Yan Bai¹, Rushi Chen¹, Rui Zhang¹, Wei Wei¹, Ying Wang¹, Mathias Nittka², Gregor Koerzdoerfer², Xianchang Zhang³, and Meiyun Wang^1
1Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China, ²MR Pre-development, Siemens Healthcare, Erlangen, Germany, ³MR Collaboration, Siemens Healthcare Ltd, Beijing, China

Magnetic resonance parametric mapping techniques such as T1 and T2 relaxation time mapping have been used to capture the potential Parkinson’s disease (PD)-related changes in the substantia nigra (SN). However, the findings in different studies were inconsistent. This study utilized a novel technique magnetic resonance fingerprinting (MRF) to obtain T1 and T2 values on thirty patients with PD and thirty matched healthy controls. Comparison results found that T1 values of the left and right SN in the PD patients were significantly higher than in healthy controls. T1 values in the SN acquired by MRF may differentiate PD from healthy controls.

Yong Zhang¹, Jian Wang², Chang-Peng Wang², Li-Rong Jin², and Bing Wu^3
1GE Healthcare, Shanghai, China, ²Zhongshan Hospital, Shanghai, China, ³GE Healthcare, Beijing, China

This preliminary study aimed to identify potential markers in diagnosis of tremor disorders such as tremor-dominant Parkinson’s disease (PDT) and essential tremor (ET). A novel 3D pulsed-continuous arterial spin labeling technique (3D pCASL) was used to provide whole brain quantitative perfusion measurement, followed by voxel-wise comparison to evaluate regional CBF characteristics in patients with PDT, ET and age- and gender- matched healthy controls. PDT patients showed decreased CBF in the caudate and precuneus when compared to ET patients. The altered metabolic patterns of PDT and ET can help to understand different pathophysiological mechanism of tremor disorders.

Nguyen Thanh Thao¹, Chih-Chien Tsai², Yao-Liang Chen³, Jur-Shan Cheng⁴, Chin-Song Lu⁵, Yi-Hsin Weng⁵, Sung-han Lin⁴, Po-Yuan Chen⁴, and Jiun-Jie Wang^6
1Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam, ²Healthy Aging Research Center, Chang-Gung University, TaoYuan, Taiwan, ³Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan, ⁴Chang-Gung University, TaoYuan, Taiwan, ⁵Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou Branch, TaoYuan, Taiwan, ⁶Department of Medical Imaging and Radiological Sciences, Chang-Gung University, TaoYuan, Taiwan

White matter degeneration have been attributed to the motor and non-motor symptoms of Parkinson’s disease and atypical parkinsonism. Our study shows different pattern of white matter changes in multiple system atrophy and progressive supranuclear palsy compared to Parkinson’s disease. Furthermore, different affected areas of white matter changes were found among atypical parkinsonism. The involved regions are consistent with the understanding of the pathogenesis of the diseases. Our result proves that fixel based analysis is a robust technique to study white matter degeneration in PD and atypical parkinsonism.

Dilek Betul Arslan¹, Hakan Ibrahim Gurvit², Ozan Genc¹, Ani Kicik^3,4, Kardelen Eryurek^3,5, Sevim Cengiz¹, Emel Erdogdu^3,6, Zerrin Yildirim², Zeynep Tufekcioglu², Aziz Mufit Ulug^1,7, Basar Bilgic², Hasmet Hanagasi², Erdem Tuzun⁵, Tamer Demiralp^3,8, and Esin Ozturk-Isik^1
1Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey, ²Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey, ³Neuroimaging Unit, Hulusi Behcet Life Sciences Research Center, Istanbul University, Istanbul, Turkey, ⁴Department of Physiology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey, ⁵Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey, ⁶Department of Psychology, Faculty of Arts and Sciences, Isik University, Istanbul, Turkey, ⁷CorTechs Labs, San Diego, CA, United States, ⁸Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

The main purpose of this study was to define possible brain perfusion deficits in risky gene carriers in Parkinson’s disease (PD) using arterial spin labeling magnetic resonance imaging (ASL-MRI). Cerebral blood flow (CBF) maps of PD and mild cognitively impaired PD (PD-MCI) with different microtubule-associated protein tau (MAPT) genotypes were compared using a voxelwise analysis. The CBF values were evaluated at brain parcellations obtained from resting-state functional MRI. Hypoperfusion in several brain regions, corresponding to the visual network, default mode network, and frontoparietal network, was observed in PD patients with MAPT H1/H1 haplotype. 

Dilek Betul Arslan¹, Hakan Ibrahim Gurvit², Ozan Genc¹, Ani Kicik^3,4, Kardelen Eryurek^3,5, Sevim Cengiz¹, Emel Erdogdu^3,6, Zerrin Yildirim², Zeynep Tufekcioglu², Aziz Mufit Ulug^1,7, Basar Bilgic², Hasmet Hanagasi², Tamer Demiralp^3,8, and Esin Ozturk-Isik^1
1Biomedical Engineering Institution, Bogazici University, Istanbul, Turkey, ²Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey, ³Neuroimaging Unit, Hulusi Behcet Life Sciences Research Center, Istanbul University, Istanbul, Turkey, ⁴Department of Physiology, Faculty of Medicine, Demiroglu Bilim University, Istanbul, Turkey, ⁵Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey, ⁶Department of Psychology, Faculty of Arts and Sciences, Isik University, Istanbul, Turkey, ⁷CorTechs Labs, San Diego, CA, United States, ⁸Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

The main aim of this study is to define possible brain perfusion-based signatures based on voxelwise comparison of cerebral blood flow (CBF) maps of Parkinson’s disease (PD) with mild cognitive impairment, cognitively normal PD and healthy controls. CBF maps were calculated by fitting a general kinetic curve model with Look-Locker readout for each pixel of arterial spin labeling MR (ASL-MR) images. The pattern of posterior hypoperfusion has been observed in PD in line with cognitive impairment.

Kiarash Ghassaban^1,2, Sean Kumar Sethi^1,2, David Utriainen³, Zenghui Cheng⁴, Pei Huang⁵, Yan Li⁴, Rongbio Tang ⁴, Paul Kokeny³, Kiran Kumar Yerramsetty⁶, Vinay Kumar Palutla⁶, Shengdi Chen ⁵, Fuhua Yan⁴, and Ewart Mark Haacke^1,2,4
1Radiology, Wayne State University, Detroit, MI, United States, ²Biomedical Engineering, Wayne State University, Detroit, MI, United States, ³SpinTech, Bingham Farms, MI, United States, ⁴Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ⁵Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ⁶MR Medical Imaging Innovations, Telangana, India

This work proposes two investigated problems. The first is the separation of confounding tissue properties of deep gray matter using R1, R2*, and QSM from a 3D GRE protocol known as STAGE by sampling a distribution of low and high iron regions across subjects, including very high iron regions in aceruloplasminemia. The second is investigating if we see any differences in these structures in Parkinson’s Disease, essential tremor, and healthy control subjects. These problems are investigated to show that susceptibility changes and R1 are linked, and that water and iron related changes are observable when comparing controls versus Parkinson’s Disease

Ruichen Zhao¹, Chunyan Zhang¹, Jinxia Zhu², Bénédicte Maréchal³, Chen Chen¹, Hong Lu⁴, and Jingliang Cheng^1
1Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, ²MR Collaboration, Siemens Healthcare Ltd., Beijing, China, ³Advanced Clinical Imaging Technology, Siemens Healthcare AG；Department of Radiology, Lausanne University Hospital and University of Lausanne；LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland, ⁴Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

In this study, the structural brain volume changes in early-onset (EOPD) and middle-late-onset Parkinson’s disease (M-LOPD) patients were evaluated. We found different patterns of volume changes in these patients. The results showed that some brain regions might represent a potential imaging marker for the early diagnosis of EOPD and could explain different clinical characteristics. MPRAGE-based morphometry may be a suitable method to provide a reference for EOPD diagnoses in clinical practice.

Hansol Lee¹, Sun-Yong Baek², Eun-Joo Kim³, Gi Yeong Huh⁴, Jae-Hyeok Lee⁵, and HyungJoon Cho^1
1Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Korea, Republic of, ²Department of Anatomy, Pusan National University School of Medicine, Yangsan, Korea, Republic of, ³Department of Neurology, Pusan National University Hospital, Busan, Korea, Republic of, ⁴Department of Forensic Medicine, Pusan National University School of Medicine, Yangsan, Korea, Republic of, ⁵Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea, Republic of

The purpose of this study was to determine the morphology change in the substantia nigra of progressive supranuclear palsy using MRI with histopathological validation. MR experiments for progressive supranuclear palsy brains were operated using 3T in vivo and 7T postmortem imaging systems. Perls’ Prussian blue staining, Luxol fast blue staining, and LA-ICP-MS for 2D iron mapping confirmed the large amount of iron deposits along the myelinated fibers within substantia nigra of PSP brain. The iron deposits along the myelinated fibers could be the potential source causing the blurred boundary between red nucleus and substantia nigra in in vivo MRI.

Cheng Zhou¹ and Minming Zhang^1
1Zhejiang university, Hangzhou, China

Parkinson’s disease (PD) is the second most common neurodegenerative disease and its related brain changes appear not to be localized in isolate region but rather in the networks. We desire to exploring the large-scale structural and functional networks change which are of great importance for understanding the mechanism of disease. Moreover, it deserves to further answer the unsolved question that whether a functional compensation resulting from structural network disruption and whether such effect would be lasting or changed longitudinally.

Jingjing Wu¹, Tao Guo¹, Cheng Zhou¹, Ting Gao ², Xiaoujun Guan ¹, Peiyu Huang¹, Xiaojun Xu¹, and Minming Zhang^1
1Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China, ²Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

The motor dysfunctions always affect hemi-body first in Parkinson's disease (PD). However, the interhemispheric relationships in patients with only unilateral motor impairment were barely known to date. In this study, 43 unilateral-symptomatic PD patients (UPD, Hoehn-Yahr staging scale, H-Y: 1-1.5), and 54 NC were recruited. We aimed to investigate the interhemispheric coordination and hemispheric dominance pattern for further understanding the pathogenesis of PD. We found that the disrupted interhemispheric coordination in bilateral sensorimotor regions may have significant implications for elucidating the mechanisms underlying the hemiparkinsonism and enabling the individual diagnosis and assessment of early PD.

Han Yu¹, Jingyun Chen¹, Henry Rusinek², and Yulin Ge^3
1Department of Neurology, New York University School of Medicine, New York, NY, United States, ²Department of Neurology and Radiology, New York University School of Medicine, New York, NY, United States, ³Department of Radiology, New York University School of Medicine, New York, NY, United States

In this study, we examined the differences of two subtypes of white matter hyperintensities (WMHs), periventricular WMHs (PVWMH) and deep WMHs (DWMH) on MRI, as they associate with cognitive dysfunction and dementia, and other clinical assessments of the elderly. A robust computational method (Bilateral Distance classification) was implemented to quantify PVWMH and DWMH. Clinical associations revealed by the algorithm are consistent with the literature findings based on subjective classification methods that the two types of WMHs have differential clinical associations and may have different pathological etiologies and roles in cognitive impairment and dementia.

Seulki Yoo^1,2, MinKyeong Kim^3,4, Doyeon Kim⁵, Jin Whan Cho^3,4, Ji Sun Kim^3,4, Jong Hyun Ahan^3,4, Jun Kyu Mun^3,4, Jinyoung Youn^3,4, and Seung-Kyun Lee^1,2
1Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Korea, Republic of, ²Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea, Republic of, ³Department of Neurology, Samsung Medical Center, Seoul, Korea, Republic of, ⁴Neuroscience Center, Samsung Medical Center, Seoul, Korea, Republic of, ⁵Department of Biomedical Engineering, Gachon University, Incheon, Korea, Republic of

Deep brain iron accumulation in Parkinson’s disease (PD) has been much studied in MRI but its involvement in clinical non-motor symptoms has been inconclusive. In this work we investigated the correlation between the deep brain iron contents and a wide array of non-motor symptoms in drug naive early PD patients using QSM and R2* mapping at 3T. We found that many non-motor symptoms are significantly correlated with R2* in the extra-striatal system, in particular the thalamus and red nucleus.   

Megan Aumann^1,2, Kathleen Larson³, Elise Bradley⁴, David Zald^2,5, Ipek Oguz³, and Daniel O Claassen^6
1Neurology, Vanderbilt University, Nashville, TN, United States, ²Psychology, Vanderbilt University, Nashville, TN, United States, ³Biomedical Engineering, Vanderbilt University, Nashville, TN, United States, ⁴Neuropsychiatry, Vanderbilt University Medical Center, Nashville, TN, United States, ⁵Psychiatry, Vanderbilt University Medical Center, Nashville, TN, United States, ⁶Neurology, Vanderbilt University Medical Center, Nashville, TN, United States

Parkinson’s Disease (PD) patients who take dopaminergic therapy are at risk for developing impulsive-compulsive behaviors, and these behaviors localize to the mesocorticolimbic regions. Using a caregiver-reported values from the Frontal Systems Behavioral Scale (FrSBe), we assessed disinhibition, apathy, and dysexecutive symptoms in 72 PD patients. All participants completed brain MRI, and we measured cortical thickness in frontal regions, assessing the relationship between cortical thickness and FrSBE scores. We find that thickness in the insula is directly related to disinhibited behaviors. These results provide new insights into how cortical changes and behavioral symptoms are linked in PD.

Jiayi Zhang¹, Ling Yun Yeow¹, Joanne Huifen Koh², Isaac Huen¹, Pei Huang¹, Tuck Wah Soong², Boon Seng Wong^2,3, Kuan Jin Lee¹, and Bhanu Prakash KN^1
1SBIC, A*STAR, Singapore, Singapore, ²Department of Physiology, National University of Singapore, Singapore, Singapore, ³Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore

Cholesterol-transporter ApoE4 is involved in lipid metabolism and is associated with neurodegenerative diseases. Studies show, functional connectivity(FC) in ApoE4 mice is significantly deviating from ApoE3 and Wild-Type(WT). Underlining cause of these differences are less explored. Since myelin is mostly comprised of cholesterol, we investigated if a change in white matter integrity(WMI) could have contributed to the FC changes. FC and WMI in ApoE4 are distinctively different from ApoE3 and WT as shown by our results. Our results within the auditory cortex show that an increase in FA in ApoE4 is associated with a decrease of FC in the region.

Koji Fujimoto¹, Martijn A. Cloos², Atsushi Shima³, Thuy Dinh Ha Duy¹, Nobukatsu Sawamoto⁴, Ryosuke Takahashi³, Tadashi Isa^1,5, and Tomohisa Okada^1
1Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan, ²Center for Advanced Imaging Innovation and Research (CAI2R) and Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, United States, ³Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan, ⁴Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan, ⁵Department of Neuroscience, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan

To investigate changes in T1 and T2 of deep gray matter in Parkinson’s disease (PD) patients at 7T, healthy volunteers (N=104, age range 20-77) and PD patients (N=42, age range 50-72) were scanned using a 1ch-Tx/32ch-Rx coil and a Plug-and-Play MR Fingeprinting (prototype) sequence. ROIs were drawn in six regions (left and right putamen, globus pallidus, caudate head, thalamus, frontal white matter (WM)) and a linear and quadratic curve fitting was performed. T2 value of the putamen was larger in PD than the age-matched subgroup of HC, but was not significant.

Xiao-Hong Zhu¹, Byeong-Yuel Lee¹, Lisa Coles², Abhishek G Sathe², Paul Tuite³, Jim Cloyd², Walter Low⁴, Clifford J. Steer⁵, Chi Chen⁶, and Wei Chen^1
1CMRR, Department of Radiology, University of Minnesota, Minneapolis, MN, United States, ²Department of Experimental and Clinical Pharmacology, University of Minnesota, Minneapolis, MN, United States, ³Department of Neurology, University of Minnesota, Minneapolis, MN, United States, ⁴Department of Neurosurgery, University of Minnesota, Minneapolis, MN, United States, ⁵Departments of Medicine and Genetics, Cell Biology and Development, University of Minnesota, Minneapolis, MN, United States, ⁶Department of Food Science and Nutrition, University of Minnesota, Minneapolis, MN, United States

Abnormal energy metabolism due to mitochondrial dysfunction is thought to be a major contributor to the progression of Parkinson’s disease (PD). We employed ³¹P MRS-MT technique at 7T to quantify key bioenergetic parameters in the occipital lobe of people with PD (PWPs). Significantly lower intracellular ATP concentrations together with elevated ATPase activity was found in PWPs; suggesting that augmented ATPase enzymatic activity may represent a compensatory mechanism to bioenergetic deficits that occur in PD. The FDA-approved drug, ursodeoxycholic acid (UDCA), shown to have energy-enhancing properties was evaluated for its effect on improving neuroenergetics in PWPs using the ³¹P MRS-MT approach.

Septian Hartono^1,2, Isabel Hui Min Chew³, Weiling Lee³, Amanda May Yeng Choo¹, Celeste Yan Teng Chen¹, Leon Qi Rong Ooi⁴, Lirong Yin³, Kuan Jin Lee⁵, Jongho Lee⁶, Ching-Yu Cheng⁷, Eng King Tan^1,2, and Ling Ling Chan^2,3
1National Neuroscience Institute, Singapore, Singapore, ²Duke-NUS Medical School, Singapore, Singapore, ³Singapore General Hospital, Singapore, Singapore, ⁴National University of Singapore, Singapore, Singapore, ⁵Singapore BioImaging Consortium, Singapore, Singapore, ⁶Seoul National University, Seoul, Republic of Korea, ⁷Singapore Eye Research Institute, Singapore, Singapore

Nigrosome-1 imaging and neuromelanin contrast have been identified as good radiological biomarkers of dopaminergic nigral degeneration in Parkinson's disease (PD) pathology. We evaluated the sensitivity of quantitative Susceptibility-Mapping Weighted Imaging (SMWI) derived from Quantitative Susceptibility Mapping (QSM) and neuromelanin sensitive (NMS) imaging in differentiating a case control cohort of PD patients. Region-of-interest analysis of the substantia nigra on both QSM/SMWI and NMS offered excellent differentiation of PD and healthy controls. However, QSM/SMWI offered more robust disease classification compared to NMS and might be preferred for use in the clinical setting.

Septian Hartono^1,2, Leon Qi Rong Ooi³, Amanda May Yeng Choo¹, Celeste Yan Teng Chen¹, Amanda Jieying Lee⁴, Weiling Lee⁴, Pik Hsien Chai⁴, Kuan Jin Lee⁵, Jongho Lee⁶, Eng King Tan^1,2, and Ling Ling Chan^2,4
1National Neuroscience Institute, Singapore, Singapore, ²Duke-NUS Medical School, Singapore, Singapore, ³National University of Singapore, Singapore, Singapore, ⁴Singapore General Hospital, Singapore, Singapore, ⁵Singapore BioImaging Consortium, Singapore, Singapore, ⁶Seoul National University, Seoul, Republic of Korea

There is increasing evidence that myelin can be directly involved in Parkinson's disease (PD). We investigated the utility of ViSTa myelin water imaging (MWI) to characterize changes in myelination in PD. Slight decrease of global white matter myelin water fraction (MWF) was observed in PD patients. MWF was also associated with cognitive status, while no such association was found between DTI metrics and cognitive status. These indicated that MWF may potentially be a more specific biomarker for dysmyelination in the brain.

Karthik R Sreenivasan¹, Xiaowei Zhuang¹, Jason Longhurst¹, Zhengshi Yang¹, Dietmar Cordes¹, Aaron Ritter¹, Jessica Caldwell¹, Jeffrey L Cummings¹, Zoltan Mari¹, Irene Litvan², Brent Bluett³, and Virendra Mishra^1
1Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States, ²University of California San Diego, La Jolla, CA, United States, ³Stanford University, Palo Alto, CA, United States

Dopaminergic deficiency can cause altered deactivation of the default mode network (DMN) connectivity, which subsequently impacts executive task performance resulting in freezing of gait (FOG). While the majority of Parkinson’s disease (PD) patients with FOG (PD-FOG) are responsive to levodopa, about 36% of PD patients are levodopa-resistant. Our results show increased DMN connectivity in levodopa-resistant PD-FOG group. Furthermore, we found that altered network connectivity in the levodopa-resistant group was correlated differently with neuropsychological measures. To the best of our knowledge this is the first study to investigate the functional connectivity differences in levodopa-resistant subtypes in PD-FOG.

Neil P Oxtoby¹, Leon M Aksman², Louise-Ann Leyland³, Rimona S Weil³, and Daniel C Alexander^1
1Department of Computer Science, University College London, London, United Kingdom, ²Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom, ³Department of Neurodegenerative Diseases, University College London, London, United Kingdom

We estimate a data-driven signature of de novo Parkinson's disease progression as a sequence of disease events. We show that clinical decline in classic markers precedes grey-matter and white-matter neurodegeneration  estimated from T1-weighted MRI and diffusion-weighted MRI. Using only cross-sectional data from the PPMI data set, we show model utility for fine-grained staging/stratification of patients, which holds promise for future clinical applications.

Virendra R Mishra¹, Jason Longhurst¹, Jessica Caldwell¹, Aaron Ritter¹, Karthik R Sreenivasan¹, Xiaowei Zhuang¹, Zhengshi Yang¹, Zoltan Mari¹, Dietmar Cordes^1,2, Jeffrey Cummings^1,3, Irene Litvan⁴, and Brent Bluett^5
1Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States, ²University of Colorado, Boulder, Boulder, CO, United States, ³Department of Brain Health, University of Nevada, Las Vegas, Las Vegas, NV, United States, ⁴University of California, San Diego, San Diego, CA, United States, ⁵Stanford University, Stanford, CA, United States

Freezing-of-gait (FoG) which is one of the main causes of falls in Parkinson’s disease (PD), results in significant morbidity and mortality. Currently, there are no robust methods of elucidating the neural mechanisms underlying this disabling aspect of PD. Utilizing a well-characterized cohort of PD-patients with-FoG (PD-FoG), PD-patients without-FoG (PD-nFoG), and healthy controls, we showed that diffusion kurtosis imaging and free-water corrected single-tensor diffusion MRI (dMRI)-derived measures identified significant differences in dMRI-derived measures between PD-FoG and PD-nFoG. Our study indicate that these beyond single-tensor dMRI models may identify robust and generalizable dMRI-derived measures to elucidate the neural mechanisms underlying PD-FoG.

Rahul Gaurav^1,2, Romain Valabregue¹, Nadya Pyatigorskaya¹, Emma Biondetti¹, Graziella Mangone³, Claire Ewenczyk⁴, Matthew Hutchison⁵, Isabelle Arnulf⁶, Jean-Christophe Corvol⁴, Marie Vidailhet⁴, Mathieu D. Santin¹, and Stephane Lehericy^1
1CENIR - Center for Neuroimaging Research, ICM - Brain and Spine Institute, Paris, France, ²Move'IT - Movement Investigations and Therapeutics, ICM - Brain and Spine Institute, Paris, France, ³Clinical Investigation Center (CIC-9503), INSERM - French National Institute of Medical Research and Health, Paris, France, ⁴Department of Neurology, Pitie-Salpetriere Hospital, Paris, France, ⁵Biogen Inc., Cambridge, MA, United States, ⁶Sleep Disorders Unit, Pitie-Salpetriere Hospital, Paris, France

Parkinson’s disease (PD) and idiopathic rapid eye movement sleep behavior disorder (iRBD) demonstrate neurodegenerative changes in the substantia nigra (SN) associated with an increase in iron deposition in PD patients. We aimed to quantify iron overload in the SN in early stage PD and iRBD patients using QSM-based and neuromelanin (NM)-based automated segmentation for QSM and R2* maps. We observed an increase in iron deposition in both early PD and iRBD patients with respect to healthy volunteers (HV).

Joana M Grilo¹, Marc Golub¹, Sofia Reimão^2,3, Rafael Neto Henriques⁴, Ana Fouto¹, Patrícia Pita Lobo³, Margherita Fabbri³, Joaquim J Ferreira^3,5, and Rita G Nunes^1
1Department of Bioengineering, ISR-Lisbon/LARSyS, Lisbon, Portugal, ²Neurological Imaging Department, Hospital de Santa Maria - CHLN, Lisbon, Portugal, ³Instituto de Medicina Molecular, Faculty of Medicine, University of Lisbon, Lisbon, Portugal, ⁴Champalimaud Neuroscience Programme, Champalimaud Centre for the Unknown, Lisbon, Portugal, ⁵CNS – Campus Neurológico Sénior, Torres Vedras, Portugal

Parkinson’s Disease is characterized by the degeneration of neuromelanin (NM)-containing neurons in the Substantia Nigra (SN). MRI techniques have emerged aiming to evaluate PD disease progression. NM-MRI (current gold-standard), depicts a reduction in signal intensity at the posterior SN. Recently, free water (FW) fraction maps obtained from DWI, have shown an increase of FW in the SN in PD. This work’s goal was to evaluate how the FW and NM signal relate. A negative correlation between FW and NM was observed in the SN posterior region, suggesting that both metrics can potentially be used as imaging biomarkers.

Yu Liu¹, Jun Chen Li^1,2, Yongsheng Chen³, Naying He¹, Zhijia Jin¹, Weibo Chen⁴, Fuhua Yan¹, and Ewart Mark Haacke^1,5,6
1Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²Radiology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China, ³Neurology, Wayne State University, Detroit, MI, United States, ⁴Philips Healthcare, Shanghai, China, ⁵Radiology, Wayne State University, Detroit, MI, United States, ⁶Biomedical Engineering, Wayne State University, Detroit, MI, United States

The locus coeruleus (LC) is mainly responsible for the synthesis of noradrenaline in the brain. Pathological alterations of the LC are involved in many neurodegenerative diseases. In this work, we use the  tissue properties (spin density and T1 value) of the LC extracted from an MTC-STAGE (strategically acquired gradient echo) susceptibility weighted imaging protocol. Choosing the right flip angle and resolution can provide optimal visualization of the LC. We found that a short echo scan, with a flip angle of 25-30^o and a resolution of 0.67 x 0.67 x 1.34mm³ provides the best visualization of the LC. 

Apoorva Safai¹, Shweta Prasad^2,3, Jitender Saini⁴, Pramod Pal², and Madhura Ingalhalikar^5
1Symbiosis Center of Medical Image Analysis, Symbiosis International University, PUNE, India, ²Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India, ³Department of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Bangalore, India, ⁴Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India, ⁵Symbiosis Center of Medical Image Analysis, Symbiosis International University, Pune, India

Parkinson’s disease (PD) is characterized by loss of dopaminergic neurons in Substantia Nigra pars compacta (SNc). SNc to whole brain resting state functional connectivity (rsFC) was compared between healthy controls (HC) and patients with PD to study the functional network of SNc in PD, and its association with disease progression was evaluated using a neuromelanin sensitive MRI based probabilistic atlas of SNc. Putamen, cerebellum and insular cortex connectivity with SNc was significantly reduced in PD as compared to HC. Widespread frontal, occipital regions, SMA and cerebellum were associated with duration and severity of PD.

Roshni Kedia¹, Archana Vadiraj Malagi¹, Jitender Saini², and Amit Mehndiratta^3
1Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India, ²Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, India, ³Indian Institute of Technology Delhi, New Delhi, India

Absolute perfusion varies in different brain regions for Parkinson’s disease (PD) and Multiple System Atrophy (MSA). These were studied quantitatively using ASL-MRI and the mean perfusion for each brain region was compared. Significant decrease in perfusion was noted for PD compared to healthy subjects for left and right caudate, anterior and posterior cingulate gyrus and occipital fusiform gyrus. For MSA, right caudate showed significant decrease in perfusion compared to healthy subjects.

Septian Hartono^1,2, Isabel Hui Min Chew³, Amanda Jieying Lee³, Joey Xin Yi Oh³, Leon Qi Rong Ooi⁴, Yao-Chia Shih³, Jongho Lee⁵, Zheyu Xu^1,2, Eng King Tan^1,2, and Ling Ling Chan^2,3
1Department of Neurology, National Neuroscience Institute, Singapore, Singapore, ²Duke-NUS Medical School, Singapore, Singapore, ³Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore, ⁴Department of Electrical & Computer Engineering, National University of Singapore, Singapore, Singapore, ⁵Department of Electrical & Computer Engineering, Seoul National University, Seoul, Korea, Republic of

Our study is the first to investigate the value of susceptibility map-weighted imaging in quantifying Nigrosome-1 loss in the substantia nigra to distinguish between tremor-dominant Parkinson’s disease (TDPD) and Essential Tremor (ET). Region-of-interest (ROI) masks of the Substantia Nigra and midbrain background were manually drawn on SMWI images of 50 subjects comprising 18 healthy controls, 25 ET and 7 TDPD patients. The SN in TDPD patients contained significantly more voxels more hypointense than the background than in ET patients. This could be explained by greater Nigrosome-1 loss and iron deposition in TDPD patients early in the disease.

Sonoko Oshima¹, Yasutaka Fushimi¹, Satoshi Nakajima¹, Yusuke Yokota¹, Sayo Otani¹, Azusa Sakurama¹, Krishna Pandu Wicaksono¹, Yuichiro Sano², Ryo Matsuda², Masahito Nambu², Koji Fujimoto³, Hitomi Numamoto⁴, Kanae Kawai Miyake⁴, Tsuneo Saga⁴, and Kaori Togashi^1
1Department of Diagnostic Radiology and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan, ²MRI Systems Division, Canon Medical Systems Corporation, Otawara, Japan, ³Human Brain Research Center, Graduate School of Medicine, Kyoto University, Kyoto, Japan, ⁴Department of Advanced Medical Imaging Research, Graduate School of Medicine, Kyoto University, Kyoto, Japan

We assessed neuromelanin-sensitive MR images with number of excitations of 1 or 2 with and without deep learning reconstruction (DLR) denoising method about visualization of the substantia nigra (SN) and locus coeruleus (LC) in 19 patients. The results of visual assessment were better in images with DLR. Contrast ratios of SN did not change after application of DLR, whereas contrast ratios of LC were decreased and hyperintense SN areas became larger. Neuromelanin imaging with DLR has a potential to reduce scan time without spoiling image quality, but further studies are needed for interpreting the signal contrast of SN and LC.

Po-Yuan Chen¹, Yi-Ming Wu², Yi-Hsin Weng³, and Jiun-Jie Wang^1
1Chang Gung University, Taoyuan, Taiwan, ²Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, ³Chang Gung Memorial Hospital, Taoyuan, Taoyuan, Taiwan

Progressive supranuclear palsy (PSP) is an atypical Parkinsonism but with a faster progressive course. Previous studies indicated that PSP patients showed not only gray matter volume decrease but also white matter tract degeneration. We use fixel based analysis to examine the difference in the fibre bundle (FD), fibre-bundle cross-section (FC) and combination of fibre density and bundle cross-sectional area (FDC) between patients with PSP and healthy controls. The results show that significant degeneration of white matter in PSP patients. The major advantage to this study is providing a fixel-based comparison that indicate more directly interpretable measures of structural integrity.

A Ankeeta¹, Shefali Chaudhary¹, S Senthil Kumaran¹, Priyanka Bhat², and Vinay Goyal^2
1NMR and MRI facility, All India Institute of Medical Sciences, New Delhi, India, ²Neurology, All India Institute of Medical Sciences, New Delhi, India

The pattern of Hyposmia hemodynamic response, functional connectivity and ERP response was investigated in patients with Parkinson's disease, Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP). Results revealed the presence of significant olfactory loss correlated with differential pattern in the olfactory pathway including frontal region and temporal areas. MRI, BOLD and EEG, can be used to detect early biomarker(s) for the identification of  Parkinson and atypical Parkinsonism patients on the basis of hyposmia. 

Apurva Shah¹, Jacob Antony Alapatt², Shweta Prasad³, Jitender Saini⁴, Pramod Pal³, Ragini Verma², and Madhura Ingalhalikar^1
1Symbiosis Center for Medical Image Analysis, Symbiosis International University, Pune, India, ²Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States, ³Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India, ⁴Department of Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, India

Parkinson’s disease is characterized by degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNc). To study the micro-structural and free-water (FW) changes using diffusion-MRI in the SNc it is critical to extract SNc accurately. Our work employs a neuromelanin sensitive MRI based atlas to delineate the SNc and demonstrates significant FW and FW eliminated microstructural alterations in a large cohort of PD (with and without psychosis) and its association with PD severity, indicative of novel diagnostic and progression markers of PD which however demonstrate no role in genesis of psychosis in PD.

Boliang Yu¹, Ling Li², Xueling Liu², Naying He³, Hongjiang Wei⁴, Chuantao Zuo², Fuhua Yan³, and Yuyao Zhang^1
1School of Information Science and Technology, ShanghaiTech University, Shanghai, China, ²PET Center, Huashan Hospital, Fudan University, Shanghai, China, ³Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China, ⁴Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China

 A limited number of atlases have been constructed using quantitative susceptibility mapping (QSM) images from subjects with Parkinson’s disease (PD), and given disease-specific subcortical structures. In this work, we generated three standard-space templates i.e. the hybrid, QSM and T1w atlas, which kept good image quality to observe brain white, gray matter, and deep-brain nuclei. Based on the atlases, we achieved the manual annotation of a few brain subcortical structures, e.g. globus pallidus, substantia nigra, subthalamic nucleus and thalamus. The results gave the position and shape of subcortical nuclei which could be meaningful for the research and surgical treatment of PD.

Tzu-Wei Lee¹, Chao-Wei Tso¹, Kuan Chen¹, Cheng-Yu Chen², and Hua-Shan Liu^1
1School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei City, Taiwan, ²Department of Radiology, School of Medicine, Taipei Medical University, Taipei City, Taiwan

A comparative study of different techniques for delineation of the nigrosome-1 in substantia nigra (SN) is needed to define the most sensitive imaging biomarker for SN-related diseases. This study was conducted to assess the potential of multiecho susceptibility-weighted imaging (SWI) in the delineation of the nigrosome-1. We also evaluated the relationship between neuromelanin (NM) and relaxation times of SN. We found that multiecho SWI can improve the contrast-to-noise ratio (CNR). The older subjects exhibited increased CNR values. The correlation between NM-MRI and T2* value suggested that magnetization-transfer effect may be related to the presence of melanin-iron complex in the nigrosome-1.

Xueling Liu¹, Liqin Yang¹, Yuxin Li¹, Daoying Geng¹, Pu-Yeh Wu², and Yong Zhang^2
1Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China, ²GE Healthcare China, Beijing, Shanghai, China

Loss of melanized dopaminergic neurons(1) and iron deposition(2) in substantia nigra (SN) were pathological hallmarks of Parkinson’s disease (PD). Susceptibility images from QSM could detect iron deposition(3, 4) while neuromelanin-sensitive MRI (NM-MRI) could reflect change of melanized dopaminergic neurons(5, 6) in SN. In this study, we found highly spatial similarity of SN_hyperintense on Mag1 images from QSM and on NM-MRI images. PD-patients could be differentiated from old HCs on Mag1 images as similar as that on NM-MRI images. Combined with Mag1 and susceptibility images, QSM could provide a promising imaging biomarker for iron deposition and NM deficiency in PD simultaneously.

Zhijia Jin¹, Zenghui Cheng¹, Naying He¹, Pei Huang², Sean K. Sethi^3,4, Mojtaba Jokar³, Weibo Chen⁵, Shengdi Chen², Fuhua Yan¹, and E. Mark Haacke^1,3,4,6
1Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ³Magnetic Resonance Innovations, Inc., Bingham Farms, MI, United States, ⁴Department of Radiology, Wayne State University, Detroit, MI, United States, ⁵Philips Healthcare, Shanghai, China, ⁶Department of Biomedical Engineering, Wayne State University, Detroit, MI, United States

Twenty-nine Parkinson’s disease (PD) patients and 29 age- and sex-matched healthy controls (HCs) were scanned using a single 3D gradient echo magnetization transfer sequence to evaluate neuromelanin volume, global and regional iron content, and the appearance of nigrosome-1 territory (the “N1 sign”) in the substantia nigra. Iron increase and neuromelanin volume reduction were found in PD patients compared to HCs. 21/29 and 4/29 of PD patients showed bilateral and unilateral loss of the N1 sign, respectively. Combining the N1 sign with neuromelanin volume, global iron content and regional iron content respectively improved diagnostic performance to differentiate PD patients from HCs.

Arthur Yong¹, Amanda Lee², Septian Hartono^2,3, Isabel Chew², Samuel Ng³, Xinyi Choi³, Wilson Jia Wei Wong², Linda Soo Lee Lim⁴, Eng King Tan^1,3, Louis Tan^1,3, and Ling Ling Chan^1,2
1Duke-NUS Graduate Medical School, Singapore, Singapore, ²Singapore General Hospital, Singapore, Singapore, ³National Neuroscience Institute, Singapore, Singapore, ⁴National Heart Centre Singapore, Singapore, Singapore

Parkinson's disease (PD) is characterized by progressive dopaminergic neuronal loss in the substantia nigra (SN) and dopaminergic deafferentation in the striatal nuclei. Diffusion tensor tractography (DTT) has been used to document cross-sectional changes in the nigrostriatal pathway (NSP) in PD. Our prospective longitudinal study using DTT revealed significant interval NSP degeneration over a two-year period compared to controls, besides cross-sectional changes in the NSP congruent with current literature. Our results suggested that demyelination may be the dominant factor in NSP degeneration in PD. DTT may be a useful objective biomarker of disease progression in the early stages of PD. 

Shefali Chaudhary¹, S Senthil Kumaran¹, Vinay Goyal², GS Kaloiya³, M Kalaivani⁴, NR Jagannathan¹, Rajesh Sagar⁵, Nalin Mehta⁶, and Achal Srivastava^2
1Department of NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, India, ²Department of Neurology, All India Institute of Medical Sciences, New Delhi, India, ³National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India, ⁴Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India, ⁵Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India, ⁶Department of Physiology, All India Institute of Medical Sciences, New Delhi, India

Cognitive impairment (CI) affects 20-40% Parkinson’s disease (PD) patients. Cortical thickness (CT), measuring the shortest distance between brain surface and inner edge of cortical gray matter may relate to CI in PD. In this study, we evaluated CT alteration in cognitively impaired PD patients (PD-CI) in comparison to cognitively normal (CN) healthy controls (HC) and PD patients (PD-CN) using 3DT1 MR data. Extended cortical thinning in frontal, temporal, parietal, occipital regions in PD-CI and significant positive association with global cognition MoCA score may signify cognition linked Lewy pathology and may be a promising tool to characterize cognition in PD.

Catarina Rua¹, Claire O'Callaghan², Ron Ye^3,4, Luca Passamonti³, P Simon Jones³, Guy B Williams¹, James B Rowe^3,4, and Christopher T Rodgers^1
1Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom, ²Behavioural and Clinical Neuroscience Institute and Department of Psychology, University of Cambridge, Cambridge, United Kingdom, ³Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom, ⁴Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom

In Parkinson’s disease, there is severe loss of dopaminergic projection neurons of the substantia nigra (SN) and locus coeruleus (LC). Histology shows that damage is non-uniform and occurs in stages; i.e. there is preferential degeneration of neurons first in the rostral portion of the SN and only later on in the LC. In this study, we measured the biochemical properties of the SN and LC with T2* and Magnetization Transfer imaging in patients with Parkinson’s disease and two groups of healthy controls.

Sadhana Kumari¹, S.Senthil Kumaran¹, Vinay Goyal², Achal Srivastava², SadaNand Dwivedi³, and N.R. Jagannathan^1
1NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, India, ²Neurology, All India Institute of Medical Sciences, New Delhi, India, ³Biostatistics, All India Institute of Medical Sciences, New Delhi, India

NMR-based metabolomics of saliva was studied in patients with Parkinson’s disease (PD) in early and advanced stages in comparison with that of healthy controls (HC). Higher levels of histidine, TMAO, propionate, GABA, valine, isoleucine, alanine, and fucose were observed in early PD in comparison with HC.  Higher propionate and acetoin concentrations were observed in both early and advanced PD groups as compared to the HC group. An association of a few metabolites with the disease duration, LEDD and H&Y stage of PD patients was observed. Gut microflora system, ketone body and energy metabolisms may be impaired in patients with PD.

Minju Jo¹ and Se-Hong Oh^2,3
1Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea, ²Department of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea, ³Imaing Institute, Cleveland Clinic Foundation, Cleveland, OH, United States

  We have described an efficient approach for SMWI visualizing SN and nigrosome 1 on clinical field strength (). QSMnet provides a similar SMWI image to that obtained with the conventional iterative QSM algorithm (such as iLSQR) but improves QSM processing speed by avoiding iterative computation. Since QSM reconstruction is the most time-consuming step of SMWI processing, QSMnet can help to achieve an improved SMWI processing speed. The application of QSMnet will be helpful when processing a massive amount of data or may contribute to the development of a scanner embedded real-time reconstruction of SWMI.

Christina Andica¹, Koji Kamagata¹, Yuya Saito^1,2, Wataru Uchida^1,2, Akifumi Hagiwara¹, Shohei Fujita^1,3, Syo Murata¹, Masaaki Hori^1,4, and Shigeki Aoki^1
1Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan, ²Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan, ³Department of Radiology, Graduate School of Medicine, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan, ⁴Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan

We evaluated the white matter (WM) of patients with newly diagnosed Parkinson’s disease (PD) with normal cognition (PD-NC) and mild cognitive impairment (PD-MCI) using diffusion tensor imaging (DTI) and free-water elimination DTI. Increased fractional anisotropy and decreased mean diffusivity and radial diffusivity in patients with PD suggested compensatory neural circuit reorganization. Changes were less extensive in WM areas previously considered vulnerable to MCI in the PD-MCI group than in the PD-NC group. Longitudinal analyses indicated neural compensation in the PD-NC group after 1 year. Overall, extensive and long compensatory mechanisms may be associated with preserved cognitive function in PD. 

Jae-Hyuk Shim¹ and Hyeon-Man Baek^1
1Gachon University, Incheon, Republic of Korea

Basal ganglia structures, globus pallidus internal, globus pallidus external, subthalamic nucleus, substantia nigra, red nucleus and striatum were automatically segmented on 7T diffusion weighted images of controls and Parkinson's disease patients. Connectivity between each basal ganglia structure was observed using probabilistic tractography generated with FSL's diffusion tools such as BEDPOSTX and PROBTRACKX. Basal ganglia tractography was compared between controls and Parkinson's disease patients to observe the possible changes that could occur in tractography due to Parkinson's disease.

Na Lu^1,2, Chunmei Li¹, Shuhua Li³, Pu-Yeh Wu⁴, Wen Su³, Haibo Chen³, and Min Chen^1,2
1Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China, ²Graduate School of Peking Union Medical College, Beijing, China, ³Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China, ⁴GE Healthcare, MR Research China, Beijing, China

This study revealed both the brain volumetric and relaxometric characteristics from synthetic MRI technique in Parkinson's disease (PD). Significantly differences were found in fraction of gray matter (GM), white matter (WM) and myelin. We also observed significantly differences in WM T1 value, GM and CSF proton density value. Hence Synthetic MRI might be a quantitative tool for clinical diagnosis of PD.

Md Nasir Uddin¹, Abrar Faiyaz², Yuchuan Zhuang², Madalina Tivarus^3,4, Jianhui Zhong^4,5, Maxime Descoteaux⁶, and Giovanni Schifitto^4,7
1Department of Neurology, University of Rochester, Rochester, NY, United States, ²Electrical & Computer Engineering, University of Rochester, Rochester, NY, United States, ³Radiology, University of Rochester, Rochester, NY, United States, ⁴Imaging Sciences, University of Rochester, Rochester, NY, United States, ⁵Physics, University of Rochester, Rochester, NY, United States, ⁶Computer Science, University of Sherbrooke, Sherbrooke, QC, Canada, ⁷Neurology, University of Rochester, Rochester, NY, United States

Free water (FW) index, a measure of extracellular non-flowing water in the brain parenchyma, can be sensitive to neuroinflammation. We examine the relationship between the FW index and putative markers of neuroinflammation in cART-naïve participants before and after 12 weeks of the treatment. We found that FW index correlated with neuroinflammation markers in HIV+ participants for some GM and WM structures at baseline while this correlation diminished after 12 weeks of cART treatment in some WM structures for NfL.

Antonio Jimenez Gonzalez*^1,2,3, Mário João Fartaria*^1,2,3, Pietro Maggi⁴, Tobias Kober^1,2,3, Jean-Philippe Thiran^2,3, Karl Egger⁵, Renaud Du Pasquier⁴, François Lazeyras⁶, Frédéric Assal⁷, Alexandra Calmy⁸, Matthias Cavassini⁹, and Cristina Granziera^10,11
1Advanced Clinical Imaging Technology, Siemens Healthcare, Lausanne, Switzerland, ²Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ³LTS5, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland, ⁴Departement of Neurology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ⁵Department of Neuroradiology, Faculty of Medicine, University of Freiburg, Freiburg, Germany, ⁶Department of Radiology and Medical Informatics, CIBM, Geneva University Hospital, Geneva, Switzerland, ⁷Cognitive Neurology Unit, Department of Neurology, University Hospitals of Geneva, Geneva, Switzerland, ⁸Division of Infectious Diseases, University Hospital Geneva, Geneva, Switzerland, ⁹Department of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ¹⁰Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland, ¹¹Translational Imaging in Neurology (ThINk) Basel, Department of Medicine and Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland

The clinical landscape of HIV has evolved from a fatal disease to a manageable condition, giving rise to secondary complications associated with the chronic infection still present under treatment. HIV penetrates the brain very early after infection. Here, we investigated the mechanism behind structural brain changes observed in 92 aviremic HIV patients compared to 125 seronegative controls using quantitative MRI. Changes in cortical and subcortical structures and T1 relaxation times were observed. We thus speculate that the differential pattern in HIV patients reflects biological mechanisms underlying different stages of brain infection, namely acute inflammation and neuronal loss.

Kyle Murray¹, Md. Nasir Uddin², Madalina Tivarus³, Arun Venkataraman¹, Yuchuan Zhuang⁴, Xing Qiu⁵, Lu Wang⁵, Meera Singh⁶, Jianhui Zhong^1,3, Sanjay Maggirwar⁷, and Giovanni Schifitto^2,3
1Physics and Astronomy, University of Rochester, Webster, NY, United States, ²Neurology, University of Rochester, Rochester, NY, United States, ³Imaging Sciences, University of Rochester, Rochester, NY, United States, ⁴Electrical and Computer Engineering, University of Rochester, Rochester, NY, United States, ⁵Biostatistics and Computational Biology, University of Rochester, Rochester, NY, United States, ⁶Microbiology and Immunology, University of Rochester, Rochester, NY, United States, ⁷Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington DC, DC, United States

Combination antiretroviral therapy (cART) maintains virologic control in HIV patients, but may lead to neurotoxicity. By using neuroimaging and cellular microparticle quantification, we explore the effects cART may have in both acute and chronic HIV-infection. We find that cART treatment does reduce microparticle levels associated with neuroinflammation to those of controls. Further, microparticle levels and neuroimaging results strengthen assumptions about immune dysfunction in HIV infection. We demonstrate that cerebral blood flow and cerebrovascular reactivity can be used in conjunction with quantitative microparticle levels to study the effects of neuroinflammation and cART treatment in both acute and chronic HIV infection.

Yuya Saito^1,2, Koji Kamagata², Christina Andica², Wataru Uchida^1,2, Syo Murata², Akifumi Hagiwara², Toshiaki Akashi², Akihiko Wada², Masaaki Hori³, and Shigeki Aoki^2
1Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan, ²Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo, Japan, ³Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan

Corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP) are two classic clinical syndromes derived from 4 microtubule-binding domain-repeat tau pathology. However, their clinical diagnosis remains challenging due overlaps in their motor symptoms. While majority of previous studies have assessed brain volumes using cross-sectional data, the present study utilizes Subtype and Stage Inference (SuStaIn) for brain volumes based on cross-sectional brain structural magnetic resonance imaging to identify the differences in temporal brain atrophy progression patterns between CBS and PSP. Our results suggested the utility of SuStaIn for estimating brain atrophy progression patterns in and discriminating between patients with CBS and PSP.

Hao Wang¹, Zhenchang Wang¹, and Zhili on Xie^2
1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China, ²GE Healthecare, MR Research China, Beijing, Beijing, China, Beijing, China

Based on gradient echo (GRE) magnetic resonance phase data, quantitative susceptibility mapping (QSM) is a novel technology which allows the noninvasive assessment of magnetic tissue susceptibility distribution in hemodialysis (HD) patients. And iron deficiency in gray matter nuclei has been reported to lead to idiopathic restless legs syndrome (RLS) symptoms. In this study, we investigated the differences of iron deposition patterns between HD-RLS and HD-nRLS patients scanned at 3T. Compared with HD-nRLS patients, HD-RLS patients demonstrated reduced susceptibility in caudate nucleus and puteman. Hence, QSM can be used for HD-RLS diagnosis and intervention.

Ting-Chieh Chen¹, Yu-Chun Lo², Szu-Yi Chou², Ssu-Ju Li¹, Ting-Chun Lin¹, Ching-Wen Chang¹, Yin-Chieh Liu¹, Hsin-Tzu Lu¹, and You-Yin Chen^1,2
1Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan, ²Ph.D. Program for Neural Regenerative Medicine, Taipei Medical University, Taipei, Taiwan

Cognitive dysfunctions were demonstrated to be associated with the metabolic syndrome (MetS), which could be treated with deep brain stimulation (DBS) of nucleus accumbens (NAc) by altering brain circuitss and facilitating synapse plasticity. However, NAc-DBS for memory-related cognitive function has yet to be investigated. Diffusion MRI, resting-state functional MRI, and behavioral test were applied in this study. We found restoration of the microstructure, increased functional connectivity, and an improvement in cognitive behaviors after NAc-DBS in the MetS models, C-C motif ligand 5/Regulated-on-Activation-Normal-T-cell-Expressed-and-Secreted knockout mice.

Na Lu^1,2, Shuhua Li³, Chunmei Li¹, Pu-Yeh Wu⁴, Wen Su³, Haibo Chen³, Piu Chan³, and Min Chen^1,2
1Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China, ²Graduate School of Peking Union Medical College, Beijing, China, ³Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China, ⁴GE Healthcare, MR Research China, Beijing, China

Multiple system atrophy (MSA) is in great need of diagnosis in its early stage. Our study aims to evaluate the feasibility of using amide proton transfer (APT) imaging in detection of multiple system atrophy (MSA) at 3.0 Tesla. We found that APT MTRasym values were significantly higher in MSA patients than in normal controls at red nucleus, substantia nigra, thalamus and putamen. We also found that APT MTRasym values were significantly higher in probable MSA than in possible MSA patients at red nucleus, caudate and putamen. Hence, CEST may be valuable in diagnosing and predicting the progression of MSA.

jianfeng he¹, yongqin xiong¹, rui zong¹, dekang zhang¹, xin zhou², longsheng pan¹, and xin lou^1
1Chinese PLA General Hospital, Beijing, China, ²Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, China

Essential tremor is the most common movement disorder and is often refractory to medical treatment, Deep brain stimulation in the thalamus has proved the efficiency for these patients. However, this treatment has risks associated with an open neurosurgical procedure. MR-guided focused ultrasound has been developed as a non-invasive means of generating precisely placed focal lesions. We examined its application to the management of refractory essential tremor. Satisfactory results were found that the mean reduction in tremor score of the treated hand was 86.7% at 1 month and 72.5% at 3 months, what’s more,no adverse events lasted beyond 3 months.

Chia-Wen Chiang¹, Ezequiel Farrher², Kuan-Hung Cho¹, Shih-Yen Lin^1,3, Kuo-Jen Wu⁴, Yun Wang⁴, Teh-Chen Wang⁵, Yi-Ping Chao⁶, Yeun-Chung Chang⁷, Chang-Hoon Choi², and Li-Wei Kuo^1,8
1Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan, ²Institute of Neuroscience and Medicine – 4, Medical Imaging Physics, Forschungszentrum Jülich, Jülich, Germany, ³Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan, ⁴Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan, ⁵Department of Medical Imaging, Taipei City Hospital, Taipei, Taiwan, ⁶Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan, ⁷Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan, ⁸Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan

Brain swelling typically occurs in acute stroke.¹ Mannitol, as a hyperosmolar agent, enables to effectively treat the increased intraocular pressure and cerebral edema in brain injury.^2,3 Diffusion kurtosis imaging with free water elimination (DKI-FWE)⁴ has been recently reported the ability to assess diffusion indices by separating free water compartment in simulations and healthy volunteers. The purpose of the study was to examine the effect of mannitol infusion using a stroke rat model at acute and chronic stages assessed by DKI-FWE and DKI. Our preliminary results revealed that mean kurtosis (MK) was sensitive to reflect mannitol-treated dehydration in acute stroke rat.

Pankaj Pankaj¹, S Senthil Kumaran¹, Snigdha Agrawal², Achal Kumar Srivastava³, and Ramesh Kumar Agrawal^2
1Department of NMR & MRI Facility, All India Institute of Medical Sciences, New Delhi, India, ²School of Computer & Systems Sciences, Jawaharlal Nehru University, New Delhi, India, ³Department of Neurology, All India Institute of Medical Sciences, New Delhi, India

Spinocerebellar ataxia type 2 (SCA2) is a progressive disorder with an early onset (10-15 years). On resting state functional connectivity and volume morphometrics, we observed reduced midbrain, sensory-motor and prefrontal cortex functional connectivity with cerebellum and atrophy in inferior parietal lobule, middle occipital gyrus, fusiform gyrus, posterior cingulate, precentral gyrus, parahippocampal gyrus, superior temporal gyrus, postcentral gyrus, fusiform gyrus, middle frontal gyrus, middle temporal gyrus, inferior frontal gyrus, middle temporal gyrus, pyramis, uvula, culmen, inferior semi-lunar lobule in SCA2, with respect to healthy controls. Atrophy and alterations in the rsfMRI connectivity suggest deficits in motor and cognition in SCA2 patients.

Yu Tang¹, Maohua Wang², Ting Zheng¹, Fengying Yuan¹, Fugang Han¹, and Guangxiang Chen^1
1Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China, ²Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China

In recent decades, a growing number of structural neuroimaging studies of grey matter (GM) in trigeminal neuralgia (TN) have reported inconsistent alterations. We carried out a systematic review and meta-analysis to identify consistent and replicable GM volume abnormalities in TN patients. Our findings provide a thorough profile of GM volume alterations in TN patients and constitute robust evidence that aberrant GM volumes in the brain regions regulating and moderating sensory-motor and affective processing may play an important role in the pathophysiology of TN.

Chao Chai¹, Huiying Wang¹, Tong Zhang², Jinxia Zhu³, Xianchang Zhang³, E Mark Haacke⁴, Shuang Xia¹, and Wen Shen^1
1Department of Radiology, Tianjin First Central Hospital, Tianjin Medical Imaging Institute, Tianjin, China, ²School of Graduates, Tianjin Medical Univeristy, Tianjin, China, ³MR Collaboration, Siemens Healthcare Ltd., Beijing, China, ⁴Department of Radiology, Wayne State University, Detroit, MI, United States

Iron metabolism is a research focus in α‑synucleinopathies. Excessive iron deposition may damage neurons and induce cognitive impairment. However, research on brain iron deposition in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) is lacking. Using quantitative susceptibility mapping (QSM), the present study showed that iRBD patients have greater brain iron deposition in the substantia nigra and dentate nucleus than healthy controls (HCs). Additionally, brain iron deposition in the striatum and cerebellum was associated with cognitive impairment, suggesting the potential of QSM as an auxiliary biomarker for neurodegeneration and the early evaluation of cognitive decline in iRBD patients.

Yang Wang¹, Alexander Cohen¹, Guanyu Chen², Veena Nair³, Piero Antuono⁴, Malgorzata Franczak⁴, Vivek Prabhakaran³, Barbara Bendlin⁵, Shi-Jiang Li², and the Alzheimer’s Disease Connectome Project^6
1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, ²Biophysics, Medical College of Wisconsin, Milwaukee, WI, United States, ³Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, ⁴Neurology, Medical College of Wisconsin, Milwaukee, WI, United States, ⁵Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, ⁶Medical College of Wisconsin, Milwaukee, WI, United States

Measured using an advanced 3D pCASL with Hadamard encoded multiple PLDs, patients with MCI showed different patterns of reduced CBF and prolonged ATT in comparison with both AD patients and healthy controls, where CBF and ATT changes highly correlated with severity of disease as assessed by neuropsychological test scores. These findings raised the speculation of underlying vascular abnormality in prodromal AD. Our results also suggested that ATT could serve as useful hemodynamic measure of itself, may be of diagnostic utility for prodromal AD or vascular dementia.

Chunming Gu^1,2,3, Martin Kronenbuerger^4,5, Di Cao^1,2,3, Adrian G. Paez^1,2, Xinyuan Miao^1,2, Xirui Hou^1,3, Jee Bang^5,6, Kia E. Ultz⁵, Wenzhen Duan^6,7, Russell L. Margolis^5,6, Peter C. M. van Zijl^1,2, Christopher A. Ross^5,6,7,8, and Jun Hua^1,2
1The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ²F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States, ³Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States, ⁴Department of Neurology, University of Greifswald, Greifswald, Germany, ⁵Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁶Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁷The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States, ⁸Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States

Significantly elevated arteriolar cerebral blood volume (CBVa) in premanifest Huntington’s Disease (HD) patients has been reported previously. In this study, inflow-based vascular-space-occupancy (iVASO) MRI at 7 Tesla was used to measure CBVa in HD patients longitudinally. We found significant longitudinal increases in CBVa in premanifest HD patients in several brain regions primarily related to motor, visual and cognitive functions, which suggests CBVa as a potential candidate biomarker for HD especially in the premanifest stage.

Riccardo Pascuzzo¹, Alexandra L. Young^2,3, Neil P. Oxtoby², Janis Blevins⁴, Gianmarco Castelli¹, Pierluigi Gambetti⁵, Brian S. Appleby⁴, Daniel C. Alexander², and Alberto Bizzi^1
1Neuroradiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy, ²Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom, ³Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King′s College London, London, United Kingdom, ⁴National Prion Disease Pathology Surveillance Center, Case Western Reserve University, School of Medicine, Cleveland, OH, United States, ⁵Department of Pathology, Case Western Reserve University, School of Medicine, Cleveland, OH, United States

Transmission studies in animal models have identified four strains of sporadic Creutzfeldt-Jakob disease (sCJD). Using a data-driven approach, we aim to identify subgroups of sCJD patients with distinct diffusion-weighted MRI (DWI) abnormality patterns, and test their association with disease strains. We used an unsupervised machine-learning algorithm named Subtype and Stage Inference, that identified 5 clusters of patients each having a distinct pattern of DWI abnormality progression: one had initial involvement of the parieto-frontal cortex; two started with subcortical regions (striatum, thalamus and cerebellum); and two had cortical and limbic regions affected early. Data-driven subgroups were significantly associated with sCJD strains.

Kyle Murray¹, Md. Nasir Uddin², Jianhui Zhong³, and Giovanni Schifitto^2
1Physics and Astronomy, University of Rochester, Webster, NY, United States, ²Neurology, University of Rochester, Rochester, NY, United States, ³Imaging Sciences, University of Rochester, Rochester, NY, United States

HIV-infected individuals are at increased risk of developing white matter hyperintensities (WMHs), which can lead to increased iron deposition in deep gray matter structures. In this abstract, we evaluate three region of interest (ROI) brain iron metrics and introduce a novel population-based whole-brain iron metric, the expected iron coefficient (EIC), derived from quantitative susceptibility mapping (QSM) in the context of HIV and mild WMH burden. While the ROI metrics did not show any significant differences between cohorts, the EIC was able to detect iron related differences in a cohort with WMH burden, due to increased statistical power.

Liu Dongtao¹, Li Kun², Bu Qiao², Pan Zhenyu², Feng Xiang³, Shi Qinglei³, and Zhou Lichun^1
1Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, ²Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, ³MR Scientific Marketing, Diagnosis Imaging, Siemens Healthcare Ltd, Beijing, China

We investigated the early microstructural alterations in hippocampus in MCI patients with cSVD by DKI. Our study found that MCI patients with cSVD show more seriously white matter hyperintensity, and showed significantly increased MD and RD values, and decreased MK, AK, RK, FA and KFA values in left hippocampus. In left hippocampus, values of FA, MK, RK, and KFA showed significantly positive correlations with MoCA score, while MD and RD values were negatively correlated with MoCA score. This may be due to the loss of neuron cell bodies, synapses and dendrites. DKI technique may be feasible to probe the microstructural changes of hippocampus in MCI patients with cSVD.

jingdong Yang¹, Juan Huang¹, Yan Song¹, and Pu Yeh Wu^2
1Radiology, Beijing Hospital, Beijing, China, ²GE Healthcare, Beijing, China

We explored the feasibility of applying Synthetic MRI to quantify leukoaraiosis and further investigated the association of leukoaraiosis with small vascular cerebral diseases and large vessel atherosclerosis in individuals with acute cerebral vascular symptom. The results show that LA could be evaluated by the volume and relaxation time from synthetic MRI and it was associated with lacune and cerebral microbleeds rather than large cerebral atherosclerosis. This finding suggests that quantitative information provided by Synthetic MRI can help to evaluate leukoaraiosis, and leukoaraiosis may be a type of cerebral small vascular diseases instead of intracranial or extracranial cerebral atherosclerosis.

Paula L Croal^1,2, Kevin J Ray¹, Karolina Wartolowska³, Amy Lawson³, Alastair Webb³, and Peter Jezzard^1
1Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, United Kingdom, ²Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom, ³Centre for the Prevention of Stroke and Dementia, University of Oxford, Oxford, United Kingdom

Small vessel disease (SVD) is associated with stroke and dementia, however pathophysiological mechanisms are poorly understood, and effective treatments are lacking.  Here, we determine the association between systemic arterial pulsatility and tissue-level cerebral pulsatility in patients with SVD, and its modulation by anti-hypertensive medication, using a novel analysis technique. We observe a significant association between systemic pulsatility and regional cerebral pulsatility, at baseline and on antihypertensive medication. The association was strongest in periventricular white matter most commonly affected by SVD. This regional dependence suggests that pulsatility is a pathophysiological factor underlying tissue damage in SVD, providing a potential treatment target.

Chunwei Ying¹, Andria L. Ford², Michael M. Binkley², Yasheng Chen², Peter Kang², Jon Christensen¹, Qing Wang¹, Lisa Cash¹, Jason Hassenstab², Jin-Moo Lee^1,2, Tammie L. S. Benzinger^1,3, and Hongyu An^1
1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, United States, ²Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States, ³Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, United States

Neuro-inflammation has been suggested as an important pathogenesis factor for cerebral small vessel disease, but direct evidence in human is lacking.  In this study, we found that neuro-inflammation, measured by ¹¹C-PK11195 uptake, was associated with white matter hyperintensities burden at baseline. More importantly, it predicted cognitive decline in a longitudinal follow-up study.  

Chao Chai¹, Huiying Wang¹, Tong Zhang², Jinping Li³, Yingying Han³, Jinxia Zhu⁴, Xianchang Zhang⁴, Shuang Xia¹, and Wen Shen^1
1Department of Radiology, Tianjin First Central Hospital, Tianjin Medical Imaging Institute, Tianjin, China, ²School of Graduates, Tianjin Medical Univeristy, Tianjin, China, ³Department of Hemodialysis, Tianjin First Central Hospital, Tianjin, China, ⁴MR Collaboration, Siemens Healthcare Ltd., Beijing, China

Cerebral blood flow (CBF) can be significantly reduced during a single hemodialysis session. However, few studies have investigated the effect of long-term hemodialysis on CBF and its correlation with neuropsychological tests. This study used pulsed arterial spin labeling to show that hemodialysis patients had significantly increased CBF in some cerebral regions. Increased CBF of the right opercular and triangular part of inferior frontal gyrus was negatively correlated with Mini Mental State Examination (MMSE) scores, and after adjusting for hemoglobin and hematocrit levels, these correlations became stronger. Dialysis duration, hemoglobin, hematocrit, and serum phosphorus were clinical risk factors for increased CBF. 

KIRAN THAPALIYA^1,2, Sonya Marshall-Gradisnik¹, Don Staines¹, Sandeep Bhuta³, Timothy Ireland³, and Leighton Barnden^1
1Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia, ²Centre for Advanced Imaging, The University of Queensland, Brisbane, Australia, ³Gold Coast University Hospital, Gold coast, Australia

Myalgic Encephalomyelitis (ME)/Chronic fatigue syndrome (CFS) patients suffer from a variety of physical and neurological complaints indicating the central nervous system plays a role in CFS pathophysiology. Studies based on genetic, immune system, psychiatric, and brain volume abnormalities and white matter hyperintensities have been investigated to identify the pathomechanism of this disease. However, assessment of myelination in brain regions between ME/CFS patients and healthy controls has not been investigated. In this study, we showed elevated myelination in white matter regions and grey matter regions in ME/CFS patients relative to normal controls.

Yi-Tien Li^1,2, Yi-Wen Chen¹, and David Yen-Ting Chen^1,3
1Department of Radiology, Taipei Medical University - Shuang Ho Hospital, New Taipei, Taiwan, ²Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan, ³Department of Radiology, Stanford University, Palo Alto, CA, United States

We applied cross-correlation method on breath-holding task to estimate the cerebrovascular response (CVR) strength and latency within deep white matter. The CVR latency showed significant negative correlation with working memory (WM) 1-back accuracy (r = -0.546, p = 0.009). Further, the significant negative correlation between the average CVR latency within deep white matter and the functional connectivity in specific regions of WM activation area, including left anterior insular cortex and bilateral putamen was found. The result suggested that the changes of cortical-subcortical connections in cerebral small vessel disease can be reflected by the delayed CVR latency within deep white matter.

Thomas Welton¹, Sarah C Hellewell¹, Michel Tchan², and Stuart M Grieve^1
1University of Sydney, Sydney, Australia, ²Department of Genetic Medicine, Westmead Hospital, Sydney, Australia

Diffusion kurtosis MRI (DKI) was used to measure changes in white matter structure in 20 patients with phenylketonuria and 43 controls. We found significant differences primarily in the periventricular parietal white matter in various DKI metrics. These scores were related to phenylalanine levels measured in the 3 years prior to MRI and with Scheltens score, reflecting white matter hyperintensities. DKI may be sensitive to pathology invisible to clinical MRI, and we propose a simple metric in the parietal lobe which robustly captures this effect.

Wei Chuang¹, Vincent Chin-Hung Chen^2,3, Yuan-Hsiung Tsai⁴, and Jun-Cheng Weng^1,3,5
1Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan, ²School of Medicine, Chang Gung University, Taoyuan, Taiwan, ³Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan, ⁴Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan, ⁵Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan

Breast neoplasms are the most common cancer among women. Whether received adjuvant chemotherapy or not, lots of them presented cognitive impairment which decreased their quality of life. Therefore, we attempted to use generalized q-sampling imaging (GQI) to detect the white matter alteration between groups that may due to post-traumatic stress disorder (PTSD), post-traumatic growth (PTG) and chemotherapy. Our results showed the differences in the brain regions associated with cognition, emotion, and execution, such as angular gyrus, cingulate gyrus and so on. It indicted traumatic stressor or chemotoxicity can cause myelin injuries in these regions.

Mohamed Salah Khlif¹, Carolina Restrepo¹, Emilio Werden¹, Laura Bird¹, Sheila K. Patel^1,2, Rebecca Singleton¹, Jeffrey D. Zajac^2,3, Richard MacIsaac⁴, Elif I. Ekinci^2,3, Louise M. Burrell^2,5, and Amy Brodtmann^1,2,6
1The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia, ²Department of Medicine, University of Melbourne, Austin Health, Heidelberg, Australia, ³Austin Health Endocrine Centre, Heidelberg, Australia, ⁴Department of Endocrinology & Diabetes, St Vincent's Hospital, Melbourne, Australia, ⁵Department of Cardiology, Austin Health, Heidelberg, Australia, ⁶Department of Neurology, Austin Health, Heidelberg, Australia

Type 2 diabetes and stroke are associated with reduced brain volumes and independently present a high risk for cognitive impairment or dementia. The interaction between diabetes and stroke and its effects on brain atrophy are unknown. We used linear mixed-effect modelling to estimate rates of atrophy over two years based on FreeSurfer segmentation of MR images of healthy participants and patients with type 2 diabetes and/or stroke. Cerebral atrophy, defined by volume reductions in specific regions of interest, was accelerated the most in the group with only type 2 diabetes. Thalamus was affected more by stroke.

Yongsheng Chen¹, E. Mark Haacke², Yang Xuan², Melody Hackett¹, Sadaf Saba³, Bo Hu¹, Daniel Moiseev¹, and Jun Li^1,3,4,5
1Department of Neurology, Wayne State University, Detroit, MI, United States, ²Department of Radiology, Wayne State University, Detroit, MI, United States, ³Center for Molecular Medicine & Genetics, Wayne State University, Detroit, MI, United States, ⁴Department of Biochemistry, Microbiology and Immunology, Wayne State University, Detroit, MI, United States, ⁵John D. Dingell VA Medical Center, Detroit, MI, United States

To test the hypothesis that quantitative MRI (qMRI) detects proximal nerve dysmyelination and axonal degeneration in Charcot-Marie-Tooth (CMT) diseases. Nine qMRI indices were collected, including whole muscle mean fat fraction (wmmFF), nerve fascicular cross-sectional area (fCSA), magnetization transfer ratio (MTR), T1, proton density (PD), R2, R2*, mean diffusivity (MD) and fractional anisotropy (FA). Compared to controls, patients with CMT had significantly elevated fCSA, T1, PD, T2* and MD for both divisions of sciatic nerves and wmmFF, elevated T2 for the tibial division but not the peroneal division, and decreased MTR for both divisions of sciatic nerves.

Sirio Cocozza¹, Giuseppe Pontillo¹, Raffaele Dubbioso¹, Stefano Tozza¹, Daniele Severi¹, Lucio Santoro¹, Andrea Elefante¹, Fiore Manganelli¹, Arturo Brunetti¹, and Mario Quarantelli^2
1University "Federico II", Naples, Italy, ²National Research Council, Naples, Italy

We investigated the presence of gray matter (GM) and white matter (GM) structural modifications in a homogeneous group of genetically defined CMT1A patients, by means of VBM and TBSS analyses, respectively. We found increased GM volume in CMT1A patients compared to HC encompassing the right paravermian portions of the cerebellar lobules III, IV and V, showing an inverse correlation with electrophysiological measures. These structural changes may reflect compensatory mechanisms in response to CMT1A peripheral nerve pathology, providing new insights into the comprehension of CNS physiopathology and its role in the development of clinical disability in this condition.

Chiara Casella¹, Jose Bourbon-Teles¹, Derek K Jones¹, Greg Daniel Parker¹, Sonya Bells², Anne Rosser³, Elizabeth Coulthard⁴, and Claudia Metzler-Baddeley^1
1Department of Psychology, Cardiff University Brain Research Imaging Centre, Cardiff, United Kingdom, ²Department of Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada, ³Department of Biosciences, Cardiff University, Cardiff, United Kingdom, ⁴Department of Clinical Neurosciences, University of Bristol, Bristol, United Kingdom

Huntington’s disease is a neurodegenerative disorder leading to debilitating cognitive and motor symptoms. It has been proposed that impaired myelination contributes to HD pathogenesis. As well, evidence shows that myelin formation underlies the learning of new motor skills. Here we demonstrate that two months of drumming and rhythm exercises result in an increase in a proxy MRI measure of myelin in patients with early HD relative to healthy controls. This suggests that tailored behavioural stimulation has the potential to result in neural benefits in early HD that could be exploited for future therapeutics aiming to delay disease progression.

Nao-Xin Huang¹, Tian-Xiu Zou¹, Zhongshuai Zhang², and Hua-Jun Chen^1
1Fujian Medical University Union Hospital, Fuzhou, China, ²SIEMENS Healthcare, Shanghai, China

White matter (WM) impairments have been well documented in amyotrophic lateral sclerosis (ALS). This study tested the potential of diffusion measurements in WM for identifying ALS based on the support vector machine (SVM). In the optimized SVM model, the FA values from the motor areas (including the bilateral precentral gyrus and the corticospinal tract) and extra-motor areas (including right postcentral gyrus, left superior/inferior longitudinal fasciculus) contributed mostly to classification. Our study suggests the feasibility of ALS diagnosis based on SVM analysis and diffusion measurements of WM. Future study with larger cohort is needed to validate the generality of our results.

Thomas B Shaw¹, Saskia Bollmann¹, Frederik Steyn¹, Christine Guo², Amir Fazlollahi³, Jurgen Fripp³, Olivier Salvado^3,4, Steffen Bollmann¹, and Markus Barth^1
1The University of Queensland, Brisbane, Australia, ²QIMR Berghofer Medical Research Intstitute, Brisbane, Australia, ³CSIRO Health and Biosecurity, Brisbane, Australia, ⁴CSIRO Data61, Sydney, Australia

Imaging biomarkers for Motor Neuron Disease (MND) using MRI presents challenges due to neurodegeneration leading to heterogeneous brain morphology, low SNR, and movement artefacts. Here, we present optimised methods for imaging and processing MND patient data using UHF MRI with submillimetre resolution, and compare hippocampal subfields between patients and healthy controls. We used automatic measures to examine the shape, volume, and morphology of hippocampal subfields and showed specific changes in MND patients that are more sensitive than previous research. This work may serve as a framework for more sensitive computational models for biological characterisation of MND in vivo.

Anjan Bhattarai^1,2, Zhaolin Chen², Phillip G. D. Ward², Paul Talman³, Susan Mathers⁴, Thanh Phan⁵, Caron Chapman⁴, James Howe⁴, Sarah Lee⁴, Yennie Lie⁴, Gary F Egan², and Phyllis Chua^1,4
1Department of Psychiatry, Monash University, Clayton, Australia, ²Monash Biomedical Imaging, Monash University, Clayton, Australia, ³Department of Neuroscience, Barwon Health, Geelong, Australia, ⁴Statewide Progressive Neurological Services, Calvary Health Care Bethlehem, South Caulfield, Australia, ⁵Department of Neuroscience, Monash Health, Clayton, Australia

We performed in-vivo measurements of the magnetic susceptibility in the motor cortex in individuals with Amyotrophic Lateral Sclerosis (ALS) at baseline and six-month follow-up, and healthy controls at baseline using Quantitative Susceptibility Mapping (QSM). The results show significant susceptibility difference between individuals with ALS compared to healthy controls. There was a trend towards more pronounced susceptibility changes in lumbar onset compared to healthy controls than cervical onset ALS compared to healthy controls. These findings may lead to the development of a sensitive neuroimaging biomarker that can provide meaningful insights into pathophysiologic changes in ALS subtypes.

Jing Yang¹, Du Lei^1,2, Xueling Suo¹, and Qiyong Gong^1,3
1Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China, ²University of Cincinnati, Cincinnati, OH, United States, ³Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), Chengdu, China

The present psychoradiological study demonstrated significant alterations both in global and nodal topological properties of single-subject brain morphological networks in a relatively large population of patients with ALS relative to HCs. This was achieved by combining graph theoretical analysis with a method of describing patterns of intercortical morphological similarities in individual participants using structural MRI data. We found that ALS showed a weaker small world organized brain network in global properties and decreased nodal centralities mainly in prefrontal-limbic network relative to HCs. Further, the nodal efficiency of right inferior frontal gyrus was positively correlated to ALSFRS in ALS group.
 

Hagen H Kitzler¹, Paul Kuntke¹, Carolin Schwamborn¹, Hannes Wahl¹, Rene Guenther², Andreas Herrmann³, Sean C Deoni⁴, and Jennifer Linn^1
1Neuroradiology, Technische Universität Dresden, Dresden, Germany, ²Neurology, Technische Universität Dresden, Dresden, Germany, ³Neurology, Universitätsmedizin Rostock, Rostock, Germany, ⁴Alpert Medical School, Brown University, Providence, RI, United States

Amyotrophic lateral sclerosis (ALS) is a rapidly progressing neurodegenerative disease of primary cortical neuronal pathology and central nervous system multisystem involvement including related white matter. Based on previous findings of early myelination changes we aimed to investigate the spatial distribution of changes of markers of axonal (diffusion) and myelin (relaxation) integrity of the related motor corticospinal tract (CST). We found different pattern with minor, predominantly diffusion or predominantly relaxation, and extensive ubiquitary alteration. However, heterogeneous distribution of changes suggest a non-uniform secondary CST degeneration and limited prognostic value of ALS disease course.

Rosalie Victoria McDonough¹, Roland Fischer^2,3, Regine Grosse⁴, Thomas Lindner¹, Roberta Ward⁵, Zhiyue Jerry Wang⁶, Marcela Weyhmiller³, Jens Fiehler¹, and Jin Yamamura^2
1Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, ²Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, ³UCSF Benioff Children’s Hospital Oakland, Oakland, CA, United States, ⁴Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany, ⁵Imperial College, London, United Kingdom, ⁶Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, United States

This study investigates the measurement of iron overload in patients using R2 MRI in selected brain regions.

Tomohisa Doi¹, Yasuhiro Fujiwara², and Hirotoshi Maruyama^3
1Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan, ²Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan, ³Department of Radiology, National Hospital Organization Kumamoto Saisyun Medical Center, Kumamoto, Japan

Degeneration of the substantia nigra cannot be evaluated using neuromelanin imaging at 1.5 T. Therefore, an imaging method to quantitatively evaluate the substantia nigra with 1.5-T magnetic resonance imaging is required. This study aimed to investigate whether the substantia nigra can be quantitatively evaluated by acquiring a T₁ map using three-dimensional phase-sensitive inversion recovery (PSIR) at 1.5 T. T₁ mapping using the PSIR sequence enables quantitative evaluation of the substantia nigra independent of the imaging parameters.

Alpay Ozcan¹, Ozge Uygun², Fuat Kaan Aras¹, Murat Gultekin³, Zuhal Yapici², and Alp Dincer^4
1Acibadem Mehmet Ali Aydinlar Univ., Istanbul, Turkey, ²Neurology, Istanbul University, Istanbul, Turkey, ³Neurology, Erciyes University, Kayseri, Turkey, ⁴Radiology, Acibadem Mehmet Ali Aydinlar Univ., Istanbul, Turkey

QSM has the potential of describing objectively iron accumulation in brain regions such as basal ganglia which is relevant in neurodegeneration with brain iron accumulation (NBIA). Herein, for accurately assessing iron accumulation,  a new metric, high susceptibility density, is introduced against mean value pitfalls which may be hindered by negative susceptibility within ROIs. When analyzing iron accumulation in basal ganglia of 16 patients with subtypes PKAN dispersion, KUFOR lower and PLAN higher accumulation, MPAN separation was obeserved in the Globus  Pallidus-Red Nucleus space compared to healthy volunteers.

Lei Wei¹, KeLiang Chen², and He Wang^1,3
1Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China, shanghai, China, ²Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China, ShangHai, China, ³Human Phenome Institute, Fudan University, Shanghai, China, Shanghai, China

The Gordon-Holmes syndrome is an rare condiion caused by mutation of genes, few study has reported the finding of GHS by neuroimaging, but several studies has found the white matter abnormal in GHS brain.  According the tracking based analysis. The different quantitative diffusion parameters suggest the white matter abnormal from different aspects. We firstly iinvestigated the white matter abnormal of GHS in the distribution of each diffusion property.

Ming-Chung Chou¹, Jei-Yuan Li², and Ping-Hong Lai^3
1Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan, ²Department of Neurology, E-Da Hospital, Kaohsiung, Taiwan, ³Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

This study performed a voxel-based morphometry to investigate global gray matter changes in patients with acute CO intoxication. The results show significantly decreased gray matter volumes mostly in the pain-matrix regions, and significantly increased gray matter volumes in the periaqueductal gray (pain-modulating center). In the pain-matrix regions, the GM volumes were significantly negatively correlated with duration of coma, suggesting that longer duration of coma may lead to more headache symptoms in patients with acute CO intoxication.

David Lohr¹, Philipp Capetian², Bernhard Landwehrmeyer³, and Laura Maria Schreiber^1
1Chair of Cellular and Molecular Imaging, Comprehensive Heart Failure Center (CHFC), University Hospital Würzburg, Würzburg, Germany, ²Department of Neurology, University Hospital Würzburg, Würzburg, Germany, ³Department of Neurology, University Hospital Ulm, Ulm, Germany

The brain of a Huntington Disease (HD) patient who received neural fetal tissue transplants 11 years before her death, was analyzed ex-vivo in a 7T MRI scanner with a total scan time of 25 hours and 8 minutes.  Signs of engrafted tissue could be found on all sites which received a stereotactic implantation (caudate nucleus, putamen) with a tendency to overgrowth for the right hemisphere. Deterministic fiber tracking based on DTI images clearly demonstrated interconnectivity of individual grafts to numerous brain regions.

Sina Straub¹, Stephanie Mangesius^2,3, Julian Emmerich^1,4, Elisabetta Indelicato⁵, Wolfgang Nachbauer⁵, Katja S. Degenhardt^1,4, Mark E. Ladd^1,4,6, Sylvia Boesch⁵, and Elke R. Gizewski^2
1Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany, ²Department of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria, ³Neuroimaging Core Facility, Medical University of Innsbruck, Innsbruck, Austria, ⁴Faculty of Physics and Astronomy, Heidelberg University, Heidelberg, Germany, ⁵Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria, ⁶Faculty of Medicine, Heidelberg University, Heidelberg, Germany

Friedreich’s ataxia is a rare disease involving degenerative processes within white matter fiber tracts, spinal nerves, and the cerebellum such as the atrophy of the dentate nuclei. A correlation of patients’ clinical status and white matter atrophy has been shown in MR volumetry studies. This ultra-high-field study assesses the degeneration of fiber tracts throughout the brainstem as well as of the dentate nuclei, the red nuclei, and the substantia nigra in Friedreich’s ataxia with quantitative MR parameters – susceptibility, diffusion anisotropy, and R₂ and R₁ relaxometry. Statistically significant differences between patients and controls and between disease characteristics were found.

Sara Leddy¹, Laura Serra², Davide Esposito³, Camilla Vizzotto⁴, Gabriella Silvestri⁵, Antonio Petrucci⁶, Giovanni Meola⁷, Mara Cercignani^2,8, and Marco Bozzali^2,8
1Brighton and Sussex University Hospitals Trust, Brighton, United Kingdom, ²Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy, ³Department of Vascular and Endovascular Surgery, University of Florence, Florence, Italy, ⁴University of, Rome, Italy, ⁵Department of Geriatrics, Orthopedics and Neuroscience, Catholic University of Sacred Heart Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy, ⁶UOC Neurologia e Neurofisiopatologia, AO San Camillo Forlanini, Rome, Italy, ⁷Department of Neurorehabilitation Sciences, Casa di Cura Policlinico, Milan, Italy, ⁸Department of Neuroscience, University of Sussex, Brighton, United Kingdom

This study compares the lesion distribution and substrate (by means of quantitative MRI) between patients with type 1 Myotonic Dystrophy (DM1) and patients with Multiple Sclerosis (MS). The main differences in anatomical distribution are the prevalence of anterior temporal lobe lesions in the former group, in the absence of cerebellum and brainstem lesions. MRI markers of myelination were not different between the normal appearing white matter of DM1 and healthy controls. By contrast they were reduced in lesions, but larger than in MS lesions.

Dmitri Shastin^1,2, Sanchita Bhatia², Chantal M. W. Tax¹, Greg Parker¹, Stefan Schwartz², Khalid Hamandi^1,2, William Gray^2,3, Derek Jones¹, and Maxime Chamberland^1
1School of Psychology, Cardiff University Brain Research Imaging Centre, Cardiff, United Kingdom, ²School of Medicine, Cardiff University Brain Research Imaging Centre, Cardiff, United Kingdom, ³BRAIN Biomedical Research Unit, Cardiff, United Kingdom

Pre-operative reconstruction of the Meyer’s loop (ML) using diffusion MRI has a clinical utility when planning temporal lobe resection in order to avoid post-operative visual field deficit. Due to its complex anatomy, precise reconstruction of the ML is challenging. Previous literature has suggested that state-of-the-art hardware and tractography using oriented priors better approximates reconstruction to the reported histological prosections. This pilot work evaluates the ability of these improvements to predict visual field deficit in surgical patients. We report a good association in three out of four cases and suggest that simplistic metrics may not necessarily correlate with function.

HSI-YUAN HU¹, Yao-Chia Shih², Chang-Le Chen¹, Horng-Huei Liou³, Yu-Ling Chang⁴, Yung-Chin Hsu⁵, and Wen-Yih Isaac Tseng^6
1Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan, Taipei, Taiwan, ²Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore, Singapore, Singapore, ³Department of Neurology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, Taipei, Taiwan, ⁴Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan, Taipei, Taiwan, ⁵AcroViz Technology, Inc., Taipei, Taiwan, Taipei, Taiwan, ⁶Molecular Imaging Center, National Taiwan University, Taipei, Taiwan, Taipei, Taiwan

Previous studies did not characterize side-specific associations between structural integrity of the Papez circuit and memory function in patients with mesial temporal lobe epilepsy (MTLE). Here, we used diffusion spectrum imaging (DSI) and T1-weighted MRI to calculate the white matter integrity and gray matter volume, respectively. The structural metrics were correlated with visual and verbal memory function scores assessed by neuropsychological test. The results showed distinct brain-behavior associations in two subtypes of MTLE.

Abdelkareem Salimeen Mustafa¹, Xianjun Li¹, Miaomiao Wang¹, Congcong Liu¹, Martha Singh¹, Mengxuan Li ¹, Xiaocheng Wei², and Jian Yang^1,3
1First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China, Xi’an, China, ²MR Research China, GE Healthcare, China, Beijing, China,, Beijing, China, ³The Key Laboratory of Biomedical Information Engineering, Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi 710049, People’s Republic of China,, Xi’an, China

Epilepsy is a common neurological disorder spread worldwide. Simple febrile seizures (simple FS) is convulsive disorder associated with fever. However, little known about diffusion changes during the developing brain. The study aimed was to assess the diffusion changes in epilepsy and simple FS at aged of 6 to 60 months, using diffusion tensor imaging (DTI). Through inter-group comparisons, fraction anisotropy (FA) decreased, and radial diffusivity (RD) increased in epileptic children compared to simple FS and control. These results suggested DTI is sensitive method in diagnosis delayed myelination in epilepsy, while simple FS have good prognosis due to different pathophysiological mechanism.

XIAONA Zhang¹, QUANXIN YANG¹, and XIAOCHEN WEI^2,3
1The Second affiliated hospital of Xi'an JiaoTong Uuniversity, Xi'an, China, ²GE Healthcare, MR Research China, Beijing, China, ³GE Healthcare, MR Research China, Xi'an, China

The current study aims to assess whether multi-contrast qualitative and quantitative relaxation imaging derived from the synthetic MRI can enhance detection of epileptogenic lesions in children. It was concluded that the synthetic MRI has the potential to be more sensitive in detecting lesions than conventional neuroimaging. Studies with more patients are needed to further demonstrate the relative advantages of the synthetic MRI over conventional MRI, and compare the synthetic MRI with 3-dimentional high resolution MRI.

Xu Zhao¹, Zhiqiang Zhou², and Wenzhen Zhu^1
1Radiology department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, ²Anesthesiology department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

The human brain is structurally and functionally asymmetrical. The asymmetry of mesial temporal lobe epilepsy (MTLE) were not clarified yet. This study analyzed the functional asymmetry of MTLE by comparing the functional connectivity (FC) of the left to the right hemisphere directly. The results showed reduction of asymmetrical areas in MTLE and a different asymmetrical features in left and right MTLE.  The reduced FC asymmetry in MTLE may play an important role in the cognitive impairment of MTLE.  The different asymmetrical features in left and right MTLE may hold the potential for differentiating left from right MTLE. 

Weike Zeng¹, Mengzhu Wang², Xu Yan³, and Guang Yang^4
1Deptpartment of Radiology, SUN YAT-SEN Memorial Hospital, SUN YAT-SEN University, Guangzhou, China, ²MR Scientific Marketing, Siemens Healthcare, Guangzhou, China, ³MR Scientific Marketing, Siemens Healthineers, Shanghai, China, ⁴Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, China

We investigated the clinical feasibility of characterizing brain tissue microstructure in epilepsy with mean apparent propagator (MAP)-MRI, and compared with diffusion tensor imaging (DTI) using whole-brain voxel-based analyses. Results demonstrated that the MAP-MRI microstructural parameters could potentially provide more sensitive clinical biomarkers than conventional DTI techniques due to increased pathophysiological specificity in microstructural changes detection.

Jitender Saini¹, Sarbesh Tiwari², Sanjib Sinha³, Ravindranadh Chowdary M³, and Raghavendra K^3
1Nueroimaging and Interventional Radiology, National Institute of Mental Health and, Bangalore, India, ²Diagnostic and Interventional Radiology, All India Institute of Medical Sciences,, Jodhpur, India, ³Neurology, National Institute of Mental Health and, Bangalore, India

Arterial Spin Labelling (ASL), a non-invasive MR based perfusion technique, has emerged as an excellent method for quantifying brain perfusion and its potential in detecting perfusion changes in drug resistant epilepsy. Our study also demonstrates the perfusion changes in the epileptogenic zone with good concordance with structural MRI and video-EEG findings.

Suk-tak Chan¹, Cora Ordway¹, Ronald J Calvanio², Ferdinando S Buonanno², and Kenneth K Kwong^1
1Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States, ²Neurology, Massachusetts General Hospital, Boston, MA, United States

We used fMRI to map BOLD responses to breath-by-breath O₂-CO₂ exchange ratio (bER) under breath hold protocol for patients with persistent symptoms from mild traumatic brain injury (mTBI). Comparing to controls, reduced cerebrovascular reactivity (CVR) to bER was reported for patients in insula, anterior cingulate, nucleus accumbens and ventral tegmental area, basically regions which overlapped with the dopamine pathway.  The mean resting bER decreased with increased symptom severity indicated by burden scores.  Our findings are consistent with impaired dopamine pathway reported for TBI patients and show the success of using bER to evaluate CVR to breath hold.

Candace C Fleischer^1,2, Jeremy L Smith¹, Maame Owusu-Ansah¹, Selin Ekici¹, Dongsuk Sung², Ojaswa Prasad³, Brandon Mines⁴, and Jason W Allen^1
1Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States, ²Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States, ³Department of Medicine, Philadelphia College of Osteopathic Medicine, Suwanee, GA, United States, ⁴Department of Sports Medicine, Emory University School of Medicine, Atlanta, GA, United States

Sports-related traumatic brain injuries are difficult to diagnose and prognose due to a lack of standardized metrics. Furthermore, there has been limited research on the effects of repeated sub-concussive and sub-clinical injuries over time. In this study, we characterized changes in resting state connectivity and brain metabolites over a season of collegiate basketball in athletes without a diagnosed concussion. We observed significant changes in resting state connectivity and brain metabolites as a function of game time played. No changes in plasma inflammatory markers were observed over time, suggesting that brain changes were not driven by systemic inflammation.

Arun Venkataraman¹, Steven P. Meyers², and Jianhui Zhong^3
1Physics, University of Rochester, Rochester, NY, United States, ²Radiology, University of Rochester, Rochester, NY, United States, ³Imaging Sciences, University of Rochester, Rochester, NY, United States

Diffusion MRI (dMRI)-based studies in Traumatic Brain Injury have elucidated local and global WM alterations after injury. However, no studies have quantified how repeated concussions affect WM microstucture and coherence. We, therefore, sought to udnerstand how the number of previous concussions impact diffusion metrics. We found that, compared to the control group, there were significant decreases in FA and increases in MD and RD in the corticospinal tract. With respect to the number of concussions, we found that FA actually increased and was related with higher uniformity of the fibers. We believe this is related to aberrant remyelination.

SuMing Zhang¹, Xinyu Hu¹, Xuan Bu¹, and Xiaoqi Huang^1
1Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, ChengDu City, China

Many tract-based spatial statistics (TBSS) studies in mild traumatic brain injury (mTBI) have been inconsistent. Meanwhile, there is evidence that trauma type may have an effect on white matter (WM) microstructure in mTBI. We performed a tract-based spatial meta-analysis of mTBI and examined the potential effects of trauma type on regional WM microstructure. Our findings identified the left anterior thalamic radiation and right superior longitudinal fasciculus were the most convergent circuitry affected in mTBI and indicated distinct patterns of anatomical connectivity abnormalities in accident related and sport related mTBI, which highlighted the potential importance of trauma specific alterations in mTBI.

Wen-Tung Wang¹, Dzung Pham¹, and John A Butman^1,2
1Center for Neuroscience and Regenerative Medicine, NIH/USU, Bethesda, MD, United States, ²Radiology and Imaging Sciences, NIH, Bethesda, MD, United States

First-order flow compensation has been widely used in MRI. While it works for visualization of vessels and CSF, the residual flow effects can impact the vessels visualization in some applications, such as minimum intensity projection, which is often used in detecting cerebral microhemorrhages on SWI images. When applying minIP, slight offset of spatial registration, and residual flow dephasing from acceleration and pulsatility can manifest as segments of hypointensities, compounding the difficulties in microhemorrhage detection. By including flow sensitization gradients in SWI sequence to suppress flow signal, dark vessels are delineated at correct spatial locations.

Ben A Duffy¹, Julia Pia Simon¹, Yan Li², Arthur W Toga¹, Wolfgang G Muhlhofer³, Robert C Knowlton², and Hosung Kim^1
1USC Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States, ²UCSF Weill Institute for Neurosciences, San Francisco, CA, United States, ³University of Alabama at Birmingham, Birmingham, AL, United States

The pathophysiology of MRI-negative temporal lobe epilepsy is not well understood. Here, we used a surface-based approach for investigating metabolic changes in the subregions of mesiotemporal structures for MRI-negative TLE patients. We found significant hypometabolism in the anterior to the intermediate hippocampus, the intermediate entorhinal cortex and the centro-medial and laterobasal amygdala. In patients with poor outcome, metabolism tended to be more interhemispherically symmetric in all three regions compared to those with good outcome, which suggests a more complicated seizure origin in this subtype of the disorder.