Evidence for Diffuse Central Retinal Edema In Vivo in Diabetic Male Sprague Dawley Rats

Background: Investigations into the mechanism of diffuse retinal edema in diabetic subjects have been limited by a lack of animal models and techniques that co-localized retinal thickness and hydration in vivo. In this study we test the hypothesis that a previously reported supernormal central retinal thickness on MRI measured in experimental diabetic retinopathy in vivo represents a persistent and diffuse edema. Methodology/Principal Findings: In diabetic and age-matched control rats, and in rats experiencing dilutional hyponatremia (as a positive edema control), whole central retinal thickness, intraretinal water content and apparent diffusion coefficients (ADC, ‘water mobility’) were measured in vivo using quantitative MRI methods. Glycated hemoglobin and retinal thickness ex vivo (histology) were also measured in control and diabetic groups. In the dilutional hyponatremia model, central retinal thickness and water content were supernormal by quantitative MRI, and intraretinal water mobility profiles changed in a manner consistent with intracellular edema. Groups of diabetic (2, 3, 4, 6, and 9 mo of diabetes), and age-matched controls were then investigated with MRI and all diabetic rats showed supernormal whole central retinal thickness. In a separate study in 4 mo diabetic rats (and controls), MRI retinal thickness and water content metrics were significantly greater than normal, and ADC was subnormal in the outer retina; the increase in retinal thickness was not detected histologically on sections of fixed and dehydrated retinas from these rats

Analysis of Drug Delivery in the Eye Using Magnetic Resonance Imaging

With the rapid increase in the elderly population, the number of Americans afflicted with vision impairment due to ocular disease is projected to rise substantially by the year 2020. Ocular disorders are becoming a major public health problem, and efforts have increased in recent years to develop methods of efficient drug delivery. Currently, the most effective method for treating serious ocular disorders is to inject drug solutions directly into the vitreous. However, injecting in this manner carries a high risk of severe side effects. As a safer alternative, researchers in recent years have been investigating transscleral drug delivery, in which the drug is administered to the outer coat of the eye. Various methods of transscleral drug delivery have been proposed, but it is still clinically not as effective as intravitreal drug delivery. In order to design improved transscleral drug delivery systems, the ocular barriers to drug transport must be accurately understood. While various barrier types have been identified in the eye, the significance and contribution of individual barriers have not been investigated and are still widely unknown. A reason for this lack of understanding is due to the inability to acquire concentration measurements in the eye in vivo. In this study, magnetic resonance imaging (MRI) was employed to obtain drug concentration measurements in vivo after transscleral drug delivery. To address the current needs of the ocular drug delivery community, several goals have been achieved in this work: (1) to evaluate transscleral drug delivery in vivo using MRI, (2) to assess MRI as a technique for evaluating drug delivery in the eye, and (3) to better understand the significance of individual barriers in the eye by quantitatively analyzing experimental (MRI) data and by pharmacokinetic modeling. While encompassing many advantages, it is found that MRI has limitations in spatial and temporal resolution that may restrict its use in measuring parameters with low sensitivity. However, the MRI results in parallel with analysis from the pharmacokinetic model give new insight into the barriers to drug transport in the eye

Cortical Layer-Dependent Hemodynamic Regulation Investigated by Functional Magnetic Resonance Imaging

Functional magnetic resonance imaging (fMRI) is currently one of the most widely used non-invasive neuroimaging modalities for mapping brain activation. Techniques such as blood oxygenation level dependent (BOLD) fMRI or cerebral blood volume (CBV)-weighted fMRI are based on the assumption that hemodynamic responses are tightly regulated by neural activity. However, the relationship between fMRI responses and neural activity is still unclear. To investigate this relationship, the unique properties of temporal frequency tuning of primary visual cortex neurons was used as a model since it can be used to separate the neural input and output activities of this area. During moving grating stimuli of 1, 2, 10 and 20 Hz temporal frequencies, two fMRI studies, areal and laminar studies, were conducted with different spatial resolution in a 9.4-T Varian spectrometer. In areal studies, BOLD fMRI was able to detect the difference in tuning properties between area 17 (A17), area 18 (A18) and lateral geniculate nucleus. In A17, the BOLD tuning curve seemed to reflect the local field potential (LFP) low frequency band (<12 Hz) rather than spiking activity and LFP gamma band (25-90 Hz). In laminar studies, a high spatial resolution protocol was adopted to resolve the different cortical layers in A17. In addition to BOLD fMRI, CBV-weighted fMRI was performed to eliminate the contamination from the superficial draining veins. These results showed that BOLD and CBV tuning curves do not reflect the underlying spiking activity or the LFP activity at infragranular layers (the bottom layer of three cortical layers). This implies that the hemodynamic response may not be regulated on a laminar level. Therefore, caution should be taken when interpreting BOLD responses as the sole indicator of different aspects of neural activity in areal and laminar scales

Microstructural imaging of the human brain with a 'super-scanner': 10 key advantages of ultra-strong gradients for diffusion MRI

The key component of a microstructural diffusion MRI 'super-scanner' is a dedicated high-strength gradient system that enables stronger diffusion weightings per unit time compared to conventional gradient designs. This can, in turn, drastically shorten the time needed for diffusion encoding, increase the signal-to-noise ratio, and facilitate measurements at shorter diffusion times. This review, written from the perspective of the UK National Facility for In Vivo MR Imaging of Human Tissue Microstructure, an initiative to establish a shared 300 mT/m-gradient facility amongst the microstructural imaging community, describes ten advantages of ultra-strong gradients for microstructural imaging. Specifically, we will discuss how the increase of the accessible measurement space compared to a lower-gradient systems (in terms of Δ, b-value, and TE) can accelerate developments in the areas of 1) axon diameter distribution mapping; 2) microstructural parameter estimation; 3) mapping micro-vs macroscopic anisotropy features with gradient waveforms beyond a single pair of pulsed-gradients; 4) multi-contrast experiments, e.g. diffusion-relaxometry; 5) tractography and high-resolution imaging in vivo and 6) post mortem; 7) diffusion-weighted spectroscopy of metabolites other than water; 8) tumour characterisation; 9) functional diffusion MRI; and 10) quality enhancement of images acquired on lower-gradient systems. We finally discuss practical barriers in the use of ultra-strong gradients, and provide an outlook on the next generation of 'super-scanners'

Transient and Local Increase in the Permeability of the Blood-Brain Barrier and the Blood-Retinal Barrier by Hyperthermia of Magnetic Nanoparticles in a Rat Model

RÉSUMÉ Après avoir réussi à propulser des agents thérapeutiques encapsulés dans des micro-transporteurs magnétiques à un endroit précis à l'intérieur d'un modèle animal en utilisant le gradient de champ magnétique dans un appareil de résonance magnétique (RM) modifié, nous visons maintenant à livrer une drogue localement dans le système nerveux central (SNC). Afin de réussir la livraison de la drogue de façon localisée et augmenter l'efficacité du traitement, ce projet met de l’avant que les agents thérapeutiques doivent être administrés par des moyens pas plus envahissants qu’une injection intraveineuse, suivis par la propulsion à distance, contrôlée, et actionnée sur commande dans le SNC. La fonction exigeante du tissu neuronal dans le SNC (haute sensibilité/complexité du système) nécessite un environnement extrêmement stable. Un changement minime dans la composition du liquide interstitiel dans le SNC peut jouer un rôle prépondérant dans la régulation de son microenvironnement et de l'activité neuronale. Par conséquent, le SNC est conçu pour se protéger des fluctuations fréquentes de la concentration extracellulaire d’hormones, d’acides aminés, et des niveaux d'ions produits après les repas, l'exercice ou le stress (ainsi que d'agents pathogènes toxiques qui peuvent être en circulation dans le sang). Cette protection du SNC est permise grâce à la présence d’une barrière, nommée barrière hémato-encéphalique (BHE). Cette barrière préventive se compose essentiellement de cellules endothéliales étroitement reliées entre elles qui tapissent la surface intérieure de la plupart des vaisseaux sanguins dans le SNC. Bien que ceci offre un environnement neuronal stable, plus de 98% des molécules que constituent les drogues ne sont pas en mesure de franchir la BHE et leur pénétration est uniquement déterminée par les caractéristiques de perméabilité de la barrière. Ceci est alors un frein pour les traitements ciblant le SNC. Par conséquent, la recherche pharmaceutique fait un réel effort pour maximiser la livraison des médicaments vers le SNC. Pour autant, la présence des barrières physiologiques, bien qu’essentielles à la survie en conditions physiologiques, limitent les traitements qu’on a à notre disposition en conditions pathologiques.----------ABSTRACT After successfully propelling therapeutic agents encapsulated in magnetic micro-carriers to a specific location inside an animal model by the gradient magnetic field of a modified clinical Magnetic Resonance (MR) scanner, we are now aiming to perform local drug delivery in the region of the central nervous system (CNS). To achieve localized drug delivery and increase efficacy, this project advances the theme that the therapeutic agents must be administered by means no more invasive than an intravenous injection followed by remote propulsion, controlled tracking, and on-command actuation in the CNS. The demanding function of the CNS requires an extremely stable environment. In fact, any small change in the composition of the interstitial fluid in the CNS plays a predominant role in regulating its microenvironment and neuronal activity. Therefore, the CNS is conceived to protect itself from frequent fluctuations of extracellular concentration of hormones, amino acids, and ion levels that occur after meals, exercise, or stress - as well as from toxic pathogens that may be circulating in the blood stream. This preventive barrier consists mainly of tightly interconnected endothelial cells that carpet the inner surface of most blood vessels in the CNS. While it provides a stable neuronal environment, more than 98% of all drug molecules are not able to cross this barrier and the extent to which a molecule enters is determined only by the permeability characteristics of the barrier. Therefore, while pharmaceutical research progresses for drug delivery to the CNS, it is limited by its pharmacokinetics through physiological barriers. Successful transient and local opening of the barrier for diffusion of therapeutics could strongly support the feasibility of treating a variety of neurological disorders. A recent effort presented in this dissertation provides evidence for the emergence of a novel approach to overcome this problem. This technique uses magnetic nanoparticles (MNPs) in conjunction with an alternating magnetic field to transiently increase barrier permeability for drug delivery. MNPs can act as miniaturized heat sources that, when under the influence of the alternating magnetic field, dissipate thermal energy directly and exclusively to the barrier (hyperthermia). In addition to its novelty, the findings confirm that the technique does not damage the neurovascular unit, i.e. neurons, astrocytes, etc

Study of ocular transport of drugs released from a sustained release device

Delivering ocular therapeutics to a target site with minimal side effects requires detailed information about the distribution and elimination pathways. This knowledge can guide the development of new drug delivery devices. In this study, we investigated the movement of two drug surrogates, H-110, which is lipophilic, and Gd-DTPA, which is hydrophilic, released from polymer-based implants using a fluorescein technique and magnetic resonance imaging (MRI). We also studied the pharmacokinetics of intravitreally injected triamcinolone acetonide, a low water soluble drug used for treating sight-threatening diseases such as diabetic retinopathy and choroidal neovascularization associated with age-related macular degeneration (AMD). At 24 hour post implantation, H-110 released from an intravitreal implant was detected in the subretinal space. However, following a subconjunctival implant, very little H-110 fluorescence was detected in the subretinal region. H-110 most likely reached the subretinal space from an intravitreal implant by diffusion through the vitreous and retina. However, most of the H-110 released from a subconjunctival implant is thought to dissipate through the choroidal blood flow. Concentration profiles of Gd-DTPA, which was released from an intravitreal implant in a New Zealand white rabbit, approached pseudo-steady state within 7 to 8 hours and showed gradients at the rabbit's vitreous-retina border suggesting that diffusion was occurring into the retinal-choroidal-scleral membrane. Parametric analysis with a finite element mathematical model of the rabbit eye yielded for Gd-DTPA a diffusion coefficient of 2.8 × 10-6 cm2/sec in the vitreous and a permeability of 1.0 × 10-5 cm/sec in the composite retina-choroid-sclera membrane. Gd-DTPA concentration decreased away from the implant. Such regional concentration variations throughout the vitreous may have clinical significance when the ubiquitous eye diseases are treated using a single positional implant. Subconjunctival implants in vivo delivered a mean total of 2.7 µg of Gd-DTPA over 8 hours into the vitreous representing only 0.12% of the total amount of compound released from the implant in vitro. No Gd-DTPA was detected in the posterior segment of the eye. Ex vivo, the Gd-DTPA concentration in the vitreous was 30 fold higher suggesting the elimination of significant in vivo barriers to the movement of drugs from the subconjunctival space into the vitreous. We developed a new preservative-free formulation for intravitreal injections of triamcinolone acetonide for the treatment of diabetic macular edema, and choroidal neovascularization associated with AMD in human clinical trials at the National Institutes of Health. A pharmacokinetic study in rabbits was done to estimate elimination rate of two injection amounts of triamcinolone acetonide, 4 mg and 16 mg, from the vitreous. From our pharmacokinetic model, we found the half-lives for 4 mg and 16 mg injection in the vitreous to be 18.6 days and 37.6 days, respectively. We subsequently estimated the half-lives of 1 mg and 8 mg triamcinolone acetonide injection in order to predict therapeutic exposure in human. There are three components in this thesis: the study of lipophilic H-110 transport with fluorescence, the study of hydrophilic transport of Gd-DTPA with MRI, and the pharmacokinetic analysis of triamcinolone acetonide. They have each contributed to further insights into our fundamental understanding of drug movement in the eye and the implication on optimal therapeutic delivery

Ultrahigh Field Functional Magnetic Resonance Electrical Impedance Tomography (fMREIT) in Neural Activity Imaging

abstract: A direct Magnetic Resonance (MR)-based neural activity mapping technique with high spatial and temporal resolution may accelerate studies of brain functional organization. The most widely used technique for brain functional imaging is functional Magnetic Resonance Image (fMRI). The spatial resolution of fMRI is high. However, fMRI signals are highly influenced by the vasculature in each voxel and can be affected by capillary orientation and vessel size. Functional MRI analysis may, therefore, produce misleading results when voxels are nearby large vessels. Another problem in fMRI is that hemodynamic responses are slower than the neuronal activity. Therefore, temporal resolution is limited in fMRI. Furthermore, the correlation between neural activity and the hemodynamic response is not fully understood. fMRI can only be considered an indirect method of functional brain imaging. Another MR-based method of functional brain mapping is neuronal current magnetic resonance imaging (ncMRI), which has been studied over several years. However, the amplitude of these neuronal current signals is an order of magnitude smaller than the physiological noise. Works on ncMRI include simulation, phantom experiments, and studies in tissue including isolated ganglia, optic nerves, and human brains. However, ncMRI development has been hampered due to the extremely small signal amplitude, as well as the presence of confounding signals from hemodynamic changes and other physiological noise. Magnetic Resonance Electrical Impedance Tomography (MREIT) methods could have the potential for the detection of neuronal activity. In this technique, small external currents are applied to a body during MR scans. This current flow produces a magnetic field as well as an electric field. The altered magnetic flux density along the main magnetic field direction caused by this current flow can be obtained from phase images. When there is neural activity, the conductivity of the neural cell membrane changes and the current paths around the neurons change consequently. Neural spiking activity during external current injection, therefore, causes differential phase accumulation in MR data. Statistical analysis methods can be used to identify neuronal-current-induced magnetic field changes.Dissertation/ThesisDoctoral Dissertation Biomedical Engineering 201

Evaluating Small Airways Disease in Asthma and COPD using the Forced Oscillation Technique and Magnetic Resonance Imaging

Obstructive lung disease, including asthma and chronic obstructive pulmonary disease (COPD), is characterized by heterogeneous ventilation. Unfortunately, the underlying structure-function relationships and the relationships between measurements of heterogeneity and patient quality-of-life in obstructive lung disease are not well understood. Hyperpolarized noble gas MRI is used to visualize and quantify ventilation distribution and the forced oscillation technique (FOT) applies a multi-frequency pressure oscillation at the mouth to measure respiratory impedance to airflow (including resistance and reactance). My objective was to use FOT, ventilation MRI and computational airway tree modeling to better understand ventilation heterogeneity in asthma and COPD. FOT-measured respiratory system impedance was correlated with MRI ventilation heterogeneity and both were related to quality-of-life in asthma and COPD. FOT-measurements and model-predictions of reactance and small-airways resistance were correlated in asthma and COPD respectively. This study is the first to demonstrate the relationships between FOT-measured impedance, MRI ventilation heterogeneity, and patient quality-of-life