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Yang X, Sullivan PF, Li B, Fan Z, Ding D, Shu J, Guo Y, Paschou P, Bao J, Shen L, Ritchie MD, Nave G, Platt ML, Li T, Zhu H, Zhao B. Multi-organ imaging-derived polygenic indexes for brain and body health. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.04.18.23288769. [PMID: 38883759 PMCID: PMC11177904 DOI: 10.1101/2023.04.18.23288769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
The UK Biobank (UKB) imaging project is a crucial resource for biomedical research, but is limited to 100,000 participants due to cost and accessibility barriers. Here we used genetic data to predict heritable imaging-derived phenotypes (IDPs) for a larger cohort. We developed and evaluated 4,375 IDP genetic scores (IGS) derived from UKB brain and body images. When applied to UKB participants who were not imaged, IGS revealed links to numerous phenotypes and stratified participants at increased risk for both brain and somatic diseases. For example, IGS identified individuals at higher risk for Alzheimer's disease and multiple sclerosis, offering additional insights beyond traditional polygenic risk scores of these diseases. When applied to independent external cohorts, IGS also stratified those at high disease risk in the All of Us Research Program and the Alzheimer's Disease Neuroimaging Initiative study. Our results demonstrate that, while the UKB imaging cohort is largely healthy and may not be the most enriched for disease risk management, it holds immense potential for stratifying the risk of various brain and body diseases in broader external genetic cohorts.
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Affiliation(s)
- Xiaochen Yang
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA
| | - Patrick F. Sullivan
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Bingxuan Li
- UCLA Samueli School of Engineering, Los Angeles, CA 90095, USA
| | - Zirui Fan
- Department of Statistics and Data Science, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Dezheng Ding
- Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Juan Shu
- Department of Statistics, Purdue University, West Lafayette, IN 47907, USA
| | - Yuxin Guo
- Department of Biological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | - Jingxuan Bao
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Graduate Group in Genomics and Computational Biology, University of Pennsylvania, Philadelphia, PA, USA
| | - Li Shen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Marylyn D. Ritchie
- Department of Genetics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Gideon Nave
- Marketing Department, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Michael L. Platt
- Marketing Department, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Neuroscience, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Tengfei Li
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Hongtu Zhu
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Biomedical Research Imaging Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Statistics and Operations Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Bingxin Zhao
- Department of Statistics and Data Science, University of Pennsylvania, Philadelphia, PA 19104, USA
- Institute for Biomedical Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
- Applied Mathematics and Computational Science Graduate Group, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for AI and Data Science for Integrated Diagnostics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Population Aging Research Center, University of Pennsylvania, Philadelphia, PA 19104, USA
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA
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2
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Ding S, Shi Z, Huang K, Fan X, Li X, Zheng H, Wang L, Yan Z, Cai J. Aberrant white matter microstructure detected by automatic fiber quantification in pediatric myelin oligodendrocyte glycoprotein antibody-associated disease. Mult Scler Relat Disord 2024; 84:105483. [PMID: 38354445 DOI: 10.1016/j.msard.2024.105483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 02/04/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND AND OBJECTIVES Myelin oligodendrocyte glycoprotein antibody-associated diseases (MOGAD) is an idiopathic inflammatory demyelinating disorder in children, for which the precise damage patterns of the white matter (WM) fibers remain unclear. Herein, we utilized diffusion tensor imaging (DTI)-based automated fiber quantification (AFQ) to identify patterns of fiber damage and to investigate the clinical significance of MOGAD-affected fiber tracts. METHODS A total of 28 children with MOGAD and 31 healthy controls were included in this study. The AFQ approach was employed to track WM fiber with 100 equidistant nodes defined along each tract for statistical analysis of DTI metrics in both the entire and nodal manner. The feature selection method was used to further screen significantly aberrant DTI metrics of the affected fiber tracts or segments for eight common machine learning (ML) to evaluate their potential in identifying MOGAD. These metrics were then correlated with clinical scales to assess their potential as imaging biomarkers. RESULTS In the entire manner, significantly reduced fractional anisotropy (FA) was shown in the left anterior thalamic radiation, arcuate fasciculus, and the posterior and anterior forceps of corpus callosum in MOGAD (all p < 0.05). In the nodal manner, significant DTI metrics alterations were widely observed across 37 segments in 10 fiber tracts (all p < 0.05), mainly characterized by decreased FA and increased radial diffusivity (RD). Among them, 14 DTI metrics in seven fiber tracts were selected as important features to establish ML models, and satisfactory discrimination of MOGAD was obtained in all models (all AUC > 0.85), with the best performance in the logistic regression model (AUC = 0.952). For those features, the FA of left cingulum cingulate and the RD of right inferior frontal-occipital fasciculus were negatively and positively correlated with the expanded disability status scale (r = -0.54, p = 0.014; r = 0.43, p = 0.03), respectively. CONCLUSION Pediatric MOGAD exhibits extensive WM fiber tract aberration detected by AFQ. Certain fiber tracts exhibit specific patterns of DTI metrics that hold promising potential as biomarkers.
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Affiliation(s)
- Shuang Ding
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China
| | - Zhuowei Shi
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
| | - Kaiping Huang
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China
| | - Xiao Fan
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China
| | - Xiujuan Li
- Department of Neurology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China
| | - Helin Zheng
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China
| | - Longlun Wang
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China
| | - Zichun Yan
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China
| | - Jinhua Cai
- Department of Radiology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Chongqing 400014, China.
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Hirschfeld LR, Deardorff R, Chumin EJ, Wu YC, McDonald BC, Cao S, Risacher SL, Yi D, Byun MS, Lee JY, Kim YK, Kang KM, Sohn CH, Nho K, Saykin AJ, Lee DY. White matter integrity is associated with cognition and amyloid burden in older adult Koreans along the Alzheimer's disease continuum. Alzheimers Res Ther 2023; 15:218. [PMID: 38102714 PMCID: PMC10725037 DOI: 10.1186/s13195-023-01369-5] [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: 04/19/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND White matter (WM) microstructural changes in the hippocampal cingulum bundle (CBH) in Alzheimer's disease (AD) have been described in cohorts of largely European ancestry but are lacking in other populations. METHODS We assessed the relationship between CBH WM integrity and cognition or amyloid burden in 505 Korean older adults aged ≥ 55 years, including 276 cognitively normal older adults (CN), 142 with mild cognitive impairment (MCI), and 87 AD patients, recruited as part of the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's disease (KBASE) at Seoul National University. RESULTS Compared to CN, AD and MCI subjects showed significantly higher RD, MD, and AxD values (all p-values < 0.001) and significantly lower FA values (left p ≤ 0.002, right p ≤ 0.015) after Bonferroni adjustment for multiple comparisons. Most tests of cognition and mood (p < 0.001) as well as higher medial temporal amyloid burden (p < 0.001) were associated with poorer WM integrity in the CBH after Bonferroni adjustment. CONCLUSION These findings are consistent with patterns of WM microstructural damage previously reported in non-Hispanic White (NHW) MCI/AD cohorts, reinforcing existing evidence from predominantly NHW cohort studies.
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Affiliation(s)
- Lauren R Hirschfeld
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
| | - Rachael Deardorff
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Evgeny J Chumin
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, 47405, USA
| | - Yu-Chien Wu
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Brenna C McDonald
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Sha Cao
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Shannon L Risacher
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, 03080, South Korea
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, 03080, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, 03080, South Korea
| | - Jun-Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, 03080, South Korea
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, 07061, South Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, 07061, South Korea
| | - Koung Mi Kang
- Department of Radiology, Seoul National University Hospital, Seoul, 03080, South Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital, Seoul, 03080, South Korea
| | - Kwangsik Nho
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Indiana University School of Informatics and Computing, Indianapolis, IN, 46202, USA
| | - Andrew J Saykin
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, 03080, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, 03080, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, 03080, South Korea
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Bhattacharyya PK, Fox RJ, Sakaie KE, Bena J, Harvey T, Raska P, Lin J, Lowe MJ. Characterizing multiple sclerosis disease progression using a combined structural and functional connectivity metric. Magn Reson Imaging 2023; 103:185-191. [PMID: 37536637 PMCID: PMC10529682 DOI: 10.1016/j.mri.2023.07.016] [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: 04/13/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE A combined resting state functional connectivity MRI (fcMRI) and diffusion tensor imaging (DTI) metric called structural and functional connectivity index (SFCI) was recently proposed for tracking disease status and progression in multiple sclerosis (MS). The metric combines fcMRI and transverse diffusivity (TD) along different functional pathways involved in principle symptomatic domains of MS. In a longitudinal study of patients with MS receiving the same MS therapy, initial worsening of transcallosal (TC) motor and frontoparietal (FP) cognitive networks, as measured by fcMRI and DTI over the first year was followed by stabilization in the second year of follow-up. In this study we have (i) probed relationships between individual and composite neurological measures of MS with SFCI and its individual components along TC motor and FP cognitive pathways and (ii) compared sensitivity of SFCI to treatment-induced longitudinal changes with each individual imaging measure. METHODS Twenty five patients with MS (15 female, age 42 ± 8 y) participated in this study and were scanned at 3 T whole body MRI scanner with diffusion tensor imaging (DTI) and resting-state functional connectivity MRI (fcMRI) scan protocol at baseline and 6, 12, 18 and 24 months after starting fingolimod. fcMRI and TD along TC and FP pathways were combined to form structural and functional connectivity index (SFCI) at each time point. Correlations between individual/combined neurological measures and individual imaging components/SFCI at baseline and were evaluated and compared. In addition, efficacies of individual and combined imaging metrics in tracking network integrity were compared. RESULTS Individual TD along the TC pathway was significantly inversely correlated with all individual/composite neurological scores. There were moderate correlations of TC and FP components of SFCI with most of the neurological scores, and the pathway-combined SFCI was significantly correlated with all neurological scores. Trend-level increases of both TC and FP fcMRI were observed during the second year of follow-up, both TC and FP TD increased significantly in the first year and then stabilized during the second year. A trend toward a decrease in combined imaging metrics along TC and FP were observed during the first year, followed by a trend toward an increase in these metrics during the second year, while a significant decrease in SFCI during the first year followed by a significant increase during the second year was observed. CONCLUSIONS SFCI was more effective in tracking network integrity/disease progression than individual pathway-specific components, which supports its use as an imaging marker for MS disease status and progression.
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Affiliation(s)
- P K Bhattacharyya
- Imaging Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - R J Fox
- Neurological Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - K E Sakaie
- Imaging Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - J Bena
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - T Harvey
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - P Raska
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - J Lin
- Imaging Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - M J Lowe
- Imaging Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
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Danielli E, Simard N, DeMatteo CA, Kumbhare D, Ulmer S, Noseworthy MD. A review of brain regions and associated post-concussion symptoms. Front Neurol 2023; 14:1136367. [PMID: 37602240 PMCID: PMC10435092 DOI: 10.3389/fneur.2023.1136367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023] Open
Abstract
The human brain is an exceptionally complex organ that is comprised of billions of neurons. Therefore, when a traumatic event such as a concussion occurs, somatic, cognitive, behavioral, and sleep impairments are the common outcome. Each concussion is unique in the sense that the magnitude of biomechanical forces and the direction, rotation, and source of those forces are different for each concussive event. This helps to explain the unpredictable nature of post-concussion symptoms that can arise and resolve. The purpose of this narrative review is to connect the anatomical location, healthy function, and associated post-concussion symptoms of some major cerebral gray and white matter brain regions and the cerebellum. As a non-exhaustive description of post-concussion symptoms nor comprehensive inclusion of all brain regions, we have aimed to amalgamate the research performed for specific brain regions into a single article to clarify and enhance clinical and research concussion assessment. The current status of concussion diagnosis is highly subjective and primarily based on self-report of symptoms, so this review may be able to provide a connection between brain anatomy and the clinical presentation of concussions to enhance medical imaging assessments. By explaining anatomical relevance in terms of clinical concussion symptom presentation, an increased understanding of concussions may also be achieved to improve concussion recognition and diagnosis.
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Affiliation(s)
- Ethan Danielli
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Nicholas Simard
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
| | - Carol A. DeMatteo
- ARiEAL Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Dinesh Kumbhare
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephan Ulmer
- Neurorad.ch, Zurich, Switzerland
- Department of Radiology and Neuroradiology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Michael D. Noseworthy
- School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Electrical and Computer Engineering, McMaster University, Hamilton, ON, Canada
- ARiEAL Research Centre, McMaster University, Hamilton, ON, Canada
- Department of Radiology, McMaster University, Hamilton, ON, Canada
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Hirschfeld LR, Deardorff R, Chumin EJ, Wu YC, McDonald BC, Cao S, Risacher SL, Yi D, Byun MS, Lee JY, Kim YK, Kang KM, Sohn CH, Nho K, Saykin AJ, Lee DY. White matter integrity is associated with cognition and amyloid burden in older adult Koreans along the Alzheimer's disease continuum. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.05.23288147. [PMID: 37066317 PMCID: PMC10104207 DOI: 10.1101/2023.04.05.23288147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND White matter (WM) microstructural changes in the hippocampal cingulum bundle (CBH) in Alzheimer's disease (AD) have been described in cohorts of largely European ancestry but are lacking in other populations. METHODS We assessed the relationship between CBH WM integrity and cognition or amyloid burden in 505 Korean older adults aged ≥55 years, including 276 cognitively normal older adults (CN), 142 mild cognitive impairment (MCI), and 87 AD, recruited as part of the Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's disease (KBASE) at Seoul National University. RESULTS Compared to CN, AD and MCI subjects showed decreased WM integrity in the bilateral CBH. Cognition, mood, and higher amyloid burden were also associated with poorer WM integrity in the CBH. CONCLUSION These findings are consistent with patterns of WM microstructural damage previously reported in non-Hispanic White (NHW) MCI/AD cohorts, reinforcing existing evidence from predominantly NHW cohort studies.
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Affiliation(s)
- Lauren Rose Hirschfeld
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
| | - Rachael Deardorff
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN USA, 46202
| | - Evgeny J Chumin
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN USA, 47405
| | - Yu-Chien Wu
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN USA, 46202
| | - Brenna C McDonald
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN USA, 46202
| | - Sha Cao
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Department of Biostatistics and Health Data Sciences, Indiana University School of Medicine, Indianapolis, IN USA, 46202
| | - Shannon L Risacher
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN USA, 46202
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Korea, 03080
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea, 03080
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea, 03080
| | - Jun-Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea, 03080
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Korea, 07061
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea, 07061
| | - Koung Mi Kang
- Department of Radiology, Seoul National University Hospital, Seoul, Korea, 03080
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital, Seoul, Korea, 03080
| | - Kwangsik Nho
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Indiana University School of Informatics and Computing, Indianapolis, IN USA, 46202
| | - Andrew J Saykin
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN USA, 46202
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN USA, 46202
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Korea, 03080
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea, 03080
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea, 03080
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Aberrant White Matter Organization Correlated With Neurodevelopment Outcomes in Tetralogy of Fallot: An Atlas-Based Diffusion Tensor Imaging Study. Pediatr Neurol 2022; 133:15-20. [PMID: 35749819 DOI: 10.1016/j.pediatrneurol.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/12/2022] [Accepted: 05/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND White matter injury (WMI) and impaired neurodevelopment are common in children with congenital heart disease. However, the effect of WMI on neurodevelopmental outcomes is still rarely reported. In this study, we aimed to investigate microstructural changes in white matter (WM) and its relationship with neurodevelopmental outcomes and further explore the underlying neurophysiological mechanisms of neurocognitive impairments in the tetralogy of Fallot (ToF). METHOD Diffusion tensor imaging (DTI) data were acquired in preschool-aged children with ToF (n = 29) and normal controls (NC, n = 19), and neurodevelopmental assessments were performed with the Wechsler Preschool and Primary Scale of Intelligence in ToF. The differences in DTI metrics including fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity were evaluated between ToF and NC. Correlations between WM microstructural changes and neurodevelopmental outcomes were further analyzed. RESULTS Significant WM differences were found in the uncinate fasciculus, cingulum hippocampus, superior longitudinal fasciculus, and corticospinal tract between children with ToF and NC. Impaired WM integrity was correlated with the verbal comprehension index and working memory index in ToF. CONCLUSIONS This study demonstrated WM microstructure injury, and this injury is related to worse language and working memory performance in preschool-aged children with ToF. These findings suggested that DTI metrics may be a potential biomarker of neurocognitive impairments in ToF and can be used to predict future neurodevelopmental outcomes, which also provide new insights into the underlying neurophysiological mechanisms of neurocognitive impairments in ToF.
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Kihara Y, Jonnalagadda D, Zhu Y, Ray M, Ngo T, Palmer C, Rivera R, Chun J. Ponesimod inhibits astrocyte-mediated neuroinflammation and protects against cingulum demyelination via S1P 1 -selective modulation. FASEB J 2022; 36:e22132. [PMID: 34986275 PMCID: PMC8740777 DOI: 10.1096/fj.202101531r] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 01/01/2023]
Abstract
Ponesimod is a sphingosine 1‐phosphate (S1P) receptor (S1PR) modulator that was recently approved for treating relapsing forms of multiple sclerosis (MS). Three other FDA‐approved S1PR modulators for MS—fingolimod, siponimod, and ozanimod—share peripheral immunological effects via common S1P1 interactions, yet ponesimod may access distinct central nervous system (CNS) mechanisms through its selectivity for the S1P1 receptor. Here, ponesimod was examined for S1PR internalization and binding, human astrocyte signaling and single‐cell RNA‐seq (scRNA‐seq) gene expression, and in vivo using murine cuprizone‐mediated demyelination. Studies confirmed ponesimod’s selectivity for S1P1 without comparable engagement to the other S1PR subtypes (S1P2,3,4,5). Ponesimod showed pharmacological properties of acute agonism followed by chronic functional antagonism of S1P1. A major locus of S1P1 expression in the CNS is on astrocytes, and scRNA‐seq of primary human astrocytes exposed to ponesimod identified a gene ontology relationship of reduced neuroinflammation and reduction in known astrocyte disease‐related genes including those of immediate early astrocytes that have been strongly associated with disease progression in MS animal models. Remarkably, ponesimod prevented cuprizone‐induced demyelination selectively in the cingulum, but not in the corpus callosum. These data support the CNS activities of ponesimod through S1P1, including protective, and likely selective, effects against demyelination in a major connection pathway of the brain, the limbic fibers of the cingulum, lesions of which have been associated with several neurologic impairments including MS fatigue.
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Affiliation(s)
- Yasuyuki Kihara
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA
| | - Deepa Jonnalagadda
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA
| | - Yunjiao Zhu
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA
| | - Manisha Ray
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA
| | - Tony Ngo
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA
| | - Carter Palmer
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA.,Biomedical Sciences Program, University of California, San Diego, La Jolla, California, USA
| | - Richard Rivera
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA
| | - Jerold Chun
- Sanford Burnham Prebys Medical Discovery Institute, Translational Neuroscience Initiative, La Jolla, California, USA
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9
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Govindarajan ST, Liu Y, Parra Corral MA, Bangiyev L, Krupp L, Charvet L, Duong TQ. White matter correlates of slowed information processing speed in unimpaired multiple sclerosis patients with young age onset. Brain Imaging Behav 2021; 15:1460-1468. [PMID: 32748319 DOI: 10.1007/s11682-020-00345-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Slowed information processing speed is among the earliest markers of cognitive impairment in multiple sclerosis (MS) and has been associated with white matter (WM) structural integrity. Localization of WM tracts associated with slowing, but not significant impairment, on specific cognitive tasks in pediatric and young age onset MS can facilitate early and effective therapeutic intervention. Diffusion tensor imaging data were collected on 25 MS patients and 24 controls who also underwent the Symbol Digit Modalities Test (SDMT) and the computer-based Cogstate simple and choice reaction time tests. Fractional anisotropy (FA), mean (MD), radial (RD) and axial (AD) diffusivities were correlated voxel-wise with processing speed measures. All DTI metrics of several white matter tracts were significantly different between groups (p < 0.05). Notably, higher MD, RD, and AD, but not FA, in the corpus callosum correlated with lower scores on both SDMT and simple reaction time. Additionally, all diffusivity metrics in the left corticospinal tract correlated negatively with SDMT scores, whereas only MD in the right superior fronto-occipital fasciculus correlated with simple reaction time. In conclusion, subtle slowing of processing speed is correlated with WM damage in the visual-motor processing pathways in patients with young age of MS onset.
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Affiliation(s)
| | - Yilin Liu
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | | | - Lev Bangiyev
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Lauren Krupp
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Leigh Charvet
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA
| | - Tim Q Duong
- Department of Radiology, Stony Brook University School of Medicine, Stony Brook, NY, USA.
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10
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Koenig KA, Beall EB, Sakaie KE, Ontaneda D, Stone L, Rao SM, Nakamura K, Jones SE, Lowe MJ. Evaluation of a connectivity-based imaging metric that reflects functional decline in Multiple Sclerosis. PLoS One 2021; 16:e0251338. [PMID: 34101741 PMCID: PMC8186801 DOI: 10.1371/journal.pone.0251338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/23/2021] [Indexed: 11/26/2022] Open
Abstract
Cognitive impairment is a common symptom in individuals with Multiple Sclerosis (MS), but meaningful, reliable biomarkers relating to cognitive decline have been elusive, making evaluation of the impact of therapeutics on cognitive function difficult. Here, we combine pathway-based MRI measures of structural and functional connectivity to construct a metric of functional decline in MS. The Structural and Functional Connectivity Index (SFCI) is proposed as a simple, z-scored metric of structural and functional connectivity, where changes in the metric have a simple statistical interpretation and may be suitable for use in clinical trials. Using data collected at six time points from a 2-year longitudinal study of 20 participants with MS and 9 age- and sex-matched healthy controls, we probe two common symptomatic domains, motor and cognitive function, by measuring structural and functional connectivity in the transcallosal motor pathway and posterior cingulum bundle. The SFCI is significantly lower in participants with MS compared to controls (p = 0.009) and shows a significant decrease over time in MS (p = 0.012). The change in SFCI over two years performed favorably compared to measures of brain parenchymal fraction and lesion volume, relating to follow-up measures of processing speed (r = 0.60, p = 0.005), verbal fluency (r = 0.57, p = 0.009), and score on the Multiple Sclerosis Functional Composite (r = 0.67, p = 0.003). These initial results show that the SFCI is a suitable metric for longitudinal evaluation of functional decline in MS.
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Affiliation(s)
- Katherine A. Koenig
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, United States of America
- * E-mail:
| | - Erik B. Beall
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Ken E. Sakaie
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Daniel Ontaneda
- Mellen Center, Neurologic Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Lael Stone
- Mellen Center, Neurologic Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Stephen M. Rao
- Schey Center for Cognitive Neuroimaging, Neurologic Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Kunio Nakamura
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Stephen E. Jones
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Mark J. Lowe
- Imaging Sciences, Imaging Institute, Cleveland Clinic, Cleveland, OH, United States of America
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11
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Kato H, Okuno T, Isohashi K, Koda T, Shimizu M, Mochizuki H, Nakatsuji Y, Hatazawa J. Astrocyte metabolism in multiple sclerosis investigated by 1-C-11 acetate PET. J Cereb Blood Flow Metab 2021; 41:369-379. [PMID: 32169013 PMCID: PMC7812519 DOI: 10.1177/0271678x20911469] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This study was aimed at evaluating the metabolism of reactive astrocytes in the brains of patients with multiple sclerosis by quantitative 1-C-11 acetate positron emission tomography (PET). Magnetic resonance imaging and 1-C-11 quantitative PET were performed in eight patients with multiple sclerosis and 10 normal control subjects. The efflux rate (k2) of 1-C-11 acetate, which reportedly reflects the metabolic rate of 1-C-11 acetate, was calculated based on the one-tissue compartmental model. Fractional anisotropy was also determined to evaluate the integrity of the neuronal tracts. The values of k2 in the patients with multiple sclerosis were significantly higher than those in the normal control subjects, in both the white matter (p = 0.003) and the gray matter (p = 0.02). In addition, the white matter/gray matter ratio of k2 was significantly higher in the multiple sclerosis patients than in the normal control subjects (p = 0.02). Voxel-based statistical analysis revealed most prominent increase in k2 in the neuronal fiber tracts, as well as decrease in fractional anisotropy in them in the multiple sclerosis patients. The present study clarified that the pathological changes associated with astrocytic reactivation in multiple sclerosis patients could be visualized by quantitative 1-C-11 acetate PET.
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Affiliation(s)
- Hiroki Kato
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsusada Okuno
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kayako Isohashi
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toru Koda
- Department of Medical Innovation, Osaka University Hospital Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mikito Shimizu
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideki Mochizuki
- Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yuji Nakatsuji
- Department of Neurology, Toyama University Hospital, Toyama, Japan
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine, Osaka, Japan
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12
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Dekker I, Schoonheim MM, Venkatraghavan V, Eijlers AJC, Brouwer I, Bron EE, Klein S, Wattjes MP, Wink AM, Geurts JJG, Uitdehaag BMJ, Oxtoby NP, Alexander DC, Vrenken H, Killestein J, Barkhof F, Wottschel V. The sequence of structural, functional and cognitive changes in multiple sclerosis. Neuroimage Clin 2020; 29:102550. [PMID: 33418173 PMCID: PMC7804841 DOI: 10.1016/j.nicl.2020.102550] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/09/2020] [Accepted: 12/20/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND As disease progression remains poorly understood in multiple sclerosis (MS), we aim to investigate the sequence in which different disease milestones occur using a novel data-driven approach. METHODS We analysed a cohort of 295 relapse-onset MS patients and 96 healthy controls, and considered 28 features, capturing information on T2-lesion load, regional brain and spinal cord volumes, resting-state functional centrality ("hubness"), microstructural tissue integrity of major white matter (WM) tracts and performance on multiple cognitive tests. We used a discriminative event-based model to estimate the sequence of biomarker abnormality in MS progression in general, as well as specific models for worsening physical disability and cognitive impairment. RESULTS We demonstrated that grey matter (GM) atrophy of the cerebellum, thalamus, and changes in corticospinal tracts are early events in MS pathology, whereas other WM tracts as well as the cognitive domains of working memory, attention, and executive function are consistently late events. The models for disability and cognition show early functional changes of the default-mode network and earlier changes in spinal cord volume compared to the general MS population. Overall, GM atrophy seems crucial due to its early involvement in the disease course, whereas WM tract integrity appears to be affected relatively late despite the early onset of WM lesions. CONCLUSION Data-driven modelling revealed the relative occurrence of both imaging and non-imaging events as MS progresses, providing insights into disease propagation mechanisms, and allowing fine-grained staging of patients for monitoring purposes.
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Affiliation(s)
- Iris Dekker
- Amsterdam UMC, Location VUmc, Departments of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands; Neurology, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Menno M Schoonheim
- Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Vikram Venkatraghavan
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Anand J C Eijlers
- Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Iman Brouwer
- Amsterdam UMC, Location VUmc, Departments of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Esther E Bron
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Stefan Klein
- Biomedical Imaging Group Rotterdam, Departments of Medical Informatics and Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Mike P Wattjes
- Dept. of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Alle Meije Wink
- Amsterdam UMC, Location VUmc, Departments of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Jeroen J G Geurts
- Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Bernard M J Uitdehaag
- Neurology, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Neil P Oxtoby
- Centre for Medical Image Computing, Department of Computer Science, UCL, London, UK
| | - Daniel C Alexander
- Centre for Medical Image Computing, Department of Computer Science, UCL, London, UK
| | - Hugo Vrenken
- Amsterdam UMC, Location VUmc, Departments of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Joep Killestein
- Neurology, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Amsterdam UMC, Location VUmc, Departments of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands; Centre for Medical Image Computing, Department of Computer Science, UCL, London, UK; Institute of Neurology, UCL, London, UK
| | - Viktor Wottschel
- Amsterdam UMC, Location VUmc, Departments of Radiology and Nuclear Medicine, MS Center Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands.
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13
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Saraste M, Bezukladova S, Matilainen M, Tuisku J, Rissanen E, Sucksdorff M, Laaksonen S, Vuorimaa A, Kuhle J, Leppert D, Airas L. High serum neurofilament associates with diffuse white matter damage in MS. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 8:8/1/e926. [PMID: 33293460 PMCID: PMC7803327 DOI: 10.1212/nxi.0000000000000926] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/21/2020] [Indexed: 01/24/2023]
Abstract
Objective To evaluate to which extent serum neurofilament light chain (NfL) increase is
related to diffusion tensor imaging–MRI measurable diffuse
normal-appearing white matter (NAWM) damage in MS. Methods Seventy-nine patients with MS and 10 healthy controls underwent MRI including
diffusion tensor sequences and serum NfL determination by single molecule
array (Simoa). Fractional anisotropy and mean, axial, and radial
diffusivities were calculated within the whole and segmented (frontal,
parietal, temporal, occipital, cingulate, and deep) NAWM. Spearman
correlations and multiple regression models were used to assess the
associations between diffusion tensor imaging, volumetric MRI data, and
NfL. Results Elevated NfL correlated with decreased fractional anisotropy and increased
mean, axial, and radial diffusivities in the entire and segmented NAWM (for
entire NAWM ρ = −0.49, p = 0.005;
ρ = 0.49, p = 0.005; ρ = 0.43,
p = 0.018; and ρ = 0.48,
p = 0.006, respectively). A multiple regression
model examining the effect of diffusion tensor indices on NfL showed
significant associations when adjusted for sex, age, disease type, the
expanded disability status scale, treatment, and presence of relapses. In
the same model, T2 lesion volume was similarly associated with NfL. Conclusions Our findings suggest that elevated serum NfL in MS results from neuroaxonal
damage both within the NAWM and focal T2 lesions. This pathologic
heterogeneity ought to be taken into account when interpreting NfL findings
at the individual patient level.
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Affiliation(s)
- Maija Saraste
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland.
| | - Svetlana Bezukladova
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Markus Matilainen
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Jouni Tuisku
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Eero Rissanen
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Marcus Sucksdorff
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Sini Laaksonen
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Anna Vuorimaa
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Jens Kuhle
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - David Leppert
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
| | - Laura Airas
- From the Turku PET Centre, Turku University Hospital and University of Turku (M. Saraste, S.B., M.M., J.T., E.R., M. Sucksdorff, S.L., A.V., L.A.); Division of Clinical Neurosciences (E.R., M. Sucksdorff, S.L., A.V., L.A.), Turku University Hospital, Finland; and Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic (J.K., D.L.), University Hospital Basel, Switzerland
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14
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Buyukturkoglu K, Zeng D, Bharadwaj S, Tozlu C, Mormina E, Igwe KC, Lee S, Habeck C, Brickman AM, Riley CS, De Jager PL, Sumowski JF, Leavitt VM. Classifying multiple sclerosis patients on the basis of SDMT performance using machine learning. Mult Scler 2020; 27:107-116. [DOI: 10.1177/1352458520958362] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective: To build a model to predict cognitive status reflecting structural, functional, and white matter integrity changes in early multiple sclerosis (MS). Methods: Based on Symbol Digit Modalities Test (SDMT) performance, 183 early MS patients were assigned “lower” or “higher” performance groups. Three-dimensional (3D)-T2, T1, diffusion weighted, and resting-state magnetic resonance imaging (MRI) data were acquired in 3T. Using Random Forest, five models were trained to classify patients into two groups based on 1—demographic/clinical, 2—lesion volume/location, 3—local/global tissue volume, 4—local/global diffusion tensor imaging, and 5—whole-brain resting-state-functional-connectivity measures. In a final model, all important features from previous models were concatenated. Area under the receiver operating characteristic curve (AUC) values were calculated to evaluate classifier performance. Results: The highest AUC value (0.90) was achieved by concatenating all important features from neuroimaging models. The top 10 contributing variables included volumes of bilateral nucleus accumbens and right thalamus, mean diffusivity of left cingulum-angular bundle, and functional connectivity among hubs of seven large-scale networks. Conclusion: These results provide an indication of a non-random brain pattern mostly compromising areas involved in attentional processes specific to patients who perform worse in SDMT. High accuracy of the final model supports this pattern as a potential neuroimaging biomarker of subtle cognitive changes in early MS.
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Affiliation(s)
- Korhan Buyukturkoglu
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Dana Zeng
- Department of Biostatistics, Columbia University, New York, NY, USA
| | - Srinidhi Bharadwaj
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Ceren Tozlu
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Enricomaria Mormina
- Department of Clinical and Experimental Medicine, Policlinico Universitario “G. Martino,” University of Messina, Messina, Italy/Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Kay C Igwe
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Seonjoo Lee
- Department of Biostatistics, Columbia University, New York, NY, USA/Mental Health Data Science, Research Foundation for Mental Hygiene, Inc, New York State Psychiatric Institute, New York, NY, USA
| | - Christian Habeck
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Adam M Brickman
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Claire S Riley
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Philip L De Jager
- Multiple Sclerosis Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA/Center for Translational & Computational Neuroimmunology, Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - James F Sumowski
- Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Mount Sinai Hospital, New York, NY, USA
| | - Victoria M Leavitt
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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15
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Changes in structural and functional connectivity during two years of fingolimod therapy for multiple sclerosis. Magn Reson Imaging 2020; 74:113-120. [PMID: 32956806 DOI: 10.1016/j.mri.2020.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/25/2020] [Accepted: 09/17/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Fingolimod, an oral drug, has been reported to reduce relapse rate in multiple sclerosis (MS). However disease progression may still occur in spite of control of inflammation. Functional imbalances within and between cerebral networks associated with disruption of structural and functional network integrity, have been reported in MS. An effective therapy is expected to stabilize such functional network integrity. OBJECTIVE The purpose of this study was to investigate changes in structural and resting-state functional connectivity of motor and cognitive networks, and associated changes in neurologic scores in MS, during 2 years of fingolimod therapy. METHODS Twenty five subjects with MS were recruited for this study. Subjects were scanned with diffusion tensor imaging (DTI) and resting-state functional connectivity MRI (fcMRI) scan protocol at 3 T with 6-month interval over a period of 2 years. Neurologic performance scores of motor and cognitive performances were also obtained. RESULTS DTI measures worsened during the 1st year and then stabilized; any trend of stabilization of fcMRI was delayed until the 2nd year. While motor performance did not change, cognitive performance showed improvement. Several baseline DTI measures correlated with relevant neurologic scores. CONCLUSION Initial worsening of motor and cognitive network was reported after 1 year of treatment, but seems DTI and fcMRI measures seem to stabilize after around one year fingolimod therapy.
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16
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Tao L, Wang L, Chen X, Liu F, Ruan F, Zhang J, Shen L, Yu Y. Modulation of Interhemispheric Functional Coordination in Breast Cancer Patients Receiving Chemotherapy. Front Psychol 2020; 11:1689. [PMID: 32849022 PMCID: PMC7403228 DOI: 10.3389/fpsyg.2020.01689] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/22/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives Chemotherapy induces cognitive impairments including memory impairment attention deficit and executive dysfunction in patients with breast cancer (BC) during or after chemotherapy. Previous studies identified brain structural and functional changes in BC patients receiving chemotherapy; however, there are no studies assessing functional connectivity (FC) between homotopic brain regions in BC patients using a voxel-mirrored homotopic connectivity (VMHC) method. In the present study, we explored cognitive function and whole brain homotopic FC in BC patients receiving chemotherapy compared with healthy controls using the VMHC method. Methods The present cross-sectional study included 35 premenopausal women with breast cancer who received chemotherapy, as well as 32 age- and sex-matched healthy controls (HC). All subjects underwent resting-state functional magnetic resonance imaging, which measured homotopic brain FC, and cognitive neuropsychological assessments evaluating attention, memory, and executive function domains. Results The BC group had lower VMHC than the HC group in the cingulated posterior, insular and postcentral regions. No region exhibited higher VMHC in the BC group than in HC group. Correlation analysis in the BC group indicated that VMHC values in the cingulated posterior were significantly correlated with executive function tests, and that the VMHC values in the insular were significantly correlated with memory tests. Conclusion The present study showed that VMHC decreased in different brain regions including cingulated posterior, insular and postcentral regions. A significant correlation was observed between the VMHC values in the brain regions and neuropsychological tests. These results suggested that changes in VMHC values in different brain regions may underlie cognitive changes in BC patients receiving chemotherapy.
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Affiliation(s)
- Longxiang Tao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Xingui Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Fujun Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Feiyan Ruan
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jingjie Zhang
- Department of Breast Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Li Shen
- Department of Radiotherapy, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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17
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Sen MK, Almuslehi MSM, Coorssen JR, Mahns DA, Shortland PJ. Behavioural and histological changes in cuprizone-fed mice. Brain Behav Immun 2020; 87:508-523. [PMID: 32014578 DOI: 10.1016/j.bbi.2020.01.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/20/2020] [Accepted: 01/30/2020] [Indexed: 12/13/2022] Open
Abstract
Feeding cuprizone (CPZ) to mice causes demyelination and reactive gliosis in the central nervous system (CNS), hallmarks of some neurodegenerative diseases like multiple sclerosis. However, relatively little is known regarding the behavioural deficits associated with CPZ-feeding and much of what is known is contradictory. This study investigated whether 37 days oral feeding of 0.2% CPZ to young adult mice evoked sensorimotor behavioural changes. Behavioural tests included measurements of nociceptive withdrawal reflex responses and locomotor tests. Additionally, these were compared to histological analysis of the relevant CNS regions by analysis of neuronal and glial cell components. CPZ-fed mice exhibited more foot slips in walking ladder and beam tests compared to controls. In contrast, no changes in nociceptive thresholds to thermal or mechanical stimuli occurred between groups. Histological analysis showed demyelination throughout the CNS, which was most prominent in white matter tracts in the cerebrum but was also elevated in areas such as the hippocampus, basal ganglia and diencephalon. Profound demyelination and gliosis was seen in the deep cerebellar nuclei and brain stem regions associated with the vestibular system. However, in the spinal cord changes were minimal. No loss of oligodendrocytes, neurons or motoneurons occurred but a significant increase in astrocyte staining ensued throughout the white matter of the spinal cord. The results suggest that CPZ differentially affects oligodendrocytes throughout the CNS and induces subtle motor changes such as ataxia. This is associated with deficits in CNS regions associated with motor and balance functions such as the cerebellum and brain stem.
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Affiliation(s)
- Monokesh K Sen
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Mohammed S M Almuslehi
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia; Department of Physiology, College of Veterinary Medicine, Diyala University, Diyala, Iraq
| | - Jens R Coorssen
- Departments of Health Sciences and Biological Sciences, Faculties of Applied Health Sciences and Mathematics & Science, Brock University, Ontario, Canada
| | - David A Mahns
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
| | - Peter J Shortland
- School of Science, Western Sydney University, Penrith, New South Wales, Australia.
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18
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Andersen KW, Lasič S, Lundell H, Nilsson M, Topgaard D, Sellebjerg F, Szczepankiewicz F, Siebner HR, Blinkenberg M, Dyrby TB. Disentangling white-matter damage from physiological fibre orientation dispersion in multiple sclerosis. Brain Commun 2020; 2:fcaa077. [PMID: 32954329 PMCID: PMC7472898 DOI: 10.1093/braincomms/fcaa077] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/20/2020] [Accepted: 05/07/2020] [Indexed: 01/23/2023] Open
Abstract
Multiple sclerosis leads to diffuse damage of the central nervous system, affecting also the normal-appearing white matter. Demyelination and axonal degeneration reduce regional fractional anisotropy in normal-appearing white matter, which can be routinely mapped with diffusion tensor imaging. However, the standard fractional anisotropy metric is also sensitive to physiological variations in orientation dispersion of white matter fibres. This complicates the detection of disease-related damage in large parts of cerebral white matter where microstructure physiologically displays a high degree of fibre dispersion. To resolve this ambiguity, we employed a novel tensor-valued encoding method for diffusion MRI, which yields a microscopic fractional anisotropy metric that is unaffected by regional variations in orientation dispersion. In 26 patients with relapsing-remitting multiple sclerosis, 14 patients with primary-progressive multiple sclerosis and 27 age-matched healthy controls, we compared standard fractional anisotropy mapping with the novel microscopic fractional anisotropy mapping method, focusing on normal-appearing white matter. Mean microscopic fractional anisotropy and standard fractional anisotropy of normal-appearing white matter were significantly reduced in both patient groups relative to healthy controls, but microscopic fractional anisotropy yielded a better reflection of disease-related white-matter alterations. The reduction in mean microscopic fractional anisotropy showed a significant positive linear relationship with physical disability, as reflected by the expanded disability status scale. Mean reduction of microscopic fractional anisotropy in normal-appearing white matter also scaled positively with individual cognitive dysfunction, as measured with the symbol digit modality test. Mean microscopic fractional anisotropy reduction in normal-appearing white matter also showed a positive relationship with total white-matter lesion load as well as lesion load in specific tract systems. None of these relationships between normal-appearing white-matter microstructure and clinical, cognitive or structural measures emerged when using mean fractional anisotropy. Together, the results provide converging evidence that microscopic fractional anisotropy mapping substantially advances the assessment of cerebral white matter in multiple sclerosis by disentangling microstructure damage from variations in physiological fibre orientation dispersion at the stage of data acquisition. Since tensor-valued encoding can be implemented in routine diffusion MRI, microscopic fractional anisotropy mapping bears considerable potential for the future assessment of disease progression in normal-appearing white matter in both relapsing-remitting and progressive forms of multiple sclerosis as well as other white-matter-related brain diseases.
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Affiliation(s)
- Kasper Winther Andersen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
| | - Samo Lasič
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
- Random Walk Imaging, AB, 222 24 Lund, Sweden
| | - Henrik Lundell
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
| | - Markus Nilsson
- Department of Radiology, Clinical Sciences, Lund, Lund University, 221 00 Lund, Sweden
| | - Daniel Topgaard
- Division of Physical Chemistry, Department of Chemistry, Lund University, 221 00 Lund, Sweden
| | - Finn Sellebjerg
- Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Filip Szczepankiewicz
- Department of Medical Radiation Physics, Clinical Sciences, Lund, Lund University, 221 00 Lund, Sweden
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg, 2400 Copenhagen NV, Denmark
| | - Morten Blinkenberg
- Danish Multiple Sclerosis Center, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Tim B Dyrby
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, 2700 Kongens Lyngby, Denmark
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19
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Erfurth EM. Diagnosis, Background, and Treatment of Hypothalamic Damage in Craniopharyngioma. Neuroendocrinology 2020; 110:767-779. [PMID: 32580186 PMCID: PMC7490511 DOI: 10.1159/000509616] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022]
Abstract
Craniopharyngiomas (CP) are rare brain tumors managed primarily with surgery and radiotherapy. There are 2 phenotypes of CP, i.e., one with a rather good outcome without hypothalamic damage and another with hypothalamic damage. With hypothalamic damage, progressive disease with recurrent operations and additional cranial radiotherapy often result in hypothalamic obesity, an affected psychosocial life, and cognitive dysfunction. The morbidity and mortality are increased for particularly cerebrovascular diseases. Preoperative hypothalamic involvement to predict hypothalamic damage is important for decision making for hypothalamus-sparing surgery. Also a postoperative hypothalamic damage evaluation with the use of hypothalamus volume measurement can predict hypothalamic obesity, which is important for early treatment options. The morbidity of CP includes cognitive dysfunction with attention deficits and impaired episodic memory and processing speed. Again patients with hypothalamic damage are more affected. Treatment options of hypothalamic obesity in the chronic phase are scarce and not convincingly successful. The most optimal situation is to try to hinder or stop the evolution of hypothalamic obesity. Prevention of hypothalamic damage is recommended, with special regard to hypothalamus-sparing therapeutic approaches that respect the integrity of essential nuclei located in both the medial and the posterior hypothalamic areas.
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Affiliation(s)
- Eva-Marie Erfurth
- Department of Endocrinology, Skåne University Hospital, Lund, Sweden,
- Clinical Sciences, Lund University, Lund, Sweden,
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20
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MR g-ratio-weighted connectome analysis in patients with multiple sclerosis. Sci Rep 2019; 9:13522. [PMID: 31534143 PMCID: PMC6751178 DOI: 10.1038/s41598-019-50025-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/05/2019] [Indexed: 12/16/2022] Open
Abstract
Multiple sclerosis (MS) is a brain network disconnection syndrome. Although the brain network topology in MS has been evaluated using diffusion MRI tractography, the mechanism underlying disconnection in the disorder remains unclear. In this study, we evaluated the brain network topology in MS using connectomes with connectivity strengths based on the ratio of the inner to outer myelinated axon diameter (i.e., g-ratio), thereby providing enhanced sensitivity to demyelination compared with the conventional measures of connectivity. We mapped g-ratio-based connectomes in 14 patients with MS and compared them with those of 14 age- and sex-matched healthy controls. For comparison, probabilistic tractography was also used to map connectomes based on the number of streamlines (NOS). We found that g-ratio- and NOS-based connectomes comprised significant connectivity reductions in patients with MS, predominantly in the motor, somatosensory, visual, and limbic regions. However, only the g-ratio-based connectome enabled detection of significant increases in nodal strength in patients with MS. Finally, we found that the g-ratio-weighted nodal strength in motor, visual, and limbic regions significantly correlated with inter-individual variation in measures of disease severity. The g-ratio-based connectome can serve as a sensitive biomarker for diagnosing and monitoring disease progression.
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21
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Cercignani M, Gandini Wheeler-Kingshott C. From micro- to macro-structures in multiple sclerosis: what is the added value of diffusion imaging. NMR IN BIOMEDICINE 2019; 32:e3888. [PMID: 29350435 DOI: 10.1002/nbm.3888] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 10/29/2017] [Accepted: 11/25/2017] [Indexed: 06/07/2023]
Abstract
Diffusion imaging has been instrumental in understanding damage to the central nervous system as a result of its sensitivity to microstructural changes. Clinical applications of diffusion imaging have grown exponentially over the past couple of decades in many neurological and neurodegenerative diseases, such as multiple sclerosis (MS). For several reasons, MS has been extensively researched using advanced neuroimaging techniques, which makes it an 'example disease' to illustrate the potential of diffusion imaging for clinical applications. In addition, MS pathology is characterized by several key processes competing with each other, such as inflammation, demyelination, remyelination, gliosis and axonal loss, enabling the specificity of diffusion to be challenged. In this review, we describe how diffusion imaging can be exploited to investigate micro-, meso- and macro-scale properties of the brain structure and discuss how they are affected by different pathological substrates. Conclusions from the literature are that larger studies are needed to confirm the exciting results from initial investigations before current trends in diffusion imaging can be translated to the neurology clinic. Also, for a comprehensive understanding of pathological processes, it is essential to take a multiple-level approach, in which information at the micro-, meso- and macroscopic scales is fully integrated.
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Affiliation(s)
- Mara Cercignani
- Clinical Imaging Sciences Centre, Department of Neuroscience, Brighton and Sussex Medical School, Brighton, UK
- Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy
| | - Claudia Gandini Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, University College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Brain MRI 3T Mondino Research Center, C. Mondino National Neurological Institute, Pavia, Italy
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22
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Harel A, Sperling D, Petracca M, Ntranos A, Katz-Sand I, Krieger S, Lublin F, Wang Z, Liu Y, Inglese M. Brain microstructural injury occurs in patients with RRMS despite 'no evidence of disease activity'. J Neurol Neurosurg Psychiatry 2018; 89:977-982. [PMID: 29549189 DOI: 10.1136/jnnp-2017-317606] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 02/22/2018] [Accepted: 02/26/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The accuracy of 'no evidence of disease activity' (NEDA) in predicting long-term clinical outcome in patients with relapsing remitting multiple sclerosis (RRMS) is unproven, and there is growing evidence that NEDA does not rule out disease worsening. We used diffusion tensor imaging (DTI) to investigate whether ongoing brain microstructural injury occurs in patients with RRMS meeting NEDA criteria. METHODS We performed a retrospective study to identify patients with RRMS visiting our centre over a 3-month period who had undergone prior longitudinal DTI evaluation at our facility spanning ≥2 years. Patients meeting NEDA criteria throughout the evaluation period were included in the NEDA group, and those not meeting NEDA criteria were included in an 'evidence of disease activity' (EDA) group. Fractional anisotropy (FA) and mean diffusivity (MD) maps were created, and annual rates of change were calculated. RESULTS We enrolled 85 patients, 39 meeting NEDA criteria. Both NEDA and EDA groups showed longitudinal DTI worsening. Yearly FA decrease was lower in the NEDA group (0.5%, p<0.0001) than in the EDA group (1.2%, p=0.003), while yearly MD increase was similar in both groups (0.8% for NEDA and EDA, both p<0.01). There was no statistical difference in deterioration within and outside of T2 lesions. DTI parameters correlated with disability scores and fatigue complaints. CONCLUSIONS White matter microstructural deterioration occurs in patients with RRMS over short-term follow-up in patients with NEDA, providing further evidence of the limitations of conventional measures and arguing for DTI in monitoring of the disease process.
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Affiliation(s)
- Asaff Harel
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Neurology, Lenox Hill Hospital, New York, USA
| | - Dylan Sperling
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Achillefs Ntranos
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ilana Katz-Sand
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stephen Krieger
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Fred Lublin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Zichen Wang
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Yangbo Liu
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Matilde Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Departmentof Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Perinatal Sciences, University of Genoa andIRCCS Azienda Ospedale Università San Martino-IST, Genoa, Italy
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23
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Bubb EJ, Metzler-Baddeley C, Aggleton JP. The cingulum bundle: Anatomy, function, and dysfunction. Neurosci Biobehav Rev 2018; 92:104-127. [PMID: 29753752 PMCID: PMC6090091 DOI: 10.1016/j.neubiorev.2018.05.008] [Citation(s) in RCA: 405] [Impact Index Per Article: 67.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/16/2022]
Abstract
The cingulum bundle is a prominent white matter tract that interconnects frontal, parietal, and medial temporal sites, while also linking subcortical nuclei to the cingulate gyrus. Despite its apparent continuity, the cingulum's composition continually changes as fibres join and leave the bundle. To help understand its complex structure, this review begins with detailed, comparative descriptions of the multiple connections comprising the cingulum bundle. Next, the impact of cingulum bundle damage in rats, monkeys, and humans is analysed. Despite causing extensive anatomical disconnections, cingulum bundle lesions typically produce only mild deficits, highlighting the importance of parallel pathways and the distributed nature of its various functions. Meanwhile, non-invasive imaging implicates the cingulum bundle in executive control, emotion, pain (dorsal cingulum), and episodic memory (parahippocampal cingulum), while clinical studies reveal cingulum abnormalities in numerous conditions, including schizophrenia, depression, post-traumatic stress disorder, obsessive compulsive disorder, autism spectrum disorder, Mild Cognitive Impairment, and Alzheimer's disease. Understanding the seemingly diverse contributions of the cingulum will require better ways of isolating pathways within this highly complex tract.
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Affiliation(s)
- Emma J Bubb
- School of Psychology, Cardiff University, 70 Park Place, Cardiff, CF10 3AT, Wales, UK
| | | | - John P Aggleton
- School of Psychology, Cardiff University, 70 Park Place, Cardiff, CF10 3AT, Wales, UK.
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24
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Fjalldal S, Follin C, Svärd D, Rylander L, Gabery S, Petersén Å, van Westen D, Sundgren PC, Björkman-Burtscher IM, Lätt J, Ekman B, Johanson A, Erfurth EM. Microstructural white matter alterations and hippocampal volumes are associated with cognitive deficits in craniopharyngioma. Eur J Endocrinol 2018; 178:577-587. [PMID: 29599407 PMCID: PMC5937918 DOI: 10.1530/eje-18-0081] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/28/2018] [Indexed: 12/13/2022]
Abstract
CONTEXT Patients with craniopharyngioma (CP) and hypothalamic lesions (HL) have cognitive deficits. Which neural pathways are affected is unknown. OBJECTIVE To determine whether there is a relationship between microstructural white matter (WM) alterations detected with diffusion tensor imaging (DTI) and cognition in adults with childhood-onset CP. DESIGN A cross-sectional study with a median follow-up time of 22 (6-49) years after operation. SETTING The South Medical Region of Sweden (2.5 million inhabitants). PARTICIPANTS Included were 41 patients (24 women, ≥17 years) surgically treated for childhood-onset CP between 1958-2010 and 32 controls with similar age and gender distributions. HL was found in 23 patients. MAIN OUTCOME MEASURES Subjects performed cognitive tests and magnetic resonance imaging, and images were analyzed using DTI of uncinate fasciculus, fornix, cingulum, hippocampus and hypothalamus as well as hippocampal volumetry. RESULTS Right uncinate fasciculus was significantly altered (P ≤ 0.01). Microstructural WM alterations in left ventral cingulum were significantly associated with worse performance in visual episodic memory, explaining approximately 50% of the variation. Alterations in dorsal cingulum were associated with worse performance in immediate, delayed recall and recognition, explaining 26-38% of the variation, and with visuospatial ability and executive function, explaining 19-29%. Patients who had smaller hippocampal volume had worse general knowledge (P = 0.028), and microstructural WM alterations in hippocampus were associated with a decline in general knowledge and episodic visual memory. CONCLUSIONS A structure to function relationship is suggested between microstructural WM alterations in cingulum and in hippocampus with cognitive deficits in CP.
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Affiliation(s)
- S Fjalldal
- Department of EndocrinologySkåne University Hospital, Lund, Sweden
| | - C Follin
- Department of EndocrinologySkåne University Hospital, Lund, Sweden
| | - D Svärd
- Department of Diagnostic RadiologyClinical Sciences
| | - L Rylander
- Division of Occupational and Environmental MedicineDepartment of Experimental Medical Science, Lund University, Lund, Sweden
| | - S Gabery
- Translational Neuroendocrine Research UnitDepartment of Experimental Medical Science, Lund University, Lund, Sweden
| | - Å Petersén
- Translational Neuroendocrine Research UnitDepartment of Experimental Medical Science, Lund University, Lund, Sweden
| | - D van Westen
- Department of Diagnostic RadiologyClinical Sciences
| | - P C Sundgren
- Department of Diagnostic RadiologyClinical Sciences
- Department of Medical Imaging and PhysiologySkåne University Hospital, Lund, Sweden
| | - I M Björkman-Burtscher
- Department of Diagnostic RadiologyClinical Sciences
- Department of Medical Imaging and PhysiologySkåne University Hospital, Lund, Sweden
| | - J Lätt
- Department of Medical Imaging and PhysiologySkåne University Hospital, Lund, Sweden
| | - B Ekman
- Department of Endocrinology and Medical and Health SciencesLinköping University, Linköping, Sweden
| | - A Johanson
- Department of Psychology and PsychiatrySkåne University Hospital, Lund, Sweden
| | - E M Erfurth
- Department of EndocrinologySkåne University Hospital, Lund, Sweden
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25
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Grzegorski T, Losy J. Cognitive impairment in multiple sclerosis - a review of current knowledge and recent research. Rev Neurosci 2018; 28:845-860. [PMID: 28787275 DOI: 10.1515/revneuro-2017-0011] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/19/2017] [Indexed: 11/15/2022]
Abstract
Multiple sclerosis (MS) is a chronic, progressive disease of the central nervous system that is characterised by inflammatory damage to the myelin sheath. Though often neglected, cognitive impairment is a common feature of MS that affects 43-70% of patients. It has a sophisticated neuroanatomic and pathophysiologic background and disturbs such vital cognitive domains as speed of information processing, memory, attention, executive functions and visual perceptual functions. In recent years there has been growing interest in neuroimaging findings with regard to cognitive impairment in MS. The possible options of managing cognitive dysfunction in MS are pharmacologic interventions, cognitive rehabilitation and exercise training; however, not enough evidence has been presented in this field. The aim of our article is to provide current knowledge on cognitive impairment in MS based on the most recent scientific results and conclusions with regard to affected cognitive domains, neuropsychological assessment, underlying mechanisms of this disturbance, neuroimaging findings and therapeutic options.
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26
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Manca R, Sharrack B, Paling D, Wilkinson ID, Venneri A. Brain connectivity and cognitive processing speed in multiple sclerosis: A systematic review. J Neurol Sci 2018; 388:115-127. [PMID: 29627004 DOI: 10.1016/j.jns.2018.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/06/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Processing speed (PS) decline is the most commonly observed cognitive deficit in people with multiple sclerosis (MS) resulting in a significant impact on quality of life. Despite its importance, knowledge of the underlying neural substrates is lacking. OBJECTIVE As MS is increasingly recognised as a disconnection syndrome, our aim was to carry out a systematic literature review to clarify the relationship between PS performance and MRI measures of structural and functional brain connectivity in people with MS. SEARCH METHODS A literature search was carried out on PubMed and Web of Science that included publications predating September 2017. Additional articles were added after inspection of the reference lists of all selected papers. DATA EXTRACTION All selected papers were categorised in three sections according to the MRI measures investigated, independently or both. Quality assessment was carried out using a customised set of criteria. RESULTS Thirty-two articles met the inclusion criteria and were included in the review. Microstructural integrity of the anterior corpus callosum and functional connectivity of frontal areas were more consistently found to correlate with PS performance, though high variability of findings was observed across studies. Several methodological flaws emerged from the reviewed literature. CONCLUSIONS Despite the observed trends, no definite conclusions can be drawn on the relationship between brain connectivity and PS decline in MS given the limitations of the current literature. Future investigations may benefit from theoretical and methodological advances to clarify how MS-related brain damage affects patients' cognition.
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Affiliation(s)
- Riccardo Manca
- Department of Neurosciences, University of Sheffield, Sheffield, UK
| | - Basil Sharrack
- Department of Neurosciences, University of Sheffield, Sheffield, UK; Department of Neurology, Sheffield Teaching Hospital NHS Trust, Sheffield, UK
| | - David Paling
- Department of Neurosciences, University of Sheffield, Sheffield, UK; Department of Neurology, Sheffield Teaching Hospital NHS Trust, Sheffield, UK
| | - Iain D Wilkinson
- Academic Unit of Radiology, University of Sheffield, Sheffield, UK
| | - Annalena Venneri
- Department of Neurosciences, University of Sheffield, Sheffield, UK.
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27
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Coppieters I, De Pauw R, Caeyenberghs K, Lenoir D, DeBlaere K, Genbrugge E, Meeus M, Cagnie B. Differences in white matter structure and cortical thickness between patients with traumatic and idiopathic chronic neck pain: Associations with cognition and pain modulation? Hum Brain Mapp 2018; 39:1721-1742. [PMID: 29327392 DOI: 10.1002/hbm.23947] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 12/05/2017] [Accepted: 01/01/2018] [Indexed: 12/18/2022] Open
Abstract
Brain alterations are hypothesized to be present in patients with chronic whiplash-associated disorders (CWAD). The aim of this case-control study was to examine alterations in cortical thickness and white matter (WM) structure, and the presence of brain microhemorrhages in a patient group encountering chronic neck pain of traumatic origin (i.e., CWAD) when compared with a patient group characterized by nontraumatic chronic neck pain [i.e., chronic idiopathic neck pain (CINP)], and healthy controls. Furthermore, we aimed to investigate associations between brain structure on one hand and cognitive performance and central sensitization (CS) on the other hand. T1-weighted, diffusion-weighted and T2*-weighted magnetic resonance images of the brain were acquired in 105 women (31 controls, 37 CINP, 37 CWAD) to investigate regional cortical thickness, WM structure, and microhemorrhages, respectively. Next, cognitive performance, and CS encompassing distant hyperalgesia and conditioned pain modulation (CPM) efficacy were examined. Cortical thinning in the left precuneus was revealed in CWAD compared with CINP patients. Also, decreased fractional anisotropy, together with increased values of mean diffusivity and radial diffusivity could be observed in the left cingulum hippocampus and tapetum in CWAD compared with CINP, and in the left tapetum in CWAD patients compared with controls. Moreover, the extent of WM structural deficits in the left tapetum coincided with decreased CPM efficacy in the CWAD group. This yields evidence for associations between decreased endogenous pain inhibition, and the degree of regional WM deficits in CWAD. Our results emphasize the role of structural brain alterations in women with CWAD compared with CINP.
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Affiliation(s)
- I Coppieters
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group (www.paininmotion.be).,Department of Physiotherapy, Human Physiology and Anatomy (KIMA), Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium
| | - R De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K Caeyenberghs
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Banyo, Australia
| | - D Lenoir
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - K DeBlaere
- Department of Radiology, Ghent University, Ghent, Belgium
| | - E Genbrugge
- Department of Radiology, Ghent University, Ghent, Belgium
| | - M Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Pain in Motion International Research Group (www.paininmotion.be).,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - B Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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28
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Wen J, Yablonskiy DA, Salter A, Cross AH. Limbic system damage in MS: MRI assessment and correlations with clinical testing. PLoS One 2017; 12:e0187915. [PMID: 29121642 PMCID: PMC5679614 DOI: 10.1371/journal.pone.0187915] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/27/2017] [Indexed: 12/21/2022] Open
Abstract
Volume loss in some limbic region structures has been observed in multiple sclerosis (MS) patients. However, in vivo evaluation of existing tissue cellular microstructure integrity has received less attention. The goal of studies reported here was to quantitatively assess loss of limbic system volumes and tissue integrity, and to evaluate associations of these measures with cognitive and physical dysfunction in MS patients. Thirty-one healthy controls (HC) and 80 MS patients, including 32 relapsing remitting (RRMS), 32 secondary progressive (SPMS) and 16 primary progressive (PPMS), participated in this study. Tissue cellular integrity was evaluated by means of recently introduced tissue-specific parameter R2t* that was calculated from multi-gradient-echo MRI signals using a recently developed method that separates R2t* from BOLD (blood oxygen level dependent) contributions to GRE signal decay rate constant (R2*), and accounting for physiological fluctuations and artifacts from background gradients. Volumes in limbic system regions, normalized to skull size (NV), were measured from standard MPRAGE images. MS patients had lower R2t* and smaller normalized volumes in the hippocampus, amygdala, and several other limbic system regions, compared to HC. Alterations in R2t* of several limbic system regions correlated with clinical and neurocognitive test scores in MS patients. In contrast, smaller normalized volumes in MS were only correlated with neurocognitive test scores in the hippocampus and amygdala. This study reports the novel finding that R2t*, a measure that estimates tissue integrity, is more sensitive to tissue damage in limbic system structures than is atrophy. R2t* measurements can serve as a biomarker that is distinct from and complementary to volume measurements.
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Affiliation(s)
- Jie Wen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Dmitriy A. Yablonskiy
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Amber Salter
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Anne H. Cross
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States of America
- * E-mail:
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29
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Pulido-Valdeolivas I, Zubizarreta I, Martinez-Lapiscina EH, Villoslada P. Precision medicine for multiple sclerosis: an update of the available biomarkers and their use in therapeutic decision making. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2017. [DOI: 10.1080/23808993.2017.1393315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Irene Pulido-Valdeolivas
- Institut d’Investigacions Biomediques August Pi Sunyer (IDBAPS), University of Barcelona, Barcelona, Spain
| | - Irati Zubizarreta
- Institut d’Investigacions Biomediques August Pi Sunyer (IDBAPS), University of Barcelona, Barcelona, Spain
| | - Elena H Martinez-Lapiscina
- Institut d’Investigacions Biomediques August Pi Sunyer (IDBAPS), University of Barcelona, Barcelona, Spain
| | - Pablo Villoslada
- Institut d’Investigacions Biomediques August Pi Sunyer (IDBAPS), University of Barcelona, Barcelona, Spain
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30
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Mohammadyfar MA, Azizpour M, Najafi M, Nooripour R. Comparison of audio-visual short-term and active memory in multiple sclerosis patients and non-patients regarding their depression, stress and anxiety level. NORDIC PSYCHOLOGY 2017. [DOI: 10.1080/19012276.2017.1362989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | | | - Mahmood Najafi
- Department of Psychology, Semnan University, Semnan, Iran
| | - Roghieh Nooripour
- Faculty of Education & Psychology, Department of Counseling, Alzahra University, Tehran, Iran
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31
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Spampinato MV, Kocher MR, Jensen JH, Helpern JA, Collins HR, Hatch NU. Diffusional Kurtosis Imaging of the Corticospinal Tract in Multiple Sclerosis: Association with Neurologic Disability. AJNR Am J Neuroradiol 2017; 38:1494-1500. [PMID: 28572153 DOI: 10.3174/ajnr.a5225] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/14/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Multiple sclerosis is an autoimmune disorder resulting in progressive neurologic disability. Our aim was to evaluate the associations between diffusional kurtosis imaging-derived metrics for the corticospinal tract and disability in multiple sclerosis. MATERIALS AND METHODS Forty patients with MS underwent brain MR imaging including diffusional kurtosis imaging. After we masked out T2 hyperintense lesions, the fractional anisotropy, mean diffusivity, radial diffusivity, axial diffusivity, mean kurtosis, radial kurtosis, and axial kurtosis were estimated for the corticospinal tract. Disability was quantified by using the Expanded Disability Status Scale at the time of MR imaging and 12 months post-MR imaging. The Pearson correlation coefficient and linear regression analyses were conducted to evaluate the associations between diffusion metrics and disability. RESULTS Significant correlations were found between the Expanded Disability Status Scale scores during the baseline visit and age (r = 0.47), T2 lesion volume (r = 0.38), corticospinal tract mean diffusivity (r = 0.41), radial diffusivity (r = 0.41), axial diffusivity (r = 0.34), fractional anisotropy (r = -0.36), and radial kurtosis (r = -0.42). Significant correlations were also found between the Expanded Disability Status Scale scores at 12-month follow-up and age (r = 0.38), mean diffusivity (r = 0.45), radial diffusivity (r = 0.41), axial diffusivity (r = 0.45), mean kurtosis (r = -0.42), radial kurtosis (r = -0.56), and axial kurtosis (r = -0.36). Linear regression analyses demonstrated significant associations among radial kurtosis, age, and Expanded Disability Status Scale score during the baseline visit, while radial kurtosis was the only variable associated with Expanded Disability Status Scale score for the 12-month follow-up. CONCLUSIONS Radial kurtosis of the corticospinal tract may have an association with neurologic disability in MS.
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Affiliation(s)
- M V Spampinato
- From the Department of Radiology and Radiological Science (M.V.S., M.R.K., J.H.J., J.A.H., H.R.C., N.U.H.) .,Center for Biomedical Imaging (M.V.S., J.H.J., J.A.H.), Medical University of South Carolina, Charleston, South Carolina
| | - M R Kocher
- From the Department of Radiology and Radiological Science (M.V.S., M.R.K., J.H.J., J.A.H., H.R.C., N.U.H.)
| | - J H Jensen
- From the Department of Radiology and Radiological Science (M.V.S., M.R.K., J.H.J., J.A.H., H.R.C., N.U.H.).,Center for Biomedical Imaging (M.V.S., J.H.J., J.A.H.), Medical University of South Carolina, Charleston, South Carolina
| | - J A Helpern
- From the Department of Radiology and Radiological Science (M.V.S., M.R.K., J.H.J., J.A.H., H.R.C., N.U.H.).,Center for Biomedical Imaging (M.V.S., J.H.J., J.A.H.), Medical University of South Carolina, Charleston, South Carolina
| | - H R Collins
- From the Department of Radiology and Radiological Science (M.V.S., M.R.K., J.H.J., J.A.H., H.R.C., N.U.H.)
| | - N U Hatch
- From the Department of Radiology and Radiological Science (M.V.S., M.R.K., J.H.J., J.A.H., H.R.C., N.U.H.)
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32
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Kaunzner UW, Gauthier SA. MRI in the assessment and monitoring of multiple sclerosis: an update on best practice. Ther Adv Neurol Disord 2017; 10:247-261. [PMID: 28607577 DOI: 10.1177/1756285617708911] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 03/09/2017] [Indexed: 01/14/2023] Open
Abstract
Magnetic resonance imaging (MRI) has developed into the most important tool for the diagnosis and monitoring of multiple sclerosis (MS). Its high sensitivity for the evaluation of inflammatory and neurodegenerative processes in the brain and spinal cord has made it the most commonly used technique for the evaluation of patients with MS. Moreover, MRI has become a powerful tool for treatment monitoring, safety assessment as well as for the prognostication of disease progression. Clinically, the use of MRI has increased in the past couple decades as a result of improved technology and increased availability that now extends well beyond academic centers. Consequently, there are numerous studies supporting the role of MRI in the management of patients with MS. The aim of this review is to summarize the latest insights into the utility of MRI in MS.
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Affiliation(s)
- Ulrike W Kaunzner
- Judith Jaffe Multiple Sclerosis Center, Weill Cornell Medicine, New York, NY, USA
| | - Susan A Gauthier
- Judith Jaffe Multiple Sclerosis Center, Weill Cornell Medicine, 1305 York Avenue, New York, NY 10021, USA
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33
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Keser Z, Hasan KM, Mwangi B, Gabr RE, Steinberg JL, Wilken J, Wolinsky JS, Nelson FM. Limbic Pathway Correlates of Cognitive Impairment in Multiple Sclerosis. J Neuroimaging 2016; 27:37-42. [PMID: 27541485 DOI: 10.1111/jon.12381] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 07/05/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Distinct injuries to various limbic white matter pathways have been reported to be associated with different aspects of cognitive dysfunction in multiple sclerosis (MS). Diffusion tensor imaging (DTI) offers a noninvasive method to map tissue microstructural organization. We utilized quantitative magnetic resonance imaging methods to analyze the main limbic system-white matter structures in MS patients with cognitive impairment (CI). METHODS Ten cognitively nonimpaired MS (MSNI) patients and 36 patients with diagnosed CI (MSCI) underwent the minimal assessment of Cognitive Function in MS (MACFIMS) battery. DTI measures of fornix, cingulum, uncinate fasciculus (UF) included tract volume and corresponding fractional anisotropy (FA), mean (MD), axial (AD), and radial (AD) diffusivities. These were statistically analyzed for associations with CI after adjusting for the confounders. RESULTS Fornix FA and RD, left cingulum FA, MD, and RD, right cingulum FA, MD, and RD, and left UF FA showed significant differences between MSNI and MSCI (P < .001). Fornix FA (r = -.6) and RD (r = .52), and right cingulum FA (r = -.54) and RD (r = .5) correlated significantly with CI in regression analyses. CONCLUSIONS The extent of disruption of microstructural disorganization in the main limbic pathways using DTI impacts the extent of CI seen in subjects with MS.
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Affiliation(s)
- Zafer Keser
- Department of Neurology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Khader M Hasan
- Department of Interventional and Diagnostic Radiology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Benson Mwangi
- UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Refaat E Gabr
- Department of Interventional and Diagnostic Radiology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Joel L Steinberg
- Collaborative Advanced Research Imaging Center for Clinical and Translational Research, Houston, TX, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Jeffrey Wilken
- Department of Neurology, Georgetown University Medical Center, Washington, DC
| | - Jerry S Wolinsky
- Department of Neurology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
| | - Flavia M Nelson
- Department of Neurology, UT Center of Excellence on Mood Disorders, The University of Texas Health Science Center (UTHealth)- McGovern Medical School, Houston, TX
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34
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Schilling K, Janve V, Gao Y, Stepniewska I, Landman BA, Anderson AW. Comparison of 3D orientation distribution functions measured with confocal microscopy and diffusion MRI. Neuroimage 2016; 129:185-197. [PMID: 26804781 DOI: 10.1016/j.neuroimage.2016.01.022] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 01/05/2016] [Accepted: 01/11/2016] [Indexed: 01/30/2023] Open
Abstract
The ability of diffusion MRI (dMRI) fiber tractography to non-invasively map three-dimensional (3D) anatomical networks in the human brain has made it a valuable tool in both clinical and research settings. However, there are many assumptions inherent to any tractography algorithm that can limit the accuracy of the reconstructed fiber tracts. Among them is the assumption that the diffusion-weighted images accurately reflect the underlying fiber orientation distribution (FOD) in the MRI voxel. Consequently, validating dMRI's ability to assess the underlying fiber orientation in each voxel is critical for its use as a biomedical tool. Here, using post-mortem histology and confocal microscopy, we present a method to perform histological validation of orientation functions in 3D, which has previously been limited to two-dimensional analysis of tissue sections. We demonstrate the ability to extract the 3D FOD from confocal z-stacks, and quantify the agreement between the MRI estimates of orientation information obtained using constrained spherical deconvolution (CSD) and the true geometry of the fibers. We find an orientation error of approximately 6° in voxels containing nearly parallel fibers, and 10-11° in crossing fiber regions, and note that CSD was unable to resolve fibers crossing at angles below 60° in our dataset. This is the first time that the 3D white matter orientation distribution is calculated from histology and compared to dMRI. Thus, this technique serves as a gold standard for dMRI validation studies - providing the ability to determine the extent to which the dMRI signal is consistent with the histological FOD, and to establish how well different dMRI models can predict the ground truth FOD.
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Affiliation(s)
- Kurt Schilling
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
| | - Vaibhav Janve
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Yurui Gao
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | | | - Bennett A Landman
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA; Department of Electrical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Adam W Anderson
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
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35
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Chiang GC, Pinto S, Comunale JP, Gauthier SA. Gadolinium-Enhancing Lesions Lead to Decreases in White Matter Tract Fractional Anisotropy in Multiple Sclerosis. J Neuroimaging 2015; 26:289-95. [PMID: 26458494 DOI: 10.1111/jon.12309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 09/01/2015] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Although MRI identification of new lesions forms the basis for monitoring disease progression in multiple sclerosis patients, how lesion activity relates to longitudinal white matter changes in the brain is unknown. We hypothesized that patients with gadolinium-enhancing lesions would show greater longitudinal decline in fractional anisotropy in major tracts compared to those with stable disease. METHODS Thirty patients with relapsing-remitting multiple sclerosis were included in this study-13 had enhancing lesions at baseline and 17 did not. Each patient underwent at least two 3 Tesla contrast-enhanced MRI scans with a DTI sequence with a median interval of 2.1 years between scans. The forceps major and minor of the corpus callosum and the bilateral corticospinal tracts were selected as the major white matter tracts of interest. These tracts were reconstructed using region-of-interest placement on standard anatomical landmarks and a fiber assignment by continuous tracking algorithm using TrackVis (version 0.5.2.2) software. Mixed-effects regression models were used to determine the association between enhancing lesions and subsequent longitudinal change in fractional anisotropy. RESULTS In patients with enhancing lesions, there was greater decline in fractional anisotropy compared to those with stable disease in the forceps major (P = .026), right corticospinal tract (P = .032), and marginally in the left corticospinal tract (P = .050), but not the forceps minor (P = .11). CONCLUSION Fractional anisotropy of major white matter tracts declined more rapidly in patients with enhancing lesions, suggesting greater diffuse white matter injury with active inflammatory disease. DTI may provide a means of monitoring white matter injury following relapses.
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Affiliation(s)
- Gloria C Chiang
- Department of Radiology, Division of Neuroradiology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY
| | - Soniya Pinto
- Department of Surgery, University of Illinois, Chicago, IL
| | - Joseph P Comunale
- Department of Radiology, Division of Neuroradiology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY
| | - Susan A Gauthier
- Department of Neurology, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY
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