ISMRM23 - Neuroinflammation: Basics, Biomarkers, Mechanisms & Implications for Neuroimaging

ISMRM & ISMRT Annual Meeting & Exhibition • 03-08 June 2023 • Toronto, ON, Canada

Neuroinflammation: Basics, Biomarkers, Mechanisms & Implications for Neuroimaging

Weekend Course

ORGANIZERS: Seena Dehkharghani, Christin Sander

Sunday, 04 June 2023

701A

07:45 - 11:45

Moderators: Myriam Chaumeil & Zahi Fayad

Skill Level: Intermediate

Session Number: WE-17

CME Credit

Session Number: WE-17

Overview
Inflammatory cascades of the neurologic system represent complex and interrelated pathways necessary for brain health, and include critical adaptations and host defenses against environmental risks. As with systemic inflammatory processes, however, neuroinflammation can produce or potentiate neurologic injury when dysregulated. Most characteristically in a variety of autoimmune or post- and parainfectious disorders, this process represents derangements of normal neuroinflammation.

The emergence, in recent years, of studies identifying neuroinflammation accompanying myriad of other neurologic disorders has broadened recognition of its role in central nervous system pathology, producing rapidly expanding mechanistic insights, biomarkers, and treatment targets. This session aims to synthesize the broad role of neuroinflammation in physiologic and pathologic contexts.

Target Audience
Clinicians and scientists interested in the fundamentals of neuroinflammation, including an introduction to the biological lexicon, mechanisms, pathways, and pharmacological interventions relevant to the rapidly expanding field of imaging of neuroinflammation. Following an initial review of fundamental principles, the role of inflammatory and immunologic derangements in various neurological disorders will be discussed, and the development and application of neuroimaging biomarkers for preclinical and clinical use, including MRI- and PET-based techniques, will be reviewed.

Educational Objectives
As a result of attending this course, participants should be able to:
- Explain the fundamental biological processes, cascades, and mechanisms of neuroinflammation;
- Discuss the specific influence of neuroimmunologic derangements in varying disease processes affecting the nervous system; and
- Review of role of imaging biomarkers in MRI and molecular techniques in pre-clinical and clinical trials and clinical practice.

07:45		Fundamentals of Neuroinflammation & Immunologic Mechanisms in Neurobiology View Presentation Video John Chen Keywords: Neuro: Nervous system, Neuro: Neurodegeneration, Neuro: Brain Neuroinflammation is a key immune response observed in many neurological and neurodegenerative diseases. While an appropriate immune response can be beneficial, aberrant activation of this response recruits excessive proinflammatory cells to cause damage. Thus, neuroinflammation can exert damaging as well as beneficial effects depending on the context. This talk will provide a broad overview of neuroinflammation and describe its unique aspects. Key immune cells and factors in mediating neuroinflammation will be introduced followed by a discussion of clinical and emerging biomarkers for neuroinflammation, including an imaging method to differentiate damaging and reparative neuroinflammatory responses in vivo by MRI.
08:15		Inflammatory Basis of Neurological Diseases I: Autoimmune & Primary Inflammatory/Infectious Disorders View Presentation Video Pascal Sati
08:45		Inflammatory Basis of Neurological Diseases II: Cerebrovascular, Neurodegenerative & Neuropsychiatric Disorders View Presentation Video Sara Martinez de Lizarrondo Keywords: Neuro: Cerebrovascular, Cross-organ: Inflammation, Contrast mechanisms: Molecular imaging Inflammation is a hallmark of most neurological disorders. Following perturbation of the homeostasis of the central nervous system, both innate and adaptive immune systems are at play to limit the extent of diseases and mediate repair and regeneration. Yet, abnormal activation of the immune system in the brain can worsen brain damages and influence cognitive functions. The pathophysiological mechanisms driving neuroinflammation in the context of cerebrovascular, neurodegenerative, and neuropsychiatric disorders are similar and offer interesting biomarkers for imaging.
09:15		Break & Meet the Teachers
09:45		Clinical Trials & Practice: PET: Present & Future View Presentation Video Steven Baete Keywords: Neuro: Brain Receptor PET imaging allows for unparalleled insights in the physiological and metabolic processes of neuroinflammation. PET radioligands targeting TSPO are the most developed and their utility has been shown in literature in a wide range of neurodegenerative and psychiatric diseases. More recently, a number of promising PET radioligands for alternative inflammation targets are being developed. When interpreting receptor PET imaging, caution is needed in carefully considering appropriate modeling approaches and distribution and expression of target receptors in the pathology of interest.
10:15		Clinical Trials & Practice: MRI: Present & Future View Presentation Video Maxime Gauberti Keywords: Contrast mechanisms: Molecular Imaging MRI of neuroinflammation currently relies on two main imaging features: edema and blood brain barrier leakage. Unfortunately, they are not specific for inflammation and the diagnosis of inflammatory lesions of the central nervous system can be challenging. New imaging biomarkers have been described such as the paramagnetic rim sign in multiple sclerosis, that improve imaging specificity but remain only applicable to a subset of neuroinflammatory diseases. More recently, there have been striking progresses in preclinical molecular MRI including the development of highly sensitive and specific contrast agents targeting the inflamed neurovascular unit with potential for clinical translation.
10:45		Panel Discussion
11:15		Break & Meet the Teachers