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Badihian N, Gatto RG, Satoh R, Ali F, Clark HM, Pham NTT, Whitwell JL, Josephs KA. Clinical and neuroimaging characteristics of primary lateral sclerosis with overlapping features of progressive supranuclear palsy. Eur J Neurol 2024; 31:e16320. [PMID: 38686979 PMCID: PMC11227385 DOI: 10.1111/ene.16320] [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: 02/14/2024] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND PURPOSE Primary lateral sclerosis (PLS) is a neurodegenerative disorder that primarily affects the central motor system. In rare cases, clinical features of PLS may overlap with those of progressive supranuclear palsy (PSP). We investigate neuroimaging features that can help distinguish PLS with overlapping features of PSP (PLS-PSP) from PSP. METHODS Six patients with PLS-PSP were enrolled between 2019 and 2023. We compared their clinical and neuroimaging characteristics with 18 PSP-Richardson syndrome (PSP-RS) patients and 20 healthy controls. Magnetic resonance imaging, 18F-flortaucipir positron emission tomography (PET), quantitative susceptibility mapping, and diffusion tensor imaging tractography (DTI) were performed to evaluate eight brain regions of interest. Area under the receiver operating characteristic curve (AUROC) was calculated. RESULTS Five of the six PLS-PSP patients (83.3%) were male. Median age at symptom onset was 61.5 (52.5-63) years, and all had mixed features of PLS and PSP. Volumes of the pallidum, caudate, midbrain, and cerebellar dentate were smaller in PSP-RS than PLS-PSP, providing good discrimination (AUROC = 0.75 for all). The susceptibilities in pallidum, midbrain, and cerebellar dentate were greater in PSP-RS compared to PLS-PSP, providing excellent discrimination (AUROC ≥ 0.90 for all). On DTI, fractional anisotropy (FA) in the posterior limb of the internal capsule from the corticospinal tract was lower in PLS-PSP compared to PSP-RS (AUROC = 0.86), but FA in the superior cerebellar peduncle was lower in PSP-RS (AUROC = 0.95). Pallidum flortaucipir PET uptake was greater in PSP-RS compared to PLS-PSP (AUROC = 0.74). CONCLUSIONS Regional brain volume, tractography, and magnetic susceptibility, but not tau-PET, are useful in distinguishing PLS-PSP from PSP.
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Affiliation(s)
| | | | - Ryota Satoh
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Farwa Ali
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
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Litwin T, Rędzia-Ogrodnik B, Antos A, Przybyłkowski A, Członkowska A, Bembenek JP. Brain Magnetic Resonance Imaging in Wilson's Disease-Significance and Practical Aspects-A Narrative Review. Brain Sci 2024; 14:727. [PMID: 39061467 PMCID: PMC11274939 DOI: 10.3390/brainsci14070727] [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: 06/28/2024] [Revised: 07/10/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
Wilson's disease (WD) is a genetic disorder of copper metabolism with pathological copper accumulation in many organs, resulting in clinical symptoms, mostly hepatic and neuropsychiatric. As copper accumulates in the brain during WD, and almost 50% of WD patients at diagnosis present with neurological symptoms, neuroimaging studies (especially brain magnetic resonance imaging (MRI)) are part of WD diagnosis. The classical sequences (T1, T2, and fluid-attenuated inversion recovery) were used to describe brain MRI; however, with the development of neuroradiology, several papers proposed the use of new MRI sequences and techniques like susceptibility-weighted images, T2*, diffusion MRI, tractography, volumetric assessment and post-processing brain MRI analysis of paramagnetic accumulation-quantitative susceptibility mapping. Based on these neuroradiological data in WD, currently, brain MRI semiquantitative scale and the pathognomonic neuroradiological brain MRI signs in WD were proposed. Further, the volumetric studies and brain iron accumulation MRI analysis suggested brain atrophy and iron accumulation as biomarkers of neurological WD disease severity. All these results highlight the significance of brain MRI examinations in WD. Due to the extreme progress of these studies, based on the available literature, the authors present the current state of knowledge about the significance, practical aspects, and future directions of brain MRI in WD.
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Affiliation(s)
- Tomasz Litwin
- Second Department of Neurology, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland; (B.R.-O.); (A.A.); (A.C.)
| | - Barbara Rędzia-Ogrodnik
- Second Department of Neurology, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland; (B.R.-O.); (A.A.); (A.C.)
| | - Agnieszka Antos
- Second Department of Neurology, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland; (B.R.-O.); (A.A.); (A.C.)
| | - Adam Przybyłkowski
- Department of Gastroenterology, Medical University, Warsaw 02-097, Poland;
| | - Anna Członkowska
- Second Department of Neurology, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland; (B.R.-O.); (A.A.); (A.C.)
| | - Jan Paweł Bembenek
- Department of Neurophysiology, Institute Psychiatry and Neurology, 02-957 Warsaw, Poland;
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Ghaderi S, Fatehi F, Kalra S, Mohammadi S, Batouli SAH. Quantitative susceptibility mapping in amyotrophic lateral sclerosis: automatic quantification of the magnetic susceptibility in the subcortical nuclei. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-12. [PMID: 38957123 DOI: 10.1080/21678421.2024.2372648] [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: 04/15/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
Objective: Previous studies have suggested a link between dysregulation of cortical iron levels and neuronal loss in amyotrophic lateral sclerosis (ALS) patients. However, few studies have reported differences in quantitative susceptibility mapping (QSM) values in subcortical nuclei between patients with ALS and healthy controls (HCs). Methods: MRI was performed using a 3 Tesla Prisma scanner (64-channel head coil), including 3D T1-MPRAGE and multi-echo 3D GRE for QSM reconstruction. Automated QSM segmentation was used to measure susceptibility values in the subcortical nuclei, which were compared between the groups. Correlations with clinical scales were analyzed. Group comparisons were performed using independent t-tests, with p < 0.05 considered significant. Correlations were assessed using Pearson's correlation, with p < 0.05 considered significant. Cohen's d was reported to compare the standardized mean difference (SMD) of QSM. Results: Twelve patients with limb-onset ALS (mean age 48.7 years, 75% male) and 13 age-, sex-, and handedness-matched HCs (mean age 44.6 years, 69% male) were included. Compared to HCs, ALS patients demonstrated significantly lower susceptibility in the left caudate nucleus (CN) (SMD = -0.845), right CN (SMD = -0.851), whole CN (SMD = -1.016), and left subthalamic nucleus (STN) (SMD = -1.000). Susceptibility in the left putamen (SMD = -0.857), left thalamus (SMD = -1.081), and whole thalamus (SMD = -0.968) was significantly higher in the patients. The susceptibility of the substantia nigra (SN), CN, and pulvinar was positively correlated with disease duration. Conclusions: QSM detects abnormal iron accumulation patterns in the subcortical gray matter of ALS patients, which correlates with disease characteristics, supporting its potential as a neuroimaging biomarker.
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Affiliation(s)
- Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neurology Department, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sanjay Kalra
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada, and
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada
| | - Sana Mohammadi
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Fushimi Y, Nakajima S, Sakata A, Okuchi S, Otani S, Nakamoto Y. Value of Quantitative Susceptibility Mapping in Clinical Neuroradiology. J Magn Reson Imaging 2024; 59:1914-1929. [PMID: 37681441 DOI: 10.1002/jmri.29010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
Quantitative susceptibility mapping (QSM) is a unique technique for providing quantitative information on tissue magnetic susceptibility using phase image data. QSM can provide valuable information regarding physiological and pathological processes such as iron deposition, hemorrhage, calcification, and myelin. QSM has been considered for use as an imaging biomarker to investigate physiological status and pathological changes. Although various studies have investigated the clinical applications of QSM, particularly regarding the use of QSM in clinical practice, have not been examined well. This review provides on an overview of the basics of QSM and its clinical applications in neuroradiology. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sachi Okuchi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sayo Otani
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Rifai OM, Waldron FM, O'Shaughnessy J, Read FL, Gilodi M, Pastore A, Shneider N, Tartaglia GG, Zacco E, Spence H, Gregory JM. Amygdala TDP-43 pathology is associated with behavioural dysfunction and ferritin accumulation in amyotrophic lateral sclerosis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.01.596819. [PMID: 38854008 PMCID: PMC11160765 DOI: 10.1101/2024.06.01.596819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background Cognitive and behavioural symptoms associated with amyotrophic lateral sclerosis and frontotemporal spectrum disorders (ALSFTSD) are thought to be driven, at least in part, by the pathological accumulation of TDP-43. Methods Here we examine post-mortem tissue from six brain regions associated with cognitive and behavioural symptoms in a cohort of 30 people with sporadic ALS (sALS), a proportion of which underwent standardized neuropsychological behavioural assessment as part of the Edinburgh Cognitive ALS Screen (ECAS). Results Overall, the behavioural screen performed as part of the ECAS predicted accumulation of pathological phosphorylated TDP-43 (pTDP-43) with 100% specificity and 86% sensitivity in behaviour-associated brain regions. Notably, of these regions, pathology in the amygdala was the most predictive correlate of behavioural dysfunction in sALS. In the amygdala of sALS patients, we show variation in morphology, cell type predominance, and severity of pTDP-43 pathology. Further, we demonstrate that the presence and severity of intra-neuronal pTDP-43 pathology, but not astroglial pathology, or phosphorylated Tau pathology, is associated with behavioural dysfunction. Cases were also evaluated using a TDP-43 aptamer (TDP-43APT), which revealed that pathology was not only associated with behavioural symptoms, but also with ferritin levels, a measure of brain iron. Conclusions Intra-neuronal pTDP-43 and cytoplasmic TDP-43APT pathology in the amygdala is associated with behavioural symptoms in sALS. TDP-43APT staining intensity is also associated with increased ferritin, regardless of behavioural phenotype, suggesting that ferritin increases may occur upstream of clinical manifestation, in line with early TDP-43APT pathology, representing a potential region-specific imaging biomarker of early disease in ALS.
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Affiliation(s)
- Olivia M Rifai
- Centre for Discovery Brain Sciences, University of Edinburgh, UK
- Department of Neurology, Center for Motor Neuron Biology and Disease, Columbia University, New York, USA
| | | | | | - Fiona L Read
- Institute of Medical Sciences, University of Aberdeen, UK
| | - Martina Gilodi
- RNA System Biology Lab, Center for Human Technology, Istituto Italiano di Tecnologia, Genoa, Italy
| | | | - Neil Shneider
- Department of Neurology, Center for Motor Neuron Biology and Disease, Columbia University, New York, USA
| | - Gian Gaetano Tartaglia
- RNA System Biology Lab, Center for Human Technology, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Elsa Zacco
- RNA System Biology Lab, Center for Human Technology, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Holly Spence
- Institute of Medical Sciences, University of Aberdeen, UK
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Tilsley P, Moutiez A, Brodovitch A, Mendili MME, Testud B, Zaaraoui W, Verschueren A, Attarian S, Guye M, Boucraut J, Grapperon AM, Stellmann JP. Neurofilament Light Chain Levels Interact with Neurodegenerative Patterns and Motor Neuron Dysfunction in Amyotrophic Lateral Sclerosis. AJNR Am J Neuroradiol 2024; 45:494-503. [PMID: 38548305 PMCID: PMC11288555 DOI: 10.3174/ajnr.a8154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/08/2023] [Indexed: 04/10/2024]
Abstract
BACKGROUND AND PURPOSE Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving rapid motor neuron degeneration leading to brain, primarily precentral, atrophy. Neurofilament light chains are a robust prognostic biomarker highly specific to ALS, yet associations between neurofilament light chains and MR imaging outcomes are not well-understood. We investigated the role of neurofilament light chains as mediators among neuroradiologic assessments, precentral neurodegeneration, and disability in ALS. MATERIALS AND METHODS We retrospectively analyzed a prospective cohort of 29 patients with ALS (mean age, 56 [SD, 12] years; 18 men) and 36 controls (mean age, 49 [SD, 11] years; 18 men). Patients underwent 3T (n = 19) or 7T (n = 10) MR imaging, serum (n = 23) and CSF (n = 15) neurofilament light chains, and clinical (n = 29) and electrophysiologic (n = 27) assessments. The control group had equivalent 3T (n = 25) or 7T (n = 11) MR imaging. Two trained neuroradiologists performed blinded qualitative assessments of MR imaging anomalies (n = 29 patients, n = 36 controls). Associations between precentral cortical thickness and neurofilament light chains and clinical and electrophysiologic data were analyzed. RESULTS We observed extensive cortical thinning in patients compared with controls. MR imaging analyses showed significant associations between precentral cortical thickness and bulbar or arm impairment following distributions corresponding to the motor homunculus. Finally, uncorrected results showed positive interactions among precentral cortical thickness, serum neurofilament light chains, and electrophysiologic outcomes. Qualitative MR imaging anomalies including global atrophy (P = .003) and FLAIR corticospinal tract hypersignal anomalies (P = .033), correlated positively with serum neurofilament light chains. CONCLUSIONS Serum neurofilament light chains may be an important mediator between clinical symptoms and neuronal loss according to cortical thickness. Furthermore, MR imaging anomalies might have underestimated prognostic value because they seem to indicate higher serum neurofilament light chain levels.
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Affiliation(s)
- Penelope Tilsley
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
- Assistance Publique-Marseille Hospitals (P.T., M.M.E.M., B.T., W.Z., M.G., J.-P.S.), Hôpital de la Timone, CEMEREM, Marseille, France
| | - Antoine Moutiez
- Department of Neuroradiology (A.M., B.T., J.-P.S.), Assistance Publique-Marseille Hospitals, Hôpital de la Timone, Marseille, France
| | - Alexandre Brodovitch
- Immunology Laboratory (A.B., J.B.), Assistance Publique-Marseille Hospitals, Conception Hospital, Marseille, France
| | - Mohamed Mounir El Mendili
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
- Assistance Publique-Marseille Hospitals (P.T., M.M.E.M., B.T., W.Z., M.G., J.-P.S.), Hôpital de la Timone, CEMEREM, Marseille, France
| | - Benoit Testud
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
- Assistance Publique-Marseille Hospitals (P.T., M.M.E.M., B.T., W.Z., M.G., J.-P.S.), Hôpital de la Timone, CEMEREM, Marseille, France
- Department of Neuroradiology (A.M., B.T., J.-P.S.), Assistance Publique-Marseille Hospitals, Hôpital de la Timone, Marseille, France
| | - Wafaa Zaaraoui
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
- Assistance Publique-Marseille Hospitals (P.T., M.M.E.M., B.T., W.Z., M.G., J.-P.S.), Hôpital de la Timone, CEMEREM, Marseille, France
| | - Annie Verschueren
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
- Referral Centre for Neuromuscular Diseases and ALS (A.V., S.A., A.-M.G.), Assistance Publique-Marseille Hospitals, Hôpital de la Timone, Marseille, France
| | - Shahram Attarian
- Referral Centre for Neuromuscular Diseases and ALS (A.V., S.A., A.-M.G.), Assistance Publique-Marseille Hospitals, Hôpital de la Timone, Marseille, France
- Institut National de la Santé et de la Recherche Médicale (S.A.,), Marseille Medical Genetics Center, Aix-Marseille University, Marseille, France
| | - Maxime Guye
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
- Assistance Publique-Marseille Hospitals (P.T., M.M.E.M., B.T., W.Z., M.G., J.-P.S.), Hôpital de la Timone, CEMEREM, Marseille, France
| | - José Boucraut
- Immunology Laboratory (A.B., J.B.), Assistance Publique-Marseille Hospitals, Conception Hospital, Marseille, France
- Institut National de la Santé et de la Recherche Médicale (J.B.) Institut de Neurosciences des Systèmes Aix-Marseille University, Marseille, France
| | - Aude-Marie Grapperon
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Jan-Patrick Stellmann
- From the Centre de Résonance Magnétique Biologique et Médicale (P.T., M.M.E.M., B.T., W.Z., A.V., M.G., A.-M.G., J.-P.S.), Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
- Assistance Publique-Marseille Hospitals (P.T., M.M.E.M., B.T., W.Z., M.G., J.-P.S.), Hôpital de la Timone, CEMEREM, Marseille, France
- Department of Neuroradiology (A.M., B.T., J.-P.S.), Assistance Publique-Marseille Hospitals, Hôpital de la Timone, Marseille, France
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Roberts AG, Romano DJ, Şişman M, Dimov AV, Nguyen TD, Kovanlikaya I, Gauthier SA, Wang Y, Spincemaille P. Maximum spherical mean value filtering for whole-brain QSM. Magn Reson Med 2024; 91:1586-1597. [PMID: 38169132 DOI: 10.1002/mrm.29963] [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: 04/21/2023] [Revised: 10/30/2023] [Accepted: 11/19/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE To develop a tissue field-filtering algorithm, called maximum spherical mean value (mSMV), for reducing shadow artifacts in QSM of the brain without requiring brain-tissue erosion. THEORY AND METHODS Residual background field is a major source of shadow artifacts in QSM. The mSMV algorithm filters large field-magnitude values near the border, where the maximum value of the harmonic background field is located. The effectiveness of mSMV for artifact removal was evaluated by comparing existing QSM algorithms in numerical brain simulation as well as using in vivo human data acquired from 11 healthy volunteers and 93 patients. RESULTS Numerical simulation showed that mSMV reduces shadow artifacts and improves QSM accuracy. Better shadow reduction, as demonstrated by lower QSM variation in the gray matter and higher QSM image quality score, was also observed in healthy subjects and in patients with hemorrhages, stroke, and multiple sclerosis. CONCLUSION The mSMV algorithm allows QSM maps that are substantially equivalent to those obtained using SMV-filtered dipole inversion without eroding the volume of interest.
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Affiliation(s)
- Alexandra G Roberts
- Department of Electrical and Computer Engineering, Cornell University, Ithaca, New York, USA
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Dominick J Romano
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA
| | - Mert Şişman
- Department of Electrical and Computer Engineering, Cornell University, Ithaca, New York, USA
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Alexey V Dimov
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Thanh D Nguyen
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Ilhami Kovanlikaya
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Susan A Gauthier
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Yi Wang
- Department of Electrical and Computer Engineering, Cornell University, Ithaca, New York, USA
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Meinig School of Biomedical Engineering, Cornell University, Ithaca, New York, USA
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8
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Zhang J, Nguyen TD, Solomon E, Li C, Zhang Q, Li J, Zhang H, Spincemaille P, Wang Y. mcLARO: Multi-contrast learned acquisition and reconstruction optimization for simultaneous quantitative multi-parametric mapping. Magn Reson Med 2024; 91:344-356. [PMID: 37655444 DOI: 10.1002/mrm.29854] [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: 04/06/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023]
Abstract
PURPOSE To develop a method for rapid sub-millimeter T1 , T2 ,T 2 * $$ {\mathrm{T}}_2^{\ast } $$ , and QSM mapping in a single scan using multi-contrast learned acquisition and reconstruction optimization (mcLARO). METHODS A pulse sequence was developed by interleaving inversion recovery and T2 magnetization preparations and single-echo and multi-echo gradient echo acquisitions, which sensitized k-space data to T1 , T2 ,T 2 * $$ {\mathrm{T}}_2^{\ast } $$ , and magnetic susceptibility. The proposed mcLARO optimized both the multi-contrast k-space under-sampling pattern and image reconstruction based on image feature fusion using a deep learning framework. The proposed mcLARO method withR = 8 $$ R=8 $$ under-sampling was validated in a retrospective ablation study and compared with other deep learning reconstruction methods, including MoDL and Wave-MoDL, using fully sampled data as reference. Various under-sampling ratios in mcLARO were investigated. mcLARO was also evaluated in a prospective study using separately acquired conventionally sampled quantitative maps as reference standard. RESULTS The retrospective ablation study showed improved image sharpness of mcLARO compared to the baseline network without the multi-contrast sampling pattern optimization or image feature fusion module. The under-sampling ratio experiment showed that higher under-sampling ratios resulted in blurrier images and lower precision of quantitative values. The prospective study showed that small or negligible bias and narrow 95% limits of agreement on regional T1 , T2 ,T 2 * $$ {\mathrm{T}}_2^{\ast } $$ , and QSM values by mcLARO (5:39 mins) compared to reference scans (40:03 mins in total). mcLARO outperformed MoDL and Wave-MoDL in terms of image sharpness, noise suppression, and artifact removal. CONCLUSION mcLARO enabled fast sub-millimeter T1 , T2 ,T 2 * $$ {\mathrm{T}}_2^{\ast } $$ , and QSM mapping in a single scan.
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Affiliation(s)
- Jinwei Zhang
- Department of Biomedical Engineering, Cornell University, Ithaca, New York, USA
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Thanh D Nguyen
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Eddy Solomon
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Chao Li
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Department of Applied Physics, Cornell University, Ithaca, New York, USA
| | - Qihao Zhang
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Jiahao Li
- Department of Biomedical Engineering, Cornell University, Ithaca, New York, USA
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Hang Zhang
- Department of Electrical and Computer Engineering, Cornell University, Ithaca, New York, USA
| | | | - Yi Wang
- Department of Biomedical Engineering, Cornell University, Ithaca, New York, USA
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
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9
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Ghaderi S, Batouli SAH, Mohammadi S, Fatehi F. Iron quantification in basal ganglia using quantitative susceptibility mapping in a patient with ALS: a case report and literature review. Front Neurosci 2023; 17:1229082. [PMID: 37877011 PMCID: PMC10593460 DOI: 10.3389/fnins.2023.1229082] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/04/2023] [Indexed: 10/26/2023] Open
Abstract
Background Quantitative susceptibility mapping (QSM) is a magnetic resonance imaging (MRI) technique that can measure the magnetic susceptibility of tissues, which can reflect their iron content. QSM has been used to detect iron accumulation in cortical and subcortical brain regions. However, its application in subcortical regions such as the basal ganglia, particularly the putamen, is rare in patients with amyotrophic lateral sclerosis (ALS). Case presentation and literature review We present the case of a 40-year-old male patient with ALS who underwent an MRI for QSM. We compared his QSM images with those of a control subject and performed a quantitative analysis of the magnetic susceptibility values in the putamen regions. We also reviewed the literature on previous QSM studies in ALS and summarized their methods and findings. Our QSM analysis revealed increased magnetic susceptibility values in the bilateral putamen of the ALS patient compared to controls, indicating iron overload. This finding is consistent with previous studies reporting iron dysregulation in subcortical nuclei in ALS. We also discussed the QSM processing techniques used in our study and in the literature, highlighting their advantages and limitations. Conclusion This case report demonstrates the potential of QSM as a sensitive MRI biomarker for evaluating iron levels in subcortical regions of ALS patients. QSM can provide quantitative information on iron deposition patterns in both motor and extra-motor areas of ALS patients, which may help understand the pathophysiology of ALS and monitor disease progression. Further studies with larger samples are needed to validate these results and explore the clinical implications of QSM in ALS.
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Affiliation(s)
- Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Neuromuscular Research Center, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sana Mohammadi
- Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Neuromuscular Research Center, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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10
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Şişman M, Nguyen TD, Roberts AG, Romano DJ, Dimov AV, Kovanlikaya I, Spincemaille P, Wang Y. Microstructure-Informed Myelin Mapping (MIMM) from Gradient Echo MRI using Stochastic Matching Pursuit. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.22.23295993. [PMID: 37808826 PMCID: PMC10557811 DOI: 10.1101/2023.09.22.23295993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Quantification of the myelin content of the white matter is important for studying demyelination in neurodegenerative diseases such as Multiple Sclerosis (MS), particularly for longitudinal monitoring. A novel noninvasive MRI method, called Microstructure-Informed Myelin Mapping (MIMM), is developed to quantify the myelin volume fraction (MVF) by utilizing a multi gradient echo sequence (mGRE) and a detailed biophysical model of tissue microstructure. Myelin is modeled as anisotropic negative susceptibility source based on the Hollow Cylindrical Fiber Model (HCFM), and iron as isotropic positive susceptibility source in the extracellular region. Voxels with a range of biophysical parameters are simulated to create a dictionary of MR echo time magnitude signals and total susceptibility values. MRI signals measured using a mGRE sequence are then matched voxel-by-voxel to the created dictionary to obtain the spatial distributions of myelin and iron. Three different MIMM versions are presented to deal with the fiber orientation dependent susceptibility effects of the myelin sheaths: a basic variation, which assumes fiber orientation is an unknown to fit, two orientation informed variations, which assume the fiber orientation distribution is available either from a separate diffusion tensor imaging (DTI) acquisition or from a DTI atlas based fiber orientation map. While all showed a significant linear correlation with the reference method based on T2-relaxometry (p < 0.0001), DTI orientation informed and atlas orientation informed variations reduced overestimation at white matter tracts compared to the basic variation. Finally, the implications and usefulness of attaining an additional iron susceptibility distribution map are discussed. Highlights novel stochastic matching pursuit algorithm called microstructure-informed myelin mapping (MIMM) is developed to quantify Myelin Volume Fraction (MVF) using Magnetic Resonance Imaging (MRI) and microstructural modeling.utilizes a detailed biophysical model to capture the susceptibility effects on both magnitude and phase to quantify myelin and iron.matter fiber orientation effects are considered for the improved MVF quantification in the major fiber tracts.acquired myelin and iron maps may be utilized to monitor longitudinal disease progress.
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11
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Cogswell PM, Fan AP. Multimodal comparisons of QSM and PET in neurodegeneration and aging. Neuroimage 2023; 273:120068. [PMID: 37003447 PMCID: PMC10947478 DOI: 10.1016/j.neuroimage.2023.120068] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/17/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Quantitative susceptibility mapping (QSM) has been used to study susceptibility changes that may occur based on tissue composition and mineral deposition. Iron is a primary contributor to changes in magnetic susceptibility and of particular interest in applications of QSM to neurodegeneration and aging. Iron can contribute to neurodegeneration through inflammatory processes and via interaction with aggregation of disease-related proteins. To better understand the local susceptibility changes observed on QSM, its signal has been studied in association with other imaging metrics such as positron emission tomography (PET). The associations of QSM and PET may provide insight into the pathophysiology of disease processes, such as the role of iron in aging and neurodegeneration, and help to determine the diagnostic utility of QSM as an indirect indicator of disease processes typically evaluated with PET. In this review we discuss the proposed mechanisms and summarize prior studies of the associations of QSM and amyloid PET, tau PET, TSPO PET, FDG-PET, 15O-PET, and F-DOPA PET in evaluation of neurologic diseases with a focus on aging and neurodegeneration.
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Affiliation(s)
- Petrice M Cogswell
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
| | - Audrey P Fan
- Department of Biomedical Engineering and Department of Neurology, University of California, Davis, 1590 Drew Avenue, Davis, CA 95618, USA
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12
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Bao Y, Chen Y, Piao S, Hu B, Yang L, Li H, Geng D, Li Y. Iron quantitative analysis of motor combined with bulbar region in M1 cortex may improve diagnosis performance in ALS. Eur Radiol 2023; 33:1132-1142. [PMID: 35951045 DOI: 10.1007/s00330-022-09045-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 06/08/2022] [Accepted: 07/09/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To explore whether the combined analysis of motor and bulbar region of M1 on susceptibility-weighted imaging (SWI) can be a valid biomarker for amyotrophic lateral sclerosis (ALS). METHODS Thirty-two non-demented ALS patients and 35 age- and gender-matched healthy controls (HC) were retrospectively recruited. SWI and 3D-T1-MPRAGE images were obtained from all individuals using a 3.0-T MRI scan. The bilateral posterior band of M1 was manually delineated by three neuroradiologists on phase images and subdivided into the motor and bulbar regions. We compared the phase values in two groups and performed a stratification analysis (ALSFRS-R score, duration, disease progression rate, and onset). Receiver operating characteristic (ROC) curves were also constructed. RESULTS ALS group showed significantly increased phase values in M1 and the two subregions than the HC group, on the all and elderly level (p < 0.001, respectively). On all-age level comparison, negative correlations were found between phase values of M1 and clinical score and duration (p < 0.05, respectively). Similar associations were found in the motor region (p < 0.05, respectively). On both the total (p < 0.01) and elderly (p < 0.05) levels, there were positive relationships between disease progression rate and M1 phase values. In comparing ROC curves, the entire M1 showed the best diagnostic performance. CONCLUSIONS Combining motor and bulbar analyses as an integral M1 region on SWI can improve ALS diagnosis performance, especially in the elderly. The phase value could be a valuable biomarker for ALS evaluation. KEY POINTS • Integrated analysis of the motor and bulbar as an entire M1 region on SWI can improve the diagnosis performance in ALS. • Quantitative analysis of iron deposition by SWI measurement helps the clinical evaluation, especially for the elderly patients. • Phase value, when combined with the disease progression rate, could be a valuable biomarker for ALS.
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Affiliation(s)
- Yifang Bao
- Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China
| | - Yan Chen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Sirong Piao
- Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China
| | - Bin Hu
- Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China
| | - Liqin Yang
- Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China
| | - Haiqing Li
- Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China.,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China.
| | - Yuxin Li
- Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, Jingan District, Shanghai, 200040, China. .,Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, 200040, China.
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13
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Younger DS. Spinal cord motor disorders. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:3-42. [PMID: 37620076 DOI: 10.1016/b978-0-323-98817-9.00007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Spinal cord diseases are frequently devastating due to the precipitous and often permanently debilitating nature of the deficits. Spastic or flaccid paraparesis accompanied by dermatomal and myotomal signatures complementary to the incurred deficits facilitates localization of the insult within the cord. However, laboratory studies often employing disease-specific serology, neuroradiology, neurophysiology, and cerebrospinal fluid analysis aid in the etiologic diagnosis. While many spinal cord diseases are reversible and treatable, especially when recognized early, more than ever, neuroscientists are being called to investigate endogenous mechanisms of neural plasticity. This chapter is a review of the embryology, neuroanatomy, clinical localization, evaluation, and management of adult and childhood spinal cord motor disorders.
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Affiliation(s)
- David S Younger
- Department of Clinical Medicine and Neuroscience, CUNY School of Medicine, New York, NY, United States; Department of Medicine, Section of Internal Medicine and Neurology, White Plains Hospital, White Plains, NY, United States.
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14
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Nikparast F, Ganji Z, Zare H. Early differentiation of neurodegenerative diseases using the novel QSM technique: what is the biomarker of each disorder? BMC Neurosci 2022; 23:48. [PMID: 35902793 PMCID: PMC9336059 DOI: 10.1186/s12868-022-00725-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
During neurodegenerative diseases, the brain undergoes morphological and pathological changes; Iron deposits are one of the causes of pathological changes in the brain. The Quantitative susceptibility mapping (QSM) technique, a type of magnetic resonance (MR) image reconstruction, is one of the newest diagnostic methods for iron deposits to detect changes in magnetic susceptibility. Numerous research projects have been conducted in this field. The purpose of writing this review article is to identify the first deep brain nuclei that undergo magnetic susceptibility changes during neurodegenerative diseases such as Alzheimer's or Parkinson's disease. The purpose of this article is to identify the brain nuclei that are prone to iron deposition in any specific disorder. In addition to the mentioned purpose, this paper proposes the optimal scan parameters and appropriate algorithms of each QSM reconstruction step by reviewing the results of different articles. As a result, The QSM technique can identify nuclei exposed to iron deposition in various neurodegenerative diseases. Also, the selection of scan parameters is different based on the sequence and purpose; an example of the parameters is placed in the tables. The BET toolbox in FSL, Laplacian-based phase-unwrapping process, the V_SHARP algorithm, and morphology-enabled dipole inversion (MEDI) method are the most widely used algorithms in various stages of QSM reconstruction. In this article, A review of the results of articles on the use of QSM technique to identify nuclei exposed to iron deposition in various neurodegenerative diseases was performed. Brain nuclei with the highest changes in iron deposition were identified as a biomarker for the identification of specific neurological diseases By studying recent articles, The best toolbox for each step of the QSM processing algorithm was introduced.
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Affiliation(s)
- Farzaneh Nikparast
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zohreh Ganji
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Zare
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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15
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Distribution Indices of Magnetic Susceptibility Values in the Primary Motor Cortex Enable to Classify Patients with Amyotrophic Lateral Sclerosis. Brain Sci 2022; 12:brainsci12070942. [PMID: 35884748 PMCID: PMC9313208 DOI: 10.3390/brainsci12070942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 12/10/2022] Open
Abstract
Quantitative Susceptibility Mapping (QSM) can measure iron concentration increase in the primary motor cortex (M1) of patients with Amyotrophic Lateral Sclerosis (ALS). However, such alteration is confined to only specific regions interested by upper motor neuron pathology; therefore, mean QSM values in the entire M1 have limited diagnostic accuracy in discriminating between ALS patients and control subjects. This study investigates the diagnostic accuracy of a broader set of M1 QSM distribution indices in classifying ALS patients and controls. Mean, standard deviation, skewness and kurtosis of M1 QSM values were used either individually or as combined predictors in support vector machines. The classification performance was compared to that obtained by the radiological assessment of T2* signal hypo-intensity of M1 in susceptibility-weighted MRI. The least informative index for the classification of ALS patients and controls was the subject’s mean QSM value in M1. The highest diagnostic performance was obtained when all the distribution indices of positive QSM values in M1 were considered, which yielded a diagnostic accuracy of 0.90, with sensitivity = 0.89 and specificity = 1. The radiological assessment of M1 yielded a diagnostic accuracy of 0.79, with sensitivity = 0.76 and specificity = 0.90. The joint evaluation of QSM distribution indices could support the clinical examination in ALS diagnosis and patient monitoring.
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16
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Chen Y, Genc O, Poynton CB, Banerjee S, Hess CP, Lupo JM. Comparison of quantitative susceptibility mapping methods on evaluating radiation-induced cerebral microbleeds and basal ganglia at 3T and 7T. NMR IN BIOMEDICINE 2022; 35:e4666. [PMID: 35075701 PMCID: PMC10443943 DOI: 10.1002/nbm.4666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 11/04/2021] [Accepted: 11/24/2021] [Indexed: 06/14/2023]
Abstract
Quantitative susceptibility mapping (QSM) has the potential for being a biomarker for various diseases because of its ability to measure tissue susceptibility related to iron deposition, myelin, and hemorrhage from the phase signal of a T2 *-weighted MRI. Despite its promise as a quantitative marker, QSM is faced with many challenges, including its dependence on preprocessing of the raw phase data, the relatively weak tissue signal, and the inherently ill posed relationship between the magnetic dipole and measured phase. The goal of this study was to evaluate the effects of background field removal and dipole inversion algorithms on noise characteristics, image uniformity, and structural contrast for cerebral microbleed (CMB) quantification at both 3T and 7T. We selected four widely used background phase removal and five dipole field inversion algorithms for QSM and applied them to volunteers and patients with CMBs, who were scanned at two different field strengths, with ground truth QSM reference calculated using multiple orientation scans. 7T MRI provided QSM images with lower noise than did 3T MRI. QSIP and VSHARP + iLSQR achieved the highest white matter homogeneity and vein contrast, with QSIP also providing the highest CMB contrast. Compared with ground truth COSMOS QSM images, overall good correlations between susceptibility values of dipole inversion algorithms and the COSMOS reference were observed in basal ganglia regions, with VSHARP + iLSQR achieving the susceptibility values most similar to COSMOS across all regions. This study can provide guidance for selecting the most appropriate QSM processing pipeline based on the application of interest and scanner field strength.
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Affiliation(s)
- Yicheng Chen
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, CA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA
| | - Ozan Genc
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA
- Institute of Biomedical Engineering, Boğaziçi University, Istanbul, Turkey
| | - Clare B. Poynton
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA
| | | | - Christopher P. Hess
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA
- Department of Neurology, University of California, San Francisco, CA
| | - Janine M. Lupo
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and San Francisco, CA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA
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17
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Longitudinal Observation of Asymmetric Iron Deposition in an Intracerebral Hemorrhage Model Using Quantitative Susceptibility Mapping. Symmetry (Basel) 2022. [DOI: 10.3390/sym14020350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Quantitative susceptibility mapping (QSM) is used to obtain quantitative magnetic susceptibility maps of materials from magnitude and phase images acquired by three-dimensional gradient-echo using inverse problem-solving. Few preclinical studies have evaluated the intracerebral hemorrhage (ICH) model and asymmetric iron deposition. We created a rat model of ICH and compared QSM and conventional magnetic resonance imaging (MRI) during the longitudinal evaluation of ICH. Collagenase was injected in the right striatum of 12-week-old Wistar rats. QSM and conventional MRI were performed on days 0, 1, 7, and 28 after surgery using 7-Tesla MRI. Susceptibility, normalized signal value, and area of the hemorrhage site were statistically compared during image analysis. Susceptibility decreased monotonically up to day 7 but increased on day 28. Other imaging methods showed a significant increase in signal from day 0 to day 1 but a decreasing trend after day 1. During the area evaluation, conventional MRI methods showed an increase from day 0 to day 1; however, decreases were observed thereafter. QSM showed a significant increase from day 0 to day 1. The temporal evaluation of ICH by QSM suggested the possibility of detecting of asymmetric iron deposition for normal brain site.
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18
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Zachariou V, Bauer CE, Powell DK, Gold BT. Ironsmith: An Automated Pipeline for QSM-based Data Analyses. Neuroimage 2021; 249:118835. [PMID: 34936923 PMCID: PMC8935985 DOI: 10.1016/j.neuroimage.2021.118835] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/27/2021] [Accepted: 12/17/2021] [Indexed: 12/13/2022] Open
Abstract
Quantitative susceptibility mapping (QSM) is an MRI-based, computational method for anatomically localizing and measuring concentrations of specific biomarkers in tissue such as iron. Growing research suggests QSM is a viable method for evaluating the impact of iron overload in neurological disorders and on cognitive performance in aging. Several software toolboxes are currently available to reconstruct QSM maps from 3D GRE MR Images. However, few if any software packages currently exist that offer fully automated pipelines for QSM-based data analyses: from DICOM images to region-of-interest (ROI) based QSM values. Even less QSM-based software exist that offer quality control measures for evaluating the QSM output. Here, we address these gaps in the field by introducing and demonstrating the reliability and external validity of Ironsmith; an open-source, fully automated pipeline for creating and processing QSM maps, extracting QSM values from subcortical and cortical brain regions (89 ROIs) and evaluating the quality of QSM data using SNR measures and assessment of outlier regions on phase images. Ironsmith also features automatic filtering of QSM outlier values and precise CSF-only QSM reference masks that minimize partial volume effects. Testing of Ironsmith revealed excellent intra- and inter-rater reliability. Finally, external validity of Ironsmith was demonstrated via an anatomically selective relationship between motor performance and Ironsmith-derived QSM values in motor cortex. In sum, Ironsmith provides a freely-available, reliable, turn-key pipeline for QSM-based data analyses to support research on the impact of brain iron in aging and neurodegenerative disease.
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Affiliation(s)
- Valentinos Zachariou
- Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, KY 40536-0298 United States.
| | - Christopher E Bauer
- Department of Neuroscience, College of Medicine, University of Kentucky, Lexington, KY 40536-0298 United States
| | - David K Powell
- Department of Neuroscience, Magnetic Resonance Imaging and Spectroscopy Center, College of Medicine, University of Kentucky, Lexington, KY 40536-0298 United States
| | - Brian T Gold
- Department of Neuroscience, Sanders-Brown Center on Aging, Magnetic Resonance Imaging and Spectroscopy Center, College of Medicine, University of Kentucky, Lexington, KY 40536-0298 United States.
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19
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Canna A, Trojsi F, Di Nardo F, Caiazzo G, Tedeschi G, Cirillo M, Esposito F. Combining structural and metabolic markers in a quantitative MRI study of motor neuron diseases. Ann Clin Transl Neurol 2021; 8:1774-1785. [PMID: 34342169 PMCID: PMC8419394 DOI: 10.1002/acn3.51418] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/13/2021] [Accepted: 06/18/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To assess the performance of a combination of three quantitative MRI markers (iron deposition, basal neuronal metabolism, and regional atrophy) for differential diagnosis between amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS). METHODS In total, 33 ALS, 12 PLS, and 28 healthy control (HC) subjects underwent a 3T MRI study including single- and multi-echo sequences for gray matter (GM) volumetry and quantitative susceptibility mapping (QSM) and a pseudo-continuous arterial spin labeling (ASL) sequence for cerebral blood flow (CBF) measurement. Mean values of QSM, CBF, and GM volumes were extracted in the motor cortex, basal ganglia, thalamus, amygdala, and hippocampus. A generalized linear model was applied to the three measures to binary discriminate between groups. The diagnostic performances were evaluated via receiver operating characteristic analyses. RESULTS A significant discrimination was obtained: between ALS and HCs in the left and right motor cortex, where QSM increases were respectively associated with disability scores and disease duration; between PLS and ALS in the left motor cortex, where PLS patients resulted significantly more atrophic; between ALS and HC in the right motor cortex, where GM volumes were associated with upper motor neuron scores. Significant discrimination between ALS and HC was achieved in subcortical structures only combining all three parameters. INTERPRETATION While increased QSM values in the motor cortex of ALS patients is a consolidated finding, combining QSM, CBF, and GM volumetry shows higher diagnostic potential for differentiating ALS patients from HC subjects and, in the motor cortex, between ALS and PLS.
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Affiliation(s)
- Antonietta Canna
- Department of Advanced Medical and Surgical SciencesUniversity of Campania "Luigi Vanvitelli”NaplesItaly
| | - Francesca Trojsi
- Department of Advanced Medical and Surgical SciencesUniversity of Campania "Luigi Vanvitelli”NaplesItaly
| | - Federica Di Nardo
- Department of Advanced Medical and Surgical SciencesUniversity of Campania "Luigi Vanvitelli”NaplesItaly
| | - Giuseppina Caiazzo
- Department of Advanced Medical and Surgical SciencesUniversity of Campania "Luigi Vanvitelli”NaplesItaly
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical SciencesUniversity of Campania "Luigi Vanvitelli”NaplesItaly
| | - Mario Cirillo
- Department of Advanced Medical and Surgical SciencesUniversity of Campania "Luigi Vanvitelli”NaplesItaly
| | - Fabrizio Esposito
- Department of Advanced Medical and Surgical SciencesUniversity of Campania "Luigi Vanvitelli”NaplesItaly
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20
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Düzel E, Costagli M, Donatelli G, Speck O, Cosottini M. Studying Alzheimer disease, Parkinson disease, and amyotrophic lateral sclerosis with 7-T magnetic resonance. Eur Radiol Exp 2021; 5:36. [PMID: 34435242 PMCID: PMC8387546 DOI: 10.1186/s41747-021-00221-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/07/2021] [Indexed: 12/18/2022] Open
Abstract
Ultra-high-field (UHF) magnetic resonance (MR) scanners, that is, equipment operating at static magnetic field of 7 tesla (7 T) and above, enable the acquisition of data with greatly improved signal-to-noise ratio with respect to conventional MR systems (e.g., scanners operating at 1.5 T and 3 T). The change in tissue relaxation times at UHF offers the opportunity to improve tissue contrast and depict features that were previously inaccessible. These potential advantages come, however, at a cost: in the majority of UHF-MR clinical protocols, potential drawbacks may include signal inhomogeneity, geometrical distortions, artifacts introduced by patient respiration, cardiac cycle, and motion. This article reviews the 7 T MR literature reporting the recent studies on the most widespread neurodegenerative diseases: Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis.
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Affiliation(s)
- Emrah Düzel
- Otto-von-Guericke University Magdeburg, Magdeburg, Germany. .,German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany. .,University College London, London, UK.
| | - Mauro Costagli
- IRCCS Stella Maris, Pisa, Italy.,University of Genoa, Genova, Italy
| | - Graziella Donatelli
- Fondazione Imago 7, Pisa, Italy.,Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Oliver Speck
- Otto-von-Guericke University Magdeburg, Magdeburg, Germany.,German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Mirco Cosottini
- Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.,University of Pisa, Pisa, Italy
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21
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Gillen KM, Mubarak M, Park C, Ponath G, Zhang S, Dimov A, Levine‐Ritterman M, Toro S, Huang W, Amici S, Kaunzner UW, Gauthier SA, Guerau‐de‐Arellano M, Wang Y, Nguyen TD, Pitt D. QSM is an imaging biomarker for chronic glial activation in multiple sclerosis lesions. Ann Clin Transl Neurol 2021; 8:877-886. [PMID: 33704933 PMCID: PMC8045922 DOI: 10.1002/acn3.51338] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Inflammation in chronic active lesions occurs behind a closed blood-brain barrier and cannot be detected with MRI. Activated microglia are highly enriched for iron and can be visualized with quantitative susceptibility mapping (QSM), an MRI technique used to delineate iron. OBJECTIVE To characterize the histopathological correlates of different QSM hyperintensity patterns in MS lesions. METHODS MS brain slabs were imaged with MRI and QSM, and processed for histology. Immunolabeled cells were quantified in the lesion rim, center, and adjacent normal-appearing white matter (NAWM). Iron+ myeloid cell densities at the rims were correlated with susceptibilities. Human-induced pluripotent stem cell (iPSC)-derived microglia were used to determine the effect of iron on the production of reactive oxygen species (ROS) and pro-inflammatory cytokines. RESULTS QSM hyperintensity at the lesion perimeter correlated with activated iron+ myeloid cells in the rim and NAWM. Lesions with high punctate or homogenous QSM signal contained no or minimally activated iron- myeloid cells. In vitro, iron accumulation was highest in M1-polarized human iPSC-derived microglia, but it did not enhance ROS or cytokine production. CONCLUSION A high QSM signal outlining the lesion rim but not punctate signal in the center is a biomarker for chronic inflammation in white matter lesions.
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Affiliation(s)
- Kelly M. Gillen
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Mayyan Mubarak
- Department of NeurologyYale School of MedicineNew HavenConnecticutUSA
| | - Calvin Park
- Department of NeurologyYale School of MedicineNew HavenConnecticutUSA
| | - Gerald Ponath
- Department of NeurologyYale School of MedicineNew HavenConnecticutUSA
| | - Shun Zhang
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Alexey Dimov
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | | | - Steven Toro
- Department of NeurologyYale School of MedicineNew HavenConnecticutUSA
| | - Weiyuan Huang
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Stephanie Amici
- Department of NeuroscienceThe Ohio State UniversityColumbusOhioUSA
| | | | - Susan A. Gauthier
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA,Department of NeurologyWeill Cornell MedicineNew YorkNew YorkUSA
| | | | - Yi Wang
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Thanh D. Nguyen
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - David Pitt
- Department of NeurologyYale School of MedicineNew HavenConnecticutUSA
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22
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Ravanfar P, Loi SM, Syeda WT, Van Rheenen TE, Bush AI, Desmond P, Cropley VL, Lane DJR, Opazo CM, Moffat BA, Velakoulis D, Pantelis C. Systematic Review: Quantitative Susceptibility Mapping (QSM) of Brain Iron Profile in Neurodegenerative Diseases. Front Neurosci 2021; 15:618435. [PMID: 33679303 PMCID: PMC7930077 DOI: 10.3389/fnins.2021.618435] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/07/2021] [Indexed: 12/11/2022] Open
Abstract
Iron has been increasingly implicated in the pathology of neurodegenerative diseases. In the past decade, development of the new magnetic resonance imaging technique, quantitative susceptibility mapping (QSM), has enabled for the more comprehensive investigation of iron distribution in the brain. The aim of this systematic review was to provide a synthesis of the findings from existing QSM studies in neurodegenerative diseases. We identified 80 records by searching MEDLINE, Embase, Scopus, and PsycInfo databases. The disorders investigated in these studies included Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Wilson's disease, Huntington's disease, Friedreich's ataxia, spinocerebellar ataxia, Fabry disease, myotonic dystrophy, pantothenate-kinase-associated neurodegeneration, and mitochondrial membrane protein-associated neurodegeneration. As a general pattern, QSM revealed increased magnetic susceptibility (suggestive of increased iron content) in the brain regions associated with the pathology of each disorder, such as the amygdala and caudate nucleus in Alzheimer's disease, the substantia nigra in Parkinson's disease, motor cortex in amyotrophic lateral sclerosis, basal ganglia in Huntington's disease, and cerebellar dentate nucleus in Friedreich's ataxia. Furthermore, the increased magnetic susceptibility correlated with disease duration and severity of clinical features in some disorders. Although the number of studies is still limited in most of the neurodegenerative diseases, the existing evidence suggests that QSM can be a promising tool in the investigation of neurodegeneration.
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Affiliation(s)
- Parsa Ravanfar
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Samantha M Loi
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Warda T Syeda
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ashley I Bush
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience & Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Patricia Desmond
- Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, The University of Melbourne, Parkville, VIC, Australia.,Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Darius J R Lane
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience & Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Carlos M Opazo
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Bradford A Moffat
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, The University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
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23
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Bhattarai A, Egan GF, Talman P, Chua P, Chen Z. Magnetic Resonance Iron Imaging in Amyotrophic Lateral Sclerosis. J Magn Reson Imaging 2021; 55:1283-1300. [PMID: 33586315 DOI: 10.1002/jmri.27530] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 01/18/2023] Open
Abstract
Amyotrophic lateral sclerosis (ALS) results in progressive impairment of upper and lower motor neurons. Increasing evidence from both in vivo and ex vivo studies suggest that iron accumulation in the motor cortex is a neuropathological hallmark in ALS. An in vivo neuroimaging marker of iron dysregulation in ALS would be useful in disease diagnosis and prognosis. Magnetic resonance imaging (MRI), with its unique capability to generate a variety of soft tissue contrasts, provides opportunities to image iron distribution in the human brain with millimeter to sub-millimeter anatomical resolution. Conventionally, MRI T1-weighted, T2-weighted, and T2*-weighted images have been used to investigate iron dysregulation in the brain in vivo. Susceptibility weighted imaging has enhanced contrast for para-magnetic materials that provides superior sensitivity to iron in vivo. Recently, the development of quantitative susceptibility mapping (QSM) has realized the possibility of using quantitative assessments of magnetic susceptibility measures in brain tissues as a surrogate measurement of in vivo brain iron. In this review, we provide an overview of MRI techniques that have been used to investigate iron dysregulation in ALS in vivo. The potential uses, strengths, and limitations of these techniques in clinical trials, disease diagnosis, and prognosis are presented and discussed. We recommend further longitudinal studies with appropriate cohort characterization to validate the efficacy of these techniques. We conclude that quantitative iron assessment using recent advances in MRI including QSM holds great potential to be a sensitive diagnostic and prognostic marker in ALS. The use of multimodal neuroimaging markers in combination with iron imaging may also offer improved sensitivity in ALS diagnosis and prognosis that could make a major contribution to clinical care and treatment trials. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Anjan Bhattarai
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Gary F Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Paul Talman
- Department of Neuroscience, Barwon Health, Geelong, Victoria, Australia
| | - Phyllis Chua
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, Melbourne, Victoria, Australia
| | - Zhaolin Chen
- Monash Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
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24
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QSM as a new powerful tool for clinical practice in neuroimaging. J Neuroradiol 2021; 48:25-27. [PMID: 33549198 DOI: 10.1016/j.neurad.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Conte G, Contarino VE, Casale S, Morelli C, Sbaraini S, Scola E, Trogu F, Siggillino S, Cinnante CM, Caschera L, Lo Russo FM, Triulzi FM, Silani V. Amyotrophic lateral sclerosis phenotypes significantly differ in terms of magnetic susceptibility properties of the precentral cortex. Eur Radiol 2021; 31:5272-5280. [PMID: 33399906 DOI: 10.1007/s00330-020-07547-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/27/2020] [Accepted: 11/19/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVES The aim of our study was to investigate whether the magnetic susceptibility varies according to the amyotrophic lateral sclerosis (ALS) phenotypes based on the predominance of upper motor neuron (UMN)/lower motor neuron (LMN) impairment. METHODS We retrospectively collected imaging and clinical data of 47 ALS patients (12 with UMN predominance (UMN-ALS), 16 with LMN predominance (LMN-ALS), and 19 with no clinically defined predominance (Np-ALS)). We further enrolled 23 healthy controls (HC) and 15 ALS mimics (ALS-Mim). These participants underwent brain 3-T magnetic resonance imaging (3-T MRI) with T1-weighted and gradient-echo multi-echo sequences. Automatic segmentation and quantitative susceptibility mapping (QSM) were performed. The skewness of the susceptibility values in the precentral cortex (SuscSKEW) was automatically computed, compared among the groups, and correlated to the clinical variables. RESULTS The Kruskal-Wallis test showed significant differences in terms of SuscSKEW among groups (χ2(3) = 24.2, p < 0.001), and pairwise tests showed that SuscSKEW was higher in UMN-ALS compared to those in LMN-ALS (p < 0.001), HC (p < 0.001), Np-ALS (p = 0.012), and ALS-Mim (p < 0.001). SuscSKEW was highly correlated with the Penn UMN score (Spearman's rho 0.612, p < 0.001). CONCLUSION This study demonstrates that the clinical ALS phenotypes based on UMN/LMN sign predominance significantly differ in terms of magnetic susceptibility properties of the precentral cortex. Combined MRI-histopathology investigations are strongly encouraged to confirm whether this evidence is due to iron overload in UMN-ALS, unlike in LMN-ALS. KEY POINTS • Magnetic susceptibility in the precentral cortex reflects the prevalence of UMN/LMN impairment in the clinical ALS phenotypes. • The degree of UMN/LMN impairment might be well described by the automatically derived measure of SuscSKEW in the precentral cortex. • Increased SuscSKEW in the precentral cortex is more relevant in UMN-ALS patients compared to those in Np-ALS and LMN-ALS patients.
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Affiliation(s)
- Giorgio Conte
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - Valeria Elisa Contarino
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - Silvia Casale
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy.
| | - Claudia Morelli
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy
| | - Sara Sbaraini
- Neuroradiology Unit, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, Via Pio II 3, Milan, Italy
| | - Elisa Scola
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - Francesca Trogu
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
| | - Silvia Siggillino
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - Claudia Maria Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - Luca Caschera
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - Francesco Maria Lo Russo
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
| | - Fabio Maria Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
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26
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Dean KE, Shen B, Askin G, Schweitzer AD, Shahbazi M, Wang Y, Lange D, Tsiouris AJ. A specific biomarker for amyotrophic lateral sclerosis: Quantitative susceptibility mapping. Clin Imaging 2021; 75:125-130. [PMID: 33548870 DOI: 10.1016/j.clinimag.2020.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/09/2020] [Accepted: 12/19/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Accurate and timely diagnosis of amyotrophic lateral sclerosis (ALS) is a diagnostic challenge given the lack of specific diagnostic and imaging biomarkers as well as the significant clinic overlap with mimic syndromes. We hypothesize that MR quantitative susceptibility mapping (QSM) can help differentiate ALS from mimic diagnoses. METHODS In a blinded retrospective study of MRIs with QSM from 2015 to 2018, we compared motor cortex susceptibility along the hand and face homunculi in ALS patients and patients with similar clinical presentations. Inclusion required a confirmed ALS or a mimic diagnosis. Comparative groups included age-matched patients with MRIs performed for non-motor neuron symptoms that were reported as normal or demonstrated leukoaraiosis. Quantitative susceptibility values were compared with ANOVA and Tukey-Kramer (post-hoc). ROC analysis and Youden's index were used to identify optimal cutoff values. RESULTS Fifty ALS, 35 mimic, and 70 non-motor neuron symptom patients (35 normal, 35 leukoaraiosis) were included. Hand and face homunculus mean susceptibility values were significantly higher in the ALS group compared to the mimic (p=0.001, p=0.004), leukoaraiosis (p<0.001, p=0.003), and normal (p<0.001, p<0.001) groups. ROC curve analysis comparing ALS to mimics resulted in an area under the curve of 0.71 and 0.67 for the hand and face homunculus measurements, respectively. In differentiating ALS from mimics, Youden's index showed 100% specificity and 36% sensitivity for hand homunculus measurements. CONCLUSIONS QSM has diagnostic potential in the assessment of suspected ALS patients, demonstrating very high specificity in differentiating ALS from mimic diagnoses.
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Affiliation(s)
- Kathryn E Dean
- Department of Radiology, NewYork-Presbyterian Hospital - Weill Cornell Medicine, New York, NY, USA.
| | - Beiyi Shen
- Department of Radiology, Stony Brook Medicine, Stony Brook, NY, USA
| | - Gulce Askin
- Department of Healthcare Policy & Research, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, USA
| | - Andrew D Schweitzer
- Department of Radiology, NewYork-Presbyterian Hospital - Weill Cornell Medicine, New York, NY, USA
| | - Mona Shahbazi
- Department of Neurology, Hospital for Special Surgery, New York, NY, USA
| | - Yi Wang
- Department of Radiology, NewYork-Presbyterian Hospital - Weill Cornell Medicine, New York, NY, USA
| | - Dale Lange
- Department of Neurology, Hospital for Special Surgery, New York, NY, USA
| | - Apostolos John Tsiouris
- Department of Radiology, NewYork-Presbyterian Hospital - Weill Cornell Medicine, New York, NY, USA
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27
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Wang C, Foxley S, Ansorge O, Bangerter-Christensen S, Chiew M, Leonte A, Menke RA, Mollink J, Pallebage-Gamarallage M, Turner MR, Miller KL, Tendler BC. Methods for quantitative susceptibility and R2* mapping in whole post-mortem brains at 7T applied to amyotrophic lateral sclerosis. Neuroimage 2020; 222:117216. [PMID: 32745677 PMCID: PMC7775972 DOI: 10.1016/j.neuroimage.2020.117216] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/03/2020] [Accepted: 07/27/2020] [Indexed: 12/12/2022] Open
Abstract
Susceptibility weighted magnetic resonance imaging (MRI) is sensitive to the local concentration of iron and myelin. Here, we describe a robust image processing pipeline for quantitative susceptibility mapping (QSM) and R2* mapping of fixed post-mortem, whole-brain data. Using this pipeline, we compare the resulting quantitative maps in brains from patients with amyotrophic lateral sclerosis (ALS) and controls, with validation against iron and myelin histology. Twelve post-mortem brains were scanned with a multi-echo gradient echo sequence at 7T, from which susceptibility and R2* maps were generated. Semi-quantitative histological analysis for ferritin (the principal iron storage protein) and myelin proteolipid protein was performed in the primary motor, anterior cingulate and visual cortices. Magnetic susceptibility and R2* values in primary motor cortex were higher in ALS compared to control brains. Magnetic susceptibility and R2* showed positive correlations with both myelin and ferritin estimates from histology. Four out of nine ALS brains exhibited clearly visible hyperintense susceptibility and R2* values in the primary motor cortex. Our results demonstrate the potential for MRI-histology studies in whole, fixed post-mortem brains to investigate the biophysical source of susceptibility weighted MRI signals in neurodegenerative diseases like ALS.
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Affiliation(s)
- Chaoyue Wang
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom.
| | - Sean Foxley
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom; Department of Radiology, University of Chicago, United States
| | - Olaf Ansorge
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Sarah Bangerter-Christensen
- Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom; Brigham Young University, Provo, United States
| | - Mark Chiew
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom
| | - Anna Leonte
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom; University of Groningen,the Netherlands
| | - Ricarda Al Menke
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom
| | - Jeroen Mollink
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom; Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, the Netherlands
| | | | - Martin R Turner
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom; Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Karla L Miller
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom
| | - Benjamin C Tendler
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, United Kingdom
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28
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Conte G, Sbaraini S, Morelli C, Casale S, Caschera L, Contarino VE, Scola E, Cinnante C, Trogu F, Triulzi F, Silani V. A susceptibility-weighted imaging qualitative score of the motor cortex may be a useful tool for distinguishing clinical phenotypes in amyotrophic lateral sclerosis. Eur Radiol 2020; 31:1281-1289. [PMID: 32886203 DOI: 10.1007/s00330-020-07239-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/21/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To distinguish amyotrophic lateral sclerosis (ALS) and its subtypes from ALS mimics and healthy controls based on the assessment of iron-related hypointensity of the primary motor cortex in susceptibility-weighted imaging (SWI). METHODS We enrolled 64 patients who had undergone magnetic resonance imaging studies with clinical suspicions of ALS. The ALS group included 48 patients; the ALS-mimicking disorder group had 16 patients. The ALS group was divided into three subgroups according to the prevalence of upper motor neuron (UMN) or lower motor neuron (LMN) impairment, with 12 subjects in the UMN-predominant ALS group (UMN-ALS), 16 in the LMN-predominant ALS group (LMN-ALS), and 20 with no prevalent impairment (C-ALS). The Motor Cortex Susceptibility (MCS) score was defined according to the hypointensity of the primary motor cortex in the SWI sequence. Its diagnostic accuracy in differentiating groups was evaluated. RESULTS The MCS was higher in the ALS group than in the healthy control and ALS-mimicking disorder groups (p < 0.001). Among ALS subgroups, the MCS was significantly higher in the UMN-ALS group than in the healthy control (p < 0.001), ALS-mimicking disorder (p = 0.002), and LMN-ALS groups (p = 0.002) and higher in the C-ALS group than in the healthy control group (p = 0.019). An MCS value ≥ 2 showed specificity and a positive predictive value of 100% in the detection of both UMN-ALS and C-ALS patients. CONCLUSIONS The assessment of MCS in the SWI sequence could be a useful tool in supporting diagnosis in patients suspicious for ALS with prevalent signs of UMN impairment or with no prevalence signs of UMN or LMN impairment. KEY POINTS • The hypointensity of the primary motor cortex in susceptibility-weighted imaging could support the diagnosis of ALS. • Our new qualitative score called MCS shows high specificity and positive predictive value in differentiating ALS patients with upper motor neuron impairment from patients with ALS-mimicking disorders and healthy controls.
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Affiliation(s)
- Giorgio Conte
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Sara Sbaraini
- Neuroradiology Unit, Department of Radiology, ASST Santi Paolo e Carlo, San Carlo Borromeo Hospital, via Pio II n. 3, Milan, Italy.
| | - Claudia Morelli
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy
| | - Silvia Casale
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Luca Caschera
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Valeria Elisa Contarino
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Elisa Scola
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Claudia Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
| | - Francesca Trogu
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
| | - Fabio Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology-Stroke Unit and Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, piazzale Brescia 20, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via Festa del Perdono 7, Milan, Italy
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29
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Bhattarai A, Chen Z, Ward PGD, Talman P, Mathers S, Phan TG, Chapman C, Howe J, Lee S, Lie Y, Egan GF, Chua P. Serial assessment of iron in the motor cortex in limb-onset amyotrophic lateral sclerosis using quantitative susceptibility mapping. Quant Imaging Med Surg 2020; 10:1465-1476. [PMID: 32676365 PMCID: PMC7358415 DOI: 10.21037/qims-20-187] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Dysregulation of iron in the cerebral motor areas has been hypothesized to occur in individuals with amyotrophic lateral sclerosis (ALS). There is still limited knowledge regarding iron dysregulation in the progression of ALS pathology. Our objectives were to use magnetic resonance based quantitative susceptibility mapping (QSM) to investigate the association between iron dysregulation in the motor cortex and clinical manifestations in patients with limb-onset ALS, and to examine changes in the iron concentration in the motor cortex in these patients over a 6-month period. METHODS Iron concentration was investigated using magnetic resonance based QSM in the primary motor cortex and the pre-motor area in 13 limb-onset ALS patients (including five lumbar onset, six cervical onset and two flail arm patients), and 11 age- and sex-matched control subjects. Nine ALS patients underwent follow-up scans at 6 months. RESULTS Significantly increased QSM values were observed in the left posterior primary motor area (P=0.02, Cohen's d =0.9) and right anterior primary motor area (P=0.02, Cohen's d =0.92) in the group of limb-onset ALS patients compared to that of control subjects. Increased QSM was observed in the primary motor and pre-motor area at baseline in patients with lumbar onset ALS patients, but not cervical limb-onset ALS patients, compared to control subjects. No significant change in QSM was observed at the 6-month follow-up scans in the ALS patients. CONCLUSIONS The findings suggest that iron dysregulation can be detected in the motor cortex in limb-onset ALS, which does not appreciably change over a further 6 months. Individuals with lumbar onset ALS appear to be more susceptible to motor cortex iron dysregulation compared to the individuals with cervical onset ALS. Importantly, this study highlights the potential use of QSM as a quantitative radiological indicator in early disease diagnosis in limb-onset ALS and its subtypes. Our serial scans results suggest a longer period than 6 months is needed to detect significant quantitative changes in the motor cortex.
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Affiliation(s)
- Anjan Bhattarai
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Zhaolin Chen
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Phillip G. D. Ward
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Paul Talman
- Department of Neuroscience, Barwon Health, Geelong, Victoria, Australia
| | - Susan Mathers
- Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
- Department of Neurology, Monash Health, and School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Thanh G. Phan
- Department of Neurology, Monash Health, and School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Caron Chapman
- Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - James Howe
- Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - Sarah Lee
- Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - Yennie Lie
- Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
| | - Gary F. Egan
- Monash Biomedical Imaging, Monash University, Clayton, Victoria, Australia
| | - Phyllis Chua
- Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, South Caulfield, Victoria, Australia
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Turner MR, Barohn RJ, Corcia P, Fink JK, Harms MB, Kiernan MC, Ravits J, Silani V, Simmons Z, Statland J, van den Berg LH, Mitsumoto H. Primary lateral sclerosis: consensus diagnostic criteria. J Neurol Neurosurg Psychiatry 2020; 91:373-377. [PMID: 32029539 PMCID: PMC7147236 DOI: 10.1136/jnnp-2019-322541] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/27/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023]
Abstract
Primary lateral sclerosis (PLS) is a neurodegenerative disorder of the adult motor system. Characterised by a slowly progressive upper motor neuron syndrome, the diagnosis is clinical, after exclusion of structural, neurodegenerative and metabolic mimics. Differentiation of PLS from upper motor neuron-predominant forms of amyotrophic lateral sclerosis remains a significant challenge in the early symptomatic phase of both disorders, with ongoing debate as to whether they form a clinical and histopathological continuum. Current diagnostic criteria for PLS may be a barrier to therapeutic development, requiring long delays between symptom onset and formal diagnosis. While new technologies sensitive to both upper and lower motor neuron involvement may ultimately resolve controversies in the diagnosis of PLS, we present updated consensus diagnostic criteria with the aim of reducing diagnostic delay, optimising therapeutic trial design and catalysing the development of disease-modifying therapy.
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Affiliation(s)
- Martin R Turner
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK
| | - Richard J Barohn
- Department of Neurology, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Philippe Corcia
- ALS Centre, Department of Neurology, CHRU Bretonneau, Tours, France
| | - John K Fink
- Neurology, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew B Harms
- Neurology, Columbia University College of Physicians and Surgeons, New York City, New York, USA
| | - Matthew C Kiernan
- Bushell Chair of Neurology, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - John Ravits
- Neurosciences, University of California San Diego, La Jolla, California, USA
| | - Vincenzo Silani
- Department of Neurology & Laboratory of Neuroscience, Istituto Auxologico Italiano IRCCS, Milano, Italy.,Department of Pathophysiology & Transplantation, "Dino Ferrari" Center, Università degli Studi di Milano, Milano, Italy
| | - Zachary Simmons
- Neurology, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Jeffrey Statland
- Department of Neurology, The University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | | | - Hiroshi Mitsumoto
- Neurology, Columbia University College of Physicians and Surgeons, New York City, New York, USA
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Contarino VE, Conte G, Morelli C, Trogu F, Scola E, Calloni SF, Sanmiguel Serpa LC, Liu C, Silani V, Triulzi F. Toward a marker of upper motor neuron impairment in amyotrophic lateral sclerosis: A fully automatic investigation of the magnetic susceptibility in the precentral cortex. Eur J Radiol 2020; 124:108815. [DOI: 10.1016/j.ejrad.2020.108815] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/13/2019] [Accepted: 12/26/2019] [Indexed: 12/12/2022]
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van der Weijden MCM, van Laar PJ, Lambrechts RA, Verbeek DS, Tijssen MAJ. Cortical pencil lining on SWI MRI in NBIA and healthy aging. BMC Neurol 2019; 19:233. [PMID: 31607263 PMCID: PMC6790995 DOI: 10.1186/s12883-019-1471-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 09/20/2019] [Indexed: 12/12/2022] Open
Abstract
Background Neurodegeneration with brain iron accumulation (NBIA) is characterized by pathological iron accumulation in the subcortical nuclei and the cortex. As age-related iron accumulation studies in these structures are lacking in healthy aging, we aimed to characterize the dynamics of age-dependent iron accumulation in subcortical nuclei in healthy aging and selected NBIA cases. This is fundamental to understand the natural age-related iron deposition in the healthy brain prior to using this marker as a potential prognostic or diagnostic tool in neurodegenerative disorders. Methods Susceptibility-weighted imaging (SWI) scans from 81 healthy volunteers (0-79 years) and four genetically confirmed patients suffering from NBIA (2-14 years) were obtained. We scored the presence or absence of pencil lining of the motor cortex and putamen and analyzed the normalized SWI signal intensity ratio (NSIR) in five subcortical nuclei. Results In healthy subjects, an age-dependent increase of pencil lining occurred starting from the second decade of life and was present in all cases at the age of 50. In their first decade, NBIA patients showed no cortical pencil lining, but we did observe putaminal pencil lining at this stage. In healthy subjects, age and NSIR of all nuclei correlated positively and was particularly dynamic in early childhood until young adulthood in the globus pallidus, dentate nucleus and red nucleus, but not in the caudate nucleus and putamen. NBIA patients showed an increased NSIR in the globus pallidus only and not in the other subcortical nuclei compared to age-matched healthy subjects. Conclusions Cortical pencil lining is part of healthy aging. This should be considered when assessing this as a potential marker in NBIA diagnosis and prognosis. Putaminal pencil lining has the potential to become a specific marker for some subtypes of NBIA in the first decade of life, as it was only observed in NBIA and not in age-matched healthy subjects. NSIR in the subcortical nuclei during healthy aging was shown to be dynamic, accentuating the importance of having an age-dependent baseline.
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Affiliation(s)
- Marlous C M van der Weijden
- Department of Neurology, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. .,Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands.
| | - Peter Jan van Laar
- Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands.,Department of Radiology, Zorggroep Twente, Almelo and Hengelo, The Netherlands
| | - Roald A Lambrechts
- Department of Neurology, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.,Department of Cell Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - Dineke S Verbeek
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Marina A J Tijssen
- Department of Neurology, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
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Welton T, Maller JJ, Lebel RM, Tan ET, Rowe DB, Grieve SM. Diffusion kurtosis and quantitative susceptibility mapping MRI are sensitive to structural abnormalities in amyotrophic lateral sclerosis. NEUROIMAGE-CLINICAL 2019; 24:101953. [PMID: 31357149 PMCID: PMC6664242 DOI: 10.1016/j.nicl.2019.101953] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/24/2019] [Accepted: 07/19/2019] [Indexed: 12/11/2022]
Abstract
Objective To construct a clinical diagnostic biomarker using state-of-the-art microstructural MRI in the motor cortex of people with amyotrophic lateral sclerosis (ALS). Methods Clinical and MRI data were obtained from 21 ALS patients (aged 54 ± 14 years, 33% female) and 63 age- and gender-matched controls (aged 48 ± 18 years, 43% female). MRI was acquired at 3T and included T1-weighted scan (for volumetrics), arterial spin labelling (for cerebral blood flow), susceptibility-weighted angiography (for iron deposition) and multiband diffusion kurtosis imaging (for tissue microstructure). Group differences in imaging measures in the motor cortex were tested by general linear model and relationships to clinical variables by linear regression. Results The ALS group had mild-to-moderate impairment (disease duration: 1.8 ± 0.8 years; ALS functional rating scale 40.2 ± 6.0; forced vital capacity 83% ± 22%). No age or gender differences were present between groups. We found significant group differences in diffusion kurtosis metrics (apparent, mean, radial and axial kurtosis: p < .01) and iron deposition in the motor cortex (p = .03). Within the ALS group, we found significant relationships between motor cortex volume, apparent diffusion and disease duration (adjusted R2 = 0.27, p = .011); and between the apparent and radial kurtosis metrics and ALS functional rating scale (adjusted R2 = 0.25, p = .033). A composite imaging biomarker comprising kurtosis and iron deposition measures yielded a maximal diagnostic accuracy of 83% (81% sensitivity, 85% specificity) and an area-under-the-curve of 0.86. Conclusion Diffusion kurtosis is sensitive to early changes present in the motor region in ALS. We propose a composite imaging biomarker reflecting tissue microstructural changes in early ALS that may provide clinically valuable diagnostic information. A biomarker based on diffusion kurtosis imaging achieved an accuracy of 83%. Kurtosis-based measures were more abnormal in ALS than tensor-based measures. Motor cortex in the symptomatic hemisphere was smaller and had greater iron concentration. There was a 1 mL volume loss per year in ALS motor cortex.
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Affiliation(s)
- Thomas Welton
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Australia.
| | - Jerome J Maller
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Australia; GE Healthcare, Richmond, Victoria, Australia.
| | | | - Ek T Tan
- GE Global Research, Niskayuna, NY, USA.
| | - Dominic B Rowe
- MND Research Centre, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia; Macquarie University Hospital, Macquarie, Australia
| | - Stuart M Grieve
- Sydney Translational Imaging Laboratory, Heart Research Institute, Charles Perkins Centre, University of Sydney, Australia; Macquarie University Hospital, Macquarie, Australia; Department of Radiology, Royal Prince Alfred Hospital, Sydney, Australia.
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Potential usefulness of signal intensity of cerebral gyri on quantitative susceptibility mapping for discriminating corticobasal degeneration from progressive supranuclear palsy and Parkinson’s disease. Neuroradiology 2019; 61:1251-1259. [DOI: 10.1007/s00234-019-02253-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/24/2019] [Indexed: 12/14/2022]
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Sawalha K, Gonzalez-Toledo E, Hussein O. Role of Magnetic Resonance Imaging in Diagnosis of Motor Neuron Disease: Literature Review and Two Case Illustrations. Perm J 2019; 23:18-131. [PMID: 30939271 DOI: 10.7812/tpp/18-131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Motor neuron diseases (MNDs) are a group of devastating neurologic disorders that cause specific damage to the motor neuron cells. The current diagnosis of MND is based on results of the clinical examination and neurophysiologic studies. The length of time of referral to a neuromuscular neurologist and the lack of validated diagnostic criteria can delay diagnosis. Although the role of imaging is currently most useful in excluding other conditions, several attempts to incorporate neuroimaging in the diagnosis of the disease and assessment of progression have shown promising results.We conducted a literature review via searches in PubMed and The Cochrane Database using multiple relevant terms to the topic. Two cases with a challenging diagnosis of MND are described, with a thorough discussion of how the diagnosis was suggested on the basis of magnetic resonance imaging evidence in each case. Advanced magnetic resonance imaging findings can be useful tools that add to the diagnostic criteria of MNDs, especially in cases where reaching a definitive diagnosis is difficult. Such findings might enable clinicians to reach an early diagnosis that can improve the patient's quality of life and prolong survival.
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Affiliation(s)
- Khalid Sawalha
- Department of Internal Medicine, University of Massachusetts Medical School-Baystate Medical Center, Springfield
| | | | - Omar Hussein
- Department of Neurology, Ohio State University Wexner Medical Center, Columbus
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Su S, Yang N, Gaillard F. Invisible cortex sign: A highly accurate feature to localize the inferolateral central sulcus. J Med Imaging Radiat Oncol 2019; 63:439-445. [PMID: 30874376 DOI: 10.1111/1754-9485.12875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 02/17/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The central sulcus is a key landmark on MRI of the brain, but its inferolateral portion is difficult to identify if unable to trace the sulcus superoinferiorly. The authors observed that the cortex abutting the central sulcus appears isointense to the adjacent white matter on DWI, we named this the 'invisible cortex sign' and our study evaluates whether it could be used to identify the inferolateral central sulcus. METHODS Observational study of 108 consecutive 'normal' MRI studies performed from May 2016 to January 2017. A single axial DWI image - obtained in the anterior commissure-posterior commissure plane - was selected from each scan just above the subcentral gyrus such that it included the most inferolateral portion of the central sulcus. These single images were given to 10 readers (neuroradiologists, a neuroradiology fellow and radiology trainees) who marked the central sulcus based on the presence of the 'invisible cortex sign'. Their accuracy in identifying the central sulcus was compared with that of the principal investigators, who used tri-planar T1 volumetric MRI sequences. RESULTS One hundred and eight consecutive patients (55 female, 53 male) were selected, ranging from 18 to 81 years old (mean = 40.5, σ = 18.2). The central sulcus was correctly identified in 95.5% of cases (σ = 3.7%; range 89.4-99.1%). CONCLUSION The 'invisible cortex sign' is a highly accurate method of identifying the inferolateral central sulcus on a single axial DWI slice without relying on the more superior aspects of the sulcus.
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Affiliation(s)
- Shu Su
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Natalie Yang
- Department of Radiology, The Austin Hospital, Melbourne, Victoria, Australia
| | - Frank Gaillard
- Department of Radiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Radiology, The University of Melbourne, Melbourne, Victoria, Australia
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Is the Hypointensity in Motor Cortex the Hallmark of Amyotrophic Lateral Sclerosis? Can J Neurol Sci 2019; 46:166-173. [DOI: 10.1017/cjn.2018.382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACT:Background: Amyotrophic lateral sclerosis (ALS) is a devastating disease that targets motor neurons. Upper motor neurons degeneration is pathologically characterized by brain iron accumulation. Signal attenuation in the shape of a ribbon at the posterior border of the precentral gyrus can be observed on conventional magnetic resonance imaging (MRI) sequences including T2-weighted sequence. Methods: With the aim to know the qualities of this potential marker of ALS, we conducted a prospective study. Patients with definite ALS in the age range of 40–70 years and healthy controls underwent 3T brain MRI using a standardized sequence. A second MRI was performed 18 months later under the same conditions in the patients with ALS. Results: Most of the patients with ALS (91.66%) exhibited a “black ribbon” (BR) with an average area of 79.98 mm3. Signal attenuation discriminated ALS with a mean value of 63.97 arbitrary units (AU) on the left BR (95% CI: 60.67–67.27), a mean value of 59.15 AU (95% CI: 54.78–63.53) on the right BR, and a significant difference with control subjects presenting a mean value of 107.85 AU (p < 0.001). The optimal cut-off point for differentiating patients with ALS from controls (sensitivity, 0.92; specificity, 0.93) was 83 AU. Forced vital capacity and muscle strength in the contralateral upper extremity were significantly correlated with the ribbon intensity in ALS. Patients who underwent a second study exhibited significant changes in the BR related to the rapid evolution of the disease. Conclusions: This marker represents a valuable tool for the selection of candidates and their follow-up in clinical trials.
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Park M, Moon Y, Han SH, Moon WJ. Motor cortex hypointensity on susceptibility-weighted imaging: a potential imaging marker of iron accumulation in patients with cognitive impairment. Neuroradiology 2019; 61:675-683. [PMID: 30693411 DOI: 10.1007/s00234-019-02159-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/03/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To assess the prevalence and characteristics of motor cortex hypointensity on 3-T susceptibility-weighted imaging (SWI) in patients with cognitive impairment and examine its clinical significance. METHODS The institutional review board approved this retrospective study and waived the requirement for informed consent. A total of 127 patients with a clinical diagnosis of probable Alzheimer's disease (AD) (n = 32) or mild cognitive impairment (MCI) (n = 95) and 127 age- and sex-matched control subjects underwent 3-T brain magnetic resonance imaging. SWI was analyzed for both subjective visual scoring and the quantitative estimation of phase shift in the posterior bank of the motor cortex. A multivariate logistic regression analysis was performed to identify clinical and imaging variables associated with motor cortex hypointensity on SWI. RESULTS Motor cortex hypointensity on SWI was observed in 94/127 cognitively impaired patients (74.0%) and 72/127 control subjects (56.7%) (p = 0.004). Age was the only variable that was significantly associated with motor cortex hypointensity in patients with cognitive impairment (odds ratio, 1.15; 95% confidence interval, 1.065-1.242; p < 0.001). The quantitative analysis confirmed a significant increase in phase shifting in the posterior bank of the motor cortex in patients with positive motor cortex hypointensity on SWI (p < 0.001). CONCLUSION Motor cortex hypointensity on SWI was more frequently found in patients with cognitive impairment than in age-matched controls and was positively associated with age. Thus, it may be a potential imaging marker of iron accumulation in patients with MCI or AD.
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Affiliation(s)
- Mina Park
- Department of Radiology, Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea.,Department of Radiology, Gangnam Severance Hospital, College of Medicine, Yonsei University, Seoul, South Korea
| | - Yeonsil Moon
- Department of Neurology, Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Seol-Heui Han
- Department of Neurology, Medical Center, Konkuk University School of Medicine, Seoul, South Korea
| | - Won-Jin Moon
- Department of Radiology, Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea.
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Chen L, Wei X, Liu C, Li C, Zhou Z. Brain iron deposition in primary insomnia-An in vivo susceptibility-weighted imaging study. Brain Behav 2019; 9:e01138. [PMID: 30548431 PMCID: PMC6346654 DOI: 10.1002/brb3.1138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/25/2018] [Accepted: 07/01/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To study the brain iron deposition and its relationships with cognitive impairment and sleep quality in primary insomnia (PI). METHODS Thirty-five patients with PI and 35 volunteers underwent MRI scanning using high-resolution susceptibility-weighted imaging sequence. Bilateral anterior cingulate cortices, posterior cingulate cortex, hippocampus, caudate nucleus, globus pallidus, putamen, thalamus, red nucleus, substantia nigra, parietal cortex, and frontal white matter were selected as regions of interest. The phase shift values of the above areas were compared between the two groups. Partial correlations between phase shifts values and neuropsychological scale scores including Pittsburgh Sleep Quality Index, Insomnia Severity Index, Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living Scale, and Clinical Dementia Rating of the PI patients were analyzed. RESULTS Compared with the normal controls, the PI patients showed significant lower MMSE and MoCA scores and increased phase shift values in the left caudate nucleus, left putamen, left hippocampus, and bilateral thalamus (p < 0.05). Close correlation was found between the phase shift value of the left hippocampus and the MMSE scores of the PI patients (R = -0.447, p < 0.01). CONCLUSION The PI patients exhibited significant cognitive impairment and increased iron deposition in several brain regions. The iron concentration of the left hippocampus is a biomarker of cognitive impairment and may play an important role in the pathophysiological mechanism.
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Affiliation(s)
- Lin Chen
- Department of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xin Wei
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chen Liu
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chuanming Li
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenhua Zhou
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Weidman EK, Schweitzer AD, Niogi SN, Brady EJ, Starikov A, Askin G, Shahbazi M, Wang Y, Lange D, Tsiouris AJ. Diffusion tensor imaging and quantitative susceptibility mapping as diagnostic tools for motor neuron disorders. Clin Imaging 2019; 53:6-11. [DOI: 10.1016/j.clinimag.2018.09.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/04/2018] [Accepted: 09/24/2018] [Indexed: 12/11/2022]
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Wirth AM, Johannesen S, Khomenko A, Baldaranov D, Bruun TH, Wendl C, Schuierer G, Greenlee MW, Bogdahn U. Value of fluid-attenuated inversion recovery MRI data analyzed by the lesion segmentation toolbox in amyotrophic lateral sclerosis. J Magn Reson Imaging 2018; 50:552-559. [PMID: 30569457 PMCID: PMC6767504 DOI: 10.1002/jmri.26577] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/28/2018] [Accepted: 10/29/2018] [Indexed: 12/11/2022] Open
Abstract
Background MRI fluid‐attenuated inversion recovery (FLAIR) studies reported hyperintensity in the corticospinal tract and corpus callosum of patients with amyotrophic lateral sclerosis (ALS). Purpose To evaluate the lesion segmentation toolbox (LST) for the objective quantification of FLAIR lesions in ALS patients. Study Type Retrospective. Population Twenty‐eight ALS patients (eight females, mean age: 50 range: 24–73, mean ALSFRS‐R sum score: 36) were compared with 31 age‐matched healthy controls (12 females, mean age: 45, range: 25–67). ALS patients were treated with riluzole and additional G‐CSF (granulocyte‐colony stimulating factor) on a named patient basis. Field Strength/Sequence 1.5 T, FLAIR, T1‐weighted MRI. Assessment The lesion prediction algorithm (LPA) of the LST enabled the extraction of individual binary lesion maps, total lesion volume (TLV), and number (TLN). Location and overlap of FLAIR lesions across patients were investigated by registration to FLAIR average space and an atlas. ALS‐specific functional rating scale revised (ALSFRS‐R), disease progression, and survival since diagnosis served as clinical correlates. Statistical Tests Univariate analysis of variance (ANOVA), repeated‐measures ANOVA, t‐test, Bravais‐Pearson correlation, Chi‐square test of independence, Kaplan–Meier analysis, Cox‐regression analysis. Results Both ALS patients and healthy controls exhibited FLAIR alterations. TLN significantly depended on age (F(1,54) = 24.659, P < 0.001) and sex (F(1,54) = 5.720, P = 0.020). ALS patients showed higher TLN than healthy controls depending on sex (F(1, 54) = 5.076, P = 0.028). FLAIR lesions were small and most pronounced in male ALS patients. FLAIR alterations were predominantly detected in the superior and posterior corona radiata, anterior capsula interna, and posterior thalamic radiation. Patients with pyramidal tract (PT) lesions exhibited significantly inferior survival than patients without PT lesions (P = 0.013). Covariate age exhibited strong prognostic value for survival (P = 0.015). Data Conclusion LST enables the objective quantification of FLAIR alterations and is a potential prognostic biomarker for ALS. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:552–559.
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Affiliation(s)
- Anna M Wirth
- Department of Neurology, University Hospital of Regensburg, Germany.,Department of Experimental Psychology, University of Regensburg, Germany
| | - Siw Johannesen
- Department of Neurology, University Hospital of Regensburg, Germany
| | - Andrei Khomenko
- Department of Neurology, University Hospital of Regensburg, Germany
| | - Dobri Baldaranov
- Department of Neurology, University Hospital of Regensburg, Germany
| | - Tim-Henrik Bruun
- Department of Neurology, University Hospital of Regensburg, Germany
| | - Christina Wendl
- Center of Neuroradiology, University Hospital and District Medical Hospital of Regensburg, Germany
| | - Gerhard Schuierer
- Center of Neuroradiology, University Hospital and District Medical Hospital of Regensburg, Germany
| | - Mark W Greenlee
- Department of Experimental Psychology, University of Regensburg, Germany
| | - Ulrich Bogdahn
- Department of Neurology, University Hospital of Regensburg, Germany
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Lin F, Prince MR, Spincemaille P, Wang Y. Patents on Quantitative Susceptibility Mapping (QSM) of Tissue Magnetism. Recent Pat Biotechnol 2018; 13:90-113. [PMID: 30556508 DOI: 10.2174/1872208313666181217112745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/04/2018] [Accepted: 12/11/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Quantitative susceptibility mapping (QSM) depicts biodistributions of tissue magnetic susceptibility sources, including endogenous iron and calcifications, as well as exogenous paramagnetic contrast agents and probes. When comparing QSM with simple susceptibility weighted MRI, QSM eliminates blooming artifacts and shows reproducible tissue susceptibility maps independent of field strength and scanner manufacturer over a broad range of image acquisition parameters. For patient care, QSM promises to inform diagnosis, guide surgery, gauge medication, and monitor drug delivery. The Bayesian framework using MRI phase data and structural prior knowledge has made QSM sufficiently robust and accurate for routine clinical practice. OBJECTIVE To address the lack of a summary of US patents that is valuable for QSM product development and dissemination into the MRI community. METHOD We searched the USPTO Full-Text and Image Database for patents relevant to QSM technology innovation. We analyzed the claims of each patent to characterize the main invented method and we investigated data on clinical utility. RESULTS We identified 17 QSM patents; 13 were implemented clinically, covering various aspects of QSM technology, including the Bayesian framework, background field removal, numerical optimization solver, zero filling, and zero-TE phase. CONCLUSION Our patent search identified patents that enable QSM technology for imaging the brain and other tissues. QSM can be applied to study a wide range of diseases including neurological diseases, liver iron disorders, tissue ischemia, and osteoporosis. MRI manufacturers can develop QSM products for more seamless integration into existing MRI scanners to improve medical care.
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Affiliation(s)
- Feng Lin
- School of Law, City University of Hong Kong, Hong Kong, China
| | - Martin R Prince
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
| | - Pascal Spincemaille
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
| | - Yi Wang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States.,Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
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Acosta-Cabronero J, Milovic C, Mattern H, Tejos C, Speck O, Callaghan MF. A robust multi-scale approach to quantitative susceptibility mapping. Neuroimage 2018; 183:7-24. [PMID: 30075277 PMCID: PMC6215336 DOI: 10.1016/j.neuroimage.2018.07.065] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/29/2018] [Accepted: 07/29/2018] [Indexed: 12/11/2022] Open
Abstract
Quantitative Susceptibility Mapping (QSM), best known as a surrogate for tissue iron content, is becoming a highly relevant MRI contrast for monitoring cellular and vascular status in aging, addiction, traumatic brain injury and, in general, a wide range of neurological disorders. In this study we present a new Bayesian QSM algorithm, named Multi-Scale Dipole Inversion (MSDI), which builds on the nonlinear Morphology-Enabled Dipole Inversion (nMEDI) framework, incorporating three additional features: (i) improved implementation of Laplace's equation to reduce the influence of background fields through variable harmonic filtering and subsequent deconvolution, (ii) improved error control through dynamic phase-reliability compensation across spatial scales, and (iii) scalewise use of the morphological prior. More generally, this new pre-conditioned QSM formalism aims to reduce the impact of dipole-incompatible fields and measurement errors such as flow effects, poor signal-to-noise ratio or other data inconsistencies that can lead to streaking and shadowing artefacts. In terms of performance, MSDI is the first algorithm to rank in the top-10 for all metrics evaluated in the 2016 QSM Reconstruction Challenge. It also demonstrated lower variance than nMEDI and more stable behaviour in scan-rescan reproducibility experiments for different MRI acquisitions at 3 and 7 Tesla. In the present work, we also explored new forms of susceptibility MRI contrast making explicit use of the differential information across spatial scales. Specifically, we show MSDI-derived examples of: (i) enhanced anatomical detail with susceptibility inversions from short-range dipole fields (hereby referred to as High-Pass Susceptibility Mapping or HPSM), (ii) high specificity to venous-blood susceptibilities for highly regularised HPSM (making a case for MSDI-based Venography or VenoMSDI), (iii) improved tissue specificity (and possibly statistical conditioning) for Macroscopic-Vessel Suppressed Susceptibility Mapping (MVSSM), and (iv) high spatial specificity and definition for HPSM-based Susceptibility-Weighted Imaging (HPSM-SWI) and related intensity projections.
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Affiliation(s)
- Julio Acosta-Cabronero
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
| | - Carlos Milovic
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Hendrik Mattern
- Department of Biomedical Magnetic Resonance, Institute of Experimental Physics, Otto von Guericke University, Magdeburg, Germany
| | - Cristian Tejos
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Oliver Speck
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Department of Biomedical Magnetic Resonance, Institute of Experimental Physics, Otto von Guericke University, Magdeburg, Germany; Center for Behavioural Brain Sciences, Magdeburg, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Martina F Callaghan
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom
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Mazón M, Vázquez Costa JF, Ten-Esteve A, Martí-Bonmatí L. Imaging Biomarkers for the Diagnosis and Prognosis of Neurodegenerative Diseases. The Example of Amyotrophic Lateral Sclerosis. Front Neurosci 2018; 12:784. [PMID: 30410433 PMCID: PMC6209630 DOI: 10.3389/fnins.2018.00784] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/10/2018] [Indexed: 12/17/2022] Open
Abstract
The term amyotrophic lateral sclerosis (ALS) comprises a heterogeneous group of fatal neurodegenerative disorders of largely unknown etiology characterized by the upper motor neurons (UMN) and/or lower motor neurons (LMN) degeneration. The development of brain imaging biomarkers is essential to advance in the diagnosis, stratification and monitoring of ALS, both in the clinical practice and clinical trials. In this review, the characteristics of an optimal imaging biomarker and common pitfalls in biomarkers evaluation will be discussed. Moreover, the development and application of the most promising brain magnetic resonance (MR) imaging biomarkers will be reviewed. Finally, the integration of both qualitative and quantitative multimodal brain MR biomarkers in a structured report will be proposed as a support tool for ALS diagnosis and stratification.
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Affiliation(s)
- Miguel Mazón
- Radiology and Biomedical Imaging Research Group (GIBI230), La Fe University and Polytechnic Hospital and La Fe Health Research Institute, Valencia, Spain
| | - Juan Francisco Vázquez Costa
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe (IIS La Fe), Valencia, Spain
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | - Amadeo Ten-Esteve
- Radiology and Biomedical Imaging Research Group (GIBI230), La Fe University and Polytechnic Hospital and La Fe Health Research Institute, Valencia, Spain
| | - Luis Martí-Bonmatí
- Radiology and Biomedical Imaging Research Group (GIBI230), La Fe University and Polytechnic Hospital and La Fe Health Research Institute, Valencia, Spain
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Mattern H, Sciarra A, Lüsebrink F, Acosta-Cabronero J, Speck O. Prospective motion correction improves high-resolution quantitative susceptibility mapping at 7T. Magn Reson Med 2018; 81:1605-1619. [PMID: 30298692 DOI: 10.1002/mrm.27509] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/12/2018] [Accepted: 08/06/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Recent literature has shown the potential of high-resolution quantitative susceptibility mapping (QSM) with ultra-high field MRI for imaging the anatomy, the vasculature, and investigating their magnetostatic properties. Higher spatial resolutions, however, translate to longer scans resulting, therefore, in higher vulnerability to, and likelihood of, subject movement. We propose a gradient-recalled echo sequence with prospective motion correction (PMC) to address such limitation. METHODS Data from 4 subjects were acquired at 7T. The effect of small and large motion on QSM with and without PMC was assessed qualitatively and quantitatively. Full brain QSM and QSM-based venograms with up to 0.33 mm isotropic voxel size were reconstructed. RESULTS With PMC, motion artifacts in QSM and QSM-based venograms were largely eliminated, enabling-in both large- and small-amplitude motion regimes-accurate depiction of the cortex, vasculature, and other small anatomical structures that are often blurred as a result of head movement or indiscernible at lower image resolutions. Quantitative analyses demonstrated that uncorrected motion could bias regional susceptibility distributions, a trend that was greatly reduced with PMC. CONCLUSION Qualitatively, PMC prevented image degradation because of motion artifacts, providing highly detailed QSM images and venograms. Quantitatively, PMC increased the reproducibility of susceptibility measures.
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Affiliation(s)
- Hendrik Mattern
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Alessandro Sciarra
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Falk Lüsebrink
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Julio Acosta-Cabronero
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, United Kingdom.,German Center for Neurodegenerative Diseases, Magdeburg, Germany
| | - Oliver Speck
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany.,German Center for Neurodegenerative Diseases, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
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Lewis MM, Du G, Baccon J, Snyder AM, Murie B, Cooper F, Sica C, Mailman RB, Connor JR, Huang X. Susceptibility MRI captures nigral pathology in patients with parkinsonian syndromes. Mov Disord 2018; 33:1432-1439. [PMID: 29756231 PMCID: PMC6185787 DOI: 10.1002/mds.27381] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/21/2018] [Accepted: 02/13/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parkinsonisms are neurodegenerative disorders characterized pathologically by α-synuclein-positive (e.g., PD, diffuse Lewy body disease, and MSA) and/or tau-positive (e.g., PSP, cortical basal degeneration) pathology. Using R2* and quantitative susceptibility mapping, susceptibility changes have been reported in the midbrain of living parkinsonian patients, although the exact underlying pathology of these alterations is unknown. OBJECTIVE The current study investigated the pathological correlates of these susceptibility MRI measures. METHODS In vivo MRIs (T1- and T2-weighted, and T2*) and pathology were obtained from 14 subjects enrolled in an NINDS PD Biomarker Program (PDBP). We assessed R2* and quantitative susceptibility mapping values in the SN, semiquantitative α-synuclein, tau, and iron values, as well as neuronal and glial counts. Data were analyzed using age-adjusted Spearman correlations. RESULTS R2* was associated significantly with nigral α-synuclein (r = 0.746; P = 0.003). Quantitative susceptibility mapping correlated significantly with Perls' (r = 0.758; P = 0.003), but not with other pathological measurements. Neither measurement correlated with tau or glial cell counts (r ≤ 0.11; P ≥ 0.129). CONCLUSIONS Susceptibility MRI measurements capture nigral pathologies associated with parkinsonian syndromes. Whereas quantitative susceptibility mapping is more sensitive to iron, R2* may reflect pathological aspects of the disorders beyond iron such as α-synuclein. They may be invaluable tools in diagnosing differential parkinsonian syndromes, and tracking in living patients the dynamic changes associated with the pathological progression of these disorders. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Jennifer Baccon
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pathology and Laboratory Medicine, Akron Children’s Hospital, Akron, OH 44308
| | - Amanda M. Snyder
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Ben Murie
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Felicia Cooper
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Christopher Sica
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Richard B. Mailman
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - James R. Connor
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
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Acosta-Cabronero J, Machts J, Schreiber S, Abdulla S, Kollewe K, Petri S, Spotorno N, Kaufmann J, Heinze HJ, Dengler R, Vielhaber S, Nestor PJ. Quantitative Susceptibility MRI to Detect Brain Iron in Amyotrophic Lateral Sclerosis. Radiology 2018; 289:195-203. [PMID: 30040038 DOI: 10.1148/radiol.2018180112] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To investigate the whole-brain landscape of iron-related abnormalities in amyotrophic lateral sclerosis (ALS) by using the in vivo MRI technique of quantitative susceptibility mapping (QSM). Materials and Methods For this prospective study, 28 patients with ALS (mean age, 61 years; age range, 43-77 years; 18 men [mean age, 61 years; range, 43-77 years] and 10 women [mean age, 61 years; range, 47-74 years]) recruited between January 17, 2014, and September 4, 2015, and 39 matched control subjects (mean age, 61 years; age range, 39-77 years; 24 men [mean age, 62 years; range, 39-77 years] and 15 women [mean age, 59 years; range, 39-73 years]) were examined by using structural and susceptibility 3.0-T MRI techniques. Group data were cross sectionally compared with family-wise error (FWE) corrections by using voxel-based morphometry (random-field theory), cortical thickness analysis (Monte Carlo simulated), subcortical volumetry (Bonferroni-corrected Wilcoxon rank-sum testing), and QSM analysis (cluster-enhanced whole-brain permutation testing and Bonferroni-corrected rank-sum testing in regions of interest). In patients with ALS, a potential relationship between diffusion and susceptibility measurements in the corticospinal tracts (CSTs) was also examined by using Spearman rank-correlation tests. Results Conventional structural measures failed to identify atrophy in the present cohort (FWE P > .05). However, QSM identified several whole-brain abnormalities (FWE P < .05) in ALS. Regionally, higher susceptibility (expressed as means in parts per million ± standard errors of the mean) was confirmed in the motor cortex (ALS = 0.0188 ± 0.0003, control = 0.0173 ± 0.0003; P < .001), the left substantia nigra (ALS = 0.127 ± 0.004, control = 0.113 ± 0.003; P = .008), the right substantia nigra (ALS = 0.141 ± 0.005, control = 0.120 ± 0.003; P < .001), the globus pallidus (ALS = 0.086 ± 0.003, control = 0.075 ± 0.002; P = .003), and the red nucleus (ALS = 0.115 ± 0.004, control = 0.098 ± 0.003; P < .001). Lower susceptibility was found in CST white matter (ALS = -0.047 ± 0.001, control = -0.043 ± 0.001; P = .01). Nigral and pallidal QSM values were cross correlated in ALS (ρ2 = 0.42, P < .001), a phenomenon visually traceable in many individual patients. QSM in the CST in ALS also correlated with diffusion-tensor metrics in this tract (ρ2 = 0.25, P = .007). Conclusion Whole-brain MRI quantitative susceptibility mapping analysis is sensitive to tissue alterations in amyotrophic lateral sclerosis that may be relevant to pathologic changes. © RSNA, 2018.
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Affiliation(s)
- Julio Acosta-Cabronero
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Judith Machts
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Stefanie Schreiber
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Susanne Abdulla
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Katja Kollewe
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Susanne Petri
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Nicola Spotorno
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Joern Kaufmann
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Hans-Jochen Heinze
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Reinhard Dengler
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Stefan Vielhaber
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
| | - Peter J Nestor
- From the German Center for Neurodegenerative Diseases, Magdeburg, Germany (J.A., J.M., N.S., H.J.H., P.J.N.); Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1N 3BG, England (J.A.); Department of Neurology, Otto von Guericke University, Magdeburg, Germany (J.M., S.S., S.A., J.K., H.J.H., S.V.); Department of Neurology and Clinical Neurophysiology, Hannover Medical School, Hannover, Germany (S.A., K.K., S.P., R.D.); Leibniz Institute for Neurobiology, Magdeburg, Germany (H.J.H.); and Queensland Brain Institute, University of Queensland, Brisbane, Australia (P.J.N.)
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Milovic C, Acosta-Cabronero J, Pinto JM, Mattern H, Andia M, Uribe S, Tejos C. A new discrete dipole kernel for quantitative susceptibility mapping. Magn Reson Imaging 2018; 51:7-13. [PMID: 29673893 DOI: 10.1016/j.mri.2018.04.004] [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: 06/23/2017] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Most approaches for quantitative susceptibility mapping (QSM) are based on a forward model approximation that employs a continuous Fourier transform operator to solve a differential equation system. Such formulation, however, is prone to high-frequency aliasing. The aim of this study was to reduce such errors using an alternative dipole kernel formulation based on the discrete Fourier transform and discrete operators. METHODS The impact of such an approach on forward model calculation and susceptibility inversion was evaluated in contrast to the continuous formulation both with synthetic phantoms and in vivo MRI data. RESULTS The discrete kernel demonstrated systematically better fits to analytic field solutions, and showed less over-oscillations and aliasing artifacts while preserving low- and medium-frequency responses relative to those obtained with the continuous kernel. In the context of QSM estimation, the use of the proposed discrete kernel resulted in error reduction and increased sharpness. CONCLUSION This proof-of-concept study demonstrated that discretizing the dipole kernel is advantageous for QSM. The impact on small or narrow structures such as the venous vasculature might by particularly relevant to high-resolution QSM applications with ultra-high field MRI - a topic for future investigations. The proposed dipole kernel has a straightforward implementation to existing QSM routines.
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Affiliation(s)
- Carlos Milovic
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile.
| | - Julio Acosta-Cabronero
- Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London. 12 Queen Square, London WC1N 3BG, UK; German Center for Neurodegenerative Diseases (DZNE), Leipziger Straße 44, Haus 64, 39120 Magdeburg, Germany.
| | - José Miguel Pinto
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile.
| | - Hendrik Mattern
- Department of Biomedical Magnetic Resonance, Institute of Experimental Physics, Otto von Guericke-University. Universitaetsplatz 2, 39106 Magdeburg, Germany.
| | - Marcelo Andia
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile; Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile. Avda. Libertador Bernardo OHiggins 340, Santiago, Chile.
| | - Sergio Uribe
- Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile; Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile. Avda. Libertador Bernardo OHiggins 340, Santiago, Chile.
| | - Cristian Tejos
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Avda. Vicuña Mackenna 4686, Macul, Santiago, Chile.
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Pallebage-Gamarallage M, Foxley S, Menke RAL, Huszar IN, Jenkinson M, Tendler BC, Wang C, Jbabdi S, Turner MR, Miller KL, Ansorge O. Dissecting the pathobiology of altered MRI signal in amyotrophic lateral sclerosis: A post mortem whole brain sampling strategy for the integration of ultra-high-field MRI and quantitative neuropathology. BMC Neurosci 2018; 19:11. [PMID: 29529995 PMCID: PMC5848544 DOI: 10.1186/s12868-018-0416-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/02/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a clinically and histopathologically heterogeneous neurodegenerative disorder, in which therapy is hindered by the rapid progression of disease and lack of biomarkers. Magnetic resonance imaging (MRI) has demonstrated its potential for detecting the pathological signature and tracking disease progression in ALS. However, the microstructural and molecular pathological substrate is poorly understood and generally defined histologically. One route to understanding and validating the pathophysiological correlates of MRI signal changes in ALS is to directly compare MRI to histology in post mortem human brains. RESULTS The article delineates a universal whole brain sampling strategy of pathologically relevant grey matter (cortical and subcortical) and white matter tracts of interest suitable for histological evaluation and direct correlation with MRI. A standardised systematic sampling strategy that was compatible with co-registration of images across modalities was established for regions representing phosphorylated 43-kDa TAR DNA-binding protein (pTDP-43) patterns that were topographically recognisable with defined neuroanatomical landmarks. Moreover, tractography-guided sampling facilitated accurate delineation of white matter tracts of interest. A digital photography pipeline at various stages of sampling and histological processing was established to account for structural deformations that might impact alignment and registration of histological images to MRI volumes. Combined with quantitative digital histology image analysis, the proposed sampling strategy is suitable for routine implementation in a high-throughput manner for acquisition of large-scale histology datasets. Proof of concept was determined in the spinal cord of an ALS patient where multiple MRI modalities (T1, T2, FA and MD) demonstrated sensitivity to axonal degeneration and associated heightened inflammatory changes in the lateral corticospinal tract. Furthermore, qualitative comparison of R2* and susceptibility maps in the motor cortex of 2 ALS patients demonstrated varying degrees of hyperintense signal changes compared to a control. Upon histological evaluation of the same region, intensity of signal changes in both modalities appeared to correspond primarily to the degree of microglial activation. CONCLUSION The proposed post mortem whole brain sampling methodology enables the accurate intraindividual study of pathological propagation and comparison with quantitative MRI data, to more fully understand the relationship of imaging signal changes with underlying pathophysiology in ALS.
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Affiliation(s)
| | - Sean Foxley
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 7822grid.170205.1Department of Radiology, University of Chicago, Chicago, IL USA
| | - Ricarda A. L. Menke
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Istvan N. Huszar
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Mark Jenkinson
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Benjamin C. Tendler
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Chaoyue Wang
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Saad Jbabdi
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Martin R. Turner
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Karla L. Miller
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- 0000 0004 1936 8948grid.4991.5Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Olaf Ansorge
- 0000 0004 1936 8948grid.4991.5Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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Gillen KM, Mubarak M, Nguyen TD, Pitt D. Significance and In Vivo Detection of Iron-Laden Microglia in White Matter Multiple Sclerosis Lesions. Front Immunol 2018. [PMID: 29515576 PMCID: PMC5826076 DOI: 10.3389/fimmu.2018.00255] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Microglia are resident immune cells that fulfill protective and homeostatic functions in the central nervous system (CNS) but may also promote neurotoxicity in the aged brain and in chronic disease. In multiple sclerosis (MS), an autoimmune demyelinating disease of the CNS, microglia and macrophages contribute to the development of white matter lesions through myelin phagocytosis, and possibly to disease progression through diffuse activation throughout myelinated white matter. In this review, we discuss an additional compartment of myeloid cell activation in MS, i.e., the rim and normal adjacent white matter of chronic active lesions. In chronic active lesions, microglia and macrophages may contain high amounts of iron, express markers of proinflammatory polarization, are activated for an extended period of time (years), and drive chronic tissue damage. Iron-positive myeloid cells can be visualized and quantified with quantitative susceptibility mapping (QSM), a magnetic resonance imaging technique. Thus, QSM has potential as an in vivo biomarker for chronic inflammatory activity in established white matter MS lesions. Reducing chronic inflammation associated with iron accumulation using existing or novel MS therapies may impact disease severity and progression.
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Affiliation(s)
- Kelly M Gillen
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Mayyan Mubarak
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
| | - Thanh D Nguyen
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - David Pitt
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
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