ISMRM 21st Annual Meeting & Exhibition 20-26 April 2013 Salt Lake City, Utah, USA

Neurodegenerative: Clinical
Wednesday 24 April 2013
Room 150 AG  10:00 - 12:00 Moderators: Rao P. Gullapalli, David B. Hackney

10:00 0379.   Differential Effects of Levodopa and Deep Brain Stimulation on Motor Networks in Parkinson’s Disease
Karsten Mueller1, Stefan Holiga1, Harald E. Möller1, Matthias L. Schroeter1,2, Josef Vymazal3, Filip Ružicka4,5, Dušan Urgošík4,5, Evžen Ružicka4, and Robert Jech4
1Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Sachsen, Germany, 2Clinic for Cognitive Neurology, Leipzig, Sachsen, Germany, 3Department of Radiology, Na Homolce Hospital, Prague, Czech Republic, 4Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic, 5Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic

We explored differential effects of levodopa treatment and deep brain stimulation (DBS) of the subthalamic nucleus (STN) on motor networks affected by Parkinson’s disease (PD), using resting-state functional magnetic resonance imaging. The results revealed significantly altered functional connectivity between premotor cortex and other brain regions as cerebellum and thalamus, by contrasting levodopa treatment with DBS. Our results indicate that levodopa and DBS might have a distinctive influence on connectivity patterns in PD motor networks. The overlying DBS and surgery-related microlesion effects need to be studied separately in order to further investigate these findings.

10:12 0380.   Brain Softening - A Hallmark of Neurodegeneration: Cerebral MR Elastography in Patients with Supranuclear Palsy and Idiopathic Parkinson’s Disease.
Ingolf Sack1, Axel Lipp2, Radmila Trbojevic1, Friedemann Paul3, Andreas Fehlner4, Sebastian Hirsch1, Michael Scheel1, Cornelia Noack2, Jing Guo5, Dieter Klatt1, Jens Wuerfel3, and Juergen Braun6
1Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Berlin, Germany, 2Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Berlin, Germany, 3Neurocure, Charité - Universitätsmedizin Berlin, Berlin, Berlin, Germany, 4Department of Radiology, Charité University Medicine, Berlin, Berlin, Germany, 5Department of Radiology, Charite - University Medicine Berlin, Berlin, Berlin, Germany, 6Institute of Medical Informatics, Charite - University Medicine Berlin, Berlin, Berlin, Germany

2D-multifrequency MRE and 3D-MRE was used to assess the sensitivity of cerebral viscoelastic properties for discriminating two neurodegenerative disorders with overlapping clinical presentation, but different underlying neuropathology -namely progressive supranuclear palsy (PSP, N=16) and idiopathic Parkinson’s disease (PD, N=18)– in comparison to healthy controls (N=18). We observed a close negative correlation between MRE constants and measures of clinical severity in PD and PSP. Moreover, we showed that brain viscoelasticity in PSP and PD is differently affected; whereas in PSP all MRE constants are reduced, changes in PD are limited to declining elasticity parameters.

10:24 0381.   
Elevated Arteriolar Cerebral Blood Volume in Prodromal Huntington’s Disease
Jun Hua1,2, Paul G. Unschuld3,4, Russell L. Margolis3,5, Peter C.M. van Zijl1,2, and Christopher A. Ross3,6
1Neurosection, Div. of MRI Research, Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States, 2F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, United States, 3Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States, 4Division of Psychiatry Research and Psychogeriatric Medicine, University of Zürich, Zürich, Zürich, Switzerland, 5Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States, 6Department of Neuroscience and Pharmacology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Neurovascular alterations have been implicated in the pathophysiology of Huntington’s Disease (HD). As arterioles are most responsive to metabolic alterations, arteriolar cerebral blood volume (CBVa) is an important indicator of cerebrovascular regulation. We show that cortical CBVa, measured with the inflow-based vascular-space-occupancy (iVASO) MRI technique, is significantly elevated in prodromal HD patients, and this effect correlates with genetic measures. By contrast, no significant brain atrophy was detected in these prodromal HD patients. Our results suggest CBVa as a potential biomarker prior to prominent brain atrophy in prodromal HD.

10:36 0382.   Disrupted Frontal White Matter Development and Integrity in Patients Treated for Pediatric Infratentorial Brain Tumors
John O. Glass1, Robert J. Ogg1, Yimei Li2, Amar Gajjar3, and Wilburn E. Reddick1
1Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN, United States, 2Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, United States, 3Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States

This study compared white matter (WM) development of 103 patients with 616 examinations to 56 normal healthy age-similar controls with 166 examinations. Conventional imaging was collected to assess WM volume, and fractional anisotropy (FA) maps were calculated from diffusion tensor imaging. A generalized estimating equation was used to model the normal developmental trajectories between groups. Relationships between age and WM volume and FA were seen in all regions, and differences between patients and controls were detected for FA and frontal WM volume. Typical maturation of frontal lobe myelination is disrupted in patients treated for pediatric infratentorial brain tumors.

10:48 0383.   CEST MR Imaging Investigation of Parkinson Disease at 3 T -permission withheld
Chunmei Li1, Xuna Zhao2, Rui Wang1, Shuai Peng1, Cheng Zhou1, Jinyuan Zhou3, and Min Chen1
1Department of Radiology, Beijing Hospital of the Ministry of Health, Beijing, China, 2Peking University, Beijing, China, 3Department of Radiology, Johns Hopkins University, Baltimore, Maryland, United States

Chemical exchange saturation transfer (CEST) imaging is a novel molecular MRI technique that can generate image contrast based on the endogenous or exogenous, low-concentration chemicals. We performed CEST imaging experiments on patients with PD. The CEST signals at the offset of 3.5ppm of caudate, putamen and globus pallidus in PD patients was significantly higher than normal controls, while the CEST signal at the offset of 1.5ppm of substantia nigra was significantly lower in PD patients than normal controls.

11:00 0384.   Physical Exercise Impacts Brain Structure: A Longitudinal VBM and TBSS Study in Overweight and Obese Subjects
Karsten Mueller1, Harald E. Möller1, Alfred Anwander1, Franziska Busse1, Annette Horstmann1,2, Matthias Raschpichler2, Jöran Lepsien1, Matthias L. Schroeter1,3, Matthias Blüher2,4, Arno Villringer1,3, and Burkhard Pleger1,3
1Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Sachsen, Germany, 2Integrated Research and Treatment Center (IFB) AdiposityDiseases, Leipzig, Sachsen, Germany, 3Clinic for Cognitive Neurology, Leipzig, Sachsen, Germany, 4Department for Internal Medicine, University Hospital Leipzig, Leipzig, Sachsen, Germany

To investigate the influence of intense physical exercise on changes in human brain structure in overweight and obese subjects, a longitudinal MR study was performed with 16 young participants before and after a 3-month fitness course with intense training twice a week. Scanning protocol included the acquisition of high resolution T1- and diffusion-weighted images using a 3T TIM Trio system (Siemens, Erlangen) with a 12-channel head array coil. Grey and white matter changes were detected using voxel-based morphometry and tract-based spatial statistics. The comparison of images before and after the fitness course suggests that physical exercise together with the parallel loss in body weight can reverse some of the overweight-related structural brain changes.

11:12 0385.   A Multivariate Approach to a MR Based Biomarker for Amyotrophic Lateral Sclerosis
Robert Cary Welsh1,2 and Bradley R. Foerster1
1Radiology, University of Michigan, Ann Arbor, MI, United States, 2Psychiatry, University of Michigan, Ann Arbor, MI, United States

We explore the utility of multi-variate techniques with diffusion tensor and resting state functional connectivity as possible biomarkers of amyotrophic lateral sclerosis.

11:24 0386.   Presymptomatic Altered White Matter Diffusivity in Inherited Prion Disease
Harpreet Hyare1, Enrico De Vita2, Gerard R. Ridgway1, Marie-Claire Porter1, Peter Rudge1, Tarek A. Yousry2, Simon Mead1, John Collinge3, and John Thornton2
1UCL - Institute of Neurology, London, United Kingdom, 2Lysholm Department of Neuroradiology, London, United Kingdom, 3UCL Institute of Neurology, London, United Kingdom

We present the application of voxel-based analysis of diffusion tensor imaging (DTI) and voxel-based morphometry in the largest cohort of presymptomatic mutation carriers of prion disease and symptomatic patients with a range of human prion diseases. We observed presymptomatic increased fractional anisotropy (FA) in functionally relevant white matter (WM) tracts whereas decreased FA was seen in symptomatic patients. Our findings could be due to propagation of the abnormal prion protein along white matter tracts before the other pathological hallmarks of prion disease that cause loss of WM integrity are evident.

11:36 0387.   GABA Level Correlates with Occupational Manganese Exposure and Motor Tests in Smelters
Zaiyang Long1,2, Yue-Ming Jiang3, Xiang-Rong Li4, Jun Xu1,2, Li-Ling Long4, Wei Zheng1, James B. Murdoch5, and Ulrike Dydak1,2
1School of Health Sciences, Purdue University, West Lafayette, IN, United States, 2Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States, 3Dept. of Occupational Health and Toxicology, Guangxi Medical University, Nanning, Guangxi, China, 4Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China, 5Toshiba Medical Research Institute USA, Mayfair village, OH, United States

Manganese (Mn) overexposure can lead to parkinson-type motor symptoms, for which no treatment exists to date. Nine Mn-exposed smelters and ten controls were recruited and underwent Purdue pegboard test to access manual dexterity and steadiness. A GABA-edited proton spectrum was acquired from the thalamus using the MEGA-PRESS sequence on a 3T Philips Achieva whole-body clinical scanner. We found a significant correlation between the increase in GABA+/total creatine (tCr) and the duration of exposure, and significant inverse correlations between GABA+/tCr and all Purdue pegboard test scores. GABA+ may function as a biomarker of Mn-induced toxic effects, in particular of motor deficits.

11:48 0388.   
Gray Matter Perfusion and Its Association with Neurocognitive Performance to Evaluate Late Effects of Cancer Treatment
Adam M. Winchell1,2, Kevin R. Krull3, Matthew A. Scoggins1, Ralf B. Loeffler1, Robert J. Ogg1, Melissa Hudson3, and Claudia M. Hillenbrand1
1Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, TN, United States, 2Biomedical Engineering, University of Memphis, Memphis, TN, United States, 3Epidemiology & Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, United States

Children treated with cranial radiation for childhood leukemia are at significant risk of developing cognitive problems as are long-term survivors of Hodgkin Lymphoma treated with thoracic radiation. Examining the late effects of treatment with radiation and chemotherapy are necessary to derive effective treatment options that simultaneously minimize late effects for future patients. GLM analysis identified a significant region in the left superior temporal gyrus where resting state blood flow was correlated with FSIQ performance in Hodgkin Lymphoma survivors and not in Acute Lymphoblastic Leukemia survivors.