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Jasperse B. Spinal Cord Imaging in Multiple Sclerosis and Related Disorders. Neuroimaging Clin N Am 2024; 34:385-398. [PMID: 38942523 DOI: 10.1016/j.nic.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Spinal cord MRI plays an important role in the diagnosis and prognosis of multiple sclerosis (MS) and related disorders. The ANATOMICAL, pathologic, imaging and prognostic consideriations for the spinal cord for MS and the most important other demyelinating disorders, neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein-associated disease, are reviewed. Finally, differential diagnostic considerations of spinal cord MRI in MS and related disorders are discussed.
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Affiliation(s)
- Bas Jasperse
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, de Boelelaan 1118, Amsterdam 1081HZ, the Netherlands.
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2
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Dabbagh A, Horn U, Kaptan M, Mildner T, Müller R, Lepsien J, Weiskopf N, Brooks JCW, Finsterbusch J, Eippert F. Reliability of task-based fMRI in the dorsal horn of the human spinal cord. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.12.22.572825. [PMID: 38187724 PMCID: PMC10769329 DOI: 10.1101/2023.12.22.572825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
The application of functional magnetic resonance imaging (fMRI) to the human spinal cord is still a relatively small field of research and faces many challenges. Here we aimed to probe the limitations of task-based spinal fMRI at 3T by investigating the reliability of spinal cord blood oxygen level dependent (BOLD) responses to repeated nociceptive stimulation across two consecutive days in 40 healthy volunteers. We assessed the test-retest reliability of subjective ratings, autonomic responses, and spinal cord BOLD responses to short heat pain stimuli (1s duration) using the intraclass correlation coefficient (ICC). At the group level, we observed robust autonomic responses as well as spatially specific spinal cord BOLD responses at the expected location, but no spatial overlap in BOLD response patterns across days. While autonomic indicators of pain processing showed good-to-excellent reliability, both β-estimates and z-scores of task-related BOLD responses showed poor reliability across days in the target region (gray matter of the ipsilateral dorsal horn). When taking into account the sensitivity of gradient-echo echo planar imaging (GE-EPI) to draining vein signals by including the venous plexus in the analysis, we observed BOLD responses with fair reliability across days. Taken together, these results demonstrate that heat pain stimuli as short as one second are able to evoke a robust and spatially specific BOLD response, which is however strongly variable within participants across time, resulting in low reliability in the dorsal horn gray matter. Further improvements in data acquisition and analysis techniques are thus necessary before event-related spinal cord fMRI as used here can be reliably employed in longitudinal designs or clinical settings.
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Affiliation(s)
- Alice Dabbagh
- Max Planck Research Group Pain Perception, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ulrike Horn
- Max Planck Research Group Pain Perception, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Merve Kaptan
- Max Planck Research Group Pain Perception, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, CA, USA
| | - Toralf Mildner
- Methods & Development Group Nuclear Magnetic Resonance, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Roland Müller
- Methods & Development Group Nuclear Magnetic Resonance, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jöran Lepsien
- Methods & Development Group Nuclear Magnetic Resonance, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Nikolaus Weiskopf
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Felix Bloch Institute for Solid State Physics, Faculty of Physics and Earth Sciences, University of Leipzig, Leipzig, Germany
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, UK
| | - Jonathan C W Brooks
- School of Psychology, University of East Anglia Wellcome Wolfson Brain Imaging Centre (UWWBIC), Norwich, United Kingdom
| | - Jürgen Finsterbusch
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Falk Eippert
- Max Planck Research Group Pain Perception, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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3
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Aigner CS, Sánchez Alarcon MF, D'Astous A, Alonso-Ortiz E, Cohen-Adad J, Schmitter S. Calibration-free parallel transmission of the cervical, thoracic, and lumbar spinal cord at 7T. Magn Reson Med 2024. [PMID: 38733068 DOI: 10.1002/mrm.30137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE To address the limitations of spinal cord imaging at ultra-high field (UHF) due to time-consuming parallel transmit (pTx) adjustments. This study introduces calibration-free offline computed universal shim modes that can be applied seamlessly for different pTx RF coils and spinal cord target regions, substantially enhancing spinal cord imaging efficiency at UHF. METHODS A library of channel-wise relativeB 1 + $$ {B}_1^{+} $$ maps for the cervical spinal cord (six datasets) and thoracic and lumbar spinal cord (nine datasets) was constructed to optimize transmit homogeneity and efficiency for these regions. A tailored B0 shim was optimized for the cervical spine to enhance spatial magnetic field homogeneity further. The performance of the universal shims was validated using absolute saturation basedB 1 + $$ {B}_1^{+} $$ mapping and high-resolution 2D and 3D multi-echo gradient-recalled echo (GRE) data to assess the image quality. RESULTS The proposed universal shims demonstrated a 50% improvement inB 1 + $$ {B}_1^{+} $$ efficiency compared to the default (zero phase) shim mode.B 1 + $$ {B}_1^{+} $$ homogeneity was also improved by 20%. The optimized universal shims achieved performance comparable to subject-specific pTx adjustments, while eliminating the need for lengthy pTx calibration times, saving about 10 min per experiment. CONCLUSION The development of universal shims represents a significant advance by eliminating time-consuming subject-specific pTx adjustments. This approach is expected to make UHF spinal cord imaging more accessible and user-friendly, particularly for non-pTx experts.
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Affiliation(s)
- Christoph S Aigner
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
| | - Manuel F Sánchez Alarcon
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
- Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, A Joint Cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Alexandre D'Astous
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, Quebec, Canada
- Centre de recherche du CHU Sainte-Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Eva Alonso-Ortiz
- Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montréal, Quebec, Canada
- Mila-Quebec AI Institute, Montréal, Quebec, Canada
| | - Julien Cohen-Adad
- Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montréal, Quebec, Canada
- Mila-Quebec AI Institute, Montréal, Quebec, Canada
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sebastian Schmitter
- Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota, USA
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4
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Seifert AC, Xu J, Kong Y, Eippert F, Miller KL, Tracey I, Vannesjo SJ. Thermal stimulus task fMRI in the cervical spinal cord at 7 Tesla. Hum Brain Mapp 2024; 45:e26597. [PMID: 38375948 PMCID: PMC10877664 DOI: 10.1002/hbm.26597] [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: 04/24/2023] [Revised: 12/15/2023] [Accepted: 01/04/2024] [Indexed: 02/21/2024] Open
Abstract
Although functional magnetic resonance imaging (fMRI) is widely applied in the brain, fMRI of the spinal cord is more technically demanding. Proximity to the vertebral column and lungs results in strong spatial inhomogeneity and temporal fluctuations in B0 . Increasing field strength enables higher spatial resolution and improved sensitivity to blood oxygenation level-dependent (BOLD) signal, but amplifies the effects of B0 inhomogeneity. In this work, we present the first task fMRI in the spinal cord at 7 T. Further, we compare the performance of single-shot and multi-shot 2D echo-planar imaging (EPI) protocols, which differ in sensitivity to spatial and temporal B0 inhomogeneity. The cervical spinal cords of 11 healthy volunteers were scanned at 7 T using single-shot 2D EPI at 0.75 mm in-plane resolution and multi-shot 2D EPI at 0.75 and 0.6 mm in-plane resolutions. All protocols used 3 mm slice thickness. For each protocol, the BOLD response to 13 10-s noxious thermal stimuli applied to the right thumb was acquired in a 10-min fMRI run. Image quality, temporal signal to noise ratio (SNR), and BOLD activation (percent signal change and z-stat) at both individual- and group-level were evaluated between the protocols. Temporal SNR was highest in single-shot and multi-shot 0.75 mm protocols. In group-level analyses, activation clusters appeared in all protocols in the ipsilateral dorsal quadrant at the expected C6 neurological level. In individual-level analyses, activation clusters at the expected level were detected in some, but not all subjects and protocols. Single-shot 0.75 mm generally produced the highest mean z-statistic, while multi-shot 0.60 mm produced the best-localized activation clusters and the least geometric distortion. Larger than expected within-subject segmental variation of BOLD activation along the cord was observed. Group-level sensory task fMRI of the cervical spinal cord is feasible at 7 T with single-shot or multi-shot EPI. The best choice of protocol will likely depend on the relative importance of sensitivity to activation versus spatial localization of activation for a given experiment. PRACTITIONER POINTS: First stimulus task fMRI results in the spinal cord at 7 T. Single-shot 0.75 mm 2D EPI produced the highest mean z-statistic. Multi-shot 0.60 mm 2D EPI provided the best-localized activation and least distortion.
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Affiliation(s)
- Alan C. Seifert
- Biomedical Engineering and Imaging InstituteIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Department of Diagnostic, Molecular, and Interventional RadiologyIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Graduate School of Biomedical SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Junqian Xu
- Department of RadiologyBaylor College of MedicineHoustonTexasUSA
- Department of PsychiatryBaylor College of MedicineHoustonTexasUSA
| | - Yazhuo Kong
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Institute of PsychologyChinese Academy of SciencesBeijingChina
| | - Falk Eippert
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Max Planck Research Group Pain PerceptionMax Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Karla L. Miller
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Irene Tracey
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - S. Johanna Vannesjo
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
- Department of PhysicsNorwegian University of Science and Technology (NTNU)TrondheimNorway
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5
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Clarke MA, Witt AA, Robison RK, Fleishman S, Combes AJE, Houston D, Prock LE, Sweeney G, O'Grady KP, McKnight CD, Smith SA. Cervical spinal cord susceptibility-weighted MRI at 7T: Application to multiple sclerosis. Neuroimage 2023; 284:120460. [PMID: 37979894 DOI: 10.1016/j.neuroimage.2023.120460] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/31/2023] [Accepted: 11/15/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND Susceptibility-weighted imaging (SWI) has been extensively studied in the brain and in diseases of the central nervous system such as multiple sclerosis (MS) providing unique opportunities to visualize cerebral vasculature and disease-related pathology, including the central vein sign (CVS) and paramagnetic rim lesions (PRLs). However, similar studies evaluating SWI in the spinal cord of patients with MS remain severely limited. PURPOSE Based on our previous findings of enlarged spinal vessels in MS compared to healthy controls (HCs), we developed high-field SWI acquisition and processing methods for the cervical spinal cord with application in people with MS (pwMS) and HCs. Here, we demonstrate the vascular variability between the two cohorts and unique MS lesion features in the cervical cord. METHODS In this retrospective, exploratory pilot study conducted between March 2021 and March 2022, we scanned 12 HCs and 9 pwMS using an optimized non-contrast 2D T2*-weighted gradient echo sequence at 7 tesla. The overall appearance of the white and gray matter as well as tissue vasculature were compared between the two cohorts and areas of MS pathology in the patient group were assessed using both the magnitude and processed SWI images. RESULTS We show improved visibility of vessels and more pronounced gray and white matter contrast in the MS group compared to HCs, hypointensities surrounding the cord in the MS cohort, and identify signal changes indicative of the CVS and paramagnetic rims in 66 % of pwMS with cervical spinal lesions. CONCLUSION In this first study of SWI at 7T in the human spinal cord, SWI holds promise in advancing our understanding of disease processes in the cervical cord in MS.
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Affiliation(s)
- Margareta A Clarke
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232 USA
| | - Atlee A Witt
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA; School of Medicine, Vanderbilt University, Nashville, TN 37232 USA
| | - Ryan K Robison
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA; Philips Healthcare, Nashville TN 37232 USA
| | - Sawyer Fleishman
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA
| | - Anna J E Combes
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232 USA
| | - Delaney Houston
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA
| | - Logan E Prock
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA
| | - Grace Sweeney
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA
| | - Kristin P O'Grady
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232 USA; Department of Biomedical Engineering, Vanderbilt University, Nashville TN 37232 USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232 USA
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN 37232 USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN 37232 USA; Department of Biomedical Engineering, Vanderbilt University, Nashville TN 37232 USA.
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6
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Kinany N, Pirondini E, Micera S, Van De Ville D. Spinal Cord fMRI: A New Window into the Central Nervous System. Neuroscientist 2023; 29:715-731. [PMID: 35822665 PMCID: PMC10623605 DOI: 10.1177/10738584221101827] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With the brain, the spinal cord forms the central nervous system. Initially considered a passive relay between the brain and the periphery, the spinal cord is now recognized as being active and plastic. Yet, it remains largely overlooked by the human neuroscience community, in stark contrast with the wealth of research investigating the brain. In this review, we argue that fMRI, traditionally used to image cerebral function, can be extended beyond the brain to help unravel spinal mechanisms involved in human behaviors. To this end, we first outline strategies that have been proposed to tackle the challenges inherent to spinal cord fMRI. Then, we discuss how they have been utilized to provide insights into the functional organization of spinal sensorimotor circuits, highlighting their potential to address fundamental and clinical questions. By summarizing guidelines and applications of spinal cord fMRI, we hope to stimulate and support further research into this promising yet underexplored field.
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Affiliation(s)
- Nawal Kinany
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Medical Image Processing Laboratory, Center for Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
| | - Elvira Pirondini
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of BioEngineering, University of Pittsburgh, PA, USA
- Rehabilitation Neural Engineering Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
- Translational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Medical Image Processing Laboratory, Center for Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
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7
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Seifert AC, Xu J, Kong Y, Eippert F, Miller KL, Tracey I, Vannesjo SJ. Thermal Stimulus Task fMRI in the Cervical Spinal Cord at 7 Tesla. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.31.526451. [PMID: 36778391 PMCID: PMC9915652 DOI: 10.1101/2023.01.31.526451] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Although functional MRI is widely applied in the brain, fMRI of the spinal cord is more technically demanding. Proximity to the vertebral column and lungs results in strong spatial inhomogeneity and temporal fluctuations in B0. Increasing field strength enables higher spatial resolution and improved sensitivity to BOLD signal, but amplifies the effects of B0 inhomogeneity. In this work, we present the first stimulus task fMRI in the spinal cord at 7 T. Further, we compare the performance of single-shot and multi-shot 2D EPI protocols, as they differ in sensitivity to spatial and temporal B0 inhomogeneity. METHODS The cervical spinal cords of 11 healthy volunteers were scanned at 7 T using single-shot 2D EPI at 0.75 mm in-plane resolution and multi-shot 2D EPI at 0.75 and 0.6 mm in-plane resolutions. For each protocol, the BOLD response to thirteen 10-second noxious thermal stimuli applied to the right thumb was acquired in a 10-minute fMRI run. Image quality, temporal SNR, and BOLD activation (percent signal change and z-stat) at both individual- and group-level were evaluated between the protocols. RESULTS Temporal SNR was highest in single-shot and multi-shot 0.75 mm protocols. In group-level analyses, activation clusters appeared in all protocols in the ipsilateral dorsal quadrant at the expected C6 neurological level. In individual-level analyses, activation clusters at the expected level were detected in some, but not all subjects and protocols. Single-shot 0.75 mm generally produced the highest mean z-statistic, while multi-shot 0.60 mm produced the best-localized activation clusters and the least geometric distortion. Larger than expected within-subject segmental variation of BOLD activation along the cord was observed. CONCLUSION Group-level sensory task fMRI of the cervical spinal cord is feasible at 7 T with single-shot or multi-shot EPI. The best choice of protocol will likely depend on the relative importance of sensitivity to activation versus spatial localization of activation for a given experiment.
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8
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Haynes G, Muhammad F, Khan AF, Mohammadi E, Smith ZA, Ding L. The current state of spinal cord functional magnetic resonance imaging and its application in clinical research. J Neuroimaging 2023; 33:877-888. [PMID: 37740582 DOI: 10.1111/jon.13158] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023] Open
Abstract
Since its development, spinal cord functional magnetic resonance imaging (fMRI) has utilized various methodologies and stimulation protocols to develop a deeper understanding of a healthy human spinal cord that lays a foundation for its use in clinical research and practice. In this review, we conducted a comprehensive literature search on spinal cord fMRI studies and summarized the recent advancements and resulting scientific achievements of spinal cord fMRI in the following three aspects: the current state of spinal cord fMRI methodologies and stimulation protocols, knowledge about the healthy spinal cord's functions obtained via spinal cord fMRI, and fMRI's exemplary usage in spinal cord diseases and injuries. We conclude with a discussion that, while technical challenges exist, novel fMRI technologies for and new knowledge about the healthy human spinal cord have been established. Empowered by these developments, investigations of pathological and injury states within the spinal cord have become the next important direction of spinal cord fMRI. Recent clinical investigations into spinal cord pathologies, for example, fibromyalgia, multiple sclerosis, spinal cord injury, and cervical spondylotic myelopathy, have already provided deep insights into spinal cord impairments and the time course of impairment-caused changes. We expect that future spinal cord fMRI advancement and research development will further enhance our understanding of various spinal cord diseases and provide the foundation for evaluating existing and developing new treatment plans.
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Affiliation(s)
- Grace Haynes
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, Oklahoma, USA
| | - Fauziyya Muhammad
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Ali F Khan
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Esmaeil Mohammadi
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Lei Ding
- Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, Oklahoma, USA
- Institute for Biomedical Engineering, Science, and Technology, University of Oklahoma, Norman, Oklahoma, USA
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9
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Combes A, Narisetti L, Sengupta A, Rogers BP, Sweeney G, Prock L, Houston D, McKnight CD, Gore JC, Smith SA, O'Grady KP. Detection of resting-state functional connectivity in the lumbar spinal cord with 3T MRI. Sci Rep 2023; 13:18189. [PMID: 37875563 PMCID: PMC10597994 DOI: 10.1038/s41598-023-45302-0] [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] [Accepted: 10/18/2023] [Indexed: 10/26/2023] Open
Abstract
Functional MRI (fMRI) of the spinal cord is an expanding area of research with potential to investigate neuronal activity in the central nervous system. We aimed to characterize the functional connectivity features of the human lumbar spinal cord using resting-state fMRI (rs-fMRI) at 3T, using region-based and data-driven analysis approaches. A 3D multi-shot gradient echo resting-state blood oxygenation level dependent-sensitive rs-fMRI protocol was implemented in 26 healthy participants. Average temporal signal-to-noise ratio in the gray matter was 16.35 ± 4.79 after denoising. Evidence of synchronous signal fluctuations in the ventral and dorsal horns with their contralateral counterparts was observed in representative participants using interactive, exploratory seed-based correlations. Group-wise average in-slice Pearson's correlations were 0.43 ± 0.17 between ventral horns, and 0.48 ± 0.16 between dorsal horns. Group spatial independent component analysis (ICA) was used to identify areas of coherent activity¸ and revealed components within the gray matter corresponding to anatomical regions. Lower-dimensionality ICA revealed bilateral components corresponding to ventral and dorsal networks. Additional separate ICAs were run on two subsets of the participant group, yielding two sets of components that showed visual consistency and moderate spatial overlap. This work shows feasibility of rs-fMRI to probe the functional features and organization of the lumbar spinal cord.
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Affiliation(s)
- Anna Combes
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Lipika Narisetti
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
| | - Anirban Sengupta
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Baxter P Rogers
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Grace Sweeney
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
| | - Logan Prock
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
| | - Delaney Houston
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - John C Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Kristin P O'Grady
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Ave S, MCN AA1105, Nashville, TN, 37232, USA.
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37235, USA.
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10
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Chen LM, Wang F, Mishra A, Yang PF, Sengupta A, Reed JL, Gore JC. Longitudinal multiparametric MRI of traumatic spinal cord injury in animal models. Magn Reson Imaging 2023; 102:184-200. [PMID: 37343904 PMCID: PMC10528214 DOI: 10.1016/j.mri.2023.06.007] [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: 03/17/2022] [Revised: 06/14/2023] [Accepted: 06/17/2023] [Indexed: 06/23/2023]
Abstract
Multi-parametric MRI (mpMRI) technology enables non-invasive and quantitative assessments of the structural, molecular, and functional characteristics of various neurological diseases. Despite the recognized importance of studying spinal cord pathology, mpMRI applications in spinal cord research have been somewhat limited, partly due to technical challenges associated with spine imaging. However, advances in imaging techniques and improved image quality now allow longitudinal investigations of a comprehensive range of spinal cord pathological features by exploiting different endogenous MRI contrasts. This review summarizes the use of mpMRI techniques including blood oxygenation level-dependent (BOLD) functional MRI (fMRI), diffusion tensor imaging (DTI), quantitative magnetization transfer (qMT), and chemical exchange saturation transfer (CEST) MRI in monitoring different aspects of spinal cord pathology. These aspects include cyst formation and axonal disruption, demyelination and remyelination, changes in the excitability of spinal grey matter and the integrity of intrinsic functional circuits, and non-specific molecular changes associated with secondary injury and neuroinflammation. These approaches are illustrated with reference to a nonhuman primate (NHP) model of traumatic cervical spinal cord injuries (SCI). We highlight the benefits of using NHP SCI models to guide future studies of human spinal cord pathology, and demonstrate how mpMRI can capture distinctive features of spinal cord pathology that were previously inaccessible. Furthermore, the development of mechanism-based MRI biomarkers from mpMRI studies can provide clinically useful imaging indices for understanding the mechanisms by which injured spinal cords progress and repair. These biomarkers can assist in the diagnosis, prognosis, and evaluation of therapies for SCI patients, potentially leading to improved outcomes.
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Affiliation(s)
- Li Min Chen
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Arabinda Mishra
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pai-Feng Yang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anirban Sengupta
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jamie L Reed
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John C Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
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11
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Rangaprakash D, Barry RL, Deshpande G. The confound of hemodynamic response function variability in human resting-state functional MRI studies. Front Neurosci 2023; 17:934138. [PMID: 37521709 PMCID: PMC10375034 DOI: 10.3389/fnins.2023.934138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 04/07/2023] [Indexed: 08/01/2023] Open
Abstract
Functional magnetic resonance imaging (fMRI) is an indirect measure of neural activity with the hemodynamic response function (HRF) coupling it with unmeasured neural activity. The HRF, modulated by several non-neural factors, is variable across brain regions, individuals and populations. Yet, a majority of human resting-state fMRI connectivity studies continue to assume a non-variable HRF. In this article, with supportive prior evidence, we argue that HRF variability cannot be ignored as it substantially confounds within-subject connectivity estimates and between-subjects connectivity group differences. We also discuss its clinical relevance with connectivity impairments confounded by HRF aberrations in several disorders. We present limited data on HRF differences between women and men, which resulted in a 15.4% median error in functional connectivity estimates in a group-level comparison. We also discuss the implications of HRF variability for fMRI studies in the spinal cord. There is a need for more dialogue within the community on the HRF confound, and we hope that our article is a catalyst in the process.
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Affiliation(s)
- D. Rangaprakash
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
| | - Robert L. Barry
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
- Department of Radiology, Harvard Medical School, Boston, MA, United States
- Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Cambridge, MA, United States
| | - Gopikrishna Deshpande
- Department of Electrical and Computer Engineering, AU MRI Research Center, Auburn University, Auburn, AL, United States
- Department of Psychological Sciences, Auburn University, Auburn, AL, United States
- Center for Neuroscience, Auburn University, Auburn, AL, United States
- Alabama Advanced Imaging Consortium, Birmingham, AL, United States
- Key Laboratory for Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
- Centre for Brain Research, Indian Institute of Science, Bangalore, India
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12
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Brasanac J, Chien C. A review on multiple sclerosis prognostic findings from imaging, inflammation, and mental health studies. Front Hum Neurosci 2023; 17:1151531. [PMID: 37250694 PMCID: PMC10213782 DOI: 10.3389/fnhum.2023.1151531] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Magnetic resonance imaging (MRI) of the brain is commonly used to detect where chronic and active lesions are in multiple sclerosis (MS). MRI is also extensively used as a tool to calculate and extrapolate brain health by way of volumetric analysis or advanced imaging techniques. In MS patients, psychiatric symptoms are common comorbidities, with depression being the main one. Even though these symptoms are a major determinant of quality of life in MS, they are often overlooked and undertreated. There has been evidence of bidirectional interactions between the course of MS and comorbid psychiatric symptoms. In order to mitigate disability progression in MS, treating psychiatric comorbidities should be investigated and optimized. New research for the prediction of disease states or phenotypes of disability have advanced, primarily due to new technologies and a better understanding of the aging brain.
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Affiliation(s)
- Jelena Brasanac
- Charité – Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Medizinische Klinik m.S. Psychosomatik, Berlin, Germany
| | - Claudia Chien
- Charité – Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Medizinische Klinik m.S. Psychosomatik, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Neuroscience Clinical Research Center, Berlin, Germany
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13
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Kaptan M, Horn U, Vannesjo SJ, Mildner T, Weiskopf N, Finsterbusch J, Brooks JCW, Eippert F. Reliability of resting-state functional connectivity in the human spinal cord: assessing the impact of distinct noise sources. Neuroimage 2023; 275:120152. [PMID: 37142169 DOI: 10.1016/j.neuroimage.2023.120152] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/06/2023] Open
Abstract
The investigation of spontaneous fluctuations of the blood-oxygen-level-dependent (BOLD) signal has recently been extended from the brain to the spinal cord, where it has stimulated interest from a clinical perspective. A number of resting-state functional magnetic resonance imaging (fMRI) studies have demonstrated robust functional connectivity between the time series of BOLD fluctuations in bilateral dorsal horns and between those in bilateral ventral horns, in line with the functional neuroanatomy of the spinal cord. A necessary step prior to extension to clinical studies is assessing the reliability of such resting-state signals, which we aimed to do here in a group of 45 healthy young adults at the clinically prevalent field strength of 3T. When investigating connectivity in the entire cervical spinal cord, we observed fair to good reliability for dorsal-dorsal and ventral-ventral connectivity, whereas reliability was poor for within- and between-hemicord dorsal-ventral connectivity. Considering how prone spinal cord fMRI is to noise, we extensively investigated the impact of distinct noise sources and made two crucial observations: removal of physiological noise led to a reduction in functional connectivity strength and reliability - due to the removal of stable and participant-specific noise patterns - whereas removal of thermal noise considerably increased the detectability of functional connectivity without a clear influence on reliability. Finally, we also assessed connectivity within spinal cord segments and observed that while the pattern of connectivity was similar to that of whole cervical cord, reliability at the level of single segments was consistently poor. Taken together, our results demonstrate the presence of reliable resting-state functional connectivity in the human spinal cord even after thoroughly accounting for physiological and thermal noise, but at the same time urge caution if focal changes in connectivity (e.g. due to segmental lesions) are to be studied, especially in a longitudinal manner.
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Affiliation(s)
- Merve Kaptan
- Max Planck Research Group Pain Perception, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Ulrike Horn
- Max Planck Research Group Pain Perception, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - S Johanna Vannesjo
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Toralf Mildner
- Methods & Development Group Nuclear Magnetic Resonance, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Nikolaus Weiskopf
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Felix Bloch Institute for Solid State Physics, Faculty of Physics and Earth Sciences, University of Leipzig, Leipzig, Germany
| | - Jürgen Finsterbusch
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jonathan C W Brooks
- School of Psychology, University of East Anglia Wellcome Wolfson Brain Imaging Centre (UWWBIC), Norwich, United Kingdom
| | - Falk Eippert
- Max Planck Research Group Pain Perception, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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14
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Combes AJ, Clarke MA, O'Grady KP, Schilling KG, Smith SA. Advanced spinal cord MRI in multiple sclerosis: Current techniques and future directions. Neuroimage Clin 2022; 36:103244. [PMID: 36306717 PMCID: PMC9668663 DOI: 10.1016/j.nicl.2022.103244] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/02/2022] [Accepted: 10/19/2022] [Indexed: 11/11/2022]
Abstract
Spinal cord magnetic resonance imaging (MRI) has a central role in multiple sclerosis (MS) clinical practice for diagnosis and disease monitoring. Advanced MRI sequences capable of visualizing and quantifying tissue macro- and microstructure and reflecting different pathological disease processes have been used in MS research; however, the spinal cord remains under-explored, partly due to technical obstacles inherent to imaging this structure. We propose that the study of the spinal cord merits equal ambition in overcoming technical challenges, and that there is much information to be exploited to make valuable contributions to our understanding of MS. We present a narrative review on the latest progress in advanced spinal cord MRI in MS, covering in the first part structural, functional, metabolic and vascular imaging methods. We focus on recent studies of MS and those making significant technical steps, noting the challenges that remain to be addressed and what stands to be gained from such advances. Throughout we also refer to other works that presend more in-depth review on specific themes. In the second part, we present several topics that, in our view, hold particular potential. The need for better imaging of gray matter is discussed. We stress the importance of developing imaging beyond the cervical spinal cord, and explore the use of ultra-high field MRI. Finally, some recommendations are given for future research, from study design to newer developments in analysis, and the need for harmonization of sequences and methods within the field. This review is aimed at researchers and clinicians with an interest in gaining an overview of the current state of advanced MRI research in this field and what is primed to be the future of spinal cord imaging in MS research.
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Affiliation(s)
- Anna J.E. Combes
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States,Corresponding author at: 1161 21st Ave S, MCN AA1105, Nashville, TN 37232, USA.
| | - Margareta A. Clarke
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States
| | - Kristin P. O'Grady
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States,Department of Biomedical Engineering, Vanderbilt University, 2301 Vanderbilt Place, PMB 351826, Nashville, TN 37235-1826, United States
| | - Kurt G. Schilling
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States
| | - Seth A. Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States,Department of Biomedical Engineering, Vanderbilt University, 2301 Vanderbilt Place, PMB 351826, Nashville, TN 37235-1826, United States
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15
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Combes AJE, O'Grady KP, Rogers BP, Schilling KG, Lawless RD, Visagie M, Houston D, Prock L, Malone S, Satish S, Witt AA, McKnight CD, Bagnato F, Gore JC, Smith SA. Functional connectivity in the dorsal network of the cervical spinal cord is correlated with diffusion tensor imaging indices in relapsing-remitting multiple sclerosis. Neuroimage Clin 2022; 35:103127. [PMID: 35917721 PMCID: PMC9421501 DOI: 10.1016/j.nicl.2022.103127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/03/2022] [Accepted: 07/23/2022] [Indexed: 01/12/2023]
Abstract
Focal lesions may affect functional connectivity (FC) of the ventral and dorsal networks in the cervical spinal cord of people with relapsing-remitting multiple sclerosis (RRMS). Resting-state FC can be measured using functional MRI (fMRI) at 3T. This study sought to determine whether alterations in FC may be related to the degree of damage in the normal-appearing tissue. Tissue integrity and FC in the cervical spinal cord were assessed with diffusion tensor imaging (DTI) and resting-state fMRI, respectively, in a group of 26 RRMS participants with high cervical lesion load, low disability, and minimally impaired sensorimotor function, and healthy controls. Lower fractional anisotropy (FA) and higher radial diffusivity (RD) were observed in the normal-appearing white matter in the RRMS group relative to controls. Average FC in ventral and dorsal networks was similar between groups. Significant associations were found between higher FC in the dorsal sensory network and several DTI markers of pathology in the normal-appearing tissue. In the normal-appearing grey matter, dorsal FC was positively correlated with axial diffusivity (AD) (r = 0.46, p = 0.020) and mean diffusivity (MD) (r = 0.43, p = 0.032). In the normal-appearing white matter, dorsal FC was negatively correlated with FA (r = -0.43, p = 0.028) and positively correlated with RD (r = 0.49, p = 0.012), AD (r = 0.42, p = 0.037) and MD (r = 0.53, p = 0.006). These results suggest that increased connectivity, while remaining within the normal range, may represent a compensatory mechanism in response to structural damage in support of preserved sensory function in RRMS.
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Affiliation(s)
- Anna J E Combes
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States.
| | - Kristin P O'Grady
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States
| | - Baxter P Rogers
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States
| | - Kurt G Schilling
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States
| | - Richard D Lawless
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States; Department of Biomedical Engineering, Vanderbilt University, 2301 Vanderbilt Place, PMB 351826, Nashville, TN 37235-1826, United States
| | - Mereze Visagie
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States
| | - Delaney Houston
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States
| | - Logan Prock
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States
| | - Shekinah Malone
- School of Medicine, Meharry Medical College, 1005 Dr. D. B. Todd, Jr. Blvd., Nashville, TN 37208, United States
| | - Sanjana Satish
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States
| | - Atlee A Witt
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States
| | - Francesca Bagnato
- Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave. South, A-0118 Medical Center North, Nashville, TN 37232, United States; Department of Neurology, Nashville VA Medical Center, TN Valley Healthcare System, 1310 24th Avenue South, Nashville, TN 37212-2637, United States
| | - John C Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States; Department of Biomedical Engineering, Vanderbilt University, 2301 Vanderbilt Place, PMB 351826, Nashville, TN 37235-1826, United States
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2310, United States; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Medical Center North, 1161 21st Ave. South, Nashville, TN 37232, United States; Department of Biomedical Engineering, Vanderbilt University, 2301 Vanderbilt Place, PMB 351826, Nashville, TN 37235-1826, United States
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16
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Smith AC, O’Dell DR, Albin SR, Berliner JC, Dungan D, Robinson E, Elliott JM, Carballido-Gamio J, Stevens-Lapsley J, Weber KA. Lateral Corticospinal Tract and Dorsal Column Damage: Predictive Relationships With Motor and Sensory Scores at Discharge From Acute Rehabilitation After Spinal Cord Injury. Arch Phys Med Rehabil 2022; 103:62-68. [PMID: 34371017 PMCID: PMC8712383 DOI: 10.1016/j.apmr.2021.07.792] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/01/2021] [Accepted: 07/06/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine if lateral corticospinal tract (LCST) integrity demonstrates a significant predictive relationship with future ipsilateral lower extremity motor function (LEMS) and if dorsal column (DC) integrity demonstrates a significant predictive relationship with future light touch (LT) sensory function post spinal cord injury (SCI) at time of discharge from inpatient rehabilitation. DESIGN Retrospective analyses of imaging and clinical outcomes. SETTING University and academic hospital. PARTICIPANTS A total of 151 participants (N=151) with SCI. INTERVENTIONS Inpatient rehabilitation. MAIN OUTCOME MEASURES LEMS and LT scores at discharge from inpatient rehabilitation. RESULTS In 151 participants, right LCST spared tissue demonstrated a significant predictive relationship with right LEMS percentage recovered (β=0.56; 95% confidence interval [CI], 0.37-0.73; R=0.43; P<.001). Left LCST spared tissue demonstrated a significant predictive relationship with left LEMS percentage recovered (β=0.66; 95% CI, 0.50-0.82; R=0.51; P<.001). DC spared tissue demonstrated a significant predictive relationship with LT percentage recovered (β=0.69; 95% CI, 0.52-0.87; R=0.55; P<.001). When subgrouping the participants into motor complete vs incomplete SCI, motor relationships were no longer significant, but the sensory relationship remained significant. Those who had no voluntary motor function but recovered some also had significantly greater LCST spared tissue than those who did not recover motor function. CONCLUSIONS LCST demonstrated significant moderate predictive relationships with lower extremity motor function at the time of discharge from inpatient rehabilitation, in an ipsilesional manner. DC integrity demonstrated a significant moderate predictive relationship with recovered function of LT. With further development, these neuroimaging methods might be used to predict potential deficits after SCI and to provide corresponding targeted interventions.
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Affiliation(s)
- Andrew C. Smith
- University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, Aurora, CO USA,Regis University School of Physical Therapy, Denver, CO USA
| | - Denise R. O’Dell
- Regis University School of Physical Therapy, Denver, CO USA,Craig Hospital, Englewood, CO USA
| | | | | | - David Dungan
- Craig Hospital, Englewood, CO USA,Radiology Imaging Associates, Denver, CO USA
| | | | - James M. Elliott
- Faculty of Medicine and Health, The University of Sydney, Northern Sydney Local Health District, The Kolling Research Institute, St Leonards, Sydney, Australia
| | | | - Jennifer Stevens-Lapsley
- University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, Aurora, CO USA
| | - Kenneth A. Weber
- Stanford University School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Palo Alto, CA USA
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17
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Preliminary Analysis of Brain Footprints in Multiple Sclerosis Females with Detrusor Sphincter Dyssynergia: A Concurrent Urodynamic and Functional Magnetic Resonance Imaging Study. Int Neurourol J 2021; 26:S38-46. [PMID: 34856727 PMCID: PMC8896778 DOI: 10.5213/inj.2142012.006] [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] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/29/2021] [Indexed: 11/08/2022] Open
Abstract
Purpose This study evaluates the grey and white brain matter characteristics in women with multiple sclerosis (MS) and detrusor sphincter dyssynergia (DSD). Grey matter is assessed via the functional connectivity (FC) of brain regions activated during voiding, using functional magnetic resonance imaging (fMRI). Two white matter tracts involved in bladder function, the anterior thalamic radiation (ATR) and superior longitudinal fasciculus (SLF), were evaluated using diffusion tensor imaging (DTI). Methods Twenty-seven women with MS (two groups: no-DSD (n=23) or DSD (n=4)), and eight healthy controls (HC) underwent concurrent urodynamic-fMRI evaluation with four cycles of bladder filling and emptying. A FC similarity measure (FC_sim) was calculated for each subject to express the similarity of individual FC at voiding initiation compared to all FC patterns. ATR and SLF tracts were traced and their fractional anisotropy (FA) and mean diffusivity (MD) were recorded. Results Mean FC_sim values were significantly different among the three groups indicating distinct FC patterns; however, no significant difference was found between DSD and no-DSD groups. DSD group showed trends of lower FA and higher MD - indicating loss of coherence - in all tracts compared to HCs, and in the left and right ATR when compared to MS women with neither DSD nor voiding dysfunction (VD), suggesting more damage in these tracts for MS women with DSD. Conclusions Women with MS show distinctly different FC patterns compared to HCs. There are trends showing more damage in the ATR in women with MS and DSD compared to those with neither DSD nor VD.
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18
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Wu C, Ferreira F, Fox M, Harel N, Hattangadi-Gluth J, Horn A, Jbabdi S, Kahan J, Oswal A, Sheth SA, Tie Y, Vakharia V, Zrinzo L, Akram H. Clinical applications of magnetic resonance imaging based functional and structural connectivity. Neuroimage 2021; 244:118649. [PMID: 34648960 DOI: 10.1016/j.neuroimage.2021.118649] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/24/2021] [Accepted: 10/10/2021] [Indexed: 12/23/2022] Open
Abstract
Advances in computational neuroimaging techniques have expanded the armamentarium of imaging tools available for clinical applications in clinical neuroscience. Non-invasive, in vivo brain MRI structural and functional network mapping has been used to identify therapeutic targets, define eloquent brain regions to preserve, and gain insight into pathological processes and treatments as well as prognostic biomarkers. These tools have the real potential to inform patient-specific treatment strategies. Nevertheless, a realistic appraisal of clinical utility is needed that balances the growing excitement and interest in the field with important limitations associated with these techniques. Quality of the raw data, minutiae of the processing methodology, and the statistical models applied can all impact on the results and their interpretation. A lack of standardization in data acquisition and processing has also resulted in issues with reproducibility. This limitation has had a direct impact on the reliability of these tools and ultimately, confidence in their clinical use. Advances in MRI technology and computational power as well as automation and standardization of processing methods, including machine learning approaches, may help address some of these issues and make these tools more reliable in clinical use. In this review, we will highlight the current clinical uses of MRI connectomics in the diagnosis and treatment of neurological disorders; balancing emerging applications and technologies with limitations of connectivity analytic approaches to present an encompassing and appropriate perspective.
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Affiliation(s)
- Chengyuan Wu
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, 909 Walnut Street, Third Floor, Philadelphia, PA 19107, USA; Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut Street, First Floor, Philadelphia, PA 19107, USA.
| | - Francisca Ferreira
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London WC1N 3BG, UK; Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK.
| | - Michael Fox
- Center for Brain Circuit Therapeutics, Departments of Neurology, Psychiatry, Radiology, and Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA.
| | - Noam Harel
- Center for Magnetic Resonance Research, University of Minnesota, 2021 Sixth Street S.E., Minneapolis, MN 55455, USA.
| | - Jona Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, Center for Precision Radiation Medicine, University of California, San Diego, 3855 Health Sciences Drive, La Jolla, CA 92037, USA.
| | - Andreas Horn
- Neurology Department, Movement Disorders and Neuromodulation Section, Charité - University Medicine Berlin, Charitéplatz 1, D-10117, Berlin, Germany.
| | - Saad Jbabdi
- Wellcome Centre for Integrative Neuroimaging, Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK.
| | - Joshua Kahan
- Department of Neurology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA.
| | - Ashwini Oswal
- Medical Research Council Brain Network Dynamics Unit, University of Oxford, Mansfield Rd, Oxford OX1 3TH, UK.
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, 7200 Cambridge, Ninth Floor, Houston, TX 77030, USA.
| | - Yanmei Tie
- Center for Brain Circuit Therapeutics, Departments of Neurology, Psychiatry, Radiology, and Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, Boston, MA 02115, USA.
| | - Vejay Vakharia
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London WC1N 3BG, UK.
| | - Ludvic Zrinzo
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London WC1N 3BG, UK; Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK.
| | - Harith Akram
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, 33 Queen Square, London WC1N 3BG, UK; Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, 33 Queen Square, London WC1N 3BG, UK.
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Kreiter DJ, van den Hurk J, Wiggins CJ, Hupperts RMM, Gerlach OHH. Ultra-high field spinal cord MRI in multiple sclerosis: Where are we standing? A literature review. Mult Scler Relat Disord 2021; 57:103436. [PMID: 34871855 DOI: 10.1016/j.msard.2021.103436] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/18/2021] [Accepted: 11/27/2021] [Indexed: 12/24/2022]
Abstract
Magnetic resonance imaging (MRI) is a cornerstone in multiple sclerosis (MS) diagnostics and monitoring. Ultra-high field (UHF) MRI is being increasingly used and becoming more accessible. Due to the small diameter and mobility of the spinal cord, imaging this structure at ultra-high fields poses additional challenges compared to brain imaging. Here we review the potential benefits for the MS field by providing a literature overview of the use UHF spinal cord MRI in MS research and we elaborate on the challenges that are faced. Benefits include increased signal- and contrast-to-noise, enabling for higher spatial resolutions, which can improve MS lesion sensitivity in both the spinal white matter as well as grey matter. Additionally, these benefits can aid imaging of microstructural abnormalities in the spinal cord in MS using advanced MRI techniques like functional imaging, MR spectroscopy and diffusion-based techniques. Technical challenges include increased magnetic field inhomogeneities, distortions from physiological motion and optimalisation of sequences. Approaches including parallel imaging techniques, real time shimming and retrospective compensation of physiological motion are making it increasingly possible to unravel the potential of spinal cord UHF MRI in the context of MS research.
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Affiliation(s)
- Daniël J Kreiter
- Academic MS center Zuyderland, Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands; School for Mental Health and Neuroscience, Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Job van den Hurk
- Scannexus, Maastricht, The Netherlands; Maastricht University, Faculty of Health, Medicine & Life Sciences, Maastricht, The Netherlands
| | | | - Raymond M M Hupperts
- Academic MS center Zuyderland, Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands; School for Mental Health and Neuroscience, Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Oliver H H Gerlach
- Academic MS center Zuyderland, Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands; School for Mental Health and Neuroscience, Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
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20
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Landelle C, Lungu O, Vahdat S, Kavounoudias A, Marchand-Pauvert V, De Leener B, Doyon J. Investigating the human spinal sensorimotor pathways through functional magnetic resonance imaging. Neuroimage 2021; 245:118684. [PMID: 34732324 DOI: 10.1016/j.neuroimage.2021.118684] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 01/29/2023] Open
Abstract
Most of our knowledge about the human spinal ascending (sensory) and descending (motor) pathways comes from non-invasive electrophysiological investigations. However, recent methodological advances in acquisition and analyses of functional magnetic resonance imaging (fMRI) data from the spinal cord, either alone or in combination with the brain, have allowed us to gain further insights into the organization of this structure. In the current review, we conducted a systematic search to produced somatotopic maps of the spinal fMRI activity observed through different somatosensory, motor and resting-state paradigms. By cross-referencing these human neuroimaging findings with knowledge acquired through neurophysiological recordings, our review demonstrates that spinal fMRI is a powerful tool for exploring, in vivo, the human spinal cord pathways. We report strong cross-validation between task-related and resting-state fMRI in accordance with well-known hemicord, postero-anterior and rostro-caudal organization of these pathways. We also highlight the specific advantages of using spinal fMRI in clinical settings to characterize better spinal-related impairments, predict disease progression, and guide the implementation of therapeutic interventions.
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Affiliation(s)
- Caroline Landelle
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
| | - Ovidiu Lungu
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | | | - Anne Kavounoudias
- CNRS, UMR7291, Laboratory of Cognitive Neurosciences, Aix-Marseille University, Marseille, France
| | | | - Benjamin De Leener
- Department of Computer Engineering and Software Engineering, Polytechnique Montreal, Montreal, QC, Canada; CHU Sainte-Justine Research Centre, Montreal, QC, Canada
| | - Julien Doyon
- McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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21
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Sengupta A, Mishra A, Wang F, Li M, Yang PF, Chen LM, Gore JC. Functional networks in non-human primate spinal cord and the effects of injury. Neuroimage 2021; 240:118391. [PMID: 34271158 PMCID: PMC8527400 DOI: 10.1016/j.neuroimage.2021.118391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022] Open
Abstract
Spontaneous fluctuations of Blood Oxygenation-Level Dependent (BOLD) MRI signal in a resting state have previously been detected and analyzed to describe intrinsic functional networks in the spinal cord of rodents, non-human primates and human subjects. In this study we combined high resolution imaging at high field with data-driven Independent Component Analysis (ICA) to i) delineate fine-scale functional networks within and between segments of the cervical spinal cord of monkeys, and also to ii) characterize the longitudinal effects of a unilateral dorsal column injury on these networks. Seven distinct functional hubs were revealed within each spinal segment, with new hubs detected at bilateral intermediate and gray commissure regions in addition to the bilateral dorsal and ventral horns previously reported. Pair-wise correlations revealed significantly stronger connections between hubs on the dominant hand side. Unilateral dorsal-column injuries disrupted predominantly inter-segmental rather than intra-segmental functional connectivities as revealed by correlation strengths and graph-theory based community structures. The effects of injury on inter-segmental connectivity were evident along the length of the cord both below and above the lesion region. Connectivity strengths recovered over time and there was revival of inter-segmental communities as animals recovered function. BOLD signals of frequency 0.01-0.033 Hz were found to be most affected by injury. The results in this study provide new insights into the intrinsic functional architecture of spinal cord and underscore the potential of functional connectivity measures to characterize changes in networks after an injury and during recovery.
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Affiliation(s)
- Anirban Sengupta
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Arabinda Mishra
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Muwei Li
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Pai-Feng Yang
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Li Min Chen
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.
| | - John C Gore
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA; Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA; Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, 37232, USA
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22
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Structural and resting state functional connectivity beyond the cortex. Neuroimage 2021; 240:118379. [PMID: 34252527 DOI: 10.1016/j.neuroimage.2021.118379] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/21/2021] [Accepted: 07/07/2021] [Indexed: 12/14/2022] Open
Abstract
Mapping the structural and functional connectivity of the central nervous system has become a key area within neuroimaging research. While detailed network structures across the entire brain have been probed using animal models, non-invasive neuroimaging in humans has thus far been dominated by cortical investigations. Beyond the cortex, subcortical nuclei have traditionally been less accessible due to their smaller size and greater distance from radio frequency coils. However, major neuroimaging developments now provide improved signal and the resolution required to study these structures. Here, we present an overview of the connectivity between the amygdala, brainstem, cerebellum, spinal cord and the rest of the brain. While limitations to their imaging and analyses remain, we also provide some recommendations and considerations for mapping brain connectivity beyond the cortex.
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McPherson JG, Bandres MF. Spontaneous neural synchrony links intrinsic spinal sensory and motor networks during unconsciousness. eLife 2021; 10:e66308. [PMID: 34042587 PMCID: PMC8177891 DOI: 10.7554/elife.66308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/26/2021] [Indexed: 12/17/2022] Open
Abstract
Non-random functional connectivity during unconsciousness is a defining feature of supraspinal networks. However, its generalizability to intrinsic spinal networks remains incompletely understood. Previously, Barry et al., 2014 used fMRI to reveal bilateral resting state functional connectivity within sensory-dominant and, separately, motor-dominant regions of the spinal cord. Here, we record spike trains from large populations of spinal interneurons in vivo in rats and demonstrate that spontaneous functional connectivity also links sensory- and motor-dominant regions during unconsciousness. The spatiotemporal patterns of connectivity could not be explained by latent afferent activity or by populations of interconnected neurons spiking randomly. We also document connection latencies compatible with mono- and disynaptic interactions and putative excitatory and inhibitory connections. The observed activity is consistent with the hypothesis that salient, experience-dependent patterns of neural transmission introduced during behavior or by injury/disease are reactivated during unconsciousness. Such a spinal replay mechanism could shape circuit-level connectivity and ultimately behavior.
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Affiliation(s)
- Jacob Graves McPherson
- Program in Physical Therapy, Washington University School of MedicineSt. LouisUnited States
- Department of Anesthesiology, Washington University School of MedicineSt. LouisUnited States
- Washington University Pain Center, Washington University School of MedicineSt. LouisUnited States
- Program in Neurosciences, Washington University School of MedicineSt. LouisUnited States
| | - Maria F Bandres
- Program in Physical Therapy, Washington University School of MedicineSt. LouisUnited States
- Department of Biomedical Engineering, Washington University School of MedicineSt. LouisUnited States
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24
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Abstract
Multiple diverse pathologies result in the clinical presentation of myelopathy. The preferred way to image the spinal cord depends on clinical history, anatomic site of interest, and patient issues limiting certain imaging modalities. This radiology-focused article discusses pertinent physiological considerations, reviews basic and newer imaging techniques, and examines several distinct disease entities in order to highlight the key role of imaging in the work-up of myelopathy.
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Affiliation(s)
- Alice C Shea
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Anderson H Kuo
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
| | - Liangge Hsu
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts
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25
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Imaging of the Spinal Cord in Multiple Sclerosis: Past, Present, Future. Brain Sci 2020; 10:brainsci10110857. [PMID: 33202821 PMCID: PMC7696997 DOI: 10.3390/brainsci10110857] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 10/30/2020] [Accepted: 11/11/2020] [Indexed: 11/17/2022] Open
Abstract
Spinal cord imaging in multiple sclerosis (MS) plays a significant role in diagnosing and tracking disease progression. The spinal cord is one of four key areas of the central nervous system where documenting the dissemination in space in the McDonald criteria for diagnosing MS. Spinal cord lesion load and the severity of cord atrophy are believed to be more relevant to disability than white matter lesions in the brain in different phenotypes of MS. Axonal loss contributes to spinal cord atrophy in MS and its degree correlates with disease severity and prognosis. Therefore, measures of axonal loss are often reliable biomarkers for monitoring disease progression. With recent technical advances, more and more qualitative and quantitative MRI techniques have been investigated in an attempt to provide objective and reliable diagnostic and monitoring biomarkers in MS. In this article, we discuss the role of spinal cord imaging in the diagnosis and prognosis of MS and, additionally, we review various techniques that may improve our understanding of the disease.
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26
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Barry RL, Conrad BN, Maki S, Watchmaker JM, McKeithan LJ, Box BA, Weinberg QR, Smith SA, Gore JC. Multi-shot acquisitions for stimulus-evoked spinal cord BOLD fMRI. Magn Reson Med 2020; 85:2016-2026. [PMID: 33169877 DOI: 10.1002/mrm.28570] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE To demonstrate the feasibility of 3D multi-shot magnetic resonance imaging acquisitions for stimulus-evoked blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) in the human spinal cord in vivo. METHODS Two fMRI studies were performed at 3T. The first study was a hypercapnic gas challenge where data were acquired from healthy volunteers using a multi-shot 3D fast field echo (FFE) sequence as well as single-shot multi-slice echo-planar imaging (EPI). In the second study, another cohort of healthy volunteers performed an upper extremity motor task while fMRI data were acquired using a 3D multi-shot acquisition. RESULTS Both 2D-EPI and 3D-FFE were shown to be sensitive to BOLD signal changes in the cervical spinal cord, and had comparable contrast-to-noise ratios in gray matter. FFE exhibited much less signal drop-out and weaker geometric distortions compared to EPI. In the motor paradigm study, the mean number of active voxels was highest in the ventral gray matter horns ipsilateral to the side of the task and at the spinal level associated with innervation of finger extensors. CONCLUSIONS Highly multi-shot acquisition sequences such as 3D-FFE are well suited for stimulus-evoked spinal cord BOLD fMRI.
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Affiliation(s)
- Robert L Barry
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Harvard-Massachusetts Institute of Technology Health Sciences & Technology, Cambridge, MA, USA
| | - Benjamin N Conrad
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
- Neuroscience Graduate Program, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Satoshi Maki
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer M Watchmaker
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lydia J McKeithan
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bailey A Box
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Quinn R Weinberg
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - John C Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
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27
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Effect size – one size doesn't fit all. Mult Scler Relat Disord 2020; 46:102587. [DOI: 10.1016/j.msard.2020.102587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/12/2020] [Accepted: 10/15/2020] [Indexed: 11/21/2022]
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28
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Kinany N, Pirondini E, Micera S, Van De Ville D. Dynamic Functional Connectivity of Resting-State Spinal Cord fMRI Reveals Fine-Grained Intrinsic Architecture. Neuron 2020; 108:424-435.e4. [PMID: 32910894 DOI: 10.1016/j.neuron.2020.07.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/23/2020] [Accepted: 07/18/2020] [Indexed: 12/24/2022]
Abstract
The neuroimaging community has shown tremendous interest in exploring the brain's spontaneous activity using functional magnetic resonance imaging (fMRI). On the contrary, the spinal cord has been largely overlooked despite its pivotal role in processing sensorimotor signals. Only a handful of studies have probed the organization of spinal resting-state fluctuations, always using static measures of connectivity. Many innovative approaches have emerged for analyzing dynamics of brain fMRI, but they have not yet been applied to the spinal cord, although they could help disentangle its functional architecture. Here, we leverage a dynamic connectivity method based on the clustering of hemodynamic-informed transients to unravel the rich dynamic organization of spinal resting-state signals. We test this approach in 19 healthy subjects, uncovering fine-grained spinal components and highlighting their neuroanatomical and physiological nature. We provide a versatile tool, the spinal innovation-driven co-activation patterns (SpiCiCAP) framework, to characterize spinal circuits during rest and task, as well as their disruption in neurological disorders.
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Affiliation(s)
- Nawal Kinany
- Medical Image Processing Laboratory, Center for Neuroprosthetics, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Elvira Pirondini
- Department of Radiology and Medical Informatics, University of Geneva, 1211 Geneva, Switzerland
| | - Silvestro Micera
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; The BioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, 56025 Pontedera, Italy.
| | - Dimitri Van De Ville
- Medical Image Processing Laboratory, Center for Neuroprosthetics, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland; Department of Radiology and Medical Informatics, University of Geneva, 1211 Geneva, Switzerland.
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29
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Weber KA, Chen Y, Paliwal M, Law CS, Hopkins BS, Mackey S, Dhaher Y, Parrish TB, Smith ZA. Assessing the spatial distribution of cervical spinal cord activity during tactile stimulation of the upper extremity in humans with functional magnetic resonance imaging. Neuroimage 2020; 217:116905. [PMID: 32387628 PMCID: PMC7386934 DOI: 10.1016/j.neuroimage.2020.116905] [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: 03/20/2020] [Revised: 04/24/2020] [Accepted: 05/03/2020] [Indexed: 12/12/2022] Open
Abstract
Dermatomal maps are a mainstay of clinical practice and provide information on the spatial distribution of the cutaneous innervation of spinal nerves. Dermatomal deficits can help isolate the level of spinal nerve root involvement in spinal conditions and guide clinicians in diagnosis and treatment. Dermatomal maps, however, have limitations, and the spatial distribution of spinal cord sensory activity in humans remains to be quantitatively assessed. Here we used spinal cord functional MRI to map and quantitatively compare the spatial distribution of sensory spinal cord activity during tactile stimulation of the left and right lateral shoulders (i.e. C5 dermatome) and dorsal third digits of the hands (i.e., C7 dermatome) in healthy humans (n = 24, age = 36.8 ± 11.8 years). Based on the central sites for processing of innocuous tactile sensory information, we hypothesized that the activity would be localized more to the ipsilateral dorsal spinal cord with the lateral shoulder stimulation activity being localized more superiorly than the dorsal third digit. The findings demonstrate lateralization of the activity with the left- and right-sided stimuli having more activation in the ipsilateral hemicord. Contradictory to our hypotheses, the activity for both stimulation sites was spread across the dorsal and ventral hemicords and did not demonstrate a clear superior-inferior localization. Instead, the activity for both stimuli had a broader than expected distribution, extending across the C5, C6, and C7 spinal cord segments. We highlight the complexity of the human spinal cord neuroanatomy and several sources of variability that may explain the observed patterns of activity. While the findings were not completely consistent with our a priori hypotheses, this study provides a foundation for continued work and is an important step towards developing normative quantitative spinal cord measures of sensory function, which may become useful objective MRI-based biomarkers of neurological injury and improve the management of spinal disorders.
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Affiliation(s)
- Kenneth A Weber
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA.
| | - Yufen Chen
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Monica Paliwal
- Department of Neurological Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christine S Law
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA
| | - Benjamin S Hopkins
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sean Mackey
- Systems Neuroscience and Pain Lab, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USA
| | - Yasin Dhaher
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Todd B Parrish
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Zachary A Smith
- Department of Neurological Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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30
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Wu TL, Byun NE, Wang F, Mishra A, Janve VA, Chen LM, Gore JC. Longitudinal assessment of recovery after spinal cord injury with behavioral measures and diffusion, quantitative magnetization transfer and functional magnetic resonance imaging. NMR IN BIOMEDICINE 2020; 33:e4216. [PMID: 31943383 PMCID: PMC7155919 DOI: 10.1002/nbm.4216] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 05/09/2023]
Abstract
Spinal cord injuries (SCIs) are a leading cause of disability and can severely impact the quality of life. However, to date, the processes of spontaneous repair of damaged spinal cord remain incompletely understood, partly due to a lack of appropriate longitudinal tracking methods. Noninvasive, multiparametric magnetic resonance imaging (MRI) provides potential biomarkers for the comprehensive evaluation of spontaneous repair after SCI. In this study in rats, a clinically relevant contusion injury was introduced at the lumbar level that impairs both hindlimb motor and sensory functions. Quantitative MRI measurements were acquired at baseline and serially post-SCI for up to 2 wk. The progressions of injury and spontaneous recovery in both white and gray matter were tracked longitudinally using pool-size ratio (PSR) measurements derived from quantitative magnetization transfer (qMT) methods, measurements of water diffusion parameters using diffusion tensor imaging (DTI) and intrasegment functional connectivity derived from resting state functional MRI. Changes in these quantitative imaging measurements were correlated with behavioral readouts. We found (a) a progressive decrease in PSR values within 2 wk post-SCI, indicating a progressive demyelination at the center of the injury that was validated with histological staining, (b) PSR correlated closely with fractional anisotropy and transverse relaxation of free water, but did not show significant correlations with behavioral recovery, and (c) preliminary evidence that SCI induced a decrease in functional connectivity between dorsal horns below the injury site at 24 h. Findings from this study not only confirm the value of qMT and DTI methods for assessing the myelination state of injured spinal cord but indicate that they may also have further implications on whether therapies targeted towards remyelination may be appropriate. Additionally, a better understanding of changes after SCI provides valuable information to guide and assess interventions.
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Affiliation(s)
- Tung-Lin Wu
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, United States
- Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, United States
| | - Nellie E. Byun
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, United States
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, United States
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, United States
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, United States
| | - Arabinda Mishra
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, United States
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, United States
| | - Vaibhav A. Janve
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, United States
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, United States
| | - Li Min Chen
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, United States
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, United States
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, United States
- Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, United States
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, United States
- Physics and Astronomy, Vanderbilt University, Nashville, TN, 37232, United States
- Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, 37232, United States
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31
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Rocca MA, Preziosa P, Filippi M. What role should spinal cord MRI take in the future of multiple sclerosis surveillance? Expert Rev Neurother 2020; 20:783-797. [PMID: 32133874 DOI: 10.1080/14737175.2020.1739524] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In multiple sclerosis (MS), inflammatory, demyelinating, and neurodegenerative phenomena affect the spinal cord, with detrimental effects on patients' clinical disability. Although spinal cord imaging may be challenging, improvements in MRI technologies have contributed to better evaluate spinal cord involvement in MS. AREAS COVERED This review summarizes the current state-of-art of the application of conventional and advanced MRI techniques to evaluate spinal cord damage in MS. Typical features of spinal cord lesions, their role in the diagnostic work-up of suspected MS, their predictive role for subsequent disease course and clinical worsening, and their utility to define treatment response are discussed. The role of spinal cord atrophy and of other advanced MRI techniques to better evaluate the associations between spinal cord abnormalities and the accumulation of clinical disability are also evaluated. Finally, how spinal cord assessment could evolve in the future to improve monitoring of disease progression and treatment effects is examined. EXPERT OPINION Spinal cord MRI provides relevant additional information to brain MRI in understanding MS pathophysiology, in allowing an earlier and more accurate diagnosis of MS, and in identifying MS patients at higher risk to develop more severe disability. A future role in monitoring the effects of treatments is also foreseen.
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Affiliation(s)
- Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute , Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute , Milan, Italy
| | - Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute , Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute , Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute , Milan, Italy.,Neurology Unit, IRCCS San Raffaele Scientific Institute , Milan, Italy.,Neurophysiology Unit, IRCCS San Raffaele Scientific Institute , Milan, Italy.,Vita-Salute San Raffaele University , Milan, Italy
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Bisulca J, De Lury A, Coyle PK, Syritsyna O, Peyster R, Bangiyev L, Duong TQ. MRI features associated with high likelihood of conversion of radiologically isolated syndrome to multiple sclerosis. Mult Scler Relat Disord 2019; 36:101381. [PMID: 31518773 DOI: 10.1016/j.msard.2019.101381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/30/2019] [Accepted: 08/31/2019] [Indexed: 10/26/2022]
Abstract
Radiologically isolated syndrome (RIS) is the asymptomatic precursor to clinically isolated syndrome, relapsing-remitting multiple sclerosis (MS) or primary progressive MS. RIS is frequently diagnosed when an individual gets an MRI for an unrelated medical issue, such as headache or trauma. Treating RIS patients is controversial, but physicians may be inclined to offer prophylactic treatment for high-risk RIS patients. Identifying imaging and clinical features associated with high likelihood of early clinical conversion may prove helpful to identify a high-risk subset for potential MS therapy. The goal of this paper is to review current literatures to identify imaging and clinical features that predict early (within 5 years) conversion from RIS to MS.
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Affiliation(s)
- Joseph Bisulca
- Departments of Radiology and Neurology, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Amy De Lury
- Departments of Radiology and Neurology, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Patricia K Coyle
- Departments of Radiology and Neurology, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Olga Syritsyna
- Departments of Radiology and Neurology, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Robert Peyster
- Departments of Radiology and Neurology, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Lev Bangiyev
- Departments of Radiology and Neurology, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA
| | - Tim Q Duong
- Departments of Radiology and Neurology, Stony Brook Medicine, 101 Nicolls Rd, Stony Brook, NY 11794, USA.
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Barry RL, Smith SA. Measurement of T 2* in the human spinal cord at 3T. Magn Reson Med 2019; 82:743-748. [PMID: 30924198 PMCID: PMC6510624 DOI: 10.1002/mrm.27755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/06/2019] [Accepted: 03/06/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE To measure the transverse relaxation time T2* in healthy human cervical spinal cord gray matter (GM) and white matter (WM) at 3T. METHODS Thirty healthy volunteers were recruited. Axial images were acquired using an averaged multi-echo gradient-echo (mFFE) T2*-weighted sequence with 5 echoes. We used the signal equation for an mFFE sequence with constant dephasing gradients after each echo to jointly estimate the spin density and T2* for each voxel. RESULTS No global difference in T2* was observed between all GM (41.3 ± 5.6 ms) and all WM (39.8 ± 5.4 ms). No significant differences were observed between left (43.2 ± 6.8 ms) and right (43.4 ± 5.5 ms) ventral GM, left (38.3 ± 6.1 ms) and right (38.6 ± 6.5 ms) dorsal GM, and left (39.4 ± 5.8 ms) and right (40.3 ± 5.8 ms) lateral WM. However, significant regional differences were observed between ventral (43.4 ± 5.7 ms) and dorsal (38.4 ± 6.0 ms) GM (p < 0.05), as well as between ventral (42.9 ± 6.5 ms) and dorsal (37.9 ± 6.2 ms) WM (p < 0.05). In analyses across slices, inferior T2* was longer than superior T2* in GM (44.7 ms vs. 40.1 ms; p < 0.01) and in WM (41.8 ms vs. 35.9 ms; p < 0.01). CONCLUSIONS Significant differences in T2* are observed between ventral and dorsal GM, ventral and dorsal WM, and superior and inferior GM and WM. There is no evidence for bilateral asymmetry in T2* in the healthy cord. These values of T2* in the spinal cord are notably lower than most reported values of T2* in the cortex.
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Affiliation(s)
- Robert L. Barry
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA,Department of Radiology, Harvard Medical School, Boston, MA, USA,Harvard-Massachusetts Institute of Technology Health Sciences & Technology, Cambridge, MA, USA
| | - Seth A. Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
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Ioachim G, Powers JM, Stroman PW. Comparing Coordinated Networks Across the Brainstem and Spinal Cord in the Resting State and Altered Cognitive State. Brain Connect 2019; 9:415-424. [DOI: 10.1089/brain.2018.0659] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Gabriela Ioachim
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada
| | - Jocelyn M. Powers
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada
| | - Patrick W. Stroman
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada
- Department of Biomedical and Molecular Sciences and Queen's University, Kingston, Canada
- Department of Physics, Queen's University, Kingston, Canada
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35
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Abstract
Persistent spinal (traumatic and nontraumatic) pain is common and contributes to high societal and personal costs globally. There is an acknowledged urgency for new and interdisciplinary approaches to the condition, and soft tissues, including skeletal muscles, the spinal cord, and the brain, are rightly receiving increased attention as important biological contributors. In reaction to the recent suspicion and questioned value of imaging-based findings, this paper serves to recognize the promise that the technological evolution of imaging techniques, and particularly magnetic resonance imaging, is allowing in characterizing previously less visible morphology. We emphasize the value of quantification and data analysis of several contributors in the biopsychosocial model for understanding spinal pain. Further, we highlight emerging evidence regarding the pathobiology of changes to muscle composition (eg, atrophy, fatty infiltration), as well as advancements in neuroimaging and musculoskeletal imaging techniques (eg, fat-water imaging, functional magnetic resonance imaging, diffusion imaging, magnetization transfer imaging) for these important soft tissues. These noninvasive and objective data sources may complement known prognostic factors of poor recovery, patient self-report, diagnostic tests, and the "-omics" fields. When combined, advanced "big-data" analyses may assist in identifying associations previously not considered. Our clinical commentary is supported by empirical findings that may orient future efforts toward collaborative conversation, hypothesis generation, interdisciplinary research, and translation across a number of health fields. Our emphasis is that magnetic resonance imaging technologies and research are crucial to the advancement of our understanding of the complexities of spinal conditions. J Orthop Sports Phys Ther 2019;49(5):320-329. Epub 26 Mar 2019. doi:10.2519/jospt.2019.8793.
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36
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Moccia M, Ruggieri S, Ianniello A, Toosy A, Pozzilli C, Ciccarelli O. Advances in spinal cord imaging in multiple sclerosis. Ther Adv Neurol Disord 2019; 12:1756286419840593. [PMID: 31040881 PMCID: PMC6477770 DOI: 10.1177/1756286419840593] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/03/2019] [Indexed: 11/18/2022] Open
Abstract
The spinal cord is frequently affected in multiple sclerosis (MS), causing motor, sensory and autonomic dysfunction. A number of pathological abnormalities, including demyelination and neuroaxonal loss, occur in the MS spinal cord and are studied in vivo with magnetic resonance imaging (MRI). The aim of this review is to summarise and discuss recent advances in spinal cord MRI. Advances in conventional spinal cord MRI include improved identification of MS lesions, recommended spinal cord MRI protocols, enhanced recognition of MRI lesion characteristics that allow MS to be distinguished from other myelopathies, evidence for the role of spinal cord lesions in predicting prognosis and monitoring disease course, and novel post-processing methods to obtain lesion probability maps. The rate of spinal cord atrophy is greater than that of brain atrophy (-1.78% versus -0.5% per year), and reflects neuroaxonal loss in an eloquent site of the central nervous system, suggesting that it can become an important outcome measure in clinical trials, especially in progressive MS. Recent developments allow the calculation of spinal cord atrophy from brain volumetric scans and evaluation of its progression over time with registration-based techniques. Fully automated analysis methods, including segmentation of grey matter and intramedullary lesions, will facilitate the use of spinal cord atrophy in trial designs and observational studies. Advances in quantitative imaging techniques to evaluate neuroaxonal integrity, myelin content, metabolic changes, and functional connectivity, have provided new insights into the mechanisms of damage in MS. Future directions of research and the possible impact of 7T scanners on spinal cord imaging will be discussed.
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Affiliation(s)
- Marcello Moccia
- Queen Square MS Centre, NMR Research Unit, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neurosciences, Federico II University of Naples, via Sergio Pansini, 5, Edificio 17 - piano terra, Napoli, 80131 Naples, Italy
| | - Serena Ruggieri
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - Antonio Ianniello
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - Ahmed Toosy
- Queen Square MS Centre, NMR Research Unit, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
| | - Carlo Pozzilli
- Department of Human Neuroscience, Sapienza University of Rome, Italy
| | - Olga Ciccarelli
- Queen Square MS Centre, NMR Research Unit, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
- National Institute for Health Research, University College London Hospitals Biomedical Research Centre, London, UK
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37
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Wu TL, Yang PF, Wang F, Shi Z, Mishra A, Wu R, Chen LM, Gore JC. Intrinsic functional architecture of the non-human primate spinal cord derived from fMRI and electrophysiology. Nat Commun 2019; 10:1416. [PMID: 30926817 PMCID: PMC6440970 DOI: 10.1038/s41467-019-09485-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/05/2019] [Indexed: 02/07/2023] Open
Abstract
Resting-state functional MRI (rsfMRI) has recently revealed correlated signals in the spinal cord horns of monkeys and humans. However, the interpretation of these rsfMRI correlations as indicators of functional connectivity in the spinal cord remains unclear. Here, we recorded stimulus-evoked and spontaneous spiking activity and local field potentials (LFPs) from monkey spinal cord in order to validate fMRI measures. We found that both BOLD and electrophysiological signals elicited by tactile stimulation co-localized to the ipsilateral dorsal horn. Temporal profiles of stimulus-evoked BOLD signals covaried with LFP and multiunit spiking in a similar way to those observed in the brain. Functional connectivity of dorsal horns exhibited a U-shaped profile along the dorsal-intermediate-ventral axis. Overall, these results suggest that there is an intrinsic functional architecture within the gray matter of a single spinal segment, and that rsfMRI signals at high field directly reflect this underlying spontaneous neuronal activity.
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Affiliation(s)
- Tung-Lin Wu
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA.
- Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA.
| | - Pai-Feng Yang
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Zhaoyue Shi
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA
- Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA
| | - Arabinda Mishra
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Ruiqi Wu
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA
| | - Li Min Chen
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - John C Gore
- Vanderbilt University Institute of Imaging Science, Nashville, TN, 37232, USA
- Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, 37232, USA
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38
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A practical protocol for measurements of spinal cord functional connectivity. Sci Rep 2018; 8:16512. [PMID: 30410122 PMCID: PMC6224587 DOI: 10.1038/s41598-018-34841-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 10/25/2018] [Indexed: 11/08/2022] Open
Abstract
Resting state functional magnetic resonance imaging (fMRI) has been used to study human brain function for over two decades, but only recently has this technique been successfully translated to the human spinal cord. The spinal cord is structurally and functionally unique, so resting state fMRI methods developed and optimized for the brain may not be appropriate when applied to the cord. This report therefore investigates the relative impact of different acquisition and processing choices (including run length, echo time, and bandpass filter width) on the detectability of resting state spinal cord networks at 3T. Our results suggest that frequencies beyond 0.08 Hz should be included in resting state analyses, a run length of ~8-12 mins is appropriate for reliable detection of the ventral (motor) network, and longer echo times - yet still shorter than values typically used for fMRI in the brain - may increase the detectability of the dorsal (sensory) network. Further studies are required to more fully understand and interpret the nature of resting state spinal cord networks in health and in disease, and the protocols described in this report are designed to assist such studies.
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39
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Gorter RP, Nutma E, Jahrei M, de Jonge JC, Quinlan RA, van der Valk P, van Noort JM, Baron W, Amor S. Heat shock proteins are differentially expressed in brain and spinal cord: implications for multiple sclerosis. Clin Exp Immunol 2018; 194:137-152. [PMID: 30014472 PMCID: PMC6194336 DOI: 10.1111/cei.13186] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2018] [Indexed: 01/10/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic neurodegenerative disease characterized by demyelination, inflammation and neurodegeneration throughout the central nervous system. Although spinal cord pathology is an important factor contributing to disease progression, few studies have examined MS lesions in the spinal cord and how they differ from brain lesions. In this study we have compared brain and spinal cord white (WM) and grey (GM) matter from MS and control tissues, focusing on small heat shock proteins (HSPB) and HSP16.2. Western blotting was used to examine protein levels of HSPB1, HSPB5, HSPB6, HSPB8 and HSP16.2 in brain and spinal cord from MS and age-matched non-neurological controls. Immunohistochemistry was used to examine expression of the HSPs in MS spinal cord lesions and controls. Expression levels were quantified using ImageJ. Western blotting revealed significantly higher levels of HSPB1, HSPB6 and HSPB8 in MS and control spinal cord compared to brain tissues. No differences in HSPB5 and HSP16.2 protein levels were observed, although HSPB5 protein levels were higher in brain WM versus GM. In MS spinal cord lesions, increased HSPB1 and HSPB5 expression was observed in astrocytes, and increased neuronal expression of HSP16.2 was observed in normal-appearing GM and type 1 GM lesions. The high constitutive expression of several HSPBs in spinal cord and increased expression of HSPBs and HSP16.2 in MS illustrate differences between brain and spinal cord in health and upon demyelination. Regional differences in HSP expression may reflect differences in astrocyte cytoskeleton composition and influence inflammation, possibly affecting the effectiveness of pharmacological agents.
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Affiliation(s)
- R. P. Gorter
- Pathology DepartmentAmsterdam UMC, VUMCGroningenUK
| | - E. Nutma
- Pathology DepartmentAmsterdam UMC, VUMCGroningenUK
| | - M.‐C. Jahrei
- Pathology DepartmentAmsterdam UMC, VUMCGroningenUK
| | - J. C. de Jonge
- Department of Cell BiologyUniversity of Groningen, University Medical Center GroningenGroningenUK
| | - R. A Quinlan
- Department of BiosciencesDurham UniversityDurhamUK
| | | | | | - W. Baron
- Department of Cell BiologyUniversity of Groningen, University Medical Center GroningenGroningenUK
| | - S. Amor
- Pathology DepartmentAmsterdam UMC, VUMCGroningenUK
- Centre for Neuroscience and Trauma, Blizard Institute, Barts and the London School of Medicine and DentistryQueen Mary University of LondonLondonUK
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40
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Powers JM, Ioachim G, Stroman PW. Ten Key Insights into the Use of Spinal Cord fMRI. Brain Sci 2018; 8:E173. [PMID: 30201938 PMCID: PMC6162663 DOI: 10.3390/brainsci8090173] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 01/27/2023] Open
Abstract
A comprehensive review of the literature-to-date on functional magnetic resonance imaging (fMRI) of the spinal cord is presented. Spinal fMRI has been shown, over more than two decades of work, to be a reliable tool for detecting neural activity. We discuss 10 key points regarding the history, development, methods, and applications of spinal fMRI. Animal models have served a key purpose for the development of spinal fMRI protocols and for experimental spinal cord injury studies. Applications of spinal fMRI span from animal models across healthy and patient populations in humans using both task-based and resting-state paradigms. The literature also demonstrates clear trends in study design and acquisition methods, as the majority of studies follow a task-based, block design paradigm, and utilize variations of single-shot fast spin-echo imaging methods. We, therefore, discuss the similarities and differences of these to resting-state fMRI and gradient-echo EPI protocols. Although it is newly emerging, complex connectivity and network analysis is not only possible, but has also been shown to be reliable and reproducible in the spinal cord for both task-based and resting-state studies. Despite the technical challenges associated with spinal fMRI, this review identifies reliable solutions that have been developed to overcome these challenges.
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Affiliation(s)
- Jocelyn M Powers
- Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Gabriela Ioachim
- Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada.
| | - Patrick W Stroman
- Centre for Neuroscience Studies, Queen's University, Kingston, ON K7L 3N6, Canada.
- Department of Biomedical Sciences, Queen's University, Kingston, ON K7L 3N6, Canada.
- Department of Physics, Queen's University, Kingston, ON K7L 3N6, Canada.
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