scholarly journals Μελέτη προσβολής του κεντρικού νευρικού συστήματος σε ασθενείς με σύνδρομο Sjogren

2014 ◽  
Author(s):  
Λουκία Τζαρούχη
Keyword(s):  
Fractional Anisotropy ◽  
Spatial Statistics ◽  
Corticospinal Tract ◽  
Mean Diffusivity ◽  
Uncinate Fasciculus ◽  
Radial Diffusivity ◽  
Superior Longitudinal Fasciculus ◽  
Axial Diffusivity ◽  
Cingulum Bundle ◽  
Anterior Thalamic Radiation

ΣκοπόςΝευρολογικές εκδηλώσεις από το κεντρικό νευρικό σύστημα έχουν αναφερθεί στοπρωτοπαθές σύνδρομο Sjögren, ήδη από την αρχική περιγραφή του. Ωστόσο, το εύρος τωνκλινικών, παθολογοανατομικών και απεικονιστικών εκδηλώσεων της προσβολής έχουνανεπαρκώς μελετηθεί. Υπάρχουν ενδείξεις στη βιβλιογραφία σχετικά με την πιθανότηταλανθάνουσας/υποκλινικής προσβολής του κεντρικού νευρικού συστήματος. Σκοπός τηςπαρούσας μελέτης ήταν η εκτίμηση της λανθάνουσας/υποκλινικής προσβολής του κεντρικούνευρικού συστήματος στο πρωτοπαθές σύνδρομο Sjögren, μελετώντας μεταβολές της φαιάς καιλευκής ουσίας σε ασυμπτωματικούς ασθενείς χρησιμοποιώντας νεότερες τεχνικές μαγνητικήςτομογραφίας εγκεφάλου.Υλικό και μέθοδοιΣτο πρώτο σκέλος της παρούσας μελέτης πήραν μέρος 53 τυχαιοποιημένοι ασθενείς μεπρωτοπαθές σύνδρομο Sjögren, 18 μάρτυρες με συστηματική σκλήρυνση συμβατοί ως προς τηνηλικία και τη διάρκεια νόσου και 35 υγιείς μάρτυρες. Η παρουσία εστιακών αλλοιώσεων τηςλευκής ουσίας αξιολογήθηκε μελετώντας εικόνες FLAIR ακολουθίας. Μεταβολές στον όγκοφαιάς και λευκής ουσίας μελετηθήκαν με την εφαρμογή της τεχνικής Voxel-BasedMorphometry (VBM) σε εικόνες 3D-T1 ακολουθίας.Στο δεύτερο σκέλος της μελέτης πήραν μέρος 19 ασθενείς με πρωτοπαθές σύνδρομοSjögren και 16 υγιείς μάρτυρες συμβατοί ως προς την ηλικία. Η ανάλυση των δεδομένων έγινεχρησιμοποιώντας την μέθοδο tract-based spatial statistics (TBSS) για την εκτίμηση μεταβολών της κλασματικής ανισοτροπίας (fractional anisotropy/FA), μέσης (mean diffusivity/MD),εγκάρσιας (radial diffusivity/RD) και επιμήκους (axial diffusivity/AD) διάχυσης.Κριτήρια αποκλεισμού από την μελέτη ήταν το ιστορικό μεταβολικών, νευρολογικώνκαι ψυχιατρικών νοσημάτων και η παρουσία παραγόντων κινδύνου για καρδιαγγειακώνσυμβάντων.ΑποτελέσματαΕστιακές αλλοιώσεις λευκής ουσίας παρατηρήθηκαν σε 38 από τους 53 (71,7%)ασθενείς με πρωτοπαθές σύνδρομο Sjögren, σε 6 από τους 18 (33,3%) ασθενείς με συστηματικήσκλήρυνση και σε 17 από τους 35 (48,6%) μάρτυρες. Ο αριθμός των εστιακών αλλοιώσεων τηςλευκής ουσίας ≥ 2 mm ήταν σημαντικά μεγαλύτερος στους ασθενείς με πρωτοπαθές σύνδρομοSjögren συγκριτικά με τους υγιείς μάρτυρες (p: 0004). Επιπλέον, ο αριθμός των εστιακώναλλοιώσεων <2mm ήταν σημαντικά μεγαλύτερος στους ασθενείς με πρωτοπαθές σύνδρομοSjögren συγκριτικά με τους υγιείς μάρτυρες (p: 0001). Δεν παρατηρήθηκαν στατιστικάσημαντικές διαφορές στον αριθμό εστιακών αλλοιώσεων ≥2mm και στον αριθμό εστιακώναλλοιώσεων <2mm μεταξύ ασθενών με πρωτοπαθές σύνδρομο Sjögren και ασθενών μεσυστηματική σκλήρυνση Στους ασθενείς με πρωτοπαθές σύνδρομο Sjögren, η παρουσίαεστιακών αλλοιώσεων της λευκής ουσίας είχε θετική συσχέτιση με τη διάρκεια νόσου.Μειωμένος όγκος φαιάς ουσίας παρατηρήθηκε στους ασθενείς με πρωτοπαθές σύνδρομοSjögren συγκριτικά με τους υγιείς μάρτυρες αμφοτερόπλευρα σε περιοχές του φλοιού κυρίωςστον ινιακό, τον βρεγματικό και μετωπιαίο λοβό καθώς και στο θάλαμο, τον κερκοφόρο πυρήνακαι τα παρεγκεφαλιδικά ημισφαίρια (p<0.05). Μειωμένος όγκος λευκής ουσίας παρατηρήθηκεστους ασθενείς με πρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες διάχυτα στα εγκεφαλικά ημισφαίρια στους μετωπιαίους λοβούς και ινιακούς λοβούς τη παρεγκεφαλίδακαι το μεσολόβιο (σπληνίο και γόνυ) (p<0.05).Σημαντικά μικρότερες τιμές κλασματικής ανισοτροπίας παρατηρήθηκαν στους ασθενείςμε πρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες. Μικρότερες τιμέςκλασματικής ανισοτροπίας παρατηρήθηκαν αμφοτερόπλευρα στη φλοιονωτιαία οδό (corticospinaltract), το ανώτερο επίμηκες δεμάτιο (superior longitudinal fasciculus), το δεμάτιο τουπροσαγωγίου (cingulum bundle), την πρόσθια ακτινοβολία του θαλάμου (anterior thalamicradiation), το κατώτερο μετωπο-ινιακό δεμάτιο (inferior fronto-occipital fasciculus), τοαγκιστρωτό δεμάτιο (uncinate fasciculus) και το κατώτερο επίμηκες δεμάτιο (inferiorlongitudinal fasciclulus). Η σύγκριση για διαφορές στις τιμές της μέσης διάχυσης, της εγκάρσιαςκαι επιμήκους διάχυσης ανέδειξε περιοχές με αυξημένη μέση και εγκάρσια διάχυση και περιοχέςμε μειωμένη επιμήκη διάχυση στους ασθενείς με πρωτοπαθές σύνδρομο Sjögren διάχυτα στονεγκέφαλο.ΣυμπεράσματαΤα κύρια ευρήματα της παρούσας μελέτης ήταν η υψηλή επίπτωση εστιακώναλλοιώσεων της λευκής ουσίας σε ασυμπτωματικούς ασθενείς με πρωτοπαθές σύνδρομοSjögren. Η παρουσία των εστιακών αλλοιώσεων της λευκής ουσίας συνοδεύεται από απώλειαόγκου φαιάς ουσίας στο φλοιό, την εν τω βάθει φαιά ουσία και την παρεγκεφαλίδα, καθώς καιαπό απώλεια λευκής ουσίας σε περιοχές του εγκεφάλου αντίστοιχα με την ατροφία της φαιάςουσίας. Ο μηχανισμός της αγγειίτιδας των μικρών αγγείων μέσω της υποαιμάτωσης τουεγκεφαλικού παρεγχύματος μπορεί να εξηγήσει αυτά τα ευρήματα. Επιπλέον, μειωμένες τιμές κλασματικής ανισοτροπίας παρατηρήθηκαν στους ασθενείς μεπρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες σε πολλαπλές οδούς λευκήςουσίας συμπεριλαμβανομένων της φλοιονωτιαίας οδού (corticospinal tract), του ανώτερουεπιμήκους δεματίου (superior longitudinal fasciculus), του δεμάτιου του προσαγωγίου (cingulatefasciculus), της πρόσθιας ακτινοβολίας του θαλάμου (anterior thalamic radiation), τουκατώτερου μετωπο-ινιακού δεματίου (inferior fronto-occipital fasciculus), του αγκιστρωτούδεματίου (uncinate fasciculus) και του κατώτερου επιμήκους συνδέσμου (inferior longitudinalfasciculus). Αυτές οι μεταβολές συνοδεύονται από διάχυτη μείωση των τιμών της επιμήκουςδιάχυσης και αύξηση της μέσης και εγκάρσιας διάχυσης αντίστοιχα στους ασθενείς μεπρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες. Η απώλεια τηςακεραιότητας της λευκής ουσίας μπορεί να οφείλεται είτε στο φαινόμενο της απομυελίνωσηςείτε στο μηχανισμό της Βαλλεριανής εκφύλισης.H παρούσα μελέτη ανέδειξε την παρουσία υποκλινικής, λανθάνουσας προσβολής τουκεντρικού νευρικού συστήματος στο πρωτοπαθές σύνδρομο Sjögren σε μικροσκοπικό επίπεδοπριν την εμφάνιση κλινικών εκδηλώσεων.

scholarly journals A Correlational Study between Microstructural White Matter Properties and Macrostructural Gray Matter Volume Across Normal Ageing: Conjoint DTI and VBM Analysis

2018 ◽  
Vol 11 ◽  
pp. 1178623X1879992 ◽  
Author(s):  
Vikas Pareek ◽  
VP Subramanyam Rallabandi ◽  
Prasun K Roy
Keyword(s):  
White Matter ◽  
Life Span ◽  
Fractional Anisotropy ◽  
Gray Matter ◽  
Healthy Aging ◽  
Gray Matter Volume ◽  
Mean Diffusivity ◽  
Radial Diffusivity ◽  
Axial Diffusivity ◽  
Matter Volume

We investigate the relationship between Gray matter’s volume vis-a-vis White matter’s integrity indices, such Axial diffusivity, Radial diffusivity, Mean diffusivity, and Fractional anisotropy, in individuals undergoing healthy aging. We investigated MRI scans of 177 adults across 20 to 85 years. We used Voxel-based morphometry, and FDT-FSL analysis for estimation of Gray matter volume and White matter’s diffusion indices respectively. Across the life span, we observed an inter-relationship between the Gray matter and White matter, namely that both Axial diffusivity and Mean Diffusivity show strong correlation with Gray matter volume, along the aging process. Furthermore, across all ages the Fractional anisotropy and Mean diffusivity are found to be significantly reduced in females when compared to males, but there are no significant gender differences in Axial Diffusivity and Radial diffusivity. We conclude that for both genders across all ages, the Gray matter’s Volume is strongly correlated with White matter’s Axial Diffusivity and Mean Diffusivity, while being weakly correlated with Fractional Anisotropy. Our study clarifies the multi-scale relationship in brain tissue, by elucidating how the White matter’s micro-structural parameters influences the Gray matter’s macro-structural characteristics, during healthy aging across the life-span.

Segmental Diffusion Properties of the Corticospinal Tract and Motor Outcome in Hemiparetic Children With Perinatal Stroke

2017 ◽  
Vol 32 (6) ◽  
pp. 550-559 ◽  
Author(s):  
Jacquie Hodge ◽  
Bradley Goodyear ◽  
Helen Carlson ◽  
Xing-Chang Wei ◽  
Adam Kirton
Keyword(s):  
Diffusion Tensor Imaging ◽  
Fractional Anisotropy ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Model Development ◽  
Structural Connectivity ◽  
Mean Diffusivity ◽  
Radial Diffusivity ◽  
Perinatal Stroke ◽  
Motor Outcomes

Perinatal stroke injures developing motor systems, resulting in hemiparetic cerebral palsy. Diffusion tensor imaging can explore structural connectivity. We used diffusion tensor imaging to assess corticospinal tract diffusion in hemiparetic children with perinatal stroke. Twenty-eight children (6-18 years) with unilateral stroke underwent diffusion tensor imaging. Four corticospinal tract assessments included full tract, partial tract, minitract and region of interest. Diffusion characteristics (fractional anisotropy, mean, axial, and radial diffusivity) were calculated. Ratios (lesioned/nonlesioned) were compared across segments and to validated long-term motor outcomes (Pediatric Stroke Outcome Measure, Assisting Hand Assessment, Melbourne Assessment). Fractional anisotropy and radial diffusivity ratios decreased as tract size decreased, while mean diffusivity showed consistent symmetry. Poor motor outcomes were associated with lower fractional anisotropy in all segments and radial diffusivity correlated with both Assisting Hand Assessment and Melbourne Assessment. Diffusion imaging of segmented corticospinal tracts is feasible in hemiparetic children with perinatal stroke. Correlations with disability support clinical relevance and utility in model development for personalized rehabilitation.

scholarly journals Greater Loss of White Matter Integrity in Postural Instability and Gait Difficulty Subtype of Parkinson's Disease

2014 ◽  
Vol 41 (6) ◽  
pp. 763-768 ◽  
Author(s):  
Quanquan Gu ◽  
Peiyu Huang ◽  
Min Xuan ◽  
Xiaojun Xu ◽  
Dan Li ◽  
...  
Keyword(s):  
White Matter ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Critical Role ◽  
Postural Instability ◽  
White Matter Integrity ◽  
Radial Diffusivity ◽  
Superior Longitudinal Fasciculus ◽  
Axial Diffusivity ◽  
White Matter Abnormalities

ABSTRACTBackground: Patients with the postural instability and gait difficulty (PIGD) subtype of Parkinson disease (PD) are at a higher risk of dysfunction and are less responsive to dopamine replacement therapy. The PIGD subtype was found to largely associate with white matter lesions, but details of the diffusion changes within these lesions have not been fully investigated. Voxel-based analysis for diffusion tensor imaging data is one of the preferred measures to compare diffusion changes in each voxel in any part of the brain. Methods: PD patients with the PIGD (n=12) and non-PIGD subtypes (n=12) were recruited to compare diffusion differences in fractional anisotropy, axial diffusivity, and radial diffusivity with voxel-based analysis. Results: Significantly reduced fractional anisotropy in bilateral superior longitudinal fasciculus, bilateral anterior corona radiata, and the left genu of the corpus callosum were shown in the PIGD subtype compared with the non-PIGD subtype. Increased radial diffusivity in the left superior longitudinal fasciculus was found in the PIGD subtype with no statistical differences in axial diffusivity found. Conclusions: Our study confirms previous findings that white matter abnormalities were greater in the PIGD subtype than in the non-PIGD subtype. Additionally, our findings suggested: (1) compared with the non-PIGD subtype, loss of white matter integrity was greater in the PIGD subtype; (2) bilateral superior longitudinal fasciculus may play a critical role in microstructural white matter abnormalities in the PIGD subtype; and (3) reduced white matter integrity in the PIGD subtype could be mainly attributed to demyelination rather than axonal loss.

scholarly journals Infratentorial pathology in frontotemporal dementia: cerebellar grey and white matter alterations in FTD phenotypes

2021 ◽  
Author(s):  
Mary Clare McKenna ◽  
Rangariroyashe H. Chipika ◽  
Stacey Li Hi Shing ◽  
Foteini Christidi ◽  
Jasmin Lope ◽  
...  
Keyword(s):  
White Matter ◽  
Fractional Anisotropy ◽  
Cortical Thickness ◽  
Cerebellar Atrophy ◽  
Primary Progressive Aphasia ◽  
Radial Diffusivity ◽  
Axial Diffusivity ◽  
Progressive Aphasia ◽  
Primary Progressive ◽  
Crus I

AbstractThe contribution of cerebellar pathology to cognitive and behavioural manifestations is increasingly recognised, but the cerebellar profiles of FTD phenotypes are relatively poorly characterised. A prospective, single-centre imaging study has been undertaken with a high-resolution structural and diffusion tensor protocol to systematically evaluate cerebellar grey and white matter alterations in behavioural-variant FTD(bvFTD), non-fluent variant primary progressive aphasia(nfvPPA), semantic-variant primary progressive aphasia(svPPA), C9orf72-positive ALS-FTD(C9 + ALSFTD) and C9orf72-negative ALS-FTD(C9-ALSFTD). Cerebellar cortical thickness and complementary morphometric analyses were carried out to appraise atrophy patterns controlling for demographic variables. White matter integrity was assessed in a study-specific white matter skeleton, evaluating three diffusivity metrics: fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD). Significant cortical thickness reductions were identified in: lobule VII and crus I in bvFTD; lobule VI VII, crus I and II in nfvPPA; and lobule VII, crus I and II in svPPA; lobule IV, VI, VII and Crus I and II in C9 + ALSFTD. Morphometry revealed volume reductions in lobule V in all groups; in addition to lobule VIII in C9 + ALSFTD; lobule VI, VIII and vermis in C9-ALSFTD; lobule V, VII and vermis in bvFTD; and lobule V, VI, VIII and vermis in nfvPPA. Widespread white matter alterations were demonstrated by significant fractional anisotropy, axial diffusivity and radial diffusivity changes in each FTD phenotype that were more focal in those with C9 + ALSFTD and svPPA. Our findings indicate that FTD subtypes are associated with phenotype-specific cerebellar signatures with the selective involvement of specific lobules instead of global cerebellar atrophy.

scholarly journals White matter differences between essential tremor and Parkinson disease

Neurology ◽  
2018 ◽  
Vol 92 (1) ◽  
pp. e30-e39 ◽  
Author(s):  
Meher R. Juttukonda ◽  
Giulia Franco ◽  
Dario J. Englot ◽  
Ya-Chen Lin ◽  
Kalen J. Petersen ◽  
...  
Keyword(s):  
White Matter ◽  
Parkinson Disease ◽  
Essential Tremor ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Superior Cerebellar Peduncle ◽  
Radial Diffusivity ◽  
Cerebellar Peduncles ◽  
Cerebellar Peduncle

ObjectiveTo assess white matter integrity in patients with essential tremor (ET) and Parkinson disease (PD) with moderate to severe motor impairment.MethodsSedated participants with ET (n = 57) or PD (n = 99) underwent diffusion tensor imaging (DTI) and fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity values were computed. White matter tracts were defined using 3 well-described atlases. To determine candidate white matter regions that differ between ET and PD groups, a bootstrapping analysis was applied using the least absolute shrinkage and selection operator. Linear regression was applied to assess magnitude and direction of differences in DTI metrics between ET and PD populations in the candidate regions.ResultsFractional anisotropy values that differentiate ET from PD localize primarily to thalamic and visual-related pathways, while diffusivity differences localized to the cerebellar peduncles. Patients with ET exhibited lower fractional anisotropy values than patients with PD in the lateral geniculate body (p < 0.01), sagittal stratum (p = 0.01), forceps major (p = 0.02), pontine crossing tract (p = 0.03), and retrolenticular internal capsule (p = 0.04). Patients with ET exhibited greater radial diffusivity values than patients with PD in the superior cerebellar peduncle (p < 0.01), middle cerebellar peduncle (p = 0.05), and inferior cerebellar peduncle (p = 0.05).ConclusionsRegionally, distinctive white matter microstructural values in patients with ET localize to the cerebellar peduncles and thalamo-cortical visual pathways. These findings complement recent functional imaging studies in ET but also extend our understanding of putative physiologic features that account for distinctions between ET and PD.

scholarly journals Discrimination of epileptogenic lesions and perilesional white matter using diffusion tensor magnetic resonance imaging

2018 ◽  
Vol 32 (1) ◽  
pp. 10-16
Author(s):  
Alexander Rau ◽  
Elias Kellner ◽  
Niels A Foit ◽  
Niklas Lützen ◽  
Dieter H Heiland ◽  
...  
Keyword(s):  
White Matter ◽  
Fractional Anisotropy ◽  
Diffusion Tensor ◽  
Focal Cortical Dysplasia ◽  
Mean Diffusivity ◽  
Area Under The Curve ◽  
P Value ◽  
Radial Diffusivity ◽  
Normal Appearing White Matter ◽  
Diffusion Parameters

The aim of this study was to evaluate whether ganglioglioma (GGL), dysembryoplastic neuroepithelial tumour (DNET) and FCD (focal cortical dysplasia) are distinguishable through diffusion tensor imaging. Additionally, it was investigated whether the diffusion measures differed in the perilesional (pNAWM) and in the contralateral normal appearing white matter (cNAWM). Six GGLs, eight DNETs and seven FCDs were included in this study. Quantitative diffusion measures, that is, axial, radial and mean diffusivity and fractional anisotropy, were determined in the lesion identified on isotropic T2 or FLAIR-weighted images and in pNAWM and cNAWM, respectively. DNET differed from FCD in mean diffusivity, and GGL from FCD in radial diffusivity. Both types of glioneuronal tumours were different from pNAWM in fractional anisotropy and radial diffusivity. For identifying the tumour edges, threshold values for tumour-free tissue were investigated with receiver operating characteristic analyses: tumour could be separated from pNAWM at a threshold ≤ 0.32 (fractional anisotropy) or ≥ 0.56 (radial diffusivity) *10–3 mm2/s (area under the curve 0.995 and 0.990 respectively). While diffusion parameters of FCDs differed from cNAWM (radial diffusivity (*10–3 mm/s2): 0.74 ± 0.19 vs. 0.43 ± 0.05; corrected p-value < 0.001), the pNAWM could not be differentiated from the FCD.

Structural connectivity alterations in chronic and episodic migraine: A diffusion magnetic resonance imaging connectomics study

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 367-383 ◽  
Author(s):  
Álvaro Planchuelo-Gómez ◽  
David García-Azorín ◽  
Ángel L Guerrero ◽  
Santiago Aja-Fernández ◽  
Margarita Rodríguez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Chronic Migraine ◽  
Fractional Anisotropy ◽  
Structural Connectivity ◽  
Episodic Migraine ◽  
Anterior Cingulate ◽  
Radial Diffusivity ◽  
Resonance Imaging ◽  
Axial Diffusivity

Objective To identify possible structural connectivity alterations in patients with episodic and chronic migraine using magnetic resonance imaging data. Methods Fifty-four episodic migraine, 56 chronic migraine patients and 50 controls underwent T1-weighted and diffusion-weighted magnetic resonance imaging acquisitions. Number of streamlines (trajectories of estimated fiber-tracts), mean fractional anisotropy, axial diffusivity and radial diffusivity were the connectome measures. Correlation analysis between connectome measures and duration and frequency of migraine was performed. Results Higher and lower number of streamlines were found in connections involving regions like the superior frontal gyrus when comparing episodic and chronic migraineurs with controls ( p < .05 false discovery rate). Between the left caudal anterior cingulate and right superior frontal gyri, more streamlines were found in chronic compared to episodic migraine. Higher and lower fractional anisotropy, axial diffusivity, and radial diffusivity were found between migraine groups and controls in connections involving regions like the hippocampus. Lower radial diffusivity and axial diffusivity were found in chronic compared to episodic migraine in connections involving regions like the putamen. In chronic migraine, duration of migraine was positively correlated with fractional anisotropy and axial diffusivity. Conclusions Structural strengthening of connections involving subcortical regions associated with pain processing and weakening in connections involving cortical regions associated with hyperexcitability may coexist in migraine.

scholarly journals Synbiotics Combined with Glutamine Stimulate Brain Development and the Immune System in Preterm Pigs

2019 ◽  
Vol 149 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Anders D Andersen ◽  
Duc Ninh Nguyen ◽  
Louise Langhorn ◽  
Ingrid B Renes ◽  
Ruurd M van Elburg ◽  
...  
Keyword(s):  
Immune System ◽  
Fractional Anisotropy ◽  
Ex Vivo ◽  
Intervention Group ◽  
Bovine Milk ◽  
Mean Diffusivity ◽  
Internal Capsule ◽  
Preterm Neonates ◽  
Radial Diffusivity ◽  
Bifidobacterium Breve

ABSTRACT Background Preterm infants are born with an immature gut, brain, and immune system, predisposing them to short- and long-term complications. Objective We hypothesized that a milk diet supplemented with pre- and probiotics (i.e. synbiotics) and glutamine would improve gut, brain, and immune maturation in preterm neonates, using preterm pigs as a model. Methods Preterm pigs (Landrace x Yorkshire x Duroc, n = 40, delivered by c-section at 90% of gestation) were reared individually until day 23 after birth under highly standardized conditions. Piglets in the intervention group (PPG, n = 20) were fed increasing volumes of bovine milk supplemented with prebiotics (short-chain galacto- and long chain fructo-oligosaccharides 9:1, 4–12 g/L), probiotics (Bifidobacterium breve M16-V, 3 × 109 CFU/d) and l-glutamine [0.15–0.30 g/(kg · d)], and compared with pigs fed bovine milk with added placebo compounds as control (CON, n = 20). Clinical, gastrointestinal, immunological, cognitive, and neurological endpoints were measured. Results The PPG pigs showed more diarrhea but weight gain, body composition, and gut parameters were similar between the groups. Cognitive performance, assessed in a T-maze, was significantly higher in PPG pigs (P < 0.01), whereas motor function and exploratory interest were similar between the groups. Using ex vivo diffusion imaging, the orientation dispersion index in brain cortical gray matter was 50% higher (P = 0.04), and fractional anisotropy value was 7% lower (P = 0.05) in PPG pigs compared with CON pigs, consistent with increased dendritic branching in PPG. In associative fibers, radial diffusivity was lower and fractional anisotropy was higher in PPG pigs compared with CON pigs (all P < 0.05), while measures in the internal capsule showed a tendency towards reduced radial diffusivity and mean diffusivity (both P = 0.09). On day 23 pigs in the PPG group showed higher blood leukocyte numbers (+43%), neutrophil counts (+100%), and phagocytic rates (+24%), relative to CON, all P < 0.05. Conclusion Preterm pigs supplemented with Bifidobacterium breve, galacto- and fructo-oligosaccharides, and l-glutamine showed enhanced neuronal and immunological development. The findings indicate the potential for targeted nutritional interventions after preterm birth, to support development of important systems such as immunity and brain.

Mapping white matter damage distribution in neuromyelitis optica spectrum disorders with a multimodal MRI approach

2020 ◽  
pp. 135245852094149
Author(s):  
Laura Cacciaguerra ◽  
Maria A Rocca ◽  
Loredana Storelli ◽  
Marta Radaelli ◽  
Massimo Filippi
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Fractional Anisotropy ◽  
Neuromyelitis Optica ◽  
Mean Diffusivity ◽  
Healthy Controls ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
White Matter Damage ◽  
Axial Diffusivity ◽  
Spectrum Disorders

Background: The pathogenetic mechanisms sustaining neuroinflammatory disorders may originate from the cerebrospinal fluid. Objective: To evaluate white matter damage with diffusion tensor imaging and T1/T2-weighted ratio at progressive distances from the ventricular system in neuromyelitis optica spectrum disorders and multiple sclerosis. Methods: Fractional anisotropy, mean, axial, and radial diffusivity and T1/T2-weighted ratio maps were obtained from patients with seropositive neuromyelitis optica spectrum disorders, multiple sclerosis, and healthy controls ( n = 20 each group). White matter damage was assessed as function of ventricular distance within progressive concentric bands. Results: Compared to healthy controls, neuromyelitis optica spectrum disorders patients had similar fractional anisotropy, radial and axial diffusivity, increased mean diffusivity ( p = 0.009–0.013) and reduced T1/T2-weighted ratio ( p = 0.024–0.037) in all bands. In multiple sclerosis, gradient of percentage lesion volume and intra-lesional mean and axial diffusivity were higher in periventricular bands. Compared to healthy controls, multiple sclerosis patients had reduced fractional anisotropy ( p = 0.001–0.043) in periventricular bands, increased mean ( p < 0.001), radial ( p < 0.001–0.004), and axial diffusivity ( p = 0.002–0.008) and preserved T1/T2-weighted ratio in all bands. Conclusion: White matter damage is higher at periventricular level in multiple sclerosis and diffuse in neuromyelitis optica spectrum disorders. Fractional anisotropy preservation, associated with increased mean diffusivity and reduced T1/T2-weighted ratio may reflect astrocyte damage.

scholarly journals White matter injury induced by diabetes in acute stroke is clinically relevant: A preliminary study

2016 ◽  
Vol 14 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Xinfeng Yu ◽  
Ruirui Song ◽  
Yerfan Jiaerken ◽  
Lixia Yuan ◽  
Peiyu Huang ◽  
...  
Keyword(s):  
White Matter ◽  
Fractional Anisotropy ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
White Matter Injury ◽  
Neurological Deficits ◽  
Diabetic Patients ◽  
Stroke Severity ◽  
Superior Longitudinal Fasciculus ◽  
Poor Outcome

The importance of white matter injury induced by diabetes in stroke severity and prognosis is largely unknown. We aimed to investigate the relationship between diabetes-related white matter injury beyond stroke lesions with acute neurological deficits and clinical outcome after stroke. In total, 36 stroke patients within 3–7 days after onset were enrolled. Neurological deficits on admission were assessed by National Institute of Health Stroke Score, and poor outcome at 3 months was defined as modified Rankin score >2. White matter tracts were compared between patients with diabetic and non-diabetic stroke using fractional anisotropy from diffusion tensor imaging. Regional white matter abnormality with decreased fractional anisotropy was observed in diabetic patients ( n = 18) when compared to non-diabetic patients ( n = 18). Decreased fractional anisotropy in ipsilesional distal corticospinal tract was independently associated with higher National Institute of Health Stroke Score motor component score ( β = −0.444, p = 0.005), and decreased fractional anisotropy in contralesional superior longitudinal fasciculus I was independently related to poor outcome (odds ratio, 0.900; p = 0.033). Our findings suggested that only white matter injury induced by diabetes in specific tracts like corticospinal tract and superior longitudinal fasciculus beyond stroke lesions has clinically relevant, providing insight into the mechanism of stroke recovery under the diabetic condition.

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