,mean , and MVF (r = -0.9648; p < 0.01) was established. Such a statistically significant linear correlation between MRI-derived values by the QSM (or R1 ) method and MVF demonstrated that variable myelin contents in the WM (i.e., CC) can be quantified across multiple stages of aging. These findings further support that both techniques based on QSM and R1 provide an efficient means of studying the brain-aging process with accurate volumetric quantification of the myelin content in WM.
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Affiliation(s)
- Hwapyeong Cho
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Hansol Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Yelim Gong
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Young Ro Kim
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Junghun Cho
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Hyung Joon Cho
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea
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Mechanism-based criteria to improve therapeutic outcomes in progressive multiple sclerosis. Nat Rev Neurol 2021; 18:40-55. [PMID: 34732831 DOI: 10.1038/s41582-021-00581-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 02/07/2023]
Abstract
In contrast to the multiple disease-modifying therapies that are available for relapsing-remitting multiple sclerosis (MS), the therapeutic options for progressive MS (PMS) are limited. Recent advances in our understanding of the neuroimmunology of PMS, including the mechanisms that drive slowly expanding lesions, have fuelled optimism for improved treatment of this condition. In this Review, we highlight the commonly observed neuropathology of PMS and discuss the associated mechanisms of CNS injury. We then apply this knowledge to formulate criteria for therapeutic efficacy in PMS, beginning with the need for early treatment owing to the substantial neuropathology that is already present at the initial clinical presentation. Other requirements include: antagonism of neuroaxonal injury mediators such as pro-inflammatory microglia and lymphocytes; remediation of oxidative stress resulting from iron deposition and mitochondrial dysfunction; and promotion of neuroprotection through remyelination. We consider whether current disease-modifying therapies for relapsing-remitting MS meet the criteria for successful therapeutics in PMS and suggest that the evidence favours the early introduction of sphingosine 1-phosphate receptor modulators. Finally, we weigh up emerging medications, including repurposed generic medications and Bruton's tyrosine kinase inhibitors, against these fundamental criteria. In this new therapeutic era in PMS, success depends collectively on understanding disease mechanisms, drug characteristics (including brain penetration) and rational use.
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Li J, Zhang Q, Che Y, Zhang N, Guo L. Iron Deposition Characteristics of Deep Gray Matter in Elderly Individuals in the Community Revealed by Quantitative Susceptibility Mapping and Multiple Factor Analysis. Front Aging Neurosci 2021; 13:611891. [PMID: 33935681 PMCID: PMC8079745 DOI: 10.3389/fnagi.2021.611891] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/15/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose The objective of this study was to determine which factors influence brain iron concentrations in deep gray matter in elderly individuals and how these factors influence regional brain iron concentrations. Methods A total of 105 elderly individuals were enrolled in this study. All participants underwent detailed magnetic resonance imaging (MRI) examinations from October 2018 to August 2019. Among them, 44 individuals had undergone a previous MRI examination from July 2010 to August 2011. Quantitative susceptibility mapping (QSM) was utilized as an indirect quantitative marker of brain iron, and the susceptibility values of deep gray matter structures were obtained. Univariate analysis and multiple linear regression analysis were used to investigate 11 possible determinants for cerebral iron deposition. Results Our results showed no sex- or hemisphere-related differences in susceptibility values in any of the regions studied. Aging was significantly correlated with increased insusceptibility values in almost all analyzed brain regions (except for the thalamus) when we compared the susceptibility values at the two time points. In a cross-sectional analysis, the relationship between gray matter nucleus susceptibility values and age was conducted using Pearson’s linear regression. Aging was significantly correlated with the susceptibility values of the globus pallidus (GP), putamen (Put), and caudate nucleus (CN), with the Put having the strongest correlations. In multiple linear regression models, associations with increased susceptibility values were found in the CN, Put, red nucleus, and dentate nucleus for individuals with a history of type 2 diabetes mellitus (T2DM). However, the patients with hypertension showed significantly reduced susceptibility values in the red nucleus and dentate nucleus. Our data suggested that smokers had increased susceptibility values in the thalamus. No significant associations were found for individuals with a history of hypercholesterolemia and Apolipoprotein E4 carrier status. Conclusion Our data revealed that aging, T2DM, and smoking could increase iron deposition in some deep gray matter structures. However, hypertension had the opposite effects in the red nuclei and dentate nuclei. Brain iron metabolism could be influenced by many factors in different modes. In future studies, we should strictly control for confounding factors.
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Affiliation(s)
- Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qihao Zhang
- Department of Radiology, Weill Cornell Medical College, Cornell University, New York City, NY, United States
| | - Yena Che
- Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Nan Zhang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Lingfei Guo
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Li J, Zhang Q, Zhang N, Guo L. Increased Brain Iron Detection by Voxel-Based Quantitative Susceptibility Mapping in Type 2 Diabetes Mellitus Patients With an Executive Function Decline. Front Neurosci 2021; 14:606182. [PMID: 33519360 PMCID: PMC7843466 DOI: 10.3389/fnins.2020.606182] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose Brain iron accumulation has been suggested as a pathomechanism in patients with type 2 diabetes mellitus (T2DM) with cognitive impairment. This research aims to examine the total-brain pattern of iron accumulation in relation to executive function decline in patients with T2DM by voxel-based quantitative susceptibility mapping (QSM) analysis. Materials and Methods A total of 32 patients with T2DM and 34 age- and sex-matched healthy controls (HCs) were enrolled in this study. All participants underwent brain magnetic resonance examination, and 48 individuals underwent cognitive function assessments. Imaging data were collected with three-dimensional fast low-angle shot sequences to achieve magnitude as well as phase images. Using voxel-based QSM analysis, we compared the voxel-wise susceptibility values of the whole brain among groups and explored whether the susceptibility values had correlations with cognitive data. Results Among the 66 participants, cognitive function was estimated in 23 patients with T2DM (11 males and 12 females; average age, 64.65 ± 8.44 years) and 25 HCs (13 males and 12 females; average age, 61.20 ± 7.62 years). T2DM patients exhibited significantly (t = 4.288, P < 0.001) lower Montreal Cognitive Assessment (MoCA) scores [T2DM, 27 (27, 28); HCs, 29 (28, 29); normal standard ≥ 26)] and higher Trail-making Test (TMT)-A/TMT-B scores [71 (51, 100)/185 (149, 260)] than HCs [53 (36.5, 63.5)/150 (103, 172.5)] (Z = 2.612, P = 0.009; Z = 2.797, P = 0.005). Subjects with T2DM showed significantly higher susceptibility values than HCs in the caudate/putamen/pallidum, frontal inferior triangular gyrus, and precentral gyrus on the right hemisphere. In contrast (HC > T2DM), no region showed a significant difference in susceptibility values between the groups. The correlation analysis between susceptibility values and cognitive function scores was tested by voxel-based susceptibility value with sex and age as covariates. After multiple comparison correction, in T2DM patients, the left thalamus showed a significant relationship with TMT-A (R 2 = 0.53, P = 0.001). The right thalamus and left thalamus showed a significant relationship with TMT-B (R 2 = 0.35, P = 0.019; and R 2 = 0.38, P = 0.017, respectively). In HCs, the cluster of right precentral/middle frontal gyrus/inferior frontal gyrus/inferior triangular gyrus showed a significant relationship with TMT-B (R 2 = 0.59, P = 0.010). No relationship was found between the susceptibility values with MoCA in the brain region in both two groups. Conclusion Patients with T2DM presented declined cognitive assessments and elevated iron deposition in the striatum and frontal lobe, suggesting that executive function decline in T2DM might be associated with the cerebral iron burden and that changes in susceptibility values may represent a latent quantitative imaging marker for early assessment of cognitive decline in patients with T2DM.
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Affiliation(s)
- Jing Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qihao Zhang
- Department of Radiology, Weill Cornell Medical College, New York, NY, United States
| | - Nan Zhang
- Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lingfei Guo
- Shandong Medical Imaging Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
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Al-Radaideh A, El-Haj N, Hijjawi N. Iron deposition and atrophy in cerebral grey matter and their possible association with serum iron in relapsing-remitting multiple sclerosis. Clin Imaging 2020; 69:238-242. [PMID: 32977196 DOI: 10.1016/j.clinimag.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/17/2020] [Accepted: 09/11/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The present study was carried out to investigate any possible linkage between cerebral grey matter volumetric, iron changes, white matter's lesions load and serum iron levels in a group of relapsing-remitting multiple sclerosis (RRMS) patients. MATERIALS AND METHODS Sixty-five RRMS patients along with thirty-four age-matched healthy controls (HCs) were recruited. Serum samples were isolated from blood samples which were collected in vacutainer plain tubes individually from both groups. Both groups were scanned at 1.5 T magnetic resonance imaging (MRI) using the following 3D sequences; T1-weighted gradient echo (MPRAGE), T2*-weighted gradient echo and T2-weighted fluid-attenuated inversion recovery (FLAIR). RESULTS Significant differences were observed between the RRMS patients and HCs for cortical and deep grey matter (dGM) volumes where cortical and dGM volumes in RRMS patient were significantly smaller than those in HCs. While iron deposition in the cortex, putamen (PT) and globus pallidus (GP) of RRMS patients were significantly higher than those of HCs, iron levels in thalamus (TH) and serum were significantly lower in RRMS compared to those in HCs. Except for T2 lesion load, none of volumetric measures showed any association with patients' disability status. Cerebral grey matter's iron changes did not show any association with those of serum. CONCLUSION Smaller cortical and subcortical grey matter volumes in RRMS patients compared to HCs were detected. None of the volumetric measures showed any association with patients' disability status. RRMS patients showed increased iron levels in the PT, GP and cortex and decreased levels in the TH and serum.
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Affiliation(s)
- Ali Al-Radaideh
- Department of Medical Imaging, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan.
| | - Nawal El-Haj
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
| | - Nawal Hijjawi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan
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Erbay MF, Kamışlı Ö, Karatoprak NB. Can T2 blackout effect be a marker of iron accumulation in brains of multiple sclerosis patients? Br J Radiol 2020; 93:20200552. [DOI: 10.1259/bjr.20200552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective : T2 blackout (TBO) effect, which is a common finding in the brains of multiple sclerosis (MS) patients and older population that are imaged for other reasons on diffusion weighted imagings (DWI) and apparent diffusion coefficient (ADC) map show the existence of paramagnetic materials in the tissue. Because iron is known to accumulate in especially deep gray matter (DGM) structures in MS brains, we aimed to investigate the relationship between TBO and clinico-radiological parameters that may be iron-related in MS. Methods: We retrospectively reviewed the latest MR images of MS patients on 3 Tesla MR scanner between 2018 and 2019. TBO existence and severity on DWI–ADC was assessed by two radiologists and its correlation with several outcomes of MS was investigated. Results: No significant relationship was found between TBO and gender, subtype of MS whereas TBO was positively correlated with parameters such as black-hole lesions, cortical atrophy, duration of disease, age and extended disability status scale (EDSS) score. Conclusions: TBO shows correlation with the conditions which were revealed to be associated with iron accumulation in the brain of MS patients in the literature. Therefore, we concluded that TBO and its severity in DGM may represent iron accumulation in MS brains. Advances in knowledge: TBO effect as a frequent imaging finding in daily practice may be used as predictor of the disease course of MS due to possible effects of iron accumulation in brain and thereby may be useful in modifying treatment strategies.
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Affiliation(s)
- Mehmet Fatih Erbay
- Department of Radiology, Inonu UniversityFaculty of Medicine, Malatya, Turkey
| | - Özden Kamışlı
- Department of Neurology, Inonu University Faculty of Medicine, Malatya, Turkey
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Al-Radaideh A, Athamneh I, Alabadi H, Hbahbih M. Deep gray matter changes in relapsing-remitting multiple sclerosis detected by multi-parametric, high-resolution magnetic resonance imaging (MRI). Eur Radiol 2020; 31:706-715. [PMID: 32851443 DOI: 10.1007/s00330-020-07199-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/16/2020] [Accepted: 08/14/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate a variety of magnetic resonance imaging (MRI) quantitative metrics, which reflect different aspects of microstructural damage in deep gray matter (dGM) regions and white matter T2 lesions in patients with relapsing-remitting multiple sclerosis (RRMS), and to determine the level of pathological interconnection between these two entities as well as their association with clinical disability. METHODS We recruited thirty RRMS patients along with thirty age-matched healthy controls (HCs). Both groups were scanned at 3 T MRI using 3D high-resolution T1-, T2-, and T2*-weighted, magnetization transfer (MT)-prepared gradient echo for MT ratio (MTR) mapping, and eight repeats of T1-weighted images acquired at different inversion times to create T1 maps. dGM structures were segmented from T1-weighted images using FreeSurfer, WM-T2 lesions were extracted from T2-weighted images, and iron maps were calculated from the phase part of the T2*-weighted sequence. Extracted dGM MRI indices were compared between both groups. In the RRMS group, dGM MRI indices were correlated with those of WM-T2 lesions, expanded disability status scale, and disease duration. RESULTS dGM volumetric metrics of RRMS patients were significantly (p < 0.01) smaller than those of HCs and showed a significant moderate association with lesions' load (p < 0.05) and lesions' iron concentration (p < 0.01). dGM MTRs of RRMS patients were significantly (p < 0.01) smaller than those of HCs and showed a significant (p < 0.01) moderate correlation with lesion T1 times. While T1 changes in some dGM regions of RRMS patients associated weakly with those of T2 lesions, dGM iron concentration did not show any association with any of lesions' metrics. Furthermore, lesions' MTR changes did not show any association with any dGM metrics. Most dGM metrics did not show any correlation with disease severity. Contrarily, most lesions' metrics showed weak association with disease severity. CONCLUSIONS dGM changes occur in a non-uniform pattern and, almost, do not link directly to MS disease severity. Contrarily, most WM-T2 lesions' metrics tend to correlate with MS disease severity better than those of dGM. KEY POINTS • Deep gray matter (dGM) structures are very much involved in the MS disease process and quite substantial neurodegeneration is undergone during the relapsing-remitting phase of the MS disease. • Deep gray matter (dGM) quantitative changes occur in a non-uniform and non-linked pattern and, except for CN's iron deposition, do not directly associate with the MS disease severity. • Most white matter T2 lesions' metrics tend to correlate with MS disease severity better than those of dGM structures.
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Affiliation(s)
- Ali Al-Radaideh
- Department of Medical Imaging, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, Jordan.
| | - Imad Athamneh
- Department of Radiology, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Hadeel Alabadi
- Department of Radiology, King Hussein Medical Center, Jordanian Royal Medical Services, Amman, Jordan
| | - Majed Hbahbih
- Department of Internal Medicine, Neurology, King Hussein Medical Centre, Jordanian Royal Medical Services, Amman, Jordan
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12
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Schweser F, Raffaini Duarte Martins AL, Hagemeier J, Lin F, Hanspach J, Weinstock-Guttman B, Hametner S, Bergsland N, Dwyer MG, Zivadinov R. Mapping of thalamic magnetic susceptibility in multiple sclerosis indicates decreasing iron with disease duration: A proposed mechanistic relationship between inflammation and oligodendrocyte vitality. Neuroimage 2018; 167:438-452. [PMID: 29097315 PMCID: PMC5845810 DOI: 10.1016/j.neuroimage.2017.10.063] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 12/13/2022] Open
Abstract
Recent advances in susceptibility MRI have dramatically improved the visualization of deep gray matter brain regions and the quantification of their magnetic properties in vivo, providing a novel tool to study the poorly understood iron homeostasis in the human brain. In this study, we used an advanced combination of the recent quantitative susceptibility mapping technique with dedicated analysis methods to study intra-thalamic tissue alterations in patients with clinically isolated syndrome (CIS) and multiple sclerosis (MS). Thalamic pathology is one of the earliest hallmarks of MS and has been shown to correlate with cognitive dysfunction and fatigue, but the mechanisms underlying the thalamic pathology are poorly understood. We enrolled a total of 120 patients, 40 with CIS, 40 with Relapsing Remitting MS (RRMS), and 40 with Secondary Progressive MS (SPMS). For each of the three patient groups, we recruited 40 controls, group matched for age- and sex (120 total). We acquired quantitative susceptibility maps using a single-echo gradient echo MRI pulse sequence at 3 T. Group differences were studied by voxel-based analysis as well as with a custom thalamus atlas. We used threshold-free cluster enhancement (TFCE) and multiple regression analyses, respectively. We found significantly reduced magnetic susceptibility compared to controls in focal thalamic subregions of patients with RRMS (whole thalamus excluding the pulvinar nucleus) and SPMS (primarily pulvinar nucleus), but not in patients with CIS. Susceptibility reduction was significantly associated with disease duration in the pulvinar, the left lateral nuclear region, and the global thalamus. Susceptibility reduction indicates a decrease in tissue iron concentration suggesting an involvement of chronic microglia activation in the depletion of iron from oligodendrocytes in this central and integrative brain region. Not necessarily specific to MS, inflammation-mediated iron release may lead to a vicious circle that reduces the protection of axons and neuronal repair.
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Affiliation(s)
- Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, USA.
| | - Ana Luiza Raffaini Duarte Martins
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Fuchun Lin
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Jannis Hanspach
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Simon Hametner
- Department of Neuroimmunology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, USA
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13
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Al-Radaideh A, Athamneh I, Alabadi H, Hbahbih M. Cortical and Subcortical Morphometric and Iron Changes in Relapsing-Remitting Multiple Sclerosis and Their Association with White Matter T2 Lesion Load. Clin Neuroradiol 2018; 29:51-64. [DOI: 10.1007/s00062-017-0654-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 12/08/2017] [Indexed: 01/05/2023]
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14
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Burgetova A, Dusek P, Vaneckova M, Horakova D, Langkammer C, Krasensky J, Sobisek L, Matras P, Masek M, Seidl Z. Thalamic Iron Differentiates Primary-Progressive and Relapsing-Remitting Multiple Sclerosis. AJNR Am J Neuroradiol 2017; 38:1079-1086. [PMID: 28450431 DOI: 10.3174/ajnr.a5166] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 01/26/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Potential differences between primary progressive and relapsing remitting multiple sclerosis are the subject of ongoing controversial discussions. The aim of this work was to determine whether and how primary-progressive and relapsing-remitting multiple sclerosis subtypes differ regarding conventional MR imaging parameters, cerebral iron deposits, and their association with clinical status. MATERIALS AND METHODS We analyzed 24 patients with primary-progressive MS, 80 with relapsing-remitting MS, and 20 healthy controls with 1.5T MR imaging for assessment of the conventional quantitative parameters: T2 lesion load, T1 lesion load, brain parenchymal fraction, and corpus callosum volume. Quantitative susceptibility mapping was performed to estimate iron concentration in the deep gray matter. RESULTS Decreased susceptibility within the thalamus in relapsing-remitting MS compared with primary-progressive MS was the only significant MR imaging difference between these MS subtypes. In the relapsing-remitting MS subgroup, the Expanded Disability Status Scale score was positively associated with conventional parameters reflecting white matter lesions and brain atrophy and with iron in the putamen and caudate nucleus. A positive association with putaminal iron and the Expanded Disability Status Scale score was found in primary-progressive MS. CONCLUSIONS Susceptibility in the thalamus might provide additional support for the differentiation between primary-progressive and relapsing-remitting MS. That the Expanded Disability Status Scale score was associated with conventional MR imaging parameters and iron concentrations in several deep gray matter regions in relapsing-remitting MS, while only a weak association with putaminal iron was observed in primary-progressive MS suggests different driving forces of disability in these MS subtypes.
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Affiliation(s)
- A Burgetova
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - P Dusek
- Neurology (P.D., D.H.), Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Institute of Neuroradiology (P.D.), University Medicine Göttingen, Göttingen, Germany
| | - M Vaneckova
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - D Horakova
- Neurology (P.D., D.H.), Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - C Langkammer
- Department of Neurology (C.L.), Medical University of Graz, Graz, Austria
| | - J Krasensky
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - L Sobisek
- Department of Statistics and Probability (L.S.), University of Economics, Prague, Czech Republic
| | - P Matras
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - M Masek
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
| | - Z Seidl
- From the Departments of Radiology (A.B., M.V., J.K., P.M., M.M., Z.S.)
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15
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Khodanovich MY, Sorokina IV, Glazacheva VY, Akulov AE, Nemirovich-Danchenko NM, Romashchenko AV, Tolstikova TG, Mustafina LR, Yarnykh VL. Histological validation of fast macromolecular proton fraction mapping as a quantitative myelin imaging method in the cuprizone demyelination model. Sci Rep 2017; 7:46686. [PMID: 28436460 PMCID: PMC5402392 DOI: 10.1038/srep46686] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 03/24/2017] [Indexed: 12/18/2022] Open
Abstract
Cuprizone-induced demyelination in mice is a frequently used model in preclinical multiple sclerosis research. A recent quantitative clinically-targeted MRI method, fast macromolecular proton fraction (MPF) mapping demonstrated a promise as a myelin biomarker in human and animal studies with a particular advantage of sensitivity to both white matter (WM) and gray matter (GM) demyelination. This study aimed to histologically validate the capability of MPF mapping to quantify myelin loss in brain tissues using the cuprizone demyelination model. Whole-brain MPF maps were obtained in vivo on an 11.7T animal MRI scanner from 7 cuprizone-treated and 7 control С57BL/6 mice using the fast single-point synthetic-reference method. Brain sections were histologically stained with Luxol Fast Blue (LFB) for myelin quantification. Significant (p < 0.05) demyelination in cuprizone-treated animals was found according to both LFB staining and MPF in all anatomical structures (corpus callosum, anterior commissure, internal capsule, thalamus, caudoputamen, and cortex). MPF strongly correlated with quantitative histology in all animals (r = 0.95, p < 0.001) as well as in treatment and control groups taken separately (r = 0.96, p = 0.002 and r = 0.93, p = 0.007, respectively). Close agreement between histological myelin staining and MPF suggests that fast MPF mapping enables robust and accurate quantitative assessment of demyelination in both WM and GM.
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Affiliation(s)
- Marina Yu Khodanovich
- Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
| | - Irina V. Sorokina
- Institute of Organic Chemistry, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Valentina Yu Glazacheva
- Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
| | - Andrey E. Akulov
- Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
- Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | | | - Alexander V. Romashchenko
- Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Tatyana G. Tolstikova
- Institute of Organic Chemistry, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | | | - Vasily L. Yarnykh
- Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russian Federation
- Department of Radiology, University of Washington, Seattle, WA, United States
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16
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Jellinger KA, Wenning GK. Overlaps between multiple system atrophy and multiple sclerosis: A novel perspective. Mov Disord 2016; 31:1767-1771. [DOI: 10.1002/mds.26870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/30/2016] [Accepted: 10/02/2016] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Gregor K. Wenning
- Division of Clinical Neurobiology, Department of Neurology; Medical University of Innsbruck; Innsbruck Austria
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17
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Bergsland N, Tavazzi E, Laganà MM, Baglio F, Cecconi P, Viotti S, Zivadinov R, Baselli G, Rovaris M. White Matter Tract Injury is Associated with Deep Gray Matter Iron Deposition in Multiple Sclerosis. J Neuroimaging 2016; 27:107-113. [DOI: 10.1111/jon.12364] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 04/21/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Niels Bergsland
- MR Research Laboratory, IRCCS; Don Gnocchi Foundation ONLUS; Milan Italy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences; State University of New York at Buffalo; Buffalo NY
- Department of Electronics, Information and Bioengineering; Politecnico di Milano; Milan Italy
| | - Eleonora Tavazzi
- Unit of Motor Neurorehabilitation, Multiple Sclerosis Center, IRCCS; Don Gnocchi Foundation ONLUS; Milan Italy
| | | | - Francesca Baglio
- MR Research Laboratory, IRCCS; Don Gnocchi Foundation ONLUS; Milan Italy
| | - Pietro Cecconi
- MR Research Laboratory, IRCCS; Don Gnocchi Foundation ONLUS; Milan Italy
| | - Stefano Viotti
- MR Research Laboratory, IRCCS; Don Gnocchi Foundation ONLUS; Milan Italy
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences; State University of New York at Buffalo; Buffalo NY
- MRI Clinical Translational Research Center, School of Medicine and Biomedical Sciences; University at Buffalo, State University of New York; Buffalo NY
| | - Giuseppe Baselli
- Department of Electronics, Information and Bioengineering; Politecnico di Milano; Milan Italy
| | - Marco Rovaris
- Unit of Motor Neurorehabilitation, Multiple Sclerosis Center, IRCCS; Don Gnocchi Foundation ONLUS; Milan Italy
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18
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Stüber C, Pitt D, Wang Y. Iron in Multiple Sclerosis and Its Noninvasive Imaging with Quantitative Susceptibility Mapping. Int J Mol Sci 2016; 17:ijms17010100. [PMID: 26784172 PMCID: PMC4730342 DOI: 10.3390/ijms17010100] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 01/05/2016] [Accepted: 01/07/2016] [Indexed: 01/06/2023] Open
Abstract
Iron is considered to play a key role in the development and progression of Multiple Sclerosis (MS). In particular, iron that accumulates in myeloid cells after the blood-brain barrier (BBB) seals may contribute to chronic inflammation, oxidative stress and eventually neurodegeneration. Magnetic resonance imaging (MRI) is a well-established tool for the non-invasive study of MS. In recent years, an advanced MRI method, quantitative susceptibility mapping (QSM), has made it possible to study brain iron through in vivo imaging. Moreover, immunohistochemical investigations have helped defining the lesional and cellular distribution of iron in MS brain tissue. Imaging studies in MS patients and of brain tissue combined with histological studies have provided important insights into the role of iron in inflammation and neurodegeneration in MS.
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Affiliation(s)
- Carsten Stüber
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - David Pitt
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - Yi Wang
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
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19
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Stüber C, Pitt D, Wang Y. Iron in Multiple Sclerosis and Its Noninvasive Imaging with Quantitative Susceptibility Mapping. Int J Mol Sci 2016. [PMID: 26784172 DOI: 10.3390/ijmsl17010100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Iron is considered to play a key role in the development and progression of Multiple Sclerosis (MS). In particular, iron that accumulates in myeloid cells after the blood-brain barrier (BBB) seals may contribute to chronic inflammation, oxidative stress and eventually neurodegeneration. Magnetic resonance imaging (MRI) is a well-established tool for the non-invasive study of MS. In recent years, an advanced MRI method, quantitative susceptibility mapping (QSM), has made it possible to study brain iron through in vivo imaging. Moreover, immunohistochemical investigations have helped defining the lesional and cellular distribution of iron in MS brain tissue. Imaging studies in MS patients and of brain tissue combined with histological studies have provided important insights into the role of iron in inflammation and neurodegeneration in MS.
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Affiliation(s)
- Carsten Stüber
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - David Pitt
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - Yi Wang
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
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20
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Große-Veldmann R, Becker B, Amor S, van der Valk P, Beyer C, Kipp M. Lesion Expansion in Experimental Demyelination Animal Models and Multiple Sclerosis Lesions. Mol Neurobiol 2015; 53:4905-17. [DOI: 10.1007/s12035-015-9420-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/02/2015] [Indexed: 01/03/2023]
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