Non-invasive brain mapping of motor-related areas of four limbs in patients with clinically isolated syndrome compared to healthy normal controls

Harirchian, Mohammad Hossein; Rezvanizadeh, Alireza; Fakhri, Mohammad; Oghabian, Mohammad Ali; Ghoreishi, Abdolreza; Zarei, Mojtaba; Firouznia, Kavous

doi:10.1016/j.jocn.2009.10.010

Cited by 13 publications

(9 citation statements)

References 35 publications

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“…However, the correlation between focal white matter (WM) lesions and clinical disability is only modest, a phenomenon which has persisted for many years and is referred to as the clinicoradiological paradox [2]. One of the factors thought to explain this discrepancy is individual variations in brain plasticity and cortical reorganization, which may limit the clinical disability caused by focal lesions [3], [4], [5]. Because of this, interest in other pathological tissue changes, beside WM lesions, has been of interest in recent years.…”

Section: Introductionmentioning

confidence: 99%

Normal Appearing and Diffusely Abnormal White Matter in Patients with Multiple Sclerosis Assessed with Quantitative MR

et al. 2014

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Introduction: Magnetic Resonance Imaging is a sensitive technique for detecting white matter (WM) MS lesions, but the relation with clinical disability is low. Because of this, changes in both ‘normal appearing white matter’ (NAWM) and ‘diffusely abnormal white matter’ (DAWM) have been of interest in recent years. MR techniques, including quantitative magnetic resonance imaging (qMRI) and quantitative magnetic resonance spectroscopy (qMRS), have been developed in order to detect and quantify such changes. In this study, qMRI and qMRS were used to investigate NAWM and DAWM in typical MS patients and in MS patients with low number of WM lesions. Patient data were compared to ‘normal white matter’ (NWM) in healthy controls. Methods: QMRI and qMRS measurements were performed on a 1.5 T Philips MR-scanner. 35 patients with clinically definite MS and 20 healthy controls were included. Twenty of the patients fulfilled the ‘Barkhof-Tintoré criteria’ for MS, (‘MRIpos’), whereas 15 showed radiologically atypical findings with few WM lesions (‘MRIneg’). QMRI properties were determined in ROIs of NAWM, DAWM and lesions in the MS groups and of NWM in controls. Descriptive statistical analysis and comparisons were performed. Correlations were calculated between qMRI measurements and (1) clinical parameters and (2) WM metabolite concentrations. Regression analyses were performed with brain parenchyma fraction and MSSS. Results: NAWM in the MRIneg group was significantly different from NAWM in the MRIpos group and NWM. In addition, R1 and R2 of NAWM in the MRIpos group correlated negatively with EDSS and MSSS. DAWM was significantly different from NWM, but similar in the MS groups. N-acetyl aspartate correlated negatively with R1 and R2 in MRIneg. R2 of DAWM was associated with BPF. Conclusions: Changes in NAWM and DAWM are independent pathological entities in the disease. The correlation between qMRI and clinical status may shed new light on the clinicoradiological paradox.

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Section: Introductionmentioning

confidence: 99%

Normal Appearing and Diffusely Abnormal White Matter in Patients with Multiple Sclerosis Assessed with Quantitative MR

et al. 2014

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“…Previous investigators proposed that reorganization of FC precedes the onset of clinical manifestations of motor dysfunction in MS [Harirchian et al, 2010], and may serve a compensatory role to limit motor disability at earlier stages of disease progression when the lesion burden is presumably lighter [Basile et al, 2013;Roosendaal et al, 2010]. Although there were more people with secondaryprogressive MS in our MI group than in the MP group, lesion loads and global brain atrophy were comparable in the two groups, and did not correlate with motor Normalized volume (upper panel) and mean MTR (lower panel) within brain regions of interest for HC, MP and MI participants were shown with mean and the standard error (SE), adjusted for age and sex.…”

Section: Correlates Of Preserved Motor Function In Msmentioning

confidence: 99%

“…Although there were more people with secondaryprogressive MS in our MI group than in the MP group, lesion loads and global brain atrophy were comparable in the two groups, and did not correlate with motor Normalized volume (upper panel) and mean MTR (lower panel) within brain regions of interest for HC, MP and MI participants were shown with mean and the standard error (SE), adjusted for age and sex. Changes in ipsilateral motor network activity have been linked to upper limb motor function in CIS [Harirchian et al 2010;Pantano et al, 2002] and RRMS [Reddy et al, 2000]. Significant post hoc comparisons were indicated with '*' after applying Tukey HSD test.…”

Section: Correlates Of Preserved Motor Function In Msmentioning

confidence: 99%

Abnormal functional connectivity and cortical integrity influence dominant hand motor disability in multiple sclerosis: a multimodal analysis

Zhong

Nantes

Holmes

et al. 2016

Human Brain Mapping

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Functional reorganization and structural damage occur in the brains of people with multiple sclerosis (MS) throughout the disease course. However, the relationship between resting-state functional connectivity (FC) reorganization in the sensorimotor network and motor disability in MS is not well understood. This study used resting-state fMRI, T1-weighted and T2-weighted, and magnetization transfer (MT) imaging to investigate the relationship between abnormal FC in the sensorimotor network and upper limb motor disability in people with MS, as well as the impact of disease-related structural abnormalities within this network. Specifically, the differences in FC of the left hemisphere hand motor region between MS participants with preserved (n = 17) and impaired (n = 26) right hand function, compared with healthy controls (n = 20) was investigated. Differences in brain atrophy and MT ratio measured at the global and regional levels were also investigated between the three groups. Motor preserved MS participants had stronger FC in structurally intact visual information processing regions relative to motor impaired MS participants. Motor impaired MS participants showed weaker FC in the sensorimotor and somatosensory association cortices and more severe structural damage throughout the brain compared with the other groups. Logistic regression analysis showed that regional MTR predicted motor disability beyond the impact of global atrophy whereas regional grey matter volume did not. More importantly, as the first multimodal analysis combining resting-state fMRI, T1-weighted, T2-weighted and MTR images in MS, we demonstrate how a combination of structural and functional changes may contribute to motor impairment or preservation in MS. Hum Brain Mapp 37:4262-4275, 2016. © 2016 Wiley Periodicals, Inc.

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“…Some lesions, when viewed on T1-weighted images, appear hypo-intense compared to surrounding WM ,and the inclusion of T1-weighted imaging may increase the correlation with clinical disability, but only to a limited degree (138,139). Factors believed to explain this discrepancy include cortical reorganisation (140), where other parts of the brain may compensate for focal injury; brain plasticity (141,142), where signal transmissions may use alternative pathways; and the consideration of strategic lesion location (143,144). Subsequently, other pathological changes have been of interest in recent years, including lesions in cortical GM (145,146), changes in deep GM (147,148) and changes in normal appearing white matter (NAWM) (5,(149)(150)(151)(152)(153).…”

Section: Mri In Msmentioning

confidence: 99%

Quantitative Magnetic Resonance Imaging of the Brain : Applications for Tissue Segmentation and Multiple Sclerosis

West¹

2014

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Magnetic resonance imaging (MRI) is a sensitive technique for assessing white matter (WM) lesions in multiple sclerosis (MS), but there is a low correlation between MRI findings and clinical disability. Because of this, other pathological changes are of interest, including changes in normal appearing white matter (NAWM) and diffusely abnormal white matter (DAWM). Even so, the mechanisms leading to permanent disability in MS remain unclear. In contrast to conventional MRI, quantitative MRI (qMRI) is aimed at the direct measurement of the physical tissue properties, such as the relaxation times, T1 and T2, as well as the proton density (PD). QMRI is promising for characterising and quantifying changes in MS and for brain tissue segmentation. The present work describes a novel method of qMRI for the human brain (QMAP), and a segmentation method based on this. The developed methods were validated in control subjects and MR phantoms. Furthermore, an application in diseased human brain was demonstrated in MS patients. In all, 50 healthy controls and 35 MS patients were scanned with qMRI in a total of 225 acquisitions. One major finding of this work was that qMRI was able to detect and quantify changes in the MS disease that were not visible using conventional MRI. In particular, it was found that DAWM appears to constitute an intermediate between focal white matter (WM) lesions and NAWM. These changes may be caused by pathological processes that are not entirely attributable to Wallerian degeneration. This study showed that the QMAP method had high accuracy and relatively high precision, within a clinically acceptable time. This work also demonstrated that qMRI could be used for brain tissue segmentation and volume estimation of the whole brain, using pre-defined tissue characteristics. The results showed that brain tissue segmentation had high repeatability, which was somewhat lower when different geometries were acquired or different field strengths used. In particular, small differences were found between 1.5 T and 3.0 T in deep brain structures, the cerebellum and the brain stem. This work leads the way for early clinical applications of qMRI, and the challenge for the years to come is to understand the connection between qMRI properties of the brain and underlying biology.Bildtagning med magnetresonanstomografi (MRT) är en teknik som kan användas för att upptäcka lesioner i vit substans hos patienter med multipel skleros (MS), men sambandet mellan lesioner och klinisk funktionsnedsättning är svagt. På grund av detta har intresset för andra patologiska processer i hjärnan ökat. Exempel är förändringar i vit substans som ser normal ut vid MRT (NAWM) och även så kallad diffus vit vävnad (DAWM). Det är emellertid fortfarande oklart vilka mekanismer i MS som leder till klinisk funktionsnedsättning. Med kvantitativ MRT (qMRT) kan fysiologiska egenskaper i vävnaden, som till exempel relaxationstiderna (T1 och T2) samt protontäthet (PD), mätas. QMRT kan användas för att mäta förändringar i hjärnan hos MS patienter och des...

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Non-invasive brain mapping of motor-related areas of four limbs in patients with clinically isolated syndrome compared to healthy normal controls

Cited by 13 publications

References 35 publications

Normal Appearing and Diffusely Abnormal White Matter in Patients with Multiple Sclerosis Assessed with Quantitative MR

Normal Appearing and Diffusely Abnormal White Matter in Patients with Multiple Sclerosis Assessed with Quantitative MR

Abnormal functional connectivity and cortical integrity influence dominant hand motor disability in multiple sclerosis: a multimodal analysis

Quantitative Magnetic Resonance Imaging of the Brain : Applications for Tissue Segmentation and Multiple Sclerosis

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