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Calandrelli R, Tuzza L, Romeo DM, Arpaia C, Colosimo C, Pilato F. Extremely Preterm Infants with a Near-total Absence of Cerebellum: Usefulness of Quantitative Magnetic Resonance in Predicting the Motor Outcome. CEREBELLUM (LONDON, ENGLAND) 2024; 23:981-992. [PMID: 37603264 DOI: 10.1007/s12311-023-01593-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 08/22/2023]
Abstract
This study aims to evaluate in extremely premature infants the severity of brain structural injury causing total absence or near-total absence of cerebellar hemispheres by using MRI visual and volumetric scoring systems. It also aims to assess the role of the score systems in predicting motor outcome. We developed qualitative and quantitative MRI scoring systems to grade the overall brain damage severity in 16 infants with total absence or near-total absence of cerebellar hemispheres. The qualitative scoring system assessed the severity of macrostructural abnormalities of cerebellum, brainstem, supratentorial gray and white matters, ventricles while the quantitative scoring system weighted the loss of brain tissue volumes, and gross motor function classification system (GMFCS) was used to assess motor function at 1- and 5-year follow-ups.Positive correlations between both MRI scores and GMFCS scales were detected at follow-ups (p > 0.05), but only the volumetric score could identify those infants developing higher levels of motor impairment.Brain volumetric MRI offers an unbiassed assessment of prenatal brain damage. The quantitative scoring system, performed at term equivalent age, can be a helpful tool for predicting the long-term motor outcome in extremely preterm infants with a near-total absence of cerebellum.
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Affiliation(s)
- Rosalinda Calandrelli
- Radiology and Neuroradiology Unit, Department of Imaging, Radiation Therapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy.
| | - Laura Tuzza
- Radiology and Neuroradiology Unit, Department of Imaging, Radiation Therapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy
| | - Domenico Marco Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Chiara Arpaia
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Cesare Colosimo
- Radiology and Neuroradiology Unit, Department of Imaging, Radiation Therapy and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 1, 00168, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabio Pilato
- Research Unit of Neurology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, -00128, Rome, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, -00128, Rome, Italy
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Öz G, Cocozza S, Henry PG, Lenglet C, Deistung A, Faber J, Schwarz AJ, Timmann D, Van Dijk KRA, Harding IH. MR Imaging in Ataxias: Consensus Recommendations by the Ataxia Global Initiative Working Group on MRI Biomarkers. CEREBELLUM (LONDON, ENGLAND) 2024; 23:931-945. [PMID: 37280482 PMCID: PMC11102392 DOI: 10.1007/s12311-023-01572-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/08/2023]
Abstract
With many viable strategies in the therapeutic pipeline, upcoming clinical trials in hereditary and sporadic degenerative ataxias will benefit from non-invasive MRI biomarkers for patient stratification and the evaluation of therapies. The MRI Biomarkers Working Group of the Ataxia Global Initiative therefore devised guidelines to facilitate harmonized MRI data acquisition in clinical research and trials in ataxias. Recommendations are provided for a basic structural MRI protocol that can be used for clinical care and for an advanced multi-modal MRI protocol relevant for research and trial settings. The advanced protocol consists of modalities with demonstrated utility for tracking brain changes in degenerative ataxias and includes structural MRI, magnetic resonance spectroscopy, diffusion MRI, quantitative susceptibility mapping, and resting-state functional MRI. Acceptable ranges of acquisition parameters are provided to accommodate diverse scanner hardware in research and clinical contexts while maintaining a minimum standard of data quality. Important technical considerations in setting up an advanced multi-modal protocol are outlined, including the order of pulse sequences, and example software packages commonly used for data analysis are provided. Outcome measures most relevant for ataxias are highlighted with use cases from recent ataxia literature. Finally, to facilitate access to the recommendations by the ataxia clinical and research community, examples of datasets collected with the recommended parameters are provided and platform-specific protocols are shared via the Open Science Framework.
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Affiliation(s)
- Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, 2021 Sixth Street Southeast, Minneapolis, MN, 55455, USA.
| | - Sirio Cocozza
- UNINA Department of Advanced Biomedical Sciences, University of Naples Federico II , Naples, Italy
| | - Pierre-Gilles Henry
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, 2021 Sixth Street Southeast, Minneapolis, MN, 55455, USA
| | - Christophe Lenglet
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, 2021 Sixth Street Southeast, Minneapolis, MN, 55455, USA
| | - Andreas Deistung
- Department for Radiation Medicine, University Clinic and Outpatient Clinic for Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Jennifer Faber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | | | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Koene R A Van Dijk
- Digital Sciences and Translational Imaging, Early Clinical Development, Pfizer, Inc., Cambridge, MA, USA
| | - Ian H Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
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Lopes da Cunha P, Fittipaldi S, González Campo C, Kauffman M, Rodríguez-Quiroga S, Yacovino DA, Ibáñez A, Birba A, García AM. Social concepts and the cerebellum: behavioural and functional connectivity signatures in cerebellar ataxic patients. Philos Trans R Soc Lond B Biol Sci 2023; 378:20210364. [PMID: 36571119 PMCID: PMC9791482 DOI: 10.1098/rstb.2021.0364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 09/26/2022] [Indexed: 12/27/2022] Open
Abstract
Neurocognitive research on social concepts underscores their reliance on fronto-temporo-limbic regions mediating broad socio-cognitive skills. Yet, the field has neglected another structure increasingly implicated in social cognition: the cerebellum. The present exploratory study examines this link combining a novel naturalistic text paradigm, a relevant atrophy model and functional magnetic resonance imaging. Fifteen cerebellar ataxia (CA) patients with focal cerebellar atrophy and 29 matched controls listened to a social text (highlighting interpersonal events) as well as a non-social text (focused on a single person's actions), and answered comprehension questionnaires. We compared behavioural outcomes between groups and examined their association with cerebellar connectivity. CA patients showed deficits in social text comprehension and normal scores in the non-social text. Also, social text outcomes in controls selectively correlated with connectivity between the cerebellum and key regions subserving multi-modal semantics and social cognition, including the superior and medial temporal gyri, the temporal pole and the insula. Conversely, brain-behaviour associations involving the cerebellum were abolished in the patients. Thus, cerebellar structures and connections seem involved in processing social concepts evoked by naturalistic discourse. Such findings invite new theoretical and translational developments integrating social neuroscience with embodied semantics. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.
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Affiliation(s)
- Pamela Lopes da Cunha
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Agency for Scientific Promotion and Technology (ANPCyT), Buenos Aires, C1425FQD, Argentina
| | - Sol Fittipaldi
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
- Global Brain Health Institute, University of California San Francisco, 94158-2324, US and Trinity College Dublin, D02 PN40, Ireland
- Latin American Brain Health Institute (BrainLat), Adolfo Ibáñez University, Santiago, 7550344, Chile
| | - Cecilia González Campo
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Marcelo Kauffman
- Consultorio y Laboratorio de Neurogenética, Centro Universitario de Neurología “José María Ramos Mejía” y División Neurología, Hospital JM Ramos Mejía, Facultad de Medicina, UBA, Buenos Aires, C1221ADC, Argentina
- School of Medicine, UBA, CONICET, Buenos Aires, C1121ABG, Argentina
| | - Sergio Rodríguez-Quiroga
- Consultorio y Laboratorio de Neurogenética, Centro Universitario de Neurología “José María Ramos Mejía” y División Neurología, Hospital JM Ramos Mejía, Facultad de Medicina, UBA, Buenos Aires, C1221ADC, Argentina
| | - Darío Andrés Yacovino
- Department of Neurology, Dr. Cesar Milstein Hospital, Buenos Aires, C1221ACI, Argentina
- Memory and Balance Clinic, Buenos Aires, C1425BPC, Argentina
| | - Agustín Ibáñez
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
- Global Brain Health Institute, University of California San Francisco, 94158-2324, US and Trinity College Dublin, D02 PN40, Ireland
- Latin American Brain Health Institute (BrainLat), Adolfo Ibáñez University, Santiago, 7550344, Chile
| | - Agustina Birba
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
| | - Adolfo M. García
- Cognitive Neuroscience Center, University of San Andrés, Buenos Aires B1644BID, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, C1425FQB, Argentina
- Global Brain Health Institute, University of California San Francisco, 94158-2324, US and Trinity College Dublin, D02 PN40, Ireland
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, 9170022, Chile
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Marapin RS, van der Horn HJ, van der Stouwe AMM, Dalenberg JR, de Jong BM, Tijssen MAJ. Altered brain connectivity in hyperkinetic movement disorders: A review of resting-state fMRI. Neuroimage Clin 2022; 37:103302. [PMID: 36669351 PMCID: PMC9868884 DOI: 10.1016/j.nicl.2022.103302] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hyperkinetic movement disorders (HMD) manifest as abnormal and uncontrollable movements. Despite reported involvement of several neural circuits, exact connectivity profiles remain elusive. OBJECTIVES Providing a comprehensive literature review of resting-state brain connectivity alterations using resting-state fMRI (rs-fMRI). We additionally discuss alterations from the perspective of brain networks, as well as correlations between connectivity and clinical measures. METHODS A systematic review was performed according to PRISMA guidelines and searching PubMed until October 2022. Rs-fMRI studies addressing ataxia, chorea, dystonia, myoclonus, tics, tremor, and functional movement disorders (FMD) were included. The standardized mean difference was used to summarize findings per region in the Automated Anatomical Labeling atlas for each phenotype. Furthermore, the activation likelihood estimation meta-analytic method was used to analyze convergence of significant between-group differences per phenotype. Finally, we conducted hierarchical cluster analysis to provide additional insights into commonalities and differences across HMD phenotypes. RESULTS Most articles concerned tremor (51), followed by dystonia (46), tics (19), chorea (12), myoclonus (11), FMD (11), and ataxia (8). Altered resting-state connectivity was found in several brain regions: in ataxia mainly cerebellar areas; for chorea, the caudate nucleus; for dystonia, sensorimotor and basal ganglia regions; for myoclonus, the thalamus and cingulate cortex; in tics, the basal ganglia, cerebellum, insula, and frontal cortex; for tremor, the cerebello-thalamo-cortical circuit; finally, in FMD, frontal, parietal, and cerebellar regions. Both decreased and increased connectivity were found for all HMD. Significant spatial convergence was found for dystonia, FMD, myoclonus, and tremor. Correlations between clinical measures and resting-state connectivity were frequently described. CONCLUSION Key brain regions contributing to functional connectivity changes across HMD often overlap. Possible increases and decreases of functional connections of a specific region emphasize that HMD should be viewed as a network disorder. Despite the complex interplay of physiological and methodological factors, this review serves to gain insight in brain connectivity profiles across HMD phenotypes.
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Affiliation(s)
- Ramesh S Marapin
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Harm J van der Horn
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - A M Madelein van der Stouwe
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Jelle R Dalenberg
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands
| | - Bauke M de Jong
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - Marina A J Tijssen
- University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands; Expertise Center Movement Disorders Groningen, University Medical Center Groningen (UMCG), Groningen, the Netherlands.
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Öz G, Harding IH, Krahe J, Reetz K. MR imaging and spectroscopy in degenerative ataxias: toward multimodal, multisite, multistage monitoring of neurodegeneration. Curr Opin Neurol 2021; 33:451-461. [PMID: 32657886 DOI: 10.1097/wco.0000000000000834] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Degenerative ataxias are rare and currently untreatable movement disorders, primarily characterized by neurodegeneration in the cerebellum and brainstem. We highlight MRI studies with the most potential for utility in pending ataxia trials and underscore advances in disease characterization and diagnostics in the field. RECENT FINDINGS With availability of advanced MRI acquisition methods and specialized software dedicated to the analysis of MRI of the cerebellum, patterns of cerebellar atrophy in different degenerative ataxias are increasingly well defined. The field further embraced rigorous multimodal investigations to study network-level microstructural and functional brain changes and their neurochemical correlates. MRI and magnetic resonance spectroscopy were shown to be more sensitive to disease progression than clinical scales and to detect abnormalities in premanifest mutation carriers. SUMMARY Magnetic resonance techniques are increasingly well placed for characterizing the expression and progression of degenerative ataxias. The most impactful work has arguably come through multi-institutional studies that monitor relatively large cohorts, multimodal investigations that assess the sensitivity of different measures and their interrelationships, and novel imaging approaches that are targeted to known pathophysiology (e.g., iron and spinal imaging in Friedreich ataxia). These multimodal, multi-institutional studies are paving the way to clinical trial readiness and enhanced understanding of disease in degenerative ataxias.
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Affiliation(s)
- Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Ian H Harding
- Department of Neuroscience, Central Clinical School.,Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Janna Krahe
- Department of Neurology.,JARA Brain Institute Molecular Neuroscience and Neuroimaging, Research Centre Ju[Combining Diaeresis]lich, RWTH Aachen University, Aachen, Germany
| | - Kathrin Reetz
- Department of Neurology.,JARA Brain Institute Molecular Neuroscience and Neuroimaging, Research Centre Ju[Combining Diaeresis]lich, RWTH Aachen University, Aachen, Germany
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Habas C. Functional Connectivity of the Cognitive Cerebellum. Front Syst Neurosci 2021; 15:642225. [PMID: 33897382 PMCID: PMC8060696 DOI: 10.3389/fnsys.2021.642225] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/11/2021] [Indexed: 12/19/2022] Open
Abstract
Anatomical tracing, human clinical data, and stimulation functional imaging have firmly established the major role of the (neo-)cerebellum in cognition and emotion. Telencephalization characterized by the great expansion of associative cortices, especially the prefrontal one, has been associated with parallel expansion of the neocerebellar cortex, especially the lobule VII, and by an increased number of interconnections between these two cortical structures. These anatomical modifications underlie the implication of the neocerebellum in cognitive control of complex motor and non-motor tasks. In humans, resting state functional connectivity has been used to determine a thorough anatomo-functional parcellation of the neocerebellum. This technique has identified central networks involving the neocerebellum and subserving its cognitive function. Neocerebellum participates in all intrinsic connected networks such as central executive, default mode, salience, dorsal and ventral attentional, and language-dedicated networks. The central executive network constitutes the main circuit represented within the neocerebellar cortex. Cerebellar zones devoted to these intrinsic networks appear multiple, interdigitated, and spatially ordered in three gradients. Such complex neocerebellar organization enables the neocerebellum to monitor and synchronize the main networks involved in cognition and emotion, likely by computing internal models.
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Affiliation(s)
- Christophe Habas
- Service de NeuroImagerie, Centre Hospitalier National d'Ophtalmologie des 15-20, Paris, France
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Pellecchia MT, Stankovic I, Fanciulli A, Krismer F, Meissner WG, Palma JA, Panicker JN, Seppi K, Wenning GK. Can Autonomic Testing and Imaging Contribute to the Early Diagnosis of Multiple System Atrophy? A Systematic Review and Recommendations by the Movement Disorder Society Multiple System Atrophy Study Group. Mov Disord Clin Pract 2020; 7:750-762. [PMID: 33043073 DOI: 10.1002/mdc3.13052] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/08/2020] [Accepted: 05/23/2020] [Indexed: 01/01/2023] Open
Abstract
Background In the current consensus diagnostic criteria, the diagnosis of probable multiple system atrophy (MSA) is based solely on clinical findings, whereas neuroimaging findings are listed as aid for the diagnosis of possible MSA. There are overlapping phenotypes between MSA-parkinsonian type and Parkinson's disease, progressive supranuclear palsy, and dementia with Lewy bodies, and between MSA-cerebellar type and sporadic adult-onset ataxia resulting in a significant diagnostic delay and misdiagnosis of MSA during life. Objectives In light of an ongoing effort to revise the current consensus criteria for MSA, the Movement Disorders Society Multiple System Atrophy Study Group performed a systematic review of original articles published before August 2019. Methods We included articles that studied at least 10 patients with MSA as well as participants with another disorder or control group for comparison purposes. MSA was defined by neuropathological confirmation, or as clinically probable, or clinically probable plus possible according to consensus diagnostic criteria. Results We discuss the pitfalls and benefits of each diagnostic test and provide specific recommendations on how to evaluate patients in whom MSA is suspected. Conclusions This systematic review of relevant studies indicates that imaging and autonomic function tests significantly contribute to increasing the accuracy of a diagnosis of MSA.
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Affiliation(s)
- Maria Teresa Pellecchia
- Center for Neurodegenerative Diseases, Department of Medicine, Neuroscience Section, University of Salerno Fisciano Italy
| | - Iva Stankovic
- Neurology Clinic, Clinical Center of Serbia School of Medicine, University of Belgrade Belgrade Serbia
| | | | - Florian Krismer
- Department of Neurology Innsbruck Medical University Innsbruck Austria
| | - Wassilios G Meissner
- French Reference Center for MSA, Department of Neurology University Hospital Bordeaux, Bordeaux and Institute of Neurodegenerative Disorders, University Bordeaux, Centre National de la Recherche Scientifique Unite Mixte de Recherche Bordeaux Bordeaux France
| | - Jose-Alberto Palma
- Dysautonomia Center, Langone Medical Center New York University School of Medicine New York New York USA
| | - Jalesh N Panicker
- Institute of Neurology, University College London London United Kingdom.,Department of Uro-Neurology The National Hospital for Neurology and Neurosurgery London United Kingdom
| | - Klaus Seppi
- Department of Neurology Innsbruck Medical University Innsbruck Austria
| | - Gregor K Wenning
- Department of Neurology Innsbruck Medical University Innsbruck Austria
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