Myelin in SIDS: Assessment of Development and Damage using MRI

Objective. Abnormalities of myelin that have been reported in Sudden Infant Death Syndrome (SIDS) include a delay in development and focal lesions presumed to be secondary to hypoxia. Magnetic resonance imaging (MRI) gives excellent images of white matter and can be used to map the progress of myelination and to demonstrate focal lesions. It was the aim of this study to determine whether any MRI abnormality of myelin could be detected in the brains of SIDS compared to control infants. Methods. The brains of 28 SIDS and 14 control infants were fixed in formalin and scanned with MRI. The proton density, T2-weighted, and inversion recovery scans were assessed for the presence of focal white matter lesions. The amount of myelin in 26 sites was measured in the proton density scans, using a densitometer. The amount of myelin present could be assessed in 21 of 26 sites. Results. In 15 of 21 sites the amount of myelin for age was the same in SIDS and controls. In three sites the rate of myelination was greater in SIDS than control and in another three sites the amount of myelin for age was greater in SIDS than control infants, but these differences were not seen in infants aged less than 8 months. No focal abnormalities of white matter were seen in either SIDS or control infants. Conclusions. The development of white matter in brains of SIDS infants less than 8 months old is the same as in controls, and in older SIDS infants white matter development may be slightly advanced compared to controls. No hypoxic changes can be seen in SIDS white matter on MRI.

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Disseminated Necrotizing Leukoencephalopathy Complicating Septic Shock in an Immunocompetent Patient

Case Reports in Critical Care ◽

10.1155/2017/1092537 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Pedro Gaspar-da-Costa ◽

Sofia Reimão ◽

Sandra Braz ◽

João Meneses Santos ◽

Rui M. M. Victorino

Keyword(s):

Septic Shock ◽

White Matter ◽

White Matter Lesions ◽

Neurological Impairment ◽

Immunocompetent Patient ◽

Resonance Imaging ◽

Mri Findings ◽

Full Neurological Recovery ◽

Magnetic Resonance Imaging Mri ◽

Immunocompetent Patients

Disseminated necrotizing leukoencephalopathy (DNL) is characterized by multiple microscopic foci of white matter necrosis. DNL was initially thought to be exclusively associated with immunosuppression conditions but it has been recently described in immunocompetent patients in septic shock. A 90-year-old immunocompetent woman with no previous neurological impairment presented with septic shock and drowsiness that responded well to therapy with clinical improvement and a full neurological recovery. Unexpectedly deterioration with progression to coma occurred. Investigation excluded other causes and Magnetic Resonance Imaging (MRI) was consistent with the diagnosis of DNL showing bilateral multifocal white matter lesions with a nonvascular pattern with restricted diffusion. Neurological impairment persisted with progression to death. DNL is an unexpected diagnosis in an immunocompetent patient. We compared the present case to those found in the literature of DNL complicating septic shock and discuss the antemortem diagnosis based on MRI findings.

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Focal lesions of the cerebral white matter in patients with arterial hypertension as evidenced by 5-year prospective study

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2004-10-1-23-25 ◽

2004 ◽

Vol 10 (1) ◽

pp. 23-25

Author(s):

V. F. Mordovin ◽

N. L. Afanasyeva ◽

P. I. Lukyanenok ◽

G. V. Semke

Keyword(s):

Magnetic Resonance Imaging ◽

White Matter ◽

Arterial Hypertension ◽

Brain Magnetic Resonance Imaging ◽

White Matter Lesions ◽

Cerebral White Matter ◽

Resonance Imaging ◽

Focal Lesions ◽

Cerebral White Matter Lesions ◽

Baseline Values

Studies were conducted in 58 patients (33 males and 25 females) aged 36 to 59 years who had arterial hypertension. 24-hour blood pressure (BP) monitoring and brain magnetic resonance imaging were performed in all the patients before and 5 years after the studies. Focal cerebral white matter lesions (FCWML) that had been absent before was found to appear in 15 (25%) patients; FCWML showed no changes in 12 (21%) patients. There was an increase in the number of FCWML in 17 (30%). The patients in whom FCWML appeared had significantly higher baseline values of BP and its time indices and, on repeated examination, they had only significantly higher time indices of BP. The findings suggest that arterial hypertension is a factor that enhances the likelihood of GCWML and that the use of 24-hour BP monitoring permits identification of a group of patients having a high risk for their appearance.

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Cerebral White Matter Lesions in Sudden Infant Death Syndrome

PEDIATRICS ◽

10.1542/peds.62.2.155 ◽

1978 ◽

Vol 62 (2) ◽

pp. 155-159 ◽

Cited By ~ 1

Author(s):

S. Takashima ◽

D. Armstrong ◽

L. E. Becker ◽

J. Hubert

Keyword(s):

Congenital Heart Disease ◽

White Matter ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Congenital Heart ◽

White Matter Lesions ◽

Sudden Infant Death ◽

Cerebral White Matter ◽

Sudden Infant ◽

Cerebral White Matter Lesions

In 21.6% of infants who died of sudden infant death syndrome, the cerebral white matter showed areas of leukomalacia. Of those infants with congenital heart disease, 24.8% had lesions, whereas 4.4% of infants who died from known acute causes had lesions. The sites of the cerebral white matter lesions, subcortical or periventricular, seem to be related to the age of the infant.

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Multi-scale MRI spectrum detects differences in myelin integrity between MS lesion types

Multiple Sclerosis Journal ◽

10.1177/1352458515624771 ◽

2016 ◽

Vol 22 (12) ◽

pp. 1569-1577 ◽

Cited By ~ 9

Author(s):

Yunyan Zhang ◽

Laura Jonkman ◽

Antoine Klauser ◽

Frederik Barkhof ◽

V Wee Yong ◽

...

Keyword(s):

White Matter ◽

Brain Slices ◽

Low Frequency ◽

White Matter Lesions ◽

Image Texture ◽

Local Spectrum ◽

Resonance Imaging ◽

Multi Scale ◽

Normal Appearing White Matter ◽

Magnetic Resonance Imaging Mri

Background: Lesions with different extents of myelin pathology are found at autopsy in multiple sclerosis (MS), but the differences are not discernible in magnetic resonance imaging (MRI). Objective: To determine whether analysis of the local spectrum in MRI is sensitive to lesion differences in myelin integrity. Methods: We imaged fresh brain slices from 21 MS patients using 1.5T scanners. White matter lesions were identified in T2-weighted MRI, matched to corresponding specimens, and then classified into five categories in histology: pre-active (intact myelin); active, chronic active, chronic inactive (complete demyelination); and remyelinated lesions. Voxel-based frequency spectrum was calculated using T2-weighted MRI to characterize lesion structure (image texture). Results: MRI texture heterogeneity resulting from all spectral scales was greater in completely demyelinated lesions than in myelin-preserved lesions ( p = 0.02) and normal-appearing white matter ( p < 0.01). Moreover, the spectral distribution pattern over low-frequency scales differentiated demyelinated lesions from remyelinated and pre-active lesions ( p < 0.01), where different lesion types also showed distinct texture scales. Conclusion: Using multi-scale spectral analysis, it may be possible for standard MRI to evaluate myelin integrity in MS lesions. This can be critical for monitoring disease activity and assessing remyelination therapies for MS patients.

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White matter lesions in Fabry disease before and after enzyme replacement therapy: a 2-year follow-up

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000500002 ◽

2006 ◽

Vol 64 (3b) ◽

pp. 711-717 ◽

Cited By ~ 30

Author(s):

Laura B. Jardim ◽

Flávio Aesse ◽

Leonardo M. Vedolin ◽

Cláudio Pitta-Pinheiro ◽

João Marconato ◽

...

Keyword(s):

White Matter ◽

Enzyme Replacement Therapy ◽

Fabry Disease ◽

Replacement Therapy ◽

White Matter Lesions ◽

Resonance Imaging ◽

Enzyme Replacement ◽

Before And After ◽

Magnetic Resonance Imaging Mri

PURPOSE: To report the clinical and neuroimaging, central nervous system (CNS) findings of patients with Fabry disease (FD) during 24 months of enzyme replacement therapy (ERT) with agalsidase-alpha. METHOD: Eight patients were included. Six completed 24 months of ERT. Clinical and magnetic resonance imaging (MRI) data were obtained at 0, 12 and 24 months of ERT. White matter lesions (WML) were evaluated as well as their relation to age, symptoms and neurological examination (CNS score). RESULTS: MRI was stable in 3 patients. WML and CNS score worsened in one patient, fluctuated in another, and improved in the sixth patient. In the whole series, there were 15 WML at baseline, and 19 at the 24th month. In two years, 4 lesions disappeared, whereas 8 appeared. CONCLUSION: A widespread pattern of silent WML in FD was seen. In two years, some WML appeared, and some disappeared. If these phenomena were related to the natural history, remains to be demonstrated.

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Intracranial deep white matter lesions (DWLs) are associated with chronic kidney disease (CKD) and cognitive impairment: A 5-year follow-up magnetic resonance imaging (MRI) study

Archives of Gerontology and Geriatrics ◽

10.1016/j.archger.2011.11.009 ◽

2013 ◽

Vol 56 (1) ◽

pp. 55-60 ◽

Cited By ~ 26

Author(s):

N. Kuriyama ◽

T. Mizuno ◽

Y. Ohshima ◽

K. Yamada ◽

E. Ozaki ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Chronic Kidney Disease ◽

Cognitive Impairment ◽

White Matter ◽

White Matter Lesions ◽

Resonance Imaging ◽

Deep White Matter ◽

Magnetic Resonance Imaging Mri ◽

Mri Study

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Magnetic Resonance Imaging of The Brain in Patients With Migraine

Cephalalgia ◽

10.1046/j.1468-2982.1991.1102069.x ◽

1991 ◽

Vol 11 (2) ◽

pp. 69-74 ◽

Cited By ~ 62

Author(s):

Hisaka Igarashi ◽

Fumihiko Sakai ◽

Shinichi Kan ◽

Jun Okada ◽

Yoshiaki Tazaki

Keyword(s):

Magnetic Resonance Imaging ◽

White Matter ◽

Magnetic Resonance ◽

Young Patients ◽

Proton Density ◽

Resonance Imaging ◽

Centrum Semiovale ◽

Migraine Frequency ◽

Magnetic Resonance Imaging Mri ◽

The Brain

Magnetic resonance imaging (MRI) was studied in 91 patients with migraine and in 98 controls. Risk factors known to cause MRI lesions were carefully examined. In 36 patients with migraine (39.6%), small foci of high intensity on T2-weighted and proton-density-weighted images were seen in the white matter. Of patients with migraine who were less than 40 years old and without any risk factor, 29.4% showed lesions on MRI; this was significantly higher than the 11.2% for the group of age-matched controls ( n = 98). The lesions were distributed predominantly in the centrum semiovale and frontal white matter in young patients, but extended to the deeper white matter at the level of basal ganglia in the older age group. The side of the MRI lesions did not always correspond to the side of usual aura or headache. Migraine-related variables such as type of migraine, frequency, duration or intensity of headache or consumption of ergotamine showed no significant correlation with the incidence of MRI abnormalities. Our data indicated that migraine may be associated with early pathologic changes in the brain.

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Prevalence of Cerebral Microbleeds in Thai Patients with Ischemic Stroke

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.203836 ◽

2017 ◽

Vol 08 (02) ◽

pp. 216-220 ◽

Cited By ~ 4

Author(s):

Artit Potigumjon ◽

Arvemas Watcharakorn ◽

Pornpatr A. Dharmasaroja

Keyword(s):

Ischemic Stroke ◽

White Matter ◽

Magnetic Resonance ◽

White Matter Lesions ◽

Cerebral Microbleeds ◽

National Institutes Of Health ◽

Asian Origin ◽

Chinese Study ◽

Japanese Studies ◽

Magnetic Resonance Imaging Mri

ABSTRACT Background: With the widespread use of magnetic resonance imaging (MRI), cerebral microbleeds (CMBs) are commonly detected. Ethnicity seems to play a role in the prevalence of CMB, with higher prevalence in participants from Asian origin. The purpose of the study is to look for the prevalence of CMBs and associated factors in Thai patients with ischemic stroke. Methods: Patients with acute ischemic stroke who had MRI and magnetic resonance angiography during January–August 2014 were included in the study. T2*-weighted gradient-recalled echo was used to define CMBs. Baseline characteristics, stroke subtypes, and severity of white matter lesions were compared between patients with and without CMBs. Results: Two hundred patients were included in the study. Mean age of the patients was 61-year-old. Mean National Institutes of Health Stroke Scale was 8. The prevalence of CMBs was 20% (39/200 patients). Hypertension (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.07–8.68, P = 0.037), and moderate-to-severe white matter lesions (Fazekas 2–3, OR 7.61, 95% CI 3.06–18.95, P < 0.001) were related to the presence of CMBs. Conclusions: CMBs were found in 20% of patients with ischemic stroke, which was lower than those reported from Japanese studies but comparable to a Chinese study. CMBs were associated with hypertension and severity of the white matter lesions.

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Juxtacortical susceptibility changes in progressive multifocal leukoencephalopathy at the gray–white matter junction correlates with iron-enriched macrophages

Multiple Sclerosis Journal ◽

10.1177/1352458521999651 ◽

2021 ◽

pp. 135245852199965

Author(s):

Kedar R Mahajan ◽

Moein Amin ◽

Matthew Poturalski ◽

Jonathan Lee ◽

Danielle Herman ◽

...

Keyword(s):

White Matter ◽

Progressive Multifocal Leukoencephalopathy ◽

Central Nervous System Lymphoma ◽

Susceptibility Weighted Imaging ◽

Resonance Imaging ◽

Gradient Echo ◽

Total N ◽

Mri Brain ◽

Fluid Attenuated Inversion Recovery ◽

Magnetic Resonance Imaging Mri

Objective: Describe magnetic resonance imaging (MRI) susceptibility changes in progressive multifocal leukoencephalopathy (PML) and identify neuropathological correlates. Methods: PML cases and matched controls with primary central nervous system lymphoma (PCNSL) were retrospectively identified. MRI brain at 3 T and 7 T were reviewed. MRI-pathology correlations in fixed brain autopsy tissue were conducted in three subjects with confirmed PML. Results: With PML ( n = 26 total, n = 5 multiple sclerosis natalizumab-associated), juxtacortical changes on susceptibility-weighted imaging (SWI) or gradient echo (GRE) sequences were noted in 3/3 cases on 7 T MRI and 14/22 cases (63.6%) on 1.5 T or 8/22 (36.4%) 3 T MRI. Similar findings were only noted in 3/25 (12.0%) of PCNSL patients (odds ratio (OR) 12.83, 95% confidence interval (CI), 2.9–56.7, p < 0.001) on 1.5 or 3 T MRI. On susceptibility sequences available prior to diagnosis of PML, 7 (87.5%) had changes present on average 2.7 ± 1.8 months (mean ± SD) prior to diagnosis. Postmortem 7 T MRI showed SWI changes corresponded to areas of increased iron density along the gray–white matter (GM-WM) junction predominantly in macrophages. Conclusion: Susceptibility changes in PML along the GM-WM junction can precede noticeable fluid-attenuated inversion recovery (FLAIR) changes and correlates with iron accumulation in macrophages.

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