1
|
Mossa-Basha M, Peterson DJ, Hippe DS, Vranic JE, Hofstetter C, Reyes M, Bombardier C, Jarvik JG. Segmented quantitative diffusion tensor imaging evaluation of acute traumatic cervical spinal cord injury. Br J Radiol 2021; 94:20201000. [PMID: 33180553 DOI: 10.1259/bjr.20201000] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To evaluate segmented diffusion tensor imaging (DTI) white matter tract fractional anisotropy (FA) and mean diffusivity (MD) values in acute cervical spinal cord injury (CSCI). METHODS 15 patients with acute CSCI and 12 control subjects were prospectively recruited and underwent axial DTI as part of the spine trauma MRI. Datasets were put through a semi-automated probabilistic segmentation algorithm that analyzed white matter, motor and sensory tracts. FA and MD values were calculated for white matter, sensory (spinal lemniscal) and motor tracts (ventral/lateral corticospinal) at the level of clinical injury, levels remote from injury and in normal controls. RESULTS There were significant differences in FA between the level of injury and controls for total white matter (0.65 ± .09 vs 0.68 ± .07; p = .044), motor tracts (0.64 ± .07 vs 0.7 ± .09; p = .006), and combined motor/sensory tracts (0.63 ± .09 vs 0.69 ± .08; p = .022). In addition, there were significant FA differences between the level of injury and one level caudal to the injury for combined motor tracts (0.64 ± .07 vs 0.69 ± .05; p = .002) and combined motor/sensory tracts (0.63 ± .09 vs 0.7 ± .07; p = .011). There were no significant differences for MD between the level of injury and one level caudal to the injury or normal controls. CONCLUSION Abnormalities in DTI metrics of DTI-segmented white matter tracts were detected at the neurological level of injury relative to normal controls and levels remote from the injury site, confirming its value in CSCI assessment. ADVANCES IN KNOWLEDGE Segmented DTI analysis can help identify microstructural spinal cord abnormalities in the setting of traumatic cervical spinal cord injury.
Collapse
Affiliation(s)
| | | | - Daniel S Hippe
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Justin E Vranic
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Maria Reyes
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Charles Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Jeffrey G Jarvik
- Department of Radiology, University of Washington, Seattle, WA, USA.,Department of Neurosurgery, University of Washington, Seattle, WA, USA.,Department of Health Services, University of Washington, Seattle, WA, USA
| |
Collapse
|
2
|
Dvorak AV, Ljungberg E, Vavasour IM, Liu H, Johnson P, Rauscher A, Kramer JLK, Tam R, Li DKB, Laule C, Barlow L, Briemberg H, MacKay AL, Traboulsee A, Kozlowski P, Cashman N, Kolind SH. Rapid myelin water imaging for the assessment of cervical spinal cord myelin damage. NEUROIMAGE-CLINICAL 2019; 23:101896. [PMID: 31276928 PMCID: PMC6611998 DOI: 10.1016/j.nicl.2019.101896] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 06/08/2019] [Accepted: 06/11/2019] [Indexed: 12/13/2022]
Abstract
Background Rapid myelin water imaging (MWI) using a combined gradient and spin echo (GRASE) sequence can produce myelin specific metrics for the human brain. Spinal cord MWI could be similarly useful, but technical challenges have hindered routine application. GRASE rapid MWI was recently successfully implemented for imaging of healthy cervical spinal cord and may complement other advanced imaging methods, such as diffusion tensor imaging (DTI) and quantitative T1 (qT1). Objective To demonstrate the feasibility of cervical cord GRASE rapid MWI in multiple sclerosis (MS), primary lateral sclerosis (PLS) and neuromyelitis optica spectrum disorder (NMO), with comparison to DTI and qT1 metrics. Methods GRASE MWI, DTI and qT1 data were acquired in 2 PLS, 1 relapsing-remitting MS (RRMS), 1 primary-progressive MS (PPMS) and 2 NMO subjects, as well as 6 age (±3 yrs) and sex matched healthy controls (HC). Internal cord structure guided template registrations, used for region of interest (ROI) analysis. Z score maps were calculated for the difference between disease subject and mean HC metric values. Results PLS subjects had low myelin water fraction (MWF) in the lateral funiculi compared to HC. RRMS subject MWF was heterogeneous within the cord. The PPMS subject showed no trends in ROI results but had a region of low MWF Z score corresponding to a focal lesion. The NMO subject with a longitudinally extensive transverse myelitis lesion had low values for whole cord mean MWF of 12.8% compared to 24.3% (standard deviation 2.2%) for HC. The NMO subject without lesions also had low MWF compared to HC. DTI and qT1 metrics showed similar trends, corroborating the MWF results and providing complementary information. Conclusion GRASE is sufficiently sensitive to detect decreased myelin within MS spinal cord plaques, NMO lesions, and PLS diffuse spinal cord injury. Decreased MWF in PLS is consistent with demyelination secondary to motor neuron degeneration. GRASE MWI is a feasible method for rapid assessment of myelin content in the cervical spinal cord and provides complementary information to that of DTI and qT1 measures. Downstream myelin changes in motor tracts of primary lateral sclerosis spinal cord. Low myelin water fraction in multiple sclerosis and neuromyelitis optica cord lesions. Diffuse demyelination evidence in neuromyelitis optica normal-appearing white matter. Myelin water imaging provides complementary information to diffusion and T1 metrics.
Collapse
Affiliation(s)
- Adam V Dvorak
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; International Collaboration on Repair Discoveries, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada.
| | - Emil Ljungberg
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park PO89, London SE5 8AF, United Kingdom
| | - Irene M Vavasour
- Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Hanwen Liu
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; International Collaboration on Repair Discoveries, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada
| | - Poljanka Johnson
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada
| | - Alexander Rauscher
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; Pediatrics, University of British Columbia, 4480 Oak Street BC Children's Hospital Vancouver, BC V6H 3V4, Canada; UBC MRI Research Centre, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - John L K Kramer
- International Collaboration on Repair Discoveries, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada; School of Kinesiology, University of British Columbia, 210-6081 University Boulevard, Vancouver, BC V6T 1Z1, Canada
| | - Roger Tam
- Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; School of Biomedical Engineering, University of British Columbia, 2222 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
| | - David K B Li
- Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; Medicine (Neurology), University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada; UBC MRI Research Centre, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Cornelia Laule
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; International Collaboration on Repair Discoveries, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada; Pathology & Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
| | - Laura Barlow
- Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; UBC MRI Research Centre, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Hannah Briemberg
- Medicine (Neurology), University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Alex L MacKay
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
| | - Anthony Traboulsee
- Medicine (Neurology), University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Piotr Kozlowski
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; International Collaboration on Repair Discoveries, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada; UBC MRI Research Centre, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Neil Cashman
- Medicine (Neurology), University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| | - Shannon H Kolind
- Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1, Canada; Radiology, University of British Columbia, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada; International Collaboration on Repair Discoveries, University of British Columbia, 818 West 10th Avenue, Vancouver, BC V5Z 1M9, Canada; Medicine (Neurology), University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada
| |
Collapse
|
3
|
Peterson DJ, Rutman AM, Hippe DS, Jarvik JG, Chokshi FH, Reyes MR, Bombardier CH, Mossa-Basha M. Test-Retest and Interreader Reproducibility of Semiautomated Atlas-Based Analysis of Diffusion Tensor Imaging Data in Acute Cervical Spine Trauma in Adult Patients. AJNR Am J Neuroradiol 2017; 38:2015-2020. [PMID: 28818826 DOI: 10.3174/ajnr.a5334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 06/05/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DTI is a tool for microstructural spinal cord injury evaluation. This study evaluated the reproducibility of a semiautomated segmentation algorithm of spinal cord DTI. MATERIALS AND METHODS Forty-two consecutive patients undergoing acute trauma cervical spine MR imaging underwent 2 axial DTI scans in addition to their clinical scan. The datasets were put through a semiautomated probabilistic segmentation algorithm that selected white matter, gray matter, and 24 individual white matter tracts. Regional and white matter tract volume, fractional anisotropy, and mean diffusivity values were calculated. Two readers performed the nonautomated steps to evaluate interreader reproducibility. The coefficient of variation and intraclass correlation coefficient were used to assess test-retest and interreader reproducibility. RESULTS Of 42 patients, 30 had useable data. Test-retest reproducibility of fractional anisotropy was high for white matter as a whole (coefficient of variation, 3.8%; intraclass correlation coefficient, 0.93). Test-retest coefficient-of-variation ranged from 8.0%-18.2% and intraclass correlation coefficients from 0.47-0.80 across individual white matter tracts. Mean diffusivity metrics also had high test-retest reproducibility (white matter: coefficient-of-variation, 5.6%; intraclass correlation coefficient, 0.86) with coefficients of variation from 11.6%-18.3% and intraclass correlation coefficients from 0.57-0.74 across individual tracts, with better agreement for larger tracts. The coefficients of variation of fractional anisotropy and mean diffusivity both had significant negative relationships with white matter volume (26%-27% decrease for each doubling of white matter volume, P < .01). CONCLUSIONS DTI spinal cord segmentation is reproducible in the setting of acute spine trauma, specifically for larger white matter tracts and total white or gray matter.
Collapse
Affiliation(s)
- D J Peterson
- From the Departments of Radiology (D.J.P., A.M.R., D.S.H., J.G.J., M.M.-B.)
| | - A M Rutman
- From the Departments of Radiology (D.J.P., A.M.R., D.S.H., J.G.J., M.M.-B.)
| | - D S Hippe
- From the Departments of Radiology (D.J.P., A.M.R., D.S.H., J.G.J., M.M.-B.)
| | - J G Jarvik
- From the Departments of Radiology (D.J.P., A.M.R., D.S.H., J.G.J., M.M.-B.)
| | - F H Chokshi
- Department of Radiology (F.H.C.), Emory University, Atlanta, Georgia
| | - M R Reyes
- Rehabilitation Medicine (M.R.R., C.H.B.), University of Washington, Seattle, Washington
| | - C H Bombardier
- Rehabilitation Medicine (M.R.R., C.H.B.), University of Washington, Seattle, Washington
| | - M Mossa-Basha
- From the Departments of Radiology (D.J.P., A.M.R., D.S.H., J.G.J., M.M.-B.)
| |
Collapse
|
4
|
Rutman AM, Peterson DJ, Cohen WA, Mossa-Basha M. Diffusion Tensor Imaging of the Spinal Cord: Clinical Value, Investigational Applications, and Technical Limitations. Curr Probl Diagn Radiol 2017; 47:257-269. [PMID: 28869104 DOI: 10.1067/j.cpradiol.2017.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/18/2017] [Accepted: 07/26/2017] [Indexed: 11/22/2022]
Abstract
Although diffusion-weighted imaging (DWI) has become a mainstay in modern brain imaging, it remains less utilized in the evaluation of the spinal cord. Many studies have shown promise in using DWI and diffusion-tensor imaging (DTI) for evaluation of the spinal cord; however, application has been stalled by technical obstacles and artifacts, and questions remain regarding its clinical utility on an individual examination level. This review discusses the background, concepts, and technical aspects of DWI and DTI, specifically for imaging of the spinal cord. The clinical and investigational applications of spinal cord DTI, as well as the practical difficulties and limitations of DWI and DTI for the evaluation of the spinal cord are examined.
Collapse
Affiliation(s)
- Aaron M Rutman
- Department of Radiology, University of Washington, Seattle, WA.
| | | | - Wendy A Cohen
- Department of Radiology, University of Washington, Seattle, WA
| | | |
Collapse
|
5
|
Combes AJ, Matthews L, Lee JS, Li DK, Carruthers R, Traboulsee AL, Barker GJ, Palace J, Kolind S. Cervical cord myelin water imaging shows degenerative changes over one year in multiple sclerosis but not neuromyelitis optica spectrum disorder. NEUROIMAGE-CLINICAL 2017; 16:17-22. [PMID: 28725551 PMCID: PMC5503831 DOI: 10.1016/j.nicl.2017.06.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/08/2017] [Accepted: 06/13/2017] [Indexed: 12/12/2022]
Abstract
Spinal cord pathology is a feature of both neuromyelitis optica spectrum disorder (NMOSD) and relapsing-remitting multiple sclerosis (MS). While subclinical disease activity has been described in MS using quantitative magnetic resonance imaging measures, current evidence suggests that neurodegeneration is absent between relapses in NMOSD, although most evidence comes from brain studies. We aimed to assess cross-sectional differences and longitudinal changes in myelin integrity in relapse-free MS and NMOSD subjects over one year. 15 NMOSD, 15 MS subjects, and 17 healthy controls were scanned at 3 T using a cervical cord mcDESPOT protocol. A subset of 8 NMOSD, 11 MS subjects and 14 controls completed follow-up. Measures of the myelin water fraction (fM) within lesioned and non-lesioned cord segments were collected. At baseline, fM in lesioned and non-lesioned segments was significantly reduced in MS (lesioned: p = 0.002; non-lesioned: p = 0.03) and NMOSD (lesioned: p = 0.0007; non-lesioned: p = 0.002) compared to controls. Longitudinally, fM decreased within non-lesioned cord segments in the MS group (− 7.3%, p = 0.02), but not in NMOSD (+ 5.8%, p = 0.1), while change in lesioned segments fM did not differ from controls' in either patient group. These results suggest that degenerative changes outside of lesioned areas can be observed over a short time frame in MS, but not NMOSD, and support the use of longitudinal myelin water imaging for the assessment of pathological changes in the cervical cord in demyelinating diseases. MS and NMOSD subjects underwent longitudinal cervical cord myelin water imaging. Reduced myelin water fraction in MS and NMOSD normal-appearing and lesioned areas Decrease in myelin in normal-appearing tissue over 1 year in MS, but not NMOSD Further evidence that disease progression is absent between relapses in NMOSD.
Collapse
Affiliation(s)
- Anna J.E. Combes
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Corresponding author at: Centre for Neuroimaging Sciences, P089, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom.
| | - Lucy Matthews
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jimmy S. Lee
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - David K.B. Li
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Robert Carruthers
- Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Anthony L. Traboulsee
- Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Gareth J. Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Jacqueline Palace
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Shannon Kolind
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
6
|
Wang J, Tian Y, Shao Y, Feng H, Qin L, Xu W, Liu H, Xu Q, Wei S, Ma L. Comparison of spontaneous brain activity revealed by regional homogeneity in AQP4-IgG neuromyelitis optica-optic neuritis versus MOG-IgG optic neuritis patients: a resting-state functional MRI study. Neuropsychiatr Dis Treat 2017; 13:2669-2679. [PMID: 29123400 PMCID: PMC5661477 DOI: 10.2147/ndt.s145183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Many previous studies have demonstrated that neuromyelitis optica (NMO) patients have abnormalities of brain anatomy and function. However, differences in spontaneous brain activity between myelin oligodendrocyte glycoprotein (MOG)-IgG ON and aquaporin 4(AQP4)-neuromyelitis optica-optic neuritis (ON) remain unknown. In the current study, we investigated the brain neural homogeneity in MOG-IgG ON versus AQP4-IgG NMO-ON subjects by regional homogeneity (ReHo) method using magnetic resonance imaging (MRI). PATIENTS AND METHODS A total of 32 NMO-ON and ON subjects (21 with AQP4-IgG+NMO-ON and 11 with MOG-IgG+ON) and 34 healthy controls (HCs) closely matched for age were recruited, and scans were performed for all subjects. A one-way analysis of variance (ANOVA) was performed to determine the regions in which the ReHo was different across the three groups. NMO-ON and ON subjects were distinguished from HCs by a receiver operating characteristic (ROC) curve. The relationship between the mean ReHo in many brain regions and clinical features in NMO subjects was calculated by Pearson correlation analysis. RESULTS Compared with HCs, MOG-IgG+ON subjects had significantly decreased ReHo values in the posterior lobe of the left cerebellum and increased ReHo values in the left inferior frontal gyrus, right prefrontal gyrus, and left precentral/postcentral gyrus. AQP4-IgG+NMO-ON subjects showed higher ReHo values in the left inferior frontal gyrus and right middle temporal/occipital gyrus. Compared with MOG-IgG+ON subjects, AQP4-IgG+NMO-ON subjects had lower ReHo values in the posterior lobe of the right cerebellum. AQP4-Ig+NMO-ON subjects showed higher ReHo values in the left precentral/postcentral gyrus and right superior temporal gyrus. CONCLUSION AQP4-IgG+NMO-ON and MOG-IgG+ON subjects showed abnormal synchronized neuronal activity in many brain regions, which is consistent with deficits in visual, motor, and cognitive function. Furthermore, different patterns of synchronized neuronal activity occurred in the AQP4-IgG+NMO-ON and MOG-IgG+ON.
Collapse
Affiliation(s)
| | - Yuan Tian
- Department of Radiology, Chinese PLA General Hospital, Beijing
| | - Yi Shao
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | | | | | | | | | | | | | - Lin Ma
- Department of Radiology, Chinese PLA General Hospital, Beijing
| |
Collapse
|
7
|
Ohnari K, Okada K, Takahashi T, Mafune K, Adachi H. Evoked potentials are useful for diagnosis of neuromyelitis optica spectrum disorder. J Neurol Sci 2016; 364:97-101. [PMID: 27084224 DOI: 10.1016/j.jns.2016.02.060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/02/2016] [Accepted: 02/24/2016] [Indexed: 01/03/2023]
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) has been differentiated from relapsing-remitting multiple sclerosis (RRMS) by clinical, laboratory, and pathological findings, including the presence of the anti-aquaporin 4 antibody. Measurement of evoked potentials (EPs) is often used for the diagnosis of RRMS, although the possibility of applying EPs to the diagnosis of NMOSD has not been investigated in detail. Eighteen patients with NMOSD and 28 patients with RRMS were included in this study. The patients' neurological symptoms and signs were examined and their EPs were recorded. Characteristic findings were absence of visual evoked potentials and absence of motor evoked potentials in the lower extremities in patients with NMOSD, and a delay in these potentials in patients with RRMS. Most patients with NMOSD did not present abnormal subclinical EPs, whereas many patients with RRMS did. None of the patients with NMOSD showed abnormalities in auditory brainstem responses. NMOSD can be differentiated from RRMS by EP data obtained in the early stages of these diseases.
Collapse
Affiliation(s)
- Keiko Ohnari
- Department of Neurology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan.
| | - Kazumasa Okada
- Department of Neurology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Toshiyuki Takahashi
- Department of Neurology, School of Medicine, University of Tohoku, Seiryomachi, Sendai 980-8574, Japan; Department of Neurology, Yonezawa National Hospital, 26100-1 Misawa, Yonezawa, Yamagata 992-1202, Japan
| | - Kosuke Mafune
- Department of Mental Health, Institute of Industrial Ecological Sciences, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan
| | - Hiroaki Adachi
- Department of Neurology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 807-8555, Japan.
| |
Collapse
|
8
|
Lemos M, Carvalho G, Carvalho R, Bichuetti D, de Oliveira E, Abdala N. Neuromyelitis optica spectrum disorders: beyond longitudinally extensive transverse myelitis. Clin Radiol 2015; 70:630-7. [DOI: 10.1016/j.crad.2015.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 10/23/2014] [Accepted: 02/20/2015] [Indexed: 10/23/2022]
|
9
|
Diffusion tensor imaging focusing on lower cervical spinal cord using 2D reduced FOV interleaved multislice single-shot diffusion-weighted echo-planar imaging: comparison with conventional single-shot diffusion-weighted echo-planar imaging. Magn Reson Imaging 2015; 33:401-6. [DOI: 10.1016/j.mri.2015.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 09/16/2014] [Accepted: 01/10/2015] [Indexed: 11/19/2022]
|
10
|
Weier K, Eshaghi A, Magon S, Andelova M, Radue EW, Kappos L, Azimi AR, Sahraian MA, Sprenger T. The role of cerebellar abnormalities in neuromyelitis optica – a comparison with multiple sclerosis and healthy controls. Mult Scler 2014; 21:757-66. [DOI: 10.1177/1352458514554051] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 08/26/2014] [Indexed: 11/15/2022]
Abstract
Background: In relapsing–remitting multiple sclerosis (RRMS), the cerebellum is a known predilection site for atrophy. Neuromyelitis optica (NMO) is characterized by extensive lesions in the spinal cord and optic nerve; however, cerebellar involvement has been less studied. Secondary degeneration of the spinocerebellar tract could impact the cerebellum in NMO. Objective: We aimed to investigate whether spinal cord and cerebellar volume measures differ between patients with NMO and RRMS. Methods: Volumetric analyses of the cerebellum (TCV), the upper cervical cord (UCV) as well as the whole brain (NBV) of age- and gender-matched patients with NMO ( n=30; 56% AQP4 +ve) and RRMS ( n=25) were performed on 3T brain magnetic resonance imaging (MRI) and compared with 34 healthy controls (HC). Results: UCV was significantly reduced in NMO patients (6.3 cm3) as compared with HC (6.7 cm3), while patients with MS had reduced brain volumes compared with HC (NBV=1482 cm3; p<0.001; TCV=188 cm3; p=0.042), but UCV close to normal values. Patients with RRMS and NMO differed in NBV ( p=0.001; lower in RRMS) and by trend (towards reduction in RRMS) in cerebellar volume ( p=0.06). Conclusions: While atrophy seems to be diffuse in MS patients, a rather focussed pattern with predominant involvement of the UCV was observed in NMO patients.
Collapse
Affiliation(s)
- Katrin Weier
- Department of Neurology, University Hospital Basel, Switzerland
| | - Arman Eshaghi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Stefano Magon
- Department of Neurology, University Hospital Basel, Switzerland
| | | | - Ernst-Wilhelm Radue
- Medical Image Analysis Center (MIAC) AG, c/o University Hospital Basel, Switzerland
| | - Ludwig Kappos
- Department of Neurology, University Hospital Basel, Switzerland
| | - Amir Reza Azimi
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Till Sprenger
- Department of Neurology, University Hospital Basel, Switzerland/Medical Image Analysis Center (MIAC) AG, c/o University Hospital Basel, Switzerland/Department of Radiology and Nuclear Medicine, Division of Neuroradiology, University Hospital Basel, Switzerland
| |
Collapse
|
11
|
Tsao WC, Lyu RK, Ro LS, Lao MF, Chen CM, Wu YR, Huang CC, Chang HS, Kuo HC, Chu CC, Chang KH. Clinical correlations of motor and somatosensory evoked potentials in neuromyelitis optica. PLoS One 2014; 9:e113631. [PMID: 25422930 PMCID: PMC4244088 DOI: 10.1371/journal.pone.0113631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 10/28/2014] [Indexed: 11/18/2022] Open
Abstract
Background Motor and somatosensory evoked potentials (MEPs and SSEPs) are sensitive tools for detecting subclinical lesions, assessing disease severity, and determining the prognosis for outcomes of patients with inflammatory neurological diseases such as multiple sclerosis. However, their roles in neuromyelitis optica (NMO), a severe inflammatory neurological disease that predominantly involves optic nerves and spinal cord, have not yet been clarified. Methods and Findings Clinical symptoms and examination findings at relapses of 30 NMO patients were retrospectively reviewed. Abnormal MEPs were observed in 69.2% of patients. Patients with abnormal motor central conduction time (CCT) of the lower limbs had higher Kurtzke Expanded Disability Status Scale (EDSS) scores than those with normal responses (P = 0.027). Abnormal SSEPs were found in 69.0% of patients. Patients with abnormal lower limb sensory CCT had higher EDSS scores than those with normal responses (P = 0.019). In 28 patients followed up more than 6 months, only one of 11 patients (9.1%) with normal SSEPs of the lower limbs had new relapses within 6 months, whereas 8 of 17 patients (47.1%, P = 0.049) with abnormal SSEPs of the lower limbs had new relapses. Conclusions These results indicate MEPs and SSEPs of the lower limbs are good indicators for the disability status at relapses of NMO. Lower limb SSEPs may be a good tool for reflecting the frequency of relapses of NMO.
Collapse
Affiliation(s)
- Wei-Chia Tsao
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Rong-Kuo Lyu
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
- * E-mail: (R-KL); (K-HC)
| | - Long-Sun Ro
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ming-Fen Lao
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chiung-Mei Chen
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chin-Chang Huang
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiu Chang
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hung-Chao Kuo
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chun-Che Chu
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kuo-Hsuan Chang
- Department of Neurology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
- * E-mail: (R-KL); (K-HC)
| |
Collapse
|
12
|
Riederer I, Karampinos DC, Settles M, Preibisch C, Bauer JS, Kleine JF, Mühlau M, Zimmer C. Double inversion recovery sequence of the cervical spinal cord in multiple sclerosis and related inflammatory diseases. AJNR Am J Neuroradiol 2014; 36:219-25. [PMID: 25169924 DOI: 10.3174/ajnr.a4093] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging plays an important role in diagnosing MS and other related inflammatory diseases; however, imaging of the spinal cord is still challenging. We hypothesized that a 3D double inversion recovery sequence for cervical spinal cord imaging would be more sensitive in detecting inflammatory lesions than a conventional 2D T2-weighted TSE sequence at 3T. MATERIALS AND METHODS On a 3T MR imaging scanner, we examined 30 patients with suspected or established MS (MS, n = 16; clinically isolated syndrome, n = 12; isolated myelitis, n = 2) and 10 healthy controls. Newly developed 3D double inversion recovery and conventional 2D axial and sagittal T2-weighted TSE images of the cervical spinal cord were acquired. Two blinded neuroradiologists independently assessed the scans in pseudorandomized order for lesion numbers and rated lesion visibility and overall image quality on 5-point scales. A subsequent consensus reading delivered definite lesion counts. Standardized contrast-to-noise ratios were calculated in representative lesions of each patient. RESULTS Overall, 28% more lesions could be detected with 3D double inversion recovery than with conventional T2WI (119 versus 93, P < .002). On average, the standardized contrast-to-noise ratio was significantly higher (P < .001) in double inversion recovery than in T2WI. Lesion visibility was rated significantly higher (P < .001) in double inversion recovery compared with T2WI despite lower image quality. CONCLUSIONS The novel 3D double inversion recovery sequence allowed better detection of lesions in MS and related inflammatory diseases of the cervical spinal cord, compared with conventional 2D T2WI.
Collapse
Affiliation(s)
- I Riederer
- From the Departments of Diagnostic and Interventional Neuroradiology (I.R., C.P., J.S.B., J.F.K., C.Z.)
| | | | - M Settles
- Diagnostic and Interventional Radiology (D.C.K., M.S.)
| | - C Preibisch
- From the Departments of Diagnostic and Interventional Neuroradiology (I.R., C.P., J.S.B., J.F.K., C.Z.) Neuroimaging Center at the Technische Universität München (C.P., M.M.)
| | - J S Bauer
- From the Departments of Diagnostic and Interventional Neuroradiology (I.R., C.P., J.S.B., J.F.K., C.Z.)
| | - J F Kleine
- From the Departments of Diagnostic and Interventional Neuroradiology (I.R., C.P., J.S.B., J.F.K., C.Z.)
| | - M Mühlau
- Neuroimaging Center at the Technische Universität München (C.P., M.M.) Department of Neurology (M.M.), Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - C Zimmer
- From the Departments of Diagnostic and Interventional Neuroradiology (I.R., C.P., J.S.B., J.F.K., C.Z.)
| |
Collapse
|