Multi‐modal quantitative MRI investigation of brain tissue neurodegeneration in multiple sclerosis

Abstract

Purpose To investigate the utility of multimodal quantitative magnetic resonance imaging (qMRI) and atlas-based methods to identify characteristics of lesion-driven injury and neurodegeneration in relapsing remitting multiple sclerosis (RRMS) Materials and Methods This work is health insurance portability and accountability act compliant. High resolution T1-weighted, dual echo and fluid-attenuated inversion recovery and diffusion tensor MRI images were prospectively acquired on 68 RRMS patients (range 25–58 years) and 68 age-matched controls. The data were analyzed using standardized human brain atlas-based tissue segmentation procedures to obtain regional volumes and their corresponding T2 relaxation times and DTI maps. Results Group-averaged brain atlas-based qMRI maps of T2, fractional anisotropy and diffusivities are visually presented and compared between controls and RRMS. The analysis shows a widespread injury in RRMS. Atrophy of the CC was substantial in RRMS. The qMRI attributes of the neocortex in combination with the CC such as T2 and diffusivities were elevated and correlated with disability. Conclusion Using a standardized multimodal qMRI acquistion and analyses that accounted for lesion distribution we demonstrate that cerebral pathology is widespread in RRMS. Our analysis of CC and neocortex qMRI metrics in relation to disability points to a neurodegenerative injury component that is independent from lesions.

Biological Water Dynamics and Entropy: A Biophysical Origin of Cancer and Other Diseases

“…Interestingly, in 2004, Law et al demonstrated that the NAWM of patients with relapsing remitting MS (RRMS), shows decreased perfusion compared with that of controls [322] by using dynamic susceptibility contrast material-enhanced perfusion magnetic resonance (MR) imaging. In 2012, Hasan et al employed quantitative DTI in the study of brain tissue neurodegeneration in MS patients [323] with lesion-driven injury and neurodegeneration in relapsing remitting MS (RRMS). Widespread cerebral pathology and a neurodegenerative injury component that was independent from lesions in RRMS were demonstrated.…”

White matter segmentation based on a skeletonized atlas: Effects on diffusion tensor imaging studies of regions of interest

“…IN DIFFUSION TENSOR imaging (DTI) studies of brain white matter regions‐of‐interest (ROI), manual outlining of ROIs can be particularly time‐consuming and may introduce user bias. Automated selection of white matter ROIs can be accomplished with atlas‐based segmentation . According to this approach an image volume corresponding to a white matter atlas is registered to an individual's image volume, and the resulting spatial transformation is applied to the white matter labels of the atlas to transform them to the individual's space.…”

Lateral ventricular cerebrospinal fluid diffusivity as a potential neuroimaging marker of brain temperature in multiple sclerosis: a hypothesis and implications

“…In addition, dual fast spin-echo (FSE) images were acquired with echo and repetition times of TE1/TE2/TR = 8.2/90/6800 ms and a FLAIR sequence with (TE/TI/TR = 80/2500/8000 ms). These images were used for lesion quantification [19, 20]. The slice thickness for both FSE and FLAIR data was 3.0 mm with 44 contiguous axial slices covering the same inferior-to-superior prescription of the 3D T1-weighted sequence and a square field-of-view (FOV) of 240 mm.…”

“…All human brain MRI data sets were masked to remove non-brain tissues and estimate the intracranial volume (ICV) for each subject as described elsewhere [19, 20]. …”

“…Whole brain lesion load (LL) was quantified in the patient groups using the co-registered multispectral dual FSE and the FLAIR volumes as described elsewhere [19, 20]. The lesion volumes were saved as binary masks to enable fusion with other multimodal volumes acquired from the same subject.…”