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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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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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Kho K, Powers C, Hamid C, Pearson M. Challenges and Successes in Medical Student and Resident Surgical Simulation Education. J Minim Invasive Gynecol 2012. [DOI: 10.1016/j.jmig.2012.08.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kho K, Powers C, Hamid C, Brooks-Heinzman A, Gala R, Scott D. Comparison of Differences in Baseline Surgical Skills and Skill Uptake between Surgery and Obstetrics & Gynecology Trainees. J Minim Invasive Gynecol 2011. [DOI: 10.1016/j.jmig.2011.08.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Passacquale G, Corrigall V, Hamid C, Ferro A. MS154 PLATELET ACTIVATION INDUCES PHENOTYPIC AND FUNCTIONAL CHANGES IN CIRCULATING MONOCYTES AS A CONSEQUENCE OF MONOCYTE–PLATELET AGGREGATE FORMATION. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70655-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Passacquale G, Corrigall V, Hamid C, Ferro A. 023 Platelet activation induces phenotypic and functional changes in circulating monocytes as a consequence of monocyte–platelet aggregate formation. Heart 2010. [DOI: 10.1136/hrt.2010.195941.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hamid C, Norgate K, D'Cruz DP, Khamashta MA, Arno M, Pearson JD, Frampton G, Murphy JJ. Anti-beta2GPI-antibody-induced endothelial cell gene expression profiling reveals induction of novel pro-inflammatory genes potentially involved in primary antiphospholipid syndrome. Ann Rheum Dis 2007; 66:1000-7. [PMID: 17223652 PMCID: PMC1954708 DOI: 10.1136/ard.2006.063909] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine the effects of primary antiphospholipid syndrome (PAPS)-derived anti-beta(2)GPI antibodies on gene expression in human umbilical vein endothelial cells (HUVEC) by gene profiling using microarrays. METHODS Anti-beta(2)GPI antibodies purified from sera of patients with PAPS or control IgG isolated from normal subjects were incubated with HUVEC for 4 h before isolation of RNA and processing for hybridisation to Affymetrix Human Genome U133A-2.0 arrays. Data were analysed using a combination of the MAS 5.0 (Affymetrix) and GeneSpring (Agilent) software programmes. For selected genes microarray data were confirmed by real-time PCR analysis or at the protein level by ELISA. RESULTS A total of 101 genes were found to be upregulated and 14 genes were downregulated twofold or more in response to anti-beta(2)GPI antibodies. A number of novel genes not previously associated with APS were induced, including chemokines CCL20, CXCL3, CX3CL1, CXCL5, CXCL2 and CXCL1, the receptors Tenascin C, OLR1, IL-18 receptor 1, and growth factors CSF2, CSF3 IL-6, IL1beta and FGF18. The majority of downregulated genes were transcription factors/signalling molecules including ID2. Quantitative real-time RT-PCR analysis confirmed the microarray results for selected genes (CSF3, CX3CL1, FGF18, ID2, SOD2, Tenascin C). CONCLUSIONS This study reveals a complex gene expression response in HUVEC to anti-beta(2)GPI antibodies with multiple chemokines, pro-inflammatory cytokines, pro-thrombotic and pro-adhesive genes regulated by these antibodies in vitro. Some of these newly identified anti-beta(2)GPI antibody-regulated genes could contribute to the vasculopathy associated with this disease.
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Affiliation(s)
- C Hamid
- Research Institute of Healthcare Sciences, University of Wolverhampton, UK
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Kelton JG, Hamid C, Aker S, Blajchman MA. The amount of blood group A substance on platelets is proportional to the amount in the plasma. Blood 1982; 59:980-5. [PMID: 7074223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Kelton JG, McDonald JW, Barr RM, Walker I, Nicholson W, Neame PB, Hamid C, Wong TY, Hirsh J. The reversible binding of vinblastine to platelets: implications for therapy. Blood 1981; 57:431-8. [PMID: 7459430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The ability of platelets to adsorb vinblastine has been used to treat patients with immune thrombocytopenia. It is hypothesized that the drug-platelet complex is coated with antibody, taken up by macrophages which are then destroyed by the drug. We gave 16 courses of vinblastine-platelets to six patients with immune thrombocytopenia. Only one patient responded, and therefore we examined possible reasons for the lack of benefit. Using 3H-vinblastine, the kinetics of vinblastine binding to platelets was studied in vitro. The binding of vinblastine to both human and rabbit platelets was identical with maximal binding occurring within 10 min at 600 microgram/ml vinblastine. Similarly, the plasma half-life of vinblastine in rabbits was close to that reported for man, and therefore, in vivo binding of vinblastine to platelets in rabbits was considered a suitable model for man. Homologous donor rabbit platelets were labeled with 51Cr alone, 51Cr plus vinblastine, or 3H-vinblastine and infused into recipient rabbits. Vinblastine had no effect on 51Cr survival, but all measureable vinblastine had left the platelets within 2 hr of the infusion. These observations suggest that delivery of the vinblastine to the macrophages depends on the platelets being phagtocytized before the drug leaves the platelets. This would be likely to occur only in those patients with severe immune thrombocytopenia. Further investigations into this treatment should be directed at methods to maintain the drug within the platelet.
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