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Reiländer A, Engel M, Nöth U, Deichmann R, Shrestha M, Wagner M, Gracien RM, Seiler A. Cortical microstructural involvement in cerebral small vessel disease. Cereb Circ Cogn Behav 2024; 6:100218. [PMID: 38510580 PMCID: PMC10951897 DOI: 10.1016/j.cccb.2024.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Background In cerebral small vessel disease (CSVD), cortical atrophy occurs at a later stage compared to microstructural abnormalities and therefore cannot be used for monitoring short-term disease progression. We aimed to investigate whether cortical diffusion tensor imaging (DTI) and quantitative (q) magnetic resonance imaging (MRI) are able to detect early microstructural involvement of the cerebral cortex in CSVD. Materials and Methods 33 CSVD patients without significant cortical or whole-brain atrophy and 16 healthy control subjects were included and underwent structural MRI, DTI and high-resolution qMRI with T2, T2* and T2' mapping at 3 T as well as comprehensive cognitive assessment. After tissue segmentation and reconstruction of the cortical boundaries with the Freesurfer software, DTI and qMRI parameters were saved as surface datasets and averaged across all vertices. Results Cortical diffusivity and quantitative T2 values were significantly increased in patients compared to controls (p < 0.05). T2 values correlated significantly positively with white matter hyperintensity (WMH) volume (p < 0.01). Both cortical diffusivity and T2 showed significant negative associations with axonal damage to the white matter fiber tracts (p < 0.05). Conclusions Cortical diffusivity and quantitative T2 mapping are suitable to detect microstructural involvement of the cerebral cortex in CSVD and represent promising imaging biomarkers for monitoring disease progression and effects of therapeutical interventions in clinical studies.
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Affiliation(s)
- Annemarie Reiländer
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Marlene Engel
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Manoj Shrestha
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Marlies Wagner
- Brain Imaging Center, Goethe University, Frankfurt, Germany
- Institute of Neuroradiology, Goethe University Hospital, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Alexander Seiler
- Brain Imaging Center, Goethe University, Frankfurt, Germany
- Department of Neurology, University Hospital Schleswig-Holstein, Kiel, Germany
- Neurovascular Center, University Hospital Schleswig-Holstein, Kiel, Germany
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Maiworm M, Hamid C, Wagner M, Nöth U, Deichmann R, Seiler A, Gracien RM. Multiparametric quantitative MRI reveals progressive cortical damage over time in clinically stable relapsing-remitting MS. J Neurol Neurosurg Psychiatry 2023; 94:786-791. [PMID: 37169544 DOI: 10.1136/jnnp-2022-330894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/17/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND In relapsing-remitting multiple sclerosis (RRMS), cortical grey matter pathology relevantly contributes to long-term disability. Still, diffuse cortical inflammation cannot be detected with conventional MRI. OBJECTIVE We aimed to assess microstructural damage of cortical grey matter over time and the relation to clinical disability as well as relapse activity in patients with RRMS using multiparametric quantitative (q)MRI techniques. METHODS On 40 patients with RRMS and 33 age-matched and sex-matched healthy controls, quantitative T1, T2, T2* and proton density (PD) mapping was performed at baseline and follow-up after 2 years. Cortical qMRI parameter values were extracted with the FreeSurfer software using a surface-based approach. QMRI parameters, cortical thickness and white matter lesion (WML) load, as well as Expanded Disability Status Scale (EDSS) and relapse rate, were compared between time points. RESULTS Over 2 years, significant increases of T1 (p≤0.001), PD (p≤0.001) and T2 (p=0.005) values were found in the patient, but not in the control group. At decreased relapse rate over time (p=0.001), cortical thickness, WML volume and EDSS remained unchanged. CONCLUSION Despite clinical stability, cortical T1, T2 and PD values increased over time, indicating progressive demyelination and increasing water content. These parameters represent promising surrogate parameters of diffuse cortical inflammation in RRMS.
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Affiliation(s)
- Michelle Maiworm
- Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Celona Hamid
- Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Marlies Wagner
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Alexander Seiler
- Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - René-Maxime Gracien
- Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt am Main, Germany
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3
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Hamid C, Maiworm M, Wagner M, Knake S, Nöth U, Deichmann R, Gracien RM, Seiler A. Focal epilepsy without overt epileptogenic lesions: no evidence of microstructural brain tissue damage in multi-parametric quantitative MRI. Front Neurol 2023; 14:1175971. [PMID: 37528856 PMCID: PMC10389268 DOI: 10.3389/fneur.2023.1175971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/03/2023] [Indexed: 08/03/2023] Open
Abstract
Background and purpose In patients with epilepsies of structural origin, brain atrophy and pathological alterations of the tissue microstructure extending beyond the putative epileptogenic lesion have been reported. However, in patients without any evidence of epileptogenic lesions on diagnostic magnetic resonance imaging (MRI), impairment of the brain microstructure has been scarcely elucidated. Using multiparametric quantitative (q) magnetic resonance imaging MRI, we aimed to investigate diffuse impairment of the microstructural tissue integrity in MRI-negative focal epilepsy patients. Methods 27 MRI-negative patients with focal epilepsy (mean age 33.1 ± 14.2 years) and 27 matched healthy control subjects underwent multiparametric qMRI including T1, T2, and PD mapping at 3 T. After tissue segmentation based on synthetic anatomies, mean qMRI parameter values were extracted from the cerebral cortex, the white matter (WM) and the deep gray matter (GM) and compared between patients and control subjects. Apart from calculating mean values for the qMRI parameters across the respective compartments, voxel-wise analyses were performed for each tissue class. Results There were no significant differences for mean values of quantitative T1, T2, and PD obtained from the cortex, the WM and the deep GM between the groups. Furthermore, the voxel-wise analyses did not reveal any clusters indicating significant differences between patients and control subjects for the qMRI parameters in the respective compartments. Conclusions Based on the employed methodology, no indication for an impairment of the cerebral microstructural tissue integrity in MRI-negative patients with focal epilepsy was found in this study. Further research will be necessary to identify relevant factors and mechanisms contributing to microstructural brain tissue damage in various subgroups of patients with epilepsy.
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Affiliation(s)
- Celona Hamid
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt, Germany
| | - Michelle Maiworm
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Marlies Wagner
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt, Germany
- Institute of Neuroradiology, Goethe University Hospital, Frankfurt, Germany
| | - Susanne Knake
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt, Germany
- Epilepsy Center Hessen and Department of Neurology, Philipps-University Marburg, Marburg, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Frankfurt, Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University Hospital, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
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Reiländer A, Pilatus U, Schüre JR, Shrestha M, Deichmann R, Nöth U, Hattingen E, Gracien RM, Wagner M, Seiler A. Impaired oxygen extraction and adaptation of intracellular energy metabolism in cerebral small vessel disease. Cereb Circ Cogn Behav 2023; 4:100162. [PMID: 36851996 PMCID: PMC9957754 DOI: 10.1016/j.cccb.2023.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/25/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND We aimed to investigate whether combined phosphorous (31P) magnetic resonance spectroscopic imaging (MRSI) and quantitative T 2 ' mapping are able to detect alterations of the cerebral oxygen extraction fraction (OEF) and intracellular pH (pHi) as markers the of cellular energy metabolism in cerebral small vessel disease (SVD). MATERIALS AND METHODS 32 patients with SVD and 17 age-matched healthy control subjects were examined with 3-dimensional 31P MRSI and oxygenation-sensitive quantitative T 2 ' mapping (1/ T 2 ' = 1/T2* - 1/T2) at 3 Tesla (T). PHi was measured within the white matter hyperintensities (WMH) in SVD patients. Quantitative T 2 ' values were averaged across the entire white matter (WM). Furthermore, T 2 ' values were extracted from normal-appearing WM (NAWM) and the WMH and compared between patients and controls. RESULTS Quantitative T 2 ' values were significantly increased across the entire WM and in the NAWM in patients compared to control subjects (149.51 ± 16.94 vs. 138.19 ± 12.66 ms and 147.45 ± 18.14 vs. 137.99 ± 12.19 ms, p < 0.05). WM T 2 ' values correlated significantly with the WMH load (ρ=0.441, p = 0.006). Increased T 2 ' was significantly associated with more alkaline pHi (ρ=0.299, p < 0.05). Both T 2 ' and pHi were significantly positively correlated with vascular pulsatility in the distal carotid arteries (ρ=0.596, p = 0.001 and ρ=0.452, p = 0.016). CONCLUSIONS This exploratory study found evidence of impaired cerebral OEF in SVD, which is associated with intracellular alkalosis as an adaptive mechanism. The employed techniques provide new insights into the pathophysiology of SVD with regard to disease-related consequences on the cellular metabolic state.
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Key Words
- BBB, blood-brain barrier
- CBF, cerebral blood flow
- CBV, cerebral blood volume
- CMRO2, Cerebral metabolic rate of oxygen
- Cellular energy metabolism
- DTI, diffusion tensor imaging
- GE, gradient echo
- Hb, hemoglobin
- ICA, internal carotid artery
- MR spectroscopy
- MRI, magnetic resonance imaging
- MRS, magnetic resonance spectroscopy
- MRSI, magnetic resonance spectroscopic imaging
- Microstructural impairment
- NAWM, normal-appearing white matter
- OEF, oxygen extraction fraction
- Oxygen extraction fraction
- PI, Pulsatility index
- RF, radio frequency
- SVD, cerebral small vessel disease
- Small vessel disease
- TR, repetition time
- WM, white matter
- WMH, white matter hyperintensities
- pHi, intracellular pH
- quantitative MRI
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Affiliation(s)
- Annemarie Reiländer
- Department of Neurology, Goethe University Hospital Frankfurt, Schleusenweg 2-16, Frankfurt 60528, Germany
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Ulrich Pilatus
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Jan-Rüdiger Schüre
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Manoj Shrestha
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Hospital Frankfurt, Schleusenweg 2-16, Frankfurt 60528, Germany
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Marlies Wagner
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
- Institute of Neuroradiology, Goethe University Hospital Frankfurt, Frankfurt Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University Hospital Frankfurt, Schleusenweg 2-16, Frankfurt 60528, Germany
- Brain Imaging Center, Goethe University Hospital Frankfurt, Frankfurt Germany
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5
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Brandhofe A, Stratmann C, Schüre JR, Pilatus U, Hattingen E, Deichmann R, Nöth U, Wagner M, Gracien RM, Seiler A. T 2 relaxation time of the normal-appearing white matter is related to the cognitive status in cerebral small vessel disease. J Cereb Blood Flow Metab 2021; 41:1767-1777. [PMID: 33327818 PMCID: PMC8221761 DOI: 10.1177/0271678x20972511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Previous diffusion tensor imaging (DTI) studies indicate that impaired microstructural integrity of the normal-appearing white matter (NAWM) is related to cognitive impairment in cerebral small vessel disease (SVD). This study aimed to investigate whether quantitative T2 relaxometry is a suitable imaging biomarker for the assessment of tissue changes related to cognitive abnormalities in patients with SVD. 39 patients and 18 age-matched healthy control subjects underwent 3 T magnetic resonance imaging (MRI) with T2-weighted multiple spin echo sequences for T2 relaxometry and DTI sequences, as well as comprehensive cognitive assessment. Averaged quantitative T2, fractional anisotropy (FA) and mean diffusivity (MD) were determined in the NAWM and related to cognitive parameters controlling for age, normalized brain volume, white matter hyperintensity volume and other conventional SVD markers. In SVD patients, quantitative T2 values were significantly increased compared to controls (p = 0.002) and significantly negatively correlated with the global cognitive performance (r= -0.410, p = 0.014) and executive function (r= -0.399, p = 0.016). DTI parameters did not correlate with cognitive function. T2 relaxometry of the NAWM seems to be sensitive to microstructural tissue damage associated with cognitive impairment in SVD and might be a promising imaging biomarker for evaluation of disease progression and possible effects of therapeutic interventions.
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Affiliation(s)
- Annemarie Brandhofe
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Christoph Stratmann
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.,Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Jan-Rüdiger Schüre
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Ulrich Pilatus
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Marlies Wagner
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
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Menzler K, Hamer HM, Mross P, Rosenow F, Deichmann R, Wagner M, Gracien RM, Doerfler A, Bluemcke I, Coras R, Belke M, Knake S. Validation of automatic MRI hippocampal subfield segmentation by histopathological evaluation in patients with temporal lobe epilepsy. Seizure 2021; 87:94-102. [PMID: 33752160 DOI: 10.1016/j.seizure.2021.03.007] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE The present study validates the results of automated hippocampal subfield segmentation with histopathology in epilepsy patients undergoing epilepsy surgery. METHODS We performed an automated hippocampal subfield segmentation on presurgical three-dimensional, T1-weighted magnetization Prepared Rapid Acquisition of Gradient Echoes Magnetic Resonance Imaging (MRI) data of 25 patients with unilateral mesial temporal lobe epilepsy due to hippocampal sclerosis (HS), using Freesurfer Version 6.0. The resulting volumes of cornu ammonis (CA) subfields CA1, CA2/3, CA4 and the dentate gyrus (DG) were compared to the histopathological cell count. RESULTS We found a significant correlation between histopathology in subregion CA2 and automated segmentation of subregion CA1 (p = 0.0062), CA2/3 (p = 0.004), CA4 (p = 0.0062) and the DG (p = 0.0054), between histopathology in CA3 and automated segmentation of CA1 (p = 0.0132), CA2/3 (p = 0.0004), CA4 (p = 0.0032) and the DG (p = 0.0037), as well as between histopathology in the DG and automated segmentation of CA1 (p = 0.0115), CA2/3 (p < 0.0001), CA4 (p < 0.0001) and the DG (p = 0.0001). The histopathological finding of HS type 1 could correctly be classified in all cases on MRI. SIGNIFICANCE The present study shows significant correlations between histopathological evaluation and results of the automated segmentation of the hippocampus, thereby validating the automated segmentation method. As the differential involvement of different hippocampal subfields may be associated with clinical parameters and the outcome after epilepsy surgery, the automated segmentation is also promising for prognostic purposes.
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Affiliation(s)
- Katja Menzler
- Epilepsy Center Hessen, Philipps-University Marburg, Department of Neurology, Baldingerstrasse, 35043, Marburg, Germany.
| | - Hajo M Hamer
- Epilepsy Center, University Hospital Erlangen, Erlangen, Germany
| | - Peter Mross
- Epilepsy Center Hessen, Philipps-University Marburg, Department of Neurology, Baldingerstrasse, 35043, Marburg, Germany
| | - Felix Rosenow
- Epilepsy Center Hessen, Philipps-University Marburg, Department of Neurology, Baldingerstrasse, 35043, Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany; Department of Neurology, Goethe University, Frankfurt/Main, Germany
| | - Ralf Deichmann
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany; Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Marlies Wagner
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany; Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany
| | - René-Maxime Gracien
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany; Department of Neurology, Goethe University, Frankfurt/Main, Germany; Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Ingmar Bluemcke
- Institute of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Roland Coras
- Institute of Neuropathology, University Hospital Erlangen, Erlangen, Germany
| | - Marcus Belke
- Epilepsy Center Hessen, Philipps-University Marburg, Department of Neurology, Baldingerstrasse, 35043, Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, Philipps-University Marburg, Department of Neurology, Baldingerstrasse, 35043, Marburg, Germany; Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
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7
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Seiler A, Nöth U, Hok P, Reiländer A, Maiworm M, Baudrexel S, Meuth S, Rosenow F, Steinmetz H, Wagner M, Hattingen E, Deichmann R, Gracien RM. Multiparametric Quantitative MRI in Neurological Diseases. Front Neurol 2021; 12:640239. [PMID: 33763021 PMCID: PMC7982527 DOI: 10.3389/fneur.2021.640239] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 12/10/2020] [Accepted: 02/12/2021] [Indexed: 11/27/2022] Open
Abstract
Magnetic resonance imaging (MRI) is the gold standard imaging technique for diagnosis and monitoring of many neurological diseases. However, the application of conventional MRI in clinical routine is mainly limited to the visual detection of macroscopic tissue pathology since mixed tissue contrasts depending on hardware and protocol parameters hamper its application for the assessment of subtle or diffuse impairment of the structural tissue integrity. Multiparametric quantitative (q)MRI determines tissue parameters quantitatively, enabling the detection of microstructural processes related to tissue remodeling in aging and neurological diseases. In contrast to measuring tissue atrophy via structural imaging, multiparametric qMRI allows for investigating biologically distinct microstructural processes, which precede changes of the tissue volume. This facilitates a more comprehensive characterization of tissue alterations by revealing early impairment of the microstructural integrity and specific disease-related patterns. So far, qMRI techniques have been employed in a wide range of neurological diseases, including in particular conditions with inflammatory, cerebrovascular and neurodegenerative pathology. Numerous studies suggest that qMRI might add valuable information, including the detection of microstructural tissue damage in areas appearing normal on conventional MRI and unveiling the microstructural correlates of clinical manifestations. This review will give an overview of current qMRI techniques, the most relevant tissue parameters and potential applications in neurological diseases, such as early (differential) diagnosis, monitoring of disease progression, and evaluating effects of therapeutic interventions.
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Affiliation(s)
- Alexander Seiler
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany
| | - Pavel Hok
- Department of Neurology, Palacký University Olomouc and University Hospital Olomouc, Olomouc, Czechia
| | - Annemarie Reiländer
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Michelle Maiworm
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany
| | - Simon Baudrexel
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Sven Meuth
- Department of Neurology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Rosenow
- Department of Neurology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany.,Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, University Hospital, Frankfurt, Germany
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany
| | - Marlies Wagner
- Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany
| | - Elke Hattingen
- Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany.,Department of Neuroradiology, Goethe University, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Goethe University, Frankfurt, Germany
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8
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Seiler A, Brandhofe A, Gracien RM, Pfeilschifter W, Hattingen E, Deichmann R, Nöth U, Wagner M. DSC perfusion-based collateral imaging and quantitative T2 mapping to assess regional recruitment of leptomeningeal collaterals and microstructural cortical tissue damage in unilateral steno-occlusive vasculopathy. J Cereb Blood Flow Metab 2021; 41:67-81. [PMID: 31987009 PMCID: PMC7747159 DOI: 10.1177/0271678x19898148] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leptomeningeal collateral supply is considered pivotal in steno-occlusive vasculopathy to prevent chronic microstructural ischaemic tissue damage. The aim of this study was to assess the alleged protective role of leptomeningeal collaterals in patients with unilateral high-grade steno-occlusive vasculopathy using quantitative (q)T2 mapping and perfusion-weighted imaging (PWI)-based collateral abundance. High-resolution qT2 was used to estimate microstructural damage of the segmented normal-appearing cortex. Volumetric abundance of collaterals was assessed based on PWI source data. The ratio relative cerebral blood flow/relative cerebral blood volume (rCBF/rCBV) as a surrogate of relative cerebral perfusion pressure (rCPP) was used to investigate the intravascular hemodynamic competency of pial collateral vessels and the hemodynamic state of brain parenchyma. Within the dependent vascular territory with increased cortical qT2 values (P = 0.0001) compared to the contralateral side, parenchymal rCPP was decreased (P = 0.0001) and correlated negatively with increase of qT2 (P < 0.05). Furthermore, volumetric abundance of adjacent leptomeningeal collaterals was significantly increased (P < 0.01) and negatively correlated with changes of parenchymal rCPP (P = 0.01). Microstructural cortical damage is closely related to restrictions of antegrade blood flow despite increased pial collateral vessel abundance. Therefore, increased leptomeningeal collateral supply cannot necessarily be regarded as a sign of effective compensation in patients with high-grade steno-occlusive vasculopathy.
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Affiliation(s)
- Alexander Seiler
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
- Alexander Seiler, Department of Neurology, Goethe University Frankfurt, Schleusenweg 2-16, 60528 Frankfurt, Germany.
| | - Annemarie Brandhofe
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | | | - Elke Hattingen
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Marlies Wagner
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
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9
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Seiler A, Schöngrundner S, Stock B, Nöth U, Hattingen E, Steinmetz H, Klein JC, Baudrexel S, Wagner M, Deichmann R, Gracien RM. Cortical aging - new insights with multiparametric quantitative MRI. Aging (Albany NY) 2020; 12:16195-16210. [PMID: 32852283 PMCID: PMC7485732 DOI: 10.18632/aging.103629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/16/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023]
Abstract
Understanding the microstructural changes related to physiological aging of the cerebral cortex is pivotal to differentiate healthy aging from neurodegenerative processes. The aim of this study was to investigate the age-related global changes of cortical microstructure and regional patterns using multiparametric quantitative MRI (qMRI) in healthy subjects with a wide age range. 40 healthy participants (age range: 2nd to 8th decade) underwent high-resolution qMRI including T1, PD as well as T2, T2* and T2′ mapping at 3 Tesla. Cortical reconstruction was performed with the FreeSurfer toolbox, followed by tests for correlations between qMRI parameters and age. Cortical T1 values were negatively correlated with age (p=0.007) and there was a widespread age-related decrease of cortical T1 involving the frontal and the parietotemporal cortex, while T2 was correlated positively with age, both in frontoparietal areas and globally (p=0.004). Cortical T2′ values showed the most widespread associations across the cortex and strongest correlation with age (r= -0.724, p=0.0001). PD and T2* did not correlate with age. Multiparametric qMRI allows to characterize cortical aging, unveiling parameter-specific patterns. Quantitative T2′ mapping seems to be a promising imaging biomarker of cortical age-related changes, suggesting that global cortical iron deposition is a prominent process in healthy aging.
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Affiliation(s)
- Alexander Seiler
- Department of Neurology, Goethe University, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Sophie Schöngrundner
- Department of Neurology, Goethe University, Frankfurt am Main, Germany.,Department of Neuroradiology, Goethe University, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Benjamin Stock
- Department of Neurology, Goethe University, Frankfurt am Main, Germany.,Department of Neuroradiology, Goethe University, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Elke Hattingen
- Department of Neuroradiology, Goethe University, Frankfurt am Main, Germany
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
| | - Johannes C Klein
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Simon Baudrexel
- Department of Neurology, Goethe University, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Marlies Wagner
- Department of Neuroradiology, Goethe University, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt am Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
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10
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Seiler A, Brandhofe A, Gracien RM, Pfeilschifter W, Hattingen E, Deichmann R, Nöth U, Wagner M. Microstructural Alterations Analogous to Accelerated Aging of the Cerebral Cortex in Carotid Occlusive Disease. Clin Neuroradiol 2020; 31:709-720. [PMID: 32638029 PMCID: PMC8463359 DOI: 10.1007/s00062-020-00928-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/14/2020] [Accepted: 06/10/2020] [Indexed: 11/28/2022]
Abstract
Purpose To investigate cortical thickness and cortical quantitative T2 values as imaging markers of microstructural tissue damage in patients with unilateral high-grade internal carotid artery occlusive disease (ICAOD). Methods A total of 22 patients with ≥70% stenosis (mean age 64.8 years) and 20 older healthy control subjects (mean age 70.8 years) underwent structural magnetic resonance imaging (MRI) and high-resolution quantitative (q)T2 mapping. Generalized linear mixed models (GLMM) controlling for age and white matter lesion volume were employed to investigate the effect of ICAOD on imaging parameters of cortical microstructural integrity in multivariate analyses. Results There was a significant main effect (p < 0.05) of the group (patients/controls) on both cortical thickness and cortical qT2 values with cortical thinning and increased cortical qT2 in patients compared to controls, irrespective of the hemisphere. The presence of upstream carotid stenosis had a significant main effect on cortical qT2 values (p = 0.01) leading to increased qT2 in the poststenotic hemisphere, which was not found for cortical thickness. The GLMM showed that in general cortical thickness was decreased and cortical qT2 values were increased with increasing age (p < 0.05). Conclusion Unilateral high-grade carotid occlusive disease is associated with widespread cortical thinning and prolongation of cortical qT2, presumably reflecting hypoperfusion-related microstructural cortical damage similar to accelerated aging of the cerebral cortex. Cortical thinning and increase of cortical qT2 seem to reflect different aspects and different pathophysiological states of cortical degeneration. Quantitative T2 mapping might be a sensitive imaging biomarker for early cortical microstructural damage.
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Affiliation(s)
- Alexander Seiler
- Department of Neurology, Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany. .,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany.
| | - Annemarie Brandhofe
- Department of Neurology, Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Waltraud Pfeilschifter
- Department of Neurology, Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Marlies Wagner
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
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11
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Maiworm M, Nöth U, Hattingen E, Steinmetz H, Knake S, Rosenow F, Deichmann R, Wagner M, Gracien RM. Improved Visualization of Focal Cortical Dysplasia With Surface-Based Multiparametric Quantitative MRI. Front Neurosci 2020; 14:622. [PMID: 32612511 PMCID: PMC7308728 DOI: 10.3389/fnins.2020.00622] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 04/15/2020] [Accepted: 05/19/2020] [Indexed: 01/09/2023] Open
Abstract
Purpose In the clinical routine, detection of focal cortical dysplasia (FCD) by visual inspection is challenging. Still, information about the presence and location of FCD is highly relevant for prognostication and treatment decisions. Therefore, this study aimed to develop, describe and test a method for the calculation of synthetic anatomies using multiparametric quantitative MRI (qMRI) data and surface-based analysis, which allows for an improved visualization of FCD. Materials and Methods Quantitative T1-, T2- and PD-maps and conventional clinical datasets of patients with FCD and epilepsy were acquired. Tissue segmentation and delineation of the border between white matter and cortex was performed. In order to detect blurring at this border, a surface-based calculation of the standard deviation of each quantitative parameter (T1, T2, and PD) was performed across the cortex and the neighboring white matter for each cortical vertex. The resulting standard deviations combined with measures of the cortical thickness were used to enhance the signal of conventional FLAIR-datasets. The resulting synthetically enhanced FLAIR-anatomies were compared with conventional MRI-data utilizing regions of interest based analysis techniques. Results The synthetically enhanced FLAIR-anatomies showed higher signal levels than conventional FLAIR-data at the FCD sites (p = 0.005). In addition, the enhanced FLAIR-anatomies exhibited higher signal levels at the FCD sites than in the corresponding contralateral regions (p = 0.005). However, false positive findings occurred, so careful comparison with conventional datasets is mandatory. Conclusion Synthetically enhanced FLAIR-anatomies resulting from surface-based multiparametric qMRI-analyses have the potential to improve the visualization of FCD and, accordingly, the treatment of the respective patients.
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Affiliation(s)
- Michelle Maiworm
- Department of Neurology, Goethe University, Frankfurt, Germany.,Department of Neuroradiology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Elke Hattingen
- Department of Neuroradiology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Susanne Knake
- Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany.,Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Felix Rosenow
- Department of Neurology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany.,Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe University, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - Marlies Wagner
- Department of Neuroradiology, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany.,Center for Personalized Translational Epilepsy Research Consortium (CePTER), Frankfurt, Germany
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12
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Ahmad R, Maiworm M, Nöth U, Seiler A, Hattingen E, Steinmetz H, Rosenow F, Deichmann R, Wagner M, Gracien RM. Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T 2 Mapping. J Magn Reson Imaging 2020; 52:1783-1789. [PMID: 32383241 DOI: 10.1002/jmri.27184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/17/2020] [Accepted: 04/17/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In epilepsy patients with focal cortical dysplasia (FCD) as the epileptogenic focus, global cortical signal changes are generally not visible on conventional MRI. However, epileptic seizures or antiepileptic medication might affect normal-appearing cerebral cortex and lead to subtle damage. PURPOSE To investigate cortical properties outside FCD regions with T2 -relaxometry. STUDY TYPE Prospective study. SUBJECTS Sixteen patients with epilepsy and FCD and 16 age-/sex-matched healthy controls. FIELD STRENGTH/SEQUENCE 3T, fast spin-echo T2 -mapping, fluid-attenuated inversion recovery (FLAIR), and synthetic T1 -weighted magnetization-prepared rapid acquisition of gradient-echoes (MP-RAGE) datasets derived from T1 -maps. ASSESSMENT Reconstruction of the white matter and cortical surfaces based on MP-RAGE structural images was performed to extract cortical T2 values, excluding lesion areas. Three independent raters confirmed that morphological cortical/juxtacortical changes in the conventional FLAIR datasets outside the FCD areas were definitely absent for all patients. Averaged global cortical T2 values were compared between groups. Furthermore, group comparisons of regional cortical T2 values were performed using a surface-based approach. Tests for correlations with clinical parameters were carried out. STATISTICAL TESTS General linear model analysis, permutation simulations, paired and unpaired t-tests, and Pearson correlations. RESULTS Cortical T2 values were increased outside FCD regions in patients (83.4 ± 2.1 msec, control group 81.4 ± 2.1 msec, P = 0.01). T2 increases were widespread, affecting mainly frontal, but also parietal and temporal regions of both hemispheres. Significant correlations were not observed (P ≥ 0.55) between cortical T2 values in the patient group and the number of seizures in the last 3 months or the number of anticonvulsive drugs in the medical history. DATA CONCLUSION Widespread increases in cortical T2 in FCD-associated epilepsy patients were found, suggesting that structural epilepsy in patients with FCD is not only a symptom of a focal cerebral lesion, but also leads to global cortical damage not visible on conventional MRI. EVIDENCE LEVEL 21 TECHNICAL EFFICACY STAGE: 3 J. MAGN. RESON. IMAGING 2020;52:1783-1789.
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Affiliation(s)
- Rida Ahmad
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - Michelle Maiworm
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Elke Hattingen
- Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - Felix Rosenow
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany.,Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, Goethe University, Frankfurt/Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - Marlies Wagner
- Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Center for Personalized Translational Epilepsy Research (CePTER) Consortium, Germany
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13
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Stock B, Shrestha M, Seiler A, Foerch C, Hattingen E, Steinmetz H, Deichmann R, Wagner M, Gracien RM. Distribution of Cortical Diffusion Tensor Imaging Changes in Multiple Sclerosis. Front Physiol 2020; 11:116. [PMID: 32231581 PMCID: PMC7083109 DOI: 10.3389/fphys.2020.00116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 10/15/2019] [Accepted: 01/31/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose Diffuse cortical damage in relapsing–remitting multiple sclerosis (RRMS) is clinically relevant but cannot be directly assessed with conventional MRI. In this study, it was aimed to use diffusion tensor imaging (DTI) techniques with optimized intrinsic eddy current compensation to quantify and characterize cortical mean diffusivity (MD) and fractional anisotropy (FA) changes in RRMS and to analyze the distribution of these changes across the cortex. Materials and Methods Three-Tesla MRI acquisition, mapping of the MD providing information about the integrity of microstructural barriers and of the FA reflecting axonal density and surface-based analysis with Freesurfer were performed for 24 RRMS patients and 25 control subjects. Results Across the whole cortex, MD was increased in patients (p < 0.001), while surface-based analysis revealed focal cortical FA decreases. MD and FA changes were distributed inhomogeneously across the cortex, the MD increase being more widespread than the FA decrease. Cortical MD correlated with the Expanded Disability Status Scale (EDSS, r = 0.38, p = 0.03). Conclusion Damage of microstructural barriers occurs inhomogeneously across the cortex in RRMS and might be spatially more widespread than axonal degeneration. The results and, in particular, the correlation with the clinical status indicate that DTI might be a promising technique for the monitoring of cortical damage under treatment in larger clinical studies.
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Affiliation(s)
- Benjamin Stock
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.,Department of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Manoj Shrestha
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Christian Foerch
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
| | - Elke Hattingen
- Department of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - Helmuth Steinmetz
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
| | - Marlies Wagner
- Department of Neuroradiology, Goethe University Frankfurt, Frankfurt, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.,Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany
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14
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Nöth U, Gracien RM, Maiworm M, Reif PS, Hattingen E, Knake S, Wagner M, Deichmann R. Detection of cortical malformations using enhanced synthetic contrast images derived from quantitative T1 maps. NMR Biomed 2020; 33:e4203. [PMID: 31797463 DOI: 10.1002/nbm.4203] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023]
Abstract
The detection of cortical malformations in conventional MR images can be challenging. Prominent examples are focal cortical dysplasias (FCD), the most common cause of drug-resistant focal epilepsy. The two main MRI hallmarks of cortical malformations are increased cortical thickness and blurring of the gray (GM) and white matter (WM) junction. The purpose of this study was to derive synthetic anatomies from quantitative T1 maps for the improved display of the above imaging characteristics in individual patients. On the basis of a T1 map, a mask comprising pixels with T1 values characteristic for GM is created from which the local cortical extent (CE) is determined. The local smoothness (SM) of the GM-WM junctions is derived from the T1 gradient. For display of cortical malformations, the resulting CE and SM maps serve to enhance local intensities in synthetic double inversion recovery (DIR) images calculated from the T1 map. The resulting CE- and/or SM-enhanced DIR images appear hyperintense at the site of cortical malformations, thus facilitating FCD detection in epilepsy patients. However, false positives may arise in areas with naturally elevated CE and/or SM, such as large GM structures and perivascular spaces. In summary, the proposed method facilitates the detection of cortical abnormalities such as cortical thickening and blurring of the GM-WM junction which are typical FCD markers. Still, subject motion artifacts, perivascular spaces, and large normal GM structures may also yield signal hyperintensity in the enhanced synthetic DIR images, requiring careful comparison with clinical MR images by an experienced neuroradiologist to exclude false positives.
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Affiliation(s)
- Ulrike Nöth
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
| | | | - Michelle Maiworm
- Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany
| | - Philipp S Reif
- Department of Neurology, Goethe University, Frankfurt am Main, Germany
- Epilepsy Center Frankfurt Rhine-Main, Goethe University, Frankfurt am Main, Germany
| | - Elke Hattingen
- Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany
| | - Susanne Knake
- Epilepsy Center Hessen, University Hospital Marburg, Marburg, Germany
| | - Marlies Wagner
- Institute of Neuroradiology, Goethe University, Frankfurt am Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt am Main, Germany
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15
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Gracien RM, Maiworm M, Brüche N, Shrestha M, Nöth U, Hattingen E, Wagner M, Deichmann R. How stable is quantitative MRI? – Assessment of intra- and inter-scanner-model reproducibility using identical acquisition sequences and data analysis programs. Neuroimage 2020; 207:116364. [DOI: 10.1016/j.neuroimage.2019.116364] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022] Open
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16
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Gracien RM, van Wijnen A, Maiworm M, Petrov F, Merkel N, Paule E, Steinmetz H, Knake S, Rosenow F, Wagner M, Deichmann R. Improved synthetic T1-weighted images for cerebral tissue segmentation in neurological diseases. Magn Reson Imaging 2019; 61:158-166. [DOI: 10.1016/j.mri.2019.05.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/11/2019] [Accepted: 05/06/2019] [Indexed: 11/29/2022]
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17
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Gracien RM, Petrov F, Hok P, van Wijnen A, Maiworm M, Seiler A, Deichmann R, Baudrexel S. Multimodal Quantitative MRI Reveals No Evidence for Tissue Pathology in Idiopathic Cervical Dystonia. Front Neurol 2019; 10:914. [PMID: 31507518 PMCID: PMC6719627 DOI: 10.3389/fneur.2019.00914] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 04/30/2019] [Accepted: 08/06/2019] [Indexed: 01/02/2023] Open
Abstract
Background: While in symptomatic forms of dystonia cerebral pathology is by definition present, it is unclear so far whether disease is associated with microstructural cerebral changes in idiopathic dystonia. Previous quantitative MRI (qMRI) studies assessing cerebral tissue composition in idiopathic dystonia revealed conflicting results. Objective: Using multimodal qMRI, the presented study aimed to investigate alterations in different cerebral microstructural compartments associated with idiopathic cervical dystonia in vivo. Methods: Mapping of T1, T2, T2*, and proton density (PD) was performed in 17 patients with idiopathic cervical dystonia and 29 matched healthy control subjects. Statistical comparisons of the parametric maps between groups were conducted for various regions of interest (ROI), including major basal ganglia nuclei, the thalamus, white matter, and the cerebellum, and voxel-wise for the whole brain. Results: Neither whole brain voxel-wise statistics nor ROI-based analyses revealed significant group differences for any qMRI parameter under investigation. Conclusions: The negative findings of this qMRI study argue against the presence of overt microstructural tissue change in patients with idiopathic cervical dystonia. The results seem to support a common view that idiopathic cervical dystonia might primarily resemble a functional network disease.
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Affiliation(s)
- René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Franca Petrov
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Pavel Hok
- Department of Neurology, Goethe University, Frankfurt, Germany.,Department of Neurology, Palacký University Olomouc and University Hospital Olomouc, Olomouc, Czechia
| | - Alexandra van Wijnen
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Michelle Maiworm
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Alexander Seiler
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt, Germany
| | - Simon Baudrexel
- Department of Neurology, Goethe University, Frankfurt, Germany.,Brain Imaging Center, Goethe University, Frankfurt, Germany
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18
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Fleischer V, Koirala N, Droby A, Gracien RM, Deichmann R, Ziemann U, Meuth SG, Muthuraman M, Zipp F, Groppa S. Longitudinal cortical network reorganization in early relapsing-remitting multiple sclerosis. Ther Adv Neurol Disord 2019; 12:1756286419838673. [PMID: 31040880 PMCID: PMC6482642 DOI: 10.1177/1756286419838673] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 09/21/2018] [Accepted: 02/09/2019] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Network science provides powerful access to essential organizational principles of the brain. The aim of this study was to investigate longitudinal evolution of gray matter networks in early relapsing-remitting MS (RRMS) compared with healthy controls (HCs) and contrast network dynamics with conventional atrophy measurements. METHODS For our longitudinal study, we investigated structural cortical networks over 1 year derived from 3T MRI in 203 individuals (92 early RRMS patients with mean disease duration of 12.1 ± 14.5 months and 101 HCs). Brain networks were computed based on cortical thickness inter-regional correlations and fed into graph theoretical analysis. Network connectivity measures (modularity, clustering coefficient, local efficiency, and transitivity) were compared between patients and HCs, and between patients with and without disease activity. Moreover, we calculated longitudinal brain volume changes and cortical atrophy patterns. RESULTS Our analyses revealed strengthening of local network properties shown by increased modularity, clustering coefficient, local efficiency, and transitivity over time. These network dynamics were not detectable in the cortex of HCs over the same period and occurred independently of patients' disease activity. Most notably, the described network reorganization was evident beyond detectable atrophy as characterized by conventional morphometric methods. CONCLUSION In conclusion, our findings provide evidence for gray matter network reorganization subsequent to clinical disease manifestation in patients with early RRMS. An adaptive cortical response with increased local network characteristics favoring network segregation could play a primordial role for maintaining brain function in response to neuroinflammation.
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Affiliation(s)
- Vinzenz Fleischer
- Department of Neurology and Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Nabin Koirala
- Department of Neurology and Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Amgad Droby
- Department of Neurology and Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - René-Maxime Gracien
- Department of Neurology, and Brain Imaging Center, Goethe University, Frankfurt/Main, Frankfurt am Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Frankfurt am Main, Germany
| | - Ulf Ziemann
- Department of Neurology and Stroke, and Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - Sven G Meuth
- Department of Neurology, University of Muenster, Muenster, Germany
| | - Muthuraman Muthuraman
- Department of Neurology and Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Frauke Zipp
- Department of Neurology and Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Neuroimaging and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main-Neuroscience Network (rmn), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany
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19
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Droby A, Yuen KSL, Muthuraman M, Reitz SC, Fleischer V, Klein J, Gracien RM, Ziemann U, Deichmann R, Zipp F, Groppa S. Changes in brain functional connectivity patterns are driven by an individual lesion in MS: a resting-state fMRI study. Brain Imaging Behav 2017; 10:1117-1126. [PMID: 26553579 DOI: 10.1007/s11682-015-9476-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Diffuse inflammation in multiple sclerosis (MS) extends beyond focal lesion sites, affecting interconnected regions; however, little is known about the impact of an individual lesion affecting major white matter (WM) pathways on brain functional connectivity (FC). Here, we longitudinally assessed the effects of acute and chronic lesions on FC in relapsing-remitting MS (RRMS) patients using resting-state fMRI. 45 MRI data sets from 9 RRMS patients were recorded using 3T MR scanner over 5 time points at 8 week intervals. Patients were divided into two groups based on the presence (n = 5; MS+) and absence (n = 4; MS-) of a lesion at a predilection site for MS. While FC levels were found not to fluctuate significantly in the overall patient group, the MS+ patient group showed increased FC in the contralateral cuneus and precuneus and in the ipsilateral precuneus (p < 0.01, corrected). This can be interpreted as the recruitment of intact cortical regions to compensate for tissue damage. During the study, one patient developed an acute WM lesion in the left posterior periventricular space. A marked increase in FC in the right pre-, post-central gyrus, right superior frontal gyrus, the left cuneus, the vermis and the posterior and anterior lobes of the cerebellum was noted following the clinical relapse, which gradually decreased in subsequent follow-ups, suggesting short-term functional reorganization during the acute phase. This strongly suggests that the lesion-related network changes observed in patients with chronic lesions occur as a result of reorganization processes following the initial appearance of an acute lesion.
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Affiliation(s)
- Amgad Droby
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Kenneth S L Yuen
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Muthuraman Muthuraman
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Sarah-Christina Reitz
- Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center (BIC), Goethe University, Frankfurt am Main, Germany
| | - Vinzenz Fleischer
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Johannes Klein
- Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center (BIC), Goethe University, Frankfurt am Main, Germany
| | - René-Maxime Gracien
- Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany
- Brain Imaging Center (BIC), Goethe University, Frankfurt am Main, Germany
| | - Ulf Ziemann
- Department of Neurology and Stroke, Hertie Institute for Clinical Brain Research, Eberhard-Karls-University, Tübingen, Germany
| | - Ralf Deichmann
- Brain Imaging Center (BIC), Goethe University, Frankfurt am Main, Germany
| | - Frauke Zipp
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany.
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
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20
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Gracien RM, Reitz SC, Hof SM, Fleischer V, Droby A, Wahl M, Steinmetz H, Groppa S, Deichmann R, Klein JC. Longitudinal quantitative MRI assessment of cortical damage in multiple sclerosis: A pilot study. J Magn Reson Imaging 2017; 46:1485-1490. [PMID: 28240801 DOI: 10.1002/jmri.25685] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/06/2017] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Quantitative MRI (qMRI) allows assessing cortical pathology in multiple sclerosis (MS) on a microstructural level, where cortical damage has been shown to prolong T1 -relaxation time and increase proton density (PD) compared to controls. However, the evolution of these changes in MS over time has not been investigated so far. In this pilot study we used an advanced method for the longitudinal assessment of cortical tissue change in MS patients with qMRI in comparison to cortical atrophy, as derived from conventional MRI. MATERIALS AND METHODS Twelve patients with relapsing-remitting MS underwent 3T T1 /PD-mapping at two timepoints with a mean interval of 12 months. The respective cortical T1 /PD-values were extracted from the middle of the cortical layer and the cortical thickness was measured for surface-based identification of clusters with increasing/decreasing values. RESULTS Statistical analysis showed clusters with increasing PD- and T1 -values over time (annualized rate for T1 /PD increase in these clusters: 3.4 ± 2.56% for T1 , P = 0.0007; 2.3 ± 2.59% for PD, P = 0.01). Changes are heterogeneous across the cortex and different patterns of longitudinal PD and T1 increase emerged. Analysis of the cortical thickness yielded only one small cluster indicating a decrease of cortical thickness. CONCLUSION Changes of cortical tissue composition in MS seem to be reflected by a spatially inhomogeneous, multifocal increase of the PD values, indicating replacement of neural tissue by water, and of the T1 -relaxation time, a surrogate of demyelination, axonal loss, and gliosis. qMRI changes were more prominent than cortical atrophy, showing the potential of qMRI techniques to quantify microstructural alterations that remain undetected by conventional MRI. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1485-1490.
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Affiliation(s)
- René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Sarah C Reitz
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Stephanie-Michelle Hof
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Vinzenz Fleischer
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany.,Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Amgad Droby
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany.,Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Mathias Wahl
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | | | - Sergiu Groppa
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany.,Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Johannes C Klein
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Nuffield Department of Clinical Neurosciences, University of Oxford, UK
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21
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Nürnberger L, Gracien RM, Hok P, Hof SM, Rüb U, Steinmetz H, Hilker R, Klein JC, Deichmann R, Baudrexel S. Longitudinal changes of cortical microstructure in Parkinson's disease assessed with T1 relaxometry. Neuroimage Clin 2016; 13:405-414. [PMID: 28116233 PMCID: PMC5226811 DOI: 10.1016/j.nicl.2016.12.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/23/2016] [Accepted: 12/19/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Histological evidence suggests that pathology in Parkinson's disease (PD) goes beyond nigrostriatal degeneration and also affects the cerebral cortex. Quantitative MRI (qMRI) techniques allow the assessment of changes in brain tissue composition. However, the development and pattern of disease-related cortical changes have not yet been demonstrated in PD with qMRI methods. The aim of this study was to investigate longitudinal cortical microstructural changes in PD with quantitative T1 relaxometry. METHODS 13 patients with mild to moderate PD and 20 matched healthy subjects underwent high resolution T1 mapping at two time points with an interval of 6.4 years (healthy subjects: 6.5 years). Data from two healthy subjects had to be excluded due to MRI artifacts. Surface-based analysis of cortical T1 values was performed with the FreeSurfer toolbox. RESULTS In PD patients, a widespread decrease of cortical T1 was detected during follow-up which affected large parts of the temporo-parietal and occipital cortices and also frontal areas. In contrast, age-related T1 decrease in the healthy control group was much less pronounced and only found in lateral frontal, parietal and temporal areas. Average cortical T1 values did not differ between the groups at baseline (p = 0.17), but were reduced in patients at follow-up (p = 0.0004). Annualized relative changes of cortical T1 were higher in patients vs. healthy subjects (patients: - 0.72 ± 0.64%/year; healthy subjects: - 0.17 ± 0.41%/year, p = 0.007). CONCLUSIONS In patients with PD, the development of widespread changes in cortical microstructure was observed as reflected by a reduction of cortical T1. The pattern of T1 decrease in PD patients exceeded the normal T1 decrease as found in physiological aging and showed considerable overlap with the pattern of cortical thinning demonstrated in previous PD studies. Therefore, cortical T1 might be a promising additional imaging marker for future longitudinal PD studies. The biological mechanisms underlying cortical T1 reductions remain to be further elucidated.
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Affiliation(s)
- Lucas Nürnberger
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Pavel Hok
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
- Department of Neurology, Palacky University, Olomouc, Czech Republic
| | - Stephanie-Michelle Hof
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Udo Rüb
- Dr. Senckenberg Chronomedical Institute, Goethe University, Frankfurt/Main, Germany
| | | | - Rüdiger Hilker
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Johannes C. Klein
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Simon Baudrexel
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
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22
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Gracien RM, Reitz SC, Wagner M, Mayer C, Volz S, Hof SM, Fleischer V, Droby A, Steinmetz H, Groppa S, Hattingen E, Klein JC, Deichmann R. Comparison of two quantitative proton density mapping methods in multiple sclerosis. MAGMA 2016; 30:75-83. [PMID: 27544270 DOI: 10.1007/s10334-016-0585-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/06/2016] [Accepted: 08/09/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Proton density (PD) mapping requires correction for the receive profile (RP), which is frequently performed via bias-field correction. An alternative RP-mapping method utilizes a comparison of uncorrected PD-maps and a value ρ(T1) directly derived from T1-maps via the Fatouros equation. This may be problematic in multiple sclerosis (MS), if respective parameters are only valid for healthy brain tissue. We aimed to investigate whether the alternative method yields correct PD values in MS patients. MATERIALS/METHODS PD mapping was performed on 27 patients with relapsing-remitting MS and 27 healthy controls, utilizing both methods, yielding reference PD values (PDref, bias-field method) and PDalt (alternative method). RESULTS PDalt-values closely matched PDref, both for patients and controls. In contrast, ρ(T1) differed by up to 3 % from PDref, and the voxel-wise correlation between PDref and ρ(T1) was reduced in a patient subgroup with a higher degree of disability. Still, discrepancies between ρ(T1) and PDref were almost identical across different tissue types, thus translating into a scaling factor, which cancelled out during normalization to 100 % in CSF, yielding a good agreement between PDalt and PDref. CONCLUSION RP correction utilizing the auxiliary parameter ρ(T1) derived via the Fatouros equation provides accurate PD results in MS patients, in spite of discrepancies between ρ(T1) and actual PD values.
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Affiliation(s)
- René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt/Main, Germany. .,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.
| | - Sarah C Reitz
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Marlies Wagner
- Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Christoph Mayer
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
| | - Steffen Volz
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Stephanie-Michelle Hof
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Vinzenz Fleischer
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany.,Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Amgad Droby
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany.,Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | | | - Sergiu Groppa
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany.,Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Elke Hattingen
- Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Johannes C Klein
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
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23
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Gracien RM, Jurcoane A, Wagner M, Reitz SC, Mayer C, Volz S, Hof SM, Fleischer V, Droby A, Steinmetz H, Zipp F, Hattingen E, Deichmann R, Klein JC. The Relationship between Gray Matter Quantitative MRI and Disability in Secondary Progressive Multiple Sclerosis. PLoS One 2016; 11:e0161036. [PMID: 27513853 PMCID: PMC4981438 DOI: 10.1371/journal.pone.0161036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 07/28/2016] [Indexed: 11/18/2022] Open
Abstract
PURPOSE In secondary progressive Multiple Sclerosis (SPMS), global neurodegeneration as a driver of disability gains importance in comparison to focal inflammatory processes. However, clinical MRI does not visualize changes of tissue composition outside MS lesions. This quantitative MRI (qMRI) study investigated cortical and deep gray matter (GM) proton density (PD) values and T1 relaxation times to explore their potential to assess neuronal damage and its relationship to clinical disability in SPMS. MATERIALS AND METHODS 11 SPMS patients underwent quantitative T1 and PD mapping. Parameter values across the cerebral cortex and deep GM structures were compared with 11 healthy controls, and correlation with disability was investigated for regions exhibiting significant group differences. RESULTS PD was increased in the whole GM, cerebral cortex, thalamus, putamen and pallidum. PD correlated with disability in the whole GM, cerebral cortex, putamen and pallidum. T1 relaxation time was prolonged and correlated with disability in the whole GM and cerebral cortex. CONCLUSION Our study suggests that the qMRI parameters GM PD (which likely indicates replacement of neural tissue with water) and cortical T1 (which reflects cortical damage including and beyond increased water content) are promising qMRI candidates for the assessment of disease status, and are related to disability in SPMS.
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Affiliation(s)
- René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
- * E-mail:
| | - Alina Jurcoane
- Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Marlies Wagner
- Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Sarah C. Reitz
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Christoph Mayer
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
| | - Steffen Volz
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Stephanie-Michelle Hof
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Vinzenz Fleischer
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Amgad Droby
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | | | - Frauke Zipp
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Elke Hattingen
- Department of Neuroradiology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Johannes C. Klein
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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24
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Gracien RM, Nürnberger L, Hok P, Hof SM, Reitz SC, Rüb U, Steinmetz H, Hilker-Roggendorf R, Klein JC, Deichmann R, Baudrexel S. Evaluation of brain ageing: a quantitative longitudinal MRI study over 7 years. Eur Radiol 2016; 27:1568-1576. [PMID: 27379992 DOI: 10.1007/s00330-016-4485-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/27/2016] [Accepted: 06/21/2016] [Indexed: 12/31/2022]
Abstract
OBJECTIVES T1 relaxometry is a promising tool for the assessment of microstructural changes during brain ageing. Previous cross-sectional studies demonstrated increasing T1 values in white and decreasing T1 values in grey matter over the lifetime. However, these findings have not yet been confirmed on the basis of a longitudinal study. In this longitudinal study over 7 years, T1 relaxometry was used to investigate the dynamics of age-related microstructural changes in older healthy subjects. METHODS T1 mapping was performed in 17 healthy subjects (range 51-77 years) at baseline and after 7 years. Advanced cortical and white matter segmentation was used to determine mean T1 values in the cortex and white matter. RESULTS The analysis revealed a decrease of mean cortical T1 values over 7 years, the rate of T1 reduction being more prominent in subjects with higher age. T1 decreases were predominantly localized in the lateral frontal, parietal and temporal cortex. In contrast, mean white matter T1 values remained stable. CONCLUSIONS T1 mapping is shown to be sensitive to age-related microstructural changes in healthy ageing subjects in a longitudinal setting. Data of a cohort in late adulthood and the senescence period demonstrate a decrease of cortical T1 values over 7 years, most likely reflecting decreasing water content and increased iron concentrations. KEY POINTS • T1 mapping is sensitive to age-related microstructural changes in a longitudinal setting. • T1 decreases were predominantly localized in the lateral frontal, parietal and temporal cortex. • The rate of T1 reduction was more prominent in subjects with higher age. • These changes most likely reflect decreasing cortical water and increasing iron concentrations.
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Affiliation(s)
- René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt/Main, Germany. .,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.
| | - Lucas Nürnberger
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Pavel Hok
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Department of Neurology, Palacky University, Olomouc, Czech Republic
| | - Stephanie-Michelle Hof
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Sarah C Reitz
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Udo Rüb
- Dr. Senckenberg Chronomedical Institute, Goethe University, Frankfurt/Main, Germany
| | | | - Rüdiger Hilker-Roggendorf
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Johannes C Klein
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Simon Baudrexel
- Department of Neurology, Goethe University, Frankfurt/Main, Germany.,Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
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25
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Gracien RM, Jurcoane A, Wagner M, Reitz SC, Mayer C, Volz S, Hof SM, Fleischer V, Droby A, Steinmetz H, Groppa S, Hattingen E, Deichmann R, Klein JC. Multimodal quantitative MRI assessment of cortical damage in relapsing-remitting multiple sclerosis. J Magn Reson Imaging 2016; 44:1600-1607. [DOI: 10.1002/jmri.25297] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/19/2016] [Indexed: 11/05/2022] Open
Affiliation(s)
- René-Maxime Gracien
- Department of Neurology; Goethe University; Frankfurt/Main Germany
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Alina Jurcoane
- Department of Neuroradiology; Goethe University; Frankfurt/Main Germany
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Marlies Wagner
- Department of Neuroradiology; Goethe University; Frankfurt/Main Germany
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Sarah C. Reitz
- Department of Neurology; Goethe University; Frankfurt/Main Germany
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Christoph Mayer
- Department of Neurology; Goethe University; Frankfurt/Main Germany
| | - Steffen Volz
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Stephanie-Michelle Hof
- Department of Neurology; Goethe University; Frankfurt/Main Germany
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Vinzenz Fleischer
- Department of Neurology; Johannes Gutenberg University; Mainz Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN); Johannes Gutenberg-University; Mainz Germany
| | - Amgad Droby
- Department of Neurology; Johannes Gutenberg University; Mainz Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN); Johannes Gutenberg-University; Mainz Germany
| | | | - Sergiu Groppa
- Department of Neurology; Johannes Gutenberg University; Mainz Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN); Johannes Gutenberg-University; Mainz Germany
| | - Elke Hattingen
- Department of Neuroradiology; Goethe University; Frankfurt/Main Germany
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Ralf Deichmann
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
| | - Johannes C. Klein
- Department of Neurology; Goethe University; Frankfurt/Main Germany
- Brain Imaging Center; Goethe University; Frankfurt/Main Germany
- Nuffield Department of Clinical Neurosciences; University of Oxford; UK
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26
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Gracien RM, Reitz SC, Hof SM, Fleischer V, Zimmermann H, Droby A, Steinmetz H, Zipp F, Deichmann R, Klein JC. Assessment of cortical damage in early multiple sclerosis with quantitative T2 relaxometry. NMR Biomed 2016; 29:444-450. [PMID: 26820580 DOI: 10.1002/nbm.3486] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/24/2015] [Accepted: 12/16/2015] [Indexed: 06/05/2023]
Abstract
T2 relaxation time is a quantitative MRI in vivo surrogate of cerebral tissue damage in multiple sclerosis (MS) patients. Cortical T2 prolongation is a known feature in later disease stages, but has not been demonstrated in the cortical normal appearing gray matter (NAGM) in early MS. This study centers on the quantitative evaluation of the tissue parameter T2 in cortical NAGM in a collective of early MS and clinically isolated syndrome (CIS) patients, hypothesizing that T2 prolongation is already present at early disease stages and variable over space, in line with global and focal inflammatory processes in MS. Additionally, magnetization transfer ratio (MTR) mapping was performed for further characterization of the expected cortical T2 alteration. Quantitative T2 and MTR maps were acquired from 12 patients with CIS and early MS, and 12 matched healthy controls. The lesion-free part of the cortical volume was identified, and the mean T2 and MTR values and their standard deviations within the cortical volume were determined. For evaluation of spatial specificity, cortical lobar subregions were tested separately for differences of mean T2 and T2 standard deviation. We detected significantly prolonged T2 in cortical NAGM in patients. T2 prolongation was found across the whole cerebral cortex and in all individual lobar subregions. Significantly higher standard deviations across the respective region of interest were found for the whole cerebral cortex and all subregions, suggesting the occurrence of spatially inhomogeneous cortical damage in all regions studied. A trend was observed for MTR reduction and increased MTR variability across the whole cortex in the MS group, suggesting demyelination. In conclusion, our results suggest that cortical damage in early MS is evidenced by spatially inhomogeneous T2 prolongation which goes beyond demyelination. Iron deposition, which is known to decrease T2, seems less prominent.
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Affiliation(s)
- René-Maxime Gracien
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Sarah C Reitz
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Stephanie-Michelle Hof
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Vinzenz Fleischer
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Hilga Zimmermann
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Amgad Droby
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | | | - Frauke Zipp
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg-University, Mainz, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
| | - Johannes C Klein
- Department of Neurology, Goethe University, Frankfurt/Main, Germany
- Brain Imaging Center, Goethe University, Frankfurt/Main, Germany
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Baudrexel S, Reitz SC, Hof S, Gracien RM, Fleischer V, Zimmermann H, Droby A, Klein JC, Deichmann R. Quantitative T1 and proton density mapping with direct calculation of radiofrequency coil transmit and receive profiles from two-point variable flip angle data. NMR Biomed 2016; 29:349-360. [PMID: 26756673 DOI: 10.1002/nbm.3460] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/10/2015] [Accepted: 11/16/2015] [Indexed: 06/05/2023]
Abstract
Quantitative T1 mapping of brain tissue is frequently based on the variable flip angle (VFA) method, acquiring spoiled gradient echo (GE) datasets at different excitation angles. However, accurate T1 calculation requires a knowledge of the sensitivity profile B1 of the radiofrequency (RF) transmit coil. For an additional derivation of proton density (PD) maps, the receive coil sensitivity profile (RP) must also be known. Mapping of B1 and RP increases the experiment duration, which may be critical when investigating patients. In this work, a method is presented for the direct calculation of B1 and RP from VFA data. Thus, quantitative maps of T1 , PD, B1 and RP can be obtained from only two spoiled GE datasets. The method is based on: (1) the exploitation of the linear relationship between 1/PD and 1/T1 in brain tissue and (2) the assumption of smoothly varying B1 and RP, so that a large number of data points can be fitted across small volume elements where B1 and RP are approximately constant. The method is tested and optimized on healthy subjects. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Simon Baudrexel
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt/Main, Germany
- Department of Neurology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Sarah C Reitz
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt/Main, Germany
- Department of Neurology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Stephanie Hof
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt/Main, Germany
- Department of Neurology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - René-Maxime Gracien
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt/Main, Germany
- Department of Neurology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Vinzenz Fleischer
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Hilga Zimmermann
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Amgad Droby
- Department of Neurology, Johannes Gutenberg University, Mainz, Germany
- Neuroimaging Center (NIC) of the Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University, Mainz, Germany
| | - Johannes C Klein
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt/Main, Germany
- Department of Neurology, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Ralf Deichmann
- Brain Imaging Center, Goethe University Frankfurt, Frankfurt/Main, Germany
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