1
|
Li X, Lin Z, Liu C, Bai R, Wu D, Yang J. Glymphatic Imaging in Pediatrics. J Magn Reson Imaging 2024; 59:1523-1541. [PMID: 37819198 DOI: 10.1002/jmri.29040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
The glymphatic system, which facilitates cerebrospinal fluid (CSF) flow through the brain parenchyma, is important for brain development and waste clearance. Advances in imaging techniques, particularly magnetic resonance imaging, have make it possible to evaluate glymphatic structures and functions in vivo. Recently, several studies have focused on the development and alterations of the glymphatic system in pediatric disorders. This review discusses the development of the glymphatic system, advances of imaging techniques and their applications in pediatric disorders. First, the results of the reviewed studies indicate that the development of the glymphatic system is a long-lasting process that continues into adulthood. Second, there is a need for improved glymphatic imaging techniques that are non-invasive and fast to improve suitability for pediatric applications, as some of existing methods use contrast injection and are susceptible to motion artifacts from long scanning times. Several novel techniques are potentially feasible for pediatric patients and may be used in the future. Third, the glymphatic dysfunction is associated with a large number of pediatric disorders, although only a few have recently been investigated. In conclusion, research on the pediatric glymphatic system remains an emerging field. The preliminary applications of glymphatic imaging techniques have provided unique insight into the pathological mechanism of pediatric diseases, but mainly limited in visualization of enlarged perivascular spaces and morphological measurements on CSF volumes. More in-depth studies on glymphatic functions are required to improve our understanding of the mechanisms underlying brain development and pediatric diseases. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
Collapse
Affiliation(s)
- Xianjun Li
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zixuan Lin
- Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Congcong Liu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ruiliang Bai
- Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dan Wu
- Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shaanxi Engineering Research Center of Computational Imaging and Medical Intelligence, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
2
|
Maitra P, Shah PK, S P, Das A, V N. Knobloch syndrome - a rare collagenopathy, revealing peripheral avascular retina. Ophthalmic Genet 2023; 44:618-622. [PMID: 36994995 DOI: 10.1080/13816810.2023.2188226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION Pediatric rhegmatogenous retinal detachments, especially those presenting at birth or soon afterward, have a high likelihood of syndromic associations that can be confirmed by genetic testing. MATERIALS AND METHODS A 5-month-old child was found to have high myopia in the right eye (RE) with highly tessellated fundus, opalescent vitreous, and peripheral thinning. Left eye had a shallow retinal detachment for which he underwent belt buckling. The baby had an occipital skin tag. A provisional diagnosis of Stickler syndrome was made. RESULTS On 1-month follow-up, left eye retina was attached and 360° laser barrage was done. Fluorescein angiography was done which revealed peripheral avascular retina in both eyes. MRI and genetic testing were suggestive of syndromic association. Genetic testing revealed pathogenic mutation in COL 18A1 suggestive of Knobloch syndrome in the baby, and both parents were found to be carriers of the same mutation. However, brain MRI showed features not pathognomonic of Knobloch syndrome. CONCLUSION Although Knobloch syndrome is associated with vitreoretinal degeneration and high risk of retinal detachment, there seems to be no recommendation for prophylaxis in the other eye and therefore we preferred to observe the RE closely. A unique feature noted in our case was the peripheral avascular zone (PAZ). The PAZ could be contributed by multiple factors such as high myopia, or due to endostatin deficiency (which is a derivative of collagen XVIII) or an underlying WNT signalling abnormality.
Collapse
Affiliation(s)
- Puja Maitra
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, India
| | - Parag K Shah
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, India
| | - Prema S
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, India
| | - Abhishek Das
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, India
| | - Narendran V
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital, Coimbatore, India
| |
Collapse
|
3
|
Jeon CW, Lim GY, Moon JU. Dedicated neuroimaging analysis in children with primary headaches: prevalence of lesions and a comparison between patients with and without migraines. BMC Med Imaging 2023; 23:152. [PMID: 37817100 PMCID: PMC10563304 DOI: 10.1186/s12880-023-01122-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND This study evaluated the prevalence and types of intracranial lesions through dedicated imaging analysis of primary headaches in children and compared them between patients with and without migraine. METHODS This study included 190 children diagnosed with primary headache who underwent neuroimaging, including brain computed tomography (CT), CT angiography (CTA), and brain magnetic resonance imaging (MRI). All patients with primary headaches was divided into two groups, namely, the migraine and non-migraine groups, on the basis of data from electronic medical records. Clinical characteristics and imaging findings were evaluated and compared between the two groups. RESULTS Patients with migraine were old and had a longer period from symptom onset to diagnosis. CT was normal in 71 of 95 patients, whereas 7 of 29 patients who underwent CTA had vascular lesions; the migraine group (n = 6/20, [30%]) had higher incidence of vascular lesions than the non-migraine group (n = 1/9, [11.1%]); however, there was no statistically significant difference (p = 0.382). Furthermore, 57.5% (61/106) of children showed normal brain MRI. The most common brain MRI finding was dilated perivascular space (n = 18, [16.8%]). Most perivascular spaces were located in the basal ganglia (n = 72, [75.8%]) and were in linear patterns (n = 58, [63.0%]). There was no statistically significant difference between the two groups. CONCLUSION A low prevalence of significant abnormalities was found in children with primary headaches. Dilated perivascular space was the most common finding in both groups on MRI. CTA showed more vascular lesions in the migraine group than in the non-migraine group. Therefore, further evaluations are needed to reveal the relationship between vascular lesions or dilated perivascular space and pediatric primary headaches.
Collapse
Affiliation(s)
- Cha Woong Jeon
- Department of Radiology & Pediatrics, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63- ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| | - Gye Yeon Lim
- Department of Radiology & Pediatrics, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63- ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea.
| | - Ja Un Moon
- Department of Radiology & Pediatrics, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, 63- ro, Yeongdeungpo-gu, Seoul, 07345, Republic of Korea
| |
Collapse
|
4
|
Salimeen MSA, Liu C, Li X, Wang M, Singh M, Si S, Li M, Cheng Y, Wang X, Zhao H, Wu F, Zhang Y, Tafawa H, Pradhan A, Yang G, Yang J. Exploring Variances of White Matter Integrity and the Glymphatic System in Simple Febrile Seizures and Epilepsy. Front Neurol 2021; 12:595647. [PMID: 33967932 PMCID: PMC8097149 DOI: 10.3389/fneur.2021.595647] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/15/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Simple febrile seizures (SFS) and epilepsy are common seizures in childhood. However, the mechanism underlying SFS is uncertain, and the presence of obvious variances in white matter (WM) integrity and glymphatic function between SFS and epilepsy remain unclear. Therefore, this study aimed to investigate the differences in WM integrity and glymphatic function between SFS and epilepsy. Material and Methods: We retrospectively included 26 children with SFS, 33 children with epilepsy, and 28 controls aged 6–60 months who underwent magnetic resonance imaging (MRI). Tract-based spatial statistics (TBSS) were used to compare the diffusion tensor imaging (DTI) metrics of WM among the above-mentioned groups. T2-weighted imaging (T2WI) was used to segment the visible Virchow-Robin space (VRS) through a custom-designed automated method. VRS counts and volume were quantified and compared among the SFS, epilepsy, and control groups. Correlations of the VRS metrics and seizure duration and VRS metrics and the time interval between seizure onset and MRI scan were also investigated. Results: In comparison with controls, children with SFS showed no significant changes in fractional anisotropy (FA), axial diffusivity (AD), or radial diffusivity (RD) in the WM (P > 0.05). Decreased FA, unchanged AD, and increased RD were observed in the epilepsy group in comparison with the SFS and control groups (P < 0.05). Meanwhile, VRS counts were higher in the SFS and epilepsy groups than in the control group (VRS_SFS, 442.42 ± 74.58, VRS_epilepsy, 629.94 ± 106.55, VRS_control, 354.14 ± 106.58; P < 0.001), and similar results were found for VRS volume (VRS_SFS, 6,228.18 ± 570.74 mm3, VRS_epilepsy, 9,684.84 ± 7,292.66mm3, VRS_control, 4,007.22 ± 118.86 mm3; P < 0.001). However, VRS metrics were lower in the SFS group than in the epilepsy group (P < 0.001). In both SFS and epilepsy, VRS metrics positively correlated with seizure duration and negatively correlated with the course after seizure onset. Conclusion: SFS may not be associated with WM microstructural disruption; however, epilepsy is related to WM alterations. Seizures are associated with glymphatic dysfunction in either SFS or epilepsy.
Collapse
Affiliation(s)
- Mustafa Salimeen Abdelkareem Salimeen
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Radiology, Dongola Teaching Hospital, University of Dongola, Dongola, Sudan
| | - Congcong Liu
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xianjun Li
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Miaomiao Wang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Martha Singh
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shuqing Si
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mengxuan Li
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yannan Cheng
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyu Wang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huifang Zhao
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fan Wu
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuli Zhang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Habib Tafawa
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Anuja Pradhan
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guanyu Yang
- School of Electronic Engineering, Xidian University, Xi'an, China
| | - Jian Yang
- Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
5
|
Taoka T, Naganawa S. Imaging for central nervous system (CNS) interstitial fluidopathy: disorders with impaired interstitial fluid dynamics. Jpn J Radiol 2021; 39:1-14. [PMID: 32653987 PMCID: PMC7813706 DOI: 10.1007/s11604-020-01017-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023]
Abstract
After the introduction of the glymphatic system hypothesis, an increasing number of studies on cerebrospinal fluid and interstitial fluid dynamics within the brain have been investigated and reported. A series of diseases are known which develop due to abnormality of the glymphatic system including Alzheimer's disease, traumatic brain injury, stroke, or other disorders. These diseases or disorders share the characteristics of the glymphatic system dysfunction or other mechanisms related to the interstitial fluid dynamics. In this review article, we propose "Central Nervous System (CNS) Interstitial Fluidopathy" as a new concept encompassing diseases whose pathologies are majorly associated with abnormal interstitial fluid dynamics. Categorizing these diseases or disorders as "CNS interstitial fluidopathies," will promote the understanding of their mechanisms and the development of potential imaging methods for the evaluation of the disease as well as clinical methods for disease treatment or prevention. In other words, having a viewpoint of the dynamics of interstitial fluid appears relevant for understanding CNS diseases or disorders, and it would be possible to develop novel common treatment methods or medications for "CNS interstitial fluidopathies."
Collapse
Affiliation(s)
- Toshiaki Taoka
- Department of Innovative Biomedical Visualization (iBMV), Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan. .,Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
6
|
Quantification of visible Virchow-Robin spaces for detecting the functional status of the glymphatic system in children with newly diagnosed idiopathic generalized epilepsy. Seizure 2020; 78:12-17. [PMID: 32151968 DOI: 10.1016/j.seizure.2020.02.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The cerebral glymphatic system, particularly the Virchow-Robin Spaces (VRS), plays an important role in waste clearance from the brain. Idiopathic generalized epilepsy (IGE) is a common epilepsy type associated with blood-brain-barrier dysfunction, abnormal exchange of cerebrospinal fluid and interstitial fluid. These disorders may be reflected in the glymphatic system. Therefore, this study investigated the relationships between visible VRS on MRI and seizures, to detect changes in glymphatic function. METHODS We retrospectively included 32 children with newly diagnosed IGE and 30 controls aged 3-13 years. Visible VRS were identified using a custom-designed automated method. VRS counts and volume were quantified and compared between children with IGE and controls. Meanwhile, Correlations of VRS counts and volume with seizure duration and course after seizure onset were respectively explored via Spearman's coefficient (r). RESULTS In this study, visible VRS counts were higher in IGE than control group (VRS_epilepsy, 234.34 ± 113.88 vs. VRS_control, 111.83 ± 52.46; P < 0.001), as similar results were found in VRS volume (VRS_epilepsy, 1377.47 ± 778.79 mm3 vs. VRS_control, 795.153 ± 452.49 mm3; P = 0.001). Visible VRS counts and volume positively correlated with seizure duration (r_counts = 0.638, r_volume = 0.639; P < 0.001) and gradually decreased with time after seizure onset (r_counts = -0.559, r_volume = -0.558; P < 0.001). CONCLUSION Epileptic seizures can induce changes in VRS counts and volume, which were associated with seizure duration and post-onset course. Quantitative metrics of VRS visible on MRI might be potential biomarkers for monitoring glymphatic function.
Collapse
|
7
|
Husøy AK, Indergaard MK, Honningsvåg LM, Håberg AK, Hagen K, Linde M, Gårseth M, Stovner LJ. Perivascular spaces and headache: A population-based imaging study (HUNT-MRI). Cephalalgia 2015; 36:232-9. [DOI: 10.1177/0333102415587691] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/25/2015] [Indexed: 11/15/2022]
Abstract
Background In four previous clinic-based MRI studies headache sufferers (in particular migraineurs) had more perivascular spaces (PVS) than individuals who were headache-free. Methods The present study was part of a large longitudinal, epidemiological study (Nord-Trøndelag Health Survey (HUNT)). The 1006 participants, age 50–65 years at inclusion, had participated in all previous HUNT surveys (1–3), and been randomly selected to a population-based imaging study of the head (HUNT-MRI, 2007–2009). The number of visible PVS in the basal ganglia (BG) and hemispheric white matter (HWM) was compared in headache sufferers (migraine with and without aura, non-migrainous headache) and people who were headache-free. Results The results showed in general small differences between headache sufferers and headache-free participants. In the cross-sectional analysis migraineurs without aura had fewer PVS than headache-free individuals in BG (OR = 0.84, 95% CI = 0.76--0.94, p value = 0.003) and in BG and HWM together (OR = 0.97, 95% CI = 0.95-1.00, p value = 0.046). No difference between long-term headache sufferers and long-term headache-free individuals with regard to number of PVS was found. Discussion In contrast to previous studies, the present large, blinded, population-based study showed no increase in number of dilated PVS among headache sufferers. Fewer PVS among those with migraine without aura may be a spurious finding.
Collapse
Affiliation(s)
- Andreas Kattem Husøy
- Department of Neuroscience, Norwegian University of Science and Technology, Norway
| | | | | | - Asta K Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Norway
- Department of Medical Imaging, St Olavs University Hospital, Norway
| | - Knut Hagen
- Department of Neuroscience, Norwegian University of Science and Technology, Norway
- Norwegian National Headache Centre, St Olavs University Hospital, Norway
| | - Mattias Linde
- Department of Neuroscience, Norwegian University of Science and Technology, Norway
- Norwegian National Headache Centre, St Olavs University Hospital, Norway
| | - Mari Gårseth
- Department of Radiology, Levanger Hospital, Norway
| | - Lars Jacob Stovner
- Department of Neuroscience, Norwegian University of Science and Technology, Norway
- Norwegian National Headache Centre, St Olavs University Hospital, Norway
| |
Collapse
|