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Tripathi SM, Majrashi NA, Alyami AS, Ageeli WA, Refaee TA. A Systematic Review of PET Contrasted with MRI for Detecting Crossed Cerebellar Diaschisis in Patients with Neurodegenerative Diseases. Diagnostics (Basel) 2023; 13:diagnostics13101674. [PMID: 37238158 DOI: 10.3390/diagnostics13101674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
There has not been extensive research into crossed cerebellar diaschisis (CCD) in neurodegenerative disorders. CCD is frequently detected using positron emission tomography (PET). However, advanced MRI techniques have come forth for the detection of CCD. The correct diagnosis of CCD is crucial for the care of neurological patients and those with neurodegenerative conditions. The purpose of this study is to determine whether PET can offer extra value over MRI or an advanced technique in MRI for detecting CCD in neurological conditions. We searched three main electronic databases from 1980 until the present and included only English and peer-reviewed journal articles. Eight articles involving 1246 participants met the inclusion criteria, six of which used PET imaging while the other two used MRI and hybrid imaging. The findings in PET studies showed decreased cerebral metabolism in the frontal, parietal, temporal, and occipital cortices, as on the opposite side of the cerebellar cortex. However, the findings in MRI studies showed decreased cerebellar volumes. This study concludes that PET is a common, accurate, and sensitive technique for detecting both crossed cerebellar and uncrossed basal ganglia as well as thalamic diaschisis in neurodegenerative diseases, while MRI is better for measuring brain volume. This study suggests that PET has a higher diagnostic value for diagnosing CCD compared to MRI, and that PET is a more valuable technique for predicting CCD.
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Affiliation(s)
| | - Naif Ali Majrashi
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 85145, Saudi Arabia
| | - Ali S Alyami
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 85145, Saudi Arabia
| | - Wael A Ageeli
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 85145, Saudi Arabia
| | - Turkey A Refaee
- Diagnostic Radiography Technology (DRT) Department, Faculty of Applied Medical Sciences, Jazan University, Jazan 85145, Saudi Arabia
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Friedli C, Wagner F, Hammer HN, Kamber N, Wiest R, Diem L, Chan A, Salmen A, Hoepner R. Leptomeningeal enhancement under different MS immunotherapies: A monocentric retrospective cohort study of 214 patients. Mult Scler 2023; 29:63-73. [PMID: 36113094 DOI: 10.1177/13524585221122210] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Leptomeningeal inflammation in patients with multiple sclerosis (MS) mainly affects meningeal B-cell follicle-like structures linked to cortical and subpial lesions and can be visualized as leptomeningeal enhancement (LME). OBJECTIVE To evaluate the evolution of LME under different MS immunotherapies. METHODS A total of 214 MS patients treated with anti-CD20 therapies or fingolimod at the university hospital Bern were screened for LME. Magnetic resonance imaging (MRI) and medical records were retrospectively evaluated, and comparative statistics were applied. RESULTS We compared MS patients treated with anti-CD20 therapies (128 patients (59.8%)) or fingolimod (86 patients (40.2%)). Of 128 anti-CD20-treated patients, 108 (84.4%) had no LME, 11 (8.6%) had persistent LME, and 9 (7.0%) showed resolution of LME. Of 86 fingolimod-treated MS patients, 81 (94.2%) had no LME and 5 (5.8%) persistent LME. Patients with LME persistence were older than those without or resolution of LME (p = 0.039). Resolution of LME was more frequent during anti-CD20 compared with fingolimod treatment (p = 0.019). CONCLUSION We observed LME resolution under treatment with anti-CD20 therapies. As LME might play an important role in cerebral gray matter pathology in MS, further investigations including extensions to higher field strengths, correlation with clinical phenotypes, and comparison with other immunotherapies are needed.
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Affiliation(s)
- Christoph Friedli
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Franca Wagner
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Helly Noemi Hammer
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Nicole Kamber
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Roland Wiest
- Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Lara Diem
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Andrew Chan
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Anke Salmen
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Robert Hoepner
- Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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Zhu Y, Ruan G, Cheng Z, Zou S, Zhu X. Lateralization of the crossed cerebellar diaschisis-associated metabolic connectivities in cortico-ponto-cerebellar and cortico-rubral pathways. Neuroimage 2022; 260:119487. [PMID: 35850160 DOI: 10.1016/j.neuroimage.2022.119487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/21/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore the glucose metabolic profile of extrapyramidal system in patients with crossed cerebellar diaschisis (CCD). Furthermore, the metabolic connectivities in cortico-ponto-cerebellar and cortico-rubral pathways associated with CCD were also investigated. A total of 130 CCD positive (CCD+) and 424 CCD negative (CCD-) patients with unilateral cerebral hemisphere hypometabolism on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) were enrolled. Besides, the control group consisted of 56 subjects without any brain structural and metabolic abnormalities. Apart from the "autocorrelation", metabolic connectivity pattern of right or left affected cerebellar hemisphere involved unilateral (left or right, respectively) caudate, pallidum, putamen, thalamus and red nucleus, in CCD+ patients with left or right supratentorial lesions, respectively (Puncorrected < 0.001, cluster size > 200). CCD+ group had significantly lower asymmetry index (AI) in cortico-ponto-cerebellar pathway (including ipsilateral cerebral white matter, ipsilateral pons, contralateral cerebellum white matter and contralateral cerebellum exterior cortex) and cortico-rubral pathway (including ipsilateral caudate, thalamus proper, pallidum, putamen, ventral diencephalon and red nucleus) than those of both CCD- and control groups (all P < 0.05). AI in contralateral cerebellum exterior cortex was significantly positively correlated with that in ipsilateral caudate, putamen, pallidum, thalamus proper, ventral diencephalon, red nucleus and pons among CCD+ group (all P < 0.01), but only with that in ipsilateral caudate and putamen among CCD- group (both P < 0.001). These results provide additional insight into the involvement of both cortico-ponto-cerebellar and cortico-rubral pathways in the presence of CCD, underlining the need for further investigation about the role of their aberrant metabolic connectivities in the associated symptoms of CCD.
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Affiliation(s)
- Yuankai Zhu
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China
| | - Ge Ruan
- Department of Radiology, Hospital, Hubei University, Wuhan 430062, China
| | - Zhaoting Cheng
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China
| | - Sijuan Zou
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China
| | - Xiaohua Zhu
- Department of Nuclear Medicine and PET Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, China.
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Tripathi SM, Murray AD, Wischik CM, Schelter B. Crossed cerebellar diaschisis in Alzheimer's disease. Nucl Med Commun 2022; 43:423-427. [PMID: 35081090 DOI: 10.1097/mnm.0000000000001531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Crossed cerebellar diaschisis (CCD) is characterized by hypometabolism and hypoperfusion on molecular imaging in the cerebellum due to a supratentorial lesion on the contralateral side. CCD is a well-established phenomenon in acute or subacute conditions such as infarction but it has been less well described in chronic conditions such as neurodegenerative dementias. Here, we investigate CCD in a large sample of 830 people meeting research criteria for Alzheimer's disease (AD) using [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET). MATERIALS AND METHODS This study is based on FDG-PET data collected at baseline as part of two large-scale Phase III clinical trials of a novel tau aggregation inhibitor medication, methylthioninium in mild to moderate AD participants. Quantification of FDG-PET hypometabolism was carried out using standardized uptake value ratio (SUVR), with the pons as the comparison region. SUVR was compared in different regions of interest between the right and left hemispheres of the brain and cerebellum in people with mild AD (Mini-Mental State Examination score ≥ 20). RESULTS Comparison of SUVR in different brain regions demonstrated significant differences in the temporal, occipital and cerebellar cortices. Right and left asymmetry was noted with lower SUVR in the left temporal and occipital regions, whereas SUVR was lower in the right side of the cerebellum. CONCLUSION Here, we found robust evidence of CCD in a large sample of people with AD, a chronic neurodegenerative condition. The presence of this phenomenon in AD opens up a new avenue of research in AD pathogenesis and has the potential to change future diagnostic and therapeutic strategies.
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Affiliation(s)
- Shailendra Mohan Tripathi
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
- King George's Medical University, Lucknow, India
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
- King George's Medical University, Lucknow, India
| | - Claude M Wischik
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen
- TauRx Therapeutics Ltd, Aberdeen
| | - Bjoern Schelter
- TauRx Therapeutics Ltd, Aberdeen
- Institute for Complex Systems and Mathematical Biology (ICSMB), Meston Building, Meston Walk, King's College, Old Aberdeen University of Aberdeen, Aberdeen, UK
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