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Xiao XY, Zeng JY, Cao YB, Tang Y, Zou ZY, Li JQ, Chen HJ. Cortical microstructural abnormalities in amyotrophic lateral sclerosis: a gray matter-based spatial statistics study. Quant Imaging Med Surg 2024; 14:5774-5788. [PMID: 39144033 PMCID: PMC11320503 DOI: 10.21037/qims-24-236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/17/2024] [Indexed: 08/16/2024]
Abstract
Background Amyotrophic lateral sclerosis (ALS)-related white-matter microstructural abnormalities have received considerable attention; however, gray-matter structural abnormalities have not been fully elucidated. This study aimed to evaluate cortical microstructural abnormalities in ALS and determine their association with disease severity. Methods This study included 34 patients with ALS and 30 healthy controls. Diffusion-weighted data were used to estimate neurite orientation dispersion and density imaging (NODDI) parameters, including neurite density index (NDI) and orientation dispersion index (ODI). We performed gray matter-based spatial statistics (GBSS) in a voxel-wise manner to determine the cortical microstructure difference. We used the revised ALS Functional Rating Scale (ALSFRS-R) to assess disease severity and conducted a correlation analysis between NODDI parameters and ALSFRS-R. Results In patients with ALS, the NDI reduction involved several cortical regions [primarily the precentral gyrus, postcentral gyrus, temporal cortex, prefrontal cortex, occipital cortex, and posterior parietal cortex; family-wise error (FWE)-corrected P<0.05]. ODI decreased in relatively few cortical regions (including the precentral gyrus, postcentral gyrus, prefrontal cortex, and inferior parietal lobule; FWE-corrected P<0.05). The NDI value in the left precentral and postcentral gyrus was positively correlated with the ALS disease severity (FWE-corrected P<0.05). Conclusions The decreases in NDI and ODI involved both motor-related and extra-motor regions and indicated the presence of gray-matter microstructural impairment in ALS. NODDI parameters are potential imaging biomarkers for evaluating disease severity in vivo. Our results showed that GBSS is a feasible method for identifying abnormalities in the cortical microstructure of patients with ALS.
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Affiliation(s)
- Xin-Yun Xiao
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jing-Yi Zeng
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yun-Bin Cao
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ying Tang
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China
| | - Zhang-Yu Zou
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jian-Qi Li
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China
| | - Hua-Jun Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
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Nakaya M, Sato N, Matsuda H, Maikusa N, Ota M, Shigemoto Y, Sone D, Yamao T, Kimura Y, Tsukamoto T, Yokoi Y, Sakata M, Abe O. Assessment of Gray Matter Microstructural Alterations in Alzheimer's Disease by Free Water Imaging. J Alzheimers Dis 2024; 99:1441-1453. [PMID: 38759008 PMCID: PMC11191448 DOI: 10.3233/jad-231416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Background Cortical neurodegenerative processes may precede the emergence of disease symptoms in patients with Alzheimer's disease (AD) by many years. No study has evaluated the free water of patients with AD using gray matter-based spatial statistics. Objective The aim of this study was to explore cortical microstructural changes within the gray matter in AD by using free water imaging with gray matter-based spatial statistics. Methods Seventy-one participants underwent multi-shell diffusion magnetic resonance imaging, 11C-Pittsburgh compound B positron emission tomography, and neuropsychological evaluations. The patients were divided into two groups: healthy controls (n = 40) and the AD spectrum group (n = 31). Differences between the groups were analyzed using voxel-based morphometry, diffusion tensor imaging, and free water imaging with gray matter-based spatial statistics. Results Voxel-based morphometry analysis revealed gray matter volume loss in the hippocampus of patients with AD spectrum compared to that in controls. Furthermore, patients with AD spectrum exhibited significantly greater free water, mean diffusivity, and radial diffusivity in the limbic areas, precuneus, frontal lobe, temporal lobe, right putamen, and cerebellum than did the healthy controls. Overall, the effect sizes of free water were greater than those of mean diffusivity and radial diffusivity, and the larger effect sizes of free water were thought to be strongly correlated with AD pathology. Conclusions This study demonstrates the utility of applying voxel-based morphometry, gray matter-based spatial statistics, free water imaging and diffusion tensor imaging to assess AD pathology and detect changes in gray matter.
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Affiliation(s)
- Moto Nakaya
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Noriko Sato
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Matsuda
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
- Drug Discovery and Cyclotron Research Center, Southern TOHOKU Research Institute for Neuroscience, Koriyama, Japan
| | - Norihide Maikusa
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Miho Ota
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
- Department of Neuropsychiatry, University of Tsukuba, Tsukuba, Japan
| | - Yoko Shigemoto
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Daichi Sone
- Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tensho Yamao
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Yukio Kimura
- Department of Radiology, National Center Hospital of Neurology and Psychiatry, Tokyo, Japan
| | - Tadashi Tsukamoto
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yuma Yokoi
- Department of Educational Promotion, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masuhiro Sakata
- Department of Psychiatry Saitama Prefectural Psychiatric Hospital, Saitama, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Huang H, Ma X, Yue X, Kang S, Rao Y, Long W, Liang Y, Li Y, Chen Y, Lyu W, Wu J, Tan X, Qiu S. Cortical gray matter microstructural alterations in patients with type 2 diabetes mellitus. Brain Behav 2022; 12:e2746. [PMID: 36059152 PMCID: PMC9575596 DOI: 10.1002/brb3.2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/02/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND AND PURPOSE Neurodegenerative processes are widespread in the brains of type 2 diabetes mellitus (T2DM) patients; gaps remain to exist in the current knowledge of the associated gray matter (GM) microstructural alterations. METHODS A cross-sectional study was conducted to investigate alterations in GM microarchitecture in T2DM patients by diffusion tensor imaging and neurite orientation dispersion and density imaging (NODDI). Seventy-eight T2DM patients and seventy-four age-, sex-, and education level-matched healthy controls (HCs) without cognitive impairment were recruited. Cortical macrostructure and GM microstructure were assessed by surface-based analysis and GM-based spatial statistics (GBSS), respectively. Machine learning models were trained to evaluate the diagnostic values of cortical intracellular volume fraction (ICVF) for the classification of T2DM versus HCs. RESULTS There were no differences in cortical thickness or area between the groups. GBSS analysis revealed similar GM microstructural patterns of significantly decreased fractional anisotropy, increased mean diffusivity and radial diffusivity in T2DM patients involving the frontal and parietal lobes, and significantly lower ICVF values were observed in nearly all brain regions of T2DM patients. A support vector machine model with a linear kernel was trained to realize the T2DM versus HC classification and exhibited the highest performance among the trained models, achieving an accuracy of 74% and an area under the curve of 83%. CONCLUSIONS NODDI may help to probe the widespread GM neuritic density loss in T2DM patients occurs before measurable macrostructural alterations. The cortical ICVF values may provide valuable diagnostic information regarding the early GM microstructural alterations in T2DM.
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Affiliation(s)
- Haoming Huang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xiaomeng Ma
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xiaomei Yue
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Shangyu Kang
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yawen Rao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Wenjie Long
- Department of Geriatrics, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yi Liang
- Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yifan Li
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Yuna Chen
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Wenjiao Lyu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Jinjian Wu
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China.,Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Xin Tan
- Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
| | - Shijun Qiu
- Department of Radiology, The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, P.R. China
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Murray KD, Singh MV, Zhuang Y, Uddin MN, Qiu X, Weber MT, Tivarus ME, Wang HZ, Sahin B, Zhong J, Maggirwar SB, Schifitto G. Pathomechanisms of HIV-Associated Cerebral Small Vessel Disease: A Comprehensive Clinical and Neuroimaging Protocol and Analysis Pipeline. Front Neurol 2020; 11:595463. [PMID: 33384655 PMCID: PMC7769815 DOI: 10.3389/fneur.2020.595463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 11/19/2020] [Indexed: 12/11/2022] Open
Abstract
Rationale: We provide an in-depth description of a comprehensive clinical, immunological, and neuroimaging study that includes a full image processing pipeline. This approach, although implemented in HIV infected individuals, can be used in the general population to assess cerebrovascular health. Aims: In this longitudinal study, we seek to determine the effects of neuroinflammation due to HIV-1 infection on the pathomechanisms of cerebral small vessel disease (CSVD). The study focuses on the interaction of activated platelets, pro-inflammatory monocytes and endothelial cells and their impact on the neurovascular unit. The effects on the neurovascular unit are evaluated by a novel combination of imaging biomarkers. Sample Size: We will enroll 110 HIV-infected individuals on stable combination anti-retroviral therapy for at least three months and an equal number of age-matched controls. We anticipate a drop-out rate of 20%. Methods and Design: Subjects are followed for three years and evaluated by flow cytometric analysis of whole blood (to measure platelet activation, platelet monocyte complexes, and markers of monocyte activation), neuropsychological testing, and brain MRI at the baseline, 18- and 36-month time points. MRI imaging follows the recommended clinical small vessel imaging standards and adds several advanced sequences to obtain quantitative assessments of brain tissues including white matter microstructure, tissue susceptibility, and blood perfusion. Discussion: The study provides further understanding of the underlying mechanisms of CSVD in chronic inflammatory disorders such as HIV infection. The longitudinal study design and comprehensive approach allows the investigation of quantitative changes in imaging metrics and their impact on cognitive performance.
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Affiliation(s)
- Kyle D Murray
- Department of Physics and Astronomy, University of Rochester, Rochester, NY, United States
| | - Meera V Singh
- Department of Microbiology and Immunology, University of Rochester, Rochester, NY, United States
| | - Yuchuan Zhuang
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, United States
| | - Md Nasir Uddin
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Xing Qiu
- Department of Biostatistics, University of Rochester, Rochester, NY, United States
| | - Miriam T Weber
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Madalina E Tivarus
- Department of Imaging Sciences, University of Rochester, Rochester, NY, United States.,Department of Neuroscience, University of Rochester, Rochester, NY, United States
| | - Henry Z Wang
- Department of Imaging Sciences, University of Rochester, Rochester, NY, United States
| | - Bogachan Sahin
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Jianhui Zhong
- Department of Physics and Astronomy, University of Rochester, Rochester, NY, United States.,Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, United States.,Department of Biostatistics, University of Rochester, Rochester, NY, United States
| | - Sanjay B Maggirwar
- Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University, Washington, DC, United States
| | - Giovanni Schifitto
- Department of Neurology, University of Rochester, Rochester, NY, United States.,Department of Imaging Sciences, University of Rochester, Rochester, NY, United States
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