Generic acquisition protocol for quantitative MRI of the spinal cord

Cohen‐Adad, Julien; Alonso‐Ortiz, Eva; Abramovic, Mihael; Arneitz, Carina; Atcheson, Nicole; Barlow, Laura; Barry, Robert; Barth, Markus; Battiston, Marco; Büchel, Christian; Budde, Matthew D.; Callot, Virginie; Combes, Anna J.E.; Leener, Benjamin De; Descoteaux, Maxime; Sousa, Paulo Loureiro de; Dostál, Marek; Doyon, Julien; Dvorak, Adam; Eippert, Falk; Epperson, Karla R.; Epperson, Kevin S.; Freund, Patrick; Finsterbusch, Jürgen; Foias, Alexandru; Fratini, Michela; Fukunaga, Issei; Wheeler-Kingshott, C; Germani, Giancarlo; Gilbert, Guillaume; Giove, Federico; Gros, Charley; Grussu, Francesco; Hagiwara, Akifumi; Henry, Pierre Gilles; Horák, Tomáš; Hori, Masaaki; Joers, James M.; Kamiya, Kazutaka; Karbasforoushan, Haleh; Keřkovský, Miloš; Khatibi, Ali; Kim, Joo Won; Kinany, Nawal; Kitzler, Hagen H.; Kolind, Shannon; Kong, Yazhuo; Kudlička, Petr; Kuntke, Paul; Kurniawan, Nyoman D.; Kusmia, Slawomir; Labounek, René; Laganà, Maria Marcella; Laule, Cornelia; Law, Christine S.; Lenglet, Christophe; Leutritz, Tobias; Liu, Yaou; Llufriú, Sara; Mackey, Sean; Martínez‐Heras, Eloy; Mattera, Loan; Nestrašil, Igor; O’Grady, Kristin P.; Papinutto, Nico; Papp, Daniel S.; Pareto, Deborah; Parrish, Todd B.; Pichiecchio, Anna; Prados, Ferrán; Rovira, Àlex; Ruitenberg, Marc J.; Samson, R; Savini, Giovanni; Seif, Maryam; Seifert, Alan C.; Smith, Alex K.; Smith, Seth A.; Smith, Zachary A.; Solana, Elisabeth; Suzuki, Yuichi; Tackley, George; Tinnermann, Alexandra; Valošek, Jan; Ville, Dimitri Van De; Yiannakas, Marios C.; Weber, Kenneth A.; Weiskopf, Nikolaus; Wise, Richard G.; Wyss, Patrik O.; Xu, Junqian

doi:10.1038/s41596-021-00588-0

Cited by 71 publications

(78 citation statements)

References 110 publications

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“…With results now providing a better picture of the expected cross-sectional alterations and longitudinal changes in the spinal cord in FRDA, the MR protocol could be streamlined and shortened substantially, benefitting from recent advances in hardware and pulse sequences. For example, while spine dMRI acquisition lasted about 40min in the present study, it can be reduced to ∼4min 21 . Similarly, the length of spinal cord MRS was about 40min (including all adjustments and shimming).…”

Section: Discussionmentioning

confidence: 79%

Spinal cord MRI and MRS Detect Early-stage Alterations and Disease Progression in Friedreich Ataxia

Joers

Adanyeguh

Deelchand

et al. 2022

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Background: Friedreich Ataxia (FRDA) is the most common hereditary ataxia. Atrophy of the spinal cord is one of the hallmarks of the disease. Magnetic resonance imaging (MRI) and spectroscopy (MRS) are powerful and non-invasive tools to investigate pathological changes in the spinal cord. A handful of studies have reported cross-sectional alterations in FRDA using MRI and diffusion MRI (dMRI) in FRDA. However, to our knowledge no longitudinal MRI, dMRI or MRS results have been reported in the spinal cord in FRDA. Objective: To investigate early-stage cross-sectional alterations and longitudinal changes in the cervical spinal cord in FRDA, using a multimodal magnetic resonance (MR) protocol comprising morphometric (anatomical MRI), microstructural (dMRI), and neurochemical (1H MRS) assessments. Design: We enrolled 28 early-stage individuals with FRDA and 20 age- and gender-matched controls (cross-sectional study). Disease duration at baseline was 5.5±4.0 years and Friedreich Ataxia Rating Scale (FARS) total neurological score at baseline was 42.7±13.6. Twenty-one FRDA participants returned for 1-year follow-up, and 19 of those for 2-year follow-up (cohort study). Each visit consisted in clinical assessments and MR scans. Controls were scanned at baseline only. Results: At baseline, individuals with FRDA had significantly lower spinal cord cross-sectional area (-31%, p=4.10-17), higher eccentricity (+10%, p=5.10-7), lower total N-acetyl-aspartate (-36%, p=6.10-9) and higher myo-inositol (+37%, p=2.10-6) corresponding to a lower ratio tNAA/mIns (-52%, p=2.10-13), lower fractional anisotropy (-24%, p=10-9) as well as higher radial diffusivity (+56%, p=2.10-9), mean diffusivity (+35%, p=10-8) and axial diffusivity (+17%, p=4.10-5) relative to controls. Longitudinally, spinal cord cross-sectional area decreased by 2.4% per year relative to baseline (p=4.10-4), the ratio tNAA/mIns decreased by 5.8% per year (p=0.03), and fractional anisotropy showed a trend to decrease (-3.2% per year, p=0.08). Spinal cord cross-sectional area correlated strongly with clinical measures, with the strongest correlation coefficients found between cross-sectional area and Scale for the Assessment and Rating of Ataxia (SARA) (R=-0.55, p=7.10-6) and between cross-sectional area and FARS total neurological score (R=-0.60, p=4.10-7). Less strong but still significant correlations were found for fractional anisotropy and tNAA/mIns. Conclusion: We report here the first quantitative longitudinal MR results in the spinal cord in FRDA. The largest longitudinal effect size was found for spinal cord cross-sectional area, followed by tNAA/mIns and fractional anisotropy. Our results provide direct evidence that abnormalities in the spinal cord result not solely from hypoplasia, but also from neurodegeneration, and show that disease progression can be monitored non-invasively in the spinal cord.

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Section: Discussionmentioning

confidence: 79%

Spinal cord MRI and MRS Detect Early-stage Alterations and Disease Progression in Friedreich Ataxia

Joers

Adanyeguh

Deelchand

et al. 2022

Preprint

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“…However, that study included only patients with loss of consciousness for a minimum of 30 min and/or brain injury among other inclusion criteria, which are the most common exclusion criteria for whiplash studies, therefore making comparison more difficult. Cohen-Adad et al [ 39 , 40 ] have recently published a consensus MRI protocol for state-of-the-art quantitative spinal cord MRI along with a post-processing pipeline based on the SCT. Their work supports the thesis that DWI may be beneficial for detecting spinal cord injuries.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, we used the SCT with the exception of the Magnetization Transfer sequence. Hence, including a Magnetization Transfer sequence for detection of white matter lesions in connection with spinal cord injury could have contributed further into detection of a difference between groups [ 39 ]. Future studies, potentially involving spinal cord injuries, should include the complete SCT recommendations.…”

Section: Discussionmentioning

confidence: 99%

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Advanced magnetic resonance imaging of chronic whiplash patients: a clinical practice-based feasibility study

et al. 2022

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Background Whiplash injury is common following road traffic crashes affecting millions worldwide, with up to 50% of the injured developing chronic symptoms and 15% having a reduced working capability due to ongoing disability. Many of these patients receive treatment in primary care settings based upon clinical and diagnostic imaging findings. Despite the identification of different types of injuries in the whiplash patients, clinically significant relationships between injuries and chronic symptoms remains to be fully established. This study investigated the feasibility of magnetic resonance imaging (MRI) techniques including quantitative diffusion weighted imaging and measurements of cerebrospinal fluid (CSF) flow as novel non-invasive biomarkers in a population of healthy volunteers and chronic whiplash patients recruited from a chiropractic clinic for the purpose of improving our understanding of whiplash injury. Methods Twenty chronic whiplash patients and 18 healthy age- and gender matched control subjects were included [mean age ± SD (sex ratio; females/males), case group: 37.8 years ± 9.1 (1.22), control group: 35.1 years ± 9.2 (1.25)]. Data was collected from May 2019 to July 2020. Data from questionnaires pertaining to the car crash, acute and current symptoms were retrieved and findings from clinical examination and MRI including morphologic, diffusion weighted and phase-contrast images were recorded. The apparent diffusion coefficient and fractional anisotropy were calculated, and measurement and analysis of CSF flow was conducted. Statistical analyses included Fisher’s exact test, Mann Whitney U test and analysis of variance between groups. Results The studied population was described in detail using readily available clinical tools. No statistically significant differences were found between the groups on MRI. Conclusions This study did not show that MRI‐based measures of morphology, spinal cord and nerve root diffusion or cerebrospinal fluid flow are sensitive biomarkers to distinguish between chronic whiplash patients and healthy controls. The detailed description of the chronic whiplash patients using readily available clinical tools may be of great relevance to the clinician. In the context of feasibility, clinical practice-based advanced imaging studies with a technical setup similar to the presented can be expected to have a high likelihood of successful completion.

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“…These advanced MR techniques have been applied together with muscle quantitative MR in the pilot study of Savini et al on three adult SMA3 patients under treatment with nusinersen to characterize SC volumes and microstructure (GM and ventral horns) as well. The authors demonstrated that quantitative cervical SC MR sequences derived from the consensus acquisition protocol produced by a consortium of SC researchers ( 1 ) including 3D T1- and T2 weighted (w), DWI, MT and T2 * -w sequences were able to capture microstructural changes induced by SMA in vivo and are a candidate methodology for monitoring the effects of this treatment.…”

Section: Cns Diseasesmentioning

confidence: 99%