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Cuoco S, Ponticorvo S, Bisogno R, Manara R, Esposito F, Di Salle G, Di Salle F, Amboni M, Erro R, Picillo M, Barone P, Pellecchia MT. Magnetic Resonance T1w/T2w Ratio in the Putamen and Cerebellum as a Marker of Cognitive Impairment in MSA: a Longitudinal Study. CEREBELLUM (LONDON, ENGLAND) 2023; 22:810-817. [PMID: 35982370 PMCID: PMC10485110 DOI: 10.1007/s12311-022-01455-8] [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] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
The exact pathophysiology of cognitive impairment in multiple system atrophy (MSA) is unclear. In our longitudinal study, we aimed to analyze (I) the relationships between cognitive functions and some subcortical structures, such as putamen and cerebellum assessed by voxel-based morphometry (VBM) and T1-weighted/T2-weighted (T1w/T2w) ratio, and (II) the neuroimaging predictors of the progression of cognitive deficits. Twenty-six patients with MSA underwent a comprehensive neuropsychological battery, motor examination, and brain MRI at baseline (T0) and 1-year follow-up (T1). Patients were then divided according to cognitive status into MSA with normal cognition (MSA-NC) and MSA with mild cognitive impairment (MCI). At T1, we divided the sample according to worsening/non worsening of cognitive status compared to baseline evaluation. Logistic regression analysis showed that age (β = - 9.45, p = .02) and T1w/T2w value in the left putamen (β = 230.64, p = .01) were significant predictors of global cognitive status at T0, explaining 65% of the variance. Logistic regression analysis showed that ∆-values of WM density in the cerebellum/brainstem (β = 2188.70, p = .02) significantly predicted cognitive worsening at T1, explaining 64% of the variance. Our results suggest a role for the putamen and cerebellum in the cognitive changes of MSA, probably due to their connections with the cortex. The putaminal T1w/T2w ratio may deserve further studies as a marker of cognitive impairment in MSA.
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Affiliation(s)
- Sofia Cuoco
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Sara Ponticorvo
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Rossella Bisogno
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Renzo Manara
- Neuroradiology Unit, Department of Neurosciences, University of Padua, 35128, Padua, Italy
| | - Fabrizio Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli, Napoli, Italy
| | - Gianfranco Di Salle
- Scuola Superiore Di Studi Universitari E Perfezionamento Sant'Anna, Classe Di Scienze Sperimentali, Pisa, Italy
| | - Francesco Di Salle
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Marianna Amboni
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Roberto Erro
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Marina Picillo
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy
| | - Maria Teresa Pellecchia
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry, Neuroscience Section, University of Salerno, 84131, Salerno, Italy.
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Ponticorvo S, Manara R, Russillo MC, Erro R, Picillo M, Di Salle G, Di Salle F, Barone P, Esposito F, Pellecchia MT. Magnetic resonance T1w/T2w ratio and voxel-based morphometry in multiple system atrophy. Sci Rep 2021; 11:21683. [PMID: 34737396 PMCID: PMC8569168 DOI: 10.1038/s41598-021-01222-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/22/2021] [Indexed: 11/09/2022] Open
Abstract
Diagnosis of multiple system atrophy (MSA) may be improved by using multimodal imaging approaches. We investigated the use of T1-weighted/T2-weighted (T1w/T2w) images ratio combined with voxel-based morphometry to evaluate brain tissue integrity in MSA compared to Parkinson’s disease (PD) and healthy controls (HC). Twenty-six patients with MSA, 43 patients with PD and 56 HC were enrolled. Whole brain voxel-based and local regional analyses were performed to evaluate gray and white matter (GM and WM) tissue integrity and mean regional values were used for patients classification using logistic regression. Increased mean regional values of T1w/T2w in bilateral putamen were detected in MSA-P compared to PD and HC. The combined use of regional GM and T1w/T2w values in the right and left putamen showed the highest accuracy in discriminating MSA-P from PD and good accuracy in discriminating MSA from PD and HC. A good accuracy was also found in discriminating MSA from PD and HC by either combining regional GM and T1w/T2w values in the cerebellum or regional WM and T1w/T2w in the cerebellum and brainstem. The T1w/T2w image ratio alone or combined with validated MRI parameters can be further considered as a potential candidate biomarker for differential diagnosis of MSA.
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Affiliation(s)
- S Ponticorvo
- Neuroscience Section, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, 84131, Salerno, Italy
| | - R Manara
- Neuroradiology Unit, Department of Neurosciences, University of Padua, Padua, Italy
| | - M C Russillo
- Neuroscience Section, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, 84131, Salerno, Italy
| | - R Erro
- Neuroscience Section, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, 84131, Salerno, Italy
| | - M Picillo
- Neuroscience Section, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, 84131, Salerno, Italy
| | - G Di Salle
- Classe di Scienze Sperimentali, Scuola Superiore di Studi Universitari e Perfezionamento Sant'Anna, Pisa, Italy
| | - F Di Salle
- Neuroscience Section, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, 84131, Salerno, Italy
| | - P Barone
- Neuroscience Section, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, 84131, Salerno, Italy
| | - F Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - M T Pellecchia
- Neuroscience Section, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, 84131, Salerno, Italy.
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Filip P, Canna A, Moheet A, Bednarik P, Grohn H, Li X, Kumar AF, Olawsky E, Eberly LE, Seaquist ER, Mangia S. Structural Alterations in Deep Brain Structures in Type 1 Diabetes. Diabetes 2020; 69:2458-2466. [PMID: 32839347 PMCID: PMC7576566 DOI: 10.2337/db19-1100] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 08/19/2020] [Indexed: 01/28/2023]
Abstract
Even though well known in type 2 diabetes, the existence of brain changes in type 1 diabetes (T1D) and both their neuroanatomical and clinical features are less well characterized. To fill the void in the current understanding of this disease, we sought to determine the possible neural correlate in long-duration T1D at several levels, including macrostructural, microstructural cerebral damage, and blood flow alterations. In this cross-sectional study, we compared a cohort of 61 patients with T1D with an average disease duration of 21 years with 54 well-matched control subjects without diabetes in a multimodal MRI protocol providing macrostructural metrics (cortical thickness and structural volumes), microstructural measures (T1-weighted/T2-weighted [T1w/T2w] ratio as a marker of myelin content, inflammation, and edema), and cerebral blood flow. Patients with T1D had higher T1w/T2w ratios in the right parahippocampal gyrus, the executive part of both putamina, both thalami, and the cerebellum. These alterations were reflected in lower putaminal and thalamic volume bilaterally. No cerebral blood flow differences between groups were found in any of these structures, suggesting nonvascular etiologies of these changes. Our findings implicate a marked nonvascular disruption in T1D of several essential neural nodes engaged in both cognitive and motor processing.
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Affiliation(s)
- Pavel Filip
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Neurology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
- First Department of Neurology, Faculty of Medicine, Masaryk University and University Hospital of St. Anne, Brno, Czech Republic
| | - Antonietta Canna
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Amir Moheet
- Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Petr Bednarik
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Heidi Grohn
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Xiufeng Li
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Anjali F Kumar
- Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Evan Olawsky
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Lynn E Eberly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | | | - Silvia Mangia
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
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Brain iron content in systemic iron overload: A beta-thalassemia quantitative MRI study. NEUROIMAGE-CLINICAL 2019; 24:102058. [PMID: 31711032 PMCID: PMC6849415 DOI: 10.1016/j.nicl.2019.102058] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/15/2019] [Accepted: 10/23/2019] [Indexed: 01/20/2023]
Abstract
Iron overload is a life-threatening condition in beta-thalassemia. Data on brain involvement in systemic iron overload are conflicting. MRI quantification of brain tissue iron content is feasible in a voxel-based approach. No iron tissue excess is evident in beta-thalassemia but in the choroid plexuses.
Objective Multisystem iron poisoning is a major concern for long-term beta-thalassemia management. Quantitative MRI-based techniques routinely show iron overload in heart, liver, endocrine glands and kidneys. However, data on the brain are conflicting and monitoring of brain iron content is still matter of debate. Methods This 3T-MRI study applied a well validated high-resolution whole-brain quantitative MRI assessment of iron content on 47 transfusion-dependent (mean-age: 36.9 ± 10.3 years, 63% females), 23 non-transfusion dependent (mean-age: 29.2 ± 11.7 years, 56% females) and 57 healthy controls (mean-age: 33.9 ± 10.8 years, 65% females). Clinical data, Wechsler Adult Intelligence Scale scores and treatment regimens were recorded. Beside whole-brain R2* analyses, regional R2*-values were extracted in putamen, globus pallidum, caudate nucleus, thalamus and red nucleus; hippocampal volumes were also determined. Results Regional analyses yielded no significant differences between patients and controls, except in those treated with deferiprone that showed lower R2*-values (p<0.05). Whole-brain analyses of R2*-maps revealed strong age-R2* correlations (r2=0.51) in both groups and clusters of significantly increased R2*-values in beta-thalassemia patients in the hippocampal formations and around the Luschka foramina; transfusion treatment was associated with additional R2* increase in dorsal thalami. Hippocampal formation R2*-values did not correlate with hippocampal volume; hippocampal volume did not differ between patients and controls. All regions with increased R2*-values shared a strict anatomical contiguity with choroid plexuses suggesting a blooming effect as the likely cause of R2* increase, in agreement with the available histopathologic literature evidence. Conclusion According to our MRI findings and the available histopathologic literature evidence, concerns about neural tissue iron overload in beta-thalassemia appear to be unjustified.
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Tabelow K, Balteau E, Ashburner J, Callaghan MF, Draganski B, Helms G, Kherif F, Leutritz T, Lutti A, Phillips C, Reimer E, Ruthotto L, Seif M, Weiskopf N, Ziegler G, Mohammadi S. hMRI - A toolbox for quantitative MRI in neuroscience and clinical research. Neuroimage 2019; 194:191-210. [PMID: 30677501 PMCID: PMC6547054 DOI: 10.1016/j.neuroimage.2019.01.029] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/21/2018] [Accepted: 01/10/2019] [Indexed: 12/20/2022] Open
Abstract
Neuroscience and clinical researchers are increasingly interested in quantitative magnetic resonance imaging (qMRI) due to its sensitivity to micro-structural properties of brain tissue such as axon, myelin, iron and water concentration. We introduce the hMRI-toolbox, an open-source, easy-to-use tool available on GitHub, for qMRI data handling and processing, presented together with a tutorial and example dataset. This toolbox allows the estimation of high-quality multi-parameter qMRI maps (longitudinal and effective transverse relaxation rates R1 and R2⋆, proton density PD and magnetisation transfer MT saturation) that can be used for quantitative parameter analysis and accurate delineation of subcortical brain structures. The qMRI maps generated by the toolbox are key input parameters for biophysical models designed to estimate tissue microstructure properties such as the MR g-ratio and to derive standard and novel MRI biomarkers. Thus, the current version of the toolbox is a first step towards in vivo histology using MRI (hMRI) and is being extended further in this direction. Embedded in the Statistical Parametric Mapping (SPM) framework, it benefits from the extensive range of established SPM tools for high-accuracy spatial registration and statistical inferences and can be readily combined with existing SPM toolboxes for estimating diffusion MRI parameter maps. From a user's perspective, the hMRI-toolbox is an efficient, robust and simple framework for investigating qMRI data in neuroscience and clinical research.
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Affiliation(s)
| | | | | | | | - Bogdan Draganski
- Laboratory for Research in Neuroimaging, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Switzerland; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Gunther Helms
- Medical Radiation Physics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Ferath Kherif
- Laboratory for Research in Neuroimaging, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Switzerland
| | - Tobias Leutritz
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Antoine Lutti
- Laboratory for Research in Neuroimaging, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Switzerland
| | | | - Enrico Reimer
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | | | | | - Nikolaus Weiskopf
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Gabriel Ziegler
- Institute for Cognitive Neurology and Dementia Research, University of Magdeburg, Germany
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