Assessing neuraxial microstructural changes in a transgenic mouse model of early stage Amyotrophic Lateral Sclerosis by ultra‐high field MRI and diffusion tensor metrics

bjective: Cell structural changes are one of the main features observed during the development of amyotrophic lateral sclerosis (ALS). In this work, we propose the useof diffusion tensor imaging (DTI) metrics to assess specific ultrastructural changes in the central nervous system during the early neurodegenerative stages of ALS.Methods: Ultra-high field MRI and DTI data at 17.6T were obtained from fixed, excised mouse brains, and spinal cords from ALS (G93A-SOD1) mice.Results: Changes in fractional anisotropy (FA) and linear, planar, and spherical anisotropy ratios (CL, CP, and CS, respectively) of the diffusion eigenvalues were measured in white matter (WM) and gray matter (GM) areas associated with early axonal degenerative processes (in both the brain and the spinal cord). Specifically, in WM structures (corpus callosum, corticospinal tract, and spinal cord funiculi) as the disease progressed, FA, CL, and CP values decreased, whereas CS values increased.In GM structures (prefrontal cortex, hippocampus, and central spinal cord) FA and CP decreased, whereas the CL a nd C values were unchanged or slightly smaller.Histological studies of a fluorescent mice model (YFP, G93A-SOD1 mouse) corroborated the early alterations in neuronal morphology and axonal connectivity measured by DTI.Conclusions: Changes in diffusion tensor shape were observed in this animal model at the early, nonsymptomatic stages of ALS. Further studies of CL, CP, and CSas imaging biomarkers should be undertaken to refine this neuroimaging tool for future clinical use in the detection of the early stages of ALSFil: Gatto, Rodolfo G.. University Of Illinois. Deparment Of Biological Science; Estados UnidosFil: Weissmann, Carina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; ArgentinaFil: Amin, Manish. University of Florida; Estados UnidosFil: Finkielsztein, Ariel. Northwestern University; Estados UnidosFil: Sumagin, Ronen. Northwestern University; Estados UnidosFil: Mareci, Thomas H.. University of Florida; Estados UnidosFil: Uchitel, Osvaldo Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Fisiología, Biología Molecular y Neurociencias. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Fisiología, Biología Molecular y Neurociencias; ArgentinaFil: Magin, Richard L.. University Of Illinois. Deparment Of Biological Science; Estados Unido

Advances in spinal cord imaging in multiple sclerosis

The spinal cord is frequently affected in multiple sclerosis (MS), causing motor, sensory and autonomic dysfunction. A number of pathological abnormalities, including demyelination and neuroaxonal loss, occur in the MS spinal cord and are studied in vivo with magnetic resonance imaging (MRI). The aim of this review is to summarise and discuss recent advances in spinal cord MRI. Advances in conventional spinal cord MRI include improved identification of MS lesions, recommended spinal cord MRI protocols, enhanced recognition of MRI lesion characteristics that allow MS to be distinguished from other myelopathies, evidence for the role of spinal cord lesions in predicting prognosis and monitoring disease course, and novel post-processing methods to obtain lesion probability maps. The rate of spinal cord atrophy is greater than that of brain atrophy (−1.78% versus −0.5% per year), and reflects neuroaxonal loss in an eloquent site of the central nervous system, suggesting that it can become an important outcome measure in clinical trials, especially in progressive MS. Recent developments allow the calculation of spinal cord atrophy from brain volumetric scans and evaluation of its progression over time with registration-based techniques. Fully automated analysis methods, including segmentation of grey matter and intramedullary lesions, will facilitate the use of spinal cord atrophy in trial designs and observational studies. Advances in quantitative imaging techniques to evaluate neuroaxonal integrity, myelin content, metabolic changes, and functional connectivity, have provided new insights into the mechanisms of damage in MS. Future directions of research and the possible impact of 7T scanners on spinal cord imaging will be discussed

Generic acquisition protocol for quantitative MRI of the spinal cord

Quantitative spinal cord (SC) magnetic resonance imaging (MRI) presents many challenges, including a lack of standardized imaging protocols. Here we present a prospectively harmonized quantitative MRI protocol, which we refer to as the spine generic protocol, for users of 3T MRI systems from the three main manufacturers: GE, Philips and Siemens. The protocol provides guidance for assessing SC macrostructural and microstructural integrity: T1-weighted and T2-weighted imaging for SC cross-sectional area computation, multi-echo gradient echo for gray matter cross-sectional area, and magnetization transfer and diffusion weighted imaging for assessing white matter microstructure. In a companion paper from the same authors, the spine generic protocol was used to acquire data across 42 centers in 260 healthy subjects. The key details of the spine generic protocol are also available in an open-access document that can be found at https://github.com/spine-generic/protocols. The protocol will serve as a starting point for researchers and clinicians implementing new SC imaging initiatives so that, in the future, inclusion of the SC in neuroimaging protocols will be more common. The protocol could be implemented by any trained MR technician or by a researcher/clinician familiar with MRI acquisition

High-resolution multi-parametric quantitative magnetic resonance imaging of the human cervical spinal cord at 7T

International audienceQuantitative MRI techniques have the potential to characterize spinal cord tissue impairments occurring in various pathologies, from both microstructural and functional perspectives. By enabling very high image resolution and enhanced tissue contrast, ultra-high field imaging may offer further opportunities for such characterization. In this study, a multi-parametric high-resolution quantitative MRI protocol is proposed to characterize in vivo the human cervical spinal cord at 7T. Multi-parametric quantitative MRI acquizitions including T1, T2(*) relaxometry mapping and axial diffusion MRI were performed on ten healthy volunteers with a whole-body 7T system using a commercial prototype coil-array dedicated to cervical spinal cord imaging. Automatic cord segmentation and multi-parametric data registration to spinal cord templates enabled robust regional studies within atlas-based WM tracts and GM horns at the C3 cervical level. T1 value, cross-sectional area and GM/WM ratio evolutions along the cervical cord were also reported. An original correction method for B1(+)-biased T1 mapping sequence was additionally proposed and validated on phantom. As a result, relaxometry and diffusion parameters derived from high-resolution quantitative MRI acquizitions were reported at 7T for the first time. Obtained images, with unmatched resolutions compared to lower field investigations, provided exquisite anatomical details and clear delineation of the spinal cord substructures within an acquisition time of 30min, compatible with clinical investigations. Regional statistically significant differences were highlighted between WM and GM based on T1 and T2* maps (p\textless10(-3)), as well as between sensory and motor tracts based on diffusion tensor imaging maps (p\textless0.05). The proposed protocol demonstrates that ultra-high field spinal cord high-resolution quantitative MRI is feasible and lays the groundwork for future clinical investigations of degenerative spinal cord pathologies

Improving longitudinal spinal cord atrophy measurements for clinical trials in multiple sclerosis by using the generalised boundary shift integral (GBSI)

Spinal cord atrophy is a common and clinically relevant feature of multiple sclerosis (MS), and can be used to monitor disease progression and as an outcome measure in clinical trials. Spinal cord atrophy is conventionally estimated with segmentation-based methods (e.g., cross-sectional spinal cord area (CSA)), where spinal cord change is calculated indirectly by numerical difference between timepoints. In this thesis, I validated the generalised boundary shift integral (GBSI), as the first registration-based method for longitudinal spinal cord atrophy measurement. The GBSI registers the baseline and follow-up spinal cord scans in a common half-way space, to directly determine atrophy on the cord edges. First, on a test dataset (9 MS patients and 9 controls), I have found that GBSI presented with lower random measurement error, than CSA, reflected by lower standard deviation, coefficient of variation and median absolute deviation. Then, on multi-centre, multi-manufacturer, and multi–field‐strength scans (282 MS patients and 82 controls), I confirmed that GBSI provided lower measurement variability in all MS subtypes and controls, than CSA, resulting into better separation between MS patients and controls, improved statistical power, and reduced sample size estimates. Finally, on a phase 2 clinical trial (220 primary-progressive MS patients), I demonstrated that spinal cord atrophy measurements on GBSI could be obtained from brain scans, considering their quality and association with corresponding spinal cord MRI-derived measurements. Not least, 1-year spinal cord atrophy measurements on GBSI, but not CSA, were associated with upper and lower limb motor function. In conclusion, spinal cord atrophy on the GBSI had higher measurement precision and stronger clinical correlates, than the segmentation method, and could be derived from high-quality brain acquisitions. Longitudinal spinal cord atrophy on GBSI could become a gold standard for clinical trials including spinal cord atrophy as an outcome measure, but should remain a secondary outcome measure, until further advancements increase the ease of acquisition and processing

Quantitative MRI for measuring myelin content in human spinal cord

The aim of this thesis is to progress the state-of-the art of quantitative Magnetic Resonance Imaging (MRI) in the human spinal cord, with particular focus on methods sensitive to myelin content. Myelin is a fundamental structure of the central nervous system, ensuring the correct transmission of action potentials along neuronal axons, affected in a number of neurological disorders, first and foremost Multiple Sclerosis (MS). MRI methods to assess myelin in the spinal cord have found limited development, despite the primary involvement of the spinal cord in demyelinating diseases, such as MS where the characterization of spinal cord pathology is key for a better diagnosis, understanding of pathological processes, and evaluation of neuroprotective and reparative treatments. In this thesis, we develop novel methods for the spinal cord to measure parameters that are known to correlate with myelin content, namely the longitudinal relaxation time (T₁) and quantitative Magnetization Transfer (qMT) parameters, and we compare them with a large set of myelin sensitive MRI indices in the post mortem MS spinal cord. The thesis is structured as follows: chapter 1 states the problem this thesis attempts to address and provides background information regarding the involvement of the spinal cord in MS; chapter 2 reviews the basic principles of MRI and introduces the theory behind the measurement of surrogate indices of myelin content with MRI; chapter 3 reviews an existing imaging sequence for the spinal cord, extends its use for measuring myelin sensitive parameters and discusses potential improvements for in vivo applications; chapter 4 and chapter 5 propose novel efficient methods to measure T₁ and qMT parameters in vivo in the spinal cord; and chapter 6 evaluates the performance of the methods developed in the previous chapter, together with other prospective myelin mapping methods, in the healthy and MS post mortem human spinal cord