scholarly journals Characterizing Brain Oxygen Metabolism in Patients with Multiple Sclerosis with T2-Relaxation-Under-Spin-Tagging MRI

2012 ◽  
Vol 32 (3) ◽  
pp. 403-412 ◽  
Author(s):  
Yulin Ge ◽  
Zhongwei Zhang ◽  
Hanzhang Lu ◽  
Lin Tang ◽  
Hina Jaggi ◽  
...  

In this study, venous oxygen saturation and oxygen metabolic changes in multiple sclerosis (MS) patients were assessed using a recently developed T2-relaxation-under-spin-tagging (TRUST) magnetic resonance imaging (MRI), which measures the superior sagittal venous sinus blood oxygenation ( Yv) and cerebral metabolic rate of oxygen ( CMRO 2), an index of global oxygen consumption. Thirty patients with relapsing-remitting MS and 30 age-matched healthy controls were studied using TRUST at 3 T MR. The mean expanded disability status scale (EDSS) of the patients was 2.3 (range, 0 to 5.5). We found significantly increased Yv ( P<0.0001) and decreased CMRO 2 ( P=0.003) in MS patients (mean±s.d.: 65.9%±5.1% and 138.8±35.4 μmol per 100 g per minute) as compared with healthy control subjects (60.2%±4.0% and 180.2±24.8 μmol per 100 g per minute, respectively), implying decrease of oxygen consumption in MS. There was a significant positive correlation between Yv and EDSS and between Yv and lesion load in MS patients ( n=30); on the contrary, there was a significant negative correlation between CMRO 2 and EDSS and between CMRO 2 and lesion load ( n=12). There was no correlation between Yv and brain atrophy measures. This study showed preliminary evidence of the potential utility of TRUST in global oxygen metabolism. Our results of significant underutilization of oxygen in MS raise important questions regarding mitochondrial respiratory dysfunction and neurodegeneration of the disease.

1998 ◽  
Vol 4 (5) ◽  
pp. 408-412 ◽  
Author(s):  
J I O'Riordan ◽  
M Gawne Cain ◽  
A Coles ◽  
L Wang ◽  
D AS Compston ◽  
...  

Magnetic resonance imaging (MRI) is increasingly being used as a monitoring tool for disease activity in therapeutic trials in multiple sclerosis. There is, however, only a limited relationship between MRI findings and clinical outcome measurements. It has been suggested that hypointense lesion load on T1 weighted imaging has a better correlation with disability than the more conventional T2 hyper intense lesion load. This study was undertaken to (i) evaluate different measurement techniques used to quantify T1 hypointense lesion load, and (ii) to compare lesion load as measured using different parameters and disability. Twenty-five patients with secondary progressive multiple sclerosis, mean age of 40 years (23-57), mean EDSS 5.7 (4-7) were analysed. T2 lesion load on FSE correlated well with both the hypointense lesion load on T1 pre-gadolinium (r=0.8, P50.0001) and T1 post-gadolinium (r=0.8, P50.0001) but less so with the enhancing lesion load (r=0.4, P50.05). There was a very strong correlation with T1 hypo-intense lesion volume pre and post gadolinium (r=0.96, P50.001). However, the EDSS was not correlated with the T2 lesion load (r=70.27, P=0.2), T1 pre-gadolinium load (r=70.3, P=0.1), T1 post gadolinium load (r=70.4, P=0.7) and enhancing lesion load (r=70.28, P=0.2), or with the degree of hypointensity of T1 weighted images determined using the threshold technique. There is a strong correlation between T1 hypointense lesion volume both pre and post gadolinium and also between T1 and T2 lesion volumes.


1996 ◽  
Vol 37 (1P1) ◽  
pp. 278-287 ◽  
Author(s):  
A.-M. Landtblom ◽  
L. Sjöqvist ◽  
B. Söderfeldt ◽  
H. Nyland ◽  
K.-Å. Thuomas

Purpose: We wanted to compare the metabolite status of brain lesions in different clinical subtypes of multiple sclerosis (MS). Two acute MS lesions with ringlike appearances were also investigated. Material and Methods: Twenty-three clinically stable MS patients, 2 patients with acute relapses, and 15 healthy individuals were examined by MR imaging and localized proton MRS. Results: No metabolite differences were seen in plaques of different subtypes. Decreased NAA/Cr and NAA/choline ratios as well as increased inositol/Cr ratios were observed in the plaques of the clinically stable or chronic active MS patients as compared with controls. The ring plaques had hyperintense cores with surrounding halos, separated from the cores by rings with low signal intensity in T2-weighted images. The core exhibited a prolonged T2 relaxation time. Proton spectra initially contained lactate. Conclusion: No differences between the metabolite status of nonacute plaques in different clinical subtypes could be detected. The ring plaques contained lactate signals indicating oedema, inflammation, and macrophage invasion, and may be transition forms between acute oedematous lesions and chronic demyelinated plaques.


2013 ◽  
Vol 71 (3) ◽  
pp. 978-989 ◽  
Author(s):  
Lisa C. Krishnamurthy ◽  
Peiying Liu ◽  
Yulin Ge ◽  
Hanzhang Lu

2021 ◽  
pp. 0271678X2110645
Author(s):  
Pieter T Deckers ◽  
Alex A Bhogal ◽  
Mathijs BJ Dijsselhof ◽  
Carlos C Faraco ◽  
Peiying Liu ◽  
...  

Blood oxygenation level-dependent (BOLD) or arterial spin labeling (ASL) MRI with hypercapnic stimuli allow for measuring cerebrovascular reactivity (CVR). Hypercapnic stimuli are also employed in calibrated BOLD functional MRI for quantifying neuronally-evoked changes in cerebral oxygen metabolism (CMRO2). It is often assumed that hypercapnic stimuli (with or without hyperoxia) are iso-metabolic; increasing arterial CO2 or O2 does not affect CMRO2. We evaluated the null hypothesis that two common hypercapnic stimuli, ‘CO2 in air’ and carbogen, are iso-metabolic. TRUST and ASL MRI were used to measure the cerebral venous oxygenation and cerebral blood flow (CBF), from which the oxygen extraction fraction (OEF) and CMRO2 were calculated for room-air, ‘CO2 in air’ and carbogen. As expected, CBF significantly increased (9.9% ± 9.3% and 12.1% ± 8.8% for ‘CO2 in air’ and carbogen, respectively). CMRO2 decreased for ‘CO2 in air’ (−13.4% ± 13.0%, p < 0.01) compared to room-air, while the CMRO2 during carbogen did not significantly change. Our findings indicate that ‘CO2 in air’ is not iso-metabolic, while carbogen appears to elicit a mixed effect; the CMRO2 reduction during hypercapnia is mitigated when including hyperoxia. These findings can be important for interpreting measurements using hypercapnic or hypercapnic-hyperoxic (carbogen) stimuli.


2021 ◽  
Author(s):  
Amir Valizadeh ◽  
Elham Barati ◽  
Mohammad Ali Sahraian ◽  
Mohammad Reza Fattahi ◽  
Mana Moassefi

Abstract Rationale: As the role of neurodegeneration in the pathophysiology of multiple sclerosis (MS) has become more prominent, the formation and evolution of chronic or persistent T1-hypointense lesions (Black Holes) have been used as markers of axonal loss and neuronal destruction to measure disease activity. However, findings regarding this subject are controversial. In this study we aim to clarify the level of importance of T1 hypointense lesions for estimating the prognosis of patients.Objectives: To evaluate the correlation between T1 hypointensities (Black holes) lesion load (lesion mean volume) on brain MRI with disability level of patients with Relapsing-Remitting Multiple Sclerosis (RRMS) or Secondary-Progressive Multiple Sclerosis (SPMS).Data sources: We will search MEDLINE (through PubMed), Embase, CENTRAL, Science Citation Index – Expanded (Web of Science), and Conference Proceedings Citation Index – Science (Web of Science). We won’t consider any timeframe, language, or geographical restrictions.Methods: Standard systematic review protocol methodology is employed. Eligibility criteria is reported in line with PICOTS system. Population is limited to adult patients diagnosed with RRMS or SPMS, based on the McDonald criteria. Index (prognostic factor) of interest will be T1 hypointense (black hole) lesion mean volume (lesion load) on brain Magnetic Resonance Imaging (MRI). There will be no comparators. Outcome of interest will be the disability measure using Expanded Disability Status Scale (EDSS). For the timing domain, we will include studies only if the outcome was measured at the same time MRI was performed (or with a very close time interval between). Inpatient and outpatient settings will both be included. All included studies will be assessed for the risk of bias using a tailored version of the Quality In Prognosis Studies (QUIPS) tool. Extracted correlation coefficients will be converted to the Fisher’s z scale and a meta-analysis will be performed on the results. We will then convert back the results to correlation coefficients again for the sake of presentation. For the purpose of assessing heterogeneity we will use prediction intervals. If feasible, we will also try to perform subgroup and sensitivity analyses. We will also evaluate the publication bias using Funnel plots and assess the confidence in cumulative evidence using an adapted version of the GRADE for prognostic factor research.


2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Mariya V. Cherkasova ◽  
Jessie F. Fu ◽  
Michael Jarrett ◽  
Poljanka Johnson ◽  
Shawna Abel ◽  
...  

AbstractDespite significant insights into the neural mechanisms of acute placebo responses, less is known about longer-term placebo responses, such as those seen in clinical trials, or their interactions with brain disease. We examined brain correlates of placebo responses in a randomized trial of a then controversial and now disproved endovascular treatment for multiple sclerosis. Patients received either balloon or sham extracranial venoplasty and were followed for 48 weeks. Venoplasty had no therapeutic effect, but a subset of both venoplasty- and sham-treated patients reported a transient improvement in health-related quality of life, suggesting a placebo response. Placebo responders did not differ from non-responders in total MRI T2 lesion load, count or location, nor were there differences in normalized brain volume, regional grey or white matter volume or cortical thickness (CT). However, responders had higher lesion activity. Graph theoretical analysis of CT covariance showed that non-responders had a more small-world-like CT architecture. In non-responders, lesion load was inversely associated with CT in somatosensory, motor and association areas, precuneus, and insula, primarily in the right hemisphere. In responders, lesion load was unrelated to CT. The neuropathological process in MS may produce in some a cortical configuration less capable of generating sustained placebo responses.


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