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Krijnen EA, Salim Karam E, Russo AW, Lee H, Chiang FL, Schoonheim MM, Huang SY, Klawiter EC. Intrinsic and extrinsic contributors to subregional thalamic volume loss in multiple sclerosis. Ann Clin Transl Neurol 2024; 11:1405-1419. [PMID: 38725151 PMCID: PMC11187835 DOI: 10.1002/acn3.52026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE To evaluate the intrinsic and extrinsic microstructural factors contributing to atrophy within individual thalamic subregions in multiple sclerosis using in vivo high-gradient diffusion MRI. METHODS In this cross-sectional study, 41 people with multiple sclerosis and 34 age and sex-matched healthy controls underwent 3T MRI with up to 300 mT/m gradients using a multi-shell diffusion protocol consisting of eight b-values and diffusion time of 19 ms. Each thalamus was parcellated into 25 subregions for volume determination and diffusion metric estimation. The soma and neurite density imaging model was applied to obtain estimates of intra-neurite, intra-soma, and extra-cellular signal fractions for each subregion and within structurally connected white matter trajectories and cortex. RESULTS Multiple sclerosis-related volume loss was more pronounced in posterior/medial subregions than anterior/ventral subregions. Intra-soma signal fraction was lower in multiple sclerosis, reflecting reduced cell body density, while the extra-cellular signal fraction was higher, reflecting greater extra-cellular space, both of which were observed more in posterior/medial subregions than anterior/ventral subregions. Lower intra-neurite signal fraction in connected normal-appearing white matter and lower intra-soma signal fraction of structurally connected cortex were associated with reduced subregional thalamic volumes. Intrinsic and extrinsic microstructural measures independently related to subregional volume with heterogeneity across atrophy-prone thalamic nuclei. Extrinsic microstructural alterations predicted left anteroventral, intrinsic microstructural alterations predicted bilateral medial pulvinar, and both intrinsic and extrinsic factors predicted lateral geniculate and medial mediodorsal volumes. INTERPRETATION Our results might be reflective of the involvement of anterograde and retrograde degeneration from white matter demyelination and cerebrospinal fluid-mediated damage in subregional thalamic volume loss.
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Affiliation(s)
- Eva A. Krijnen
- Department of NeurologyMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- MS Center Amsterdam, Anatomy and Neurosciences, Amsterdam NeuroscienceAmsterdam UMC, Location VUmcAmsterdamThe Netherlands
| | - Elsa Salim Karam
- Department of NeurologyMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Andrew W. Russo
- Department of NeurologyMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Hansol Lee
- Athinoula A. Martinos Center for Biomedical Imaging, Department of RadiologyMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusettsUSA
| | - Florence L. Chiang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of RadiologyMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusettsUSA
| | - Menno M. Schoonheim
- MS Center Amsterdam, Anatomy and Neurosciences, Amsterdam NeuroscienceAmsterdam UMC, Location VUmcAmsterdamThe Netherlands
| | - Susie Y. Huang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of RadiologyMassachusetts General Hospital, Harvard Medical SchoolCharlestownMassachusettsUSA
| | - Eric C. Klawiter
- Department of NeurologyMassachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
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Koubiyr I, Yamamoto T, Blyau S, Kamroui RA, Mansencal B, Planche V, Petit L, Saranathan M, Casey R, Ruet A, Brochet B, Manjón JV, Dousset V, Coupé P, Tourdias T. Vulnerability of Thalamic Nuclei at CSF Interface During the Entire Course of Multiple Sclerosis. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200222. [PMID: 38635941 PMCID: PMC11087027 DOI: 10.1212/nxi.0000000000200222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 01/19/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Thalamic atrophy can be used as a proxy for neurodegeneration in multiple sclerosis (MS). Some data point toward thalamic nuclei that could be affected more than others. However, the dynamic of their changes during MS evolution and the mechanisms driving their differential alterations are still uncertain. METHODS We paired a large cohort of 1,123 patients with MS with the same number of healthy controls, all scanned with conventional 3D-T1 MRI. To highlight the main atrophic regions at the thalamic nuclei level, we validated a segmentation strategy consisting of deep learning-based synthesis of sequences, which were used for automatic multiatlas segmentation. Then, through a lifespan-based approach, we could model the dynamics of the 4 main thalamic nuclei groups. RESULTS All analyses converged toward a higher rate of atrophy for the posterior and medial groups compared with the anterior and lateral groups. We also demonstrated that focal MS white matter lesions were associated with atrophy of groups of nuclei when specifically located within the associated thalamocortical projections. The volumes of the most affected posterior group, but also of the anterior group, were better associated with clinical disability than the volume of the whole thalamus. DISCUSSION These findings point toward the thalamic nuclei adjacent to the third ventricle as more susceptible to neurodegeneration during the entire course of MS through potentiation of disconnection effects by regional factors. Because this information can be obtained even from standard T1-weighted MRI, this paves the way toward such an approach for future monitoring of patients with MS.
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Affiliation(s)
- Ismail Koubiyr
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Takayuki Yamamoto
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Simon Blyau
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Reda A Kamroui
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Boris Mansencal
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Vincent Planche
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Laurent Petit
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Manojkumar Saranathan
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Romain Casey
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Aurélie Ruet
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Bruno Brochet
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - José V Manjón
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Vincent Dousset
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Pierrick Coupé
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
| | - Thomas Tourdias
- From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain
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Jung Y, Damoiseaux JS. The potential of blood neurofilament light as a marker of neurodegeneration for Alzheimer's disease. Brain 2024; 147:12-25. [PMID: 37540027 DOI: 10.1093/brain/awad267] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/22/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023] Open
Abstract
Over the past several years, there has been a surge in blood biomarker studies examining the value of plasma or serum neurofilament light (NfL) as a biomarker of neurodegeneration for Alzheimer's disease. However, there have been limited efforts to combine existing findings to assess the utility of blood NfL as a biomarker of neurodegeneration for Alzheimer's disease. In addition, we still need better insight into the specific aspects of neurodegeneration that are reflected by the elevated plasma or serum concentration of NfL. In this review, we survey the literature on the cross-sectional and longitudinal relationships between blood-based NfL levels and other, neuroimaging-based, indices of neurodegeneration in individuals on the Alzheimer's continuum. Then, based on the biomarker classification established by the FDA-NIH Biomarker Working group, we determine the utility of blood-based NfL as a marker for monitoring the disease status (i.e. monitoring biomarker) and predicting the severity of neurodegeneration in older adults with and without cognitive decline (i.e. a prognostic or a risk/susceptibility biomarker). The current findings suggest that blood NfL exhibits great promise as a monitoring biomarker because an increased NfL level in plasma or serum appears to reflect the current severity of atrophy, hypometabolism and the decline of white matter integrity, particularly in the brain regions typically affected by Alzheimer's disease. Longitudinal evidence indicates that blood NfL can be useful not only as a prognostic biomarker for predicting the progression of neurodegeneration in patients with Alzheimer's disease but also as a susceptibility/risk biomarker predicting the likelihood of abnormal alterations in brain structure and function in cognitively unimpaired individuals with a higher risk of developing Alzheimer's disease (e.g. those with a higher amyloid-β). There are still limitations to current research, as discussed in this review. Nevertheless, the extant literature strongly suggests that blood NfL can serve as a valuable prognostic and susceptibility biomarker for Alzheimer's disease-related neurodegeneration in clinical settings, as well as in research settings.
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Affiliation(s)
- Youjin Jung
- Department of Psychology, Wayne State University, Detroit, MI 48202, USA
- Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA
| | - Jessica S Damoiseaux
- Department of Psychology, Wayne State University, Detroit, MI 48202, USA
- Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA
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4
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Weeda MM, van Nederpelt DR, Twisk JWR, Brouwer I, Kuijer JPA, van Dam M, Hulst HE, Killestein J, Barkhof F, Vrenken H, Pouwels PJW. Multimodal MRI study on the relation between WM integrity and connected GM atrophy and its effect on disability in early multiple sclerosis. J Neurol 2024; 271:355-373. [PMID: 37716917 PMCID: PMC10769935 DOI: 10.1007/s00415-023-11937-2] [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: 05/26/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterized by pathology in white matter (WM) and atrophy of grey matter (GM), but it remains unclear how these processes are related, or how they influence clinical progression. OBJECTIVE To study the spatial and temporal relationship between GM atrophy and damage in connected WM in relapsing-remitting (RR) MS in relation to clinical progression. METHODS Healthy control (HC) and early RRMS subjects visited our center twice with a 1-year interval for MRI and clinical examinations, including the Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Functional Composite (MSFC) scores. RRMS subjects were categorized as MSFC decliners or non-decliners based on ΔMSFC over time. Ten deep (D)GM and 62 cortical (C) GM structures were segmented and probabilistic tractography was performed to identify the connected WM. WM integrity was determined per tract with, amongst others, fractional anisotropy (FA), mean diffusivity (MD), neurite density index (NDI), and myelin water fraction (MWF). Linear mixed models (LMMs) were used to investigate GM and WM differences between HC and RRMS, and between MSFC decliners and non-decliners. LMM was also used to test associations between baseline WM z-scores and changes in connected GM z-scores, and between baseline GM z-scores and changes in connected WM z-scores, in HC/RRMS subjects and in MSFC decliners/non-decliners. RESULTS We included 13 HCs and 31 RRMS subjects with an average disease duration of 3.5 years and a median EDSS of 3.0. Fifteen RRMS subjects showed declining MSFC scores over time, and they showed higher atrophy rates and greater WM integrity loss compared to non-decliners. Lower baseline WM integrity was associated with increased CGM atrophy over time in RRMS, but not in HC subjects. This effect was only seen in MSFC decliners, especially when an extended WM z-score was used, which included FA, MD, NDI and MWF. Baseline GM measures were not significantly related to WM integrity changes over time in any of the groups. DISCUSSION Lower baseline WM integrity was related to more cortical atrophy in RRMS subjects that showed clinical progression over a 1-year follow-up, while baseline GM did not affect WM integrity changes over time. WM damage, therefore, seems to drive atrophy more than conversely.
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Affiliation(s)
- Merlin M Weeda
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands.
| | - D R van Nederpelt
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - J W R Twisk
- Epidemiology and Data Science, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - I Brouwer
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - J P A Kuijer
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - M van Dam
- MS Center Amsterdam, Anatomy and Neurosciences, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - H E Hulst
- Health-, Medical-, and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - J Killestein
- MS Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - F Barkhof
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
- UCL Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London, London, UK
| | - H Vrenken
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - P J W Pouwels
- MS Center Amsterdam, Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
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Coupé P, Planche V, Mansencal B, Kamroui RA, Koubiyr I, Manjòn JV, Tourdias T. Lifespan neurodegeneration of the human brain in multiple sclerosis. Hum Brain Mapp 2023; 44:5602-5611. [PMID: 37615064 PMCID: PMC10619394 DOI: 10.1002/hbm.26464] [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: 03/14/2023] [Revised: 07/17/2023] [Accepted: 08/08/2023] [Indexed: 08/25/2023] Open
Abstract
Atrophy related to multiple sclerosis (MS) has been found at the early stages of the disease. However, the archetype dynamic trajectories of the neurodegenerative process, even prior to clinical diagnosis, remain unknown. We modeled the volumetric trajectories of brain structures across the entire lifespan using 40,944 subjects (38,295 healthy controls and 2649 MS patients). Then, we estimated the chronological progression of MS by assessing the divergence of lifespan trajectories between normal brain charts and MS brain charts. Chronologically, the first affected structure was the thalamus, then the putamen and the pallidum (around 4 years later), followed by the ventral diencephalon (around 7 years after thalamus) and finally the brainstem (around 9 years after thalamus). To a lesser extent, the anterior cingulate gyrus, insular cortex, occipital pole, caudate and hippocampus were impacted. Finally, the precuneus and accumbens nuclei exhibited a limited atrophy pattern. Subcortical atrophy was more pronounced than cortical atrophy. The thalamus was the most impacted structure with a very early divergence in life. Our experiments showed that lifespan models of most impacted structures could be an important tool for future preclinical/prodromal prognosis and monitoring of MS.
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Affiliation(s)
| | - Vincent Planche
- Univ. Bordeaux, CNRSBordeauxFrance
- Centre Mémoire Ressources Recherches, Pôle de Neurosciences Cliniques, CHU de BordeauxBordeauxFrance
| | | | | | - Ismail Koubiyr
- Inserm U1215 ‐ Neurocentre MagendieBordeauxFrance
- Service de Neuroimagerie diagnostique et thérapeutique, CHU de BordeauxBordeauxFrance
| | - José V. Manjòn
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de ValènciaValenciaSpain
| | - Thomas Tourdias
- Inserm U1215 ‐ Neurocentre MagendieBordeauxFrance
- Service de Neuroimagerie diagnostique et thérapeutique, CHU de BordeauxBordeauxFrance
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6
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Alkemade A, Großmann R, Bazin PL, Forstmann BU. Mixed methodology in human brain research: integrating MRI and histology. Brain Struct Funct 2023; 228:1399-1410. [PMID: 37365411 PMCID: PMC10335951 DOI: 10.1007/s00429-023-02675-2] [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: 04/26/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
Postmortem magnetic resonance imaging (MRI) can provide a bridge between histological observations and the in vivo anatomy of the human brain. Approaches aimed at the co-registration of data derived from the two techniques are gaining interest. Optimal integration of the two research fields requires detailed knowledge of the tissue property requirements for individual research techniques, as well as a detailed understanding of the consequences of tissue fixation steps on the imaging quality outcomes for both MRI and histology. Here, we provide an overview of existing studies that bridge between state-of-the-art imaging modalities, and discuss the background knowledge incorporated into the design, execution and interpretation of postmortem studies. A subset of the discussed challenges transfer to animal studies as well. This insight can contribute to furthering our understanding of the normal and diseased human brain, and to facilitate discussions between researchers from the individual disciplines.
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Affiliation(s)
- Anneke Alkemade
- Integrative Model-Based Cognitive Neuroscience Unit, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
| | - Rosa Großmann
- Integrative Model-Based Cognitive Neuroscience Unit, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Pierre-Louis Bazin
- Integrative Model-Based Cognitive Neuroscience Unit, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Birte U Forstmann
- Integrative Model-Based Cognitive Neuroscience Unit, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
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7
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Coupé P, Planche V, Mansencal B, Kamroui RA, Koubiyr I, Manjon JV, Tourdias T. Lifespan Neurodegeneration Of The Human Brain In Multiple Sclerosis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.14.532535. [PMID: 36993352 PMCID: PMC10055083 DOI: 10.1101/2023.03.14.532535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Background Atrophy related to Multiple Sclerosis (MS) has been found at the early stages of the disease. However, the archetype dynamic trajectories of the neurodegenerative process, even prior to clinical diagnosis, remain unknown. Methods We modeled the volumetric trajectories of brain structures across the entire lifespan using 40944 subjects (38295 healthy controls and 2649 MS patients). Then, we estimated the chronological progression of MS by assessing the divergence of lifespan trajectories between normal brain charts and MS brain charts. Results Chronologically, the first affected structure was the thalamus, then the putamen and the pallidum (3 years later), followed by the ventral diencephalon (7 years after thalamus) and finally the brainstem (9 years after thalamus). To a lesser extent, the anterior cingulate gyrus, insular cortex, occipital pole, caudate and hippocampus were impacted. Finally, the precuneus and accumbens nuclei exhibited a limited atrophy pattern. Conclusion Subcortical atrophy was more pronounced than cortical atrophy. The thalamus was the most impacted structure with a very early divergence in life. It paves the way toward utilization of these lifespan models for future preclinical/prodromal prognosis and monitoring of MS.
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Affiliation(s)
- Pierrick Coupé
- CNRS, Univ. Bordeaux, Bordeaux INP, LABRI, UMR5800, F-33400 Talence, France
| | - Vincent Planche
- Univ. Bordeaux, CNRS, UMR 5293, Institut des Maladies Neurodégénératives, F-33000 Bordeaux, France
- Centre Mémoire Ressources Recherches, Pôle de Neurosciences Cliniques, CHU de Bordeaux, F-33000 Bordeaux, France
| | - Boris Mansencal
- CNRS, Univ. Bordeaux, Bordeaux INP, LABRI, UMR5800, F-33400 Talence, France
| | - Reda A. Kamroui
- CNRS, Univ. Bordeaux, Bordeaux INP, LABRI, UMR5800, F-33400 Talence, France
| | - Ismail Koubiyr
- Inserm U1215 - Neurocentre Magendie, Bordeaux F-33000, France
- Service de Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
| | - José V. Manjon
- Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA), Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain
| | - Thomas Tourdias
- Inserm U1215 - Neurocentre Magendie, Bordeaux F-33000, France
- Service de Neuroimagerie diagnostique et thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
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8
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Lahna D, Roese N, Woltjer R, Boespflug EL, Schwartz D, Grinstead J, Dodge HH, Wall R, Kaye JA, Rooney WD, Silbert LC. Postmortem 7T MRI for guided histopathology and evaluation of cerebrovascular disease. J Neuropathol Exp Neurol 2022; 82:57-70. [PMID: 36343095 PMCID: PMC9764082 DOI: 10.1093/jnen/nlac103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Postmortem (PM) magnetic resonance imaging (MRI) can serve as a bridge between in vivo imaging and histology by connecting MRI observed macrostructural findings to histological staining and microstructural changes. Data were acquired from 20 formalin-fixed brains including T2, T1, PD, and T2*-weighted images of left hemispheres and 6-mm-thick coronal slices. Tissue slices were bisected, aligned to MR images and used to guide histological sampling. Markers of myelin and oligodendroglia alterations were semiquantitatively rated and compared within white matter hyperintensities (WMHs) and normal-appearing white matter. Tissue priors were created from 3T in vivo data and used to guide segmentation of WMH. PM WMH and hemisphere volumes were compared to volumes derived from in vivo data. PM T2 WMH and T1 hemisphere volumes were correlated with in vivo 3T FLAIR WMH and T1 hemisphere volumes. WMH showed significant myelin loss, decreased GFAP expression and increased vimentin expression. MR-visible perivascular spaces and cortical microvascular lesions were successfully captured on histopathological sections. PM MRI can quantify cerebrovascular disease burden and guide tissue sampling, allowing for more comprehensive characterization of cerebrovascular disease that may be used to study etiologies of age-related cognitive change.
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Affiliation(s)
- David Lahna
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Natalie Roese
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Randy Woltjer
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA
| | - Erin L Boespflug
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Daniel Schwartz
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Hiroko H Dodge
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rachel Wall
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA
| | - Jeffrey A Kaye
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Lisa C Silbert
- NIA-Layton Alzheimer’s Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
- Veterans Affairs Portland Health Care System, Portland, Oregon, USA
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9
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Chen X, Peng Y, Zheng Q, Luo D, Han Y, Luo Q, Zhu Q, Luo T, Li Y. The different damage patterns of short-, middle- and long-range connections between patients with relapse-remitting multiple sclerosis and neuromyelitis optica spectrum disorder. Front Immunol 2022; 13:1007335. [PMID: 36532033 PMCID: PMC9755727 DOI: 10.3389/fimmu.2022.1007335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/16/2022] [Indexed: 12/04/2022] Open
Abstract
Objective To investigate the differences in short-, middle- and long-range connections between patients with relapse-remitting multiple sclerosis (RRMS) and neuromyelitis optica spectrum disorder (NMOSD), and their correlation with brain tissue volume, structural and functional network parameters. Methods A total of 51 RRMS, 42 NMOSD and 56 health controls (HC) were recruited. Of these 25 RRMS (median: 1.37 years) and 20 NMOSD (median: 1.25 years) patients were also studied at follow-up. The whole-brain fiber connection was divided into three groups according to the trisected lengths of the tract in HC group, including short-, middle- and long-range connections. The brain tissue features (including total brain tissue and deep grey matter volumes) and parameters of DTI and functional networks (including the shortest path, clustering coefficient, local efficiency and global efficiency) were calculated. The differences in fiber number (FN) and average fractional anisotropy (FA) were compared between RRMS and NMOSD by the One-way ANOVA and post hoc tests. The correlation between the FN or FA and the brain tissue volume, DTI and functional network parameters were further analyzed by Pearson analysis. Results Compared to HC and NMOSD, the total number of fibers in RRMS was decreased, including the reduced FN of middle- and long-range connections, but increased FN of short-range connections. Compared to HC, the FA of three fibers in RRMS and NMOSD were reduced significantly, and the decrease of FA in RRMS was greater than in NMOSD. There were correlations between the FN of short-, and long-range connections and the atrophy of whole brain tissue in two diseases and structural network topological parameters in RRMS. Additionally, there was no significant difference of FN and FA in short-, middle- and long-range connections between the baseline and follow-up in two diseases. Conclusions RRMS and NMOSD patients have different patterns of fiber connection damage. The FN of different lengths in RRMS and NMOSD patients may be associated with brain atrophy. The FN and FA of different lengths may explain the decreased efficiency of the structural network in RRMS patients. In the short-term follow-up, neither has worsened damage of different fibers in two diseases.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Yongmei Li
- *Correspondence: Tianyou Luo, ; Yongmei Li,
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10
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Misin O, Matilainen M, Nylund M, Honkonen E, Rissanen E, Sucksdorff M, Airas L. Innate Immune Cell–Related Pathology in the Thalamus Signals a Risk for Disability Progression in Multiple Sclerosis. NEUROLOGY - NEUROIMMUNOLOGY NEUROINFLAMMATION 2022; 9:9/4/e1182. [PMID: 35581004 PMCID: PMC9128041 DOI: 10.1212/nxi.0000000000001182] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/17/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives Our aim was to investigate whether 18-kDa translocator protein (TSPO) radioligand binding in gray matter (GM) predicts later disability progression in multiple sclerosis (MS). Methods In this prospective imaging study, innate immune cells were investigated in the MS patient brain using PET imaging. The distribution volume ratio (DVR) of the TSPO-binding radioligand [11C]PK11195 was determined in 5 GM regions: thalamus, caudate, putamen, pallidum, and cortical GM. Volumetric brain MRI parameters were obtained for comparison. The Expanded Disability Status Scale (EDSS) score was assessed at baseline and after follow-up of 3.0 ± 0.3 (mean ± SD) years. Disability progression was defined as an EDSS score increase of 1.0 point or 0.5 point if the baseline EDSS score was ≥6.0. A forward-type stepwise logistic regression model was constructed to compare multiple imaging and clinical variables in their ability to predict later disability progression. Results The cohort consisted of 66 patients with MS and 18 healthy controls. Patients with later disability progression (n = 17) had more advanced atrophy in the thalamus, caudate, and putamen at baseline compared with patients with no subsequent worsening. TSPO binding was significantly higher in the thalamus among the patients with later worsening. The thalamic DVR was the only measured imaging variable that remained a significant predictor of disability progression in the regression model. The final model predicted disability progression with 52.9% sensitivity and 93.9% specificity with an area under the curve value of 0.82 (receiver operating characteristic curve). Discussion Increased TSPO radioligand binding in the thalamus has potential in predicting short-term disability progression in MS and seems to be more sensitive for this than GM atrophy measures.
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11
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Arnold DL, Sprenger T, Bar-Or A, Wolinsky JS, Kappos L, Kolind S, Bonati U, Magon S, van Beek J, Koendgen H, Bortolami O, Bernasconi C, Gaetano L, Traboulsee A. Ocrelizumab reduces thalamic volume loss in patients with RMS and PPMS. Mult Scler 2022; 28:1927-1936. [PMID: 35672926 PMCID: PMC9493406 DOI: 10.1177/13524585221097561] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: In multiple sclerosis (MS), thalamic integrity is affected directly by demyelination and neuronal loss, and indirectly by gray/white matter lesions outside the thalamus, altering thalamic neuronal projections. Objective: To assess the efficacy of ocrelizumab compared with interferon beta-1a (IFNβ1a)/placebo on thalamic volume loss and the effect of switching to ocrelizumab on volume change in the Phase III trials in relapsing MS (RMS, OPERA I/II; NCT01247324/NCT01412333) and in primary progressive MS (PPMS, ORATORIO; NCT01194570). Methods: Thalamic volume change was computed using paired Jacobian integration and analyzed using an adjusted mixed-effects repeated measurement model. Results: Over the double-blind period, ocrelizumab treatment significantly reduced thalamic volume loss with the largest effect size (Cohen’s d: RMS: 0.561 at week 96; PPMS: 0.427 at week 120) compared with whole brain, cortical gray matter, and white matter volume loss. At the end of up to 7 years of follow-up, patients initially randomized to ocrelizumab still showed less thalamic volume loss than those switching from IFNβ1a ( p < 0.001) or placebo ( p < 0.001). Conclusion: Ocrelizumab effectively reduced thalamic volume loss compared with IFNβ1a/placebo. Early treatment effects on thalamic tissue preservation persisted over time. Thalamic volume loss could be a potential sensitive marker of persisting tissue damage.
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Affiliation(s)
- Douglas L Arnold
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada/NeuroRx Research, Montreal, QC, Canada
| | - Till Sprenger
- Department of Neurology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany/Research Center for Clinical Neuroimmunology and Neuroscience and MS Center, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Amit Bar-Or
- Department of Neurology and Center for Neuroinflammation and Experimental Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jerry S Wolinsky
- McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Ludwig Kappos
- Research Center for Clinical Neuroimmunology and Neuroscience and MS Center, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | | | | | | | - Johan van Beek
- F. Hoffmann-La Roche Ltd, Basel, Switzerland/Biogen, Baar, Switzerland
| | - Harold Koendgen
- F. Hoffmann-La Roche Ltd, Basel, Switzerland/UCB Farchim SA, Bulle, Switzerland
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12
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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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13
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Riemenschneider M, Hvid LG, Ringgaard S, Nygaard MKE, Eskildsen SF, Gaemelke T, Magyari M, Jensen HB, Nielsen HH, Kant M, Falah M, Petersen T, Stenager E, Dalgas U. Investigating the potential disease-modifying and neuroprotective efficacy of exercise therapy early in the disease course of multiple sclerosis: The Early Multiple Sclerosis Exercise Study (EMSES). Mult Scler 2022; 28:1620-1629. [PMID: 35296183 DOI: 10.1177/13524585221079200] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Potential supplemental disease-modifying and neuroprotective treatment strategies are warranted in multiple sclerosis (MS). Exercise is a promising non-pharmacological approach, and an uninvestigated 'window of opportunity' exists early in the disease course. OBJECTIVE To investigate the effect of early exercise on relapse rate, global brain atrophy and secondary magnetic resonance imaging (MRI) outcomes. METHODS This randomized controlled trial (n = 84, disease duration <2 years) included 48 weeks of supervised aerobic exercise or control condition. Population-based control data (Danish MS Registry) was included (n = 850, disease duration <2 years). Relapse rates were obtained from medical records, and patients underwent structural and diffusion-kurtosis MRI at baseline, 24 and 48 weeks. RESULTS No between-group differences were observed for primary outcomes, relapse rate (incidence-rate-ratio exercise relative to control: (0.49 (0.15; 1.66), p = 0.25) and global brain atrophy rate (-0.04 (-0.48; 0.40)%, p = 0.87), or secondary measures of lesion load. Aerobic fitness increased in favour of the exercise group. Microstructural integrity was higher in four of eight a priori defined motor-related tracts and nuclei in the exercise group compared with the control (thalamus, corticospinal tract, globus pallidus, cingulate gyrus) at 48 weeks. CONCLUSION Early supervised aerobic exercise did not reduce relapse rate or global brain atrophy, but does positively affect the microstructural integrity of important motor-related tracts and nuclei.
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Affiliation(s)
| | - Lars G Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus C, Denmark/MS Hospitals in Denmark, The Danish MS Hospitals, Ry and Haslev, Denmark
| | - Steffen Ringgaard
- The MR Research Centre, Aarhus University Hospital, Aarhus N, Denmark
| | - Mikkel Karl Emil Nygaard
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
| | - Simon Fristed Eskildsen
- Center of Functionally Integrative Neuroscience, Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
| | - Tobias Gaemelke
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Melinda Magyari
- The Danish Multiple Sclerosis Registry, Department of Neurology, University Hospital Rigshospitalet, Glostrup, Denmark
| | - Henrik Boye Jensen
- Brain and Nerve Diseases, Lillebaelt Hospital, Kolding, Denmark/Department of Regional Health Research, University of Southern Denmark, Odense M, Denmark
| | | | - Matthias Kant
- MS-Clinics of Southern Jutland (Sønderborg, Esbjerg and Kolding), Department of Neurology, Sønderborg, Denmark
| | - Masoud Falah
- MS-Clinic Hospital Unit of Western Denmark, Department of Neurology, Holstebro, Denmark
| | - Thor Petersen
- The Multiple Sclerosis Clinic, Department of Neurology, Aarhus University Hospital, Aarhus N, Denmark
| | - Egon Stenager
- Department of Regional Health Research, University of Southern Denmark, Odense M, Denmark/MS-Clinics of Southern Jutland (Sønderborg, Esbjerg and Kolding), Department of Neurology, Sønderborg, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus C, Denmark
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14
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Kiely M, Triebswetter C, Cortina LE, Gong Z, Alsameen MH, Spencer RG, Bouhrara M. Insights into human cerebral white matter maturation and degeneration across the adult lifespan. Neuroimage 2022; 247:118727. [PMID: 34813969 PMCID: PMC8792239 DOI: 10.1016/j.neuroimage.2021.118727] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/15/2021] [Accepted: 11/12/2021] [Indexed: 01/01/2023] Open
Abstract
White matter (WM) microstructural properties change across the adult lifespan and with neuronal diseases. Understanding microstructural changes due to aging is paramount to distinguish them from neuropathological changes. Conducted on a large cohort of 147 cognitively unimpaired subjects, spanning a wide age range of 21 to 94 years, our study evaluated sex- and age-related differences in WM microstructure. Specifically, we used diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) indices, sensitive measures of myelin and axonal density in WM, and myelin water fraction (MWF), a measure of the fraction of the signal of water trapped within the myelin sheets, to probe these differences. Furthermore, we examined regional correlations between MWF and DTI indices to evaluate whether the DTI metrics provide information complementary to MWF. While sexual dimorphism was, overall, nonsignificant, we observed region-dependent differences in MWF, that is, myelin content, and axonal density with age and found that both exhibit nonlinear, but distinct, associations with age. Furthermore, DTI indices were moderately correlated with MWF, indicating their good sensitivity to myelin content as well as to other constituents of WM tissue such as axonal density. The microstructural differences captured by our MRI metrics, along with their weak to moderate associations with MWF, strongly indicate the potential value of combining these outcome measures in a multiparametric approach. Furthermore, our results support the last-in-first-out and the gain-predicts-loss hypotheses of WM maturation and degeneration. Indeed, our results indicate that the posterior WM regions are spared from neurodegeneration as compared to anterior regions, while WM myelination follows a temporally symmetric time course across the adult life span.
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Affiliation(s)
- Matthew Kiely
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, 21224 MD, USA
| | - Curtis Triebswetter
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, 21224 MD, USA
| | - Luis E Cortina
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, 21224 MD, USA
| | - Zhaoyuan Gong
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, 21224 MD, USA
| | - Maryam H Alsameen
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, 21224 MD, USA
| | - Richard G Spencer
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, 21224 MD, USA
| | - Mustapha Bouhrara
- Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, 21224 MD, USA.
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15
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Cooze BJ, Dickerson M, Loganathan R, Watkins LM, Grounds E, Pearson BR, Bevan RJ, Morgan BP, Magliozzi R, Reynolds R, Neal JW, Howell OW. The association between neurodegeneration and local complement activation in the thalamus to progressive multiple sclerosis outcome. Brain Pathol 2022; 32:e13054. [PMID: 35132719 PMCID: PMC9425007 DOI: 10.1111/bpa.13054] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/17/2021] [Accepted: 01/17/2022] [Indexed: 01/22/2023] Open
Abstract
The extent of grey matter demyelination and neurodegeneration in the progressive multiple sclerosis (PMS) brains at post‐mortem associates with more severe disease. Regional tissue atrophy, especially affecting the cortical and deep grey matter, including the thalamus, is prognostic for poor outcomes. Microglial and complement activation are important in the pathogenesis and contribute to damaging processes that underlie tissue atrophy in PMS. We investigated the extent of pathology and innate immune activation in the thalamus in comparison to cortical grey and white matter in blocks from 21 cases of PMS and 10 matched controls. Using a digital pathology workflow, we show that the thalamus is invariably affected by demyelination and had a far higher proportion of active inflammatory lesions than forebrain cortical tissue blocks from the same cases. Lesions were larger and more frequent in the medial nuclei near the ventricular margin, whilst neuronal loss was greatest in the lateral thalamic nuclei. The extent of thalamic neuron loss was not associated with thalamic demyelination but correlated with the burden of white matter pathology in other forebrain areas (Spearman r = 0.79, p < 0.0001). Only thalamic neuronal loss, and not that seen in other forebrain cortical areas, correlated with disease duration (Spearman r = −0.58, p = 0.009) and age of death (Spearman r = −0.47, p = 0.045). Immunoreactivity for the complement pattern recognition molecule C1q, and products of complement activation (C4d, Bb and C3b) were elevated in thalamic lesions with an active inflammatory pathology. Complement regulatory protein, C1 inhibitor, was unchanged in expression. We conclude that active inflammatory demyelination, neuronal loss and local complement synthesis and activation in the thalamus, are important to the pathological and clinical disease outcomes of PMS.
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Affiliation(s)
- Benjamin J Cooze
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Matthew Dickerson
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | | | - Lewis M Watkins
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Ethan Grounds
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Ben R Pearson
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Ryan Jack Bevan
- UK Dementia Research Institute at Cardiff University, Cardiff, UK
| | - B Paul Morgan
- UK Dementia Research Institute at Cardiff University, Cardiff, UK
| | - Roberta Magliozzi
- Department of Neurological and Movement Sciences, University of Verona, Italy
| | | | - James W Neal
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
| | - Owain W Howell
- Faculty of Medical, Health and Life Sciences, Swansea University, Swansea, UK
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16
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van Veluw SJ, Arfanakis K, Schneider JA. Neuropathology of Vascular Brain Health: Insights From Ex Vivo Magnetic Resonance Imaging-Histopathology Studies in Cerebral Small Vessel Disease. Stroke 2022; 53:404-415. [PMID: 35000425 PMCID: PMC8830602 DOI: 10.1161/strokeaha.121.032608] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Sporadic cerebral small vessel disease (SVD) is a major contributor to vascular cognitive impairment and dementia in the aging human brain. On neuropathology, sporadic SVD is characterized by abnormalities to the small vessels of the brain predominantly in the form of cerebral amyloid angiopathy and arteriolosclerosis. These pathologies frequently coexist with Alzheimer disease changes, such as plaques and tangles, in a single brain. Conversely, during life, magnetic resonance imaging (MRI) only captures the larger manifestations of SVD in the form of parenchymal brain abnormalities. There appears to be a major knowledge gap regarding the underlying neuropathology of individual MRI-detectable SVD abnormalities. Ex vivo MRI in postmortem human brain tissue is a powerful tool to bridge this gap. This review summarizes current insights into the histopathologic correlations of MRI manifestations of SVD, their underlying cause, presumed pathophysiology, and associated secondary tissue injury. Moreover, we discuss the advantages and limitations of ex vivo MRI-guided histopathologic investigations and make recommendations for future studies.
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Affiliation(s)
- Susanne J. van Veluw
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital, Charlestown, MA, USA,Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA,Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA,Departments of Pathology and Neurological Sciences, Rush University Medical Center, Chicago IL, USA
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17
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Rivera-Urbina GN, Molero-Chamizo A, Nitsche MA. Discernible effects of tDCS over the primary motor and posterior parietal cortex on different stages of motor learning. Brain Struct Funct 2022; 227:1115-1131. [PMID: 35037127 DOI: 10.1007/s00429-021-02451-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/29/2021] [Indexed: 11/28/2022]
Abstract
Implicit motor learning and memory involve complex cortical and subcortical networks. The induction of plasticity in these network components via non-invasive brain stimulation, including transcranial direct current stimulation (tDCS), has shown to improve motor learning. However, studies showing these effects are mostly restricted to stimulation of the primary motor cortex (M1) during the early stage of learning. Because of this, we aimed to explore the efficacy of anodal tDCS applied over the posterior parietal cortex (PPC), which is involved in memory processes, on serial reaction time task (SRTT) performance. Specifically, to evaluate the involvement of both motor learning network components, we compared the effects of tDCS applied over regions corresponding to M1 and PPC during the early and late stages of learning. The results revealed a selective improvement of reaction time (RT) during anodal stimulation over the PPC in the late stage of learning. These findings support the assumption that the PPC is relevant during specific phases of learning, at least for SRTT performance. The results also indicate that not only the target area (i.e., PPC), but also timing is crucial for achieving the effects of stimulation on motor learning.
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Affiliation(s)
- Guadalupe Nathzidy Rivera-Urbina
- Autonomous University of Baja California, Blvd Juan A Zertuche y Blvd de los Lagos s/n Fracc, Valle Dorado, C.P. 22890, Ensenada, Baja California, México.
| | | | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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18
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Bussas M, Grahl S, Pongratz V, Berthele A, Gasperi C, Andlauer T, Gaser C, Kirschke JS, Wiestler B, Zimmer C, Hemmer B, Mühlau M. Gray matter atrophy in relapsing-remitting multiple sclerosis is associated with white matter lesions in connecting fibers. Mult Scler 2021; 28:900-909. [PMID: 34591698 PMCID: PMC9024016 DOI: 10.1177/13524585211044957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Lesions of brain white matter (WM) and atrophy of brain gray matter (GM) are well-established surrogate parameters in multiple sclerosis (MS), but it is unclear how closely these parameters relate to each other. Objective: To assess across the whole cerebrum whether GM atrophy can be explained by lesions in connecting WM tracts. Methods: GM images of 600 patients with relapsing-remitting MS (women = 68%; median age = 33.0 years, median expanded disability status scale score = 1.5) were converted to atrophy maps by data from a healthy control cohort. An atlas of WM tracts from the Human Connectome Project and individual lesion maps were merged to identify potentially disconnected GM regions, leading to individual disconnectome maps. Across the whole cerebrum, GM atrophy and potentially disconnected GM were tested for association both cross-sectionally and longitudinally. Results: We found highly significant correlations between disconnection and atrophy across most of the cerebrum. Longitudinal analysis demonstrated a close temporal relation of WM lesion formation and GM atrophy in connecting fibers. Conclusion: GM atrophy is associated with WM lesions in connecting fibers. Caution is warranted when interpreting group differences in GM atrophy exclusively as differences in early neurodegeneration independent of WM lesion formation.
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Affiliation(s)
- Matthias Bussas
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany/TUM-Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sophia Grahl
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany/TUM-Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Viola Pongratz
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany/TUM-Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
| | - Achim Berthele
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christiane Gasperi
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Till Andlauer
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Christian Gaser
- Department of Psychiatry and Department of Neurology, Jena University Hospital, Jena, Germany
| | - Jan S Kirschke
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Benedikt Wiestler
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Bernhard Hemmer
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany/Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mark Mühlau
- Department of Neurology, School of Medicine, Technical University of Munich, Munich, Germany/TUM-Neuroimaging Center, School of Medicine, Technical University of Munich, Munich, Germany
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19
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Ontaneda D, Raza PC, Mahajan KR, Arnold DL, Dwyer MG, Gauthier SA, Greve DN, Harrison DM, Henry RG, Li DKB, Mainero C, Moore W, Narayanan S, Oh J, Patel R, Pelletier D, Rauscher A, Rooney WD, Sicotte NL, Tam R, Reich DS, Azevedo CJ. Deep grey matter injury in multiple sclerosis: a NAIMS consensus statement. Brain 2021; 144:1974-1984. [PMID: 33757115 PMCID: PMC8370433 DOI: 10.1093/brain/awab132] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/13/2022] Open
Abstract
Although multiple sclerosis has traditionally been considered a white matter disease, extensive research documents the presence and importance of grey matter injury including cortical and deep regions. The deep grey matter exhibits a broad range of pathology and is uniquely suited to study the mechanisms and clinical relevance of tissue injury in multiple sclerosis using magnetic resonance techniques. Deep grey matter injury has been associated with clinical and cognitive disability. Recently, MRI characterization of deep grey matter properties, such as thalamic volume, have been tested as potential clinical trial end points associated with neurodegenerative aspects of multiple sclerosis. Given this emerging area of interest and its potential clinical trial relevance, the North American Imaging in Multiple Sclerosis (NAIMS) Cooperative held a workshop and reached consensus on imaging topics related to deep grey matter. Herein, we review current knowledge regarding deep grey matter injury in multiple sclerosis from an imaging perspective, including insights from histopathology, image acquisition and post-processing for deep grey matter. We discuss the clinical relevance of deep grey matter injury and specific regions of interest within the deep grey matter. We highlight unanswered questions and propose future directions, with the aim of focusing research priorities towards better methods, analysis, and interpretation of results.
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Affiliation(s)
- Daniel Ontaneda
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Praneeta C Raza
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Kedar R Mahajan
- Cleveland Clinic Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland, OH 44195, USA
| | - Douglas L Arnold
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, The State University of New York, Buffalo, NY 14214, USA
| | - Susan A Gauthier
- Department of Neurology, Weill Cornell Medicine, New York, NY 10021, USA
| | - Douglas N Greve
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02129, USA
| | - Daniel M Harrison
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Roland G Henry
- Department of Neurology, Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA
- The UC San Francisco and Berkeley Bioengineering Graduate Group, University of California San Francisco, San Francisco, CA 94143, USA
| | - David K B Li
- Department of Radiology and Medicine (Neurology), University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
| | - Caterina Mainero
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA 02129, USA
- Department of Radiology, Harvard Medical School, Boston, MA 02129, USA
| | - Wayne Moore
- Department of Pathology and Laboratory Medicine, and International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Sridar Narayanan
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Jiwon Oh
- Division of Neurology, St. Michael’s Hospital, University of Toronto, Toronto, Ontario M5B 1W8, Canada
| | - Raihaan Patel
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec H4H 1R3, Canada
- Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Daniel Pelletier
- Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
| | - Alexander Rauscher
- Physics and Astronomy, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - William D Rooney
- Advanced Imaging Research Center, Oregon Health and Science University, Portland, OR 97239, USA
| | - Nancy L Sicotte
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Roger Tam
- Department of Radiology and Medicine (Neurology), University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
- Biomedical Engineering, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada
| | - Daniel S Reich
- Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20824, USA
| | - Christina J Azevedo
- Department of Neurology, University of Southern California Keck School of Medicine, Los Angeles, CA 90033, USA
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20
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Zhang M, Ni Y, Zhou Q, He L, Meng H, Gao Y, Huang X, Meng H, Li P, Chen M, Wang D, Hu J, Huang Q, Li Y, Chauveau F, Li B, Chen S. 18F-florbetapir PET/MRI for quantitatively monitoring myelin loss and recovery in patients with multiple sclerosis: A longitudinal study. EClinicalMedicine 2021; 37:100982. [PMID: 34195586 PMCID: PMC8234356 DOI: 10.1016/j.eclinm.2021.100982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 05/19/2021] [Accepted: 06/02/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Amyloid positron emission tomography (PET) can measure in-vivo demyelination in patients with multiple sclerosis (MS). However, the value of 18F-labeled amyloid PET tracer, 18F-florbetapir in the longitudinal study for monitoring myelin loss and recovery has not been confirmed. METHODS From March 2019 to September 2020, twenty-three patients with MS and nine healthy controls (HCs) underwent a hybrid PET/MRI at baseline and expanded disability status scale (EDSS) assessment, and eight of 23 patients further underwent follow-up PET/MRI. The distribution volume ratio (DVR) and standard uptake value ratio (SUVR) of 18F-florbetapir in damaged white matter (DWM) and normal-appearance white matter (NAWM) were obtained from dynamic and static PET acquisition. Diffusion tensor imaging-derived parameters were also calculated. Data were expressed as mean ± standard deviation with 99% confidence interval (99%CI). FINDING The mean DVR (1.08 ± 0.12, 99%CI [1.02 ~ 1.14]) but not the mean SUVR of DWM lesions was lower than that of NAWM in patients with MS (1.25 ± 0.10, 99%CI [1.20 ~ 1.31]) and HCs (1.29 ± 0.08, 99%CI [1.23 ~ 1.36]). A trend toward lower mean fractional anisotropy (374.95 ± 45.30 vs. 419.07 ± 4.83) and higher mean radial diffusivity (0.45 ± 0.05 vs. 0.40 ± 0.01) of NAWM in patients with MS than those in HCs was found. DVR decreased in DWM lesions with higher MD (rho = -0.261, 99%CI [-0.362 ~ -0.144]), higher AD (rho = -0.200, 99%CI [-0.318 ~ -0.070]) and higher RD (rho = -0.198, 99%CI [-0.313 ~ -0.075]). Patients' EDSS scores were reduced (B = 0.04, 99%CI [-0.005 ~ 0.084]) with decreased index of global demyelination in the longitudinal study. INTERPRETATION Our exploratory study suggests that dynamic 18F-florbetapir PET/MRI may be a very promising tool for quantitatively monitoring myelin loss and recovery in patients with MS. FUNDING Shanghai Pujiang Program, Shanghai Municipal Key Clinical Specialty, Shanghai Shuguang Plan Project, Shanghai Health and Family Planning Commission Research Project, Clinical Research Plan of SHDC, French-Chinese program "Xu Guangqi".
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Affiliation(s)
- Min Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You Ni
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - Qinming Zhou
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - Lu He
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - Huanyu Meng
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - Yining Gao
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
| | - Xinyun Huang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongping Meng
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peihan Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Meidi Chen
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Danni Wang
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyi Hu
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qiu Huang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Fabien Chauveau
- Univ Lyon, Lyon Neuroscience research Center, CNRS UMR5292, INSERM U1028, Univ Lyon 1, Lyon, France
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sheng Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China
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21
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Trans-synaptic degeneration in the visual pathway: Neural connectivity, pathophysiology, and clinical implications in neurodegenerative disorders. Surv Ophthalmol 2021; 67:411-426. [PMID: 34146577 DOI: 10.1016/j.survophthal.2021.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
There is a strong interrelationship between eye and brain diseases. It has been shown that neurodegenerative changes can spread bidirectionally in the visual pathway along neuronal projections. For example, damage to retinal ganglion cells in the retina leads to degeneration of the visual cortex (anterograde degeneration) and vice versa (retrograde degeneration). The underlying mechanisms of this process, known as trans-synaptic degeneration (TSD), are unknown, but TSD contributes to the progression of numerous neurodegenerative disorders, leading to clinical and functional deterioration. The hierarchical structure of the visual system comprises of a strong topographic connectivity between the retina and the visual cortex and therefore serves as an ideal model to study the cellular effect, clinical manifestations, and deterioration extent of TSD. With this review we provide comprehensive information about the neural connectivity, synapse function, molecular changes, and pathophysiology of TSD in visual pathways. We then discuss its bidirectional nature and clinical implications in neurodegenerative diseases. A thorough understanding of TSD in the visual pathway can provide insights into progression of neurodegenerative disorders and its potential as a therapeutic target.
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22
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Demyelination and remyelination detected in an alternative cuprizone mouse model of multiple sclerosis with 7.0 T multiparameter magnetic resonance imaging. Sci Rep 2021; 11:11060. [PMID: 34040141 PMCID: PMC8155133 DOI: 10.1038/s41598-021-90597-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 05/11/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to investigate the mechanisms underlying demyelination and remyelination with 7.0 T multiparameter magnetic resonance imaging (MRI) in an alternative cuprizone (CPZ) mouse model of multiple sclerosis (MS). Sixty mice were divided into six groups (n = 10, each), and these groups were imaged with 7.0 T multiparameter MRI and treated with an alternative CPZ administration schedule. T2-weighted imaging (T2WI), susceptibility-weighted imaging (SWI), and diffusion tensor imaging (DTI) were used to compare the splenium of the corpus callosum (sCC) among the groups. Prussian blue and Luxol fast blue staining were performed to assess pathology. The correlations of the mean grayscale value (mGSV) of the pathology results and the MRI metrics were analyzed to evaluate the multiparameter MRI results. One-way ANOVA and post hoc comparison showed that the normalized T2WI (T2-nor), fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) values were significantly different among the six groups, while the mean phase (Φ) value of SWI was not significantly different among the groups. Correlation analysis showed that the correlation between the T2-nor and mGSV was higher than that among the other values. The correlations among the FA, RD, MD, and mGSV remained instructive. In conclusion, ultrahigh-field multiparameter MRI can reflect the pathological changes associated with and the underlying mechanisms of demyelination and remyelination in MS after the successful establishment of an acute CPZ-induced model.
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23
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De Meo E, Storelli L, Moiola L, Ghezzi A, Veggiotti P, Filippi M, Rocca MA. In vivo gradients of thalamic damage in paediatric multiple sclerosis: a window into pathology. Brain 2021; 144:186-197. [PMID: 33221873 DOI: 10.1093/brain/awaa379] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/12/2020] [Accepted: 08/21/2020] [Indexed: 01/01/2023] Open
Abstract
The thalamus represents one of the first structures affected by neurodegenerative processes in multiple sclerosis. A greater thalamic volume reduction over time, on its CSF side, has been described in paediatric multiple sclerosis patients. However, its determinants and the underlying pathological changes, likely occurring before this phenomenon becomes measurable, have never been explored. Using a multiparametric magnetic resonance approach, we quantified, in vivo, the different processes that can involve the thalamus in terms of focal lesions, microstructural damage and atrophy in paediatric multiple sclerosis patients and their distribution according to the distance from CSF/thalamus interface and thalamus/white matter interface. In 70 paediatric multiple sclerosis patients and 26 age- and sex-matched healthy controls, we tested for differences in thalamic volume and quantitative MRI metrics-including fractional anisotropy, mean diffusivity and T1/T2-weighted ratio-in the whole thalamus and in thalamic white matter, globally and within concentric bands originating from CSF/thalamus interface. In paediatric multiple sclerosis patients, the relationship of thalamic abnormalities with cortical thickness and white matter lesions was also investigated. Compared to healthy controls, patients had significantly increased fractional anisotropy in whole thalamus (f2 = 0.145; P = 0.03), reduced fractional anisotropy (f2 = 0.219; P = 0.006) and increased mean diffusivity (f2 = 0.178; P = 0.009) in thalamic white matter and a trend towards a reduced thalamic volume (f2 = 0.027; P = 0.058). By segmenting the whole thalamus and thalamic white matter into concentric bands, in paediatric multiple sclerosis we detected significant fractional anisotropy abnormalities in bands nearest to CSF (f2 = 0.208; P = 0.002) and in those closest to white matter (f2 range = 0.183-0.369; P range = 0.010-0.046), while we found significant mean diffusivity (f2 range = 0.101-0.369; P range = 0.018-0.042) and T1/T2-weighted ratio (f2 = 0.773; P = 0.001) abnormalities in thalamic bands closest to CSF. The increase in fractional anisotropy and decrease in mean diffusivity detected at the CSF/thalamus interface correlated with cortical thickness reduction (r range = -0.27-0.34; P range = 0.004-0.028), whereas the increase in fractional anisotropy detected at the thalamus/white matter interface correlated with white matter lesion volumes (r range = 0.24-0.27; P range = 0.006-0.050). Globally, our results support the hypothesis of heterogeneous pathological processes, including retrograde degeneration from white matter lesions and CSF-mediated damage, leading to thalamic microstructural abnormalities, likely preceding macroscopic tissue loss. Assessing thalamic microstructural changes using a multiparametric magnetic resonance approach may represent a target to monitor the efficacy of neuroprotective strategies early in the disease course.
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Affiliation(s)
- Ermelinda De Meo
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Loredana Storelli
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lucia Moiola
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Ghezzi
- Multiple Sclerosis Center, Ospedale di Gallarate, Gallarate, Italy
| | - Pierangelo Veggiotti
- Paediatric Neurology Unit, V. Buzzi Children's Hospital, Milan, Italy.,Biomedical and Clinical Science Department, University of Milan, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Identifying multiple sclerosis subtypes using unsupervised machine learning and MRI data. Nat Commun 2021; 12:2078. [PMID: 33824310 PMCID: PMC8024377 DOI: 10.1038/s41467-021-22265-2] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
Multiple sclerosis (MS) can be divided into four phenotypes based on clinical evolution. The pathophysiological boundaries of these phenotypes are unclear, limiting treatment stratification. Machine learning can identify groups with similar features using multidimensional data. Here, to classify MS subtypes based on pathological features, we apply unsupervised machine learning to brain MRI scans acquired in previously published studies. We use a training dataset from 6322 MS patients to define MRI-based subtypes and an independent cohort of 3068 patients for validation. Based on the earliest abnormalities, we define MS subtypes as cortex-led, normal-appearing white matter-led, and lesion-led. People with the lesion-led subtype have the highest risk of confirmed disability progression (CDP) and the highest relapse rate. People with the lesion-led MS subtype show positive treatment response in selected clinical trials. Our findings suggest that MRI-based subtypes predict MS disability progression and response to treatment and may be used to define groups of patients in interventional trials. Multiple sclerosis is a heterogeneous progressive disease. Here, the authors use an unsupervised machine learning algorithm to determine multiple sclerosis subtypes, progression, and response to potential therapeutic treatments based on neuroimaging data.
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25
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Ricigliano VA, Tonietto M, Palladino R, Poirion E, De Luca A, Branzoli F, Bera G, Maillart E, Stankoff B, Bodini B. Thalamic energy dysfunction is associated with thalamo-cortical tract damage in multiple sclerosis: A diffusion spectroscopy study. Mult Scler 2021; 27:528-538. [PMID: 33566723 DOI: 10.1177/1352458520921362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Diffusion-weighted 1H magnetic resonance spectroscopy (DW-MRS) allows to quantify creatine-phosphocreatine brain diffusivity (ADC(tCr)), whose reduction in multiple sclerosis (MS) has been proposed as a proxy of energy dysfunction. OBJECTIVE To investigate whether thalamic ADC(tCr) changes are associated with thalamo-cortical tract damage in MS. METHODS Twenty patients with MS and 13 healthy controls (HC) were enrolled in a DW-MRS and DW imaging (DWI) study. From DW-MRS, ADC(tCr) and total N-acetyl-aspartate diffusivity (ADC(tNAA)) were extracted in the thalami. Three thalamo-cortical tracts and one non-thalamic control tract were reconstructed from DWI. Fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD), reflecting microstructural integrity, were extracted for each tract. Associations between thalamic ADC(tCr) and tract metrics were assessed using linear regression models adjusting for age, sex, thalamic volume, thalamic ADC(tNAA), and tract-specific lesion load. RESULTS Lower thalamic ADC(tCr) was associated with higher MD and RD of thalamo-cortical projections in MS (MD: p = 0.029; RD: p = 0.017), but not in HC (MD: p = 0.625, interaction term between thalamic ADC(tCr) and group = 0.019; RD: p = 0.320, interaction term = 0.05). Thalamic ADC(tCr) was not associated with microstructural changes of the control tract. CONCLUSION Reduced thalamic ADC(tCr) correlates with thalamo-cortical tract damage in MS, showing that pathologic changes in thalamic energy metabolism are associated with structural degeneration of connected fibers.
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Affiliation(s)
- Vito Ag Ricigliano
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France
| | - Matteo Tonietto
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France / Paris-Saclay University, CEA, CNRS, Inserm, BioMaps, Service Hospitalier Fréderic Joliot, Orsay, France
| | - Raffaele Palladino
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK/Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Emilie Poirion
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France
| | - Alberto De Luca
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Francesca Branzoli
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France / Centre de Neuroimagerie de la Recherche, Paris Brain Institute, ICM, Paris, France
| | - Geraldine Bera
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France
| | | | - Bruno Stankoff
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France / Neurology Department, St Antoine Hospital, APHP, Paris, France
| | - Benedetta Bodini
- Sorbonne University, Paris Brain Institute, ICM, Pitié Salpêtrière Hospital, Inserm UMR S 1127, CNRS UMR 7225, Paris, France / Neurology Department, St Antoine Hospital, APHP, Paris, France
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26
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Qian W, Khattar N, Cortina LE, Spencer RG, Bouhrara M. Nonlinear associations of neurite density and myelin content with age revealed using multicomponent diffusion and relaxometry magnetic resonance imaging. Neuroimage 2020; 223:117369. [PMID: 32931942 PMCID: PMC7775614 DOI: 10.1016/j.neuroimage.2020.117369] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 12/18/2022] Open
Abstract
Most magnetic resonance imaging (MRI) studies investigating the relationship between regional brain myelination or axonal density and aging have relied upon nonspecific methods to probe myelin and axonal content, including diffusion tensor imaging and relaxation time mapping. While these studies have provided pivotal insights into changes in cerebral architecture with aging and pathology, details of the underlying microstructural alterations have not been fully elucidated. In the current study, we used the BMC-mcDESPOT analysis, a direct and specific multicomponent relaxometry method for imaging of myelin water fraction (MWF), a marker of myelin content, and NODDI, an emerging multicomponent diffusion technique, for neurite density index (NDI) imaging, a proxy of axonal density. We investigated age-related differences in MWF and NDI in several white matter brain regions in a cohort of cognitively unimpaired participants over a wide age range. Our results indicate a quadratic, inverted U-shape, relationship between MWF and age in all brain regions investigated, suggesting that myelination continues until middle age followed by a decrease at older ages, in agreement with previous work. We found a similarly complex regional association between NDI and age, with several cerebral structures also exhibiting a quadratic, inverted U-shape, relationship. This novel observation suggests an increase in axonal density until the fourth decade of age followed by a rapid loss at older ages. We also observed that these age-related differences in MWF and NDI vary across different brain regions, as expected. Finally, our study indicates no significant association between MWF and NDI in most cerebral structures investigated, although this association approached significance in a limited number of brain regions, indicating the complementary nature of their information and encouraging further investigation. Overall, we find evidence of nonlinear associations between age and myelin or axonal density in a sample of well-characterized adults, using direct myelin and axonal content imaging methods.
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Affiliation(s)
- Wenshu Qian
- Magnetic Resonance Physics of Aging and Dementia Unit, Laboratory of Clinical Investigations, National Institute on Aging, National Institutes of Health, NIA, NIH, 251 Bayview Blvd., Baltimore, MD 21224, USA
| | - Nikkita Khattar
- Magnetic Resonance Physics of Aging and Dementia Unit, Laboratory of Clinical Investigations, National Institute on Aging, National Institutes of Health, NIA, NIH, 251 Bayview Blvd., Baltimore, MD 21224, USA
| | - Luis E Cortina
- Magnetic Resonance Physics of Aging and Dementia Unit, Laboratory of Clinical Investigations, National Institute on Aging, National Institutes of Health, NIA, NIH, 251 Bayview Blvd., Baltimore, MD 21224, USA
| | - Richard G Spencer
- Magnetic Resonance Physics of Aging and Dementia Unit, Laboratory of Clinical Investigations, National Institute on Aging, National Institutes of Health, NIA, NIH, 251 Bayview Blvd., Baltimore, MD 21224, USA
| | - Mustapha Bouhrara
- Magnetic Resonance Physics of Aging and Dementia Unit, Laboratory of Clinical Investigations, National Institute on Aging, National Institutes of Health, NIA, NIH, 251 Bayview Blvd., Baltimore, MD 21224, USA.
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27
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Rothstein TL. Gray Matter Matters: A Longitudinal Magnetic Resonance Voxel-Based Morphometry Study of Primary Progressive Multiple Sclerosis. Front Neurol 2020; 11:581537. [PMID: 33281717 PMCID: PMC7689315 DOI: 10.3389/fneur.2020.581537] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/14/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Multiple Sclerosis (MS) lesions in white matter (WM) are easily detected with conventional MRI which induce inflammation thereby generating contrast. WM lesions do not consistently explain the extent of clinical disability, cognitive impairment, or the source of an exacerbation. Gray matter (GM) structures including the cerebral cortex and various deep nuclei are known to be affected early in Primary Progressive Multiple Sclerosis (PPMS) and drive disease progression, disability, fatigue, and cognitive dysfunction. However, little is known about how rapidly GM lesions develop and accumulate over time. Objective: The purpose of this study is to analyze the degree and rate of progression in 25 patients with PPMS using voxel-based automated volumetric quantitation. Methods: This is a retrospective single-center study which includes a cohort of 25 patients with PPMS scanned utilizing NeuroQuant® 3 dimensional voxel-based morphometry (3D VBM) automated analysis and database and restudied after a period of ~1 year (11–14 months). Comparisons with normative data were acquired for whole brain, forebrain parenchyma, cortical GM, hippocampus, thalamus, superior and inferior lateral ventricles. GM volume changes were correlated with their clinical motor and cognitive scores using Extended Disability Status Scales (EDSS) and Montreal Cognitive Assessments (MoCA). Results: Steep reductions occurred in cerebral cortical GM and deep GM nuclei volumes which correlated with each patient's clinical and cognitive impairment. The median observed percentile volume losses were statistically significant compared with the 50th percentile for each GM component. Longitudinal assessments of an unselected sample of one dozen patients involved in the PPMS study showed prominent losses occurring mainly in cortical GM and hippocampus which were reflected in their EDSS and MoCA. The longitudinal results were compared with a similar sample of patients having Relapsing MS (RMS) whose GM values were largely in normal range, annualized volume GM changes were much less, while WM hyperintensities were in abnormal range in half the unselected cases. Conclusions: Knowledge of the degree and rapidity with which cortical atrophy and deep GM volume loss develops clarifies the source of progressive cognitive and clinical decline in PPMS.
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Affiliation(s)
- Ted L Rothstein
- Department of Neurology, Multiple Sclerosis Clinical Care and Research Center, George Washington University School of Medicine, Washington, DC, United States
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28
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Anurova I, Carlson S, Rauschecker JP. Overlapping Anatomical Networks Convey Cross-Modal Suppression in the Sighted and Coactivation of "Visual" and Auditory Cortex in the Blind. Cereb Cortex 2020; 29:4863-4876. [PMID: 30843062 DOI: 10.1093/cercor/bhz021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/09/2019] [Accepted: 01/29/2019] [Indexed: 12/13/2022] Open
Abstract
In the present combined DTI/fMRI study we investigated adaptive plasticity of neural networks involved in controlling spatial and nonspatial auditory working memory in the early blind (EB). In both EB and sighted controls (SC), fractional anisotropy (FA) within the right inferior longitudinal fasciculus correlated positively with accuracy in a one-back sound localization but not sound identification task. The neural tracts passing through the cluster of significant correlation connected auditory and "visual" areas in the right hemisphere. Activity in these areas during both sound localization and identification correlated with FA within the anterior corpus callosum, anterior thalamic radiation, and inferior fronto-occipital fasciculus. In EB, FA in these structures correlated positively with activity in both auditory and "visual" areas, whereas FA in SC correlated positively with activity in auditory and negatively with activity in visual areas. The results indicate that frontal white matter conveys cross-modal suppression of occipital areas in SC, while it mediates coactivation of auditory and reorganized "visual" cortex in EB.
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Affiliation(s)
- Irina Anurova
- Helsinki Institute of Life Science, Neuroscience Center, University of Helsinki, Helsinki 00014, Finland.,Department of Neuroscience, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Synnöve Carlson
- Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo 02150, Finland.,Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki 00014, Finland
| | - Josef P Rauschecker
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC 20057, USA.,Institute for Advanced Study, Technical University of Munich, Munich 85748, Germany
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29
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Zhou Z, Tong Q, Zhang L, Ding Q, Lu H, Jonkman LE, Yao J, He H, Zhu K, Zhong J. Evaluation of the diffusion MRI white matter tract integrity model using myelin histology and Monte-Carlo simulations. Neuroimage 2020; 223:117313. [PMID: 32882384 DOI: 10.1016/j.neuroimage.2020.117313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022] Open
Abstract
Quantitative evaluation of brain myelination has drawn considerable attention. Conventional diffusion-based magnetic resonance imaging models, including diffusion tensor imaging and diffusion kurtosis imaging (DKI),1 have been used to infer the microstructure and its changes in neurological diseases. White matter tract integrity (WMTI) was proposed as a biophysical model to relate the DKI-derived metrics to the underlying microstructure. Although the model has been validated on ex vivo animal brains, it was not well evaluated with ex vivo human brains. In this study, histological samples (namely corpus callosum) from postmortem human brains have been investigated based on WMTI analyses on a clinical 3T scanner and comparisons with gold standard myelin staining in proteolipid protein and Luxol fast blue. In addition, Monte Carlo simulations were conducted to link changes from ex vivo to in vivo conditions based on the microscale parameters of water diffusivity and permeability. The results show that WMTI metrics, including axonal water fraction AWF, radial extra-axonal diffusivity De⊥, and intra-axonal diffusivity Dawere needed to characterize myelin content alterations. Thus, WMTI model metrics are shown to be promising candidates as sensitive biomarkers of demyelination.
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Affiliation(s)
- Zihan Zhou
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Zhouyiqing Building, Room 314, Yuquan Campus, Hangzhou 310027, China
| | - Qiqi Tong
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Zhouyiqing Building, Room 314, Yuquan Campus, Hangzhou 310027, China
| | - Lei Zhang
- China Brain Bank and Department of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, and Department of Neurobiology, Zhejiang University School of Medicine, Hangzhou 310058, China; Department of Pathology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Qiuping Ding
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Zhouyiqing Building, Room 314, Yuquan Campus, Hangzhou 310027, China
| | - Hui Lu
- China Brain Bank and Department of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, and Department of Neurobiology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Laura E Jonkman
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, location VUmc, the Netherlands
| | - Junye Yao
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Zhouyiqing Building, Room 314, Yuquan Campus, Hangzhou 310027, China
| | - Hongjian He
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Zhouyiqing Building, Room 314, Yuquan Campus, Hangzhou 310027, China.
| | - Keqing Zhu
- China Brain Bank and Department of Neurology in Second Affiliated Hospital, Key Laboratory of Medical Neurobiology of Zhejiang Province, and Department of Neurobiology, Zhejiang University School of Medicine, Hangzhou 310058, China; Department of Pathology, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Jianhui Zhong
- Center for Brain Imaging Science and Technology, Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering and Instrumental Science, Zhejiang University, Zhouyiqing Building, Room 314, Yuquan Campus, Hangzhou 310027, China; Department of Imaging Sciences, University of Rochester, United States
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30
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Meijer KA, Steenwijk MD, Douw L, Schoonheim MM, Geurts JJG. Long-range connections are more severely damaged and relevant for cognition in multiple sclerosis. Brain 2020; 143:150-160. [PMID: 31730165 PMCID: PMC6938033 DOI: 10.1093/brain/awz355] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/06/2019] [Accepted: 09/21/2019] [Indexed: 02/04/2023] Open
Abstract
An efficient network such as the human brain features a combination of global integration of information, driven by long-range connections, and local processing involving short-range connections. Whether these connections are equally damaged in multiple sclerosis is unknown, as is their relevance for cognitive impairment and brain function. Therefore, we cross-sectionally investigated the association between damage to short- and long-range connections with structural network efficiency, the functional connectome and cognition. From the Amsterdam multiple sclerosis cohort, 133 patients (age = 54.2 ± 9.6) with long-standing multiple sclerosis and 48 healthy controls (age = 50.8 ± 7.0) with neuropsychological testing and MRI were included. Structural connectivity was estimated from diffusion tensor images using probabilistic tractography (MRtrix 3.0) between pairs of brain regions. Structural connections were divided into short- (length < quartile 1) and long-range (length > quartile 3) connections, based on the mean distribution of tract lengths in healthy controls. To determine the severity of damage within these connections, (i) fractional anisotropy as a measure for integrity; (ii) total number of fibres; and (iii) percentage of tract affected by lesions were computed for each connecting tract and averaged for short- and long-range connections separately. To investigate the impact of damage in these connections for structural network efficiency, global efficiency was computed. Additionally, resting-state functional connectivity was computed between each pair of brain regions, after artefact removal with FMRIB’s ICA-based X-noiseifier. The functional connectivity similarity index was computed by correlating individual functional connectivity matrices with an average healthy control connectivity matrix. Our results showed that the structural network had a reduced efficiency and integrity in multiple sclerosis relative to healthy controls (both P < 0.05). The long-range connections showed the largest reduction in fractional anisotropy (z = −1.03, P < 0.001) and total number of fibres (z = −0.44, P < 0.01), whereas in the short-range connections only fractional anisotropy was affected (z = −0.34, P = 0.03). Long-range connections also demonstrated a higher percentage of tract affected by lesions than short-range connections, independent of tract length (P < 0.001). Damage to long-range connections was more strongly related to structural network efficiency and cognition (fractional anisotropy: r = 0.329 and r = 0.447. number of fibres r = 0.321 and r = 0.278. and percentage of lesions: r = −0.219; r = −0.426, respectively) than damage to short-range connections. Only damage to long-distance connections correlated with a more abnormal functional network (fractional anisotropy: r = 0.226). Our findings indicate that long-range connections are more severely affected by multiple sclerosis-specific damage than short-range connections. Moreover compared to short-range connections, damage to long-range connections better explains network efficiency and cognition.
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Affiliation(s)
- Kim A Meijer
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam UMC location VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam UMC location VU University Medical Center, Amsterdam, The Netherlands
| | - Linda Douw
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam UMC location VU University Medical Center, Amsterdam, The Netherlands.,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam UMC location VU University Medical Center, Amsterdam, The Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam UMC location VU University Medical Center, Amsterdam, The Netherlands
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31
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Zacharzewska-Gondek A, Pokryszko-Dragan A, Budrewicz S, Sąsiadek M, Trybek G, Bladowska J. The role of ADC values within the normal-appearing brain in the prognosis of multiple sclerosis activity during interferon-β therapy in the 3-year follow-up: a preliminary report. Sci Rep 2020; 10:12828. [PMID: 32732968 PMCID: PMC7393067 DOI: 10.1038/s41598-020-69383-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 07/03/2020] [Indexed: 11/17/2022] Open
Abstract
Predictors of multiple sclerosis (MS) activity during disease-modifying treatment are being extensively investigated. The aim of this study was to assess the prognosis of NEDA (no evidence of disease activity) status during IFN-β (interferon-β) treatment, using apparent diffusion coefficient (ADC) measurements obtained at initial MRI (magnetic resonance imaging). In 87 MS patients treated with IFN-β, ADC values were calculated for 13 regions of normal-appearing white and grey matter (NAWM, NAGM) based on MRI performed with a 1.5 T magnet before (MS0, n = 45) or after one year of therapy (MS1, n = 42). Associations were evaluated between ADC, conventional MRI findings, demographic and clinical factors and NEDA status within the following 3 years using logistic, Cox and multinomial logistic regression models. NEDA rates in the MS0 group were 64.4%, 46.5% and 33.3% after the 1st, 2nd and 3rd year of treatment, respectively and in MS1 patients 71.4% and 48.7% for the periods 1st–2nd and 1st–3rd years of treatment, respectively. ADC values in the NAWM regions contributed to loss of NEDA and its clinical and radiological components, with a 1–3% increase in the risk of NEDA loss (p = 0.0001–0.0489) in both groups. ADC measurements may have an additional prognostic value with regard to NEDA status.
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Affiliation(s)
- Anna Zacharzewska-Gondek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 213 Borowska Street, 50-556, Wroclaw, Poland.
| | - Anna Pokryszko-Dragan
- Department and Clinic of Neurology, Wroclaw Medical University, 213 Borowska Street, 50-556, Wroclaw, Poland
| | - Sławomir Budrewicz
- Department and Clinic of Neurology, Wroclaw Medical University, 213 Borowska Street, 50-556, Wroclaw, Poland
| | - Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 213 Borowska Street, 50-556, Wroclaw, Poland
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University, 72 Powstańców Wielkopolskich Street, 70-111, Szczecin, Poland
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, 213 Borowska Street, 50-556, Wroclaw, Poland
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32
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Waldman AT, Sollee JR, Datta R, Lavery AM, Liu G, Aleman TS, Banwell BL, Gaetz WC. Structural correlates of atypical visual and motor cortical oscillations in pediatric-onset multiple sclerosis. Hum Brain Mapp 2020; 41:4299-4313. [PMID: 32648649 PMCID: PMC7502834 DOI: 10.1002/hbm.25126] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/18/2020] [Accepted: 06/23/2020] [Indexed: 01/05/2023] Open
Abstract
We have previously demonstrated that pediatric‐onset multiple sclerosis (POMS) negatively impacts the visual pathway as well as motor processing speed. Relationships between MS‐related diffuse structural damage of gray and white matter (WM) tissue and cortical responses to visual and motor stimuli remain poorly understood. We used magnetoencephalography in 14 POMS patients and 15 age‐ and sex‐matched healthy controls to assess visual gamma (30–80 Hz), motor gamma (60–90 Hz), and motor beta (15–30 Hz) cortical oscillatory responses to a visual‐motor task. Then, 3T MRI was used to: (a) calculate fractional anisotropy (FA) of the posterior visual and corticospinal motor WM pathways and (b) quantify volume and thickness of the cuneus and primary motor cortex. Visual gamma band power was reduced in POMS and was associated with reduced FA of the optic radiations but not with loss of cuneus volume or thickness. Activity in the primary motor cortex, as measured by postmovement beta rebound amplitude associated with peak latency, was decreased in POMS, although this reduction was not predicted by structural metrics. Our findings implicate loss of WM integrity as a contributor to reduced electrical responses in the visual cortex in POMS. Future work in larger cohorts will inform on the cognitive implications of this finding in terms of visual processing function and will determine whether the progressive loss of brain volume known to occur in POMS ultimately contributes to both progressive dysfunction in such tasks as well as progressive reduction in cortical electrical responses in the visual cortex.
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Affiliation(s)
- Amy T Waldman
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John R Sollee
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Ritobrato Datta
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Amy M Lavery
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Geraldine Liu
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Tomas S Aleman
- Division of Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Brenda L Banwell
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - William C Gaetz
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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33
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Kiljan S, Preziosa P, Jonkman LE, van de Berg WD, Twisk J, Pouwels PJ, Schenk GJ, Rocca MA, Filippi M, Geurts JJ, Steenwijk MD. Cortical axonal loss is associated with both gray matter demyelination and white matter tract pathology in progressive multiple sclerosis: Evidence from a combined MRI-histopathology study. Mult Scler 2020; 27:380-390. [PMID: 32390507 PMCID: PMC7897796 DOI: 10.1177/1352458520918978] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Neuroaxonal degeneration is one of the hallmarks of clinical deterioration in progressive multiple sclerosis (PMS). Objective: To elucidate the association between neuroaxonal degeneration and both local cortical and connected white matter (WM) tract pathology in PMS. Methods: Post-mortem in situ 3T magnetic resonance imaging (MRI) and cortical tissue blocks were collected from 16 PMS donors and 10 controls. Cortical neuroaxonal, myelin, and microglia densities were quantified histopathologically. From diffusion tensor MRI, fractional anisotropy, axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were quantified in normal-appearing white matter (NAWM) and white matter lesions (WML) of WM tracts connected to dissected cortical regions. Between-group differences and within-group associations were investigated through linear mixed models. Results: The PMS donors displayed significant axonal loss in both demyelinated and normal-appearing (NA) cortices (p < 0.001 and p = 0.02) compared with controls. In PMS, cortical axonal density was associated with WML MD and AD (p = 0.003; p = 0.02, respectively), and NAWM MD and AD (p = 0.04; p = 0.049, respectively). NAWM AD and WML AD explained 12.6% and 22.6%, respectively, of axonal density variance in NA cortex. Additional axonal loss in demyelinated cortex was associated with cortical demyelination severity (p = 0.002), explaining 34.4% of axonal loss variance. Conclusion: Reduced integrity of connected WM tracts and cortical demyelination both contribute to cortical axonal loss in PMS.
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Affiliation(s)
- Svenja Kiljan
- Department of Anatomy & Neurosciences, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands/Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - Paolo Preziosa
- Department of Anatomy & Neurosciences, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands/Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands/Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura E Jonkman
- Department of Anatomy & Neurosciences, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands
| | - Wilma Dj van de Berg
- Department of Anatomy & Neurosciences, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands
| | - Jos Twisk
- Department of Epidemiology and Biostatistics, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands
| | - Petra Jw Pouwels
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands
| | - Geert J Schenk
- Department of Anatomy & Neurosciences, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands/Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, and Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Neurology Unit, Neurophysiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy/Vita-Salute San Raffaele University, Milan, Italy
| | - Jeroen Jg Geurts
- Department of Anatomy & Neurosciences, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands/Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Anatomy & Neurosciences, Amsterdam UMC, locatie VU University Medical Center, Amsterdam, The Netherlands/Amsterdam Neuroscience, MS Center Amsterdam, Amsterdam, The Netherlands
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34
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de Mol CL, Jansen PR, Muetzel RL, Knol MJ, Adams HH, Jaddoe VW, Vernooij MW, Hintzen RQ, White TJ, Neuteboom RF. Polygenic Multiple Sclerosis Risk and Population-Based Childhood Brain Imaging. Ann Neurol 2020; 87:774-787. [PMID: 32162725 PMCID: PMC7187244 DOI: 10.1002/ana.25717] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 11/20/2022]
Abstract
Objective Multiple sclerosis (MS) is a neurological disease with a substantial genetic component and immune‐mediated neurodegeneration. Patients with MS show structural brain differences relative to individuals without MS, including smaller regional volumes and alterations in white matter (WM) microstructure. Whether genetic risk for MS is associated with brain structure during early neurodevelopment remains unclear. In this study, we explore the association between MS polygenic risk scores (PRS) and brain imaging outcomes from a large, population‐based pediatric sample to gain insight into the underlying neurobiology of MS. Methods We included 8‐ to 12‐year‐old genotyped participants from the Generation R Study in whom T1‐weighted volumetric (n = 1,136) and/or diffusion tensor imaging (n = 1,088) had been collected. PRS for MS were calculated based on a large genome‐wide association study of MS (n = 41,505) and were regressed on regional volumes, global and tract‐specific fractional anisotropy (FA), and global mean diffusivity using linear regression. Results No associations were observed for the regional volumes. We observed a positive association between the MS PRS and global FA (β = 0.098, standard error [SE] = 0.030, p = 1.08 × 10−3). Tract‐specific analyses showed higher FA and lower radial diffusivity in several tracts. We replicated our findings in an independent sample of children (n = 186) who were scanned in an earlier phase (global FA; β = 0.189, SE = 0.072, p = 9.40 × 10−3). Interpretation This is the first study to show that greater genetic predisposition for MS is associated with higher global brain WM FA at an early age in the general population. Our results suggest a preadolescent time window within neurodevelopment in which MS risk variants act upon the brain. ANN NEUROL 2020;87:774–787
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Affiliation(s)
- C Louk de Mol
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Neurology, MS Center ErasMS, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Philip R Jansen
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University Amsterdam, Amsterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Clinical Genetics, VU Medical Center, Amsterdam, the Netherlands
| | - Ryan L Muetzel
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Maria J Knol
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hieab H Adams
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Clinical Genetics, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Vincent W Jaddoe
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Pediatrics, Sophia Children's Hospital, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Meike W Vernooij
- Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rogier Q Hintzen
- Department of Neurology, MS Center ErasMS, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tonya J White
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rinze F Neuteboom
- Department of Neurology, MS Center ErasMS, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
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35
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Tsagkas C, Chakravarty MM, Gaetano L, Naegelin Y, Amann M, Parmar K, Papadopoulou A, Wuerfel J, Kappos L, Sprenger T, Magon S. Longitudinal patterns of cortical thinning in multiple sclerosis. Hum Brain Mapp 2020; 41:2198-2215. [PMID: 32067281 PMCID: PMC7268070 DOI: 10.1002/hbm.24940] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/21/2019] [Accepted: 01/13/2020] [Indexed: 01/19/2023] Open
Abstract
In multiple sclerosis (MS), cortical atrophy is correlated with clinical and neuropsychological measures. We aimed to examine the differences in the temporospatial evolution of cortical thickness (CTh) between MS‐subtypes and to study the association of CTh with T2‐weighted white matter lesions (T2LV) and clinical progression. Two hundred and forty‐three MS patients (180 relapsing–remitting [RRMS], 51 secondary‐progressive [SPMS], and 12 primary‐progressive [PPMS]) underwent annual clinical (incl. expanded disability status scale [EDSS]) and MRI‐examinations over 6 years. T2LV and CTh were measured. CTh did not differ between MS‐subgroups. Higher total T2LV was associated with extended bilateral CTh‐reduction on average, but did not correlate with CTh‐changes over time. In RRMS, CTh‐ and EDSS‐changes over time were negatively correlated in large bilateral prefrontal, frontal, parietal, temporal, and occipital areas. In SPMS, CTh was not associated with the EDSS. In PPMS, CTh‐ and EDSS‐changes over time were correlated in small clusters predominantly in left parietal areas. Increase of brain lesion load does not lead to an immediate CTh‐reduction. Although CTh did not differ between MS‐subtypes, a dissociation in the correlation between CTh‐ and EDSS‐changes over time between RRMS and progressive‐MS was shown, possibly underlining the contribution of subcortical pathology to clinical progression in progressive‐MS.
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Affiliation(s)
- Charidimos Tsagkas
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland.,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.,Medical Image Analysis Center AG, Basel, Switzerland
| | - M Mallar Chakravarty
- Cerebral Imaging Centre - Douglas Mental Health University Institute, Verdun, QC, Canada.,Department of Biomedical Engineering, McGill University, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | | | - Yvonne Naegelin
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland
| | - Michael Amann
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland.,Medical Image Analysis Center AG, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Katrin Parmar
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland.,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Athina Papadopoulou
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland.,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland.,NeuroCure Clinical Research Center, Charite - Universitatsmedizin Berlin, corporate member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jens Wuerfel
- Medical Image Analysis Center AG, Basel, Switzerland.,Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Ludwig Kappos
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland.,Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Till Sprenger
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland.,Department of Neurology, DKD HELIOS Klinik Wiesbaden, Wiesbaden, Germany
| | - Stefano Magon
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland.,Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
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36
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Magon S, Tsagkas C, Gaetano L, Patel R, Naegelin Y, Amann M, Parmar K, Papadopoulou A, Wuerfel J, Stippich C, Kappos L, Chakravarty MM, Sprenger T. Volume loss in the deep gray matter and thalamic subnuclei: a longitudinal study on disability progression in multiple sclerosis. J Neurol 2020; 267:1536-1546. [PMID: 32040710 DOI: 10.1007/s00415-020-09740-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Volume loss in the deep gray matter (DGM) has been reported in patients with multiple sclerosis (MS) already at early stages of the disease and is thought to progress throughout the disease course. OBJECTIVE To investigate the impact and predictive value of volume loss in DGM and thalamic subnuclei on disability worsening in patients MS over a 6-year follow-up period. METHODS Hundred and seventy-nine patients with RRMS (132 women; median Expanded Disability Status Scale, EDSS: 2.5) and 50 with SPMS (27 women; median EDSS: 4.5) were included in the study. Patients underwent annual EDSS assessments and annual MRI at 1.5 T. DGM/thalamic subnuclei volumes were identified on high-resolution T1-weighted. A hierarchical linear mixed model for each anatomical DGM area and each thalamic subnucleus was performed to investigate the associations with disability scores. Cox regression was used to estimate the predictive properties of volume loss in DGM and thalamic subnuclei on disease worsening. RESULTS In the whole sample and in RRMS, volumes of the thalamus and the striatum were associated with the EDSS; however, only thalamic volume loss was associated with EDSS change at follow-up. Regarding thalamic subnuclei, volume loss in the anterior nucleus, the pulvinar and the ventral anterior nucleus was associated with EDSS change in the whole cohort. A trend was observed for the ventral lateral nucleus. Volume loss in the anterior and ventral anterior nuclei was associated with EDSS change over time in patients with RRMS. Moreover, MS phenotype and annual rates of volume loss in the thalamus and ventral lateral nucleus were predictive of disability worsening. CONCLUSION These results highlight the relevance of volume loss in the thalamus as a key metric for predicting disability worsening as assessed by EDSS (in RRMS). Moreover, the volume loss in specific nuclei such as the ventral lateral nucleus seems to play a role in disability worsening.
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Affiliation(s)
- Stefano Magon
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland. .,Medical Image Analysis Center AG, Basel, Switzerland.
| | - Charidimos Tsagkas
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.,Medical Image Analysis Center AG, Basel, Switzerland
| | - Laura Gaetano
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.,Medical Image Analysis Center AG, Basel, Switzerland
| | - Raihaan Patel
- Cerebral Imaging Centre-Douglas Mental Health University Institute, Verdun, QC, Canada.,Department of Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Yvonne Naegelin
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Michael Amann
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.,Medical Image Analysis Center AG, Basel, Switzerland.,Department of Biomedical Engineering, University Basel, Basel, Switzerland
| | - Katrin Parmar
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.,Medical Image Analysis Center AG, Basel, Switzerland
| | - Athina Papadopoulou
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jens Wuerfel
- Medical Image Analysis Center AG, Basel, Switzerland.,Department of Biomedical Engineering, University Basel, Basel, Switzerland
| | - Christoph Stippich
- Department of Neuroradiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ludwig Kappos
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - M Mallar Chakravarty
- Cerebral Imaging Centre-Douglas Mental Health University Institute, Verdun, QC, Canada.,Department of Biomedical Engineering, McGill University, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Till Sprenger
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, Department of Neurology, University Hospital Basel and University of Basel, Petersgraben 4, 4031, Basel, Switzerland.,Department of Neurology, DKD HELIOS Klinik Wiesbaden, Wiesbaden, Germany
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37
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Owen JE, BenediktsdÓttir B, Gislason T, Robinson SR. Neuropathological investigation of cell layer thickness and myelination in the hippocampus of people with obstructive sleep apnea. Sleep 2019; 42:5139668. [PMID: 30346595 DOI: 10.1093/sleep/zsy199] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Indexed: 12/11/2022] Open
Abstract
Obstructive sleep apnea (OSA) is commonly associated with memory impairments. Although MRI studies have found volumetric differences in the hippocampus of people with OSA compared with controls, MRI lacks the spatial resolution to detect changes in the specific regions of the hippocampus that process different types of memory. The present study performed histopathological investigations on autopsy brain tissue from 32 people with OSA (17 females and 15 males) to examine whether the thickness and myelination of the hippocampus and entorhinal cortex (EC) vary as a function of OSA severity. Increasing OSA severity was found to be related to cortical thinning in the molecular layer of the dentate gyrus (r2 = 0.136, p = 0.038), the CA1 (overall, r2 = 0.135, p = 0.039; layer 1, r2 = 0.157, p = 0.025; layer 2, r2 = 0.255, p = 0.003; and layer 3, r2 = 0.185, p = 0.014) and in some layers of the EC (layer 1, r2 = 0.186, p = 0.028; trend in layer 3, r2 = 0.124, p = 0.078). OSA severity was also related to decreased myelin in the deep layers but not the superficial layers of the EC (layer 6, r2 = 0.282, p = 0.006; deep white matter, r2 = 0.390, p = 0.001). Patients known to have used continuous positive airway pressure (CPAP) treatment showed no significant reductions in cortical thickness when compared with controls, suggesting that CPAP had a protective effect. However, CPAP did not protect against myelin loss. The regions of decreased cortical thickness and demyelination are locations of synaptic connections in both the polysynaptic (episodic and spatial) and direct (semantic) memory pathways and may underpin the impairments observed in episodic, semantic, and spatial memory in people with OSA.
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Affiliation(s)
- Jessica E Owen
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | | | - Thorarinn Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Sleep Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Stephen R Robinson
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
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38
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Haider L, Chan WSE, Olbert E, Mangesius S, Dal-Bianco A, Leutmezer F, Prayer D, Thurnher M. Cranial Nerve Enhancement in Multiple Sclerosis Is Associated With Younger Age at Onset and More Severe Disease. Front Neurol 2019; 10:1085. [PMID: 31781014 PMCID: PMC6851051 DOI: 10.3389/fneur.2019.01085] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/26/2019] [Indexed: 11/13/2022] Open
Abstract
Background: The overall frequency of cranial nerve pathology, including cranial nerves other than the trigeminal nerve, as well as its relation to brainstem lesion formation on magnetic resonance imaging (MRI) and clinical correlates in multiple sclerosis (MS) is unknown. Objective: We aimed to determine the frequency of cranial nerve enhancement on MRI, and its association with brainstem lesion formation and clinical outcomes. Methods: We retrospectively analyzed, in 183 patients, (RRMS: 156, SPMS: 15, PPMS: 6, CIS: 6) 651 MRIs (76.5% on the identical scanner Siemens Trio Tim, 3T with identical MRI protocols). Frequencies of cranial nerve enhancement on post contrast T1-weighted MRIs were compared to lesion counts and the MS-severity-score. Results: Cranial nerve enhancement was present in 8.2% of the analyzed MS patients (oculomotor-nerve: 1.1%, trigeminal-nerve: 2.7%, abducens-nerve: 2.2%, facial-/vestibulocochlear nerve: 1.6%, vagal-nerve: 0.5%). Of those, 13% suffered from repeated episodes and 27% exhibited a cranial nerve enhancement duration of >12 months. Age at MS onset was lower in patients with cranial nerve enhancement, 23 vs. 28 years, p = 0.049. The MS-severity-score, 5.15 vs. 0.88 (p = 0.019), the T2 brainstem-, 1 vs. 0 (p = 0.041), and the total intracranial contrast-enhancing lesion counts, 2 vs. 0 (p = 0.000), were higher in patients with cranial nerve enhancement, compared to age-, disease duration-, and gender- matched MS patients. Conclusions: Cranial nerve enhancement, present in 8.2% of our patients, was associated with a younger age at MS onset, brainstem lesions, and a more severe disease course.
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Affiliation(s)
- Lukas Haider
- NMR Research Unit, Department of Neuroinflammation, Faculty of Brain Science, Queen Square MS Centre, UCL Institute of Neurology, University College London, London, United Kingdom.,Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
| | - Wei-Shin Evelyn Chan
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
| | - Elisabeth Olbert
- Department of Neurology, University Hospital Tulln, Tulln, Austria
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, AUT, Innsbruck, Austria.,Neuroimaging Core Facility, Medical University of Innsbruck, AUT, Innsbruck, Austria
| | | | - Fritz Leutmezer
- Department of Neurology, Medical University Vienna, Vienna, Austria
| | - Daniela Prayer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
| | - Majda Thurnher
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
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39
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Datta R, Sollee JR, Lavery AM, Ficerai-Garland G, Karoscik K, Liu G, Banwell BL, Waldman AT. Effects of Optic Neuritis, T2 Lesions, and Microstructural Diffusion Integrity in the Visual Pathway on Cortical Thickness in Pediatric-Onset Multiple Sclerosis. J Neuroimaging 2019; 29:760-770. [PMID: 31317617 PMCID: PMC10637320 DOI: 10.1111/jon.12654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 06/06/2019] [Accepted: 06/24/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND PURPOSE Pediatric-onset multiple sclerosis (POMS) is associated with focal inflammatory lesions and the loss of cortical and deep gray matter. Optic neuritis (ON) and white matter (WM) lesions in the visual pathway can directly contribute to visual cortical mantle thinning. We determine the relative contributions of MS insult on anterior and posterior visual pathway integrity. METHODS High- and low-contrast visual acuity, optical coherence tomography (OCT), and 3T MRI scans were obtained from 20 POMS patients (10 with remote ON) and 22 age- and sex-matched healthy controls. Cortical mantle thickness was measured using FreeSurfer. Fractional anisotropy (FA) and mean diffusivity were calculated for postchiasmal optic radiations (with and without WM lesions). Groups were compared using Student's t-test (adjusted for multiple comparisons), and simple linear regression was used to investigate interrelationships between measures. RESULTS Mean cortical thickness of the whole brain was reduced in patients (2.49 mm) versus controls (2.58 mm, P = .0432) and in the visual cortex (2.07 mm vs. 2.17 mm, P = .0059), although the foveal confluence was spared. Mean FA of the optic radiations was reduced in POMS (.40) versus controls (.43, P = .0042) and correlated with visual cortical mantle thickness in POMS (P = .017). Visual acuity, OCT measures, and lesion volumes in the optic radiations were not associated with cortical mantle thickness. CONCLUSIONS POMS negatively impacts the integrity of the anterior visual pathway, but it is the loss of WM integrity that drives anterograde loss of the cortical mantle. Preserved visual acuity and foveal sparing imply some degree of functional and structural resilience.
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Affiliation(s)
- Ritobrato Datta
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - John R Sollee
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Amy M Lavery
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Gabriella Ficerai-Garland
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Krystle Karoscik
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Geraldine Liu
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Brenda L Banwell
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
- Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Amy T Waldman
- Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
- Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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40
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McKavanagh R, Torso M, Jenkinson M, Kolasinski J, Stagg CJ, Esiri MM, McNab JA, Johansen‐Berg H, Miller KL, Chance SA. Relating diffusion tensor imaging measurements to microstructural quantities in the cerebral cortex in multiple sclerosis. Hum Brain Mapp 2019; 40:4417-4431. [PMID: 31355989 PMCID: PMC6772025 DOI: 10.1002/hbm.24711] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/20/2019] [Accepted: 05/31/2019] [Indexed: 12/13/2022] Open
Abstract
To investigate whether the observed anisotropic diffusion in cerebral cortex may reflect its columnar cytoarchitecture and myeloarchitecture, as a potential biomarker for disease-related changes, we compared postmortem diffusion magnetic resonance imaging scans of nine multiple sclerosis brains with histology measures from the same regions. Histology measurements assessed the cortical minicolumnar structure based on cell bodies and associated axon bundles in dorsolateral prefrontal cortex (Area 9), Heschl's gyrus (Area 41), and primary visual cortex (V1). Diffusivity measures included mean diffusivity, fractional anisotropy of the cortex, and three specific measures that may relate to the radial minicolumn structure: the angle of the principal diffusion direction in the cortex, the component that was perpendicular to the radial direction, and the component that was parallel to the radial direction. The cellular minicolumn microcircuit features were correlated with diffusion angle in Areas 9 and 41, and the axon bundle features were correlated with angle in Area 9 and to the parallel component in V1 cortex. This may reflect the effect of minicolumn microcircuit organisation on diffusion in the cortex, due to the number of coherently arranged membranes and myelinated structures. Several of the cortical diffusion measures showed group differences between MS brains and control brains. Differences between brain regions were also found in histology and diffusivity measurements consistent with established regional variation in cytoarchitecture and myeloarchitecture. Therefore, these novel measures may provide a surrogate of cortical organisation as a potential biomarker, which is particularly relevant for detecting regional changes in neurological disorders.
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Affiliation(s)
- Rebecca McKavanagh
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Mario Torso
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Mark Jenkinson
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - James Kolasinski
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Charlotte J. Stagg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Margaret M. Esiri
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Jennifer A. McNab
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Heidi Johansen‐Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Karla L. Miller
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
| | - Steven A. Chance
- Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUnited Kingdom
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Adult brain aging investigated using BMC-mcDESPOT-based myelin water fraction imaging. Neurobiol Aging 2019; 85:131-139. [PMID: 31735379 DOI: 10.1016/j.neurobiolaging.2019.10.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/30/2019] [Accepted: 10/07/2019] [Indexed: 01/23/2023]
Abstract
The relationship between regional brain myelination and aging has been the subject of intense study, with magnetic resonance imaging perhaps the most effective modality for elucidating this. However, most of these studies have used nonspecific methods to probe myelin content, including diffusion tensor imaging, magnetization transfer ratio, and relaxation times. In the present study, we used the BMC-mcDESPOT analysis, a direct and specific method for imaging of myelin water fraction (MWF), a surrogate of myelin content. We investigated age-related differences in MWF in several brain regions in a large cohort of cognitively unimpaired participants, spanning a wide age range. Our results indicate a quadratic, inverted U-shape, relationship between MWF and age in all brain regions investigated, suggesting that myelination continues until middle age followed by decreases at older ages. We also observed that these age-related differences vary across different brain regions, as expected. Our results provide evidence for nonlinear associations between age and myelin in a large sample of well-characterized adults, using a direct myelin content imaging method.
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Azevedo CJ, Cen SY, Jaberzadeh A, Zheng L, Hauser SL, Pelletier D. Contribution of normal aging to brain atrophy in MS. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2019; 6:6/6/e616. [PMID: 32330116 PMCID: PMC6807662 DOI: 10.1212/nxi.0000000000000616] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 07/01/2019] [Indexed: 12/21/2022]
Abstract
Objective To identify the top brain regions affected by MS-specific atrophy (i.e., atrophy in excess of normal aging) and to test whether normal aging and MS-specific atrophy increase or decrease in these regions with age. Methods Six hundred fifty subjects (2,790 MRI time points) were analyzed: 520 subjects with relapse-onset MS from a 5-year prospective cohort with annual standardized 1-mm 3D T1-weighted images (3DT1s; 2,483 MRIs) and 130 healthy controls with longitudinal 3DT1s (307 MRIs). Rates of change in all FreeSurfer regions (v5.3) and Structural Image Evaluation Using Normalization of Atrophy (SIENA) were estimated with mixed-effects models. All FreeSurfer regions were ranked by the MS-specific atrophy slope/standard error ratio (βMS × time/SEβMS × time). In the top regions, age was added as an effect modifier to test whether MS-specific atrophy varied by age. Results The top-ranked regions were all gray matter structures. For SIENA, normal aging increased from 0.01%/y at age 30 years to −0.31%/y at age 60 years (−0.11% ± 0.032%/decade, p < 0.01), whereas MS-specific atrophy decreased from −0.38%/y at age 30 years to −0.12%/y at age 60 years (0.09% ± 0.035%/decade, p = 0.01). Similarly, in the thalamus, normal aging increased from −0.15%/y at age 30 years to −0.62%/y at age 60 years (−0.16% ± 0.079%/decade, p < 0.05), and MS-specific atrophy decreased from −0.59%/y at age 30 years to −0.05%/y at age 60 years (0.18% ± 0.08%/decade, p < 0.05). In the putamen and caudate, normal aging and MS-specific atrophy did not vary by age. Conclusions For SIENA and thalamic atrophy, the contribution of normal aging increases with age, but does not change in the putamen and caudate. This may have substantial implications to understand the biology of brain atrophy in MS.
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Affiliation(s)
- Christina J Azevedo
- From the Department of Neurology (C.J.A., S.Y.C., A.J., L.Z., D.P.), University of Southern California, Los Angeles; and Department of Neurology (S.L.H.), University of California, San Francisco
| | - Steven Y Cen
- From the Department of Neurology (C.J.A., S.Y.C., A.J., L.Z., D.P.), University of Southern California, Los Angeles; and Department of Neurology (S.L.H.), University of California, San Francisco
| | - Amir Jaberzadeh
- From the Department of Neurology (C.J.A., S.Y.C., A.J., L.Z., D.P.), University of Southern California, Los Angeles; and Department of Neurology (S.L.H.), University of California, San Francisco
| | - Ling Zheng
- From the Department of Neurology (C.J.A., S.Y.C., A.J., L.Z., D.P.), University of Southern California, Los Angeles; and Department of Neurology (S.L.H.), University of California, San Francisco
| | - Stephen L Hauser
- From the Department of Neurology (C.J.A., S.Y.C., A.J., L.Z., D.P.), University of Southern California, Los Angeles; and Department of Neurology (S.L.H.), University of California, San Francisco
| | - Daniel Pelletier
- From the Department of Neurology (C.J.A., S.Y.C., A.J., L.Z., D.P.), University of Southern California, Los Angeles; and Department of Neurology (S.L.H.), University of California, San Francisco.
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Jakimovski D, Kuhle J, Ramanathan M, Barro C, Tomic D, Hagemeier J, Kropshofer H, Bergsland N, Leppert D, Dwyer MG, Michalak Z, Benedict RHB, Weinstock-Guttman B, Zivadinov R. Serum neurofilament light chain levels associations with gray matter pathology: a 5-year longitudinal study. Ann Clin Transl Neurol 2019; 6:1757-1770. [PMID: 31437387 PMCID: PMC6764487 DOI: 10.1002/acn3.50872] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/05/2019] [Accepted: 07/29/2019] [Indexed: 01/16/2023] Open
Abstract
Background Gray matter (GM) pathology is closely associated with physical and cognitive impairment in persons with multiple sclerosis (PwMS). Similarly, serum neurofilament light chain (sNfL) levels are related to MS disease activity and progression. Objectives To assess the cross–sectional and longitudinal associations between sNfL and MRI–derived lesion and brain volume outcomes in PwMS and age–matched healthy controls (HCs). Materials and Methods Forty‐seven HCs and 120 PwMS were followed over 5 years. All subjects underwent baseline and follow–up 3T MRI and sNfL examinations. Lesion volumes (LV) and global, tissue–specific and regional brain volumes were assessed. sNfL levels were analyzed using single molecule array (Simoa) assay and quantified in pg/mL. The associations between sNfL levels and MRI outcomes were investigated using regression analyses adjusted for age, sex, baseline disease modifying treatment (DMT) use and change in DMT over the follow‐up. False discovery rate (FDR)–adjusted q‐values <0.05 were considered significant. Results In PwMS, baseline sNfL was associated with baseline T1‐, T2‐ and gadolinium‐LV (q = 0.002, q = 0.001 and q < 0.001, respectively), but not with their longitudinal changes. Higher baseline sNfL levels were associated with lower baseline deep GM (β = −0.257, q = 0.017), thalamus (β = −0.216, q = 0.0017), caudate (β = −0.263, q = 0.014) and hippocampus (β = −0.267, q = 0.015) volumes. Baseline sNfL was associated with longitudinal decline of deep GM (β = −0.386, q < 0.001), putamen (β = −0.395, q < 0.001), whole brain (β = −0.356, q = 0.002), thalamus (β = −0.272, q = 0.049), globus pallidus (β = −0.284, q = 0.017), and GM (β = −0.264, q = 0.042) volumes. No associations between sNfL and MRI–derived measures were seen in the HCs. Conclusion Higher sNfL levels were associated with baseline LVs and greater development of GM atrophy in PwMS.
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Affiliation(s)
- Dejan Jakimovski
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - Jens Kuhle
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Murali Ramanathan
- Department of Pharmaceutical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - Christian Barro
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | | | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | | | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, New York
| | - Zuzanna Michalak
- Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ralph H B Benedict
- Jacobs MS Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - Bianca Weinstock-Guttman
- Jacobs MS Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York.,Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, New York
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Sotiropoulos SN, Zalesky A. Building connectomes using diffusion MRI: why, how and but. NMR IN BIOMEDICINE 2019; 32:e3752. [PMID: 28654718 PMCID: PMC6491971 DOI: 10.1002/nbm.3752] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 04/05/2017] [Accepted: 05/03/2017] [Indexed: 05/14/2023]
Abstract
Why has diffusion MRI become a principal modality for mapping connectomes in vivo? How do different image acquisition parameters, fiber tracking algorithms and other methodological choices affect connectome estimation? What are the main factors that dictate the success and failure of connectome reconstruction? These are some of the key questions that we aim to address in this review. We provide an overview of the key methods that can be used to estimate the nodes and edges of macroscale connectomes, and we discuss open problems and inherent limitations. We argue that diffusion MRI-based connectome mapping methods are still in their infancy and caution against blind application of deep white matter tractography due to the challenges inherent to connectome reconstruction. We review a number of studies that provide evidence of useful microstructural and network properties that can be extracted in various independent and biologically relevant contexts. Finally, we highlight some of the key deficiencies of current macroscale connectome mapping methodologies and motivate future developments.
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Affiliation(s)
- Stamatios N. Sotiropoulos
- Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Sir Peter Mansfield Imaging Centre, School of MedicineUniversity of NottinghamNottinghamUK
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre and Melbourne School of EngineeringUniversity of MelbourneVictoriaAustralia
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van Veluw SJ, Reijmer YD, van der Kouwe AJ, Charidimou A, Riley GA, Leemans A, Bacskai BJ, Frosch MP, Viswanathan A, Greenberg SM. Histopathology of diffusion imaging abnormalities in cerebral amyloid angiopathy. Neurology 2019; 92:e933-e943. [PMID: 30700595 PMCID: PMC6404469 DOI: 10.1212/wnl.0000000000007005] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/23/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE We sought to determine the underlying mechanism for altered white matter diffusion tensor imaging (DTI) measures at the histopathologic level in patients with cerebral amyloid angiopathy (CAA). METHODS Formalin-fixed intact hemispheres from 9 CAA cases and 2 elderly controls were scanned at 3-tesla MRI, including a diffusion-weighted sequence. DTI measures (i.e., fractional anisotropy [FA] and mean diffusivity [MD]) and histopathology measures were obtained from 2 tracts: the anterior thalamic radiation and inferior longitudinal fasciculus. RESULTS FA was reduced in both tracts and MD was increased in cases with CAA compared to controls. Regional FA was significantly correlated with tissue rarefaction, myelin density, axonal density, and white matter microinfarcts. MD correlated significantly with tissue rarefaction, myelin density, and white matter microinfarcts, but not axonal density. FA and MD did not correlate with oligodendrocytes, astrocytes, or gliosis. Multivariate analysis revealed that tissue rarefaction (β = -0.32 ± 0.12, p = 0.009) and axonal density (β = 0.25 ± 0.12, p = 0.04) were both independently associated with FA, whereas myelin density was independently associated with MD (β = -0.32 ± 0.12, p = 0.013). Finally, we found an association between increased MD in the frontal white matter and CAA severity in the frontal cortex (p = 0.035). CONCLUSIONS These results suggest that overall tissue loss, and in particular axonal and myelin loss, are major components underlying CAA-related alterations in DTI properties observed in living patients. The findings allow for a more mechanistic interpretation of DTI parameters in small vessel disease and for mechanism-based selection of candidate treatments to prevent vascular cognitive impairment.
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Affiliation(s)
- Susanne J van Veluw
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown.
| | - Yael D Reijmer
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Andre J van der Kouwe
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Andreas Charidimou
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Grace A Riley
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Alexander Leemans
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Brian J Bacskai
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Matthew P Frosch
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Anand Viswanathan
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
| | - Steven M Greenberg
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.J.v.V., Y.D.R., A.C., G.A.R., A.V., S.M.G.), and Neuropathology Service, C.S. Kubik Laboratory for Neuropathology (M.P.F.), Massachusetts General Hospital and Harvard Medical School, Boston; MassGeneral Institute for Neurodegenerative Disease (S.J.v.V., B.J.B., M.P.F.), Charlestown Navy Yard, MA; Department of Neurology, Brain Center Rudolf Magnus (Y.D.R.), and Image Sciences Institute (A.L.), University Medical Center Utrecht, Utrecht University, the Netherlands; and Athinoula A. Martinos Center for Biomedical Imaging (A.J.v.d.K.), Department of Radiology, Massachusetts General Hospital, Charlestown
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Zacharzewska-Gondek A, Pokryszko-Dragan A, Gondek TM, Kołtowska A, Gruszka E, Budrewicz S, Sąsiadek M, Bladowska J. Apparent diffusion coefficient measurements in normal appearing white matter may support the differential diagnosis between multiple sclerosis lesions and other white matter hyperintensities. J Neurol Sci 2019; 397:24-30. [DOI: 10.1016/j.jns.2018.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/30/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
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Sampaio-Baptista C, Diosi K, Johansen-Berg H. Magnetic Resonance Techniques for Imaging White Matter. Methods Mol Biol 2019; 1936:397-407. [PMID: 30820911 DOI: 10.1007/978-1-4939-9072-6_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The white matter is a complex network of brain fibers connecting different information processing regions in the brain. In recent years, the investigation of white matter in humans and in animal models has greatly benefitted from the introduction of in vivo noninvasive magnetic resonance imaging (MRI) techniques. MRI allows for multiple in vivo time-point whole-brain acquisition in the same subject, thus it can be used longitudinally to monitor white matter brain change, intervention effects, as well as disease progression. However, MRI has low spatial resolution compared to gold standard cellular techniques and MRI measures are sensitive to a number of tissue properties resulting in a lack of specificity.The following chapter describes in simple technical terms to non-imaging experts some common MRI techniques that can be used to investigate white matter structure noninvasively, covering some of the advantages and pitfalls of each technique.
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Affiliation(s)
- Cassandra Sampaio-Baptista
- NDCN Department, Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, University of Oxford, Oxford, UK.
| | - Kata Diosi
- NDCN Department, Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, University of Oxford, Oxford, UK
| | - Heidi Johansen-Berg
- NDCN Department, Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, University of Oxford, Oxford, UK
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Yu FF, Chiang FL, Stephens N, Huang SY, Bilgic B, Tantiwongkosi B, Romero R. Characterization of normal-appearing white matter in multiple sclerosis using quantitative susceptibility mapping in conjunction with diffusion tensor imaging. Neuroradiology 2018; 61:71-79. [PMID: 30539215 DOI: 10.1007/s00234-018-2137-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/13/2018] [Indexed: 01/18/2023]
Abstract
PURPOSE Quantitative susceptibility mapping (QSM) is influenced by iron as well as myelin, which makes interpretation of pathologic changes challenging. Concurrent acquisition of MR sequences that are sensitive to axonal/myelin integrity, such as diffusion tensor imaging (DTI), may provide context for interpreting quantitative susceptibility (QS) signal. The purpose of our study was to investigate alterations in normal-appearing white matter (NAWM) in multiple sclerosis (MS) using QSM in conjunction with DTI. METHODS Twenty relapsing-remitting MS patients and 20 age-matched healthy controls (HC) were recruited for this prospective study. QS, radial diffusivity (RD), fractional anisotropy (FA), and R2* maps within the whole brain as well as individual tracts were generated for comparison between NAWM and HC white matter (HCWM). RESULTS MS lesions demonstrated significant differences in QS, FA, RD, and R2* compared to HCWM (p < 0.03). These metrics did not show a significant difference between whole-brain NAWM and HCWM. Among NAWM tracts, the cingulate gyri demonstrated significantly decreased QS compared to HCWM (p = 0.004). The forceps major showed significant differences in FA and RD without corresponding changes in QS (p < 0.01). CONCLUSION We found discordant changes in QSM and DTI metrics within the cingulate gyri and forceps major. This may potentially reflect the influence of paramagnetic substrates such as iron, which could be decreased along these NAWM tracts. Our results point to the potential role of QSM as a unique biomarker, although additional validation studies are needed.
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Affiliation(s)
- Fang F Yu
- Division of Neuroradiology, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
| | - Florence L Chiang
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Nicholas Stephens
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Susie Y Huang
- Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Berkin Bilgic
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Bundhit Tantiwongkosi
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rebecca Romero
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Petracca M, Margoni M, Bommarito G, Inglese M. Monitoring Progressive Multiple Sclerosis with Novel Imaging Techniques. Neurol Ther 2018; 7:265-285. [PMID: 29956263 PMCID: PMC6283788 DOI: 10.1007/s40120-018-0103-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Indexed: 02/04/2023] Open
Abstract
Imaging markers for monitoring disease progression in progressive multiple sclerosis (PMS) are scarce, thereby limiting the possibility to monitor disease evolution and to test effective treatments in clinical trials. Advanced imaging techniques that have the advantage of metrics with increased sensitivity to short-term tissue changes and increased specificity to the structural abnormalities characteristic of PMS have recently been applied in clinical trials of PMS. In this review, we (1) provide an overview of the pathological features of PMS, (2) summarize the findings of research and clinical trials conducted in PMS which have applied conventional and advanced magnetic resonance imaging techniques and (3) discuss recent advancements and future perspectives in monitoring PMS with imaging techniques.
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Affiliation(s)
- Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Monica Margoni
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Multiple Sclerosis Centre, Department of Neurosciences DNS, University Hospital, University of Padua, Padua, Italy
| | - Giulia Bommarito
- Department of Neuroscience, Rehabilitation, Genetics and Maternal and Perinatal Sciences, University of Genoa, Genoa, Italy
| | - Matilde Inglese
- Department of Neuroscience, Rehabilitation, Genetics and Maternal and Perinatal Sciences, University of Genoa, Genoa, Italy.
- Departments of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Local volume fraction distributions of axons, astrocytes, and myelin in deep subcortical white matter. Neuroimage 2018; 179:275-287. [DOI: 10.1016/j.neuroimage.2018.06.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 05/31/2018] [Accepted: 06/11/2018] [Indexed: 01/28/2023] Open
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