1
|
Lyndon D, Davagnanam I, Wilson D, Jichi F, Merwick A, Bolsover F, Jager HR, Cipolotti L, Wheeler-Kingshott C, Hughes D, Murphy E, Lachmann R, Werring DJ. MRI-visible perivascular spaces as an imaging biomarker in Fabry disease. J Neurol 2020; 268:872-878. [PMID: 33078310 PMCID: PMC7914182 DOI: 10.1007/s00415-020-10209-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/30/2020] [Accepted: 09/02/2020] [Indexed: 12/02/2022]
Abstract
Introduction Fabry disease (FD) is an X-linked lysosomal storage disorder resulting in vascular glycosphingolipid accumulation and increased stroke risk. MRI findings associated with FD include white matter hyperintensities (WMH) and cerebral microbleeds (CMBs), suggesting the presence of cerebral small vessel disease. MRI-visible perivascular spaces (PVS) are another promising marker of small vessel disease associated with impaired interstitial fluid drainage. We investigated the association of PVS severity and anatomical distribution with FD.
Patients and methods We compared patients with genetically proven FD to healthy controls. PVS, WMH, lacunes and CMBs were rated on standardised sequences using validated criteria and scales, blinded to diagnosis. A trained observer (using a validated rating scale), quantified the total severity of PVS. We used logistic regression to investigate the association of severe PVS with FD. Results We included 33 FD patients (median age 44, 44.1% male) and 20 healthy controls (median age 33.5, 50% male). Adjusting for age and sex, FD was associated with more severe basal ganglia PVS (odds ratio (OR) 5.80, 95% CI 1.03–32.7) and higher total PVS score (OR 4.03, 95% CI 1.36–11.89). Compared with controls, participants with FD had: higher WMH volume (median 495.03 mm3 vs 0, p = 0.0008), more CMBs (21.21% vs none, p = 0.04), and a higher prevalence of lacunes (21.21% vs. 5%, p = 0.23). Conclusions PVS scores are more severe in FD than control subjects. Our findings have potential relevance for FD diagnosis and suggest that impaired interstitial fluid drainage might be a mechanism of white matter injury in FD.
Collapse
Affiliation(s)
- D Lyndon
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, Institute of Neurology, Russell Square House, London, UK
| | - I Davagnanam
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK.
| | - D Wilson
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, Institute of Neurology, Russell Square House, London, UK.,New Zealand Brain Research Institute, Christchurch, New Zealand
| | - F Jichi
- Department of Biostatistics, University College of London, London, UK
| | - A Merwick
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, Institute of Neurology, Russell Square House, London, UK
| | - F Bolsover
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - H R Jager
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London, UK
| | - L Cipolotti
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - C Wheeler-Kingshott
- Department of Neuroinflammation Queen Square MS Centre, UCL Institute of Neurology, London, UK
| | - D Hughes
- Lysosomal Storage Disorders Unit, Royal Free Hospital, Rowland Hill Street, London, UK
| | - E Murphy
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - R Lachmann
- Charles Dent Metabolic Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - D J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, Institute of Neurology, Russell Square House, London, UK
| |
Collapse
|
2
|
Muhlert N, Sethi V, Ron M, Cipolotti L, Parker G, Haroon H, Yousry T, Wheeler-Kingshott C, Miller D, Chard D. IMPAIRED DECISION-MAKING AND DIFFUSION ORIENTATIONAL COMPLEXITY IN PEOPLE WITH MULTIPLE SCLEROSIS. Journal of Neurology, Neurosurgery & Psychiatry 2013. [DOI: 10.1136/jnnp-2013-306103.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
3
|
Stroman PW, Wheeler-Kingshott C, Bacon M, Schwab JM, Bosma R, Brooks J, Cadotte D, Carlstedt T, Ciccarelli O, Cohen-Adad J, Curt A, Evangelou N, Fehlings MG, Filippi M, Kelley BJ, Kollias S, Mackay A, Porro CA, Smith S, Strittmatter SM, Summers P, Tracey I. The current state-of-the-art of spinal cord imaging: methods. Neuroimage 2013; 84:1070-81. [PMID: 23685159 DOI: 10.1016/j.neuroimage.2013.04.124] [Citation(s) in RCA: 217] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 04/08/2013] [Accepted: 04/16/2013] [Indexed: 12/28/2022] Open
Abstract
A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small cross-sectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research.
Collapse
Affiliation(s)
- P W Stroman
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Stroman P, Bosma R, Kornelsen J, Lawrence-Dewar J, Wheeler-Kingshott C, Cadotte D, Fehlings M. Advanced MR imaging techniques and characterization of residual anatomy. Clin Neurol Neurosurg 2012; 114:460-70. [DOI: 10.1016/j.clineuro.2012.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 01/05/2012] [Indexed: 12/28/2022]
|
5
|
Sethi V, Yousry T, Muhlert N, Ron M, Golay X, Wheeler-Kingshott C, Miller D, Chard D. Improving the Detection of Grey Matter Lesions in MS Using MRI: A Comparison of Double Inversion Recovery and Phase Sensitive Inversion Recovery (S51.001). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s51.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|