Diffusion basis spectrum imaging measures anti-inflammatory and neuroprotective effects of fingolimod on murine optic neuritis

OBJECTIVE: To prospectively determine whether diffusion basis spectrum imaging (DBSI) detects, differentiates and quantitates coexisting inflammation, demyelination, axonal injury and axon loss in mice with optic neuritis (ON) due to experimental autoimmune encephalomyelitis (EAE), and to determine if DBSI accurately measures effects of fingolimod on underlying pathology. METHODS: EAE was induced in 7-week-old C57BL/6 female mice. Visual acuity (VA) was assessed daily to detect onset of ON after which daily oral-treatment with either fingolimod (1 mg/kg) or saline was given for ten weeks. In vivo DBSI scans of optic nerves were performed at baseline, 2-, 6- and 10-weeks post treatment. DBSI-derived metrics including restricted isotropic diffusion tensor fraction (putatively reflecting cellularity), non-restricted isotropic diffusion tensor fraction (putatively reflecting vasogenic edema), DBSI-derived axonal volume, axial diffusivity, λ RESULTS: Optic nerves of fingolimod-treated mice exhibited significantly better (p \u3c 0.05) VA than saline-treated group at each time point. During ten-week of treatment, DBSI-derived non-restricted and restricted-isotropic-diffusion-tensor fractions, and axonal volumes were not significantly different (p \u3e 0.05) from the baseline values in fingolimod-treated mice. Transient DBSI-λ CONCLUSION: DBSI was used to assess changes of the underlying optic nerve pathologies in EAE mice with ON, exhibiting great potential as a noninvasive outcome measure for monitoring disease progression and therapeutic efficacy for MS

Diffusion basis spectrum imaging detects subclinical traumatic optic neuropathy in a closed-head impact mouse model of traumatic brain injury

INTRODUCTION: Traumatic optic neuropathy (TON) is the optic nerve injury secondary to brain trauma leading to visual impairment and vision loss. Current clinical visual function assessments often fail to detect TON due to slow disease progression and clinically silent lesions resulting in potentially delayed or missed treatment in patients with traumatic brain injury (TBI). METHODS: Diffusion basis spectrum imaging (DBSI) is a novel imaging modality that can potentially fill this diagnostic gap. Twenty-two, 16-week-old, male mice were equally divided into a sham or TBI (induced by moderate Closed-Head Impact Model of Engineered Rotational Acceleration device) group. Briefly, mice were anesthetized with isoflurane (5% for 2.5 min followed by 2.5% maintenance during injury induction), had a helmet placed over the head, and were placed in a holder prior to a 2.1-joule impact. Serial visual acuity (VA) assessments, using the Virtual Optometry System, and DBSI scans were performed in both groups of mice. Immunohistochemistry (IHC) and histological analysis of optic nerves was also performed after RESULTS: VA of the TBI mice showed unilateral or bilateral impairment. DBSI of the optic nerves exhibited bilateral involvement. IHC results of the optic nerves revealed axonal loss, myelin injury, axonal injury, and increased cellularity in the optic nerves of the TBI mice. Increased DBSI axon volume, decreased DBSI λ CONCLUSION: DBSI provides an imaging modality capable of detecting subclinical changes of indirect TON in TBI mice

Assessing Optic Neuritis in a Mouse Model of Multiple Sclerosis with Diffusion MR Imaging

Optic neuritis (ON) is an early manifestation in patients of multiple sclerosis (MS), typically resulting in visual dysfunction. The inflammatory demyelination of the optic nerve in ON closely resembles pathologies of the rest of central nervous system (CNS) white matter in MS. Since accumulated axonal degeneration in MS was considered as the potential cause leading to permanent disability, correlating optic nerve pathology and visual function in ON could be a model system to investigate the relationship between functional outcome and neuropathology. It may also present a new way to reflect the disease progression in MS. Various MR techniques have been used to assess inflammation (inflammatory cell infiltration and vasogenic edema) of ON, but rarely demonstrated the ability to image cellularity changes non-invasively. Diffusion MRI measures the Brownian motion of water molecules in the microstructure of biological tissues. Diffusion tensor imaging (DTI) holds the promise to provide a specific biomarker of axonal injury and demyelination in CNS white matter by axial diffusivity (the diffusion parallel to white matter fibers) and radial diffusivity (the diffusion perpendicular to white matter fibers), respectively. However, DTI assumes a single diffusion tensor model and thus takes an average of varied diffusion components. In contrast, our recently developed diffusion basis spectrum imaging (DBSI) resolves the complex diffusion components and provides relatively accurate directional diffusivities and diffusion component fractions, relating to the detail and accurate pathological picture of the disease or injury. In the current work, in vivo 25-direction DBSI was applied to the optic nerve of mice with experimental autoimmune encephalomyelitis (EAE), an animal model of MS, with visual impairment at onset of ON. Our results demonstrate that inflammation correlated well with visual impairment in acute ON. DBSI successfully detected inflammatory cell infiltration and optic nerve white matter pathology in EAE that was consistent with histology, supporting the capability of DBSI to quantify increased cellularity, axonal injury and myelin damage in the optic nerve of EAE mice

Age Effects and Sex Differences in Human Brain White Matter of Young to Middle-Aged Adults: A DTI, NODDI, and q-Space Study

Microstructural changes in human brain white matter of young to middle-aged adults were studied using advanced diffusion Magnetic Resonance Imaging (dMRI). Multiple shell diffusion-weighted data were acquired using the Hybrid Diffusion Imaging (HYDI). The HYDI method is extremely versatile and data were analyzed using Diffusion Tensor Imaging (DTI), Neurite Orientation Dispersion and Density Imaging (NODDI), and q-space imaging approaches. Twenty-four females and 23 males between 18 and 55years of age were included in this study. The impact of age and sex on diffusion metrics were tested using least squares linear regressions in 48 white matter regions of interest (ROIs) across the whole brain and adjusted for multiple comparisons across ROIs. In this study, white matter projections to either the hippocampus or the cerebral cortices were the brain regions most sensitive to aging. Specifically, in this young to middle-aged cohort, aging effects were associated with more dispersion of white matter fibers while the tissue restriction and intra-axonal volume fraction remained relatively stable. The fiber dispersion index of NODDI exhibited the most pronounced sensitivity to aging. In addition, changes of the DTI indices in this aging cohort were correlated mostly with the fiber dispersion index rather than the intracellular volume fraction of NODDI or the q-space measurements. While men and women did not differ in the aging rate, men tend to have higher intra-axonal volume fraction than women. This study demonstrates that advanced dMRI using a HYDI acquisition and compartmental modeling of NODDI can elucidate microstructural alterations that are sensitive to age and sex. Finally, this study provides insight into the relationships between DTI diffusion metrics and advanced diffusion metrics of NODDI model and q-space imaging

Diffusion imaging markers of accelerated aging of the lower cingulum in subjective cognitive decline

IntroductionAlzheimer’s Disease (AD) typically starts in the medial temporal lobe, then develops into a neurodegenerative cascade which spreads to other brain regions. People with subjective cognitive decline (SCD) are more likely to develop dementia, especially in the presence of amyloid pathology. Thus, we were interested in the white matter microstructure of the medial temporal lobe in SCD, specifically the lower cingulum bundle that leads into the hippocampus. Diffusion tensor imaging (DTI) has been shown to differentiate SCD participants who will progress to mild cognitive impairment from those who will not. However, the biology underlying these DTI metrics is unclear, and results in the medial temporal lobe have been inconsistent.MethodsTo better characterize the microstructure of this region, we applied DTI to cognitively normal participants in the Cam-CAN database over the age of 55 with cognitive testing and diffusion MRI available (N = 325, 127 SCD). Diffusion MRI was processed to generate regional and voxel-wise diffusion tensor values in bilateral lower cingulum white matter, while T1-weighted MRI was processed to generate regional volume and cortical thickness in the medial temporal lobe white matter, entorhinal cortex, temporal pole, and hippocampus.ResultsSCD participants had thinner cortex in bilateral entorhinal cortex and right temporal pole. No between-group differences were noted for any of the microstructural metrics of the lower cingulum. However, correlations with delayed story recall were significant for all diffusion microstructure metrics in the right lower cingulum in SCD, but not in controls, with a significant interaction effect. Additionally, the SCD group showed an accelerated aging effect in bilateral lower cingulum with MD, AxD, and RD.DiscussionThe diffusion profiles observed in both interaction effects are suggestive of a mixed neuroinflammatory and neurodegenerative pathology. Left entorhinal cortical thinning correlated with decreased FA and increased RD, suggestive of demyelination. However, right entorhinal cortical thinning also correlated with increased AxD, suggestive of a mixed pathology. This may reflect combined pathologies implicated in early AD. DTI was more sensitive than cortical thickness to the associations between SCD, memory, and age. The combined effects of mixed pathology may increase the sensitivity of DTI metrics to variations with age and cognition

FiberBlender: A Realistic Computer Model of Nerve Bundles for Simulating and Validating the Acquisition of Diffusion Tensor Imaging

Diffusion Tensor Imaging (DTI) is a powerful medical imaging technique that provides a unique method to investigate the structure and connectivity of neural pathways. DTI is a special magnetic resonance imaging (MRI) modality that combines the principles of magnetic resonance with molecular diffusion to trace the motion of water molecules. In the central nervous system, where nerve fibers are packed in highly-directional bundles, these molecules diffuse along the orientation of the fibers. Hence, characterizing the motion of water with DTI delivers a non-invasive in vivo technique to capture the connectivity of nerves themselves. Despite its promises and successful clinical applications for nearly thirty years, problems with validation and interpretation of measurements still persist. Most validation studies attempt to generate ground-truth data from animal models, phantoms, and computer models. This dissertation proposes a novel validation system, FiberBlender, capable of reproducing three-dimensional fiber structures and simulating the diffusion of water molecules to generate ground-truth synthetic DTI data. In particular FiberBlender contributes to: (i) creating more biologically accurate representations of fiber bundles with the inclusion of myelin and glial cells, (ii) examining the effect of demyelination and gliosis on DTI measurements, (iii) optimizing acquisition sequences, and (iv) evaluating the performance of multi-tensor models for the study of crossing fibers. FiberBlender strays away from the “one size fits all” approach taken by previous studies and uses computer algorithms in conjunction with some limited manual operations to produce brain-like geometries that take into account the random spatial location of axons and correct distributions of axon diameters, myelin to axon radius, and myelin to glia ratio. In this way no two models are the same and the system is capable of generating structures that can potentially represent any region of the brain and encompass the heterogeneity between human subjects. This feature is essential for optimization as the performance of DTI acquisition sequences may vary among subjects and the type of scanner used. In addition to better accuracy, the system offers a high degree of flexibility as the geometry can be modified to simulate events that cause drastic changes to the fiber structure. Specially, this dissertation looks at demyelination (an extensive loss of myelin volume), gliosis (a proliferation of glial cells), and axon compaction (a condensation of axons due to a loss of total brain volume) to determine their effects on the observed DTI signal. Simulation results confirm that axon compaction and partial remyelination have similar characteristics. Results also show that some standard clinically used acquisition sequences are incapable of capturing the effects of demyelination, gliosis and compaction when performing longitudinal studies. A novel sequence optimization technique based on Shannon entropy and mutual information is proposed to better capture demyelination. Optimized sequences are tested on a number of non-identical models to confirm their validity and can be used to improve the quality of DTI diagnostics. Finally this work looks at crossing fibers for the validation of multi-tensor models in their ability to characterize crossing diffusion profiles. The performance of multi-tensor models from CHARMED, Q-ball and spherical deconvolution that are widely used in both research and clinical settings are evaluated against ground-truth data generated with FiberBlender. The study is performed on a number of different crossing geometries and preliminary results show that the CHARMED model is the most comprehensive approach

Methods for improved mapping of brain lesion connectivity

Recent advances over the past two decades in neuroimaging methods have enabled us to map the connectivity of the brain. In parallel, pathophysiological models of brain disease have shifted from an emphasis on understanding pathology in specific brain regions to characterizing disruptions to interconnected neural networks. Nevertheless, these recent methods for mapping brain connectivity are still under development. Every step of the mapping process becomes a potential source for additional error due to noise or artifacts that could impact final analyses. Segmentation, parcellation, registration, and tractography are some of the steps where this occurs. Moreover, mapping the connectivity in a brain lesion is even more susceptible to errors in these steps. In this body of work, I describe multiple new methods for improving the accuracy of mapping lesion connectivity by reducing errors at the tractography stage which is the most error prone stage. First, we develop an approach for directly normalizing streamlines into a template space that avoids performing tractography in the normalized template space, reducing the error of connectomes constructed in the template space with respect to the ground truth native space connectome. Second, we develop a rapid approach for performing shortest path tractography and constructing shortest path probability weighted connectomes which increases the connection specificity relative to local streamline tracking approaches. We then demonstrate how our shortest path tractography approach can be used construct a disconnectome, a connectivity map of the proportion of connections lost due to intersecting a lesion. We then develop a fast, greedy graph-theoretic algorithm that extracts the maximally disconnected subgraph containing brain regions with the greatest shared loss of connectivity. Finally, we demonstrate how combining methods from diffusion based image inpainting and optimal estimation can be used to restore or inpaint corrupted fiber diffusion models in lesioned white matter tissue, enabling tractography and the study of lesion connectivity and modeling of microstructural measures in the patient’s native space

HIV and Early Life Stress on Neuroimaging and Risky Behavior

This study examined the interactive effects of early life stress (ELS) and HIV on brain morphometry, diffusion-basis-spectrum-imaging (DBSI), risky decision-making, and sex-risk behavior. 122 people with HIV (PWH) and 113 people without HIV (PWoH), free of major psychiatric illness and neurological confounds, were stratified into high (≥ 3 events) vs. low (\u3c 3 events) ELS [PWoH/low ELS (n = 57), PWoH/high ELS (n =56), PWH/low ELS (n = 43), PWH/high ELS (n = 79)] and underwent structural magnetic resonance imaging, DBSI, neuropsychological, and risky-behavior assessment; all PWH were virologically controlled. Compared to PWoH, PWH had smaller orbitofrontal cortex (OFC), parietal lobes, insula, caudate and anterior cingulate. No ELS effects were detected in volumetric measures. Significant interactions were found between HIV serostatus and ELS on the OFC and on cellularity of the inferior fronto-occipital fasciculus after multiple comparisons adjustment. Specifically, PWH/high ELS exhibited significantly smaller OFC and PWoH/high ELS show significantly larger OFC than the other groups. PWoH/high ELS exhibited higher DBSI cellularity (neuroinflammation proxy) of the inferior-occipital-fasciculus compared to PWoH/high ELS. Regardless of HIV status, executive function moderated the relationship between the OFC and sex-risk behavior such that individuals within the sample who performed above average on a measure of executive function and had a larger OFC reported fewer sex partners in past six months than individuals with smaller volumes. No interaction was found between HIV serostatus and ELS on risky behavior measures. Clustering analyses defined ELS subgroups in PWH that were determined by demographic characteristics, duration of infection, recent CD4+ T-cell count, nadir CD4+ T-cell count and high/low ELS.Even in PWH that are virologically controlled, without major current psychiatric comorbidities, there is evidence of a synergistic impact of ELS and HIV on OFC volumes. Higher volumes in the OFC were detrimental when associated with lower executive function scores or advantageous when associated with higher executive function. Findings suggest that ELS is associated with different brain signatures among PWoH and virally suppressed PWH. However, ELS was not directly associated with risky behaviors, and subgroups in PWH were characterized by demographic variables, past substance use and HIV clinical variables

Myelin imaging and characterization by magnetic resonance imaging

280 p.Los axones neuronales están recubiertos de una membrana lipídica llamada mielina, que protege a los axones y posibilita una transmisión rápida y eficiente del impulso eléctrico. En ciertas patologías como la lesión cerebral traumática, la isquemia o principalmente, en la esclerosis múltiple, la pérdida de mielina o desmielinización da lugar a la muerte neuronal y por consiguiente a la pérdida de capacidades cognitivas. Este estado puede ser revertido por medio de la remielinización, en la que los oligodendrocitos mielinizantes del sistema nervioso central regeneran la vaina de mielina, evitando la degeneración de las neuronas. En los últimos años se ha realizado un esfuerzo considerable en el desarrollo de terapias remielinizantes. Para ello, es imprescindible el desarrollo de técnicas para la evaluación no-invasiva de estas terapias y una caracterización profunda de los procesos de desmielinización y remielinización. En este contexto, la imagen por resonancia magnética (IRM) juega un papel fundamental por su carácter no-invasivo, alta resolución y versatilidad.Los principales objetivos de esta tesis han sido el desarrollo de protocolos de IRM para la cuantificación de mielina y la caracterización de los procesos de remielinización y desmielinización a través de resonancia magnética funcional en reposo. Para ello se ha utilizado como base el modelo murinocuprizona, en la que la administración del tóxico da lugar a la desmielinización en el cerebro, seguido por la remielinización. Los datos y conclusiones obtenidas se han contrastado en otros modelos de ratón, como en modelos de Alzheimer o en ratones sanos envejecidos.A grandes rasgos, hemos podido concluir que la imagen ponderada en peso T2 es la más específica y sensible para la cuantificación de mielina en el modelo cuprizona. Por ello, en este trabajo se propone la utilización de la imagen ponderada en peso T2 para la evaluación de terapias remielinizantes en el modelo cuprizona. Sin embargo, el interés de realizar imagen multiparamétríca ha quedado al descubierto al realizar imagen de modelos de ratón de Alzheimer, pudiendo detectar patología no relacionada con pérdida de mielina en zonas de materia blanca.Así mismo, hemos podido comprobar como la desmielinización conlleva la pérdida de la conectividad y función cerebral y la remielinización posibilita la recuperación por medio de la resonancia magnética funcional en reposo. Además, el potencial agente remielinizante clemastina, ha demostrado su capacidad de promover la remielinización a nivel anatómico y funcional tras 2 semanas de tratamiento. Finalmente, se ha realizado un estudio para determinar el efecto del envejecimiento en la conectividad del cerebro. Hemos podido observar que en ratones sanos, se ha observado un incremento de la conectividad cerebral hasta el mes 8, seguido de un descenso hasta el mes 13, probablemente debido a la neurodegeneración.En este trabajo hemos contribuido al desarrollo de terapias remielinizantes, por un lado, desarrollando protocolos de imagen para la cuantificación de mielina en modelos animales y por otro lado, caracterizando la desmielinización y remielinización a nivel funcional y anatómico