Central Atrophy Early in Multiple Sclerosis: Third Ventricle Volumetry versus Planimetry

Lutz, Theodor; Bellenberg, Barbara; Schneider, Ruth; Weiler, Florian; Köster, O.; Lukas, Carsten

doi:10.1111/jon.12410

Cited by 9 publications

(16 citation statements)

References 33 publications

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“…Both transmit and receive B 1 inhomogeneity may also play a role in studies in which metabolites are quantified relative to a signal external to the voxel used for spectroscopy, such as the water signal from the ventricles or a separately measured metabolite phantom. Because individuals with multiple sclerosis can exhibit wider ventricles than those without (291), one may imagine a scenario in which periventricular cortical voxels are systematically located more peripherally in those with more progressed disease. Depending on the field profiles of the transmit pulses and receive coils used, such an offset may lead to either over- or underestimation of the metabolites at hand in this cohort, especially at higher field strengths at which increased Larmor frequency necessitates the use of radiofrequency pulses of a wavelength shorter than the diameter of the human skull.…”

Section: Metabolite Quantificationmentioning

confidence: 99%

Quantifying the Metabolic Signature of Multiple Sclerosis by in vivo Proton Magnetic Resonance Spectroscopy: Current Challenges and Future Outlook in the Translation From Proton Signal to Diagnostic Biomarker

et al. 2019

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Proton magnetic resonance spectroscopy (1H-MRS) offers a growing variety of methods for querying potential diagnostic biomarkers of multiple sclerosis in living central nervous system tissue. For the past three decades, 1H-MRS has enabled the acquisition of a rich dataset suggestive of numerous metabolic alterations in lesions, normal-appearing white matter, gray matter, and spinal cord of individuals with multiple sclerosis, but this body of information is not free of seeming internal contradiction. The use of 1H-MRS signals as diagnostic biomarkers depends on reproducible and generalizable sensitivity and specificity to disease state that can be confounded by a multitude of influences, including experiment group classification and demographics; acquisition sequence; spectral quality and quantifiability; the contribution of macromolecules and lipids to the spectroscopic baseline; spectral quantification pipeline; voxel tissue and lesion composition; T1 and T2 relaxation; B1 field characteristics; and other features of study design, spectral acquisition and processing, and metabolite quantification about which the experimenter may possess imperfect or incomplete information. The direct comparison of 1H-MRS data from individuals with and without multiple sclerosis poses a special challenge in this regard, as several lines of evidence suggest that experimental cohorts may differ significantly in some of these parameters. We review the existing findings of in vivo 1H-MRS on central nervous system metabolic abnormalities in multiple sclerosis and its subtypes within the context of study design, spectral acquisition and processing, and metabolite quantification and offer an outlook on technical considerations, including the growing use of machine learning, by future investigations into diagnostic biomarkers of multiple sclerosis measurable by 1H-MRS.

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Section: Metabolite Quantificationmentioning

confidence: 99%

Quantifying the Metabolic Signature of Multiple Sclerosis by in vivo Proton Magnetic Resonance Spectroscopy: Current Challenges and Future Outlook in the Translation From Proton Signal to Diagnostic Biomarker

et al. 2019

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“…Second, GM atrophy begins early in the disease process [5,7,25,29], even before the onset of MS symptoms [30]. Third, GM atrophy is associated with and predictive of a range of clinical manifestations of MS, such as physical disability, cognitive dysfunction, depression, and quality of life [7,[31][32][33][34][35][36][37][38][39][40][41].…”

Section: Introductionmentioning

confidence: 99%

A two-year study using cerebral gray matter volume to assess the response to fingolimod therapy in multiple sclerosis

Yousuf

Dupuy

Tauhid

et al. 2017

Journal of the Neurological Sciences

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“…It has previously been shown that atrophy around the third and fourth ventricle can be found in RR, but not progressive, MS patients. 25 Third ventricle enlargement has been well documented, even at the early stages of MS. 26 It may even predict a motor and neuropsychological dysfunction in MS patients. 27 As for the involvement of brain parenchyma around the fourth ventricle, it has rather been described in the context of neuromyelitis optica spectrum disorders, especially myelin oligodendrocyte glycoprotein (MOG)-antibody disease, with regards to WML in this region.…”

Section: Discussionmentioning

confidence: 99%

Distinct regional brain atrophy pattern in multiple sclerosis and neuropsychiatric systemic lupus erythematosus patients

Kalinowska-Łyszczarz

Pawlak

Pietrzak

et al. 2018

Lupus

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Differentiation of systemic lupus erythematosus (SLE) from multiple sclerosis (MS) can be challenging, especially when neuropsychiatric (NP) symptoms are accompanied by white matter lesions in the brain. Given the lack of discriminative power of currently applied tools for their differentiation, there is an unmet need for other measures that can aid in distinguishing between the two autoimmune disorders. In this study we aimed at exploring whether brain atrophy measures could serve as markers differentiating MS and SLE. Thirty-seven relapsing-remitting MS and 38 SLE patients with nervous system manifestations, matched according to age and disease duration, underwent 1.5 Tesla magnetic resonance imaging (MRI), including volumetric sequences, and clinical assessment. Voxelwise analysis was performed using ANTS-SyN elastic registration protocol, FSL Randomise and Gamma methods. Cortical and subcortical segmentation was performed with Freesurfer 5.3 pipeline using T1-weighted MPRAGE sequence data. Using MRI volumetric markers of general and subcortical gray matter atrophy and clinical variables, we built a stepwise multivariable logistic diagnostic model to identify MRI parameters that best differentiate MS and SLE patients. We found that the best volumetric predictors to distinguish them were: fourth ventricle volume (sensitivity 0.86, specificity 0.57, area under the curve, AUC 0.77), posterior corpus callosum (sensitivity 0.81, specificity 0.57, AUC 0.68), and third ventricle to thalamus ratio (sensitivity 0.42, specificity 0.84, AUC 0.65). The same classifiers were identified in a subgroup analysis that included patients with a short disease duration. In MS brain atrophy and lesion load correlated with clinical disability, while in SLE age was the main determinant of brain volume. This study proposes new imaging parameters for differential diagnosis of MS and SLE with central nervous system involvement. We show there is a different pattern of atrophy in MS and SLE, and the key structural volumes that are differentially affected include fourth ventricle and posterior section of corpus callosum, followed by third ventricle to thalamus ratio. Different correlation patterns between volumetric and clinical data may suggest that while in MS atrophy is driven mainly by disease activity, in SLE it is mostly associated with age. However, these results need further replication in a larger cohort.

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Central Atrophy Early in Multiple Sclerosis: Third Ventricle Volumetry versus Planimetry

Abstract: a3VW is a time-effective and robust biomarker that has strong correlations with volumetric measurements and can be established as standard in the MRI quantification of central brain atrophy in patients with early MS.

Cited by 9 publications

References 33 publications

Quantifying the Metabolic Signature of Multiple Sclerosis by in vivo Proton Magnetic Resonance Spectroscopy: Current Challenges and Future Outlook in the Translation From Proton Signal to Diagnostic Biomarker

Quantifying the Metabolic Signature of Multiple Sclerosis by in vivo Proton Magnetic Resonance Spectroscopy: Current Challenges and Future Outlook in the Translation From Proton Signal to Diagnostic Biomarker

A two-year study using cerebral gray matter volume to assess the response to fingolimod therapy in multiple sclerosis

Distinct regional brain atrophy pattern in multiple sclerosis and neuropsychiatric systemic lupus erythematosus patients

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