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Karimi D, Kebiri H, Gholipour A. TBSS++: A novel computational method for Tract-Based Spatial Statistics. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.10.548454. [PMID: 37503293 PMCID: PMC10369867 DOI: 10.1101/2023.07.10.548454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Diffusion-weighted magnetic resonance imaging (dMRI) is widely used to assess the brain white matter. One of the most common computations in dMRI involves cross-subject tract-specific analysis, whereby dMRI-derived biomarkers are compared between cohorts of subjects. The accuracy and reliability of these studies hinges on the ability to compare precisely the same white matter tracts across subjects. This is an intricate and error-prone computation. Existing computational methods such as Tract-Based Spatial Statistics (TBSS) suffer from a host of shortcomings and limitations that can seriously undermine the validity of the results. We present a new computational framework that overcomes the limitations of existing methods via (i) accurate segmentation of the tracts, and (ii) precise registration of data from different subjects/scans. The registration is based on fiber orientation distributions. To further improve the alignment of cross-subject data, we create detailed atlases of white matter tracts. These atlases serve as an unbiased reference space where the data from all subjects is registered for comparison. Extensive evaluations show that, compared with TBSS, our proposed framework offers significantly higher reproducibility and robustness to data perturbations. Our method promises a drastic improvement in accuracy and reproducibility of cross-subject dMRI studies that are routinely used in neuroscience and medical research.
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Affiliation(s)
- Davood Karimi
- Computational Radiology Laboratory (CRL), Department of Radiology, Boston Children's Hospital, and Harvard Medical School, USA
| | - Hamza Kebiri
- Computational Radiology Laboratory (CRL), Department of Radiology, Boston Children's Hospital, and Harvard Medical School, USA
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Ali Gholipour
- Computational Radiology Laboratory (CRL), Department of Radiology, Boston Children's Hospital, and Harvard Medical School, USA
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Bells S, Longoni G, Berenbaum T, de Medeiros CB, Narayanan S, Banwell BL, Arnold DL, Mabbott DJ, Ann Yeh E. Patterns of white and gray structural abnormality associated with paediatric demyelinating disorders. Neuroimage Clin 2022; 34:103001. [PMID: 35381508 PMCID: PMC8980471 DOI: 10.1016/j.nicl.2022.103001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 11/26/2022]
Abstract
A multi-modal approach was used to evaluate the visual pathway from anterior (retina) to posterior (visual cortex) in both paediatric MOGAD and MS patients. MS patients exhibited more widespread white matter abnormalities; MOGAD patients exhibited white matter changes primarily within the optic radiation. The pattern of cortical thinning differed in MS and MOGAD patients. Reduced RNFLT was associated with lower axonal density in MOGAD and tortuosity in MS.
The impact of multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein (MOG) - associated disorders (MOGAD) on brain structure in youth remains poorly understood. Reductions in cortical mantle thickness on structural MRI and abnormal diffusion-based white matter metrics (e.g., diffusion tensor parameters) have been well documented in MS but not in MOGAD. Characterizing structural abnormalities found in children with these disorders can help clarify the differences and similarities in their impact on neuroanatomy. Importantly, while MS and MOGAD affect the entire CNS, the visual pathway is of particular interest in both groups, as most patients have evidence for clinical or subclinical involvement of the anterior visual pathway. Thus, the visual pathway is of key interest in analyses of structural abnormalities in these disorders and may distinguish MOGAD from MS patients. In this study we collected MRI data on 18 MS patients, 14 MOGAD patients and 26 age- and sex-matched typically developing children (TDC). Full-brain group differences in fixel diffusion measures (fibre-bundle populations) and cortical thickness measures were tested using age and sex as covariates. Visual pathway analysis was performed by extracting mean diffusion measures within lesion free optic radiations, cortical thickness within the visual cortex, and retinal nerve fibre layer (RNFL) and ganglion cell layer thickness measures from optical coherence tomography (OCT). Fixel based analysis (FBA) revealed MS patients have widespread abnormal white matter within the corticospinal tract, inferior longitudinal fasciculus, and optic radiations, while within MOGAD patients, non-lesional impact on white matter was found primarily in the right optic radiation. Cortical thickness measures were reduced predominately in the temporal and parietal lobes in MS patients and in frontal, cingulate and visual cortices in MOGAD patients. Additionally, our findings of associations between reduced RNFLT and axonal density in MOGAD and TORT in MS patients in the optic radiations imply widespread axonal and myelin damage in the visual pathway, respectively. Overall, our approach of combining FBA, cortical thickness and OCT measures has helped evaluate similarities and differences in brain structure in MS and MOGAD patients in comparison to TDC.
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Affiliation(s)
- Sonya Bells
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada; Pediatric Neurology, Spectrum Health Helen Devos Children's Hospital, Grand Rapids, USA; Department of Pediatrics and Human Development, Michigan State University, East Lansing, USA
| | - Giulia Longoni
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada; Department of Neurology, Hospital for Sick Children, Toronto, Canada; Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Tara Berenbaum
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada
| | - Cynthia B de Medeiros
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada
| | - Sridar Narayanan
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Brenda L Banwell
- Division of Child Neurology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, USA
| | - Douglas L Arnold
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Donald J Mabbott
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada; Department of Psychology, University of Toronto, Toronto, Canada
| | - E Ann Yeh
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada; Department of Neurology, Hospital for Sick Children, Toronto, Canada; Department of Paediatrics, University of Toronto, Toronto, Canada.
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3
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Hidalgo de la Cruz M, Valsasina P, Mesaros S, Meani A, Ivanovic J, Martinovic V, Drulovic J, Filippi M, Rocca MA. Clinical predictivity of thalamic sub-regional connectivity in clinically isolated syndrome: a 7-year study. Mol Psychiatry 2021; 26:2163-2174. [PMID: 32322087 DOI: 10.1038/s41380-020-0726-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 03/12/2020] [Accepted: 04/01/2020] [Indexed: 02/07/2023]
Abstract
Here, we explored trajectories of sub-regional thalamic resting state (RS) functional connectivity (FC) modifications occurring in clinically isolated syndrome (CIS) patients early after their first clinical episode, and assessed their relationship with disability over 7 years. RS fMRI and clinical data were prospectively acquired from 59 CIS patients and 13 healthy controls (HC) over 2 years. A clinical re-assessment was performed in 53 (89%) patients after 7 years. Using a structural connectivity-based atlas, five thalamic sub-regions (frontal, motor, postcentral, occipital, and temporal) were used for seed-based RS FC. Thalamic RS FC abnormalities and their longitudinal changes were correlated with disability. Thirty-nine (66.1%) patients suffered a second clinical relapse, but the median EDSS remained stable over time. At baseline, CIS patients vs HC showed reduced RS FC (p < 0.001, uncorrected) with: (1) frontal cortices, for the whole thalamus, occipital, postcentral, and temporal thalamic sub-regions, (2) occipital cortices, for the occipital thalamic sub-region. In CIS, the longitudinal analysis revealed at year 2 vs baseline: (1) no significant whole-thalamic RS FC changes; (2) reduction of motor, postcentral, and temporal sub-regional RS FC with occipital cortices (p < 0.05, corrected); (3) an increase (p < 0.001, uncorrected) of postcentral and occipital sub-regional thalamic RS FC with frontal cortices, left putamen, and ipsi- and contralateral thalamus, this latter correlating with less severe clinical disability at year 7. Thalamo-cortical disconnections were present in CIS mainly in thalamic sub-regions closer to the third ventricle early after the demyelinating event, evolved in the subsequent 2 years, and were associated with long-term clinical disability.
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Affiliation(s)
- Milagros Hidalgo de la Cruz
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paola Valsasina
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sarlota Mesaros
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Alessandro Meani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jovana Ivanovic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vanja Martinovic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Drulovic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy. .,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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Andersen KW, Lasič S, Lundell H, Nilsson M, Topgaard D, Sellebjerg F, Szczepankiewicz F, Siebner HR, Blinkenberg M, Dyrby TB. Disentangling white-matter damage from physiological fibre orientation dispersion in multiple sclerosis. Brain Commun 2020; 2:fcaa077. [PMID: 32954329 PMCID: PMC7472898 DOI: 10.1093/braincomms/fcaa077] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/20/2020] [Accepted: 05/07/2020] [Indexed: 01/23/2023] Open
Abstract
Multiple sclerosis leads to diffuse damage of the central nervous system, affecting also the normal-appearing white matter. Demyelination and axonal degeneration reduce regional fractional anisotropy in normal-appearing white matter, which can be routinely mapped with diffusion tensor imaging. However, the standard fractional anisotropy metric is also sensitive to physiological variations in orientation dispersion of white matter fibres. This complicates the detection of disease-related damage in large parts of cerebral white matter where microstructure physiologically displays a high degree of fibre dispersion. To resolve this ambiguity, we employed a novel tensor-valued encoding method for diffusion MRI, which yields a microscopic fractional anisotropy metric that is unaffected by regional variations in orientation dispersion. In 26 patients with relapsing-remitting multiple sclerosis, 14 patients with primary-progressive multiple sclerosis and 27 age-matched healthy controls, we compared standard fractional anisotropy mapping with the novel microscopic fractional anisotropy mapping method, focusing on normal-appearing white matter. Mean microscopic fractional anisotropy and standard fractional anisotropy of normal-appearing white matter were significantly reduced in both patient groups relative to healthy controls, but microscopic fractional anisotropy yielded a better reflection of disease-related white-matter alterations. The reduction in mean microscopic fractional anisotropy showed a significant positive linear relationship with physical disability, as reflected by the expanded disability status scale. Mean reduction of microscopic fractional anisotropy in normal-appearing white matter also scaled positively with individual cognitive dysfunction, as measured with the symbol digit modality test. Mean microscopic fractional anisotropy reduction in normal-appearing white matter also showed a positive relationship with total white-matter lesion load as well as lesion load in specific tract systems. None of these relationships between normal-appearing white-matter microstructure and clinical, cognitive or structural measures emerged when using mean fractional anisotropy. Together, the results provide converging evidence that microscopic fractional anisotropy mapping substantially advances the assessment of cerebral white matter in multiple sclerosis by disentangling microstructure damage from variations in physiological fibre orientation dispersion at the stage of data acquisition. Since tensor-valued encoding can be implemented in routine diffusion MRI, microscopic fractional anisotropy mapping bears considerable potential for the future assessment of disease progression in normal-appearing white matter in both relapsing-remitting and progressive forms of multiple sclerosis as well as other white-matter-related brain diseases.
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Affiliation(s)
- Kasper Winther Andersen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
| | - Samo Lasič
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
- Random Walk Imaging, AB, 222 24 Lund, Sweden
| | - Henrik Lundell
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
| | - Markus Nilsson
- Department of Radiology, Clinical Sciences, Lund, Lund University, 221 00 Lund, Sweden
| | - Daniel Topgaard
- Division of Physical Chemistry, Department of Chemistry, Lund University, 221 00 Lund, Sweden
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Filip Szczepankiewicz
- Department of Medical Radiation Physics, Clinical Sciences, Lund, Lund University, 221 00 Lund, Sweden
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg, 2400 Copenhagen NV, Denmark
| | - Morten Blinkenberg
- Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Tim B Dyrby
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, 2700 Kongens Lyngby, Denmark
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5
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Tractography in the presence of multiple sclerosis lesions. Neuroimage 2019; 209:116471. [PMID: 31877372 PMCID: PMC7613131 DOI: 10.1016/j.neuroimage.2019.116471] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/13/2019] [Accepted: 12/16/2019] [Indexed: 12/11/2022] Open
Abstract
Accurate anatomical localisation of specific white matter tracts and the quantification of their tract-specific microstructural damage in conditions such as multiple sclerosis (MS) can contribute to a better understanding of symptomatology, disease evolution and intervention effects. Diffusion MRI-based tractography is being used increasingly to segment white matter tracts as regions-of-interest for subsequent quantitative analysis. Since MS lesions can interrupt the tractography algorithm’s tract reconstruction, clinical studies frequently resort to atlas-based approaches, which are convenient but ignorant to individual variability in tract size and shape. Here, we revisit the problem of individual tractography in MS, comparing tractography algorithms using: (i) The diffusion tensor framework; (ii) constrained spherical deconvolution (CSD); and (iii) damped Richardson-Lucy (dRL) deconvolution. Firstly, using simulated and in vivo data from 29 MS patients and 19 healthy controls, we show that the three tracking algorithms respond differentially to MS pathology. While the tensor-based approach is unable to deal with crossing fibres, CSD produces spurious streamlines, in particular in tissue with high fibre loss and low diffusion anisotropy. With dRL, streamlines are increasingly interrupted in pathological tissue. Secondly, we demonstrate that despite the effects of lesions on the fibre orientation reconstruction algorithms, fibre tracking algorithms are still able to segment tracts that pass through areas with a high prevalence of lesions. Combining dRL-based tractography with an automated tract segmentation tool on data from 131 MS patients, the corticospinal tracts and arcuate fasciculi could be reconstructed in more than 90% of individuals. Comparing tract-specific microstructural parameters (fractional anisotropy, radial diffusivity and magnetisation transfer ratio) in individually segmented tracts to those from a tract probability map, we show that there is no systematic disease-related bias in the individually reconstructed tracts, suggesting that lesions and otherwise damaged parts are not systematically omitted during tractography. Thirdly, we demonstrate modest anatomical correspondence between the individual and tract probability-based approach, with a spatial overlap between 35 and 55%. Correlations between tract-averaged microstructural parameters in individually segmented tracts and the probability-map approach ranged between r = .53 (p < .001) for radial diffusivity in the right cortico-spinal tract and r = .97 (p < .001) for magnetisation transfer ratio in the arcuate fasciculi. Our results show that MS white matter lesions impact fibre orientation reconstructions but this does not appear to hinder the ability to anatomically reconstruct white matter tracts in MS. Individual tract segmentation in MS is feasible on a large scale and could prove a powerful tool for investigating diagnostic and prognostic markers.
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Walker MR, Zhong J, Waspe AC, Looi T, Piorkowska K, Drake JM, Hodaie M. Acute ex vivo changes in brain white matter diffusion tensor metrics. PLoS One 2019; 14:e0223211. [PMID: 31557265 PMCID: PMC6762128 DOI: 10.1371/journal.pone.0223211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 09/15/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose Diffusion magnetic resonance imaging and tractography has an important role in the visualization of brain white matter and assessment of tissue microstructure. There is a lack of correspondence between diffusion metrics of live tissue, ex vivo tissue, and histological findings. The objective of this study is to elucidate this connection by determining the specific diffusion alterations between live and ex vivo brain tissue. This may have an important role in the incorporation of diffusion imaging in ex vivo studies as a complement to histological sectioning as well as investigations of novel neurosurgical techniques. Methods This study presents a method of high angular resolution diffusion imaging and tractography of intact and non-fixed ex vivo piglet brains. Most studies involving ex vivo brain specimens have been formalin-fixed or excised from their original biological environment, processes both of which are known to affect diffusion parameters. Thus, non-fixed ex vivo tissue is used. A region-of-interest based analysis of diffusion tensor metrics are compared to in vivo subjects in a selection of major white matter bundles in order to assess the translatability of ex vivo diffusion measurements. Results Tractography was successfully achieved in both in vivo and ex vivo groups. No significant differences were found in tract connectivity, average streamline length, or apparent fiber density. Significantly decreased diffusivity (mean, axial, and radial; p<0.0005) in the non-fixed ex vivo group and unaltered fractional anisotropy (p>0.059) between groups were observed. Conclusion This study validates the extrapolation of non-fixed fractional anisotropy measurements to live tissue and the potential use of ex vivo tissue for methodological development.
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Affiliation(s)
- Matthew R. Walker
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Jidan Zhong
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Adam C. Waspe
- Centre for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Looi
- Centre for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karolina Piorkowska
- Centre for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, Ontario, Canada
| | - James M. Drake
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Centre for Image Guided Innovation and Therapeutic Intervention, Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mojgan Hodaie
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Division of Brain, Imaging and Behaviour - Systems Neuroscience, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- * E-mail:
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7
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Chouteau R, Combès B, Bannier E, Snoussi H, Ferré JC, Barillot C, Edan G, Sauleau P, Kerbrat A. Joint assessment of brain and spinal cord motor tract damage in patients with early RRMS: predominant impact of spinal cord lesions on motor function. J Neurol 2019; 266:2294-2303. [PMID: 31175433 DOI: 10.1007/s00415-019-09419-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/30/2019] [Accepted: 06/01/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND In patients with MS, the effect of structural damage to the corticospinal tract (CST) has been separately evaluated in the brain and spinal cord (SC), even though a cumulative impact is suspected. OBJECTIVE To evaluate CST damages on both the cortex and cervical SC, and examine their relative associations with motor function, measured both clinically and by electrophysiology. METHODS We included 43 patients with early relapsing-remitting MS. Lesions were manually segmented on SC (axial T2*) and brain (3D FLAIR) scans. The CST was automatically segmented using an atlas (SC) or tractography (brain). Lesion volume fractions and diffusion parameters were calculated for SC, brain and CST. Central motor conduction time (CMCT) and triple stimulation technique amplitude ratio were measured for 42 upper limbs, from 22 patients. RESULTS Mean lesion volume fractions were 5.2% in the SC portion of the CST and 0.9% in the brain portion. We did not find a significant correlation between brain and SC lesion volume fraction (r = 0.06, p = 0.68). The pyramidal EDSS score and CMCT were both significantly correlated with the lesion fraction in the SC CST (r = 0.39, p = 0.01 and r = 0.33, p = 0.03), but not in the brain CST. CONCLUSION Our results highlight the major contribution of SC lesions to CST damage and motor function abnormalities.
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Affiliation(s)
- Raphaël Chouteau
- Neurology Department, CHU Rennes, Rennes, France.,Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France
| | - Benoit Combès
- Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France
| | - Elise Bannier
- Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France.,Radiology Department, CHU Rennes, Rennes, France
| | - Haykel Snoussi
- Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France
| | - Jean-Christophe Ferré
- Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France.,Radiology Department, CHU Rennes, Rennes, France
| | - Christian Barillot
- Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France
| | - Gilles Edan
- Neurology Department, CHU Rennes, Rennes, France.,Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France.,Plurithematic Clinical Investigation Center (CIC-P 1414), INSERM, Rennes, France
| | - Paul Sauleau
- Neurophysiology Department, CHU Rennes, Rennes, France.,Behavior and Basal Ganglia Research Unit (EA4712), Rennes 1 University, Rennes, France
| | - Anne Kerbrat
- Neurology Department, CHU Rennes, Rennes, France. .,Univ Rennes, CHU Rennes, CNRS, Inria, Inserm, IRISA UMR 6074, VISAGES (Vision, Action Et Gestion Des Informations en santé), ERL U 1228, 35000, Rennes, France.
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8
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Savini G, Pardini M, Castellazzi G, Lascialfari A, Chard D, D'Angelo E, Gandini Wheeler-Kingshott CAM. Default Mode Network Structural Integrity and Cerebellar Connectivity Predict Information Processing Speed Deficit in Multiple Sclerosis. Front Cell Neurosci 2019; 13:21. [PMID: 30853896 PMCID: PMC6396736 DOI: 10.3389/fncel.2019.00021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 01/17/2019] [Indexed: 01/21/2023] Open
Abstract
Cognitive impairment affects about 50% of multiple sclerosis (MS) patients, but the mechanisms underlying this remain unclear. The default mode network (DMN) has been linked with cognition, but in MS its role is still poorly understood. Moreover, within an extended DMN network including the cerebellum (CBL-DMN), the contribution of cortico-cerebellar connectivity to MS cognitive performance remains unexplored. The present study investigated associations of DMN and CBL-DMN structural connectivity with cognitive processing speed in MS, in both cognitively impaired (CIMS) and cognitively preserved (CPMS) MS patients. 68 MS patients and 22 healthy controls (HCs) completed a symbol digit modalities test (SDMT) and had 3T brain magnetic resonance imaging (MRI) scans that included a diffusion weighted imaging protocol. DMN and CBL-DMN tracts were reconstructed with probabilistic tractography. These networks (DMN and CBL-DMN) and the cortico-cerebellar tracts alone were modeled using a graph theoretical approach with fractional anisotropy (FA) as the weighting factor. Brain parenchymal fraction (BPF) was also calculated. In CIMS SDMT scores strongly correlated with the FA-weighted global efficiency (GE) of the network [GE(CBL-DMN): ρ = 0.87, R2 = 0.76, p < 0.001; GE(DMN): ρ = 0.82, R2 = 0.67, p < 0.001; GE(CBL): ρ = 0.80, R2 = 0.64, p < 0.001]. In CPMS the correlation between these measures was significantly lower [GE(CBL-DMN): ρ = 0.51, R2 = 0.26, p < 0.001; GE(DMN): ρ = 0.48, R2 = 0.23, p = 0.001; GE(CBL): ρ = 0.52, R2 = 0.27, p < 0.001] and SDMT scores correlated most with BPF (ρ = 0.57, R2 = 0.33, p < 0.001). In a multivariable regression model where SDMT was the independent variable, FA-weighted GE was the only significant explanatory variable in CIMS, while in CPMS BPF and expanded disability status scale were significant. No significant correlation was found in HC between SDMT scores, MRI or network measures. DMN structural GE is related to cognitive performance in MS, and results of CBL-DMN suggest that the cerebellum structural connectivity to the DMN plays an important role in information processing speed decline.
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Affiliation(s)
| | - Matteo Pardini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy.,Ospedale Policlinico S. Martino, Genoa, Italy
| | - Gloria Castellazzi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.,NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom
| | | | - Declan Chard
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom.,National Institute for Health Research, University College London Hospitals, Biomedical Research Centre, London, United Kingdom
| | - Egidio D'Angelo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Brain Connectivity Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Claudia A M Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, Institute of Neurology, University College London, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Brain MRI 3T Mondino Research Center, IRCCS Mondino Foundation, Pavia, Italy
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9
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Barghi A, Allendorfer JB, Taub E, Womble B, Hicks JM, Uswatte G, Szaflarski JP, Mark VW. Phase II Randomized Controlled Trial of Constraint-Induced Movement Therapy in Multiple Sclerosis. Part 2: Effect on White Matter Integrity. Neurorehabil Neural Repair 2019; 32:233-241. [PMID: 29668401 DOI: 10.1177/1545968317753073] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Constraint-induced movement therapy (CIMT) is a method of physical rehabilitation that has demonstrated clinical efficacy in patients with chronic stroke, cerebral palsy, and multiple sclerosis (MS). OBJECTIVE This pilot randomized controlled trial tested whether CIMT can also induce increases in white matter integrity in patients with MS. METHODS Twenty adults with chronic hemiparetic MS were randomized to receive either CIMT or complementary and alternative medicine (CAM) treatment (reported in the first article of this pair). Structural white matter change was assessed by tract-based spatial statistics (TBSS); measures included fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). RESULTS CIMT and CAM groups did not differ in pretreatment disability or expectancy to benefit. As noted in the companion paper, the motor activity log (MAL) improved more after CIMT than CAM ( P < .001); the within-group effect size for CIMT was 3.7 (large d' = 0.57), while for CAM it was just 0.7. Improvements in white matter integrity followed CIMT and were observed in the contralateral corpus callosum (FA, P < .05), ipsilateral superior occipital gyrus (AD, P < .05), ipsilateral superior temporal gyrus (FA, P < .05), and contralateral corticospinal tract (MD and RD, P < .05). CONCLUSION CIMT produced a very large improvement in real-world limb use and induced white matter changes in patients with hemiparetic MS when compared with CAM. The findings suggest in preliminary fashion that the adverse changes in white matter integrity induced by MS might be reversed by CIMT. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT01081275).
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Affiliation(s)
| | | | - Edward Taub
- 2 University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brent Womble
- 2 University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jarrod M Hicks
- 2 University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | - Victor W Mark
- 2 University of Alabama at Birmingham, Birmingham, AL, USA
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10
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Máté A, Kis D, Czigner A, Fischer T, Halász L, Barzó P. Connectivity-based segmentation of the brainstem by probabilistic tractography. Brain Res 2018; 1690:74-88. [PMID: 29555236 DOI: 10.1016/j.brainres.2018.03.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 02/16/2018] [Accepted: 03/08/2018] [Indexed: 11/26/2022]
Abstract
Diffusion magnetic resonance imaging is a non-invasive tool increasingly used for the investigation of brain connectivity in vivo. In this paper we propose a method that allows segmentation of the brainstem to four subregions (frontopontine, motor, sensory and reticular) based on connections to supratentorial structures, thereby eliminating the need for using anatomical landmarks within the brainstem for the identification of these subregions. The feasibility of connectivity-based brainstem segmentation was investigated in a group of healthy subjects (n = 20). Multifiber probabilistic tractography was performed using the FMRIB Software Library, and connections between a pontomesencephalic seed mask and four supratentorial target regions (anterior and posterior limbs of the internal capsule, sensory and medial thalamus) were used to determine connectivity maps of the brainstem. Results were compared with a neuroanatomy atlas and histological sections, confirming good anatomic correspondence. The four subregions detected by the connectivity-based segmentation showed good intersubject reproducibility. The presented method may be a potential tool to investigate brainstem connectivity in diseases that distort normal anatomy, and quantitative analyses of the diffusion-related parameters may provide additional information on the involvement of brainstem pathways in certain disease states (e.g., traumatic brain injury, demyelinating disorders, brainstem tumors). The potential clinical applicability of the method is demonstrated in two cases of severe traumatic brain injury.
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Affiliation(s)
- Adrienn Máté
- Department of Neurosurgery, Albert Szent-Györgyi Clinical Center, University of Szeged, 6 Semmelweis Street, H-6725 Szeged, Hungary.
| | - Dávid Kis
- Department of Neurosurgery, Albert Szent-Györgyi Clinical Center, University of Szeged, 6 Semmelweis Street, H-6725 Szeged, Hungary
| | - Andrea Czigner
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, University of Szeged, 40 Kossuth L. Boulevard, H-6724 Szeged, Hungary
| | - Tamás Fischer
- Department of Neurosurgery, Albert Szent-Györgyi Clinical Center, University of Szeged, 6 Semmelweis Street, H-6725 Szeged, Hungary
| | - László Halász
- National Institute of Clinical Neurosciences, 44-46 Laky Adolf Street, H-1145 Budapest, Hungary
| | - Pál Barzó
- Department of Neurosurgery, Albert Szent-Györgyi Clinical Center, University of Szeged, 6 Semmelweis Street, H-6725 Szeged, Hungary
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11
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12
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Bommarito G, Bellini A, Pardini M, Solaro C, Roccatagliata L, Laroni A, Capello E, Mancardi GL, Uccelli A, Inglese M. Composite MRI measures and short-term disability in patients with clinically isolated syndrome suggestive of MS. Mult Scler 2017; 24:623-631. [PMID: 28394195 DOI: 10.1177/1352458517704077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The use of composite magnetic resonance imaging (MRI) measures has been suggested to better explain disability in patients with multiple sclerosis (MS). However, little is known about the utility of composite scores at the earliest stages of the disease. OBJECTIVE To investigate whether, in patients with clinically isolated syndrome (CIS), a composite MRI measure, rather than the single metrics, would explain conversion to MS and would better correlate with disability at baseline and at 1 year of follow-up. METHODS Corticospinal tract (CST), corpus callosum (CC) and optic radiation (OR) volume, fractional anisotropy (FA), and mean diffusivity (MD) values were measured in 27 CIS patients and 24 healthy controls (HCs). Z-scores of FA, MD, and tract volume measures were calculated in patients, based on the corresponding measures obtained from HCs, and then combined in a composite score for each tract. Correlations between Z-scores at baseline and both the Expanded Disability Status Scale (EDSS) at baseline and at follow-up (FU-EDSS) were investigated. RESULTS Only CST, CC, and OR composite scores as well as the CST volume were significantly associated with FU-EDSS ( p = 0.005, p = 0.007, p = 0.020, and p = 0.010, respectively). CONCLUSION The combination of MRI measures rather than the individual metrics better captured the association between tissue damage in both the CC, OR and CST and short-term follow-up disability.
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Affiliation(s)
- Giulia Bommarito
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy
| | - Alessandro Bellini
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy/UOC Fisica Medica e Sanitaria, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Matteo Pardini
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy
| | - Claudio Solaro
- Neurology Unit, Department of Head and Neck, PA Micone Hospital, ASL3 Genovese, Genoa, Italy
| | - Luca Roccatagliata
- Department of Health Science (DISSAL), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy
| | - Alice Laroni
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy
| | - Elisabetta Capello
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giovanni Luigi Mancardi
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy
| | - Antonio Uccelli
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy
| | - Matilde Inglese
- Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy/IRCCS AOU San Martino-IST, Genoa, Italy/Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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Carotenuto A, Iodice R, Petracca M, Inglese M, Cerillo I, Cocozza S, Saiote C, Brunetti A, Tedeschi E, Manganelli F, Orefice G. Upper motor neuron evaluation in multiple sclerosis patients treated with Sativex ®. Acta Neurol Scand 2017; 135:442-448. [PMID: 27500463 DOI: 10.1111/ane.12660] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spasticity in multiple sclerosis (MS) results from an imbalance of inputs from descending pathways to the spinal motor circuits, as well as from a damage of the corticospinal tract (CST). OBJECTIVES To assess CST impairment in MS patients with and without spasticity and to evaluate its evolution under Sativex® treatment. METHODS Ten MS patients with spasticity ("cases") underwent clinical (EDSS, 9-hole Peg, Ashworth scale, Timed 25-Foot Walk, and NRS for spasticity), MRI (CST fractional anisotropy [FA]), and electrophysiological (central motor conduction time [CMCT] and H/M ratio) evaluations at baseline and after 12 months. We selected 20 MS patients without spasticity as control group at baseline. RESULTS At baseline, cases showed a lower CST FA (0.492±0.045 vs 0.543±0.047; P=.01) and a higher CMCT (P=.001) compared to the control group. No correlations were found between clinical, electrophysiological, and MRI features. After 12 months, cases showed a decrease in non-prevalent degree of impairment (PDI) side FA (0.502±0.023 vs 0.516±0.033; P=.01) without differences for electrophysiological features compared to baseline. Treatment with Sativex® resulted in a reduction of NRS for spasticity (P=.01). CONCLUSIONS We confirm the presence of CST impairment in MS patients with spasticity. We did not identify structural/electrophysiological correlates that could explain Sativex® clinical effect.
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Affiliation(s)
- A. Carotenuto
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; Federico II University of Naples; Naples Italy
| | - R. Iodice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; Federico II University of Naples; Naples Italy
| | - M. Petracca
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; Federico II University of Naples; Naples Italy
- Department of Neurology, Radiology, Neuroscience; Icahn School of Medicine; Mount Sinai NY USA
| | - M. Inglese
- Department of Neurology, Radiology, Neuroscience; Icahn School of Medicine; Mount Sinai NY USA
| | - I. Cerillo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; Federico II University of Naples; Naples Italy
| | - S. Cocozza
- Department of Advanced Biomedical Sciences; Federico II University of Naples; Naples Italy
| | - C. Saiote
- Department of Neurology; Icahn School of Medicine; Mount Sinai NY USA
| | - A. Brunetti
- Department of Advanced Biomedical Sciences; Federico II University of Naples; Naples Italy
| | - E. Tedeschi
- Department of Advanced Biomedical Sciences; Federico II University of Naples; Naples Italy
| | - F. Manganelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; Federico II University of Naples; Naples Italy
| | - G. Orefice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences; Federico II University of Naples; Naples Italy
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14
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Jung NY, Han CE, Kim HJ, Yoo SW, Kim HJ, Kim EJ, Na DL, Lockhart SN, Jagust WJ, Seong JK, Seo SW. Tract-Specific Correlates of Neuropsychological Deficits in Patients with Subcortical Vascular Cognitive Impairment. J Alzheimers Dis 2016; 50:1125-35. [PMID: 26836179 DOI: 10.3233/jad-150841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The white matter tract-specific correlates of neuropsychological deficits are not fully established in patients with subcortical vascular cognitive impairment (SVCI), where white matter tract damage may be a critical factor in cognitive impairment. The purpose of this study is to investigate the tract-specific correlates of neuropsychological deficits in SVCI patients using tract-specific statistical analysis (TSSA). We prospectively recruited 114 SVCI patients, and 55 age-, gender-, and education-matched individuals with normal cognition (NC). All participants underwent diffusion weighted imaging and neuropsychological testing. We classified tractography results into fourteen major fiber tracts and analyzed group comparison and correlation with cognitive impairments. Relative to NC subjects, SVCI patients showed decreased fractional anisotropy values in bilateral anterior-thalamic radiation, cingulum, superior-longitudinal fasciculus, uncinate fasciculus, corticospinal tract, and left inferior-longitudinal fasciculus. Focal disruptions in specific tracts were associated with specific cognitive impairments. Our findings suggest that disconnection of specific white matter tracts, especially those neighboring and providing connections between gray matter regions important to certain cognitive functions, may contribute to specific cognitive impairments in SVCI.
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Affiliation(s)
- Na-Yeon Jung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Cheol E Han
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea.,Department of Bio-convergence Engineering, Korea University, Seoul, Republic of Korea
| | - Hee Jin Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Sang Wook Yoo
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea.,Department of Bio-convergence Engineering, Korea University, Seoul, Republic of Korea
| | - Hee-Jong Kim
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea.,Department of Bio-convergence Engineering, Korea University, Seoul, Republic of Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Busan, Republic of Korea
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Samuel N Lockhart
- Helen Wills Neuroscience Institute, University of California, Berkeley, USA.,Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, USA.,Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Joon-Kyung Seong
- School of Biomedical Engineering, Korea University, Seoul, Republic of Korea.,Department of Bio-convergence Engineering, Korea University, Seoul, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
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15
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McNulty JP, Lonergan R, Bannigan J, O’Laoide R, Rainford LA, Tubridy N. Visualisation of the medial longitudinal fasciculus using fibre tractography in multiple sclerosis patients with internuclear ophthalmoplegia. Ir J Med Sci 2016; 185:393-402. [DOI: 10.1007/s11845-016-1405-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 01/07/2016] [Indexed: 11/29/2022]
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16
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Abstract
Due to its sensitivity to the different multiple sclerosis (MS)-related abnormalities, magnetic resonance imaging (MRI) has become an established tool to diagnose MS and to monitor its evolution. MRI has been included in the diagnostic workup of patients with clinically isolated syndromes suggestive of MS, and ad hoc criteria have been proposed and are regularly updated. In patients with definite MS, the ability of conventional MRI techniques to explain patients' clinical status and progression of disability is still suboptimal. Several advanced MRI-based technologies have been applied to estimate overall MS burden in the different phases of the disease. Their use has allowed the heterogeneity of MS pathology in focal lesions, normal-appearing white matter and gray matter to be graded in vivo. Recently, additional features of MS pathology, including macrophage infiltration and abnormal iron deposition, have become quantifiable. All of this, combined with functional imaging techniques, is improving our understanding of the mechanisms associated with MS evolution. In the near future, the use of ultrahigh-field systems is likely to provide additional insight into disease pathophysiology. However, the utility of advanced MRI techniques in clinical trial monitoring and in assessing individual patients' response to treatment still needs to be assessed.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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17
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Abstract
The advances in diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and functional magnetic resonance imaging (fMRI) over the last 20 years have vastly contributed to improving the understanding of the brain structure and function in patients with many diseases of the central nervous system (CNS). DWI is commonly used, for instance, in the diagnostic workup of stroke, CNS neoplasia, and rapidly progressive dementia cases. The new DTI methods provide more specific information about the most destructive aspects of tumors, neurodegenerative dementia, and multiple sclerosis pathology and give a more complete picture of the complex pathologic mechanisms of these conditions. More recently, fMRI has provided insight to the mechanisms of brain adaptation and plasticity to damage related to many neurologic conditions and has further extended our ability to understand the functional significance of pathologic changes in these diseases. Although at present fMRI does not have a role in the diagnosis, routine assessment, and monitoring of neurologic diseases, significant efforts are under way in order to achieve harmonization of both acquisition and postprocessing procedures, which are likely to contribute to a significant change of the clinical scenario.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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18
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Abstract
Multiple sclerosis (MS) is a chronic, inflammatory disease of the central nervous system characterised by immune-mediated demyelination, and is a leading cause of neurological disability worldwide. It has a wide spectrum of clinical presentations which overlap with other neurological conditions many times. Further, the radiological array of findings in MS can also be confused for multiple other conditions, leading to the need to look for the more typical findings, and interpret these in close conjunction with the clinical picture including temporal evolution. This review aims to revisit the MRI findings in MS, including recent innovations in imaging, and to help distinguish MS from its mimics.
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Affiliation(s)
- Aparna Katdare
- Department of Neuroradiology, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India
| | - Meher Ursekar
- Department of Neuroradiology, Sir HN Reliance Foundation Hospital, Mumbai, Maharashtra, India
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19
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Geva S, Correia MM, Warburton EA. Contributions of bilateral white matter to chronic aphasia symptoms as assessed by diffusion tensor MRI. BRAIN AND LANGUAGE 2015; 150:117-28. [PMID: 26401977 PMCID: PMC4669306 DOI: 10.1016/j.bandl.2015.09.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/09/2015] [Accepted: 09/01/2015] [Indexed: 06/05/2023]
Abstract
Language reorganisation following stroke has been studied widely. However, while studies of brain activation and grey matter examined both hemispheres, studies of white matter changes have mostly focused on the left hemisphere. Here we examined the relationship between bilateral hemispheric white matter and aphasia symptoms. 15 chronic stroke patients with aphasia and 18 healthy adults were studied using Diffusion Weighted Imaging data. By applying histogram analysis, Tract-Based Spatial Statistics, tractography and lesion-tract overlap methods, it was found that damage to the left hemisphere in general, and to the arcuate fasciculus in particular, correlated with impairments on word repetition, object naming, sentence comprehension and homophone and rhyme judgement. However, no such relationship was found in the right hemisphere. It is suggested that while some language function in aphasia can be explained by damage to the left arcuate fasciculus, it cannot be explained by looking at the contra-lesional tract.
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Affiliation(s)
- Sharon Geva
- Department of Clinical Neurosciences, University of Cambridge, United Kingdom; Cognitive Neuroscience and Neuropsychiatry Section, UCL Institute of Child Health, United Kingdom.
| | - Marta M Correia
- MRC Cognition and Brain Sciences Unit, Cambridge, United Kingdom
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20
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Martínez-Heras E, Varriano F, Prčkovska V, Laredo C, Andorrà M, Martínez-Lapiscina EH, Calvo A, Lampert E, Villoslada P, Saiz A, Prats-Galino A, Llufriu S. Improved Framework for Tractography Reconstruction of the Optic Radiation. PLoS One 2015; 10:e0137064. [PMID: 26376179 PMCID: PMC4573981 DOI: 10.1371/journal.pone.0137064] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 08/12/2015] [Indexed: 01/21/2023] Open
Abstract
The optic radiation (OR) is one of the major components of the visual system and a key structure at risk in white matter diseases such as multiple sclerosis (MS). However, it is challenging to perform track reconstruction of the OR using diffusion MRI due to a sharp change of direction in the Meyer's loop and the presence of kissing and crossing fibers along the pathway. As such, we aimed to provide a highly precise and reproducible framework for tracking the OR from thalamic and visual cortex masks. The framework combined the generation of probabilistic streamlines by high order fiber orientation distributions estimated with constrained spherical deconvolution and an automatic post-processing based on anatomical exclusion criteria (AEC) to compensate for the presence of anatomically implausible streamlines. Specifically, those ending in the contralateral hemisphere, cerebrospinal fluid or grey matter outside the visual cortex were automatically excluded. We applied the framework to two distinct high angular resolution diffusion-weighted imaging (HARDI) acquisition protocols on one cohort, comprised of ten healthy volunteers and five MS patients. The OR was successfully delineated in both HARDI acquisitions in the healthy volunteers and MS patients. Quantitative evaluation of the OR position was done by comparing the results with histological reference data. Compared with histological mask, the OR reconstruction into a template (OR-TCT) was highly precise (percentage of voxels within the OR-TCT correctly defined as OR), ranging from 0.71 to 0.83. The sensitivity (percentage of voxels in histological reference mask correctly defined as OR in OR-TCT) ranged from 0.65 to 0.81 and the accuracy (measured by F1 score) was 0.73 to 0.77 in healthy volunteers. When AEC was not applied the precision and accuracy decreased. The absolute agreement between both HARDI datasets measured by the intraclass correlation coefficient was 0.73. This improved framework allowed us to reconstruct the OR with high reliability and accuracy independently of the acquisition parameters. Moreover, the reconstruction was possible even in the presence of tissue damage due to MS. This framework could also be applied to other tracts with complex configuration.
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Affiliation(s)
- Eloy Martínez-Heras
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Federico Varriano
- Laboratory of Surgical NeuroAnatomy (LSNA). Facultat de Medicina. Universitat de Barcelona, Barcelona, Spain
| | - Vesna Prčkovska
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Carlos Laredo
- Comprehensive Stroke Center, Department of Neuroscience. Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Magí Andorrà
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Elena H. Martínez-Lapiscina
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Calvo
- Medical Imaging Platform, Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Erika Lampert
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Pablo Villoslada
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Albert Saiz
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | - Alberto Prats-Galino
- Laboratory of Surgical NeuroAnatomy (LSNA). Facultat de Medicina. Universitat de Barcelona, Barcelona, Spain
| | - Sara Llufriu
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d′Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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21
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Yoo SW, Guevara P, Jeong Y, Yoo K, Shin JS, Mangin JF, Seong JK. An Example-Based Multi-Atlas Approach to Automatic Labeling of White Matter Tracts. PLoS One 2015; 10:e0133337. [PMID: 26225419 PMCID: PMC4520495 DOI: 10.1371/journal.pone.0133337] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 06/25/2015] [Indexed: 11/18/2022] Open
Abstract
We present an example-based multi-atlas approach for classifying white matter (WM) tracts into anatomic bundles. Our approach exploits expert-provided example data to automatically classify the WM tracts of a subject. Multiple atlases are constructed to model the example data from multiple subjects in order to reflect the individual variability of bundle shapes and trajectories over subjects. For each example subject, an atlas is maintained to allow the example data of a subject to be added or deleted flexibly. A voting scheme is proposed to facilitate the multi-atlas exploitation of example data. For conceptual simplicity, we adopt the same metrics in both example data construction and WM tract labeling. Due to the huge number of WM tracts in a subject, it is time-consuming to label each WM tract individually. Thus, the WM tracts are grouped according to their shape similarity, and WM tracts within each group are labeled simultaneously. To further enhance the computational efficiency, we implemented our approach on the graphics processing unit (GPU). Through nested cross-validation we demonstrated that our approach yielded high classification performance. The average sensitivities for bundles in the left and right hemispheres were 89.5% and 91.0%, respectively, and their average false discovery rates were 14.9% and 14.2%, respectively.
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Affiliation(s)
- Sang Wook Yoo
- Department of Biomedical Engineering, Korea University, Seoul, Republic of Korea
- Department of Computer Science, KAIST, Daejeon, Republic of Korea
| | - Pamela Guevara
- IBM, CEA, Gif-sur-Yvette, France
- Institut Fédératif de Recherche 49, Gif-sur-Yvette, France
- University of Concepción, Concepción, Chile
| | - Yong Jeong
- Department of Bio and Brain Engineering, KAIST, Daejeon, Republic of Korea
| | - Kwangsun Yoo
- Department of Bio and Brain Engineering, KAIST, Daejeon, Republic of Korea
| | - Joseph S. Shin
- Department of Computer Science, KAIST, Daejeon, Republic of Korea
- Handong Global University, Pohang, Republic of Korea
| | - Jean-Francois Mangin
- Institut Fédératif de Recherche 49, Gif-sur-Yvette, France
- University of Concepción, Concepción, Chile
| | - Joon-Kyung Seong
- Department of Biomedical Engineering, Korea University, Seoul, Republic of Korea
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22
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Daams M, Steenwijk MD, Wattjes MP, Geurts JJG, Uitdehaag BMJ, Tewarie PK, Balk LJ, Pouwels PJW, Killestein J, Barkhof F. Unraveling the neuroimaging predictors for motor dysfunction in long-standing multiple sclerosis. Neurology 2015; 85:248-55. [PMID: 26115736 DOI: 10.1212/wnl.0000000000001756] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/24/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To find the strongest neuroimaging predictors for motor dysfunction using conventional and quantitative imaging measures focusing on the corticospinal tract (CST) in a large cohort of patients with long-standing multiple sclerosis (MS). METHODS In this cross-sectional study, a wide spectrum of neuroimaging measures at the whole-brain, cervical, and CST level were analyzed in 195 patients with MS and 54 healthy controls. Motor function was assessed using the Expanded Disability Status Scale (EDSS), 9-Hole Peg Test, Timed 25-Foot Walk Test, and Multiple Sclerosis Walking Scale. Associations between damage in different parts of the motor system and motor functioning were assessed using stepwise linear regression. RESULTS Patients had an average disease duration of 19.98 (±6.99) years and a median EDSS score of 4 (range: 1.0-8.0). EDSS score was associated with number of infratentorial and cervical cord lesions, lesion volume in the CST, and mean upper cervical cord area (adjusted R(2) = 0.403). Timed 25-Foot Walk Test score was associated with number of infratentorial lesions and cerebellar volume (adjusted R(2) = 0.150), 9-Hole Peg Test score with number of infratentorial lesions and thickness of the cortex connected to the CST (adjusted R(2) = 0.245), and Multiple Sclerosis Walking Scale with number of infratentorial and cervical lesions, thickness of the cortex connected to the CST, and mean upper cervical cord area (adjusted R(2) = 0.354). CONCLUSIONS Motor dysfunction in MS has a complex substrate that cannot be ascribed to a single neuroimaging finding, but is the consequence of infratentorial and spinal cord damage, as well as damage in the CST.
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Affiliation(s)
- Marita Daams
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
| | - Martijn D Steenwijk
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Mike P Wattjes
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Jeroen J G Geurts
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Bernard M J Uitdehaag
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Prejaas K Tewarie
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Lisanne J Balk
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Petra J W Pouwels
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Joep Killestein
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Frederik Barkhof
- From the Departments of Radiology and Nuclear Medicine (M.D., M.D.S., M.P.W., F.B.), Anatomy and Neurosciences (M.D., J.J.G.G.), Neurology (B.M.J.U., P.K.T., L.J.B., J.K.), and Physics and Medical Technology (P.J.W.P.), Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
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23
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In MH, Posnansky O, Speck O. PSF mapping-based correction of eddy-current-induced distortions in diffusion-weighted echo-planar imaging. Magn Reson Med 2015; 75:2055-63. [PMID: 26096666 DOI: 10.1002/mrm.25746] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/27/2015] [Accepted: 03/31/2015] [Indexed: 11/12/2022]
Abstract
PURPOSE To accurately correct diffusion-encoding direction-dependent eddy-current-induced geometric distortions in diffusion-weighted echo-planar imaging (DW-EPI) and to minimize the calibration time at 7 Tesla (T). METHODS A point spread function (PSF) mapping based eddy-current calibration method is newly presented to determine eddy-current-induced geometric distortions even including nonlinear eddy-current effects within the readout acquisition window. To evaluate the temporal stability of eddy-current maps, calibration was performed four times within 3 months. Furthermore, spatial variations of measured eddy-current maps versus their linear superposition were investigated to enable correction in DW-EPIs with arbitrary diffusion directions without direct calibration. For comparison, an image-based eddy-current correction method was additionally applied. Finally, this method was combined with a PSF-based susceptibility-induced distortion correction approach proposed previously to correct both susceptibility and eddy-current-induced distortions in DW-EPIs. RESULTS Very fast eddy-current calibration in a three-dimensional volume is possible with the proposed method. The measured eddy-current maps are very stable over time and very similar maps can be obtained by linear superposition of principal-axes eddy-current maps. High resolution in vivo brain results demonstrate that the proposed method allows more efficient eddy-current correction than the image-based method. CONCLUSION The combination of both PSF-based approaches allows distortion-free images, which permit reliable analysis in diffusion tensor imaging applications at 7T.
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Affiliation(s)
- Myung-Ho In
- Department of Biomedical Magnetic Resonance, Institute for Experimental Physics, Otto-von-Guericke University Magdeburg, Germany
| | - Oleg Posnansky
- Department of Biomedical Magnetic Resonance, Institute for Experimental Physics, Otto-von-Guericke University Magdeburg, Germany
| | - Oliver Speck
- Department of Biomedical Magnetic Resonance, Institute for Experimental Physics, Otto-von-Guericke University Magdeburg, Germany.,German Centre for Neurodegenerative Diseases (DZNE), Site Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
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24
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Bisecco A, Rocca MA, Pagani E, Mancini L, Enzinger C, Gallo A, Vrenken H, Stromillo ML, Copetti M, Thomas DL, Fazekas F, Tedeschi G, Barkhof F, Stefano ND, Filippi M. Connectivity-based parcellation of the thalamus in multiple sclerosis and its implications for cognitive impairment: A multicenter study. Hum Brain Mapp 2015; 36:2809-25. [PMID: 25873194 DOI: 10.1002/hbm.22809] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/25/2015] [Accepted: 03/25/2015] [Indexed: 11/06/2022] Open
Abstract
In this multicenter study, we performed a tractography-based parcellation of the thalamus and its white matter connections to investigate the relationship between thalamic connectivity abnormalities and cognitive impairment in multiple sclerosis (MS). Dual-echo, morphological and diffusion tensor (DT) magnetic resonance imaging (MRI) scans were collected from 52 relapsing-remitting MS patients and 57 healthy controls from six European centers. Patients underwent an extensive neuropsychological assessment. Thalamic connectivity defined regions (CDRs) were segmented based on their cortical connectivity using diffusion tractography-based parcellation. Between-group differences of CDRs and cortico-thalamic tracts DT MRI indices were assessed. A vertex analysis of thalamic shape was also performed. A random forest analysis was run to identify the best imaging predictor of global cognitive impairment and deficits of specific cognitive domains. Twenty-two (43%) MS patients were cognitively impaired (CI). Compared to cognitively preserved, CI MS patients had increased fractional anisotropy of frontal, motor, postcentral and occipital connected CDRs (0.002<P<0.02). They also experienced more pronounced atrophy in anterior thalamic regions and abnormal DT MRI indices of all cortico-thalamic tracts. Damage of specific cortico-thalamic tracts explained global cognitive dysfunction and impairment of selected cognitive domains better than all other MRI variables. Thalamic CDR DT MRI abnormalities were correlated with abnormalities of the corresponding cortico-thalamic tracts. Cortico-thalamic disconnection is, at various levels, implicated in cognitive dysfunction in MS. Thalamic involvement in CI MS patients is likely related to gray matter rather than white matter damage of thalamic subregions.
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Affiliation(s)
- Alvino Bisecco
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy.,MRI Center "SUN-FISM," Second University of Naples and Institute of Diagnosis and Care "Hermitage-Capodimonte,", Naples, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Laura Mancini
- National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, UK
| | | | - Antonio Gallo
- I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy.,MRI Center "SUN-FISM," Second University of Naples and Institute of Diagnosis and Care "Hermitage-Capodimonte,", Naples, Italy
| | - Hugo Vrenken
- Department of Radiology and Nuclear Medicine, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | | | - Massimiliano Copetti
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - David L Thomas
- Neuroradiological Academic Unit, UCL Institute of Neurology, Queen Square, London, United Kingdom
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Austria
| | - Gioacchino Tedeschi
- I Division of Neurology, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, Italy.,MRI Center "SUN-FISM," Second University of Naples and Institute of Diagnosis and Care "Hermitage-Capodimonte,", Naples, Italy
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, MS Centre Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - Nicola De Stefano
- Department of Neurological and Behavioral Sciences, University of Siena, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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25
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Droby A, Fleischer V, Carnini M, Zimmermann H, Siffrin V, Gawehn J, Erb M, Hildebrandt A, Baier B, Zipp F. The impact of isolated lesions on white-matter fiber tracts in multiple sclerosis patients. NEUROIMAGE-CLINICAL 2015; 8:110-6. [PMID: 26106534 PMCID: PMC4473264 DOI: 10.1016/j.nicl.2015.03.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/08/2015] [Indexed: 01/05/2023]
Abstract
Infratentorial lesions have been assigned an equivalent weighting to supratentorial plaques in the new McDonald criteria for diagnosing multiple sclerosis. Moreover, their presence has been shown to have prognostic value for disability. However, their spatial distribution and impact on network damage is not well understood. As a preliminary step in this study, we mapped the overall infratentorial lesion pattern in relapsing-remitting multiple sclerosis patients (N = 317) using MRI, finding the pons (lesion density, 14.25/cm(3)) and peduncles (13.38/cm(3)) to be predilection sites for infratentorial lesions. Based on these results, 118 fiber bundles from 15 healthy controls and a subgroup of 23 patients showing lesions unilaterally at the predilection sites were compared using diffusion tensor imaging to analyze the impact of an isolated infratentorial lesion on the affected fiber tracts. Fractional anisotropy, mean diffusion as well as axial and radial diffusivity were investigated at the lesion site and along the entire fiber tract. Infratentorial lesions were found to have an impact on the fractional anisotropy and radial diffusivity not only at the lesion site itself but also along the entire affected fiber tract. As previously found in animal experiments, inflammatory attack in the posterior fossa in multiple sclerosis impacts the whole affected fiber tract. Here, this damaging effect, reflected by changes in diffusivity measures, was detected in vivo in multiple sclerosis patients in early stages of the disease, thus demonstrating the influence of a focal immune attack on more distant networks, and emphasizing the pathophysiological role of Wallerian degeneration in multiple sclerosis.
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Affiliation(s)
- Amgad Droby
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Neuroimage Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Vinzenz Fleischer
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Neuroimage Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Marco Carnini
- Department of Computer Science, Johannes Gutenberg University, Mainz, Germany
| | - Hilga Zimmermann
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Neuroimage Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Volker Siffrin
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Joachim Gawehn
- Department of Neuroradiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University Hospital, Tübingen, Germany
| | - Andreas Hildebrandt
- Department of Computer Science, Johannes Gutenberg University, Mainz, Germany
| | - Bernhard Baier
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Neuroimage Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Frauke Zipp
- Department of Neurology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- Neuroimage Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
- Corresponding author at: Department of Neurology, University Medical Center of the Johannes Gutenberg University Mainz, Neuroimage Center (NIC) of the Focus Program Translational Neuroscience (FTN), Langenbeckstr. 1, 55131 Mainz, Germany. Tel.: +49 (0)6131 17 7156; fax: +49 (0)6131 17 5697.
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26
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Messina R, Rocca MA, Colombo B, Pagani E, Falini A, Comi G, Filippi M. White matter microstructure abnormalities in pediatric migraine patients. Cephalalgia 2015; 35:1278-86. [PMID: 25795038 DOI: 10.1177/0333102415578428] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 02/26/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Diffusion tensor (DT) magnetic resonance imaging (MRI) provides several quantities with the potential to disclose white matter (WM) microstructural abnormalities. We explored alterations of WM architecture in pediatric migraine patients using DT MRI and two different methods of analysis. METHODS Dual-echo and DT MRI scans were acquired from 15 pediatric migraine patients and 15 age-matched controls. Whole-brain voxel-wise comparisons of WM DT MRI abnormalities were performed using tract-based-spatial-statistics (TBSS). A DT probabilistic tractography analysis was also run. RESULTS Both TBSS and DT tractography analysis showed that, compared to controls, pediatric migraine patients had significant lower mean (MD), axial (AD) and radial (RD) diffusivity of WM tracts located in the brainstem, thalamus and fronto-temporo-occipital lobes, bilaterally. Patients also experienced increased fractional anisotropy (FA) of the optic radiations. No correlation was found between WM tract abnormalities and disease duration and attack frequency. CONCLUSIONS Pediatric migraine patients harbor diffuse brain WM microstructural abnormalities. High FA and low MD, AD and RD in these patients might be explained by repeated neuronal activation, which may lead to cell swelling and stimulate activity-dependent myelin-modulation, or by increased fiber and dendritic densities. Both these mechanisms might reflect a hyperexcitability of the brain in migraineurs.
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Affiliation(s)
- Roberta Messina
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Bruno Colombo
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Falini
- Department of Neuroradiology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Italy
| | - Giancarlo Comi
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Milan, Italy Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, Vita-Salute San Raffaele University, Milan, Italy
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27
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Advanced diffusion MRI fiber tracking in neurosurgical and neurodegenerative disorders and neuroanatomical studies: A review. Biochim Biophys Acta Mol Basis Dis 2014; 1842:2286-2297. [PMID: 25127851 DOI: 10.1016/j.bbadis.2014.08.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 08/03/2014] [Accepted: 08/05/2014] [Indexed: 12/26/2022]
Abstract
Diffusion MRI enabled in vivo microstructural imaging of the fiber tracts in the brain resulting in its application in a wide range of settings, including in neurological and neurosurgical disorders. Conventional approaches such as diffusion tensor imaging (DTI) have been shown to have limited applications due to the crossing fiber problem and the susceptibility of their quantitative indices to partial volume effects. To overcome these limitations, the recent focus has shifted to the advanced acquisition methods and their related analytical approaches. Advanced white matter imaging techniques provide superior qualitative data in terms of demonstration of multiple crossing fibers in their spatial orientation in a three dimensional manner in the brain. In this review paper, we discuss the advancements in diffusion MRI and introduce their roles. Using examples, we demonstrate the role of advanced diffusion MRI-based fiber tracking in neuroanatomical studies. Results from its preliminary application in the evaluation of intracranial space occupying lesions, including with respect to future directions for prognostication, are also presented. Building upon the previous DTI studies assessing white matter disease in Huntington's disease and Amyotrophic lateral sclerosis; we also discuss approaches which have led to encouraging preliminary results towards developing an imaging biomarker for these conditions.
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28
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Odenthal C, Coulthard A. The prognostic utility of MRI in clinically isolated syndrome: a literature review. AJNR Am J Neuroradiol 2014; 36:425-31. [PMID: 24831592 DOI: 10.3174/ajnr.a3954] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
For patients presenting with clinically isolated syndrome, the treating clinician needs to advise the patient on the probability of conversion to clinically definite multiple sclerosis. MR imaging may give useful prognostic information, and there is large body of literature pertaining to the use of MR imaging in assessing patients presenting with clinically isolated syndrome. This literature review evaluates the accuracy of MR imaging in predicting which patients with clinically isolated syndrome will go on to develop long-term disease and/or disability. New and emerging MR imaging technologies and their applicability to patients with clinically isolated syndrome are also considered.
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Affiliation(s)
- C Odenthal
- From the School of Medicine (C.O.), University of Queensland, Brisbane, Queensland, Australia
| | - A Coulthard
- Department of Medical Imaging (A.C.), Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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29
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Andreotti J, Jann K, Melie-Garcia L, Giezendanner S, Dierks T, Federspiel A. Repeatability Analysis of Global and Local Metrics of Brain Structural Networks. Brain Connect 2014; 4:203-20. [DOI: 10.1089/brain.2013.0202] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jennifer Andreotti
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Kay Jann
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
- Department of Neurology, Ahmanson-Lovelace Brain Mapping Center, University of California–Los Angeles, Los Angeles, California
| | - Lester Melie-Garcia
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
- Neuroinformatics Department, Cuban Neuroscience Center, Havana, Cuba
| | - Stéphanie Giezendanner
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Thomas Dierks
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Andrea Federspiel
- Department of Psychiatric Neurophysiology, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
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30
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Preziosa P, Rocca MA, Mesaros S, Pagani E, Drulovic J, Stosic-Opincal T, Dackovic J, Copetti M, Caputo D, Filippi M. Relationship between damage to the cerebellar peduncles and clinical disability in multiple sclerosis. Radiology 2014; 271:822-30. [PMID: 24555637 DOI: 10.1148/radiol.13132142] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To assess whether a structural disconnection between the cerebellum and the cerebral hemispheres contributes to cerebellar and brainstem symptoms in multiple sclerosis (MS). MATERIALS AND METHODS This study was approved by the local ethics committee, and written informed consent was obtained from each participant. Brain T2 lesion load, cerebellar white matter and gray matter volumes, and tract-specific measures of the middle and superior cerebellar peduncles were derived from 172 patients with MS and 46 control subjects. Predictors of clinical impairment, which was determined at ambulation and with cerebellar and brainstem functional system scores, were identified by using random forest analysis. RESULTS Of the 172 patients, 112 (65%) had middle cerebellar peduncle T2 lesions and 74 (43%) had superior cerebellar peduncle T2 lesions. T2 lesions in the middle and superior cerebellar peduncles were more common in clinically impaired patients than in unimpaired patients (P = .05 to <.0001). Most conventional magnetic resonance imaging metrics were more abnormal in impaired patients than in unimpaired patients (P = .03 to <.0001). Except for axial diffusivity, diffusivity abnormalities of the middle and superior cerebellar peduncles were more severe in clinically impaired patients than in unimpaired patients (P = .04 to <.0001). A minimal overlap was found between diffusivity abnormalities and T2 lesions. Compared with volumetric measures of T2 lesions or cerebellar atrophy, diffusivity measures of middle or superior cerebellar peduncle damage enabled better differentiation between clinically impaired and unimpaired patients (C statistics: 61%-70%). CONCLUSION The assessment of middle and superior cerebellar peduncle damage contributes to the explanation of cerebellar and/or brainstem symptoms and ambulatory impairment in MS.
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Affiliation(s)
- Paolo Preziosa
- From the Neuroimaging Research Unit (P.P., M.A.R., E.P., M.F.) and Department of Neurology (P.P., M.A.R., M.F.), Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Clinics of Neurology (S.M., J. Drulovic, J. Dackovic) and Radiology (T.S.O.), Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Biostatistics Unit, IRCCS-Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy (M.C.); and Department of Neurology, Scientific Institute Fondazione Don Gnocchi, Milan, Italy (D.C.)
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31
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Filippi M, Charil A, Rovaris M, Absinta M, Rocca MA. Insights from magnetic resonance imaging. HANDBOOK OF CLINICAL NEUROLOGY 2014; 122:115-149. [PMID: 24507516 DOI: 10.1016/b978-0-444-52001-2.00006-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Recent years have witnessed impressive advancements in the use of magnetic resonance imaging (MRI) for the assessment of patients with multiple sclerosis (MS). Complementary to the clinical evaluation, conventional MRI (cMRI) provides crucial pieces of information for the diagnosis of MS, the understanding of its natural history, and monitoring the efficacy of experimental treatments. Measures derived from cMRI present clear advantages over the clinical assessment, including their more objective nature and an increased sensitivity to MS-related changes. However, the correlation between these measures and the clinical manifestations of the disease remains weak, and this can be explained, at least partially, by the limited ability of cMRI to characterize and quantify the heterogeneous features of MS pathology. Quantitative MR-based techniques have the potential to overcome the limitations of cMRI. Magnetization transfer MRI, diffusion-weighted and diffusion tensor MRI with fiber tractography, proton magnetic resonance spectroscopy, T1 and T2 relaxation time measurement, and functional MRI are contributing to elucidate the mechanisms that underlie injury, repair, and functional adaptation in patients with MS. All conventional and nonconventional MR techniques will benefit from the use of high-field MR systems (3.0T or more).
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Arnaud Charil
- Neuroimaging Research Unit, Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Rovaris
- Neuroimaging Research Unit, Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Martina Absinta
- Neuroimaging Research Unit, Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria Assunta Rocca
- Neuroimaging Research Unit, Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Esposito R, Cilli F, Pieramico V, Ferretti A, Macchia A, Tommasi M, Saggino A, Ciavardelli D, Manna A, Navarra R, Cieri F, Stuppia L, Tartaro A, Sensi SL. Acute effects of modafinil on brain resting state networks in young healthy subjects. PLoS One 2013; 8:e69224. [PMID: 23935959 PMCID: PMC3723829 DOI: 10.1371/journal.pone.0069224] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 06/05/2013] [Indexed: 11/19/2022] Open
Abstract
Background There is growing debate on the use of drugs that promote cognitive enhancement. Amphetamine-like drugs have been employed as cognitive enhancers, but they show important side effects and induce addiction. In this study, we investigated the use of modafinil which appears to have less side effects compared to other amphetamine-like drugs. We analyzed effects on cognitive performances and brain resting state network activity of 26 healthy young subjects. Methodology A single dose (100 mg) of modafinil was administered in a double-blind and placebo-controlled study. Both groups were tested for neuropsychological performances with the Raven’s Advanced Progressive Matrices II set (APM) before and three hours after administration of drug or placebo. Resting state functional magnetic resonance (rs-FMRI) was also used, before and after three hours, to investigate changes in the activity of resting state brain networks. Diffusion Tensor Imaging (DTI) was employed to evaluate differences in structural connectivity between the two groups. Protocol ID: Modrest_2011; NCT01684306; http://clinicaltrials.gov/ct2/show/NCT01684306. Principal Findings Results indicate that a single dose of modafinil improves cognitive performance as assessed by APM. Rs-fMRI showed that the drug produces a statistically significant increased activation of Frontal Parietal Control (FPC; p<0.04) and Dorsal Attention (DAN; p<0.04) networks. No modifications in structural connectivity were observed. Conclusions and Significance Overall, our findings support the notion that modafinil has cognitive enhancing properties and provide functional connectivity data to support these effects. Trial Registration ClinicalTrials.gov NCT01684306 http://clinicaltrials.gov/ct2/show/NCT01684306.
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Affiliation(s)
- Roberto Esposito
- Department of Neuroscience and Imaging, University “G. d’Annunzio” Chieti-Pescara, Italy
- Molecular Neurology Unit, Center of Excellence on Aging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Franco Cilli
- Molecular Neurology Unit, Center of Excellence on Aging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Valentina Pieramico
- Molecular Neurology Unit, Center of Excellence on Aging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Antonio Ferretti
- Department of Neuroscience and Imaging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Antonella Macchia
- Department of Psychological sciences, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Marco Tommasi
- Department of Psychological sciences, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Aristide Saggino
- Department of Psychological sciences, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Domenico Ciavardelli
- Molecular Neurology Unit, Center of Excellence on Aging, University “G. d’Annunzio” Chieti-Pescara, Italy
- School of Engineering, Architecture, and Motor Science, Kore University of Enna, Enna, Italy
| | - Antonietta Manna
- Department of Neuroscience and Imaging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Riccardo Navarra
- Department of Neuroscience and Imaging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Filippo Cieri
- Department of Neuroscience and Imaging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Liborio Stuppia
- Department of Psychological sciences, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Armando Tartaro
- Department of Neuroscience and Imaging, University “G. d’Annunzio” Chieti-Pescara, Italy
| | - Stefano L. Sensi
- Department of Neuroscience and Imaging, University “G. d’Annunzio” Chieti-Pescara, Italy
- Molecular Neurology Unit, Center of Excellence on Aging, University “G. d’Annunzio” Chieti-Pescara, Italy
- Departments of Neurology and Pharmacology, University of California-Irvine, Irvine, California, United States of America
- Institute for Mind Impairments and Neurological Disorders, University of California-Irvine, Irvine, California, United States of America
- * E-mail:
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Yeh FC, Tang PF, Tseng WYI. Diffusion MRI connectometry automatically reveals affected fiber pathways in individuals with chronic stroke. NEUROIMAGE-CLINICAL 2013; 2:912-21. [PMID: 24179842 PMCID: PMC3777702 DOI: 10.1016/j.nicl.2013.06.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 06/05/2013] [Accepted: 06/20/2013] [Indexed: 11/25/2022]
Abstract
Building a human connectome database has recently attracted the attention of many researchers, although its application to individual subjects has yet to be explored. In this study, we acquired diffusion spectrum imaging of 90 subjects and showed that this dataset can be used as a norm to examine pathways with deviant connectivity in individuals. This analytical approach, termed diffusion MRI connectometry, was realized by reconstructing patient data to a common stereotaxic space and calculating the percentile rank of the diffusion quantities with respect to those of the norm. The affected tracks were constructed with deterministic tractography using the local tract orientations with substantially low percentile ranks as seeds. To demonstrate the performance of the connectometry, we applied it to 7 patients with chronic stroke and compared the results with lesions shown on T2-weighted images, apparent diffusion coefficient (ADC) maps, and fractional anisotropy (FA) maps, as well as clinical manifestations. The results showed that the affected tracks revealed by the connectometry corresponded well with the stroke lesions shown on T2-weighted images. Moreover, while the T2-weighted images, as well as the ADC and FA maps, showed only the stroke lesions, connectometry revealed entire affected tracks, a feature that is potentially useful for diagnostic or prognostic evaluation. This unique capability may provide personalized information regarding the structural connectivity underlying brain development, plasticity, or disease in each individual subject. Diffusion MRI connectometry can identify tracks with decreased connectivity. T2-weighted images, and ADC, and FA maps show only the stroke lesions. Diffusion MRI connectometry reveals the entire affected pathways.
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Affiliation(s)
- Fang-Cheng Yeh
- Department of Biomedical Engineering, Carnegie Mellon University, PA, USA
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Bodini B, Cercignani M, Toosy A, De Stefano N, Miller DH, Thompson AJ, Ciccarelli O. A novel approach with "skeletonised MTR" measures tract-specific microstructural changes in early primary-progressive MS. Hum Brain Mapp 2013; 35:723-33. [PMID: 23616276 DOI: 10.1002/hbm.22196] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 07/26/2012] [Accepted: 08/20/2012] [Indexed: 11/05/2022] Open
Abstract
We combined tract-based spatial statistics (TBSS) and magnetization transfer (MT) imaging to assess white matter (WM) tract-specific short-term changes in early primary-progressive multiple sclerosis (PPMS) and their relationships with clinical progression. Twenty-one PPMS patients within 5 years from onset underwent MT and diffusion tensor imaging (DTI) at baseline and after 12 months. Patients' disability was assessed. DTI data were processed to compute fractional anisotropy (FA) and to generate a common WM "skeleton," which represents the tracts that are "common" to all subjects using TBSS. The MT ratio (MTR) was computed from MT data and co-registered with the DTI. The skeletonization procedure derived for FA was applied to each subject's MTR image to obtain a "skeletonised" MTR map for every subject. Permutation tests were used to assess (i) changes in FA, principal diffusivities, and MTR over the follow-up, and (ii) associations between changes in imaging parameters and changes in disability. Patients showed significant decreases in MTR over one year in the corpus callosum (CC), bilateral corticospinal tract (CST), thalamic radiations, and superior and inferior longitudinal fasciculi. These changes were located both within lesions and the normal-appearing WM. No significant longitudinal change in skeletonised FA was found, but radial diffusivity (RD) significantly increased in several regions, including the CST bilaterally and the right inferior longitudinal fasciculus. MTR decreases, RD increases, and axial diffusivity decreases in the CC and CST correlated with a deterioration in the upper limb function. We detected tract-specific multimodal imaging changes that reflect the accrual of microstructural damage and possibly contribute to clinical impairment in PPMS. We propose a novel methodology that can be extended to other diseases to map cross-subject and tract-specific changes in MTR.
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Affiliation(s)
- Benedetta Bodini
- Department of Brain Repair and Rehabilitation, University College London Institute of Neurology, Queen Square, London, United Kingdom
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35
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Rocca MA, Mesaros S, Preziosa P, Pagani E, Stosic-Opincal T, Dujmovic-Basuroski I, Drulovic J, Filippi M. Wallerian and trans-synaptic degeneration contribute to optic radiation damage in multiple sclerosis: a diffusion tensor MRI study. Mult Scler 2013; 19:1610-7. [DOI: 10.1177/1352458513485146] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Optic radiation (OR) damage occurs in multiple sclerosis (MS). Objectives: The purpose of this study was to explore the contribution of local and distant mechanisms associated with OR damage in MS. Methods: Diffusion tensor (DT) magnetic resonance imaging (MRI) tractography probability maps of the ORs were derived from 102 MS patients and 11 controls. Between-group differences of OR normal-appearing white matter (NAWM) damage and topographical distribution of OR damage were assessed using quantitative and voxel-wise analyses, considering the influence of previous optic neuritis (ON+) and T2 OR lesions (T2 OR+). Results: OR NAWM diffusivity abnormalities were more severe in ON+ patients vs patients without previous optic neuritis (ON–) and T2 OR+ vs T2 OR– patients. Damage to the anterior portions of the ORs was more severe in ON+ vs ON– patients. Compared to controls and T2 OR– patients, T2 OR+ patients experienced a more distributed pattern of DT MRI abnormalities along the ORs, with an increased axial diffusivity limited to the anterior portions of the ORs. In T2 OR+ group, ON+ vs ON– patients showed DT MRI abnormalities in the middle portion of the ORs, in correspondence with focal lesions. OR damage correlated with OR T2 lesion volume, visual dysfunction and optic nerve atrophy. Conclusions: Both trans-synaptic degeneration secondary to optic nerve damage and Wallerian degeneration due to local T2 lesions contribute to OR damage in MS.
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Affiliation(s)
- Maria A Rocca
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
- Department of Neurology, Vita-Salute San Raffaele University, Italy
| | - Sarlota Mesaros
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Serbia
| | - Paolo Preziosa
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
- Department of Neurology, Vita-Salute San Raffaele University, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
| | | | | | - Jelena Drulovic
- Clinic of Neurology, Faculty of Medicine, University of Belgrade, Serbia
| | - Massimo Filippi
- Neuroimaging Research Unit, Vita-Salute San Raffaele University, Italy
- Department of Neurology, Vita-Salute San Raffaele University, Italy
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Matsui JT, Vaidya JG, Johnson HJ, Magnotta VA, Long JD, Mills JA, Lowe MJ, Sakaie KE, Rao SM, Smith MM, Paulsen JS. Diffusion weighted imaging of prefrontal cortex in prodromal Huntington's disease. Hum Brain Mapp 2013; 35:1562-73. [PMID: 23568433 DOI: 10.1002/hbm.22273] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 11/09/2012] [Accepted: 01/28/2013] [Indexed: 11/07/2022] Open
Abstract
Huntington's disease (HD) is a devastating neurodegenerative disease with no effective disease-modifying treatments. There is considerable interest in finding reliable indicators of disease progression to judge the efficacy of novel treatments that slow or stop disease onset before debilitating signs appear. Diffusion-weighted imaging (DWI) may provide a reliable marker of disease progression by characterizing diffusivity changes in white matter (WM) in individuals with prodromal HD. The prefrontal cortex (PFC) may play a role in HD progression due to its prominent striatal connections and documented role in executive function. This study uses DWI to characterize diffusivity in specific regions of PFC WM defined by FreeSurfer in 53 prodromal HD participants and 34 controls. Prodromal HD individuals were separated into three CAG-Age Product (CAP) groups (16 low, 22 medium, 15 high) that indexed baseline progression. Statistically significant increases in mean diffusivity (MD) and radial diffusivity (RD) among CAP groups relative to controls were seen in inferior and lateral PFC regions. For MD and RD, differences among controls and HD participants tracked with baseline disease progression. The smallest difference was for the low group and the largest for the high group. Significant correlations between Trail Making Test B (TMTB) and mean fractional anisotropy (FA) and/or RD paralleled group differences in mean MD and/or RD in several right hemisphere regions. The gradient of effects that tracked with CAP group suggests DWI may provide markers of disease progression in future longitudinal studies as increasing diffusivity abnormalities in the lateral PFC of prodromal HD individuals.
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Affiliation(s)
- Joy T Matsui
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa; John A. Burns School of Medicine, The University of Hawaii, Honolulu, Hawaii
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DTI Measurements in Multiple Sclerosis: Evaluation of Brain Damage and Clinical Implications. Mult Scler Int 2013; 2013:671730. [PMID: 23606965 PMCID: PMC3628664 DOI: 10.1155/2013/671730] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Revised: 02/20/2013] [Accepted: 03/05/2013] [Indexed: 11/18/2022] Open
Abstract
Diffusion tensor imaging (DTI) is an effective means of quantifying parameters of demyelination and axonal loss. The application of DTI in Multiple Sclerosis (MS) has yielded noteworthy results. DTI abnormalities, which are already detectable in patients with clinically isolated syndrome (CIS), become more pronounced as disease duration and neurological impairment increase. The assessment of the microstructural alterations of white and grey matter in MS may shed light on mechanisms responsible for irreversible disability accumulation. In this paper, we examine the DTI analysis methods, the results obtained in the various tissues of the central nervous system, and correlations with clinical features and other MRI parameters. The adoption of DTI metrics to assess the outcome of prognostic measures may represent an extremely important step forward in the MS research field.
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Adluru N, Zhang H, Tromp DPM, Alexander AL. Effects of DTI spatial normalization on white matter tract reconstructions. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2013; 8669. [PMID: 24163728 DOI: 10.1117/12.2007130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Major white matter (WM) pathways in the brain can be reconstructed in vivo using tractography on diffusion tensor imaging (DTI) data. Performing tractography using the native DTI data is often considered to produce more faithful results than performing it using the spatially normalized DTI obtained using highly non-linear transformations. However, tractography in the normalized DTI is playing an increasingly important role in population analyses of the WM. In particular, the emerging tract specific analyses (TSA) can benefit from tractography in the normalized DTI for statistical parametric mapping in specific WM pathways. It is well known that the preservation of tensor orientations at the individual voxel level is enforced in tensor based registrations. However small reorientation errors at individual voxel level can accumulate and could potentially affect the tractography results adversely. To our knowledge, there has been no study investigating the effects of normalization on consistency of tractography that demands non-local preservation of tensor orientations which is not explicitly enforced in typical DTI spatial normalization routines. This study aims to evaluate and compare tract reconstructions obtained using normalized DTI against those obtained using native DTI. Although tractography results have been used to measure and influence the quality of spatial normalization, the presented study addresses a distinct question: whether non-linear spatial normalization preserves even long-range anatomical connections obtained using tractography for accurate reconstructions of pathways. Our results demonstrate that spatial normalization of DTI data does preserve tract reconstructions of major WM pathways and does not alter the variance (individual differences) of their macro and microstructural properties. This suggests one can extract quantitative and shape properties efficiently from the tractography data in the normalized DTI for performing population statistics on major WM pathways.
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Affiliation(s)
- Nagesh Adluru
- Waisman Center, University of Wisconsin-Madison, USA
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Tur C, Wheeler-Kingshott CAM, Altmann DR, Miller DH, Thompson AJ, Ciccarelli O. Spatial variability and changes of metabolite concentrations in the cortico-spinal tract in multiple sclerosis using coronal CSI. Hum Brain Mapp 2012; 35:993-1003. [PMID: 23281189 PMCID: PMC4238834 DOI: 10.1002/hbm.22229] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 10/03/2012] [Accepted: 11/05/2012] [Indexed: 11/07/2022] Open
Abstract
We characterized metabolic changes along the cortico-spinal tract (CST) in multiple sclerosis (MS) patients using a novel application of chemical shift imaging (CSI) and considering the spatial variation of metabolite levels. Thirteen relapsing-remitting (RR) and 13 primary-progressive (PP) MS patients and 16 controls underwent (1)H-MR CSI, which was applied to coronal-oblique scans to sample the entire CST. The concentrations of the main metabolites, i.e., N-acetyl-aspartate, myo-Inositol (Ins), choline containing compounds (Cho) and creatine and phosphocreatine (Cr), were calculated within voxels placed in regions where the CST is located, from cerebral peduncle to corona radiata. Differences in metabolite concentrations between groups and associations between metabolite concentrations and disability were investigated, allowing for the spatial variability of metabolite concentrations in the statistical model. RRMS patients showed higher CST Cho concentration than controls, and higher CST Ins concentration than PPMS, suggesting greater inflammation and glial proliferation in the RR than in the PP course. In RRMS, a significant, albeit modest, association between greater Ins concentration and greater disability suggested that gliosis may be relevant to disability. In PPMS, lower CST Cho and Cr concentrations correlated with greater disability, suggesting that in the progressive stage of the disease, inflammation declines and energy metabolism reduces. Attention to the spatial variation of metabolite concentrations made it possible to detect in patients a greater increase in Cr concentration towards the superior voxels as compared to controls and a stronger association between Cho and disability, suggesting that this step improves our ability to identify clinically relevant metabolic changes.
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Affiliation(s)
- Carmen Tur
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom; Department of Medicine, Clinical Neuroimmunology Unit, Multiple Sclerosis Centre of Catalonia (CEM-Cat), Autonomous University of Barcelona, CARM-Vall d'Hebron University Hospital, Barcelona, Spain
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Abstract
MR imaging without and with gadolinium-based contrast agents (GBCAs) is an important imaging tool for defining normal anatomy and characteristics of lesions. GBCAs have been used in contrast-enhanced MR imaging in defining and characterizing lesions of the central nervous system for more than 20 years. The combination of unenhanced and GBCA-enhanced MR imaging is the clinical gold standard for the noninvasive detection and delineation of most intracranial and spinal lesions. MR imaging has a high predictive value that rules out neoplasm and most inflammatory and demyelinating processes of the central nervous system.
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Affiliation(s)
- Bum-soo Kim
- Department of Radiology, The Catholic University of Korea, Seoul, Korea
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A robust method for investigating thalamic white matter tracts after traumatic brain injury. Neuroimage 2012; 63:779-88. [PMID: 22813952 PMCID: PMC3471070 DOI: 10.1016/j.neuroimage.2012.07.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 06/21/2012] [Accepted: 07/10/2012] [Indexed: 11/30/2022] Open
Abstract
Damage to the structural connections of the thalamus is a frequent feature of traumatic brain injury (TBI) and can be a key factor in determining clinical outcome. Until recently it has been difficult to quantify the extent of this damage in vivo. Diffusion tensor imaging (DTI) provides a validated method to investigate traumatic axonal injury, and can be applied to quantify damage to thalamic connections. DTI can also be used to assess white matter tract structure using tractography, and this technique has been used to study thalamo-cortical connections in the healthy brain. However, the presence of white matter injury can cause failure of tractography algorithms. Here, we report a method for investigating thalamo-cortical connectivity that bypasses the need for individual tractography. We first created a template for a number of thalamo-cortical connections using probabilistic tractography performed in ten healthy subjects. This template for investigating white matter structure was validated by comparison with individual tractography in the same group, as well as in an independent control group (N = 11). We also evaluated two methods of masking tract location using the tract skeleton generated by tract based spatial statistics, and a cerebrospinal fluid mask. Voxel-wise estimates of fractional anisotropy derived from the template were more strongly correlated with individual tractography when both types of masking were used. The tract templates were then used to sample DTI measures from a group of TBI patients (N = 22), with direct comparison performed against probabilistic tractography in individual patients. Probabilistic tractography often failed to produce anatomically plausible tracts in TBI patients. Importantly, we show that this problem increases as tracts become more damaged, and leads to underestimation of the amount of traumatic axonal injury. In contrast, the tract template can be used in these cases, allowing a more accurate assessment of white matter damage. In summary, we propose a method suitable for assessing specific thalamo-cortical white matter connections after TBI that is robust to the presence of varying amounts of traumatic axonal injury, as well as highlighting the potential problems of applying tractography algorithms in patient populations.
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Ukmar M, Montalbano A, Makuc E, Specogna I, Bratina A, Longo R, Cova MA. Fiber density index in the evaluation of the spinal cord in patients with multiple sclerosis. Radiol Med 2012; 117:1215-24. [PMID: 22744352 DOI: 10.1007/s11547-012-0848-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 08/23/2011] [Indexed: 10/28/2022]
Abstract
PURPOSE The aims of this study were to determine fractional anisotropy (FA) and the fibre density index (FDi) in the cervical spinal cord of patients with multiple sclerosis (MS) by using diffusion-tensor magnetic resonance imaging (DT-MRI) to identify possible differences between MS patients and controls. MATERIALS AND METHODS We studied 27 patients with MS - nine with primary progressive (PPMS), nine with secondary progressive (SPMS) and nine with relapsing-remitting (RRMS) disease - and 18 healthy individuals as controls. Conventional and DTI sequences with diffusion gradients applied in 32 directions were obtained. The results were compared between healthy controls and patients, between healthy controls and individual forms of MS and between the three forms of MS. Statistical analysis was performed by analysis of variance (ANOVA) and Student's t test. RESULTS The FDi in the three subgroups of patients and in controls showed a statistically significant difference. Using the t test, we found results from both PPMS and SPMS groups were different from controls. The correlation between FA and FDi was significant both in healthy controls and in MS patients evaluated as a single group. CONSLUCIONS: Despite the small group of patients, these findings suggest that FDi associated with FA is a sensitive parameter for assessing spinal cord damage in patients with MS.
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Affiliation(s)
- M Ukmar
- U.C.O. di Radiologia, Ospedale di Cattinara, Azienda Ospedaliero-Universitaria, Ospedale di Cattinara, Strada di Fiume 447, 34149, Trieste, Italy.
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Besseling RMH, Jansen JFA, Overvliet GM, Vaessen MJ, Braakman HMH, Hofman PAM, Aldenkamp AP, Backes WH. Tract specific reproducibility of tractography based morphology and diffusion metrics. PLoS One 2012; 7:e34125. [PMID: 22485157 PMCID: PMC3317780 DOI: 10.1371/journal.pone.0034125] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 02/22/2012] [Indexed: 12/16/2022] Open
Abstract
Introduction The reproducibility of tractography is important to determine its sensitivity to pathological abnormalities. The reproducibility of tract morphology has not yet been systematically studied and the recently developed tractography contrast Tract Density Imaging (TDI) has not yet been assessed at the tract specific level. Materials and Methods Diffusion tensor imaging (DTI) and probabilistic constrained spherical deconvolution (CSD) tractography are performed twice in 9 healthy subjects. Tractography is based on common space seed and target regions and performed for several major white matter tracts. Tractograms are converted to tract segmentations and inter-session reproducibility of tract morphology is assessed using Dice similarity coefficient (DSC). The coefficient of variation (COV) and intraclass correlation coefficient (ICC) are calculated of the following tract metrics: fractional anisotropy (FA), apparent diffusion coefficient (ADC), volume, and TDI. Analyses are performed both for proximal (deep white matter) and extended (including subcortical white matter) tract segmentations. Results Proximal DSC values were 0.70–0.92. DSC values were 5–10% lower in extended compared to proximal segmentations. COV/ICC values of FA, ADC, volume and TDI were 1–4%/0.65–0.94, 2–4%/0.62–0.94, 3–22%/0.53–0.96 and 8–31%/0.48–0.70, respectively, with the lower COV and higher ICC values found in the proximal segmentations. Conclusion For all investigated metrics, reproducibility depended on the segmented tract. FA and ADC had relatively low COV and relatively high ICC, indicating clinical potential. Volume had higher COV but its moderate to high ICC values in most tracts still suggest subject-differentiating power. Tract TDI had high COV and relatively low ICC, which reflects unfavorable reproducibility.
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Affiliation(s)
- René M. H. Besseling
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Jacobus F. A. Jansen
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Geke M. Overvliet
- Department of Neurology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Maarten J. Vaessen
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Hilde M. H. Braakman
- Department of Neurology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Paul A. M. Hofman
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Albert P. Aldenkamp
- Department of Neurology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- Epilepsy Center Kempenhaeghe, Heeze, The Netherlands
| | - Walter H. Backes
- Department of Radiology, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
- * E-mail:
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Wang Q, Yap PT, Wu G, Shen D. Application of neuroanatomical features to tractography clustering. Hum Brain Mapp 2012; 34:2089-102. [PMID: 22461221 DOI: 10.1002/hbm.22051] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 12/05/2011] [Accepted: 01/03/2012] [Indexed: 11/06/2022] Open
Abstract
Diffusion tensor imaging allows unprecedented insight into brain neural connectivity in vivo by allowing reconstruction of neuronal tracts via captured patterns of water diffusion in white matter microstructures. However, tractography algorithms often output hundreds of thousands of fibers, rendering subsequent data analysis intractable. As a remedy, fiber clustering techniques are able to group fibers into dozens of bundles and thus facilitate analyses. Most existing fiber clustering methods rely on geometrical information of fibers, by viewing them as curves in 3D Euclidean space. The important neuroanatomical aspect of fibers, however, is ignored. In this article, the neuroanatomical information of each fiber is encapsulated in the associativity vector, which functions as the unique "fingerprint" of the fiber. Specifically, each entry in the associativity vector describes the relationship between the fiber and a certain anatomical ROI in a fuzzy manner. The value of the entry approaches 1 if the fiber is spatially related to the ROI at high confidence; on the contrary, the value drops closer to 0. The confidence of the ROI is calculated by diffusing the ROI according to the underlying fibers from tractography. In particular, we have adopted the fast marching method for simulation of ROI diffusion. Using the associativity vectors of fibers, we further model fibers as observations sampled from multivariate Gaussian mixtures in the feature space. To group all fibers into relevant major bundles, an expectation-maximization clustering approach is employed. Experimental results indicate that our method results in anatomically meaningful bundles that are highly consistent across subjects.
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Affiliation(s)
- Qian Wang
- Department of Computer Science, University of North Carolina at Chapel Hill, NC 27599, USA
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45
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Oishi K, Mielke MM, Albert M, Lyketsos CG, Mori S. DTI analyses and clinical applications in Alzheimer's disease. J Alzheimers Dis 2012; 26 Suppl 3:287-96. [PMID: 21971468 DOI: 10.3233/jad-2011-0007] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
DTI is one of the most effective MR tools for the investigation of the brain anatomy. In addition to the gray matter, histopathological studies indicate that white matter is also a good target for both the early diagnosis of AD and for monitoring disease progression, which motivates us to use DTI to study AD patients in vivo. There are already a large amount of studies reporting significant differences between AD patients and controls, as well as to predict progression of disease in symptomatic non-demented individuals. Application of these findings in clinical practice remains to be demonstrated.
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Affiliation(s)
- Kenichi Oishi
- The Russell H. Morgan Department of Radiology and Radiological Science, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA.
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46
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Tozer D, Chard D, Bodini B, Ciccarelli O, Miller D, Thompson A, Wheeler-Kingshott C. Linking white matter tracts to associated cortical grey matter: A tract extension methodology. Neuroimage 2012; 59:3094-102. [DOI: 10.1016/j.neuroimage.2011.10.088] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 10/07/2011] [Accepted: 10/26/2011] [Indexed: 11/24/2022] Open
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Filippi M, Rocca MA. New magnetic resonance imaging biomarkers for the diagnosis of multiple sclerosis. ACTA ACUST UNITED AC 2012; 6:109-20. [PMID: 23480654 DOI: 10.1517/17530059.2012.657624] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) is sensitive in revealing focal white matter (WM) lesions in patients suspected of having multiple sclerosis (MS). As a consequence, MRI has become an established tool in addition to clinical evaluation in the diagnostic work-up of these patients. AREAS COVERED This review discusses the role of MRI biomarkers in patients at presentation with clinically isolated syndromes (CIS) suggestive of MS. Conventional MRI has been formally included in the diagnostic work-up of these patients, and imaging criteria have been proposed and are updated on a regular basis. Since in patients with established MS, pathologic and MRI studies have demonstrated that the disease affects the normal-appearing WM and gray matter of the brain and spinal cord in a distributed fashion, significant efforts have been devoted to the development of quantitative MR measures, sensitive to damage to these central nervous system compartments, to better characterize lesion burden at disease onset, to differentiate MS from other neurological conditions and to identify objective markers of an unfavorable clinical evolution in the subsequent years. EXPERT OPINION In addition to clinical measures, conventional MR sequences are the 'reference standard' for diagnosis and monitoring disease progression in patients who present with CIS suggestive of MS. The potential and utility of novel advanced MRI techniques in these patients still need to be fully evaluated.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute , Vita-Salute San Raffaele University, Milan , Italy
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Hasan KM, Walimuni IS, Abid H, Wolinsky JS, Narayana PA. Multi-modal quantitative MRI investigation of brain tissue neurodegeneration in multiple sclerosis. J Magn Reson Imaging 2012; 35:1300-11. [PMID: 22241681 DOI: 10.1002/jmri.23539] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 11/22/2011] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To investigate the utility of multimodal quantitative MRI (qMRI) and atlas-based methods to identify characteristics of lesion-driven injury and neurodegeneration in relapsing remitting multiple sclerosis (RRMS). MATERIALS AND METHODS This work is health insurance portability and accountability act compliant. High resolution T1-weighted, dual echo, and fluid-attenuated inversion recovery and diffusion tensor MRI images were prospectively acquired on 68 RRMS patients (range, 25-58 years) and 68 age-matched controls. The data were analyzed using standardized human brain atlas-based tissue segmentation procedures to obtain regional volumes and their corresponding T2 relaxation times and DTI maps. RESULTS Group-averaged brain atlas-based qMRI maps of T2, fractional anisotropy and diffusivities are visually presented and compared between controls and RRMS. The analysis shows a widespread injury in RRMS. Atrophy of the corpus callosum (CC) was substantial in RRMS. The qMRI attributes of the neocortex in combination with the CC such as T2 and diffusivities were elevated and correlated with disability. CONCLUSION Using a standardized multimodal qMRI acquisition and analyses that accounted for lesion distribution we demonstrate that cerebral pathology is widespread in RRMS. Our analysis of CC and neocortex qMRI metrics in relation to disability points to a neurodegenerative injury component that is independent from lesions.
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Affiliation(s)
- Khader M Hasan
- Department of Diagnostic and Interventional Imaging, University of Texas Health Science Center at Houston, Houston, Texas, USA.
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King AV, Linke J, Gass A, Hennerici MG, Tost H, Poupon C, Wessa M. Microstructure of a three-way anatomical network predicts individual differences in response inhibition: A tractography study. Neuroimage 2012; 59:1949-59. [DOI: 10.1016/j.neuroimage.2011.09.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 08/31/2011] [Accepted: 09/06/2011] [Indexed: 11/28/2022] Open
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Kacar K, Rocca MA, Copetti M, Sala S, Mesaros S, Stosic Opincal T, Caputo D, Absinta M, Drulovic J, Kostic VS, Comi G, Filippi M. Overcoming the clinical-MR imaging paradox of multiple sclerosis: MR imaging data assessed with a random forest approach. AJNR Am J Neuroradiol 2011; 32:2098-102. [PMID: 22081673 DOI: 10.3174/ajnr.a2864] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE In MS, the relation between clinical and MR imaging measures is still suboptimal. We assessed the correlation of disability and specific impairment of the clinical functional system with overall and regional CNS damage in a large cohort of patients with MS with different clinical phenotypes by using a random forest approach. MATERIALS AND METHODS Brain conventional MR imaging and DTI were performed in 172 patients with MS and 46 controls. Cervical cord MR imaging was performed in a subgroup of subjects. To evaluate whether MR imaging measures were able to correctly classify impairment in specific clinical domains, we performed a random forest analysis. RESULTS Between-group differences were found for most of the MR imaging variables, which correlated significantly with clinical measures (r ranging from -0.57 to 0.55). The random forest analysis showed a high performance in identifying impaired versus unimpaired patients, with a global error between 7% (pyramidal functional system) and 31% (Ambulation Index) in the different outcomes considered. When considering the performance in the unimpaired and impaired groups, the random forest analysis showed a high performance in identifying patients with impaired sensory, cerebellar, and brain stem functions (error below 10%), while it performed poorly in defining impairment of visual and mental systems (error of 91% and 70%, respectively). In analyses with a good level of classification, for most functional systems, damage of the WM fiber bundles subserving their function, measured by using DTI tractography, had the highest classification power. CONCLUSIONS Random forest analysis, especially if applied to DTI tractography data, is a valuable approach, which might contribute to overcoming the MS clinical-MR imaging paradox.
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Affiliation(s)
- K Kacar
- Scientific Institute and University Hospital San Raffaele, Milan, Italy
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