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Rapid myelin water imaging for the assessment of cervical spinal cord myelin damage

Dvorak, Adam V. ; Ljungberg, Emil LU orcid ; Vavasour, Irene M. ; Liu, Hanwen ; Johnson, Poljanka ; Rauscher, Alexander ; Kramer, John L.k. ; Tam, Roger ; Li, David K.b. and Laule, Cornelia , et al. (2019) In NeuroImage: Clinical 23.
Abstract
Background
Rapid myelin water imaging (MWI) using a combined gradient and spin echo (GRASE) sequence can produce myelin specific metrics for the human brain. Spinal cord MWI could be similarly useful, but technical challenges have hindered routine application. GRASE rapid MWI was recently successfully implemented for imaging of healthy cervical spinal cord and may complement other advanced imaging methods, such as diffusion tensor imaging (DTI) and quantitative T1 (qT1).
Objective
To demonstrate the feasibility of cervical cord GRASE rapid MWI in multiple sclerosis (MS), primary lateral sclerosis (PLS) and neuromyelitis optica spectrum disorder (NMO), with comparison to DTI and qT1 metrics.
Methods
GRASE MWI, DTI and... (More)
Background
Rapid myelin water imaging (MWI) using a combined gradient and spin echo (GRASE) sequence can produce myelin specific metrics for the human brain. Spinal cord MWI could be similarly useful, but technical challenges have hindered routine application. GRASE rapid MWI was recently successfully implemented for imaging of healthy cervical spinal cord and may complement other advanced imaging methods, such as diffusion tensor imaging (DTI) and quantitative T1 (qT1).
Objective
To demonstrate the feasibility of cervical cord GRASE rapid MWI in multiple sclerosis (MS), primary lateral sclerosis (PLS) and neuromyelitis optica spectrum disorder (NMO), with comparison to DTI and qT1 metrics.
Methods
GRASE MWI, DTI and qT1 data were acquired in 2 PLS, 1 relapsing-remitting MS (RRMS), 1 primary-progressive MS (PPMS) and 2 NMO subjects, as well as 6 age (±3 yrs) and sex matched healthy controls (HC). Internal cord structure guided template registrations, used for region of interest (ROI) analysis. Z score maps were calculated for the difference between disease subject and mean HC metric values.
Results
PLS subjects had low myelin water fraction (MWF) in the lateral funiculi compared to HC. RRMS subject MWF was heterogeneous within the cord. The PPMS subject showed no trends in ROI results but had a region of low MWF Z score corresponding to a focal lesion. The NMO subject with a longitudinally extensive transverse myelitis lesion had low values for whole cord mean MWF of 12.8% compared to 24.3% (standard deviation 2.2%) for HC. The NMO subject without lesions also had low MWF compared to HC. DTI and qT1 metrics showed similar trends, corroborating the MWF results and providing complementary information.
Conclusion
GRASE is sufficiently sensitive to detect decreased myelin within MS spinal cord plaques, NMO lesions, and PLS diffuse spinal cord injury. Decreased MWF in PLS is consistent with demyelination secondary to motor neuron degeneration. GRASE MWI is a feasible method for rapid assessment of myelin content in the cervical spinal cord and provides complementary information to that of DTI and qT1 measures. (Less)
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publishing date
type
Contribution to journal
publication status
published
subject
in
NeuroImage: Clinical
volume
23
article number
101896
publisher
Elsevier
external identifiers
  • scopus:85068155819
ISSN
2213-1582
DOI
10.1016/j.nicl.2019.101896
language
English
LU publication?
no
id
3726d5e2-b69b-4257-a989-0b2ac27b222e
date added to LUP
2023-05-01 14:05:22
date last changed
2023-05-02 08:39:24
@article{3726d5e2-b69b-4257-a989-0b2ac27b222e,
  abstract     = {{Background<br/>Rapid myelin water imaging (MWI) using a combined gradient and spin echo (GRASE) sequence can produce myelin specific metrics for the human brain. Spinal cord MWI could be similarly useful, but technical challenges have hindered routine application. GRASE rapid MWI was recently successfully implemented for imaging of healthy cervical spinal cord and may complement other advanced imaging methods, such as diffusion tensor imaging (DTI) and quantitative T1 (qT1).<br/>Objective<br/>To demonstrate the feasibility of cervical cord GRASE rapid MWI in multiple sclerosis (MS), primary lateral sclerosis (PLS) and neuromyelitis optica spectrum disorder (NMO), with comparison to DTI and qT1 metrics.<br/>Methods<br/>GRASE MWI, DTI and qT1 data were acquired in 2 PLS, 1 relapsing-remitting MS (RRMS), 1 primary-progressive MS (PPMS) and 2 NMO subjects, as well as 6 age (±3 yrs) and sex matched healthy controls (HC). Internal cord structure guided template registrations, used for region of interest (ROI) analysis. Z score maps were calculated for the difference between disease subject and mean HC metric values.<br/>Results<br/>PLS subjects had low myelin water fraction (MWF) in the lateral funiculi compared to HC. RRMS subject MWF was heterogeneous within the cord. The PPMS subject showed no trends in ROI results but had a region of low MWF Z score corresponding to a focal lesion. The NMO subject with a longitudinally extensive transverse myelitis lesion had low values for whole cord mean MWF of 12.8% compared to 24.3% (standard deviation 2.2%) for HC. The NMO subject without lesions also had low MWF compared to HC. DTI and qT1 metrics showed similar trends, corroborating the MWF results and providing complementary information.<br/>Conclusion<br/>GRASE is sufficiently sensitive to detect decreased myelin within MS spinal cord plaques, NMO lesions, and PLS diffuse spinal cord injury. Decreased MWF in PLS is consistent with demyelination secondary to motor neuron degeneration. GRASE MWI is a feasible method for rapid assessment of myelin content in the cervical spinal cord and provides complementary information to that of DTI and qT1 measures.}},
  author       = {{Dvorak, Adam V. and Ljungberg, Emil and Vavasour, Irene M. and Liu, Hanwen and Johnson, Poljanka and Rauscher, Alexander and Kramer, John L.k. and Tam, Roger and Li, David K.b. and Laule, Cornelia and Barlow, Laura and Briemberg, Hannah and Mackay, Alex L. and Traboulsee, Anthony and Kozlowski, Piotr and Cashman, Neil and Kolind, Shannon H.}},
  issn         = {{2213-1582}},
  language     = {{eng}},
  month        = {{01}},
  publisher    = {{Elsevier}},
  series       = {{NeuroImage: Clinical}},
  title        = {{Rapid myelin water imaging for the assessment of cervical spinal cord myelin damage}},
  url          = {{http://dx.doi.org/10.1016/j.nicl.2019.101896}},
  doi          = {{10.1016/j.nicl.2019.101896}},
  volume       = {{23}},
  year         = {{2019}},
}