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Wang PF, Jiang F, Zeng QM, Yin WF, Hu YZ, Li Q, Hu ZL. Mitochondrial and metabolic dysfunction of peripheral immune cells in multiple sclerosis. J Neuroinflammation 2024; 21:28. [PMID: 38243312 PMCID: PMC10799425 DOI: 10.1186/s12974-024-03016-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by the infiltration of inflammatory cells and demyelination of nerves. Mitochondrial dysfunction has been implicated in the pathogenesis of MS, as studies have shown abnormalities in mitochondrial activities, metabolism, mitochondrial DNA (mtDNA) levels, and mitochondrial morphology in immune cells of individuals with MS. The presence of mitochondrial dysfunctions in immune cells contributes to immunological dysregulation and neurodegeneration in MS. This review provided a comprehensive overview of mitochondrial dysfunction in immune cells associated with MS, focusing on the potential consequences of mitochondrial metabolic reprogramming on immune function. Current challenges and future directions in the field of immune-metabolic MS and its potential as a therapeutic target were also discussed.
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Affiliation(s)
- Peng-Fei Wang
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China
| | - Fei Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha City, 410011, Hunan, China
| | - Qiu-Ming Zeng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha City, 410011, Hunan, China
| | - Wei-Fan Yin
- Department of Neurology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China
| | - Yue-Zi Hu
- Clinical Laboratory, The Second Hospital of Hunan University of Chinese Medicine, 233 Cai' e North Road, Changsha City, 410005, Hunan, China
| | - Qiao Li
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China
| | - Zhao-Lan Hu
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, 139 Ren-Min Central Road, Changsha City, 410011, Hunan, China.
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Althobity AA, Khan N, Sandrock CJ, Woodruff TM, Cowin GJ, Brereton IM, Kurniawan ND. Multiparametric magnetic resonance imaging for detection of pathological changes in the central nervous system of a mouse model of multiple sclerosis in vivo. NMR IN BIOMEDICINE 2023; 36:e4964. [PMID: 37122101 PMCID: PMC10909458 DOI: 10.1002/nbm.4964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/28/2023] [Accepted: 04/26/2023] [Indexed: 05/19/2023]
Abstract
Multiple sclerosis (MS) is an autoimmune disease involving demyelination and axonal damage in the central nervous system (CNS). In this study, we investigated pathological changes in the lumbar spinal cord of C57BL/6 mice induced with progressive experimental autoimmune encephalomyelitis (EAE) disease using 9.4-T magnetic resonance imaging (MRI). Multiparametric MRI measurements including MR spectroscopy, diffusion tensor imaging (DTI) and volumetric analyses were applied to detect metabolic changes in the CNS of EAE mice. Compared with healthy mice, EAE mice showed a significant reduction in N-acetyl aspartate and increases in choline, glycine, taurine and lactate. DTI revealed a significant reduction in fractional anisotropy and axial diffusivity and an increase in radial diffusivity in the lumbar spinal cord white matter (WM), while in the grey matter (GM), fractional anisotropy increased. High-resolution structural imaging also revealed lumbar spinal cord WM hypertrophy and GM atrophy. Importantly, these MRI changes were strongly correlated with EAE disease scoring and pathological changes in the lumbar (L2-L6), particularly WM demyelination lesions and aggregation of immune cells (microglia/macrophages and astrocytes) in this region. This study identified changes in MRI biomarker signatures that can be useful for evaluating the efficacy of novel drugs using EAE models in vivo.
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Affiliation(s)
- Abdullah A. Althobity
- Centre for Advanced ImagingThe University of QueenslandBrisbaneAustralia
- Al Azhar HospitalRiyadhSaudi Arabia
- Society of Artificial Intelligence in HealthcareRiyadhSaudi Arabia
- Department of Radiological Sciences and Medical Imaging, College of Applied Medical SciencesMajmaah UniversityMajmaahSaudi Arabia
| | - Nemat Khan
- Faculty of Medicine, School of Biomedical SciencesThe University of QueenslandBrisbaneAustralia
| | - Cheyenne J. Sandrock
- Faculty of Medicine, School of Biomedical SciencesThe University of QueenslandBrisbaneAustralia
| | - Trent M. Woodruff
- Faculty of Medicine, School of Biomedical SciencesThe University of QueenslandBrisbaneAustralia
- Queensland Brain InstituteThe University of QueenslandBrisbaneAustralia
| | - Gary J. Cowin
- Centre for Advanced ImagingThe University of QueenslandBrisbaneAustralia
- NCRIS Australian National Imaging FacilityThe University of QueenslandBrisbaneAustralia
| | - Ian M. Brereton
- Centre for Advanced ImagingThe University of QueenslandBrisbaneAustralia
- NCRIS Australian National Imaging FacilityThe University of QueenslandBrisbaneAustralia
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Tkáč I, Deelchand D, Dreher W, Hetherington H, Kreis R, Kumaragamage C, Považan M, Spielman DM, Strasser B, de Graaf RA. Water and lipid suppression techniques for advanced 1 H MRS and MRSI of the human brain: Experts' consensus recommendations. NMR IN BIOMEDICINE 2021; 34:e4459. [PMID: 33327042 PMCID: PMC8569948 DOI: 10.1002/nbm.4459] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 11/23/2020] [Indexed: 05/09/2023]
Abstract
The neurochemical information provided by proton magnetic resonance spectroscopy (MRS) or MR spectroscopic imaging (MRSI) can be severely compromised if strong signals originating from brain water and extracranial lipids are not properly suppressed. The authors of this paper present an overview of advanced water/lipid-suppression techniques and describe their advantages and disadvantages. Moreover, they provide recommendations for choosing the most appropriate techniques for proper use. Methods of water signal handling are primarily focused on the VAPOR technique and on MRS without water suppression (metabolite cycling). The section on lipid-suppression methods in MRSI is divided into three parts. First, lipid-suppression techniques that can be implemented on most clinical MR scanners (volume preselection, outer-volume suppression, selective lipid suppression) are described. Second, lipid-suppression techniques utilizing the combination of k-space filtering, high spatial resolutions and lipid regularization are presented. Finally, three promising new lipid-suppression techniques, which require special hardware (a multi-channel transmit system for dynamic B1+ shimming, a dedicated second-order gradient system or an outer volume crusher coil) are introduced.
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Affiliation(s)
- Ivan Tkáč
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Dinesh Deelchand
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Wolfgang Dreher
- Department of Chemistry, In vivo-MR Group, University Bremen, Bremen, Germany
| | - Hoby Hetherington
- Department of Radiology Magnetic Resonance Research Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roland Kreis
- Departments of Radiology and Biomedical Research, University Bern, Bern, Switzerland
| | - Chathura Kumaragamage
- Department of Radiology and Biomedical Imaging, Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
| | - Michal Považan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Daniel M. Spielman
- Department of Radiology, Stanford University, Stanford, California, CA, USA
| | - Bernhard Strasser
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Department of Radiology, Boston, MA, USA
| | - Robin A. de Graaf
- Department of Radiology and Biomedical Imaging, Magnetic Resonance Research Center, Yale University School of Medicine, New Haven, CT, USA
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Esmael A, Talaat M, Egila H, Eltoukhy K. Mitochondrial dysfunction and serum lactate as a biomarker for the progression and disability in MS and its correlation with the radiological findings. Neurol Res 2021; 43:582-590. [PMID: 33657991 DOI: 10.1080/01616412.2021.1893567] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: To study the serum lactate level in MS and to explore its correlation with the progression and disability in multiple sclerosis (MS), and the important role of mitochondrial dysfunction in the pathogenesis of MS.Methods: This case-control study included 80 participants, involved 50 MS patients and 30 normal healthy controls. Detailed history taking, complete neurological examination, and clinical evaluation of the disability using the Expanded Disability Status Scale (EDSS) were done for all patients. Level of serum lactate was measured in both groups and was correlated with EDSS, MS subtypes, MRI brain, and MRS findings.Results: Serum lactate in MS patients was about three and half times higher than serum lactate levels of healthy controls (22.87 ± 5.92 mg/dl versus 6.39 ± 0.9 6.39 ± 0.91, p < 0.001). Importantly, serum lactate values were increased in MS cases with a progressive course compared with MS cases with RR course. Also, there were linearly correlations linking serum lactate levels and the duration of MS (r = 0.342, P = 0.015), relapses numbers (r = 0.335, P = 0.022), and EDSS (r = 0.483, P < 0.001). Also, there were strong positive correlations between serum lactate and Lipid/Lactate (r = 0.461, P = 0.001), periventricular lesion (r = 0.453, P = 0.005), and moderate positive correlations between serum lactate and juxtacortical lesion (r = 0.351, P = 0.02), and infratentorial lesion (r = 0.355, P = 0.02).Conclusion: Measurement of serum lactate may be helpful in MS and this supports the hypothesis of the critical role of mitochondrial dysfunction and axonal damage in MS.Registration of Clinical Trial Research: ClinicalTrials.gov ID: NCT04210960.
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Affiliation(s)
- Ahmed Esmael
- Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - Mona Talaat
- Diagnostic Radiology Department, Faculty of Medicine, Kafrelsheikh University, Kafr Ash Shaykh, Egypt
| | - Hosam Egila
- Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
| | - Khaled Eltoukhy
- Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt
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Hatchondo L, Vallée A, Vallée R, Jaafari N, Maillochaud S, Naudin M, Vallée JN, Guillevin R, Guillevin C. Altered phospholipid and high-energy phosphate metabolism in the basal ganglia and thalamus of severe obsessive compulsive patients with treatment resistance: A phosphorus 31 nuclear magnetic resonance spectroscopy study. Psychiatry Res Neuroimaging 2021; 307:111217. [PMID: 33199172 DOI: 10.1016/j.pscychresns.2020.111217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Cerebral metabolism in obsessive-compulsive-disorder(OCD) has been the subject of numerous studies using proton magnetic resonance spectroscopy(MRS). Despite heterogeneous results, some studies have unraveled membrane turnover and energy metabolism abnormalities in different brain regions, suggesting that alterations in these processes may contribute to the pathophysiology. So far, no authors have explored phospholipids and high-energy phosphate metabolism using 31P-MRS, which allows in vivo quantification of phosphorus metabolites that are considered to be related to membrane turnover and energy metabolism. MATERIALS AND METHODS The aim of our study was to describe and compare brain metabolic changes using 31P-MRS in the striatum and the thalamus, between 23 severe OCD patients and 22 healthy controls. All subject underwent a clinical examination and a same 31P-MRS protocol. RESULTS Significantly, increased concentrations of PC, PDE,PME,GPC,PME/PCr,PDE/PCr were found in patients compared to controls in the striatum and the thalamus. PCr and tATP were decreased in the striatum. Finally, significant correlations were found in the striatum and the thalamus between illness duration and some specific measured parameters. CONCLUSION Our results showed significant modifications of the membrane and energy metabolism in the basal ganglia of severe OCD patients and suggests a link between energetic buffer and serotonin metabolism disorder.
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Affiliation(s)
- Laura Hatchondo
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France
| | - Alexandre Vallée
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France
| | - Rodolphe Vallée
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; Avicenne University hospital, Paris 13 University, AP-HP, 93009 Bobigny, France
| | - Nemat Jaafari
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France; Poitiers University, France.
| | - Sylvie Maillochaud
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Mathieu Naudin
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France.
| | - Jean-Noël Vallée
- Amiens-Picardie University Hospital, Picardie Jules Verne (UPJV) University, Amiens, France
| | - Rémy Guillevin
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France.
| | - Carole Guillevin
- I3M Laboratory, DACTIM-MIS team, Laboratoire de mathématiques Appliqués (LMA) CNRS 7348, Poitiers University, France; University Hospital of Poitiers, 2 rue de la milétrie, 86021 Poitiers, France.
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Mango D, Nisticò R. Role of ASIC1a in Normal and Pathological Synaptic Plasticity. Rev Physiol Biochem Pharmacol 2020; 177:83-100. [PMID: 32789788 DOI: 10.1007/112_2020_45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Acid-sensing ion channels (ASICs), members of the degenerin/epithelial Na+ channel superfamily, are broadly distributed in the mammalian nervous system where they play important roles in a variety of physiological processes, including neurotransmission and memory-related behaviors. In the last few years, we and others have investigated the role of ASIC1a in different forms of synaptic plasticity especially in the CA1 area of the hippocampus. This review summarizes the latest research linking ASIC1a to synaptic function either in physiological or pathological conditions. A better understanding of how these channels are regulated in brain circuitries relevant to synaptic plasticity and memory may offer novel targets for pharmacological intervention in neuropsychiatric and neurological disorders.
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Affiliation(s)
- Dalila Mango
- Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, Rome, Italy.
| | - Robert Nisticò
- Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, Rome, Italy
- School of Pharmacy, University of Rome Tor Vergata, Rome, Italy
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Swanberg KM, Landheer K, Pitt D, Juchem C. Quantifying the Metabolic Signature of Multiple Sclerosis by in vivo Proton Magnetic Resonance Spectroscopy: Current Challenges and Future Outlook in the Translation From Proton Signal to Diagnostic Biomarker. Front Neurol 2019; 10:1173. [PMID: 31803127 PMCID: PMC6876616 DOI: 10.3389/fneur.2019.01173] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/21/2019] [Indexed: 01/03/2023] Open
Abstract
Proton magnetic resonance spectroscopy (1H-MRS) offers a growing variety of methods for querying potential diagnostic biomarkers of multiple sclerosis in living central nervous system tissue. For the past three decades, 1H-MRS has enabled the acquisition of a rich dataset suggestive of numerous metabolic alterations in lesions, normal-appearing white matter, gray matter, and spinal cord of individuals with multiple sclerosis, but this body of information is not free of seeming internal contradiction. The use of 1H-MRS signals as diagnostic biomarkers depends on reproducible and generalizable sensitivity and specificity to disease state that can be confounded by a multitude of influences, including experiment group classification and demographics; acquisition sequence; spectral quality and quantifiability; the contribution of macromolecules and lipids to the spectroscopic baseline; spectral quantification pipeline; voxel tissue and lesion composition; T1 and T2 relaxation; B1 field characteristics; and other features of study design, spectral acquisition and processing, and metabolite quantification about which the experimenter may possess imperfect or incomplete information. The direct comparison of 1H-MRS data from individuals with and without multiple sclerosis poses a special challenge in this regard, as several lines of evidence suggest that experimental cohorts may differ significantly in some of these parameters. We review the existing findings of in vivo1H-MRS on central nervous system metabolic abnormalities in multiple sclerosis and its subtypes within the context of study design, spectral acquisition and processing, and metabolite quantification and offer an outlook on technical considerations, including the growing use of machine learning, by future investigations into diagnostic biomarkers of multiple sclerosis measurable by 1H-MRS.
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Affiliation(s)
- Kelley M Swanberg
- Department of Biomedical Engineering, Columbia University Fu Foundation School of Engineering and Applied Science, New York, NY, United States
| | - Karl Landheer
- Department of Biomedical Engineering, Columbia University Fu Foundation School of Engineering and Applied Science, New York, NY, United States
| | - David Pitt
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| | - Christoph Juchem
- Department of Biomedical Engineering, Columbia University Fu Foundation School of Engineering and Applied Science, New York, NY, United States.,Department of Radiology, Columbia University College of Physicians and Surgeons, New York, NY, United States
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Hatchondo L, Jaafari N, Langbour N, Maillochaud S, Herpe G, Guillevin R, Guillevin C. 1H magnetic resonance spectroscopy suggests neural membrane alteration in specific regions involved in obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2017; 269:48-53. [PMID: 28938221 DOI: 10.1016/j.pscychresns.2017.08.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/23/2022]
Affiliation(s)
- Laura Hatchondo
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Nematollah Jaafari
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Nicolas Langbour
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Sylvie Maillochaud
- Clinical Research Unit of Psychiatry - Henri Laborit Hospital, Poitiers, France.
| | - Guillaume Herpe
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Rémy Guillevin
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
| | - Carole Guillevin
- University Hospital of Poitiers, 2 rue de la Milétrie, 86021 Poitiers, France; Department of Medical Imaging - University Hospital of Poitiers, France; DACTIM-MIS team LMA/ CNRS 7348, Poitiers University, France.
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Kocevar G, Stamile C, Hannoun S, Roch JA, Durand-Dubief F, Vukusic S, Cotton F, Sappey-Marinier D. Weekly follow up of acute lesions in three early multiple sclerosis patients using MR spectroscopy and diffusion. J Neuroradiol 2017; 45:108-113. [PMID: 29032126 DOI: 10.1016/j.neurad.2017.06.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 01/06/2017] [Accepted: 06/24/2017] [Indexed: 11/19/2022]
Abstract
OBJECT Pathophysiological mechanisms underlying multiple sclerosis (MS) lesion formation, including inflammation, demyelination/remyelination and axonal damage, and their temporal evolution are still not clearly understood. To this end, three acute white matter lesions were monitored using a weekly multimodal magnetic resonance (MR) protocol. MATERIALS AND METHODS Three untreated patients with early relapsing-remitting MS and one healthy control subject were followed weekly for two months. MR protocol included conventional MR imaging (MRI), diffusion tensor imaging (DTI), and localized MR spectroscopy (MRS), performed on the largest gadolinium-enhancing lesion, selected at the first exam. RESULTS Mean diffusivity increased and fractional anisotropy decreased in lesions compared to healthy control. Cho/Cr ratios remained elevated in lesions throughout the follow-up. In contrast, temporal profiles of mI/Cr ratios varied between patients' lesions. For patient 1, mI/Cr ratios were already elevated at the beginning of the follow-up. Patients 2 and 3 ratios increase was delayed by two and five weeks. Blood-brain barrier (BBB) recovery occurred after three weeks. CONCLUSION This multimodal MR follow-up highlighted the complementary role of DTI and MRS in identifying temporal relationships between BBB disruption, inflammation, and demyelination. Diffusion metrics showed high sensitivity to detect inflammatory processes. The different temporal profiles of mI suggested a potential better specificity to monitor pathological mechanisms occurring after lesion formation, such as glial proliferation and remyelination.
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Affiliation(s)
- Gabriel Kocevar
- CREATIS, UMR5520, U1206 Inserm, université Claude-Bernard-Lyon1, 69621 Lyon, France
| | - Claudio Stamile
- CREATIS, UMR5520, U1206 Inserm, université Claude-Bernard-Lyon1, 69621 Lyon, France
| | - Salem Hannoun
- Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, 1107 2020 Beirut, Lebanon
| | - Jean-Amédée Roch
- Service de radiologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Lyon, France
| | - Françoise Durand-Dubief
- CREATIS, UMR5520, U1206 Inserm, université Claude-Bernard-Lyon1, 69621 Lyon, France; Service de neurologie A, hôpital neurologique de Lyon, hospices civils de Lyon, 69677 Lyon, France
| | - Sandra Vukusic
- Service de neurologie A, hôpital neurologique de Lyon, hospices civils de Lyon, 69677 Lyon, France
| | - François Cotton
- CREATIS, UMR5520, U1206 Inserm, université Claude-Bernard-Lyon1, 69621 Lyon, France; Service de radiologie, centre hospitalier Lyon-Sud, hospices civils de Lyon, 69495 Lyon, France
| | - Dominique Sappey-Marinier
- CREATIS, UMR5520, U1206 Inserm, université Claude-Bernard-Lyon1, 69621 Lyon, France; CERMEP, Imagerie-du-Vivant, université de Lyon, 69677 Lyon, France.
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Kirov II, Liu S, Tal A, Wu WE, Davitz MS, Babb JS, Rusinek H, Herbert J, Gonen O. Proton MR spectroscopy of lesion evolution in multiple sclerosis: Steady-state metabolism and its relationship to conventional imaging. Hum Brain Mapp 2017; 38:4047-4063. [PMID: 28523763 DOI: 10.1002/hbm.23647] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 04/17/2017] [Accepted: 05/01/2017] [Indexed: 12/21/2022] Open
Abstract
Although MRI assessment of white matter lesions is essential for the clinical management of multiple sclerosis, the processes leading to the formation of lesions and underlying their subsequent MRI appearance are incompletely understood. We used proton MR spectroscopy to study the evolution of N-acetyl-aspartate (NAA), creatine (Cr), choline (Cho), and myo-inositol (mI) in pre-lesional tissue, persistent and transient new lesions, as well as in chronic lesions, and related the results to quantitative MRI measures of T1-hypointensity and T2-volume. Within 10 patients with relapsing-remitting course, there were 180 regions-of-interest consisting of up to seven semi-annual follow-ups of normal-appearing white matter (NAWM, n = 10), pre-lesional tissue giving rise to acute lesions which resolved (n = 3) or persisted (n = 3), and of moderately (n = 9) and severely hypointense (n = 6) chronic lesions. Compared with NAWM, pre-lesional tissue had higher Cr and Cho, while compared with lesions, pre-lesional tissue had higher NAA. Resolving acute lesions showed similar NAA levels pre- and post-formation, suggesting no long-term axonal damage. In chronic lesions, there was an increase in mI, suggesting accumulating astrogliosis. Lesion volume was a better predictor of axonal health than T1-hypointensity, with lesions larger than 1.5 cm3 uniformly exhibiting very low (<4.5 millimolar) NAA concentrations. A positive correlation between longitudinal changes in Cho and in lesion volume in moderately hypointense lesions implied that lesion size is mediated by chronic inflammation. These and other results are integrated in a discussion on the steady-state metabolism of lesion evolution in multiple sclerosis, viewed in the context of conventional MRI measures. Hum Brain Mapp 38:4047-4063, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Ivan I Kirov
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
| | - Shu Liu
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
| | - Assaf Tal
- Department of Chemical Physics, Weizmann Institute of Science, Rehovot, Israel
| | - William E Wu
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
| | - Matthew S Davitz
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
| | - James S Babb
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
| | - Henry Rusinek
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
| | - Joseph Herbert
- Multiple Sclerosis Comprehensive Care Center, New York University Langone Medical Center, New York, New York
| | - Oded Gonen
- Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, New York, New York.,Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York
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11
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Payne GS, Harris LM, Cairns GS, Messiou C, deSouza NM, Macdonald A, Saran F, Leach MO. Validating a robust double-quantum-filtered (1) H MRS lactate measurement method in high-grade brain tumours. NMR IN BIOMEDICINE 2016; 29:1420-6. [PMID: 27514007 PMCID: PMC5042032 DOI: 10.1002/nbm.3587] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/23/2016] [Accepted: 06/23/2016] [Indexed: 05/23/2023]
Abstract
(1) H MRS measurements of lactate are often confounded by overlapping lipid signals. Double-quantum (DQ) filtering eliminates lipid signals and permits single-shot measurements, which avoid subtraction artefacts in moving tissues. This study evaluated a single-voxel-localized DQ filtering method qualitatively and quantitatively for measuring lactate concentrations in the presence of lipid, using high-grade brain tumours in which the results could be compared with standard acquisition as a reference. Paired standard acquisition and DQ-filtered (1) H MR spectra were acquired at 3T from patients receiving treatment for glioblastoma, using fLASER (localization by adiabatic selective refocusing using frequency offset corrected inversion pulses) single-voxel localization. Data were acquired from 2 × 2 × 2 cm(3) voxels, with a repetition time of 1 s and 128 averages (standard acquisition) or 256 averages (DQ-filtered acquisition), requiring 2.15 and 4.3 min respectively. Of 37 evaluated data pairs, 20 cases (54%) had measureable lactate (fitted Cramér-Rao lower bounds ≤ 20%) in either the DQ-filtered or the standard acquisition spectra. The measured DQ-filtered lactate signal was consistently downfield of lipid (1.33 ± 0.03 ppm vs 1.22 ± 0.08 ppm; p = 0.002), showing that it was not caused by lipid breakthrough, and that it matched the lactate signal seen in standard measurements (1.36 ± 0.02 ppm). In the absence of lipid, similar lactate concentrations were measured by the two methods (mean ratio DQ filtered/standard acquisition = 1.10 ± 0.21). In 7/20 cases with measurable lactate, signal was not measureable in the standard acquisition owing to lipid overlap but was quantified in the DQ-filtered acquisition. Conversely, lactate was undetected in seven DQ-filtered acquisitions but visible using the standard acquisition. In conclusion, the DQ filtering method has proven robust in eliminating lipid and permits uncontaminated measurement of lactate. This is important validation prior to use in tissues outside the brain, which contain large amounts of lipid and which are often susceptible to motion.
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Affiliation(s)
- G S Payne
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK.
| | - L M Harris
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK
| | - G S Cairns
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK
| | - C Messiou
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK
| | - N M deSouza
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK
| | - A Macdonald
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK
| | - F Saran
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK
| | - M O Leach
- MRI Unit, Royal Marsden Hospital, Sutton, Surrey, UK
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Albanese M, Zagaglia S, Landi D, Boffa L, Nicoletti CG, Marciani MG, Mandolesi G, Marfia GA, Buttari F, Mori F, Centonze D. Cerebrospinal fluid lactate is associated with multiple sclerosis disease progression. J Neuroinflammation 2016; 13:36. [PMID: 26863878 PMCID: PMC4750170 DOI: 10.1186/s12974-016-0502-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/03/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Altered cerebrospinal fluid (CSF) levels of lactate have been described in neurodegenerative diseases and related to mitochondrial dysfunction and neuronal degeneration. We investigated the relationship between CSF lactate levels, disease severity, and biomarkers associated with neuroaxonal damage in patients with multiple sclerosis (MS). METHODS One-hundred eighteen subjects with relapsing-remitting multiple sclerosis (RRMS) were included, along with one-hundred fifty seven matched controls. CSF levels of lactate, tau protein, and neurofilament light were detected at the time of diagnosis. Patients were followed-up for a mean of 5 years. Progression index (PI), multiple sclerosis severity scale (MSSS), and Bayesian risk estimate for multiple sclerosis (BREMS) were assessed as clinical measures of disease severity and progression. Differences between groups and correlation between CSF lactate, disease severity and CSF biomarkers of neuronal damage were explored. RESULTS CSF lactate was higher in RRMS patients compared to controls. A negative correlation was found between lactate levels and disease duration. Patients with higher CSF lactate concentration had significantly higher PI, MSSS, and BREMS scores at long-term follow-up. Furthermore, CSF lactate correlated positively and significantly with CSF levels of both tau protein and neurofilament light protein. CONCLUSIONS Measurement of CSF lactate may be helpful, in conjunction with other biomarkers of tissue damage, as an early predictor of disease severity in RRMS patients. A better understanding of the alterations of mitochondrial metabolic pathways associated to RRMS severity may pave the way to new therapeutic targets to contrast axonal damage and disease severity.
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Affiliation(s)
- Maria Albanese
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, 86077, Pozzilli, IS, Italy
| | - Sara Zagaglia
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy.,Clinica di Neurologia, Università Politecnica delle Marche, 60100, Ancona, Italy
| | - Doriana Landi
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, 86077, Pozzilli, IS, Italy
| | - Laura Boffa
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy
| | - Carolina G Nicoletti
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy
| | - Maria Grazia Marciani
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy
| | | | - Girolama A Marfia
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, 86077, Pozzilli, IS, Italy
| | - Fabio Buttari
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, 86077, Pozzilli, IS, Italy
| | - Francesco Mori
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, 86077, Pozzilli, IS, Italy
| | - Diego Centonze
- Multiple Sclerosis Clinical and Research Unit, Department of Systems Medicine, Tor Vergata University, Via Montpellier 1, 00133, Rome, Italy. .,IRCCS Istituto Neurologico Mediterraneo (INM) Neuromed, 86077, Pozzilli, IS, Italy.
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13
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Enzinger C, Pinter D, Rocca MA, De Luca J, Sastre-Garriga J, Audoin B, Filippi M. Longitudinal fMRI studies: Exploring brain plasticity and repair in MS. Mult Scler 2015; 22:269-78. [DOI: 10.1177/1352458515619781] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 11/04/2015] [Indexed: 11/17/2022]
Abstract
Functional magnetic resonance imaging (fMRI) has greatly advanced our understanding of cerebral functional changes occurring in patients with multiple sclerosis (MS). However, most of our knowledge regarding brain plasticity and repair in MS as evidenced by fMRI has been extrapolated from cross-sectional studies across different phenotypes of the disease. This topical review provides an overview of this research, but also highlights limitations of existing fMRI studies with cross-sectional design. We then review the few existing longitudinal fMRI studies and discuss the feasibility and constraints of serial fMRI in individuals with MS. We further emphasize the potential to track fMRI changes in evolving disease and the insights this may give in terms of mechanisms of adaptation and repair, focusing on serial fMRI to monitor response to disease-modifying therapies or rehabilitation interventions. Finally, we offer recommendations for designing future research studies to overcome previous methodological shortcomings.
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Affiliation(s)
- Christian Enzinger
- Department of Neurology, Medical University of Graz, Graz, Austria/Division of Neuroradiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Daniela Pinter
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Maria A Rocca
- Neuroimaging Research Unit and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - John De Luca
- Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, New Jersey Medical School, Rutgers University, Newark, NJ, USA
| | - Jaume Sastre-Garriga
- Department of Neurology-Neuroimmunology and Multiple Sclerosis Centre of Catalonia (Cemcat), Edifici Cemcat, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bertrand Audoin
- Aix-Marseille University, National Center for Scientific Research, Center for Magnetic Resonance in Biology and Medicine UMR 7339; Department of Neurology and Clinical Neurosciences, Timone University Hospital, Marseille, France
| | - Massimo Filippi
- Neuroimaging Research Unit and Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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14
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Nijland PG, Molenaar RJ, van der Pol SMA, van der Valk P, van Noorden CJF, de Vries HE, van Horssen J. Differential expression of glucose-metabolizing enzymes in multiple sclerosis lesions. Acta Neuropathol Commun 2015; 3:79. [PMID: 26637184 PMCID: PMC4670517 DOI: 10.1186/s40478-015-0261-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 11/22/2015] [Indexed: 02/06/2023] Open
Abstract
Introduction Demyelinated axons in multiple sclerosis (MS) lesions have an increased energy demand in order to maintain conduction. However, oxidative stress-induced mitochondrial dysfunction likely alters glucose metabolism and consequently impairs neuronal function in MS. Imaging and pathological studies indicate that glucose metabolism is altered in MS, although the underlying mechanisms and its role in neurodegeneration remain elusive. We investigated expression patterns of key enzymes involved in glycolysis, tricarboxylic acid (TCA) cycle and lactate metabolism in well-characterized MS tissue to establish which regulators of glucose metabolism are involved in MS and to identify underlying mechanisms. Results Expression levels of glycolytic enzymes were increased in active and inactive MS lesions, whereas expression levels of enzymes involved in the TCA cycle were upregulated in active MS lesions, but not in inactive MS lesions. We observed reduced expression and production capacity of mitochondrial α-ketoglutarate dehydrogenase (αKGDH) in demyelinated axons, which correlated with signs of axonal dysfunction. In inactive lesions, increased expression of lactate-producing enzymes was observed in astrocytes, whereas lactate-catabolising enzymes were mainly detected in axons. Our results demonstrate that the expression of various enzymes involved in glucose metabolism is increased in both astrocytes and axons in active MS lesions. In inactive MS lesions, we provide evidence that astrocytes undergo a glycolytic shift resulting in enhanced astrocyte-axon lactate shuttling, which may be pivotal for the survival of demyelinated axons. Conclusion In conclusion, we show that key enzymes involved in energy metabolism are differentially expressed in active and inactive MS lesions. Our findings imply that, in addition to reduced oxidative phosphorylation activity, other bioenergetic pathways are affected as well, which may contribute to ongoing axonal degeneration in MS. Electronic supplementary material The online version of this article (doi:10.1186/s40478-015-0261-8) contains supplementary material, which is available to authorized users.
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Lee JY, Taghian K, Petratos S. Axonal degeneration in multiple sclerosis: can we predict and prevent permanent disability? Acta Neuropathol Commun 2014; 2:97. [PMID: 25159125 PMCID: PMC4243718 DOI: 10.1186/s40478-014-0097-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/06/2014] [Indexed: 12/24/2022] Open
Abstract
Axonal degeneration is a major determinant of permanent neurological impairment during multiple sclerosis (MS). Due to the variable course of clinical disease and the heterogeneity of MS lesions, the mechanisms governing axonal degeneration may differ between disease stages. While the etiology of MS remains elusive, there now exist potential prognostic biomarkers that can predict the conversion to clinically definite MS. Specialized imaging techniques identifying axonal injury and drop-out are becoming established in clinical practice as a predictive measure of MS progression, such as optical coherence tomography (OCT) or diffusion tensor imaging (DTI). However, these imaging techniques are still being debated as predictive biomarkers since controversy surrounds their lesion-specific association with expanded disability status scale (EDSS). A more promising diagnostic measure of axonal degeneration has been argued for the detection of reduced N-acetyl aspartate (NAA) and Creatine ratios via magnetic resonance spectroscopic (MRS) imaging, but again fail with its specificity for predicting actual axonal degeneration. Greater accuracy of predictive biomarkers is therefore warranted and may include CSF neurofilament light chain (NF-L) and neurofilament heavy chain (NF-H) levels, for progressive MS. Furthermore, defining the molecular mechanisms that occur during the neurodegenerative changes in the various subgroups of MS may in fact prove vital for the future development of efficacious neuroprotective therapies. The clinical translation of a combined Na+ and Ca2+ channel blocker may lead to the establishment of a bona fide neuroprotective agent for the treatment of progressive MS. However, more specific therapeutic targets to limit axonal damage in MS need investigation and may include such integral axonal proteins such as the collapsin response mediator protein-2 (CRMP-2), a molecule which upon post-translational modification may propagate axonal degeneration in MS. In this review, we discuss the current clinical determinants of axonal damage in MS and consider the cellular and molecular mechanisms that may initiate these neurodegenerative changes. In particular we highlight the therapeutic candidates that may formulate novel therapeutic strategies to limit axonal degeneration and EDSS during progressive MS.
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Amorini AM, Nociti V, Petzold A, Gasperini C, Quartuccio E, Lazzarino G, Di Pietro V, Belli A, Signoretti S, Vagnozzi R, Lazzarino G, Tavazzi B. Serum lactate as a novel potential biomarker in multiple sclerosis. Biochim Biophys Acta Mol Basis Dis 2014; 1842:1137-43. [DOI: 10.1016/j.bbadis.2014.04.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 03/13/2014] [Accepted: 04/04/2014] [Indexed: 12/26/2022]
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Rovira A, Auger C, Alonso J. Magnetic resonance monitoring of lesion evolution in multiple sclerosis. Ther Adv Neurol Disord 2013; 6:298-310. [PMID: 23997815 DOI: 10.1177/1756285613484079] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Disease activity in multiple sclerosis (MS) is strongly linked to the formation of new lesions, which involves a complex sequence of inflammatory, degenerative, and reparative processes. Conventional magnetic resonance imaging (MRI) techniques, such as T2-weighted and gadolinium-enhanced T1-weighted sequences, are highly sensitive in demonstrating the spatial and temporal dissemination of demyelinating plaques in the brain and spinal cord. Hence, these techniques can provide quantitative assessment of disease activity in patients with MS, and they are commonly used in monitoring treatment efficacy in clinical trials and in individual cases. However, the correlation between conventional MRI measures of disease activity and the clinical manifestations of the disease, particularly irreversible disability, is weak. This has been explained by a process of exhaustion of both structural and functional redundancies that increasingly prevents repair and recovery, and by the fact that these imaging techniques do not suffice to explain the entire spectrum of the disease process and lesion development. Nonconventional MRI techniques, such as magnetization transfer imaging, diffusion-weighted imaging, and proton magnetic resonance spectroscopy, which can selectively measure the more destructive aspects of MS pathology and monitor the reparative mechanisms of this disease, are increasingly being used for serial analysis of new lesion formation and provide a better approximation of the pathological substrate of MS plaques. These nonconventional MRI-based measures better assess the serial changes in newly forming lesions and improve our understanding of the relationship between the damaging and reparative mechanisms that occur in MS.
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Affiliation(s)
- Alex Rovira
- Magnetic Resonance Unit (IDI), Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain
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Rovira A, Alonso J. 1H magnetic resonance spectroscopy in multiple sclerosis and related disorders. Neuroimaging Clin N Am 2013; 23:459-74. [PMID: 23928200 DOI: 10.1016/j.nic.2013.03.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Proton magnetic resonance spectroscopy ((1)H-MRS) is an unconventional technique that allows noninvasive characterization of metabolic abnormalities in the central nervous system. (1)H-MRS provides important insights into the chemical-pathologic changes that occur in patients with multiple sclerosis (MS). In this review article we present the main brain and spinal cord (1)H-MRS features in MS, their diagnostic value in differentiating pseudotumoral demyelinating lesions from primary brain tumors, and their relationship with clinical variables. Last, some data related to the use of (1)H-MRS in therapeutic trials is presented.
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Affiliation(s)
- Alex Rovira
- Department of Radiology, Magnetic Resonance Unit (IDI), Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona 08035, Spain.
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20
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NMR and pattern recognition methods in metabolomics: From data acquisition to biomarker discovery: A review. Anal Chim Acta 2012; 750:82-97. [DOI: 10.1016/j.aca.2012.05.049] [Citation(s) in RCA: 303] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 05/25/2012] [Accepted: 05/26/2012] [Indexed: 01/09/2023]
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21
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van Horssen J, Witte ME, Ciccarelli O. The role of mitochondria in axonal degeneration and tissue repair in MS. Mult Scler 2012; 18:1058-67. [PMID: 22723572 DOI: 10.1177/1352458512452924] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Axonal injury is a key feature of multiple sclerosis (MS) pathology and is currently seen as the main correlate for permanent clinical disability. Although little is known about the pathogenetic mechanisms that drive axonal damage and loss, there is accumulating evidence highlighting the central role of mitochondrial dysfunction in axonal degeneration and associated neurodegeneration. The aim of this topical review is to provide a concise overview on the involvement of mitochondrial dysfunction in axonal damage and destruction in MS. Hereto, we will discuss putative pathological mechanisms leading to mitochondrial dysfunction and recent imaging studies performed in vivo in patients with MS. Moreover, we will focus on molecular mechanisms and novel imaging studies that address the role of mitochondrial metabolism in tissue repair. Finally, we will briefly review therapeutic strategies aimed at improving mitochondrial metabolism and function under neuroinflammatory conditions.
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Affiliation(s)
- J van Horssen
- Department of Molecular Cell Biology and Immunology, VU University Medical Center, The Netherlands.
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Saini J, Chatterjee S, Thomas B, Kesavadas C. Conventional and advanced magnetic resonance imaging in tumefactive demyelination. Acta Radiol 2011; 52:1159-68. [PMID: 22025739 DOI: 10.1258/ar.2011.110007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Tumefactive demyelination (TD) is a relatively uncommon entity which mimics other focal intracranial lesions. Conventional radiological findings in tumefactive demyelination have been well described. However, DTI and MRS findings in TD have not been studied in detail. PURPOSE To evaluate the usefulness of conventional magnetic resonance imaging (MRI), multivoxel 1H spectroscopy (MRS) and diffusion tensor imaging (DTI) in diagnosis and follow-up of TD of the brain. MATERIAL AND METHODS Clinical and imaging findings of 18 patients were reviewed. MR imaging data which included conventional imaging as well as MRS and DTI were reviewed. At TE 135ms MRS various metabolite ratios were calculated at different depths of the demyelinating lesions. At TE 30 ms, glutamate-glutamine (GLX-2.1-2.5 ppm) was compared in the lesion to the contralateral normal side. DTI data were available for 15 patients and Dav (mean diffusivity) and trace values were recorded from central and peripheral layers of the index lesion. Histopathological (9 patients) and therapeutic response (9 patients) on follow-up imaging were taken as the diagnostic criterion. In addition, the follow-up MRI scans available were also reviewed. RESULTS Characteristic peripheral 'broken ring' type of contrast enhancement was noted in 12 cases. Two or three concentric distinct zones were noted on imaging with distinct metabolic and structural signature in most cases. On TE 135ms, the central part showed variable Choline (Cho) and significantly low N-Acetyl Aspartate (NAA). DTI demonstrated high Dav and very low trace value in this zone. The intermediate area showed higher Cho and lower NAA compared to contralateral normal side. The outermost layer, which corresponded to the contrast enhancing areas on MRI, showed high Cho, lower NAA, and restricted diffusion on DTI. The GLX increase was noted in tumefactive lesions. Lactate was observed in all patients and it appeared higher at the center compared to the periphery of lesions. Follow-up imaging showed shrinkage of index lesions, disappearance of contrast enhancement, and diffusion restriction. MRS showed, persistent abnormalities on follow-up imaging. CONCLUSION Tumefactive demyelinating lesions reveal different microstructural changes at different depths of the lesion and this unique feature may be useful in differentiating them from other focal lesions of brain.
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Affiliation(s)
- Jitender Saini
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Somenath Chatterjee
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Bejoy Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Chandrasekharan Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Trivandrum, India
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Paling D, Golay X, Wheeler-Kingshott C, Kapoor R, Miller D. Energy failure in multiple sclerosis and its investigation using MR techniques. J Neurol 2011; 258:2113-27. [DOI: 10.1007/s00415-011-6117-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 05/18/2011] [Accepted: 05/20/2011] [Indexed: 12/22/2022]
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Current World Literature. Curr Opin Neurol 2011; 24:300-7. [DOI: 10.1097/wco.0b013e328347b40e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zaaraoui W, Reuter F, Rico A, Faivre A, Crespy L, Malikova I, Soulier E, Viout P, Fur Y, Confort-Gouny S, Cozzone PJ, Pelletier J, Ranjeva JP, Audoin B. Occurrence of neuronal dysfunction during the first 5 years of multiple sclerosis is associated with cognitive deterioration. J Neurol 2010; 258:811-9. [DOI: 10.1007/s00415-010-5845-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 11/16/2010] [Accepted: 11/18/2010] [Indexed: 12/12/2022]
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