1H-Magnetic Resonance Spectroscopy in diffuse and focal cervical cord lesions in Multiple Sclerosis

Bellenberg, Barbara; Busch, M.; Trampe, Nadine; Gold, Ralf; Chan, Andrew; Lukas, Carsten

doi:10.1007/s00330-013-2942-7

Cited by 24 publications

(31 citation statements)

References 34 publications

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“…RRMS and SPMS were regarded separately to reflect the different course of UCCA evolution within the two groups, with mainly constant, low grade cord atrophy during the first years after MS diagnosis and a phase of progressive UCCA atrophy at longer disease durations (Figure 1). In line with previous findings, we detected atrophy of UCCA and brain in RRMS and at a higher grade in SPMS (Table 1) (Bakshi et al, 2005;Bellenberg et al, 2013;Ceccarelli et al, 2008;Edwards et al, 1999;Liu et al, 1999;Lukas et al, 2013;Pagani et al, 2005).…”

Section: Discussionsupporting

confidence: 93%

Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing–remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry

Bellenberg

Schneider

Weiler

et al. 2015

Multiple Sclerosis and Related Disorders

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Section: Discussionsupporting

confidence: 93%

Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing–remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry

Bellenberg

Schneider

Weiler

et al. 2015

Multiple Sclerosis and Related Disorders

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“…Four additional studies collected longitudinal clinical data but did not report prediction of outcomes using baseline MRI metrics. Among the 10 studies investigating predictive utility, 5 employed a detailed battery of clinical assessments ( Bellenberg et al, 2013 , El Mendili et al, 2014 , Freund et al, 2010 , Ikeda et al, 2013 , Jones et al, 2013 ). Baseline FA showed weak to moderate correlations with clinical outcomes such as ALSFRS in ALS (1 study), mJOA recovery ratio in CSM (1/2 studies), and EDSS in MS (2/2 studies), but not mJOA in CSM (1 study).…”

Section: Resultsmentioning

confidence: 99%

Translating state-of-the-art spinal cord MRI techniques to clinical use: A systematic review of clinical studies utilizing DTI, MT, MWF, MRS, and fMRI

Martín

Aleksanderek

Cohen‐Adad

et al. 2016

NeuroImage: Clinical

192

169

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BackgroundA recent meeting of international imaging experts sponsored by the International Spinal Research Trust (ISRT) and the Wings for Life Foundation identified 5 state-of-the-art MRI techniques with potential to transform the field of spinal cord imaging by elucidating elements of the microstructure and function: diffusion tensor imaging (DTI), magnetization transfer (MT), myelin water fraction (MWF), MR spectroscopy (MRS), and functional MRI (fMRI). However, the progress toward clinical translation of these techniques has not been established.MethodsA systematic review of the English literature was conducted using MEDLINE, MEDLINE-in-Progress, Embase, and Cochrane databases to identify all human studies that investigated utility, in terms of diagnosis, correlation with disability, and prediction of outcomes, of these promising techniques in pathologies affecting the spinal cord. Data regarding study design, subject characteristics, MRI methods, clinical measures of impairment, and analysis techniques were extracted and tabulated to identify trends and commonalities. The studies were assessed for risk of bias, and the overall quality of evidence was assessed for each specific finding using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.ResultsA total of 6597 unique citations were identified in the database search, and after full-text review of 274 articles, a total of 104 relevant studies were identified for final inclusion (97% from the initial database search). Among these, 69 studies utilized DTI and 25 used MT, with both techniques showing an increased number of publications in recent years. The review also identified 1 MWF study, 11 MRS studies, and 8 fMRI studies. Most of the studies were exploratory in nature, lacking a priori hypotheses and showing a high (72%) or moderately high (20%) risk of bias, due to issues with study design, acquisition techniques, and analysis methods. The acquisitions for each technique varied widely across studies, rendering direct comparisons of metrics invalid. The DTI metric fractional anisotropy (FA) had the strongest evidence of utility, with moderate quality evidence for its use as a biomarker showing correlation with disability in several clinical pathologies, and a low level of evidence that it identifies tissue injury (in terms of group differences) compared with healthy controls. However, insufficient evidence exists to determine its utility as a sensitive and specific diagnostic test or as a tool to predict clinical outcomes. Very low quality evidence suggests that other metrics also show group differences compared with controls, including DTI metrics mean diffusivity (MD) and radial diffusivity (RD), the diffusional kurtosis imaging (DKI) metric mean kurtosis (MK), MT metrics MT ratio (MTR) and MT cerebrospinal fluid ratio (MTCSF), and the MRS metric of N-acetylaspartate (NAA) concentration, although these results were somewhat inconsistent.ConclusionsState-of-the-art spinal cord MRI techniques are emerging with great pot...

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“…The essential future steps are therefore establishing a spinal‐cord‐specific macromolecular baseline model and an MRS reference standard more reliable than tCr for absolute quantification (e.g. ERETIC or internal water referencing calibrated with phantom measurements). However, the use of water as a reference has to be evaluated carefully, because it is very sensitive to subject movement .…”

Section: Discussionmentioning

confidence: 99%

Neurochemical profile of the human cervical spinal cord determined by MRS

et al. 2016

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MRS enables insight into the chemical composition of central nervous system tissue. However, technical challenges degrade the data quality when applied to the human spinal cord. Therefore, to date detection of only the most prominent metabolite resonances has been reported in the healthy human spinal cord. The aim of this investigation is to provide an extended metabolic profile including neurotransmitters and antioxidants in addition to metabolites involved in the energy and membrane metabolism of the human cervical spinal cord in vivo. To achieve this, data quality was improved by using a custom-made, cervical detector array together with constructive averaging of a high number of echo signals, which is enabled by the metabolite cycling technique at 3T. In addition, the improved spinal cord spectra were extensively cross-validated, in vivo, post-mortem in situ and ex vivo. Reliable identification of up to nine metabolites was achieved in group analyses for the first time. Distinct features of the spinal cord neurochemical profile, in comparison with the brain neurotransmission system, include decreased concentrations of the sum of glutamate and glutamate and increased concentrations of aspartate, γ-amino-butyric acid, scyllo-inositol and the sum of myo-inositol and glycine.

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1H-Magnetic Resonance Spectroscopy in diffuse and focal cervical cord lesions in Multiple Sclerosis

Abstract: MRS indicated differences in demyelination and gliosis between diffuse and focal cervical lesions in MS. Although longitudinal spectral and clinical changes were sparse, NAA/Cre turned out to be the most sensitive spectral parameter.

Cited by 24 publications

References 34 publications

Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing–remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry

Cervical cord area is associated with infratentorial grey and white matter volume predominantly in relapsing–remitting multiple sclerosis: A study using semi-automated cord volumetry and voxel-based morphometry

Translating state-of-the-art spinal cord MRI techniques to clinical use: A systematic review of clinical studies utilizing DTI, MT, MWF, MRS, and fMRI

Neurochemical profile of the human cervical spinal cord determined by MRS

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