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Yamashita K, Hatae R, Kikuchi K, Kuga D, Hata N, Yamamoto H, Obara M, Yoshimoto K, Ishigami K, Togao O. Predicting TERT promoter mutation status using 1H-MR spectroscopy and stretched-exponential model of diffusion-weighted imaging in IDH-wildtype diffuse astrocytic glioma without intense enhancement. Neuroradiology 2023:10.1007/s00234-023-03177-y. [PMID: 37308686 DOI: 10.1007/s00234-023-03177-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/04/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE Isocitrate dehydrogenase (IDH)-wildtype diffuse astrocytic glioma with telomerase reverse transcriptase (TERT) promoter mutation is defined as glioblastoma by the WHO 2021 criteria, revealing that TERT promotor mutation is highly associated with tumor aggressiveness. The aim of this study was to identify features from MR spectroscopy (MRS) and multi-exponential models of DWI distinguishing wild-type TERT (TERTw) from TERT promoter mutation (TERTm) in IDH-wildtype diffuse astrocytic glioma. METHODS Participants comprised 25 adult patients with IDH-wildtype diffuse astrocytic glioma. Participants were classified into TERTw and TERTm groups. Point-resolved spectroscopy sequences were used for MRS data acquisition. DWI was performed with 13 different b-factors. Peak height ratios of NAA/Cr and Cho/Cr were calculated from MRS data. Mean apparent diffusion coefficient (ADC), perfusion fraction (f), diffusion coefficient (D), pseudo-diffusion coefficient (D*), distributed diffusion coefficient (DDC), and heterogeneity index (α) were obtained using multi-exponential models from DWI data. Each parameter was compared between TERTw and TERTm using the Mann-Whitney U test. Correlations between parameters derived from MRS and DWI were also evaluated. RESULTS NAA/Cr and Cho/Cr were both higher for TERTw than for TERTm. The α of TERTw was smaller than that of TERTm, while the f of TERTw was higher than that of TERTm. NAA/Cr correlated negatively with α, but not with other DWI parameters. Cho/Cr did not show significant correlations with any DWI parameters. CONCLUSION The combination of NAA/Cr and α may have merit in clinical situation to predict the TERT mutation status of IDH-wildtype diffuse astrocytic glioma without intense enhancement.
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Affiliation(s)
- Koji Yamashita
- Departments of Radiology Informatics and Network, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Ryusuke Hatae
- Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Kazufumi Kikuchi
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Daisuke Kuga
- Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Nobuhiro Hata
- Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Hidetaka Yamamoto
- Departments of Anatomic Pathology Pathologic Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Makoto Obara
- Philips Japan, 13-37, Kohnan 2-Chome, Minato-Ku, Tokyo, 108-8507, Japan
| | - Koji Yoshimoto
- Departments of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Kousei Ishigami
- Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Osamu Togao
- Departments of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
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Duan F, Xiao Z, Wang Y, Sun X, Tang Z, Wang R, Guo L, Tang W, Liu T, Wang P, Zhan Y. Metabolic alterations in the visual pathway of retinitis pigmentosa rats: A longitudinal multimodal magnetic resonance imaging study with histopathological validation. NMR IN BIOMEDICINE 2022; 35:e4751. [PMID: 35478360 DOI: 10.1002/nbm.4751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
Because retinitis pigmentosa (RP) has been shown to cause degenerative changes in the entire visual pathway, there is an urgent need to perform longitudinal assessments of RP-induced degeneration and identify imaging protocols to detect this degeneration as early as possible. In this study, we assessed a transgenic rat model of RP by using complementary noninvasive magnetic resonance imaging techniques, namely, proton magnetic resonance spectroscopy (1 H-MRS), to investigate the metabolic changes in RP. Our study demonstrated decreased concentrations and ratios to creatine (Cr) of N-acetylaspartate (NAA), glutamate (Glu), γ-aminobutyric acid (GABA), and taurine (Tau), whereas myo-inositol (Ins) and choline (Cho) were increased in the visual cortex of Royal College of Surgeons (RCS) rats compared with control rats (p < 0.05). Furthermore, with the progression of RP, the concentrations of NAA, Glu, GABA, and Tau, and the ratios of GABA/Cr and Tau/Cr significantly decreased over time, whereas the concentrations of Ins and Cho and the ratio of Ins/Cr significantly increased over time (p < 0.05). In addition, in RCS rats, NAA/Cr decreased significantly from 3 to 4 months postnatal (p < 0.001), and Cho/Cr increased significantly from 4 to 5 months postnatal (p = 0.005). Meanwhile, the 1 H-MRS indicators in 5-month postnatal RCS rats could be confirmed by immunohistochemical staining. In conclusion, with the progression of RP, the metabolic alterations in the visual cortex indicated progressive reprogramming with the decrease of neurons and axons, accompanied by the proliferation of gliocytes.
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Affiliation(s)
- Fei Duan
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Zebin Xiao
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Yuzhe Wang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, China
- Key Laboratory of Myopia, NHFPC (Fudan University), Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Rong Wang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
- Department of Radiology, Huashan Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Linying Guo
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Weijun Tang
- Department of Radiology, Huashan Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Tingting Liu
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Peng Wang
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
| | - Yang Zhan
- Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai Medical School, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
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Joyce JM, La PL, Walker R, Harris A. Magnetic resonance spectroscopy of traumatic brain injury and subconcussive hits: A systematic review and meta-analysis. J Neurotrauma 2022; 39:1455-1476. [PMID: 35838132 DOI: 10.1089/neu.2022.0125] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Magnetic resonance spectroscopy (MRS) is a non-invasive technique used to study metabolites in the brain. MRS findings in traumatic brain injury (TBI) and subconcussive hit literature have been mixed. The most common observation is a decrease in N-acetyl-aspartate (NAA), traditionally considered a marker of neuronal integrity. Other metabolites, however, such as creatine (Cr), choline (Cho), glutamate+glutamine (Glx) and myo-inositol (mI) have shown inconsistent changes in these populations. The objective of this systematic review and meta-analysis was to synthesize MRS literature in head injury and explore factors (brain region, injury severity, time since injury, demographic, technical imaging factors, etc.) that may contribute to differential findings. One hundred and thirty-eight studies met inclusion criteria for the systematic review and of those, 62 NAA, 24 Cr, 49 Cho, 18 Glx and 21 mI studies met inclusion criteria for meta-analysis. A random effects model was used for meta-analyses with brain region as a subgroup for each of the five metabolites studied. Meta-regression was used to examine the influence of potential moderators including injury severity, time since injury, age, sex, tissue composition and methodological factors. In this analysis of 1428 unique head-injured subjects and 1132 controls, the corpus callosum was identified as a brain region highly susceptible to metabolite alteration. NAA was consistently decreased in TBI of all severity, but not in subconcussive hits. Cho and mI were found to be increased in moderate-to-severe TBI but not mild TBI. Glx and Cr were largely unaffected, however did show alterations in certain conditions.
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Affiliation(s)
- Julie Michele Joyce
- University of Calgary, 2129, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
| | - Parker L La
- University of Calgary, 2129, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
| | - Robyn Walker
- University of Calgary, 2129, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
| | - Ashley Harris
- University of Calgary, Radiology, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, 157742, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, 157744, Calgary, Alberta, Canada.,Integrated Concussion Research Program, Calgary, Alberta, Canada;
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Rawat V, Tyagi R, Singh I, Das P, Srivastava AK, Makharia GK, Sharma U. Cerebellar Abnormalities on Proton MR Spectroscopy and Imaging in Patients With Gluten Ataxia: A Pilot Study. Front Hum Neurosci 2022; 16:782579. [PMID: 35655925 PMCID: PMC9152097 DOI: 10.3389/fnhum.2022.782579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Gluten ataxia is a rare immune-mediated neurological disorder caused by the ingestion of gluten. The diagnosis is not straightforward as antibodies are present in only up to 38% of patients, but often at lower titers. The symptoms of ataxia may be mild at the onset but lead to permanent damage if remain untreated. It is characterized by damage to the cerebellum however, the pathophysiology of the disease is not clearly understood. The present study investigated the neurochemical profile of vermis and right cerebellum and structural changes in various brain regions of patients with gluten ataxia (n = 6, age range 40–65 years) and compared it with healthy controls (n = 10, 40–55 years). Volumetric 3-D T1 and T1-weighted magnetic resonance imaging (MRI) in the three planes (axial, coronal, and sagittal) of the whole brain and single-voxel 1H- magnetic resonance spectroscopy (MRS) of the vermis and right cerebellum were acquired on 3 T human MR scanner. The metabolite concentrations were estimated using LC Model (6.1–4A) while brain volumes were estimated using the online tool volBrain pipeline and CERES and corrected for partial volumes. The levels of neuro-metabolites (N-acetyl aspartate + N-acetyl aspartate glutamate, glycerophosphocholine + phosphocholine, and total creatine) were found to be significantly lower in vermis, while N-acetyl aspartate + N-acetyl aspartate glutamate and glycerophosphocholine + phosphocholine was lower in cerebellum regions in the patients with gluten ataxia compared to healthy controls. A significant reduction in the white matter of (total brain, cerebellum, and cerebrum); reduction in the volumes of cerebellum lobe (X) and thalamus while lateral ventricles were increased in the patients with gluten ataxia compared to healthy controls. The reduced neuronal metabolites along with structural changes in the brain suggested neuronal degeneration in the patients with gluten ataxia. Our preliminary findings may be useful in understanding the gluten-induced cerebral damage and indicated that MRI and MRS may serve as a non-invasive useful tool in the early diagnosis, thereby enabling better management of these patients.
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Affiliation(s)
- Vishwa Rawat
- Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi, India
| | - Ritu Tyagi
- Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi, India
| | - Inder Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Prasenjit Das
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Govind K. Makharia
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
| | - Uma Sharma
- Department of NMR and MRI Facility, All India Institute of Medical Sciences, New Delhi, India
- *Correspondence: Uma Sharma
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Garg A, Goel V, Joseph L, Dash D, Agarwal S. Single ring-enhancing lesion with the lipid peak on MR spectroscopy. Ann Indian Acad Neurol 2022; 25:265-266. [PMID: 35693691 PMCID: PMC9175415 DOI: 10.4103/aian.aian_604_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/31/2021] [Accepted: 09/29/2021] [Indexed: 11/04/2022] Open
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Tuovinen N, Yalcin-Siedentopf N, Welte AS, Siedentopf CM, Steiger R, Gizewski ER, Hofer A. Neurometabolite correlates with personality and stress in healthy emerging adults: A focus on sex differences. Neuroimage 2021; 247:118847. [PMID: 34954024 DOI: 10.1016/j.neuroimage.2021.118847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 12/21/2022] Open
Abstract
Personality traits have been linked with both brain structure and function. However, the exact relationship between personality traits and other behavioural measures with neurometabolites, measured with proton magnetic resonance spectroscopy, is not clear. Here we investigated the association between behavioural measures (i.e., personality traits, resilience, perceived stress, self-esteem, hopelessness, psychological distress) and metabolite ratios (i.e., of choline-containing compounds [Cho], creatine and phosphocreatine [Cr], and N-acetyl-aspartate [NAA]) in the posterior cingulate cortex (pCC) and the dorsal anterior cingulate cortex (dACC) and surrounding white matter (WM) regions in healthy emerging adults (N = 57, 26 women, mean age=23.40 years, SD=2.50). The pCC and the dACC were selected for their known involvement as important brain network hubs and their association to five factor personality dimensions and other psychological measures. Spectral analysis as well as statistics for demographic, clinical, and imaging data were performed. Correlation and multiple regression analyses were used to test the relationship between metabolite ratios and behavioural scores in the entire sample as well as in female and male participants separately. The entire sample showed significant (p<0.05) negative correlates of stress with the NAA/Cr ratio in the pCC, and of extraversion with WM metabolite ratios. In regards of sex differences, a significantly higher NAA/Cho ratio in the pCC (p<0.05), the dACC (p<0.01), and in the left and right posterior WM matter (p<0.05), and a lower Cho/Cr ratio in the dACC (p<0.01) was detected in women. Moreover, the two sexes differed in regards of metabolite correlates of openness, conscientiousness, extraversion, agreeableness, neuroticism, stress, hopelessness, and self-esteem, and in multiple regression model predictions. Our results point to a role of the ACC in conscientiousness through its involvement in higher-order cognitive control as part of the salience network and internally directed thoughts as part of the default mode network (DMN). Furthermore, the two sexes differ in terms of metabolite correlates of openness and conscientiousness in the pCC, suggesting mental process involvement through the DMN, and of agreeableness in the dACC, possibly through involvement in social cognitive processes, particularly in women. Additionally, our results suggest that the ACC is linked to the so-called Alpha-factor of personality. Our findings on stress correlates contribute to the existing literature of the involvement of the ACC as part of the limbic system. In addition, our results suggest a possible role of the pCC in stress-regulatory processes through a possible co-involvement of stress, hopelessness, and self-esteem in the pCC in men, where higher self-esteem may help to cope with stress.
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Affiliation(s)
- Noora Tuovinen
- Medical University of Innsbruck, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Nursen Yalcin-Siedentopf
- Medical University of Innsbruck, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Anna-Sophia Welte
- Medical University of Innsbruck, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Christian M Siedentopf
- Medical University of Innsbruck, Department of Neuroradiology, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Ruth Steiger
- Medical University of Innsbruck, Department of Neuroradiology, Anichstrasse 35, Innsbruck 6020, Austria; Medical University of Innsbruck, Neuroimaging Research Core Facility, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Elke R Gizewski
- Medical University of Innsbruck, Department of Neuroradiology, Anichstrasse 35, Innsbruck 6020, Austria; Medical University of Innsbruck, Neuroimaging Research Core Facility, Anichstrasse 35, Innsbruck 6020, Austria.
| | - Alex Hofer
- Medical University of Innsbruck, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Anichstrasse 35, Innsbruck 6020, Austria.
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Wang HX, Chen Y, Haque Z, de Veer M, Egan G, Wang B. Sialylated milk oligosaccharides alter neurotransmitters and brain metabolites in piglets: an In vivo magnetic resonance spectroscopic (MRS) study. Nutr Neurosci 2021; 24:885-895. [PMID: 31746283 DOI: 10.1080/1028415x.2019.1691856] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: Human milk contains high concentrations and diversity of sialylated oligosaccharides that have multifunctional health benefits, however, their potential role in optimizing neurodevelopment remains unknown.Objective: To investigate the effect of sialylated milk oligosaccharides (SMOS) intervention on neurotransmitters and brain metabolites in piglets.Methods: 3-day-old piglets were randomly allocated to one of three groups and fed either standard sow milk replacer (SMR) alone (n = 15), SMR supplemented with sialyllactose 9.5 g/kg (SL, n = 16) or a combination of SL and 6'-sialyllactosamine 9.5 g/kg (SL/SLN, n = 15) for 35 days. Brain spectra were acquired using a 3T Magnetic Resonance Spectroscopic (MRS) system.Results: SMOS fed piglets were observed to have significantly increased the absolute levels of myo-inositol (mIns) and glutamate + glutamine (Glx), in particular, the SL/SLN group. Similar findings were found in the relative amount of these metabolites calculated as ratios to creatine (Cr), choline (Cho) and N-acetylaspartate (NAA) respectively (P < .05). In addition, there were significant positive correlations of brain NAA, total NAA (TNAA), mIns, total Cho (TCho), total Cr (TCr), scyllo-Inositol (SI) and glutathione (Glth) with total white matter volume; Glu and SI with whole brain volume; and SI with whole brain weight respectively (P < .01). SLN and 3'SL intake were closely correlated with the levels of brain Glu, mlns and Glx in the treatment groups only (P < .01-.05).Conclusions: We provide in vivo evidences that milk SMOS can alter many important brain metabolites and neurotransmitters required for optimizing neurodevelopment in piglets, an animal model of human infants.
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Affiliation(s)
- Hong Xin Wang
- Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, Australia
| | - Yue Chen
- Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, Australia
| | - Ziaul Haque
- Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, Australia
| | - Michael de Veer
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Gary Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Bing Wang
- Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, Australia
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McKenna MC, Corcia P, Couratier P, Siah WF, Pradat PF, Bede P. Frontotemporal Pathology in Motor Neuron Disease Phenotypes: Insights From Neuroimaging. Front Neurol 2021; 12:723450. [PMID: 34484106 PMCID: PMC8415268 DOI: 10.3389/fneur.2021.723450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/22/2021] [Indexed: 01/18/2023] Open
Abstract
Frontotemporal involvement has been extensively investigated in amyotrophic lateral sclerosis (ALS) but remains relatively poorly characterized in other motor neuron disease (MND) phenotypes such as primary lateral sclerosis (PLS), progressive muscular atrophy (PMA), spinal muscular atrophy (SMA), spinal bulbar muscular atrophy (SBMA), post poliomyelitis syndrome (PPS), and hereditary spastic paraplegia (HSP). This review focuses on insights from structural, metabolic, and functional neuroimaging studies that have advanced our understanding of extra-motor disease burden in these phenotypes. The imaging literature is limited in the majority of these conditions and frontotemporal involvement has been primarily evaluated by neuropsychology and post mortem studies. Existing imaging studies reveal that frontotemporal degeneration can be readily detected in ALS and PLS, varying degree of frontotemporal pathology may be captured in PMA, SBMA, and HSP, SMA exhibits cerebral involvement without regional predilection, and there is limited evidence for cerebral changes in PPS. Our review confirms the heterogeneity extra-motor pathology across the spectrum of MNDs and highlights the role of neuroimaging in characterizing anatomical patterns of disease burden in vivo. Despite the contribution of neuroimaging to MND research, sample size limitations, inclusion bias, attrition rates in longitudinal studies, and methodological constraints need to be carefully considered. Frontotemporal involvement is a quintessential clinical facet of MND which has important implications for screening practices, individualized management strategies, participation in clinical trials, caregiver burden, and resource allocation. The academic relevance of imaging frontotemporal pathology in MND spans from the identification of genetic variants, through the ascertainment of presymptomatic changes to the design of future epidemiology studies.
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Affiliation(s)
- Mary Clare McKenna
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | - Philippe Corcia
- Department of Neurology-Neurophysiology, CRMR ALS, Tours, France.,UMR 1253 iBrain, University of Tours, Tours, France.,LITORALS, Federation of ALS Centres: Tours-Limoges, Limoges, France
| | - Philippe Couratier
- LITORALS, Federation of ALS Centres: Tours-Limoges, Limoges, France.,ALS Centre, Limoges University Hospital (CHU de Limoges), Limoges, France
| | - We Fong Siah
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland
| | | | - Peter Bede
- Computational Neuroimaging Group, Trinity College Dublin, Dublin, Ireland.,Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France
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9
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Neurochemical Changes in the Brain and Neuropsychiatric Symptoms in Clinically Isolated Syndrome. J Clin Med 2020; 9:jcm9123909. [PMID: 33276455 PMCID: PMC7761482 DOI: 10.3390/jcm9123909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/08/2020] [Accepted: 11/28/2020] [Indexed: 11/20/2022] Open
Abstract
To assess cognitive impairment and affective symptoms and their association with damage to normal-appearing white matter (NAWM) in patients with clinically isolated syndrome (CIS), we compared neuropsychological test scores between patients with CIS and healthy controls and examined correlations between these and proton magnetic resonance spectroscopy (1H-MRS) outcomes in patients with CIS. Forty patients with CIS and 40 healthy participants were tested with a set of neuropsychological tests, which included the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS). Single-voxel 1H-MRS was performed on frontal and parietal NAWM of patients with CIS to assess ratios of N-acetyl-aspartate (NAA) to creatine (Cr), myo-inositol (mI), and choline (Cho), as well as mI/Cr and Cho/Cr ratios. Patients with CIS had lower cognitive performance and higher scores for the BDI and anxiety subscale of HADS than healthy controls. There were significant correlations between the following neuropsychological tests and metabolic ratios in the frontal NAWM: Stroop Color-Word Test and Cho/Cr, Symbol Digit Modalities Test and mI/Cr, as well as NAA/mI, Go/no-go reaction time, and NAA/Cho, as well as NAA/mI, Californian Verbal Learning Test, and NAA/Cr. BDI scores were related to frontal NAA/mI and parietal NAA/Cr and Cho/Cr ratios, whereas HADS-depression scores were associated with frontal NAA/Cr and NAA/mI and parietal NAA/Cr and Cho/Cr ratios. HADS-anxiety correlated with parietal NAA/Cr ratio. This study suggests that neurochemical changes in the NAWM assessed with single-voxel 1H-MRS are associated with cognitive performance and affective symptoms in patients with CIS.
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10
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Franco P, Würtemberger U, Dacca K, Hübschle I, Beck J, Schnell O, Mader I, Binder H, Urbach H, Heiland DH. SPectroscOpic prediction of bRain Tumours (SPORT): study protocol of a prospective imaging trial. BMC Med Imaging 2020; 20:123. [PMID: 33228567 PMCID: PMC7685595 DOI: 10.1186/s12880-020-00522-y] [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: 06/18/2020] [Accepted: 11/15/2020] [Indexed: 12/26/2022] Open
Abstract
Background The revised 2016 WHO-Classification of CNS-tumours now integrates molecular information of glial brain tumours for accurate diagnosis as well as for the development of targeted therapies. In this prospective study, our aim is to investigate the predictive value of MR-spectroscopy in order to establish a solid preoperative molecular stratification algorithm of these tumours. We will process a 1H MR-spectroscopy sequence within a radiomics analytics pipeline.
Methods Patients treated at our institution with WHO-Grade II, III and IV gliomas will receive preoperative anatomical (T2- and T1-weighted imaging with and without contrast enhancement) and proton MR spectroscopy (MRS) by using chemical shift imaging (MRS) (5 × 5 × 15 mm3 voxel size). Tumour regions will be segmented and co-registered to corresponding spectroscopic voxels.
Raw signals will be processed by a deep-learning approach for identifying patterns in metabolic data that provides information with respect to the histological diagnosis as well patient characteristics obtained and genomic data such as target sequencing and transcriptional data. Discussion By imaging the metabolic profile of a glioma using a customized chemical shift 1H MR spectroscopy sequence and by processing the metabolic profiles with a machine learning tool we intend to non-invasively uncover the genetic signature of gliomas. This work-up will support surgical and oncological decisions to improve personalized tumour treatment.
Trial registration This study was initially registered under another name and was later retrospectively registered under the current name at the German Clinical Trials Register (DRKS) under DRKS00019855.
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Affiliation(s)
- Pamela Franco
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany. .,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany.
| | - Urs Würtemberger
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Karam Dacca
- Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Irene Hübschle
- Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Jürgen Beck
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Oliver Schnell
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Irina Mader
- Specialist Centre for Radiology, Schoen Clinic, Vogtareuth, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Harald Binder
- Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany.,Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg im Breisgau, Germany
| | - Horst Urbach
- Department of Neuroradiology, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
| | - Dieter Henrik Heiland
- Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106, Freiburg im Breisgau, Germany.,Faculty of Medicine, University of Freiburg, Breisacher Str. 153, 79110, Freiburg im Breisgau, Germany
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11
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Tong E, McCullagh KL, Iv M. Advanced Imaging of Brain Metastases: From Augmenting Visualization and Improving Diagnosis to Evaluating Treatment Response. Front Neurol 2020; 11:270. [PMID: 32351445 PMCID: PMC7174761 DOI: 10.3389/fneur.2020.00270] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/24/2020] [Indexed: 12/11/2022] Open
Abstract
Early detection of brain metastases and differentiation from other neuropathologies is crucial. Although biopsy is often required for definitive diagnosis, imaging can provide useful information. After treatment commences, imaging is also performed to assess the efficacy of treatment. Contrast-enhanced magnetic resonance imaging (MRI) is the traditional imaging method for the evaluation of brain metastases, as it provides information about lesion size, morphology, and macroscopic properties. Newer MRI sequences have been developed to increase the conspicuity of detecting enhancing metastases. Other advanced MRI techniques, that have the capability to probe beyond the anatomic structure, are available to characterize micro-structures, cellularity, physiology, perfusion, and metabolism. Artificial intelligence provides powerful computational tools for detection, segmentation, classification, prediction, and prognosis. We highlight and review a few advanced MRI techniques for the assessment of brain metastases-specifically for (1) diagnosis, including differentiating between malignancy types and (2) evaluation of treatment response, including the differentiation between radiation necrosis and disease progression.
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Affiliation(s)
- Elizabeth Tong
- Stanford University Medical Center, Stanford, CA, United States
| | | | - Michael Iv
- Stanford University Medical Center, Stanford, CA, United States
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12
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Falk Delgado A, Van Westen D, Nilsson M, Knutsson L, Sundgren PC, Larsson EM, Falk Delgado A. Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging-a comprehensive overview. Insights Imaging 2019; 10:84. [PMID: 31444580 PMCID: PMC6708018 DOI: 10.1186/s13244-019-0771-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/12/2019] [Indexed: 12/16/2022] Open
Abstract
Gadolinium-based contrast agents (GBCAs) increase lesion detection and improve disease characterization for many cerebral pathologies investigated with MRI. These agents, introduced in the late 1980s, are in wide use today. However, some non-ionic linear GBCAs have been associated with the development of nephrogenic systemic fibrosis in patients with kidney failure. Gadolinium deposition has also been found in deep brain structures, although it is of unclear clinical relevance. Hence, new guidelines from the International Society for Magnetic Resonance in Medicine advocate cautious use of GBCA in clinical and research practice. Some linear GBCAs were restricted from use by the European Medicines Agency (EMA) in 2017. This review focuses on non-contrast-enhanced MRI techniques that can serve as alternatives for the use of GBCAs. Clinical studies on the diagnostic performance of non-contrast-enhanced as well as contrast-enhanced MRI methods, both well established and newly proposed, were included. Advantages and disadvantages together with the diagnostic performance of each method are detailed. Non-contrast-enhanced MRIs discussed in this review are arterial spin labeling (ASL), time of flight (TOF), phase contrast (PC), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), susceptibility weighted imaging (SWI), and amide proton transfer (APT) imaging. Ten common diseases were identified for which studies reported comparisons of non-contrast-enhanced and contrast-enhanced MRI. These specific diseases include primary brain tumors, metastases, abscess, multiple sclerosis, and vascular conditions such as aneurysm, arteriovenous malformation, arteriovenous fistula, intracranial carotid artery occlusive disease, hemorrhagic, and ischemic stroke. In general, non-contrast-enhanced techniques showed comparable diagnostic performance to contrast-enhanced MRI for specific diagnostic questions. However, some diagnoses still require contrast-enhanced imaging for a complete examination.
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Affiliation(s)
- Anna Falk Delgado
- Clinical neurosciences, Karolinska Institutet, Stockholm, Sweden. .,Department of Neuroradiology, Karolinska University Hospital, Eugeniavägen 3, Solna, Stockholm, Sweden.
| | - Danielle Van Westen
- Department of Clinical Sciences/Radiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Markus Nilsson
- Department of Clinical Sciences/Radiology, Faculty of Medicine, Lund University, Lund, Sweden
| | - Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden.,Russell H. Morgan Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Pia C Sundgren
- Department of Clinical Sciences/Radiology, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Elna-Marie Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
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13
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Li L, Li N, An L, Shen J. A novel approach to probing in vivo metabolite relaxation: Linear quantification of spatially modulated magnetization. Magn Reson Med 2018; 79:2491-2499. [PMID: 28940581 PMCID: PMC5821591 DOI: 10.1002/mrm.26941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/16/2017] [Accepted: 08/31/2017] [Indexed: 11/08/2022]
Abstract
PURPOSE Conventional sequences for metabolite transverse relaxation quantification all generally measure signal changes at different echo times (TEs). However, quantification results obtained via these conventional methods can be very different and are highly dependent on the type of sequence being applied. TE-dependent effects such as diffusion, macromolecule baseline, and J-coupling modulation contribute significantly to these differences. Here, we propose a novel technique-multiple flip angle pulse-driven ratio of longitudinal steady states (MARzss)-for preparing magnetization with T2 /T1 weighting. Using premeasured T1 values, T2 values for metabolites can thereby be determined. The measurement procedure does not require varying TE and is TE independent; T2 , diffusion, and J-coupling effects induced by the readout sequence are cancelled. METHOD Longitudinal steady states at different flip angles were prepared with trains of radio frequency pulses interspersed with field gradients. The resulting spatially modulated longitudinal magnetization was acquired with a PRESS readout module. A new linear equation for quantification of MARzss was derived from Bloch equations. RESULTS By implementing this readout-independent method, T2 measurement of brain metabolites at 7T was demonstrated through Bloch simulations, phantom, and in vivo experiments. CONCLUSIONS The proposed MARzss technique can be used to largely avoid multi-TE associated interference, including diffusion, macromolecules, and J modulation. This MARzss technology, which is uniquely insensitive to readout sequence type and TE, is a promising technique for more accurately probing in vivo metabolite relaxation. Magn Reson Med 79:2491-2499, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Linqing Li
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Ningzhi Li
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Li An
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Jun Shen
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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14
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Berrington A, Voets NL, Larkin SJ, de Pennington N, Mccullagh J, Stacey R, Schofield CJ, Jezzard P, Clare S, Cadoux-Hudson T, Plaha P, Ansorge O, Emir UE. A comparison of 2-hydroxyglutarate detection at 3 and 7 T with long-TE semi-LASER. NMR IN BIOMEDICINE 2018; 31. [PMID: 29315915 DOI: 10.1002/nbm.3886] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 06/07/2023]
Abstract
Abnormally high levels of the 'oncometabolite' 2-hydroxyglutarate (2-HG) occur in many grade II and III gliomas, and correlate with mutations in the genes of isocitrate dehydrogenase (IDH) isoforms. In vivo measurement of 2-HG in patients, using magnetic resonance spectroscopy (MRS), has largely been carried out at 3 T, yet signal overlap continues to pose a challenge for 2-HG detection. To combat this, several groups have proposed MRS methods at ultra-high field (≥7 T) where theoretical increases in signal-to-noise ratio and spectral resolution could improve 2-HG detection. Long echo time (long-TE) semi-localization by adiabatic selective refocusing (semi-LASER) (TE = 110 ms) is a promising method for improved 2-HG detection in vivo at either 3 or 7 T owing to the use of broad-band adiabatic localization. Using previously published semi-LASER methods at 3 and 7 T, this study directly compares the detectability of 2-HG in phantoms and in vivo across nine patients. Cramér-Rao lower bounds (CRLBs) of 2-HG fitting were found to be significantly lower at 7 T (6 ± 2%) relative to 3 T (15 ± 7%) (p = 0.0019), yet were larger at 7 T in an IDH wild-type patient. Although no increase in SNR was detected at 7 T (77 ± 26) relative to 3 T (77 ± 30), the detection of 2-HG was greatly enhanced through an improved spectral profile and increased resolution at 7 T. 7 T had a large effect on pairwise fitting correlations between γ-aminobutyric acid (GABA) and 2-HG (p = 0.004), and resulted in smaller coefficients. The increased sensitivity for 2-HG detection using long-TE acquisition at 7 T may allow for more rapid estimation of 2-HG (within a few spectral averages) together with other associated metabolic markers in glioma.
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Affiliation(s)
- Adam Berrington
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Natalie L Voets
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Sarah J Larkin
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Nick de Pennington
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Richard Stacey
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Peter Jezzard
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Stuart Clare
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Tom Cadoux-Hudson
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Puneet Plaha
- Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Olaf Ansorge
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Uzay E Emir
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
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