MRI/MRS of corpus callosum in patients with clinically isolated syndrome suggestive of multiple sclerosis

2003 ◽  
Vol 9 (6) ◽  
pp. 554-565 ◽  
Author(s):  
J P Ranjeva ◽  
J Pelletier ◽  
S Confort-Gouny ◽  
D Ibarrola ◽  
B Audoin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Corpus Callosum ◽  
Early Stage ◽  
Magnetization Transfer ◽  
Mean Diffusivity ◽  
Clinically Isolated Syndrome ◽  
Resonance Spectroscopy ◽  
Magnetization Transfer Ratio ◽  
R Ratio

A trophy of corpus callosum (C C) related to axonal loss has previously been observed in patients at the early stage of clinically definite multiple sclerosis (CDMS). Atrophy increases with the progression of the disease. Nevertheless, no data concerning the onset of atrophy of C C are currently available. The purpose of this study is to determine if damage in callosal tissue was present at the earliest stage of MS, in a subgroup of patients presenting with a clinically isolated syndrome suggestive of MS (C ISSMS), fulfilling the dissemination in space criteria according to McDonald. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) techniques were applied to measure C C volume, magnetization transfer ratio (MTR), mean diffusivity (MD), N-acetyl aspartate/choline-containing compounds (NAA/C ho) ratio, N-acetyl aspartate/total creatine (NA A/C r) ratio and C ho/C r ratio inside the C C of 46 C ISSMS patients and 24 sexand age-matched controls. No atrophy of C C was observed in the C ISSMS group. C C of patients was character ized by decreased MTR and increased MD. No change in the NA A/C r ratio was observed while the NA A/C ho ratio decreased and C ho/C r ratio increased in the splenium and the central anterio r part of C C. These abnormalities were present in patients with, but also without, macroscopic lesions inside the C C. O ur results indicate that diffuse structural and metabolic changes, which may be interpreted as representing predominantly myelin patho logy, occur in the C C at the earliest stage of MS before any atrophy is detected.

Clinically benign multiple sclerosis despite large T2 lesion load: Can we explain this paradox?

2007 ◽  
Vol 14 (2) ◽  
pp. 205-211 ◽  
Author(s):  
S. Strasser-Fuchs ◽  
C. Enzinger ◽  
S. Ropele ◽  
M. Wallner ◽  
F. Fazekas
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Brain Plasticity ◽  
Magnetization Transfer ◽  
Brain Parenchyma ◽  
Quantitative Mri ◽  
Resonance Spectroscopy ◽  
Magnetization Transfer Ratio ◽  
Lesion Load ◽  
Brain Parenchymal

Magnetic resonance imaging (MRI) techniques such as magnetization transfer imaging and magnetic resonance spectroscopy (MRS) may reveal otherwise undetectable tissue damage in multiple sclerosis (MS) and can serve to explain more severe disability than expected from conventional MRI. That an inverse situation may exist where non-conventional quantitative MRI and MRS metrics would indicate less abnormality than expected from T2 lesion load to explain preserved clinical functioning was hypothesized. Quantitative MRI and MRS were obtained in 13 consecutive patients with clinically benign MS (BMS; mean age 44 ± 9 years) despite large T 2 lesion load and in 15 patients with secondary progressive MS (SPMS; mean age 47 ± 6 years) matched for disease duration. The magnetization transfer ratio (MTR), magnetization transfer rate ( kfor), brain parenchymal fraction (BPF) and brain metabolite concentrations from proton MRS were determined. BMS patients were significantly less disabled than their SPMS counterparts (mean expanded disability status score: 2.1 ± 1.1 versus 6.2 ± 1.1; P < 0.001) and had an even somewhat higher mean T2 lesion load (41.2 ± 27.1 versus 27.9 ± 24.8 cm3; P = 0.19). Normal appearing brain tissue histogram metrics for MTR and kfor, mean MTR and kfor of MS lesions and mean BPF were similar in BMS and SPMS patients. Levels of N-acetyl-aspartate, choline and myoinositol were comparable between groups. This study thus failed to explain the preservation of function in our BMS patients with large T2 lesion load by a higher morphologic or metabolic integrity of the brain parenchyma. Functional compensation must come from other mechanisms such as brain plasticity. Multiple Sclerosis 2008; 14: 205—211. http://msj.sagepub.com

scholarly journals MRI of the corpus callosum in multiple sclerosis: association with disability

2010 ◽  
Vol 16 (2) ◽  
pp. 166-177 ◽  
Author(s):  
A. Ozturk ◽  
SA Smith ◽  
EM Gordon-Lipkin ◽  
DM Harrison ◽  
N. Shiee ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Corpus Callosum ◽  
Diffusion Tensor ◽  
Magnetization Transfer ◽  
Quantitative Mri ◽  
Magnetization Transfer Ratio ◽  
Lesion Volume ◽  
Impaired Performance ◽  
Disability Status ◽  
Axon Damage

Inflammatory demyelination and axon damage in the corpus callosum are prominent features of multiple sclerosis (MS) and may partially account for impaired performance on complex tasks. The objective of this article was to characterize quantitative callosal MRI abnormalities and their association with disability. In 69 participants with MS and 29 healthy volunteers, lesional and extralesional callosal MRI indices were estimated via diffusion tensor tractography. expanded disability status scale (EDSS) and MS functional composite (MSFC) scores were recorded in 53 of the participants with MS. All tested callosal MRI indices were diffusely abnormal in MS. EDSS score was correlated only with age (r = 0.51). Scores on the overall MSFC and its paced serial auditory addition test (PASAT) and 9-hole peg test components were correlated with callosal fractional anisotropy (r = 0.27, 0.35, and 0.31, respectively) and perpendicular diffusivity (r = —0.29, —0.30, and —0.31) but not with overall callosal volume or callosal lesion volume; the PASAT score was more weakly correlated with callosal magnetization-transfer ratio (r = 0.21). Anterior callosal abnormalities were associated with impaired PASAT performance and posterior abnormalities with slow performance on the 9-hole peg test. In conclusion, abnormalities in the corpus callosum can be assessed with quantitative MRI and are associated with cognitive and complex upper-extremity dysfunction in MS.

Onset and underpinnings of white matter atrophy at the very early stage of multiple sclerosis - a two-year longitudinal MRI/MRSI study of corpus callosum

2007 ◽  
Vol 13 (1) ◽  
pp. 41-51 ◽  
Author(s):  
B Audoin ◽  
D Ibarrola ◽  
I Malikova ◽  
E Soulier ◽  
S Confort-Gouny ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Magnetic Resonance ◽  
Corpus Callosum ◽  
Early Stage ◽  
Disability Status ◽  
Longitudinal Mri ◽  
Anterior Body ◽  
One Year

Backgrounds Atrophy of corpus callosum (CC), a white matter structure linking the two hemispheres, is commonly observed in multiple sclerosis (MS). However, the occurrence and processes leading to this alteration are not yet determined. Goal and methods To better characterize the onset and progression of CC atrophy from the early stage of MS, we performed a two-year follow-up magnetic resonance imaging/magnetic resonance spectroscopic imaging (MRI/MRSI) exploration of CC in 24 patients with clinically isolated syndrome. These patients were explored using the same protocol at month (M)6, M12 and M24. MRI/MRSI techniques were applied to measure CC volume, and relative concentrations of N-acetylaspartate (NAA), creatine/phosphocreatine (Cr) and choline-containing compounds (Cho). A group of matched controls was also explored. Results Atrophy of CC, not present at baseline, was observed at M12 and progressed over the second year (M24). At baseline, a decrease in relative NAA level was observed in the anterior and posterior body of CC, with normalization during the follow-up period. In the anterior body, an increase in relative Cho level was observed, with normalization at M6. Normal relative Cr levels were observed at all time points in all sub-regions. The rate of CC atrophy was correlated with the change in the Expanded Disability Status Scale (EDSS) during the follow-up period. Conclusion These results suggest that CC atrophy appears over a period of one year after the first acute inflammatory episode, and that this atrophy is accompanied, especially in the anterior body of CC, by a normalization of the relative Cho levels, marker of acute inflammation, and NAA levels, marker of neuronal dysfunction and/or loss.

scholarly journals Quantitative MRI Demonstrates Abnormality of the Fornix and Cingulum in Multiple Sclerosis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Stephanie B. Syc ◽  
Daniel M. Harrison ◽  
Shiv Saidha ◽  
Michaela Seigo ◽  
Peter A. Calabresi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Healthy Volunteers ◽  
Cognitive Dysfunction ◽  
Diffusion Tensor ◽  
Magnetization Transfer ◽  
Mean Diffusivity ◽  
Brain Structures ◽  
Quantitative Mri ◽  
Magnetization Transfer Ratio

Objective. To characterize MR signal changes associated with tissue damage in the fornix and cingulum in multiple sclerosis (MS) using quantitative MRI measures and to determine associations with cognitive dysfunction.Background. The fornix and cingulum are white-matter bundles that carry information related to cognition. While cognitive dysfunction is reported in 40–60% of MS patients, the neuroanatomical correlates of cognitive impairment remain incompletely understood.Methods. The cingulum, pillars of the fornix, and corticospinal tract were segmented by fiber tracking via diffusion tensor imaging. Average tract-specific fractional anisotropy (FA), mean diffusivity (MD), and magnetization transfer ratio (MTR) were compared in MS cases and healthy volunteers. Associations with clinical measures and neuropsychological tests were derived by multivariate linear regression.Results. Fornix FA (P=0.004) and MTR (P=0.005) were decreased, and fornix MD (P<0.001) and cingulum MD (P<0.001) increased, in MS cases (n=101) relative to healthy volunteers (n=16) after adjustment for age and sex. Lower fornix FA and MTR, and higher fornix MD andλ∥, were correlated with lower PASAT-3 scores, but not with slower 25FTW times. Lower PASAT-3 scores were associated with lower cingulum FA and higher MD andλ⊥.Conclusions. Cognitive dysfunction in MS may involve damage to a widespread network of brain structures, including white-matter pathways within the limbic system.

scholarly journals Glutamine + glutamate level predicts the magnitude of microstructural organization in the gray matter in the healthy elderly

2019 ◽  
pp. 1-9
Author(s):  
Tomokazu Motegi ◽  
Kosuke Narita ◽  
Kazuyuki Fujihara ◽  
Masato Kasagi ◽  
Yusuke Suzuki ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Gray Matter ◽  
Diffusion Tensor ◽  
Early Stage ◽  
Mean Diffusivity ◽  
Posterior Cingulate Cortex ◽  
Resonance Spectroscopy ◽  
Cortical Region ◽  
Healthy Elderly

ABSTRACTBackground:Diffusion tensor imaging (DTI), which is a technique for measuring the degree and direction of movement of water molecules in tissue, has been widely used to noninvasively assess white matter (WM) or gray matter (GM) microstructures in vivo. Mean diffusivity (MD), which is the average diffusion across all directions, has been considered as a marker of WM tract degeneration or extracellular space enlargement in GM. Recent lines of evidence suggest that cortical MD can better identify early-stage Alzheimer’s disease than structural morphometric parameters in magnetic resonance imaging. However, knowledge of the relationships between cortical MD and other biological factors in the same cortical region, e.g. metabolites, is still limited.Methods:Thirty-three healthy elderly individuals [aged 50–77 years (mean, 63.8±7.4 years); 11 males and 22 females] were enrolled. We estimated the associations between cortical MD and neurotransmitter levels. Specifically, we measured levels of γ-aminobutyric acid (GABA) and glutamate + glutamine (Glx), which are inhibitory and excitatory neurotransmitters, respectively, in medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) using MEGA-PRESS magnetic resonance spectroscopy, and we measured regional cortical MD using DTI.Results:Cortical MD was significantly negatively associated with Glx levels in both mPFC and PCC. No significant association was observed between cortical MD and GABA levels in either GM region.Conclusion:Our findings suggest that degeneration of microstructural organization in GM, as determined on the basis of cortical MD measured by DTI, is accompanied by the decline of Glx metabolism within the same GM region.

Multicentre proton magnetic resonance spectroscopy imaging of primary progressive multiple sclerosis

2004 ◽  
Vol 10 (3_suppl) ◽  
pp. S73-S78 ◽  
Author(s):  
Ponnada A Narayana ◽  
Jerry S Wolinsky ◽  
Sajja B Rao ◽  
Renjie He ◽  
Meghana Mehta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Proton Magnetic Resonance ◽  
Progressive Multiple Sclerosis ◽  
Resonance Spectroscopy ◽  
Primary Progressive Multiple Sclerosis ◽  
Primary Progressive ◽  
R Ratio ◽  
Magnetic Resonance Spectroscopy Imaging ◽  
Microscopic Pathology

Multicentre baseline proton magnetic resonance spectro scopic data on primary progressive multiple sclerosis (PPMS) patients are acquired and analysed, using automatic analysis software. The metabolite ratios did not differ from centre to centre. The average N-acetylaspar tate/creatine (NA A/C r) ratio in PPMS was significantly lower compared to normal controls. No significant differences were observed in this ratio between lesion-containing regions (LC R) and normal-appearing tissues (NAT). Strong lipid resonances, even in the absence of lesions, are observed in the both grey and white matter in these patients. These observations suggest extensive diffuse and/or microscopic pathology in PPMS. No significant correlation between any of the metabolite ratios and the Extended Disability Scale Score (EDSS) or with other MR measures such as lesion burden and enhancement volumes is observed.

scholarly journals Histopathology and serial, multimodal magnetic resonance imaging in a multiple sclerosis variant

2007 ◽  
Vol 13 (4) ◽  
pp. 471-482 ◽  
Author(s):  
S. Lindquist ◽  
N. Bodammer ◽  
J. Kaufmann ◽  
F. König ◽  
H.-J. Heinze ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Diffusion Tensor Imaging ◽  
Magnetic Resonance ◽  
Clinical Course ◽  
Diffusion Tensor ◽  
Magnetization Transfer ◽  
Resonance Spectroscopy ◽  
Resonance Imaging ◽  
Baló’S Concentric Sclerosis

Defining tools in magnetic resonance imaging (MRI) representing specific pathological processes is needed to understand the complex relationship between inflammation, myelin breakdown, axonal injury and clinical symptoms in multiple sclerosis (MS) and its variants. Here, we describe a case of histologically-defined MS, in which the radiological appearance of the lesion and clinical course support the diagnosis of Balo's concentric sclerosis. Serial magnetization transfer, diffusion tensor imaging and 1H-magnetic resonance spectroscopy, from 14 days to 13 months after biopsy, allow the contextual interpretation of specific pathological changes. In our case, acute inflammation was sensitively traced by fractional anisotropy and increased lactate in spectroscopy. In contrast, magnetization transfer ratio and the apparent diffusion coefficient monitor the sequential loss of tissue in selected rings of the lesion. The delay from the peak of symptoms in a dramatic clinical course to the maximum tissue destruction indicated through MRI suggests that compromise of axonal function may be decisive for the acute clinical situation. This is the first report comparing 1Hmagnetic resonance spectroscopy, magnetization transfer and diffusion tensor imaging with histopathology in a patient with Balo's concentric sclerosis. Multiple Sclerosis 2007; 13: 471-482. http://msj.sagepub.com

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