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Derfuss T, Sastre-Garriga J, Montalban X, Rodegher M, Wuerfel J, Gaetano L, Tomic D, Azmon A, Wolf C, Kappos L. The ACROSS study: Long-term efficacy of fingolimod in patients with relapsing-remitting multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6:2055217320907951. [PMID: 32284874 PMCID: PMC7132565 DOI: 10.1177/2055217320907951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/03/2019] [Revised: 12/18/2019] [Accepted: 12/23/2019] [Indexed: 01/10/2023] Open
Abstract
Background In chronic diseases such as multiple sclerosis requiring lifelong treatment,
studies on long-term outcomes are important. Objective To assess disability and magnetic resonance imaging-related outcomes in
relapsing multiple sclerosis patients from a Phase 2 study of fingolimod 10
or more years after randomization and to compare outcomes in patients who
had a higher fingolimod exposure versus those with a lower fingolimod
exposure. Methods ACROSS was a cross-sectional follow-up study of patients originally enrolled
in a Phase 2 fingolimod proof-of-concept study (NCT00333138). Disability and
magnetic resonance imaging-related outcomes were assessed in patients
grouped according to fingolimod treatment duration, based on an arbitrary
cut-off: ≥8 years (high exposure) and <8 years (low exposure). Results Overall, 175/281 (62%) patients participated in ACROSS; 104 (59%) of these
were classified “high exposure.” At 10 years, patients in the high-exposure
group had smaller increases in Expanded Disability Status Scale (+0.55 vs.
+1.21), and lower frequencies of disability progression (34.7% vs. 56.1%),
wheelchair use (4.8% vs. 16.9%), or transition to secondary progressive
multiple sclerosis (9.6% vs. 22.5%) than those in the low-exposure group.
The high-exposure patients also had less progression in most magnetic
resonance imaging-related outcomes. Conclusion After 10 years of fingolimod treatment, disability progression was lower in
the high-exposure group than in the low-exposure group.
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Affiliation(s)
- T Derfuss
- Neurologic Clinic and Policlinic, University Hospital and University of Basel, Switzerland
| | - J Sastre-Garriga
- Multiple Sclerosis Centre of Catalonia (Cemcat), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - X Montalban
- Multiple Sclerosis Centre of Catalonia (Cemcat), Department of Neurology/Neuroimmunology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Division of Neurology, St Michael's Hospital, University of Toronto, Toronto, Canada
| | - M Rodegher
- MS Centre, IRCCS Santa Maria Nascente, Fondazione Don Carlo Gnocchi, via Capecelatro, Milan
| | | | - L Gaetano
- Medical Image Analysis Center Basel and Department of Biomedical Engineering, University Hospital, Switzerland
| | | | - A Azmon
- Novartis Pharma AG, Basel, Switzerland
| | | | - L Kappos
- Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research, Biomedicine and Biomedical Engineering, University Hospital and University of Basel, Basel, Switzerland
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2
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Yushchenko M, Sarracanie M, Amann M, Sinkus R, Wuerfel J, Salameh N. Remote palpation of the human brain with magnetic resonance imaging: protocol optimization for the study of glioblastoma. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- M. Yushchenko
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - M. Sarracanie
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Medical Image Analysis Center (MIAC) AG, Basel, Switzerland
| | - M. Amann
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Medical Image Analysis Center (MIAC) AG, Basel, Switzerland
| | - R. Sinkus
- Laboratory for Vascular Translational Science (LVTS), U1148, INSERM, Paris, France
| | - J. Wuerfel
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
- Medical Image Analysis Center (MIAC) AG, Basel, Switzerland
| | - N. Salameh
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
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3
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Sprenger T, Yamout B, Comi G, Lebrun-frenay C, Park M, Chinchilla D, Lincoln J, Kappos L, Radue E, Lublin A, Cavalier S, Thangavelu K, Wuerfel J. Investigating the Effect of Teriflunomide on Diffuse Brain Tissue Damage in the Phase 3 TEMSO Study. Mult Scler Relat Disord 2018. [DOI: 10.1016/j.msard.2018.10.088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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4
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Meyre P, Eggimann L, Beer J, Bonati L, Di Valentino M, Kuehne M, Monsch A, Moschovitis G, Aubert C, Shah D, Sticherling C, Stippich C, Wuerfel J, Mueller A, Osswald S. P4626Cognitive function correlates with CHA2DS2-VASc score in patients with atrial fibrillation: The Swiss atrial fibrillation cohort study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- P. Meyre
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - L. Eggimann
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - J.H. Beer
- University Hospital Zurich, Medicine, Zurich, Switzerland
| | - L.H. Bonati
- University Hospital Basel, Neurology Division and Stroke Center, Basel, Switzerland
| | - M. Di Valentino
- Hospital of San Giovanni, Cardiology, Bellinzona, Switzerland
| | - M. Kuehne
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - A. Monsch
- University of Basel, Memory Clinic, Felix Platter Hospital Basel, Basel, Switzerland
| | - G. Moschovitis
- Lugano Regional Hospital, Cardiology, Lugano, Switzerland
| | - C. Aubert
- Bern University Hospital, General Internal Medicine, Bern, Switzerland
| | - D. Shah
- Geneva University Hospitals, Cardiology, Geneva, Switzerland
| | - C. Sticherling
- University Hospital Basel, Cardiology, Basel, Switzerland
| | - C. Stippich
- University Hospital Basel, Neurology, Basel, Switzerland
| | - J. Wuerfel
- University Hospital Basel, Medical Image Analysis Center (MIAC AG), Basel, Switzerland
| | - A. Mueller
- Triemli Hospital, Cardiology, Zurich, Switzerland
| | - S. Osswald
- University Hospital Basel, Cardiology, Basel, Switzerland
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5
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Dusek P, Bahn E, Litwin T, Jabłonka-Salach K, Łuciuk A, Huelnhagen T, Madai VI, Dieringer MA, Bulska E, Knauth M, Niendorf T, Sobesky J, Paul F, Schneider SA, Czlonkowska A, Brück W, Wegner C, Wuerfel J. Brain iron accumulation in Wilson disease: apost mortem7 Tesla MRI - histopathological study. Neuropathol Appl Neurobiol 2016; 43:514-532. [DOI: 10.1111/nan.12341] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/18/2016] [Accepted: 08/20/2016] [Indexed: 12/12/2022]
Affiliation(s)
- P. Dusek
- Institute of Neuroradiology; University Medical Center Göttingen; Göttingen Germany
- Department of Neurology and Center of Clinical Neuroscience; 1 Faculty of Medicine and General University Hospital in Prague; Charles University in Prague; Praha Czech Republic
| | - E. Bahn
- Institute of Neuropathology; University Medical Center Göttingen; Göttingen Germany
| | - T. Litwin
- 2 Department of Neurology; Institute Psychiatry and Neurology; Warsaw Poland
| | - K. Jabłonka-Salach
- Faculty of Chemistry; Biological and Chemical Research Centre; University of Warsaw; Warsaw Poland
| | - A. Łuciuk
- Faculty of Chemistry; Biological and Chemical Research Centre; University of Warsaw; Warsaw Poland
| | - T. Huelnhagen
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max-Delbrück Center for Molecular Medicine in the Helmholtz Association; Berlin Germany
| | - V. I. Madai
- Department of Neurology and Center for Stroke Research Berlin (CSB); Charité-Universitätsmedizin; Berlin Germany
| | - M. A. Dieringer
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max-Delbrück Center for Molecular Medicine in the Helmholtz Association; Berlin Germany
- Experimental and Clinical Research Center (ECRC); Charité-Universitätsmedizin and Max Delbrück Center for Molecular Medicine (MDC); Berlin Germany
| | - E. Bulska
- Faculty of Chemistry; Biological and Chemical Research Centre; University of Warsaw; Warsaw Poland
| | - M. Knauth
- Institute of Neuroradiology; University Medical Center Göttingen; Göttingen Germany
| | - T. Niendorf
- Berlin Ultrahigh Field Facility (B.U.F.F.); Max-Delbrück Center for Molecular Medicine in the Helmholtz Association; Berlin Germany
- Experimental and Clinical Research Center (ECRC); Charité-Universitätsmedizin and Max Delbrück Center for Molecular Medicine (MDC); Berlin Germany
| | - J. Sobesky
- Department of Neurology and Center for Stroke Research Berlin (CSB); Charité-Universitätsmedizin; Berlin Germany
- Experimental and Clinical Research Center (ECRC); Charité-Universitätsmedizin and Max Delbrück Center for Molecular Medicine (MDC); Berlin Germany
| | - F. Paul
- Experimental and Clinical Research Center (ECRC); Charité-Universitätsmedizin and Max Delbrück Center for Molecular Medicine (MDC); Berlin Germany
- NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center; Department of Neurology; Charité-Universitätsmedizin; Berlin Germany
| | - S. A. Schneider
- Neurology Department; University of Kiel; Kiel Germany
- Department of Neurology; Ludwig-Maximilians-University; Munich Germany
| | - A. Czlonkowska
- 2 Department of Neurology; Institute Psychiatry and Neurology; Warsaw Poland
- Department of Experimental and Clinical Pharmacology; Medical University; Warsaw Poland
| | - W. Brück
- Institute of Neuropathology; University Medical Center Göttingen; Göttingen Germany
| | - C. Wegner
- Institute of Neuropathology; University Medical Center Göttingen; Göttingen Germany
| | - J. Wuerfel
- Institute of Neuroradiology; University Medical Center Göttingen; Göttingen Germany
- NeuroCure Clinical Research Center and Clinical and Experimental Multiple Sclerosis Research Center; Department of Neurology; Charité-Universitätsmedizin; Berlin Germany
- Medical Imaging Analysis Center AG; Basel Switzerland
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6
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Chawla S, Kister I, Wuerfel J, Brisset JC, Liu S, Sinnecker T, Dusek P, Haacke EM, Paul F, Ge Y. Iron and Non-Iron-Related Characteristics of Multiple Sclerosis and Neuromyelitis Optica Lesions at 7T MRI. AJNR Am J Neuroradiol 2016; 37:1223-30. [PMID: 27012298 DOI: 10.3174/ajnr.a4729] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 01/01/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND PURPOSE Characterization of iron deposition associated with demyelinating lesions of multiple sclerosis and neuromyelitis optica has not been well studied. Our aim was to investigate the potential of ultra-high-field MR imaging to distinguish MS from neuromyelitis optica and to characterize tissue injury associated with iron pathology within lesions. MATERIALS AND METHODS Twenty-one patients with MS and 21 patients with neuromyelitis optica underwent 7T high-resolution 2D-gradient-echo-T2* and 3D-susceptibility-weighted imaging. An in-house-developed algorithm was used to reconstruct quantitative susceptibility mapping from SWI. Lesions were classified as "iron-laden" if they demonstrated hypointensity on gradient-echo-T2*-weighted images and/or SWI and hyperintensity on quantitative susceptibility mapping. Lesions were considered "non-iron-laden" if they were hyperintense on gradient-echo-T2* and isointense or hyperintense on quantitative susceptibility mapping. RESULTS Of 21 patients with MS, 19 (90.5%) demonstrated at least 1 quantitative susceptibility mapping-hyperintense lesion, and 11/21 (52.4%) had iron-laden lesions. No quantitative susceptibility mapping-hyperintense or iron-laden lesions were observed in any patients with neuromyelitis optica. Iron-laden and non-iron-laden lesions could each be further characterized into 2 distinct patterns based on lesion signal and morphology on gradient-echo-T2*/SWI and quantitative susceptibility mapping. In MS, most lesions (n = 262, 75.9% of all lesions) were hyperintense on gradient-echo T2* and isointense on quantitative susceptibility mapping (pattern A), while a small minority (n = 26, 7.5% of all lesions) were hyperintense on both gradient-echo-T2* and quantitative susceptibility mapping (pattern B). Iron-laden lesions (n = 57, 16.5% of all lesions) were further classified as nodular (n = 22, 6.4%, pattern C) or ringlike (n = 35, 10.1%, pattern D). CONCLUSIONS Ultra-high-field MR imaging may be useful in distinguishing MS from neuromyelitis optica. Different patterns related to iron and noniron pathology may provide in vivo insight into the pathophysiology of lesions in MS.
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Affiliation(s)
- S Chawla
- From the Department of Radiology (S.C., J.-C.B., Y.G.), Center for Advanced Imaging Innovation and Research and Bernard and Irene Schwartz Center for Biomedical Imaging Department of Radiology (S.C.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - I Kister
- Department of Neurology (I.K.), New York University School of Medicine, New York, New York
| | - J Wuerfel
- NeuroCure (J.W., T.S., F.P.), Charité University Medicine, Berlin, Germany Institute of Neuroradiology (J.W., P.D.), Universitätsmedizin Göttingen, Göttingen, Germany Medical Image Analysis Center (J.W.), Basel, Switzerland
| | - J-C Brisset
- From the Department of Radiology (S.C., J.-C.B., Y.G.), Center for Advanced Imaging Innovation and Research and Bernard and Irene Schwartz Center for Biomedical Imaging
| | - S Liu
- Department of Radiology (S.L., E.M.H.), Wayne State University School of Medicine, Detroit, Michigan
| | - T Sinnecker
- NeuroCure (J.W., T.S., F.P.), Charité University Medicine, Berlin, Germany
| | - P Dusek
- Institute of Neuroradiology (J.W., P.D.), Universitätsmedizin Göttingen, Göttingen, Germany Department of Neurology and Center of Clinical Neuroscience (P.D.), Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic
| | - E M Haacke
- Department of Radiology (S.L., E.M.H.), Wayne State University School of Medicine, Detroit, Michigan
| | - F Paul
- NeuroCure (J.W., T.S., F.P.), Charité University Medicine, Berlin, Germany
| | - Y Ge
- From the Department of Radiology (S.C., J.-C.B., Y.G.), Center for Advanced Imaging Innovation and Research and Bernard and Irene Schwartz Center for Biomedical Imaging
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7
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Bennett JL, de Seze J, Lana-Peixoto M, Palace J, Waldman A, Schippling S, Tenembaum S, Banwell B, Greenberg B, Levy M, Fujihara K, Chan KH, Kim HJ, Asgari N, Sato DK, Saiz A, Wuerfel J, Zimmermann H, Green A, Villoslada P, Paul F. Neuromyelitis optica and multiple sclerosis: Seeing differences through optical coherence tomography. Mult Scler 2015; 21:678-88. [PMID: 25662342 PMCID: PMC4425816 DOI: 10.1177/1352458514567216] [Citation(s) in RCA: 175] [Impact Index Per Article: 19.4] [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: 11/02/2014] [Accepted: 11/27/2014] [Indexed: 01/12/2023]
Abstract
Neuromyelitis optica (NMO) is an inflammatory autoimmune disease of the central nervous system that preferentially targets the optic nerves and spinal cord. The clinical presentation may suggest multiple sclerosis (MS), but a highly specific serum autoantibody against the astrocytic water channel aquaporin-4 present in up to 80% of NMO patients enables distinction from MS. Optic neuritis may occur in either condition resulting in neuro-anatomical retinal changes. Optical coherence tomography (OCT) has become a useful tool for analyzing retinal damage both in MS and NMO. Numerous studies showed that optic neuritis in NMO typically results in more severe retinal nerve fiber layer (RNFL) and ganglion cell layer thinning and more frequent development of microcystic macular edema than in MS. Furthermore, while patients’ RNFL thinning also occurs in the absence of optic neuritis in MS, subclinical damage seems to be rare in NMO. Thus, OCT might be useful in differentiating NMO from MS and serve as an outcome parameter in clinical studies.
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Affiliation(s)
- J L Bennett
- Departments of Neurology and Ophthalmology, University of Colorado, Denver, Colorado, USA
| | - J de Seze
- Neurology Service, University Hospital of Strasbourg, France
| | - M Lana-Peixoto
- CIEM MS Research Center, University of Minas Gerais Medical School, Belo Horizonte Brazil
| | - J Palace
- Department of Neurology, Oxford University Hospitals National Health Service Trust, Oxford, UK
| | - A Waldman
- Division of Neurology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, USA
| | - S Schippling
- Neuroimmunology and Multiple Sclerosis Research Section, Department of Neurology, University Hospital Zürich, Switzerland
| | - S Tenembaum
- Department of Neurology, National Pediatric Hospital Dr Juan P. Garrahan, Buenos Aires, Argentina
| | - B Banwell
- Division of Neurology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, USA
| | - B Greenberg
- Departments of Neurology & Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Texas, USA
| | - M Levy
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland USA
| | - K Fujihara
- Department of Multiple Sclerosis Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - K H Chan
- University Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - H J Kim
- Research Institute and Hospital of National Cancer Center Goyang Republic of Korea
| | - N Asgari
- Institute of Molecular Medicine, University of Southern Denmark, and Department of Neurology, Vejle Hospital, Odense, Denmark
| | - D K Sato
- Department of Neurology, Tohoku University School of Medicine, Sendai, Japan
| | - A Saiz
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institute of Biomedical Research August Pi Sunyer, Barcelona, Spain
| | - J Wuerfel
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, and Institute of Interventional and Diagnostic Neuroradiology, University Medicine Göttingen, Germany
| | - H Zimmermann
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Germany
| | - A Green
- Multiple Sclerosis Center, UCSF Department of Neurology and Neuro-ophthalmology Service, UCSF Department of Ophthalmology, San Francisco, USA
| | - P Villoslada
- Center of Neuroimmunology, Service of Neurology, Hospital Clinic and Institute of Biomedical Research August Pi Sunyer, Barcelona, Spain
| | - F Paul
- NeuroCure Clinical Research and Department of Neurology, Charité - Universitätsmedizin Berlin and Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
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8
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Kuchling J, Sinnecker T, Bozin I, Dörr J, Madai VI, Sobesky J, Niendorf T, Paul F, Wuerfel J. [Ultrahigh field MRI in context of neurological diseases]. Nervenarzt 2014; 85:445-58. [PMID: 24549692 DOI: 10.1007/s00115-013-3967-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ultrahigh field magnetic resonance imaging (UHF-MRI) has recently gained substantial scientific interest. At field strengths of 7 Tesla (T) and higher UHF-MRI provides unprecedented spatial resolution due to an increased signal-to-noise ratio (SNR). The UHF-MRI method has been successfully applied in various neurological disorders. In neuroinflammatory diseases UHF-MRI has already provided a detailed insight into individual pathological disease processes and elucidated differential diagnoses of several disease entities, e.g. multiple sclerosis (MS), neuromyelitis optica (NMO) and Susac's syndrome. The excellent depiction of normal blood vessels, vessel abnormalities and infarct morphology by UHF-MRI can be utilized in vascular diseases. Detailed imaging of the hippocampus in Alzheimer's disease and the substantia nigra in Parkinson's disease as well as sensitivity to iron depositions could be valuable in neurodegenerative diseases. Current UHF-MRI studies still suffer from small sample sizes, selection bias or propensity to image artefacts. In addition, the increasing clinical relevance of 3T-MRI has not been sufficiently appreciated in previous studies. Although UHF-MRI is only available at a small number of medical research centers it could provide a high-end diagnostic tool for healthcare optimization in the foreseeable future. The potential of UHF-MRI still has to be carefully validated by profound prospective research to define its place in future medicine.
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Affiliation(s)
- J Kuchling
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland
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9
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Finke C, Schlichting J, Papazoglou S, Scheel M, Freing A, Soemmer C, Pech LM, Pajkert A, Pfüller C, Wuerfel JT, Ploner CJ, Paul F, Brandt AU. Altered basal ganglia functional connectivity in multiple sclerosis patients with fatigue. Mult Scler 2014; 21:925-34. [DOI: 10.1177/1352458514555784] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 09/21/2014] [Indexed: 12/23/2022]
Abstract
Background: Fatigue is one of the most frequent and disabling symptoms in multiple sclerosis, but its pathophysiological mechanisms are poorly understood. It is in particular unclear whether and how fatigue relates to structural and functional brain changes. Objective: We aimed to analyse the association of fatigue severity with basal ganglia functional connectivity, basal ganglia volumes, white matter integrity and grey matter density. Methods: In 44 patients with relapsing–remitting multiple sclerosis and 20 age- and gender-matched healthy controls, resting-state fMRI, diffusion tensor imaging and voxel-based morphometry was performed. Results: In comparison with healthy controls, patients showed alteration of grey matter density, white matter integrity, basal ganglia volumes and basal ganglia functional connectivity. No association of fatigue severity with grey matter density, white matter integrity and basal ganglia volumes was observed within patients. In contrast, fatigue severity was negatively correlated with functional connectivity of basal ganglia nuclei with medial prefrontal cortex, precuneus and posterior cingulate cortex in patients. Furthermore, fatigue severity was positively correlated with functional connectivity between caudate nucleus and motor cortex. Conclusion: Fatigue is associated with distinct alterations of basal ganglia functional connectivity independent of overall disability. The pattern of connectivity changes suggests that disruption of motor and non-motor basal ganglia functions, including motivation and reward processing, contributes to fatigue pathophysiology in multiple sclerosis.
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Affiliation(s)
- C Finke
- Department of Neurology, Charité – Universitätsmedizin Berlin, Germany/Equal contribution
| | - J Schlichting
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany/Equal contribution
| | - S Papazoglou
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany
| | - M Scheel
- Department of Radiology, Charité – Universitätsmedizin Berlin, Germany
| | - A Freing
- Department of Neuroradiology, Universitätsmedizin Göttingen, Germany
| | - C Soemmer
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany
| | - LM Pech
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany
| | - A Pajkert
- Department of Neurology, Charité – Universitätsmedizin Berlin, Germany
| | - C Pfüller
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany
| | - JT Wuerfel
- Department of Neuroradiology, Universitätsmedizin Göttingen, Germany
| | - CJ Ploner
- Department of Neurology, Charité – Universitätsmedizin Berlin, Germany
| | - F Paul
- Department of Neurology, Charité – Universitätsmedizin Berlin, Germany/NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany
| | - AU Brandt
- NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, Germany
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10
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Sinnecker T, Dorr J, Pfueller CF, Harms L, Ruprecht K, Jarius S, Bruck W, Niendorf T, Wuerfel J, Paul F. Distinct lesion morphology at 7-T MRI differentiates neuromyelitis optica from multiple sclerosis. Neurology 2012; 79:708-14. [DOI: 10.1212/wnl.0b013e3182648bc8] [Citation(s) in RCA: 153] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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11
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Neumann A, Wuerfel J, Hunold P. [Wedge-shaped vertebra-an unusual complication of the pathomechanical cascade of ankylosing spondylitis-osteoporosis-vertebral body fraction]. ROFO-FORTSCHR RONTG 2011; 183:564-6. [PMID: 21442565 DOI: 10.1055/s-0031-1273279] [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: 10/18/2022]
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12
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Brüggemann N, Wuerfel J, Petersen D, Klein C, Hagenah J, Schneider SA. Idiopathic NBIA - clinical spectrum and transcranial sonography findings. Eur J Neurol 2011; 18:e58-9. [DOI: 10.1111/j.1468-1331.2010.03298.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Steindl K, Alazami AM, Bhatia KP, Wuerfel JT, Petersen D, Cartolari R, Neri G, Klein C, Mongiardo B, Alkuraya FS, Schneider SA. A novel C2orf37 mutation causes the first Italian cases of Woodhouse Sakati syndrome. Clin Genet 2010; 78:594-7. [DOI: 10.1111/j.1399-0004.2010.01447.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Bellmann-Strobl J, Wuerfel J, Aktas O, Dorr J, Wernecke KD, Zipp F, Paul F. Poor PASAT performance correlates with MRI contrast enhancement in multiple sclerosis. Neurology 2009; 73:1624-7. [DOI: 10.1212/wnl.0b013e3181c1de4f] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Weygandt M, Hackmack K, Zipp F, Wuerfel J, Paul F, Haynes JD. Fully Automated Diagnosis of Multiple Sclerosis based on Pattern Recognition Methods. Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70227-7] [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: 11/27/2022] Open
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Bellmann-Strobl J, Stiepani H, Wuerfel J, Bohner G, Paul F, Warmuth C, Aktas O, Wandinger KP, Zipp F, Klingebiel R. MR spectroscopy (MRS) and magnetisation transfer imaging (MTI), lesion load and clinical scores in early relapsing remitting multiple sclerosis: a combined cross-sectional and longitudinal study. Eur Radiol 2009; 19:2066-74. [PMID: 19308417 DOI: 10.1007/s00330-009-1364-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2008] [Revised: 01/12/2009] [Accepted: 01/21/2009] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to correlate magnetic resonance imaging (MRI)-based lesion load assessment with clinical disability in early relapsing remitting multiple sclerosis (RRMS). Seventeen untreated patients (ten women, seven men; mean age 33.0 +/- 7.9 years) with the initial diagnosis of RRMS were included for cross-sectional as well as longitudinal (24 months) clinical and MRI-based assessment in comparison with age-matched healthy controls. Conventional MR sequences, MR spectroscopy (MRS) and magnetisation transfer imaging (MTI) were performed at 1.5 T. Lesion number and volume, MRS and MTI measurements for lesions and normal appearing white matter (NAWM) were correlated to clinical scores [Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC)] for monitoring disease course after treatment initiation (interferon beta-1a). MTI and MRS detected changes [magnetisation transfer ratio (MTR), N-acetylaspartate (NAA)/creatine ratio] in NAWM over time. EDSS and lesional MTR increases correlated throughout the disease course. Average MTR of NAWM raised during the study (p < 0.05) and correlated to the MSFC score (r = 0.476, p < 0.001). At study termination, NAA/creatine ratio of NAWM correlated to the MSFC score (p < 0.05). MTI and MRS were useful for initial disease assessment in NAWM. MTI and MRS correlated with clinical scores, indicating potential for monitoring the disease course and gaining new insights into treatment-related effects.
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Affiliation(s)
- J Bellmann-Strobl
- Cecilie Vogt Clinic for Neurology, Charité-University Medicine Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany
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Wuerfel J, Beierbach B, Paul F, Klatt D, Hamhaber U, Papazoglou S, Braun J, Petersen D, Sack I. MR-Elastografie des Gehirns – Erste Untersuchungen an Patienten mit Multipler Sklerose. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1208357] [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: 10/21/2022]
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Wuerfel J, Asbach P, Tysiak E, Taupitz M, Aktas O, Zipp F. Diffuse Blut-Hirn-Schrankenstörung in MRT-Verlaufsuntersuchungen eines Mausmodells der Multiplen Sklerose (aktive experimentelle autoimmune Enzephalomyelitis, EAE) - mögliche Abweichung von Eintrittspforte und Entzündungsherd. Akt Neurol 2005. [DOI: 10.1055/s-2005-919601] [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: 10/26/2022]
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Wuerfel J, Krishnamoorthy ES, Brown RJ, Lemieux L, Koepp M, Tebartz van Elst L, Trimble MR. Religiosity is associated with hippocampal but not amygdala volumes in patients with refractory epilepsy. J Neurol Neurosurg Psychiatry 2004; 75:640-2. [PMID: 15026516 PMCID: PMC1739034 DOI: 10.1136/jnnp.2003.06973] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess the relationship between the behavioural triad of hyper-religiosity, hypergraphia and hyposexuality in epilepsy, and volumes of the mesial temporal structures. METHOD Magnetic resonance images were obtained from 33 patients with refractory epilepsy and mesial temporal structure volumes assessed. Amygdala and hippocampal volumes were then compared in high and low scorers on the religiosity, writing, and sexuality sub-scales of the Neurobehavioural Inventory. RESULTS Patients with high ratings on the religiosity scale had significantly smaller right hippocampi. Religiosity scores rated by both patient and carer showed a significant negative correlation with right hippocampal volumes in this group. There were no other differences in amygdala or hippocampal volumes between these groups, or between high and low scorers on the writing and sexuality sub-scales. CONCLUSIONS These findings suggest that right hippocampal volumes are negatively correlated with religiosity in patients with refractory epilepsy.
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Affiliation(s)
- J Wuerfel
- Raymond Way Neuropsychiatry Research Group, University Department of Clinical Neurology, Institute of Neurology, Queen Square, London, UK
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