Diffusion directions imaging (high resolution reconstruction of white matter fascicles from low angular resolution diffusion MRI)

L'objectif de cette thèse est de fournir une chaine de traitement complète pour la reconstruction des faisceaux de la matière blanche à partir d'images pondérées en diffusion caractérisées par une faible résolution angulaire. Cela implique (i) d'inférer en chaque voxel un modèle de diffusion à partir des images de diffusion et (ii) d'accomplir une ''tractographie", i.e., la reconstruction des faisceaux à partir de ces modèles locaux. Notre contribution en modélisation de la diffusion est une nouvelle distribution statistique dont les propriétés sont étudiées en détail. Nous modélisons le phénomène de diffusion par un mélange de telles distributions incluant un outil de sélection de modèle destiné à estimer le nombre de composantes du mélange. Nous montrons que le modèle peut être correctement estimé à partir d'images de diffusion ''single-shell" à faible résolution angulaire et qu'il fournit des biomarqueurs spécifiques pour l'étude des tumeurs. Notre contribution en tractographie est un algorithme qui approxime la distribution des faisceaux émanant d'un voxel donné. Pour cela, nous élaborons un filtre particulaire mieux adapté aux distributions multi-modales que les filtres traditionnels. Pour démontrer l'applicabilité de nos outils en usage clinique, nous avons participé aux trois éditions du MICCAI DTI Tractography challenge visant à reconstruire le faisceau cortico-spinal à partir d'images de diffusion ''single-shell" à faibles résolutions angulaire et spatiale. Les résultats montrent que nos outils permettent de reconstruire toute l'étendue de ce faisceau.The objective of this thesis is to provide a complete pipeline that achieves an accurate reconstruction of the white matter fascicles using clinical diffusion images characterized by a low angular resolution. This involves (i) a diffusion model inferred in each voxel from the diffusion images and (ii) a tractography algorithm fed with these local models to perform the actual reconstruction of fascicles. Our contribution in diffusion modeling is a new statistical distribution, the properties of which are extensively studied. We model the diffusion as a mixture of such distributions, for which we design a model selection tool that estimates the number of mixture components. We show that the model can be accurately estimated from single shell low angular resolution diffusion images and that it provides specific biomarkers for studying tumors. Our contribution in tractography is an algorithm that approximates the distribution of fascicles emanating from a seed voxel. We achieve that by means of a particle filter better adapted to multi-modal distributions than the traditional filters. To demonstrate the clinical applicability of our tools, we participated to all three editions of the MICCAI DTI Tractography challenge aiming at reconstructing the cortico-spinal tract from single-shell low angular and low spatial resolution diffusion images. Results show that our pipeline provides a reconstruction of the full extent of the CST.RENNES1-Bibl. électronique (352382106) / SudocSudocFranceF

Connectomics across development:towards mapping brain structure from birth to childhood

The brain is probably the most complex system of the human body, composed of numerous neural units interconnected at dierent scales. This highly structured architecture provides the ability to communicate, synthesize information and perform the analytical tasks of human beings. Its development starts during the transition between the embryonic and fetal periods, from a simple tubular to a highly complex folded structure. It is globally organized as early as birth. This developing process is highly vulnerable to antenatal adverse conditions. Indeed, extreme prematurity and intra uterine growth restriction are major risk factors for long-term morbidities, including developmental ailments such as cerebral palsy, mental retardation and a wide spectrum of learning disabilities and behavior disorders. In this context, the characterization of the brainâs normative wiring pattern is crucial for our understanding of its architecture and workings, as the origin of many neurological and neurobehavioral disorders is found in early structural brain development. Diusion magnetic resonance imaging (dMRI) allows the in vivo assessment of biological tissues at the microstructural level. It has emerged as a powerful tool to study brain connectivity and analyse the underlying substrate of the human brain, comprising its structurally integrated and functionally specialized architecture. dMRI has been widely used in adult studies. Nevertheless, due to technical constraints, this mapping at earlier stages of development has not yet been accomplished. Yet, this time period is of extreme importance to comprehend the structural and functional integrity of the brain. This thesis is motivated by this shortfall, and intends to fill the gap between the clinical and neuroscience demands and the methodological developments needed to fulfill them. In our work, we comprehensibly study the brain structural connectivity of children born extremely prematurely and/or with additional prenatal restriction at school-age. We provide evidence that brain systems that mature early in development are the most vulnerable to antenatal insults. Interestingly, the alterations highlighted in these systems correlate with the neurobehavioral and cognitive impairments seen in these children at school-age. The overall brain organization appear also altered after preterm birth and prenatal restriction. Indeed, these children show dierent brain network modular topology, with a reduction in the overall network capacity. What remains unclear is whether the alterations seen at school age are already present at birth and, if yes, to what extent. In this thesis we set the technical basis to enable the connectome analysis as early as at birth. This task is challenging when dealing with neonatal data. Indeed, most of the assumptions used in adult data processing methods do not hold, due to the inverted image contrast and other MRI artefacts such as motion, partial volume and intensity inhomogeneities. Here, we propose a novel technique for surface reconstruction, and provide a fully-automatic procedure to delineate the newborn cortical surface, opening the way to establish the newborn connectome

Imagerie du tenseur de diffusion du cerveau : vers des outils cliniques quantitatifs

The thesis explores three major methodological questions in clinical brain DTI, in the context of a clinical study on HIV. The first question is how to improve the DTI resolution. The second problem addressed in the thesis is how to create a multimodal population specific atlas. The third question is on the computation of statistics to compare white matter (WM) regions among controls and HIV patients. Clinical DTIs have low spatial resolution and signal-to-noise ratio making it difficult to compute meaningful statistics. We propose a super-resolution (SRR) algorithm for improving DTI resolution. The SRR is achieved using anisotropic regularization prior. This method demonstrates improved fractional anisotropy and tractography. In order to spatially normalize all images in a consistent coordinate system, we create a multimodal population specific brain atlas using the T1 and DTI images from a HIV dataset. We also transfer WM labels from an existing white matter parcellation map to create probabilistic WM atlas. This atlas can be used for region of interest based statistics and refining manual segmentation. On the statistical analysis side, we improve the existing tract based spatial statistics (TBSS) by using DTI based registration for spatial normalization. Contrary to traditional TBSS routines, we use multivariate statistics for detecting changes in WM tracts. With the improved method it is possible to detect differences in WM regions and correlate it with the neuropschylogical test scores of the subjects.La thèse explore trois questions méthodologiques en imagerie de diffusion (DTI) clinique du cerveau, dans le contexte d’une étude sur le VIH. La première question est comment améliorer la résolution du DTI. Le deuxième problème est comment créer un atlas multimodal spécifique à la population. La troisième question porte sur le calcul des statistiques pour comparer les zones de matière blanche entre les contrôles et patients. Les DTI cliniques ont une résolution spatiale et un rapport signal sur bruit faibles, ce qui rend difficile le calcul de statistiques significatives. Nous proposons un algorithme de super-résolution pour améliorer la résolution qui utilise un a priori spatial anisotrope. Cette méthode démontre une amélioration de l’anisotropie fractionnelle et de la tractographie. Pour normaliser spatialement les images du cerveau dans un système de coordonnées commun, nous proposons ensuite de construire un atlas multimodal spécifique á la population. Ceci permet de créer un atlas probabiliste de la matière blanche qui est consistant avec l’atlas anatomique. Cet atlas peut être utilisé pour des statistiques basées sur des régions d’intérêt ou pour le raffinement d’une segmentation. Enfin, nous améliorons les résultats de la méthode TBSS (Tract-Based Spatial Statistics) en utilisant le recalage des images DTI. Contrairement á la méthode TBSS traditionnelle, nous utilisons ici des statistiques multivariées. Nous montrons que ceci permet de détecter des différences dans les régions de matière blanche qui étaient non significatives auparavant, et de les corréler avec les scores des tests neuropsychologiques

Brain Microstructure: Impact of the Permeability on Diffusion MRI

Diffusion Magnetic Resonance Imaging (dMRI) enables a non invasive in-vivo characterization of the brain tissue. The disentanglement of each microstructural property reflected on the total dMRI signal is one of the hottest topics in the field. The dMRI reconstruction techniques ground on assumptions on the signal model and consider the neurons axons as impermeable cylinders. Nevertheless, interactions with the environment is characteristic of the biological life and diffusional water exchange takes place through cell membranes. Myelin wraps axons with multiple layers constitute a barrier modulating exchange between the axon and the extracellular tissue. Due to the short transverse relaxation time (T2) of water trapped between sheets, myelin contribution to the diffusion signal is often neglected. This thesis aims to explore how the exchange influences the dMRI signal and how this can be informative on myelin structure. We also aimed to explore how recent dMRI signal reconstruction techniques could be applied in clinics proposing a strategy for investigating the potential as biomarkers of the derived tissue descriptors. The first goal of the thesis was addressed performing Monte Carlo simulations of a system with three compartments: intra-axonal, spiraling myelin and extra-axonal. The experiments showed that the exchange time between intra- and extra-axonal compartments was on the sub-second level (and thus possibly observable) for geometries with small axon diameter and low number of wraps such as in the infant brain and in demyelinating diseases. The second goal of the thesis was reached by assessing the indices derived from three dimensional simple harmonics oscillator-based reconstruction and estimation (3D-SHORE) in stroke disease. The tract-based analysis involving motor networks and the region-based analysis in grey matter (GM) were performed. 3D-SHORE indices proved to be sensitive to plasticity in both white matter (WM) and GM, highlighting their viability as biomarkers in ischemic stroke. The overall study could be considered the starting point for a future investigation of the interdependence of different phenomena like exchange and relaxation related to the established dMRI indices. This is valuable for the accurate dMRI data interpretation in heterogeneous tissues and different physiological conditions

Fast Identification of Optimal Fascicle Configurations from Standard Clinical Diffusion MRI Using Akaike Information Criterion

International audienceAnalytic multi-compartment models have gained a tremen- dous popularity in the recent literature for studying the brain white matter microstructure from diffusion MRI. This class of models require the number of compartments to be known in advance. In the white matter however, several non-collinear bundles of axons, termed fascicles, often coexist in a same voxel. Determining the optimal fascicle configuration is a model selection problem. In this paper, we aim at proposing a novel approach to identify such a configuration from clinical diffusion MRI where only few diffusion images can be ac- quired and time is of the essence. Starting from a set of fitted models with increasing number of fascicles, we use Akaike information criterion to estimate the probability of each can- didate model to be the best Kullback-Leibler model. These probabilities are then used to average the different candidate models and output an MCM with optimal fascicle configura- tion. This strategy is fast and can be adapted to any multi- compartment model. We illustrate its implementation with the ball-and-stick model and show that we obtain better re- sults on single-shell low angular resolution diffusion MRI, compared to the state-of-the-art automatic relevance detection method, in a shorter processing time

Apport de l’IRM structurelle multimodale dans la chirurgie d’épilepsie : le cas de l’épilepsie insulaire

L’épilepsie insulaire (ÉI) est une forme rare d’épilepsie focale qui, en raison des défis liés à son diagnostic, est difficilement cernable. De plus, la prise en charge des patients avec ÉI s’avère complexifiée par le fait que cette pathologie est fréquemment résistante aux médicaments anti-crises. Pour ces cas médico-réfractaires, la chirurgie insulaire est une option viable. Cela dit, les patients subissant une telle intervention développent fréquemment des déficits neurologiques postopératoires; heureusement, la grande majorité de ceux-ci récupèrent complètement et rapidement. Or, le mécanisme sous-tendant ce singulier rétablissement fonctionnel demeure à ce jour mal compris. Deux modalités modernes d’IRM structurelle, soit l’analyse d’épaisseur corticale et la tractographie, ont permis, dans les dernières années, de décrire les altérations architecturales caractéristiques et potentiellement diagnostiques de divers types d’épilepsie ainsi que de caractériser les remodelages plastiques qui suivent la chirurgie de l’épilepsie extra-insulaire. Cependant, à ce jour, aucune étude ne s’est encore penchée sur le cas de l’ÉI. De ce fait, les études qui constituent cette thèse exploitent l’IRM structurelle afin, d’une part, de dépeindre les altérations d’épaisseur du cortex et de connectivité de matière blanche associées à l’ÉI et, d’autre part, de définir les réarrangements de connectivité subséquents à la chirurgie insulaire pour contrôle épileptique. Les deux premières études de cette thèse ont révélé que l’ÉI était associée à un pattern majoritairement ipsilatéral d’atrophie corticale et d’hyperconnectivité impliquant principalement des sous-régions insulaires et des régions connectées à l’insula. De manière intéressante, la topologie de ces changements correspondait, au moins en partie, à celle du réseau épileptique de l’ÉI. Ensuite, la troisième étude visait à décrire, par le biais d’une méta-analyse, l’histoire naturelle postopératoire des patients subissant une chirurgie pour ÉI. Cette analyse a, entre autres, confirmé que cette chirurgie était efficace (66.7% de disparition des crises) et qu’elle était fréquemment accompagnée de complications neurologiques (42.5%) qui, dans la plupart des cas, étaient transitoires (78.7% des complications) et récupéraient entièrement dans les trois mois postopératoires (91.6% des complications transitoires). Finalement, la quatrième étude a révélé que la chirurgie pour ÉI était suivie d’altérations de connectivité diffuses et bilatérales. Notamment, les connexions présentant une augmentation de connectivité concernaient particulièrement des régions localisées soit près de la cavité chirurgicale ou dans l’hémisphère controlatéral à l’intervention. De plus, la majorité de ces renforcements structurels se sont produits dans les six premiers mois suivant la chirurgie, un délai comparable à celui durant lequel la majeure partie de la récupération fonctionnelle postopératoire a été observée dans notre méta-analyse. En somme, nos résultats suggèrent que les altérations morphologiques en lien avec l’ÉI peuvent correspondre à son réseau épileptique sous-jacent. La topologie de ces changements pourrait constituer un biomarqueur structurel diagnostique qui aiderait à la reconnaissance de l’ÉI et, concomitamment, favoriserait possiblement un traitement chirurgical plus adapté et plus efficace. De plus, les augmentations de connectivité postopératoires pourraient correspondre à des réponses neuroplastiques permettant de prendre en charge les fonctions altérées par la chirurgie. Nos constats ont ainsi contribué à la caractérisation des mécanismes étayant la singulière récupération fonctionnelle accompagnant la chirurgie pour ÉI. À plus grande échelle, nos travaux offrent un aperçu du potentiel de l’IRM structurelle à assister au diagnostic de l’épilepsie focale ainsi qu’à participer à la description des changements plastiques subséquents à une résection neurochirurgicale.Insular epilepsy (IE) is a rare type of focal epilepsy that is difficult to diagnose. In addition to the challenging nature of IE detection, management of patients with this condition is complicated by the tendency of insular seizures to be resistant to anti-seizure medications. For such medically refractory cases, insular surgery constitutes a viable and long-lasting therapeutic option. That said, patients who undergo an insular resection for seizure control frequently develop postoperative neurological deficits; fortunately, most of these impairments recover fully and rapidly. While this favorable postoperative course contributes to improving the outcome of IE surgery, the mechanism underlying the functional recovery remains unknown. Two contemporary structural MRI modalities, namely cortical thickness analysis and tractography, have recently been used to describe characteristic structural alterations of focal epilepsies and to elucidate the postoperative plastic remodeling associated with surgery for extra-insular epilepsy. While these analyses added to our understanding of several localization-related epilepsies, none specifically studied IE. In this thesis, we exploit structural MRI techniques to, first, depict the alterations of cortical thickness and white matter connectivity in IE and, second, define the progressive rearrangements that follow insular surgery for epilepsy. The first two studies of the current thesis showed that IE is associated with a primarily ipsilateral pattern of cortical thinning and hyperconnectivity that mainly involves insular subregions and insula-connected regions. Interestingly, the topology of these changes corresponded, at least in part, to the epileptic network of IE. Furthermore, the third study aimed to describe, via a meta-analysis, the postoperative outcome of patients undergoing surgery for IE. Among other findings, the analysis revealed that insular surgery was effective (66.7% seizure freedom rate) but was associated with a significant risk of neurological complications (42.5%) which, in most cases, were transient (78.7% of all complications) and recovered fully within three months (91.6% of transient complications). Finally, the fourth study showed that surgery for IE was followed by a diffuse pattern of bilateral structural connectivity changes. Notably, connections exhibiting an increase in connectivity were specifically located near the surgical cavity and in the contralateral healthy hemisphere. In addition, the majority of the structural strengthening occurred in the first six months following surgery, a time course that is consistent with the short delay during which most of the postoperative functional recovery was observed in our meta-analysis. Our results suggest that the morphological alterations in IE may reflect its underlying epileptic network. The topology of these changes may constitute a structural biomarker that could help diagnose IE more readily and, concomitantly, potentially enable a more targeted and more effective surgical treatment. Moreover, the postoperative increases in connectivity may be compatible with compensatory neuroplastic responses, a process that arose to recoup the functions of the injured insular cortex. Our findings have therefore contributed to the characterization of the driving process that supports the striking functional recovery seen following surgery for IE. On a larger scale, our work provides insights into the potential of structural MRI to assist in the diagnosis of focal epilepsy and to describe plastic changes following neurosurgical resections