Format

Send to:

Choose Destination
See comment in PubMed Commons below
Neuroimage Clin. 2014 Jan 31;4:426-35. doi: 10.1016/j.nicl.2014.01.011. eCollection 2014.

Application of quantitative DTI metrics in sporadic CJD.

Author information

  • 1Department of Neurology, University of California, San Francisco (UCSF), San Francisco, CA, USA ; Department of Neuroradiology, C. Mondino National Neurological Institute, Pavia. University of Pavia, Italy.
  • 2Department of Neurology, University of California, San Francisco (UCSF), San Francisco, CA, USA ; Graduate Group in Bioengineering, UCSF, San Francisco, CA, USA ; Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
  • 3Brain MRI 3T Mondino Research Center C. Mondino National Neurological Institute, Pavia, Italy.
  • 4Department of Neurology, University of California, San Francisco (UCSF), San Francisco, CA, USA.
  • 5Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA.
  • 6Department of Neuroradiology, C. Mondino National Neurological Institute, Pavia. University of Pavia, Italy.
  • 7Institute for Neurodegenerative Diseases, University of California, San Francisco (UCSF), USA ; Department of Pathology, University of California, San Francisco (UCSF), USA.
  • 8Memory and Aging Center, Department of Neurology, University of California, San Francisco, (UCSF), USA.

Abstract

Diffusion Weighted Imaging is extremely important for the diagnosis of probable sporadic Jakob-Creutzfeldt disease, the most common human prion disease. Although visual assessment of DWI MRI is critical diagnostically, a more objective, quantifiable approach might more precisely identify the precise pattern of brain involvement. Furthermore, a quantitative, systematic tracking of MRI changes occurring over time might provide insights regarding the underlying histopathological mechanisms of human prion disease and provide information useful for clinical trials. The purposes of this study were: 1) to describe quantitatively the average cross-sectional pattern of reduced mean diffusivity, fractional anisotropy, atrophy and T1 relaxation in the gray matter (GM) in sporadic Jakob-Creutzfeldt disease, 2) to study changes in mean diffusivity and atrophy over time and 3) to explore their relationship with clinical scales. Twenty-six sporadic Jakob-Creutzfeldt disease and nine control subjects had MRIs on the same scanner; seven sCJD subjects had a second scan after approximately two months. Cortical and subcortical gray matter regions were parcellated with Freesurfer. Average cortical thickness (or subcortical volume), T1-relaxiation and mean diffusivity from co-registered diffusion maps were calculated in each region for each subject. Quantitatively on cross-sectional analysis, certain brain regions were preferentially affected by reduced mean diffusivity (parietal, temporal lobes, posterior cingulate, thalamus and deep nuclei), but with relative sparing of the frontal and occipital lobes. Serial imaging, surprisingly showed that mean diffusivity did not have a linear or unidirectional reduction over time, but tended to decrease initially and then reverse and increase towards normalization. Furthermore, there was a strong correlation between worsening of patient clinical function (based on modified Barthel score) and increasing mean diffusivity.

KEYWORDS:

Atrophy; Creutzfeldt–Jakob disease; DWI; MD; Prion disease; sCJD

PMID:
24624328
[PubMed - in process]
PMCID:
PMC3950558
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science Icon for PubMed Central
    Loading ...
    Write to the Help Desk