Longitudinal quantitative MRI assessment of cortical damage in multiple sclerosis: A pilot study

Gracien, René‐Maxime; Reitz, Sandra; Hof, Stephanie‐Michelle; Fleischer, Vinzenz; Droby, Amgad; Wahl, Michael J.; Steinmetz, Helmuth; Groppa, Sergiu; Deichmann, Ralf; Klein, Johannes

doi:10.1002/jmri.25685

Cited by 22 publications

(25 citation statements)

References 35 publications

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“…28 The FCD voxels were removed from the T 2 maps to exclude FCD-associated changes from the analysis. To reduce partial volume effects with cerebrospinal fluid (CSF) and WM, T 2 values were sampled in the central 20% of the cortex 29 and saved in surface datasets.…”

Section: Segmentation and Data Analysismentioning

confidence: 99%

Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T₂ Mapping

Ahmad

Maiworm

Nöth

et al. 2020

Magnetic Resonance Imaging

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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 T 2-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 T 2-mapping, fluid-attenuated inversion recovery (FLAIR), and synthetic T 1weighted magnetization-prepared rapid acquisition of gradient-echoes (MP-RAGE) datasets derived from T 1-maps. Assessment: Reconstruction of the white matter and cortical surfaces based on MP-RAGE structural images was performed to extract cortical T 2 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 T 2 values were compared between groups. Furthermore, group comparisons of regional cortical T 2 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 T 2 values were increased outside FCD regions in patients (83.4 AE 2.1 msec, control group 81.4 AE 2.1 msec, P = 0.01). T 2 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 T 2 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 T 2 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

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Section: Segmentation and Data Analysismentioning

confidence: 99%

Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T₂ Mapping

Ahmad

Maiworm

Nöth

et al. 2020

Magnetic Resonance Imaging

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“…1 Modern magnetic resonance imaging (MRI) techniques and immunohistochemical studies have revealed neuronal damage in early stages of the disease course of patients with clinically isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS). [2][3][4] Based on the apparent molecular mass of the mammalian subunits, three major subunits of neurofilament have been defined: light (65−70 kDa), medium (140-160 kDa) and heavy chain (200-220 kDa). Neurofilament light chain (NfL) has been studied most extensively and an association with acute neuro-axonal damage was demonstrated for NfL which is elevated in CSF during all stages of multiple sclerosis (MS) with a heightened (10 times) increase in times of acute relapses.…”

Section: Introductionmentioning

confidence: 99%

Serum neurofilament light chain is a biomarker of acute and chronic neuronal damage in early multiple sclerosis

et al. 2018

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“…Quantitative multi-parameter mapping (MPM) is an excellent example, whereby four quantitative maps [proton density (PD), magnetization transfer saturation (MT), longitudinal relaxation rate (R1 = 1/T1), and transverse relaxation rate (R2 * = 1/T2 * )] of the whole brain can be measured in a scan time of around 20 min (Weiskopf et al, 2013). These maps are sensitive to microstructural tissue properties of high clinical relevance, such as myelin and iron content (Weiskopf et al, 2015), and have been shown to be sensitive to pathology, for example in multiple sclerosis (Jurcoane et al, 2013;Gracien et al, 2017;Lommers et al, 2019) and spinal cord injury (Grabher et al, 2015). Despite the high validity of MPM (Weiskopf et al, 2013;Leutritz et al, 2020), the widely used standard MPM protocol with 1 mm resolution (Weiskopf et al, 2013;Callaghan et al, 2014;Grabher et al, 2015;Ziegler et al, 2018;Lommers et al, 2019;Leutritz et al, 2020;Taubert et al, 2020) has a relatively long acquisition time, limiting its translational potential (Bagnato et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Quantitative Multi-Parameter Mapping Optimized for the Clinical Routine

et al. 2020

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Using quantitative multi-parameter mapping (MPM), studies can investigate clinically relevant microstructural changes with high reliability over time and across subjects and sites. However, long acquisition times (20 min for the standard 1-mm isotropic protocol) limit its translational potential. This study aimed to evaluate the sensitivity gain of a fast 1.6-mm isotropic MPM protocol including post-processing optimized for longitudinal clinical studies. 6 healthy volunteers (35±7 years old; 3 female) were scanned at 3T to acquire the following whole-brain MPM maps with 1.6 mm isotropic resolution: proton density (PD), magnetization transfer saturation (MT), longitudinal relaxation rate (R1), and transverse relaxation rate (R2*). MPM maps were generated using two RF transmit field (B1+) correction methods: (1) using an acquired B1+ map and (2) using a data-driven approach. Maps were generated with and without Gibb's ringing correction. The intra-/inter-subject coefficient of variation (CoV) of all maps in the gray and white matter, as well as in all anatomical regions of a fine-grained brain atlas, were compared between the different post-processing methods using Student's t-test. The intra-subject stability of the 1.6-mm MPM protocol is 2–3 times higher than for the standard 1-mm sequence and can be achieved in less than half the scan duration. Intra-subject variability for all four maps in white matter ranged from 1.2–5.3% and in gray matter from 1.8 to 9.2%. Bias-field correction using an acquired B1+ map significantly improved intra-subject variability of PD and R1 in the gray (42%) and white matter (54%) and correcting the raw images for the effect of Gibb's ringing further improved intra-subject variability in all maps in the gray (11%) and white matter (10%). Combining Gibb's ringing correction and bias field correction using acquired B1+ maps provides excellent stability of the 7-min MPM sequence with 1.6 mm resolution suitable for the clinical routine.

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Longitudinal quantitative MRI assessment of cortical damage in multiple sclerosis: A pilot study

Abstract: 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1485-1490.

Cited by 22 publications

References 35 publications

Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T₂ Mapping

Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T₂ Mapping

Serum neurofilament light chain is a biomarker of acute and chronic neuronal damage in early multiple sclerosis

Quantitative Multi-Parameter Mapping Optimized for the Clinical Routine

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Longitudinal quantitative MRI assessment of cortical damage in multiple sclerosis: A pilot study

Abstract: 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2017;46:1485-1490.

Cited by 22 publications

References 35 publications

Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T2 Mapping

Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T2 Mapping

Serum neurofilament light chain is a biomarker of acute and chronic neuronal damage in early multiple sclerosis

Quantitative Multi-Parameter Mapping Optimized for the Clinical Routine

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Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T₂ Mapping

Cortical Changes in Epilepsy Patients With Focal Cortical Dysplasia: New Insights With T₂ Mapping