1
|
De Lury AD, Bisulca JA, Lee JS, Altaf MD, Coyle PK, Duong TQ. Magnetic resonance imaging detection of deep gray matter iron deposition in multiple sclerosis: A systematic review. J Neurol Sci 2023; 453:120816. [PMID: 37827008 DOI: 10.1016/j.jns.2023.120816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/14/2023]
Abstract
Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease involving immune-mediated damage. Iron deposition in deep gray matter (DGM) structures like the thalamus and basal ganglia have been suggested to play a role in MS pathogenesis. Magnetic Resonance Imaging (MRI) imaging methods like T2 and T2* imaging, susceptibility-weighted imaging, and quantitative susceptibility mapping can track iron deposition storage in the brain primarily from ferritin and hemosiderin (paramagnetic iron storage proteins) with varying levels of tissue contrast and sensitivity. In this systematic review, we evaluated the role of DGM iron deposition as detected by MRI techniques in relation to MS-related neuroinflammation and its potential as a novel therapeutic target. We searched through PubMed, Embase, and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, against predetermined inclusion and exclusion criteria. We included 89 articles (n = 6630 patients), and then grouped them into different categories: i) methodological techniques to measure DGM iron, ii) cross-sectional and group comparison of DGM iron content, iii) longitudinal comparisons of DGM iron, iv) associations between DGM iron and other imaging and neurobiological markers, v) associations with disability, and vi) associations with cognitive impairment. The review revealed that iron deposition in DGM is independent yet concurrent with demyelination, and that these iron deposits contribute to MS-related cognitive impairment and disability. Variability in iron distributions appears to rely on a positive feedback loop between inflammation, and release of iron by oligodendrocytes. DGM iron seems to be a promising prognostic biomarker for MS pathophysiology.
Collapse
Affiliation(s)
- Amy D De Lury
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Joseph A Bisulca
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Jimmy S Lee
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Muhammad D Altaf
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| | - Patricia K Coyle
- Department of Neurology, Stony Brook University Medical Center, Stony Brook, NY, USA.
| | - Tim Q Duong
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 East 210(th) Street, Bronx, NY, USA.
| |
Collapse
|
2
|
Distinct brain iron profiles associated with logopenic progressive aphasia and posterior cortical atrophy. Neuroimage Clin 2022; 36:103161. [PMID: 36029670 PMCID: PMC9428862 DOI: 10.1016/j.nicl.2022.103161] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/05/2022] [Accepted: 08/18/2022] [Indexed: 12/14/2022]
Abstract
Quantitative susceptibility mapping (QSM) can detect iron distribution in the brain by estimating local tissue magnetic susceptibility properties at every voxel. Iron deposition patterns are well studied in typical Alzheimer's disease (tAD), but little is known about these patterns in atypical clinical presentations of AD such as logopenic progressive aphasia (LPA) and posterior cortical atrophy (PCA). Seventeen PCA patients and eight LPA patients were recruited by the Neurodegenerative Research Group at Mayo Clinic, Rochester, MN, and underwent MRI that included a five-echo gradient echo sequence for calculation of QSM. Mean QSM signal was extracted from gray and white matter for regions-of-interest across the brain using the Mayo Clinic Adult Lifespan Template. Bayesian hierarchical models were fit per-region and per-hemisphere to compare PCA, LPA, 63 healthy controls, and 20 tAD patients. Strong evidence (posterior probability > 0.99) was observed for greater susceptibility in the middle occipital gyrus and amygdala in both LPA and PCA, and in the right inferior parietal, inferior temporal, and angular gyri in PCA and the caudate and substantia nigra in LPA compared to controls. Moderate evidence for greater susceptibility (posterior probability > 0.90) was also observed in the inferior occipital gyrus, precuneus, putamen and entorhinal cortex in both LPA and PCA, along with superior frontal gyrus in PCA and inferior temporal gyri, insula and basal ganglia in LPA, when compared to controls. Between phenotypic comparisons, LPA had greater susceptibility in the caudate, hippocampus, and posterior cingulate compared to PCA, while PCA showed greater susceptibility in the right superior frontal and middle temporal gyri compared to LPA. Both LPA and PCA showed moderate and strong evidence for greater susceptibility than tAD, particularly in medial and lateral parietal regions, while tAD showed greater susceptibility in the hippocampus and basal ganglia. This study proposes the possibility of unique iron profiles existing between LPA and PCA within cortical and subcortical structures. These changes match well with the disease-related changes of the clinical phenotypes, suggesting that QSM could be an informative candidate marker to study iron deposition in these patients.
Collapse
|
3
|
Li Y, Sethi SK, Zhang C, Miao Y, Yerramsetty KK, Palutla VK, Gharabaghi S, Wang C, He N, Cheng J, Yan F, Haacke EM. Iron Content in Deep Gray Matter as a Function of Age Using Quantitative Susceptibility Mapping: A Multicenter Study. Front Neurosci 2021; 14:607705. [PMID: 33488350 PMCID: PMC7815653 DOI: 10.3389/fnins.2020.607705] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/07/2020] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To evaluate the effect of resolution on iron content using quantitative susceptibility mapping (QSM); to verify the consistency of QSM across field strengths and manufacturers in evaluating the iron content of deep gray matter (DGM) of the human brain using subjects from multiple sites; and to establish a susceptibility baseline as a function of age for each DGM structure using both a global and regional iron analysis. METHODS Data from 623 healthy adults, ranging from 20 to 90 years old, were collected across 3 sites using gradient echo imaging on one 1.5 Tesla and two 3.0 Tesla MR scanners. Eight subcortical gray matter nuclei were semi-automatically segmented using a full-width half maximum threshold-based analysis of the QSM data. Mean susceptibility, volume and total iron content with age correlations were evaluated for each measured structure for both the whole-region and RII (high iron content regions) analysis. For the purpose of studying the effect of resolution on QSM, a digitized model of the brain was applied. RESULTS The mean susceptibilities of the caudate nucleus (CN), globus pallidus (GP) and putamen (PUT) were not significantly affected by changing the slice thickness from 0.5 to 3 mm. But for small structures, the susceptibility was reduced by 10% for 2 mm thick slices. For global analysis, the mean susceptibility correlated positively with age for the CN, PUT, red nucleus (RN), substantia nigra (SN), and dentate nucleus (DN). There was a negative correlation with age in the thalamus (THA). The volumes of most nuclei were negatively correlated with age. Apart from the GP, THA, and pulvinar thalamus (PT), all the other structures showed an increasing total iron content despite the reductions in volume with age. For the RII regional high iron content analysis, mean susceptibility in most of the structures was moderately to strongly correlated with age. Similar to the global analysis, apart from the GP, THA, and PT, all structures showed an increasing total iron content. CONCLUSION A reasonable estimate for age-related iron behavior can be obtained from a large cross site, cross manufacturer set of data when high enough resolutions are used. These estimates can be used for correcting for age related iron changes when studying diseases like Parkinson's disease, Alzheimer's disease, and other iron related neurodegenerative diseases.
Collapse
Affiliation(s)
- Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sean K. Sethi
- Department of Radiology, Wayne State University, Detroit, MI, United States
- MR Innovations, Inc., Bingham Farms, MI, United States
- SpinTech, Inc., Bingham Farms, MI, United States
| | - Chunyan Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanwei Miao
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | | | | | | | - Chengyan Wang
- Human Phenome Institute, Fudan University, Shanghai, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ewart Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Radiology, Wayne State University, Detroit, MI, United States
- MR Innovations, Inc., Bingham Farms, MI, United States
- SpinTech, Inc., Bingham Farms, MI, United States
| |
Collapse
|
4
|
Bahrami M, Rabbani M, Shaygannejad V, Badiei S. Comparison of susceptibility weighted imaging with conventional MRI sequences in multiple sclerosis plaque assessment: A cross-sectional study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021; 26:128. [PMID: 35126591 PMCID: PMC8772512 DOI: 10.4103/jrms.jrms_726_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/29/2017] [Accepted: 11/09/2018] [Indexed: 11/30/2022]
Abstract
Background: The current study was performed to compare susceptibility-weighted imaging (SWI) with magnetic resonance imaging (MRI) methods of T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) imaging in multiple sclerosis (MS) plaque assessment Materials and Methods: This cross-sectional study was conducted among 50 MS patients referred to Shafa Imaging Center, Isfahan, Iran. Patients who fulfilled McDonald criteria and were diagnosed with MS by a professional neurologist at least 1 year before the study initiation were included in the study. Eligible patients underwent brain scans using SWI, T2W imaging, and FLAIR. Plaques’ number and volume were detected separately for each imaging sequence. Moreover, identified lesions in SWI sequence were evaluated in terms of iron deposition and central veins Results: Totally 50 patients (10 males and 40 females) with a mean age of 28.48 ± 5.25 years were included in the current study. Majority of patients (60%) had a disease duration of >5 years, and mean expanded disability status score was 2.56 ± 1.32. There was no significant difference between different imaging modalities in terms of plaques’ number and volume (P > 0.05). It was also found that there was a high correlation between SWI and conventional imaging techniques of T2W (r = 0.97, 0.91, P < 0.001) and FLAIR (r = 0.99, 0.99, P < 0.001) in the estimation of both the number and volume of plaques (P < 0.001) Conclusion: The results of the present study indicated that SWI and conventional MRI sequences have similar efficiency for plaque assessment in MS patients.
Collapse
|
5
|
Cortical hypointensity in T2-weighted gradient-echo sequences in patients with progressive multifocal leukoencephalopathy. RADIOLOGIA 2020. [DOI: 10.1016/j.rxeng.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
6
|
Sugiyama A, Sato N, Kimura Y, Fujii H, Maikusa N, Shigemoto Y, Suzuki F, Morimoto E, Koide K, Takahashi Y, Matsuda H, Kuwabara S. Quantifying iron deposition in the cerebellar subtype of multiple system atrophy and spinocerebellar ataxia type 6 by quantitative susceptibility mapping. J Neurol Sci 2019; 407:116525. [PMID: 31639532 DOI: 10.1016/j.jns.2019.116525] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/14/2019] [Accepted: 10/06/2019] [Indexed: 01/08/2023]
Abstract
We used quantitative susceptibility mapping (QSM) to assess the brain iron deposition in 28 patients with the cerebellar subtype of multiple system atrophy (MSA-C), nine patients with spinocerebellar ataxia type 6 (SCA6), and 23 healthy controls. Two reviewers independently measured the mean QSM values in brain structures including the putamen, globus pallidus, caudate nucleus, red nucleus, substantia nigra, and cerebellar dentate nucleus. A receiver operating characteristics (ROC) analysis was performed to assess the diagnostic usefulness of the QSM measurements. The QSM values in the substantia nigra were significantly higher in the MSA-C group compared to the HC group (p = .007). The QSM values in the cerebellar dentate nucleus were significantly higher in MSA-C than those in the SCA6 and HC groups (p < .001), and significantly lower in the SCA6 patients compared to the HCs (p = .027). The QSM values in the cerebellar dentate nucleus were correlated with disease duration in MSA-C, but inversely correlated with disease duration in SCA6. In the ROC analysis, the QSM values in the cerebellar dentate nucleus showed excellent accuracy for differentiating MSA-C from SCA6 (area under curve [AUC], 0.925), and good accuracy for differentiating MSA-C from healthy controls (AUC 0.834). QSM can identify increased susceptibility of the substantia nigra and cerebellar dentate nucleus in MSA-C patients. These results suggest that an increase in iron accumulation in the cerebellar dentate nucleus may be secondary to the neurodegeneration associated with MSA-C.
Collapse
Affiliation(s)
- Atsuhiko Sugiyama
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan; Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan.
| | - Yukio Kimura
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroyuki Fujii
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Norihide Maikusa
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoko Shigemoto
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Fumio Suzuki
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Emiko Morimoto
- Department of Radiology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kyosuke Koide
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yuji Takahashi
- Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroshi Matsuda
- Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| |
Collapse
|
7
|
López Sala P, Alberdi Aldasoro N, Zelaya Huerta MV, Bacaicoa Saralegui MC, Cabada Giadás T. Cortical hypointensity in T2-weighted gradient-echo sequences in patients with progressive multifocal leukoencephalopathy. RADIOLOGIA 2019; 62:59-66. [PMID: 31375267 DOI: 10.1016/j.rx.2019.06.003] [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: 12/10/2018] [Revised: 05/06/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Progressive multifocal leukoencephalopathy is a demyelinating disease of the central nervous system caused by the reactivation of the JC virus. This opportunistic encephalopathy mainly affects immunodepressed patients with stage III HIV infection, although in recent years it has also been found in association with treatment with immunosuppressors such as natalizumab. MRI plays an important role in both the early diagnosis and follow-up of this disease. Recently, it has been reported that hypointensities in U-fibers and cortex adjacent to white-matter lesions characteristic of the disease can be identified on T2-weighted gradient-echo and susceptibility-weighted sequences in patients with progressive multifocal leukoencephalopathy. OBJECTIVE We aimed to analyze the presence and usefulness of cortical hypointensity on T2-weighted gradient-echo sequences in relation to the diagnosis of progressive multifocal leukoencephalopathy and to review the literature on the topic. MATERIAL AND METHODS We analyze three cases of progressive multifocal leukoencephalopathy seen at our center in three patients with immunosuppression of different origins: one with stage III HIV infection, one with multiple sclerosis being treated with natalizumab, and one with rheumatoid arthritis being treated with rituximab. RESULTS In all three cases MRI showed the cortical hypointensity adjacent to the white-matter lesion in the T2-weighted gradient-echo sequence. In the patient with multiple sclerosis, this sign appeared earlier than the abnormal signal in the white matter. The patient being treated with rituximab was diagnosed postmortem and the pathology findings correlated with the MRI findings. CONCLUSION The finding of cortical hypointensity on T2-weighted gradient-echo MRI sequences seems to support the diagnosis of progressive multifocal leukoencephalopathy, regardless of the type of immunosuppression, so this finding should routinely assessed in patients suspected of having this disease.
Collapse
Affiliation(s)
- P López Sala
- Servicio de Radiodiagnóstico, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
| | - N Alberdi Aldasoro
- Servicio de Radiodiagnóstico, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - M V Zelaya Huerta
- Servicio de Anatomía Patológica, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - M C Bacaicoa Saralegui
- Servicio de Radiodiagnóstico, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| | - T Cabada Giadás
- Servicio de Radiodiagnóstico, Complejo Hospitalario de Navarra, Pamplona, Navarra, España
| |
Collapse
|
8
|
Evaluation of iron deposition in brain basal ganglia of patients with Parkinson's disease using quantitative susceptibility mapping. Eur J Radiol Open 2019; 6:169-174. [PMID: 31065578 PMCID: PMC6495059 DOI: 10.1016/j.ejro.2019.04.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/11/2022] Open
Abstract
Aim of the study Parkinson's disease is associated with iron deposition in the brain. The QSM (quantitative susceptibility mapping) is more sensitive than T2-weighted imaging, T2* and R2. Few studies have been used QSM to evaluate the iron in the basal ganglia of patients with Parkinson's disease. Our aim was to evaluate the iron deposition in the basal ganglia using QSM and determination of diagnostic value of this method and evaluation of the association between disease stage with QSM and age with QSM in all nuclei, separately. Materials and methods Thirty patients were tested using Hoehn and Yahr test in three different stages. Fifteen healthy subjects were considered as control group. MRI sequences were performed using SIEMENS 3 T scanner.The Signal Processing in NMR software was used to process and analyze the images. The QSM in every of the basal ganglia was measured separately. Results There was a significant difference for QSM in the Subtania Nigera, Red Nucleus, Thalamic Nucleus and Globus Pallidus nucleus between two groups. The relationship between disease stage with QSM was significant in Subtania Nigera, Red Nucleus, and Globus Pallidus nucleus. The QSM values had a significant association with disease stage in all nuclei. The results showed that QSM has a higher accuracy in Subtania Nigera, Globus Pallidus, Red Nucleus and Thalamic Nucleus, respectively. Conclusions Using QSM in Red Nucleus, Subtania Nigera, and Globus Pallidus nuclei can help diagnosis and staging the patients with Parkinson's disease. In future, studies with emphasis on the disease stage can be helpful in evaluation the different parts of these three nuclei.
Collapse
|
9
|
Zivadinov R, Tavazzi E, Bergsland N, Hagemeier J, Lin F, Dwyer MG, Carl E, Kolb C, Hojnacki D, Ramasamy D, Durfee J, Weinstock-Guttman B, Schweser F. Brain Iron at Quantitative MRI Is Associated with Disability in Multiple Sclerosis. Radiology 2018; 289:487-496. [PMID: 30015589 PMCID: PMC6219694 DOI: 10.1148/radiol.2018180136] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/30/2018] [Accepted: 05/04/2018] [Indexed: 11/11/2022]
Abstract
Purpose To study deep gray matter susceptibility in multiple sclerosis (MS) by using quantitative susceptibility mapping (QSM) and to assess the relationship between susceptibility and clinical disability. Materials and Methods For this prospective study between March 2009 and November 2013, 600 participants with MS (452 with relapsing-remitting MS and 148 with secondary progressive MS) and 250 age- and sex-matched healthy control participants were imaged with 3.0-T MRI to measure magnetic susceptibility. Deep gray matter susceptibility (in parts per billion) was analyzed by using region of interest and voxelwise methods. QSM and MRI volumetric differences between study groups and associations with clinical outcomes were assessed. Analysis of covariance, multivariable linear regression, and voxelwise analyses, controlling for age and sex, were used to compare study groups and to explore associations between MRI and clinical outcomes. Results Compared with control participants, participants with MS presented with lower thalamic susceptibility (-7.5 ppb vs -1.1 ppb; P < .001) and higher susceptibility of basal ganglia (62 ppb vs 54.8 ppb; P < .001). Lower thalamic susceptibility was associated with longer disease duration (β = -0.42; P = .002), higher degree of disability (β = -0.64; P = .03), and secondary-progressive course (β = -4.3; P = .009). Higher susceptibility of the globus pallidus was associated with higher disability (β = 2; P = .03). After correcting for each individual structural volume in voxelwise analysis, lower thalamic susceptibility and higher susceptibility of the globus pallidus remained associated with clinical disability (P < .05). Conclusion Quantitative susceptibility mapping (QSM) suggests that altered deep gray matter iron is associated with the evolution of multiple sclerosis (MS) and on disability accrual, independent of tissue atrophy. © RSNA, 2018 Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Robert Zivadinov
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Eleonora Tavazzi
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Niels Bergsland
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Jesper Hagemeier
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Fuchun Lin
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Michael G. Dwyer
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Ellen Carl
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Channa Kolb
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - David Hojnacki
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Deepa Ramasamy
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Jacqueline Durfee
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Bianca Weinstock-Guttman
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| | - Ferdinand Schweser
- From the Buffalo Neuroimaging Analysis Center, Department of
Neurology, Jacobs School of Medicine and Biomedical Sciences (R.Z., E.T., N.B.,
J.H., F.L., M.G.D., E.C., D.R., J.D., F.S.), Center for Biomedical Imaging,
Clinical Translational Science Institute (R.Z.), and Jacobs Multiple Sclerosis
Center, Department of Neurology, School of Medicine and Biomedical Sciences
(C.K., D.H., B.W.G.), University at Buffalo, State University of New York, 100
High St, Buffalo, NY 14203
| |
Collapse
|
10
|
Belova AN, Solovieva VS, Boyko AN. [Anemia and dysregulation of iron metabolism in multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:10-17. [PMID: 30160662 DOI: 10.17116/jnevro201811808210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anemia is one of the common diseases comorbid with multiple sclerosis (MS). This article reviews the prevalence and types of anemia in MS patients. It has been shown that anemia is often accompanied by a decrease in serum iron level. The authors present the data on iron metabolism in patients with MS and MRI findings concerning deposits of iron in the gray matter of the brain. The causal relationship between abnormalities in iron metabolism and MS remains unclear; this study allows to approach the understanding of the MS pathogenesis and to increase the efficacy of therapy for this disease.
Collapse
Affiliation(s)
- A N Belova
- Privolzskyi Federal Medical Research Center, Nizhny Novgorod, Russia
| | - V S Solovieva
- City Clinical Hospital #3, Regional Center fo Multiple Sclerosis, Nizhny Novgorod, Russia
| | - A N Boyko
- Pirogov Russian National Research Medical University, Moscow, Russia; Center for Demyelination Diseases 'Neuroclinic', Moscow, Russia
| |
Collapse
|
11
|
Yan F, He N, Lin H, Li R. Iron deposition quantification: Applications in the brain and liver. J Magn Reson Imaging 2018; 48:301-317. [PMID: 29897645 DOI: 10.1002/jmri.26161] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/02/2018] [Indexed: 01/01/2023] Open
Abstract
Iron has long been implicated in many neurological and other organ diseases. It is known that over and above the normal increases in iron with age, in certain diseases there is an excessive iron accumulation in the brain and liver. MRI is a noninvasive means by which to image the various structures in the brain in three dimensions and quantify iron over the volume of the object of interest. The quantification of iron can provide information about the severity of iron-related diseases as well as quantify changes in iron for patient follow-up and treatment monitoring. This article provides an overview of current MRI-based methods for iron quantification, specifically for the brain and liver, including: signal intensity ratio, R2 , R2*, R2', phase, susceptibility weighted imaging and quantitative susceptibility mapping (QSM). Although there are numerous approaches to measuring iron, R2 and R2* are currently preferred methods in imaging the liver and QSM has become the preferred approach for imaging iron in the brain. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018. J. MAGN. RESON. IMAGING 2018;48:301-317.
Collapse
Affiliation(s)
- Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huimin Lin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruokun Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
12
|
Quantifying iron content in magnetic resonance imaging. Neuroimage 2018; 187:77-92. [PMID: 29702183 DOI: 10.1016/j.neuroimage.2018.04.047] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 04/13/2018] [Accepted: 04/20/2018] [Indexed: 01/19/2023] Open
Abstract
Measuring iron content has practical clinical indications in the study of diseases such as Parkinson's disease, Huntington's disease, ferritinopathies and multiple sclerosis as well as in the quantification of iron content in microbleeds and oxygen saturation in veins. In this work, we review the basic concepts behind imaging iron using T2, T2*, T2', phase and quantitative susceptibility mapping in the human brain, liver and heart, followed by the applications of in vivo iron quantification in neurodegenerative diseases, iron tagged cells and ultra-small superparamagnetic iron oxide (USPIO) nanoparticles.
Collapse
|
13
|
Schweser F, Raffaini Duarte Martins AL, Hagemeier J, Lin F, Hanspach J, Weinstock-Guttman B, Hametner S, Bergsland N, Dwyer MG, Zivadinov R. Mapping of thalamic magnetic susceptibility in multiple sclerosis indicates decreasing iron with disease duration: A proposed mechanistic relationship between inflammation and oligodendrocyte vitality. Neuroimage 2018; 167:438-452. [PMID: 29097315 PMCID: PMC5845810 DOI: 10.1016/j.neuroimage.2017.10.063] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 12/13/2022] Open
Abstract
Recent advances in susceptibility MRI have dramatically improved the visualization of deep gray matter brain regions and the quantification of their magnetic properties in vivo, providing a novel tool to study the poorly understood iron homeostasis in the human brain. In this study, we used an advanced combination of the recent quantitative susceptibility mapping technique with dedicated analysis methods to study intra-thalamic tissue alterations in patients with clinically isolated syndrome (CIS) and multiple sclerosis (MS). Thalamic pathology is one of the earliest hallmarks of MS and has been shown to correlate with cognitive dysfunction and fatigue, but the mechanisms underlying the thalamic pathology are poorly understood. We enrolled a total of 120 patients, 40 with CIS, 40 with Relapsing Remitting MS (RRMS), and 40 with Secondary Progressive MS (SPMS). For each of the three patient groups, we recruited 40 controls, group matched for age- and sex (120 total). We acquired quantitative susceptibility maps using a single-echo gradient echo MRI pulse sequence at 3 T. Group differences were studied by voxel-based analysis as well as with a custom thalamus atlas. We used threshold-free cluster enhancement (TFCE) and multiple regression analyses, respectively. We found significantly reduced magnetic susceptibility compared to controls in focal thalamic subregions of patients with RRMS (whole thalamus excluding the pulvinar nucleus) and SPMS (primarily pulvinar nucleus), but not in patients with CIS. Susceptibility reduction was significantly associated with disease duration in the pulvinar, the left lateral nuclear region, and the global thalamus. Susceptibility reduction indicates a decrease in tissue iron concentration suggesting an involvement of chronic microglia activation in the depletion of iron from oligodendrocytes in this central and integrative brain region. Not necessarily specific to MS, inflammation-mediated iron release may lead to a vicious circle that reduces the protection of axons and neuronal repair.
Collapse
Affiliation(s)
- Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, USA.
| | - Ana Luiza Raffaini Duarte Martins
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Fuchun Lin
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Jannis Hanspach
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Institute of Radiology, University Hospital Erlangen, Erlangen, Germany
| | - Bianca Weinstock-Guttman
- Jacobs Multiple Sclerosis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Simon Hametner
- Department of Neuroimmunology, Center for Brain Research, Medical University of Vienna, Vienna, Austria
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Michael G Dwyer
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, NY, USA
| |
Collapse
|
14
|
Bamm VV, Henein MEL, Sproul SLJ, Lanthier DK, Harauz G. Potential role of ferric hemoglobin in MS pathogenesis: Effects of oxidative stress and extracellular methemoglobin or its degradation products on myelin components. Free Radic Biol Med 2017; 112:494-503. [PMID: 28863941 DOI: 10.1016/j.freeradbiomed.2017.08.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/22/2017] [Accepted: 08/28/2017] [Indexed: 10/19/2022]
Abstract
There is a well-documented relationship between cerebral vasculature and multiple sclerosis (MS) lesions: abnormal accumulations of iron have been found in the walls of the dilated veins in cerebral MS plaques. The source of this iron is unknown, but could be related to the recognized phenomenon of capillary and venous hemorrhages leading to blood extravasation. In turn, hemorrhaging leading to hemolysis results in extracellular release of hemoglobin, a reactive molecule that could induce local oxidative stress, inflammation, and tissue damage. Our previous studies with a reduced form of hemoglobin (oxyHb) have demonstrated its ability to cause extensive lipid and protein oxidation in vitro, which would result in membrane destabilization. Here, we investigated in further detail the mechanism by which the more abundant oxidized form of extracellular hemoglobin (metHb), and dissociated hemin, cause direct oxidative damage to myelin components, specifically membrane-mimetic lipid vesicles and myelin basic protein (MBP), a highly-abundant protein in the CNS. Oxidation of lipids was assessed by the formation of conjugated diene/triene and malondialdehyde, and oxidation of MBP was demonstrated by the bityrosine formation and by the change in protein mass. Our results show that metHb causes oxidative damage to MBP and myelin lipids, partly by transferring its hemin moiety to protein and lipid, but mostly as an intact protein possibly via formation of a ferryl radical. These results elucidating the mechanism of extracellular hemoglobin-induced oxidative damage to myelin components support the need for further research into vascular pathology in MS pathogenesis, to gain insight into the role of iron deposits and/or in stimulation of different comorbidities associated with the disease.
Collapse
Affiliation(s)
- Vladimir V Bamm
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada N1G 2W1
| | - Mary E L Henein
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada N1G 2W1; Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Shannon L J Sproul
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada N1G 2W1; Department of Cell and Developmental Biology, University of British Columbia, Vancouver, BC, Canada
| | - Danielle K Lanthier
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada N1G 2W1
| | - George Harauz
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada N1G 2W1.
| |
Collapse
|
15
|
Mahajan KR, Ontaneda D. The Role of Advanced Magnetic Resonance Imaging Techniques in Multiple Sclerosis Clinical Trials. Neurotherapeutics 2017; 14:905-923. [PMID: 28770481 PMCID: PMC5722766 DOI: 10.1007/s13311-017-0561-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Magnetic resonance imaging has been crucial in the development of anti-inflammatory disease-modifying treatments. The current landscape of multiple sclerosis clinical trials is currently expanding to include testing not only of anti-inflammatory agents, but also neuroprotective, remyelinating, neuromodulating, and restorative therapies. This is especially true of therapies targeting progressive forms of the disease where neurodegeneration is a prominent feature. Imaging techniques of the brain and spinal cord have rapidly evolved in the last decade to permit in vivo characterization of tissue microstructural changes, connectivity, metabolic changes, neuronal loss, glial activity, and demyelination. Advanced magnetic resonance imaging techniques hold significant promise for accelerating the development of different treatment modalities targeting a variety of pathways in MS.
Collapse
Affiliation(s)
- Kedar R Mahajan
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue, U-10, Cleveland, OH, 44195, USA
| | - Daniel Ontaneda
- Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue, U-10, Cleveland, OH, 44195, USA.
| |
Collapse
|
16
|
Bamm VV, Geist AM, Harauz G. Correlation of geographic distributions of haptoglobin alleles with prevalence of multiple sclerosis (MS) - a narrative literature review. Metab Brain Dis 2017; 32:19-34. [PMID: 27807673 DOI: 10.1007/s11011-016-9923-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/19/2016] [Indexed: 12/15/2022]
Abstract
We have proposed that the myelin damage observed in multiple sclerosis (MS) may be partly mediated through the long-term release and degradation of extracellular hemoglobin (Hb) and the products of its oxidative degradation [Cellular and Molecular Life Sciences, 71, 1789-1798, 2014]. The protein haptoglobin (Hpt) binds extracellular Hb as a first line of defense, and can serve as a vascular antioxidant. Humans have two different Hpt alleles: Hpt1 and Hpt2, giving either homozygous Hpt1-1 or Hpt2-2 phenotypes, or a heterozygous Hpt1-2 phenotype. We questioned whether those geographic regions with higher frequency of the Hpt2 allele (conversely, lower frequency of Hpt1 allele) would correlate with an increased incidence of MS, because different Hpt phenotypes will have variable anti-oxidative potentials in protecting myelin from damage inflicted by extracellular Hb and its degradation products. To test this hypothesis, we undertook a systematic analysis of the literature on reported geographic distributions of Hpt alleles to compare them with data reported in the World Health Organization Atlas of worldwide MS prevalence. We found the frequency of the Hpt1 allele to be low in European and North American countries with a high prevalence of MS, consistent with our hypothesis. However, this correlation was not observed in China and India, countries with the lowest Hpt1 frequencies, yet low reported prevalence of MS. Nevertheless, this work shows the need for continued refinement of geographic patterns of MS prevalence, including data on ethnic or racial origin, and for new clinical studies to probe the observed correlation and evaluate Hpt phenotype as a predictor of disease variability and progression, severity, and/or comorbidity with cardiovascular disorders.
Collapse
Affiliation(s)
- Vladimir V Bamm
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Arielle M Geist
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - George Harauz
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| |
Collapse
|
17
|
Sinnecker T, Schumacher S, Mueller K, Pache F, Dusek P, Harms L, Ruprecht K, Nytrova P, Chawla S, Niendorf T, Kister I, Paul F, Ge Y, Wuerfel J. MRI phase changes in multiple sclerosis vs neuromyelitis optica lesions at 7T. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2016; 3:e259. [PMID: 27489865 PMCID: PMC4959510 DOI: 10.1212/nxi.0000000000000259] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 05/31/2016] [Indexed: 01/08/2023]
Abstract
Objective: To characterize paramagnetic MRI phase signal abnormalities in neuromyelitis optica spectrum disorder (NMOSD) vs multiple sclerosis (MS) lesions in a cross-sectional study. Methods: Ten patients with NMOSD and 10 patients with relapsing-remitting MS underwent 7-tesla brain MRI including supratentorial T2*-weighted imaging and supratentorial susceptibility weighted imaging. Next, we analyzed intra- and perilesional paramagnetic phase changes on susceptibility weighted imaging filtered magnetic resonance phase images. Results: We frequently observed paramagnetic rim-like (75 of 232 lesions, 32%) or nodular (32 of 232 lesions, 14%) phase changes in MS lesions, but only rarely in NMOSD lesions (rim-like phase changes: 2 of 112 lesions, 2%, p < 0.001; nodular phase changes: 2 of 112 lesions, 2%, p < 0.001). Conclusions: Rim-like or nodular paramagnetic MRI phase changes are characteristic for MS lesions and not frequently detectable in NMOSD. Future prospective studies should ask whether these imaging findings can be used as a biomarker to distinguish between NMOSD- and MS-related brain lesions.
Collapse
Affiliation(s)
- Tim Sinnecker
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Sophie Schumacher
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Katharina Mueller
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Florence Pache
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Petr Dusek
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Lutz Harms
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Klemens Ruprecht
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Petra Nytrova
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Sanjeev Chawla
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Thoralf Niendorf
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Ilya Kister
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Friedemann Paul
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Yulin Ge
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| | - Jens Wuerfel
- NeuroCure Clinical Research Center (T.S., S.S., K.M., F. Pache, F. Paul, J.W.), Clinical and Experimental Multiple Sclerosis Research Center (L.H., K.R., F. Paul), and Department of Neurology (L.H., K.R., F. Paul), Charité-Universitaetsmedizin Berlin; Institute of Neuroradiology (P.D., J.W.), Universitaetsmedizin Goettingen, Germany; Department of Neurology and Center of Clinical Neuroscience (P.D., P.N.), Charles University in Prague, 1st Faculty of Medicine and General University Hospital in Prague, Czech Republic; Berlin Ultrahigh Field Facility (T.N., J.W.), Max Delbrueck Center for Molecular Medicine, Berlin; Experimental and Clinical Research Center (T.N., F. Paul, J.W.), Charité-Universitaetsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany; Department of Radiology (S.C., Y.G.), and Multiple Sclerosis Care Center, Department of Neurology (I.K.), NYU School of Medicine, New York, NY; and Medical Imaging Analysis Center AG (T.S., J.W.), Basel, Switzerland. T.S. is currently with Universitätsspital Basel, Switzerland
| |
Collapse
|
18
|
Stüber C, Pitt D, Wang Y. Iron in Multiple Sclerosis and Its Noninvasive Imaging with Quantitative Susceptibility Mapping. Int J Mol Sci 2016; 17:ijms17010100. [PMID: 26784172 PMCID: PMC4730342 DOI: 10.3390/ijms17010100] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 01/05/2016] [Accepted: 01/07/2016] [Indexed: 01/06/2023] Open
Abstract
Iron is considered to play a key role in the development and progression of Multiple Sclerosis (MS). In particular, iron that accumulates in myeloid cells after the blood-brain barrier (BBB) seals may contribute to chronic inflammation, oxidative stress and eventually neurodegeneration. Magnetic resonance imaging (MRI) is a well-established tool for the non-invasive study of MS. In recent years, an advanced MRI method, quantitative susceptibility mapping (QSM), has made it possible to study brain iron through in vivo imaging. Moreover, immunohistochemical investigations have helped defining the lesional and cellular distribution of iron in MS brain tissue. Imaging studies in MS patients and of brain tissue combined with histological studies have provided important insights into the role of iron in inflammation and neurodegeneration in MS.
Collapse
Affiliation(s)
- Carsten Stüber
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - David Pitt
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - Yi Wang
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
| |
Collapse
|
19
|
Stüber C, Pitt D, Wang Y. Iron in Multiple Sclerosis and Its Noninvasive Imaging with Quantitative Susceptibility Mapping. Int J Mol Sci 2016. [PMID: 26784172 DOI: 10.3390/ijmsl17010100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Iron is considered to play a key role in the development and progression of Multiple Sclerosis (MS). In particular, iron that accumulates in myeloid cells after the blood-brain barrier (BBB) seals may contribute to chronic inflammation, oxidative stress and eventually neurodegeneration. Magnetic resonance imaging (MRI) is a well-established tool for the non-invasive study of MS. In recent years, an advanced MRI method, quantitative susceptibility mapping (QSM), has made it possible to study brain iron through in vivo imaging. Moreover, immunohistochemical investigations have helped defining the lesional and cellular distribution of iron in MS brain tissue. Imaging studies in MS patients and of brain tissue combined with histological studies have provided important insights into the role of iron in inflammation and neurodegeneration in MS.
Collapse
Affiliation(s)
- Carsten Stüber
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - David Pitt
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT 06511, USA.
| | - Yi Wang
- Department of Radiology, Weill Cornell Medical College, New York, NY 10044, USA.
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA.
| |
Collapse
|
20
|
Liu M, Liu S, Ghassaban K, Zheng W, Dicicco D, Miao Y, Habib C, Jazmati T, Haacke EM. Assessing global and regional iron content in deep gray matter as a function of age using susceptibility mapping. J Magn Reson Imaging 2015; 44:59-71. [DOI: 10.1002/jmri.25130] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 12/01/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Manju Liu
- Wayne State University, Department of Biomedical Engineering; Detroit Michigan USA
| | - Saifeng Liu
- MRI Institute for Biomedical Research; Waterloo Ontario Canada
| | - Kiarash Ghassaban
- Wayne State University, Department of Biomedical Engineering; Detroit Michigan USA
| | - Weili Zheng
- HUH-MR Research/Radiology; Wayne State University; Detroit Michigan USA
| | - Dane Dicicco
- MRI Institute for Biomedical Research; Detroit Michigan USA
| | - Yanwei Miao
- Department of Radiology; First Affiliated Hospital; Dalian Liaoning China
| | - Charbel Habib
- HUH-MR Research/Radiology; Wayne State University; Detroit Michigan USA
| | - Tarek Jazmati
- MRI Institute for Biomedical Research; Detroit Michigan USA
| | - E. Mark Haacke
- Wayne State University, Department of Biomedical Engineering; Detroit Michigan USA
- MRI Institute for Biomedical Research; Waterloo Ontario Canada
- HUH-MR Research/Radiology; Wayne State University; Detroit Michigan USA
- MRI Institute for Biomedical Research; Detroit Michigan USA
| |
Collapse
|
21
|
Viallon M, Cuvinciuc V, Delattre B, Merlini L, Barnaure-Nachbar I, Toso-Patel S, Becker M, Lovblad KO, Haller S. State-of-the-art MRI techniques in neuroradiology: principles, pitfalls, and clinical applications. Neuroradiology 2015; 57:441-67. [PMID: 25859832 DOI: 10.1007/s00234-015-1500-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/04/2015] [Indexed: 12/20/2022]
Abstract
This article reviews the most relevant state-of-the-art magnetic resonance (MR) techniques, which are clinically available to investigate brain diseases. MR acquisition techniques addressed include notably diffusion imaging (diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and diffusion kurtosis imaging (DKI)) as well as perfusion imaging (dynamic susceptibility contrast (DSC), arterial spin labeling (ASL), and dynamic contrast enhanced (DCE)). The underlying models used to process these images are described, as well as the theoretic underpinnings of quantitative diffusion and perfusion MR imaging-based methods. The technical requirements and how they may help to understand, classify, or follow-up neurological pathologies are briefly summarized. Techniques, principles, advantages but also intrinsic limitations, typical artifacts, and alternative solutions developed to overcome them are discussed. In this article, we also review routinely available three-dimensional (3D) techniques in neuro MRI, including state-of-the-art and emerging angiography sequences, and briefly introduce more recently proposed 3D quantitative neuro-anatomy sequences, and new technology, such as multi-slice and multi-transmit imaging.
Collapse
Affiliation(s)
- Magalie Viallon
- CREATIS, UMR CNRS 5220 - INSERM U1044, INSA de Lyon, Université de Lyon, Lyon, France,
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Chai C, Yan S, Chu Z, Wang T, Wang L, Zhang M, Zuo C, Haacke EM, Xia S, Shen W. Quantitative measurement of brain iron deposition in patients with haemodialysis using susceptibility mapping. Metab Brain Dis 2015; 30:563-71. [PMID: 25182196 DOI: 10.1007/s11011-014-9608-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
Abstract
To compare the susceptibility of different brain structures in patients with haemodialysis with that in healthy controls using susceptibility mapping and explore the correlations with neuropsychiatric tests and clinical parameters. Fifty three patients with haemodialysis and forty-five age-and sex-matched healthy controls were recruited in this prospective study. Susceptibility maps (SM) were reconstructed from original phase data and used to compare the susceptibility of different brain structures between patients and healthy controls. The SM was compared with iron predictions from a classic cadaver brain study. Spearman's correlation and stepwise multiple regression analysis between susceptibility and neuropsychiatric tests and clinical parameters were calculated. In patients with haemodialysis, the susceptibility of the bilateral caudate head, putamen, substantia nigra, red nucleus and dentate nucleus were significantly higher than those in healthy controls (P < 0.01). There was positive correlation between susceptibility both from normal controls and patients and iron concentration from a classic post-mortem brain study (both r = 0.900, both P = 0.037). In patients with haemodialysis, the susceptibility of the left putamen (r = 0.944), right putamen (r = 0.882) and right thalamus (r = 0.852) were correlated to dialysis duration (all P < 0.05). The susceptibility of the left caudate head (r = -0.415) and right caudate head (r = -0.311) were mildly negatively correlated with neuropsychiatric test scores (all P < 0.05). In summary, our findings indicated that increased brain iron deposition does occur in patients with haemodialysis and correlated with duration of dialysis.
Collapse
Affiliation(s)
- Chao Chai
- Department of Medical Imaging, Tianjin First Central Hospital, Tianjin, 300192, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Raz E, Branson B, Jensen JH, Bester M, Babb JS, Herbert J, Grossman RI, Inglese M. Relationship between iron accumulation and white matter injury in multiple sclerosis: a case-control study. J Neurol 2015; 262:402-9. [PMID: 25416468 PMCID: PMC4452503 DOI: 10.1007/s00415-014-7569-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/28/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
Abstract
Despite the increasing development and applications of iron imaging, the pathophysiology of iron accumulation in multiple sclerosis (MS), and its role in disease progression and development of clinical disability, is poorly understood. The aims of our study were to determine the presence and extent of iron in T2 visible lesions and gray and white matter using magnetic field correlation (MFC) MRI and correlate with microscopic white matter (WM) injury as measured by diffusion tensor imaging (DTI). This is a case-control study including a series of 31 patients with clinically definite MS. The mean age was 39 years [standard deviation (SD) = 9.55], they were 11 males and 20 females, with a disease duration average of 3 years (range 0-13) and a median EDSS of 2 (0-4.5). Seventeen healthy volunteers (6 males and 11 females) with a mean age of 36 years (SD = 11.4) were recruited. All subjects underwent MR imaging on a 3T scanner using T2-weighted sequence, 3D T1 MPRAGE, MFC, single-shot DTI and post-contrast T1. T2-lesion volumes, brain volumetry, DTI parameters and iron quantification were calculated and multiple correlations were exploited. Increased MFC was found in the putamen (p = 0.061), the thalamus (p = 0.123), the centrum semiovale (p = 0.053), globus pallidus (p = 0.008) and gray matter (GM) (p = 0.004) of MS patients compared to controls. The mean lesional MFC was 121 s(-2) (SD = 67), significantly lower compared to the GM MFC (<0.0001). The GM mean diffusivity (MD) was inversely correlated with the MFC in the centrum semiovale (p < 0.001), and in the splenium of the corpus callosum (p < 0.001). Patients with MS have increased iron in the globus pallidus, putamen and centrum with a trend toward increased iron in all the brain structures. Quantitative iron evaluation of WM and GM may improve the understanding of MS pathophysiology, and might serve as a surrogate marker of disease progression.
Collapse
Affiliation(s)
- Eytan Raz
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
- Department of Neurology and Psychiatry, Sapienza University, Rome, Italy
| | - Brittany Branson
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
| | - Jens H. Jensen
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA
| | - Maxim Bester
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
- Department of Diagnostic and Interventional Neuroradiology, University Medical Centre, Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - James S. Babb
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
| | - Joseph Herbert
- Department of Neurology, New York University Langone Medical Center, New York, NY, USA
| | - Robert I. Grossman
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
| | - Matilde Inglese
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
- Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai New York, NY
| |
Collapse
|
24
|
Wang Y, Liu T. Quantitative susceptibility mapping (QSM): Decoding MRI data for a tissue magnetic biomarker. Magn Reson Med 2015; 73:82-101. [PMID: 25044035 PMCID: PMC4297605 DOI: 10.1002/mrm.25358] [Citation(s) in RCA: 570] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/13/2014] [Accepted: 06/18/2014] [Indexed: 01/03/2023]
Abstract
In MRI, the main magnetic field polarizes the electron cloud of a molecule, generating a chemical shift for observer protons within the molecule and a magnetic susceptibility inhomogeneity field for observer protons outside the molecule. The number of water protons surrounding a molecule for detecting its magnetic susceptibility is vastly greater than the number of protons within the molecule for detecting its chemical shift. However, the study of tissue magnetic susceptibility has been hindered by poor molecular specificities of hitherto used methods based on MRI signal phase and T2* contrast, which depend convolutedly on surrounding susceptibility sources. Deconvolution of the MRI signal phase can determine tissue susceptibility but is challenged by the lack of MRI signal in the background and by the zeroes in the dipole kernel. Recently, physically meaningful regularizations, including the Bayesian approach, have been developed to enable accurate quantitative susceptibility mapping (QSM) for studying iron distribution, metabolic oxygen consumption, blood degradation, calcification, demyelination, and other pathophysiological susceptibility changes, as well as contrast agent biodistribution in MRI. This paper attempts to summarize the basic physical concepts and essential algorithmic steps in QSM, to describe clinical and technical issues under active development, and to provide references, codes, and testing data for readers interested in QSM.
Collapse
Affiliation(s)
- Yi Wang
- Radiology, Weill Medical College of Cornell UniversityNew York, New York, USA
- Biomedical Engineering, Cornell UniversityIthaca, New York, USA
- Biomedical Engineering, Kyung Hee UniversitySeoul, South Korea
| | - Tian Liu
- MedImageMetric, LLCNew York, New York, USA
| |
Collapse
|
25
|
White ML, Zhang Y, Helvey JT, Yu F, Omojola MF. Effects of Age, Gender and Hemispheric Location on T2 Hypointensity in the Pulvinar at 3T. Neuroradiol J 2014; 27:645-52. [PMID: 25489885 DOI: 10.15274/nrj-2014-10107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 08/19/2014] [Indexed: 11/12/2022] Open
Abstract
Pulvinar signal intensity decrease on T2-weighted images has been reported in some neurological abnormalities. We aimed to define the normal T2 signal hypointensity pattern present in the pulvinar to avoid erroneous radiological interpretation. One hundred and forty-two subjects (54 men and 88 women; age range 9-91 years) with unremarkable brain 3T MR findings were enrolled. MR images were analyzed with regard to signal intensity of the pulvinar relative to the thalamus on fluid attenuated inversion recovery images. Effects of age, gender and hemispheric location on the degree of T2 hypointensity were statistically analyzed. The statistical association was measured between the pattern of signal changes in the pulvinar region and that in the putamen and the globus pallidus. We detected a linear signal decrease in the pulvinar region with age. The male subjects had a more rapid decrease of signal with age than female subjects. The right pulvinar region had a higher chance of hypointensity compared to the left. A positive linear association was found when signal change from the pulvinar region was compared with signal in the putamen and globus pallidus. We detected a linear signal decrease with age in the pulvinar. The physiological signal features of the pulvinar also depend on gender and hemispheric lateralization. The pattern of signal change in the pulvinar is similar to but not the same as that in the putamen and globus pallidus.
Collapse
Affiliation(s)
- Matthew L White
- Departments of Radiology, University of Nebraska Medical Center; Omaha, Nebraska, USA -
| | - Yan Zhang
- Departments of Radiology, University of Nebraska Medical Center; Omaha, Nebraska, USA
| | - Jason T Helvey
- Departments of Radiology, University of Nebraska Medical Center; Omaha, Nebraska, USA
| | - Fang Yu
- Biostatistics, University of Nebraska Medical Center; Omaha, Nebraska, USA
| | - Matthew F Omojola
- Departments of Radiology, University of Nebraska Medical Center; Omaha, Nebraska, USA
| |
Collapse
|
26
|
Bamm VV, Lanthier DK, Stephenson EL, Smith GST, Harauz G. In vitro study of the direct effect of extracellular hemoglobin on myelin components. Biochim Biophys Acta Mol Basis Dis 2014; 1852:92-103. [PMID: 25463632 DOI: 10.1016/j.bbadis.2014.10.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 09/26/2014] [Accepted: 10/09/2014] [Indexed: 01/04/2023]
Abstract
There is a relationship between cerebral vasculature and multiple sclerosis (MS) lesions: abnormal accumulations of iron have been found in the walls of dilated veins in MS plaques. The sources of this iron can be varied, but capillary and venous hemorrhages leading to blood extravasation have been recorded, and could result in the release of hemoglobin extracellularly. Extracellular hemoglobin oxidizes quickly and is known to become a reactive molecule that triggers low-density lipoprotein oxidation and plays a pivotal role in atherogenesis. In MS, it could lead to local oxidative stress, inflammation, and tissue damage. Here, we investigated whether extracellular hemoglobin and its breakdown products can cause direct oxidative damage to myelin components in a peroxidative environment such as occurs in inflamed tissue. Oxidation of lipids was assessed by the formation of fluorescent peroxidized lipid-protein covalent adducts, by the increase in conjugated diene and malondialdehyde. Oxidation of proteins was analyzed by the change in protein mass. The results suggest that the globin radical could be a trigger of myelin basic protein oxidative cross-linking, and that heme transferred to the lipids is involved in lipid peroxidation. This study provides new insight into the mechanism by which hemoglobin exerts its pathological oxidative activity towards myelin components. This work supports further research into the vascular pathology in MS, to gain insight into the origin and role of iron deposits in disease pathogenesis, or in stimulation of different comorbidities such as cardiovascular disease.
Collapse
Affiliation(s)
- Vladimir V Bamm
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada
| | - Danielle K Lanthier
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada
| | - Erin L Stephenson
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada
| | - Graham S T Smith
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada
| | - George Harauz
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada.
| |
Collapse
|
27
|
Iron and multiple sclerosis. Neurobiol Aging 2014; 35 Suppl 2:S51-8. [DOI: 10.1016/j.neurobiolaging.2014.03.039] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 02/28/2014] [Accepted: 03/14/2014] [Indexed: 11/23/2022]
|
28
|
Zhang XD, Zhang LJ, Wu SY, Lu GM. Multimodality magnetic resonance imaging in hepatic encephalopathy: An update. World J Gastroenterol 2014; 20:11262-11272. [PMID: 25170210 PMCID: PMC4145764 DOI: 10.3748/wjg.v20.i32.11262] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 01/29/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatic encephalopathy (HE) is a neuropsychiatric complication of cirrhosis or acute liver failure. Currently, HE is regarded as a continuous cognitive impairment ranging from the mildest stage, minimal HE to overt HE. Hyperammonaemia and neuroinflammation are two main underlying factors which contribute to the neurological alterations in HE. Both structural and functional impairments are found in the white mater and grey mater involved in HE. Although the investigations into HE pathophysiological mechanism are enormous, the exact pathophysiological causes underlying HE remain controversial. Multimodality magnetic resonance imaging (MRI) plays an important role in helping to understand the pathological process of HE. This paper reviews the up-to-date multimodality MRI methods and predominant findings in HE patients with a highlight of the increasingly important role of blood oxygen level dependent functional MRI.
Collapse
|
29
|
Barnett Y, Sutton IJ, Ghadiri M, Masters L, Zivadinov R, Barnett MH. Conventional and advanced imaging in neuromyelitis optica. AJNR Am J Neuroradiol 2014; 35:1458-66. [PMID: 23764723 DOI: 10.3174/ajnr.a3592] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Myelitis and optic neuritis are prototypic clinical presentations of both multiple sclerosis and neuromyelitis optica. Once considered a subtype of multiple sclerosis, neuromyelitis optica, is now known to have a discrete pathogenesis in which antibodies to the water channel, aquaporin 4, play a critical role. Timely differentiation of neuromyelitis optica from MS is imperative, determining both prognosis and treatment strategy. Early, aggressive immunosuppression is required to prevent the accrual of severe disability in neuromyelitis optica; conversely, MS-specific therapies may exacerbate the disease. The diagnosis of neuromyelitis optica requires the integration of clinical, MR imaging, and laboratory data, but current criteria are insensitive and exclude patients with limited clinical syndromes. Failure to recognize the expanding spectrum of cerebral MR imaging patterns associated with aquaporin 4 antibody seropositivity adds to diagnostic uncertainty in some patients. We present the state of the art in conventional and nonconventional MR imaging in neuromyelitis optica and review the place of neuroimaging in the diagnosis, management, and research of the condition.
Collapse
Affiliation(s)
- Y Barnett
- From the Sydney Neuroimaging Analysis Centre (Y.B., M.H.B.), Sydney, AustraliaBrain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, AustraliaDepartment of Medical Imaging and Neurology (Y.B., I.J.S.), St Vincent's Hospital, Sydney, Australia
| | - I J Sutton
- Department of Medical Imaging and Neurology (Y.B., I.J.S.), St Vincent's Hospital, Sydney, Australia
| | - M Ghadiri
- Brain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, Australia
| | - L Masters
- Brain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, Australia
| | - R Zivadinov
- Buffalo Neuroimaging Analysis Center (R.Z.), Department of Neurology, University of Buffalo, Buffalo, New York
| | - M H Barnett
- From the Sydney Neuroimaging Analysis Centre (Y.B., M.H.B.), Sydney, AustraliaBrain and Mind Research Institute (Y.B., M.G., L.M., M.H.B.), University of Sydney, Sydney, Australia
| |
Collapse
|
30
|
Miyagawa M, Maeda M, Umino M, Kagawa K, Nakamichi K, Sakuma H, Tomimoto H. Low signal intensity in U-fiber identified by susceptibility-weighted imaging in two cases of progressive multifocal leukoencephalopathy. J Neurol Sci 2014; 344:198-202. [PMID: 24972818 DOI: 10.1016/j.jns.2014.06.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 12/29/2022]
Abstract
Magnetic resonance imaging (MRI) is a useful tool for diagnosing and monitoring progressive multifocal leukoencephalopathy (PML). Although characteristic MRI findings of PML are well known, we noted a potential new finding for this disease on susceptibility-weighted imaging (SWI). Two patients with PML were studied and followed using MRI. SWI revealed low signal intensities in U-fibers adjacent to the white matter lesions of PML. These findings progressed along with the disease progression. The cause underlying these findings remains unclear. This new finding suggests that SWI is useful for the diagnosis of PML. It can provide a helpful clue in a clinical setting.
Collapse
Affiliation(s)
- Mai Miyagawa
- Department of Radiology, Mie University School of Medicine, Japan
| | - Masayuki Maeda
- Department of Radiology, Mie University School of Medicine, Japan.
| | - Maki Umino
- Department of Radiology, Mie University School of Medicine, Japan
| | - Ken Kagawa
- Department of Neurology, Mie University School of Medicine, Japan
| | - Kazuo Nakamichi
- Department of Virology 1, National Institute of Infectious Diseases, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, Japan
| | | |
Collapse
|
31
|
Bamm VV, Harauz G. "Back to the future" or iron in the MS brain - commentary on "perivascular iron deposits are associated with protein nitration in cerebral experimental autoimmune encephalomyelitis". Neurosci Lett 2014; 582:130-2. [PMID: 24942652 DOI: 10.1016/j.neulet.2014.05.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 05/24/2014] [Indexed: 01/19/2023]
Affiliation(s)
- Vladimir V Bamm
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, N1G 2W1, Canada
| | - George Harauz
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, N1G 2W1, Canada.
| |
Collapse
|
32
|
Bamm VV, Harauz G. Hemoglobin as a source of iron overload in multiple sclerosis: does multiple sclerosis share risk factors with vascular disorders? Cell Mol Life Sci 2014; 71:1789-98. [PMID: 24504127 PMCID: PMC11113400 DOI: 10.1007/s00018-014-1570-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 01/16/2014] [Accepted: 01/20/2014] [Indexed: 12/12/2022]
Abstract
Although iron is known to be essential for the normal development and health of the central nervous system, abnormal iron deposits are found in and around multiple sclerosis (MS) lesions that themselves are closely associated with the cerebral vasculature. However, the origin of this excess iron is unknown, and it is not clear whether this is one of the primary causative events in the pathogenesis of MS, or simply another consequence of the long-lasting inflammatory conditions. Here, applying a systems biology approach, we propose an additional way for understanding the neurodegenerative component of the disease caused by chronic subclinical extravasation of hemoglobin, in combination with multiple other factors including, but not limited to, dysfunction of different cellular protective mechanisms against extracellular hemoglobin reactivity and oxidative stress. Moreover, such considerations could also shed light on and explain the higher susceptibility of MS patients to a wide range of cardiovascular disorders.
Collapse
Affiliation(s)
- Vladimir V. Bamm
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - George Harauz
- Department of Molecular and Cellular Biology, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| |
Collapse
|
33
|
Gizewski ER, Maderwald S, Linn J, Dassinger B, Bochmann K, Forsting M, Ladd ME. High-resolution anatomy of the human brain stem using 7-T MRI: improved detection of inner structures and nerves? Neuroradiology 2013; 56:177-86. [PMID: 24357075 DOI: 10.1007/s00234-013-1312-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 12/04/2013] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The purpose of this paper is to assess the value of 7 Tesla (7 T) MRI for the depiction of brain stem and cranial nerve (CN) anatomy. METHODS Six volunteers were examined at 7 T using high-resolution SWI, MPRAGE, MP2RAGE, 3D SPACE T2, T2, and PD images to establish scanning parameters targeted at optimizing spatial resolution. Direct comparisons between 3 and 7 T were performed in two additional subjects using the finalized sequences (3 T: T2, PD, MPRAGE, SWAN; 7 T: 3D T2, MPRAGE, SWI, MP2RAGE). Artifacts and the depiction of structures were evaluated by two neuroradiologists using a standardized score sheet. RESULTS Sequences could be established for high-resolution 7 T imaging even in caudal cranial areas. High in-plane resolution T2, PD, and SWI images provided depiction of inner brain stem structures such as pons fibers, raphe, reticular formation, nerve roots, and periaqueductal gray. MPRAGE and MP2RAGE provided clear depiction of the CNs. 3D T2 images improved depiction of inner brain structure in comparison to T2 images at 3 T. Although the 7-T SWI sequence provided improved contrast to some inner structures, extended areas were influenced by artifacts due to image disturbances from susceptibility differences. CONCLUSIONS Seven-tesla imaging of basal brain areas is feasible and might have significant impact on detection and diagnosis in patients with specific diseases, e.g., trigeminal pain related to affection of the nerve root. Some inner brain stem structures can be depicted at 3 T, but certain sequences at 7 T, in particular 3D SPACE T2, are superior in producing anatomical in vivo images of deep brain stem structures.
Collapse
Affiliation(s)
- Elke R Gizewski
- Department of Neuroradiology, Medical University Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria,
| | | | | | | | | | | | | |
Collapse
|
34
|
Chen W, Gauthier SA, Gupta A, Comunale J, Liu T, Wang S, Pei M, Pitt D, Wang Y. Quantitative susceptibility mapping of multiple sclerosis lesions at various ages. Radiology 2013; 271:183-92. [PMID: 24475808 DOI: 10.1148/radiol.13130353] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess multiple sclerosis (MS) lesions at various ages by using quantitative susceptibility mapping (QSM) and conventional magnetic resonance (MR) imaging. MATERIALS AND METHODS Retrospectively selected were 32 clinically confirmed MS patients (nine men and 23 women; 39.3 years ± 10.9) who underwent two MR examinations (interval, 0.43 years ± 0.16) with three-dimensional gradient-echo sequence from August 2011 to August 2012. To estimate the ages of MS lesions, MR examinations performed 0.3-10.6 years before study examinations were studied. Hyperintensity on T2-weighted images was used to define MS lesions. QSM images were reconstructed from gradient-echo data. Susceptibility of MS lesions and temporal rates of change were obtained from QSM images. Lesion susceptibilities were analyzed by t test with intracluster correlation adjustment and Bonferroni correction in multiple comparisons. RESULTS MR imaging of 32 patients depicted 598 MS lesions, of which 162 lesions (27.1%) in 23 patients were age measurable and six (1.0%) were only visible at QSM. The susceptibilities relative to normal-appearing white matter (NAWM) were 0.53 ppb ± 3.34 for acute enhanced lesions, 38.43 ppb ± 13.0 (positive; P < .01) for early to intermediately aged nonenhanced lesions, and 4.67 ppb ± 3.18 for chronic nonenhanced lesions. Temporal rates of susceptibility changes relative to cerebrospinal fluid were 12.49 ppb/month ± 3.15 for acute enhanced lesions, 1.27 ppb/month ± 2.31 for early to intermediately aged nonenhanced lesions, and -0.004 ppb/month ± 0 for chronic nonenhanced lesions. CONCLUSION Magnetic susceptibility of MS lesions increased rapidly as it changed from enhanced to nonenhanced, it attained a high susceptibility value relative to NAWM during its initial few years (approximately 4 years), and it gradually dissipated back to susceptibility similar to that of NAWM as it aged, which may provide new insight into pathophysiologic features of MS lesions. Online supplemental material is available for this article.
Collapse
Affiliation(s)
- Weiwei Chen
- From the Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China (W.C.); Departments of Neurology (S.A.G.) and Radiology (W.C., A.G., J.C., T.L., S.W., M.P., Y.W.), Weill Cornell Medical College, 515 E 71st St, New York, NY 10021; Department of Biomedical Engineering, Cornell University, Ithaca, NY (T.L., Y.W.); Department of Biomedical Engineering, Kyung Hee University, Seoul, South Korea (Y.W.); School of Electronic Engineering, University of Electronic Science and Technology of China, Chengdu, China (S.W.); and Department of Neurology, Yale University, New Haven, Conn (D.P.)
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Hagemeier J, Dwyer MG, Bergsland N, Schweser F, Magnano CR, Heininen-Brown M, Ramasamy DP, Carl E, Kennedy C, Melia R, Polak P, Deistung A, Geurts JJG, Reichenbach JR, Zivadinov R. Effect of age on MRI phase behavior in the subcortical deep gray matter of healthy individuals. AJNR Am J Neuroradiol 2013; 34:2144-51. [PMID: 23721902 DOI: 10.3174/ajnr.a3569] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE It has been demonstrated that increased levels of iron in the brain occur with aging. In this study we investigated the nature of the association between age and SWI-filtered phase values, indicative of iron content, in the subcortical deep gray matter of healthy individuals. MATERIALS AND METHODS A total of 210 healthy individuals (men: n = 89, women: n = 121), mean age, 39.8 years (standard deviation = 15.5; range = 6-76 years), were imaged on a 3T scanner. Mean MRI phase, mean phase of low-phase voxels, and normalized volumes were determined for total subcortical deep gray matter, caudate, putamen, globus pallidus, thalamus, pulvinar nucleus, hippocampus, amygdala, nucleus accumbens, red nucleus, and substantia nigra. Linear and nonlinear regression models were used to explore the relationship between phase and volume measures, and aging. RESULTS Mean phase values of subcortical deep gray matter structures showed a quadratic relationship, with individuals in late middle age (40-59 years) having the lowest mean phase values, followed by a reversal of this trend in the elderly. In contrast, mean phase of low-phase voxel measurements showed strong negative linear relationships with aging. Significantly lower phase values were detected in women compared with men (P < .001), whereas no sex differences were observed for mean phase of low-phase voxels. Normalized volume measurements were also linearly related to aging, and women showed smaller normalized volumes of subcortical deep gray matter structures than men (P < .001). Lower mean phase of low-phase voxels was related to decreased volume measures. CONCLUSIONS A strong association between phase (quadratic effect; phase decreases are followed by increases), mean phase of low-phase voxels (linear effect), volume (linear effect), and age was observed. Low phase was related to brain atrophy.
Collapse
Affiliation(s)
- J Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, Buffalo, New York
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Grabner G, Dal-Bianco A, Hametner S, Lassmann H, Trattnig S. Group specific vein-atlasing: An application for analyzing the venous system under normal and multiple sclerosis conditions. J Magn Reson Imaging 2013; 40:655-61. [DOI: 10.1002/jmri.24393] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 08/16/2013] [Indexed: 11/11/2022] Open
Affiliation(s)
- Günther Grabner
- Medical University of Vienna, MR Centre of Excellence; Department of Biomedical Imaging and Image-Guided Therapy; Vienna Austria
| | | | - Simon Hametner
- Medical University of Vienna; Center for Brain Research; Vienna Austria
| | - Hans Lassmann
- Medical University of Vienna; Center for Brain Research; Vienna Austria
| | - Siegfried Trattnig
- Medical University of Vienna, MR Centre of Excellence; Department of Biomedical Imaging and Image-Guided Therapy; Vienna Austria
| |
Collapse
|
37
|
Utriainen D, Trifan G, Sethi S, Elias S, Hewett J, Feng W, Haacke EM. Magnetic resonance imaging signatures of vascular pathology in multiple sclerosis. Neurol Res 2013; 34:780-92. [PMID: 22971468 DOI: 10.1179/1743132812y.0000000078] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Venous vascular contributing factors to multiple sclerosis (MS) have been known for some time. Only recently has the scope of their potential role become more apparent with the theory of chronic cerebrospinal venous insufficiency (CCSVI). As research expands to further explore the role of vascular pathology in the MS population, it is expedient to review the evidence from an imaging perspective. In this paper, we review the current state-of-the-art methods using magnetic resonance imaging (MRI) as applied to imaging MS patients and CCSVI. This includes evaluating imaging signatures of vascular structure and flow as well as brain iron content. Upon review of the literature, we find that extracranial venous anomalies including stenosis, venous malformations, and collateralization of flow in the major veins of the neck have been observed to be prevalent in the MS population. Abnormal flow has been reported in MS patients both in major vessels using phase-contrast flow quantification and in the brain using perfusion-weighted imaging. We discuss the role of quantitative flow imaging and its potential in assessing possible biomarkers for abnormal flow. Finally, it has been suggested that the presence of high iron content may indirectly indicate progression of existing vascular pathology. To that end, we review the use of susceptibility-weighted imaging in monitoring iron in the thalamus, basal ganglia, and MS lesions.
Collapse
|
38
|
Jellinger KA. The relevance of metals in the pathophysiology of neurodegeneration, pathological considerations. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2013; 110:1-47. [PMID: 24209432 DOI: 10.1016/b978-0-12-410502-7.00002-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurodegenerative disorders are featured by a variety of pathological conditions that share similar critical processes, such as oxidative stress, free radical activity, proteinaceous aggregations, mitochondrial dysfunctions, and energy failure. They are mediated or triggered by an imbalance of metal ions leading to changes of critical biological systems and initiating a cascade of events finally leading to neurodegeneration and cell death. Their causes are multifactorial, and although the source of the shift in oxidative homeostasis is still unclear, current evidence points to changes in the balance of redox transition metals, especially iron, copper, and other trace metals. They are present at elevated levels in Alzheimer disease, Parkinson disease, multisystem atrophy, etc., while in other neurodegenerative disorders, copper, zinc, aluminum, and manganese are involved. This chapter will review the recent advances of the role of metals in the pathogenesis and pathophysiology of major neurodegenerative diseases and discuss the use of chelating agents as potential therapies for metal-related disorders.
Collapse
|
39
|
Rumzan R, Wang JJ, Zeng C, Chen X, Li Y, Luo T, Lv F, Wang ZP, Hou H, Huang F. Iron deposition in the precentral grey matter in patients with multiple sclerosis: a quantitative study using susceptibility-weighted imaging. Eur J Radiol 2012; 82:e95-9. [PMID: 23079047 DOI: 10.1016/j.ejrad.2012.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 09/06/2012] [Accepted: 09/16/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Several studies suggest that iron deposition may play a role in multiple sclerosis (MS) pathology. Three-dimensional (3D) enhanced T2*-weighted angiography (ESWAN) at 3T was used to quantify iron deposition in the precentral grey matter in MS and its relationship with disease duration, atrophy and Expanded Disability Status Scale (EDSS) scores. METHODS We recruited 33 patients with diagnosis of clinically definite MS and 31 age- and sex-matched healthy controls who underwent conventional brain MRI, 3D-ESWAN and 3D T1sequences. We obtained the mean phase values (MPVs) of the precentral grey matter on ESWAN-filtered phase images and volume of the precentral gyrus on 3D T1 images. We investigated the correlation between precentral grey matter MPVs, precentral gyrus volume, disease duration and EDSS scores of MS patients and healthy controls. RESULTS The precentral grey matter MPVs in MS patients and controls were 1870.83 ± 56.61 and 1899.22 ± 51.73 respectively and had significant difference in the MS group vs. the control group (t=-2.09, P=0.04). There was significant negative correlation between precentral grey matter MPVs and disease duration (r=-0.365, P=0.03). No correlation was found between MPVs and EDSS scores. Mean precentral gyrus volume in MS patients was 4368.55 ± 867.78 whereas in controls was 5701.00 ± 1184.03 with significant difference between volume of the precentral gyrus in MS patients compared to healthy controls (t=-5.167, P<0.001). There was a positive correlation between MPVs and precentral gyrus volume (r=0.291, P=0.020). CONCLUSIONS Our study demonstrated that quantitative assessment of abnormal iron deposition in the precentral grey matter in MS patients can be measured using 3D-ESWAN.
Collapse
Affiliation(s)
- Reshiana Rumzan
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Hagemeier J, Yeh EA, Brown MH, Bergsland N, Dwyer MG, Carl E, Weinstock-Guttman B, Zivadinov R. Iron content of the pulvinar nucleus of the thalamus is increased in adolescent multiple sclerosis. Mult Scler 2012; 19:567-76. [PMID: 22968543 DOI: 10.1177/1352458512459289] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this paper is to assess abnormal phase values, indicative of increased iron content, using susceptibility-weighted imaging (SWI)-filtered phase of the subcortical deep gray matter (SDGM) in adolescent multiple sclerosis (MS) and other neurological disorders (OND) patients, and in healthy controls (HC). METHODS Twenty adolescent MS and eight adolescent OND patients and 21 age- and sex-matched HC were scanned on a 3T GE scanner. Mean phase of abnormal phase tissue (MP-APT), MP-APT volume, normal phase tissue volume (NPTV) and normalized volume measurements were obtained for total SDGM, as well as specific structures separately. RESULTS Significantly increased MP-APT (28.2%, p<.001) and MP-APT volume (82.7%, p<.001), and decreased NPTV (-23.3%, p<.001) and normalized volume (-15.5%, p<.001) in the pulvinar nucleus of the thalamus was found in MS patients compared to HC. MP-APT in MS patients was also increased in total SDGM (p=.012) and thalamus (p=.044). Compared to OND patients, MS patients had increased MP-APT volume in the pulvinar nucleus of the thalamus (p=.044) and caudate (p=.045). Increased MP-APT of the SDGM structures were associated with increased T2 and T1 lesion burden and brain atrophy in MS patients. CONCLUSION Adolescent MS patients showed increased iron content in the SDGM compared to OND patients and HC.
Collapse
Affiliation(s)
- Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, University at Buffalo, USA
| | | | | | | | | | | | | | | |
Collapse
|