Multi-Modality, Quantitative MRI to Assess the Human Optic Nerve in vivo

多模态定量 MRI 评估体内人类视神经

• 批准号: 8266270
• 负责人: Seth A Smith
• 金额: $ 13.3万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-19 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8266270
• 关键词: Anisotropy; Area; Biological Markers; Brain; Clinic; Clinical; Data; Diagnosis; Diffusion; Diffusion Magnetic Resonance Imaging; Etiology; Evaluation; Evolution; Functional disorder; Goals; Human; Image; Inflammation; Legal patent; Magnetic Resonance Imaging; Magnetism; Maxillary Sinus; Measures; Methodology; Methods; Metric; Microscopic; Modality; Morphologic artifacts; Motion; Myelin; Optic Nerve; Optic Neuritis; Optical Coherence Tomography; Pathology; Patients; Predisposition; Recording of previous events; Reproducibility; Resolution; Scheme; Sensitivity and Specificity; Staging; Structure; Symptoms; Thick; Time; Tissues; Visual; Visual Acuity; base; effective therapy; healthy volunteer; in vivo; retinal nerve fiber layer

DESCRIPTION (provided by applicant): Optic Neuritis, marked by idiopathic, sudden inflammation of the optic nerve (ON), is the most commonly presenting symptom of MS. An estimated 50% of MS patients have a history of optic neuritis, which often resolves with time, and there are no effective treatments. However, its mere presence can be a signature of the early stages of MS, which, even with resolved clinical symptoms, could represent devastating axonal and myelin pathology. Our first hypothesis is that assessment of the optic nerve using MRI methods sensitive to axonal and myelin integrity can provide quantitative information about microscopic tissue changes in the ON of patients with MS. Our second hypothesis is that these metrics can be related to measures of the retinal nerve fiber layer (optical coherence tomography [OCT]) thickness, and visual dysfunction (low contrast visual acuity). Our overall goal is to devise and validate a multi-modality, myelin and axonal sensitive set of MR metrics for routine application in the clinic to study overt and silent ON damage in MS patients with and without history of optic neuritis. To accomplish our goal, we have set the following specific Aims. Aim 1: To develop Diffusion Tensor Imaging (DTI) and Magnetization Transfer (MT) imaging for the ON, a structure whose size, constant motion and proximity to the maxillary sinuses (increased magnetic susceptibility artifacts) has hampered DTI and MT methods. The reproducibility of the derived DTI and MT metrics will be assessed in healthy controls. Aim 2: To assess the ability of the DTI and MT schemes to detect pathology in patients with MS who have history of optic neuritis. Patient data will be compared with the healthy volunteer data obtained in AIM 1, and the sensitivity and specificity for ON damage will be assessed. Aim 3: To relate MT and DTI-derived metrics of the ON in MS patents with and without history of optic neuritis to 1) retinal nerve fiber layer thickness as determined by OCT and 2) low-contrast visual acuity assessed in the clinic. RELEVANCE: It is known that 17-20% of patients who present with optic neuritis eventually develop MS. The relevance is that quantitative diffusion and magnetization transfer MRI evaluation of the microstructure of the optic nerve (ON) in MS with or without history of optic neuritis may provide an earlier biomarker for MS and the evolution of MS. These methods should be applicable to other ON pathologies, and other difficult CNS tissues outside the brain.

描述（由申请人提供）：视神经炎，以视神经（ON）特发性、突发性炎症为特征，是多发性硬化症最常见的症状。据估计，50% 的多发性硬化症患者有视神经炎病史，这种病通常会随着时间的推移而消退，并且没有有效的治疗方法。然而，它的存在可能是多发性硬化症早期阶段的标志，即使临床症状得到缓解，也可能代表破坏性的轴突和髓磷脂病理。我们的第一个假设是，使用对轴突和髓磷脂完整性敏感的 MRI 方法评估视神经可以提供有关多发性硬化症患者视神经的微观组织变化的定量信息。我们的第二个假设是，这些指标可能与视网膜神经纤维层（光学相干断层扫描 [OCT]）厚度和视觉功能障碍（低对比度视力）的测量有关。我们的总体目标是设计和验证一套多模态、髓磷脂和轴突敏感的 MR 指标，用于临床常规应用，以研究有或无视神经炎病史的多发性硬化症患者的明显和无症状视神经损伤。为了实现我们的目标，我们制定了以下具体目标。目标 1：开发用于 ON 的扩散张量成像 (DTI) 和磁化转移 (MT) 成像，ON 是一种结构，其尺寸、持续运动和靠近上颌窦（磁化率伪影增加）阻碍了 DTI 和 MT 方法。所得出的 DTI 和 MT 指标的再现性将在健康对照中进行评估。目标 2：评估 DTI 和 MT 方案检测有视神经炎病史的多发性硬化症患者病理的能力。将患者数据与 AIM 1 中获得的健康志愿者数据进行比较，并评估 ON 损伤的敏感性和特异性。目标 3：将有或无视神经炎病史的 MS 患者中 ON 的 MT 和 DTI 衍生指标与 1) OCT 测定的视网膜神经纤维层厚度和 2) 临床评估的低对比度视力相关联。 关联： 据了解，17-20% 的视神经炎患者最终会发展为多发性硬化症。相关性在于定量扩散和磁化转移 MRI 评估视神经的微观结构 (ON) 在有或没有视神经炎病史的 MS 中可能为 MS 和 MS 的演变提供早期生物标志物。这些方法应该适用于其他 ON 病理，以及脑外其他困难的 CNS 组织。