Jun Sun¹, Yuerong Lizhu¹, Min Guo¹, Siyao Xu¹, Xianchang Zhang², Zhizheng Zhuo¹, and Yaou Liu^1
1Capital Medical Universtiy, Beijing Tiantan Hospital, Beijing, China, ²MR Research Collaboration, Siemens Healthineers Ltd., Beijing, China

Keywords: Neuroinflammation, Neuroinflammation, virtual histology

Motivation: Gray matter (GM) atrophied early in multiple sclerosis (MS), anti-aquaporin-4 antibody-positive [AQP4+] / -negative [AQP4-] neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Their neurobiological underpinnings have not been clarified.

Goal(s): The purpose was to explore their GM atrophy-associated histology using a multicenter cohort.

Approach: 324 MS, 197 AQP4+ NMOSD, 75 AQP4- NMOSD, 47 MOGAD, and 2,169 healthy controls (HCs) were examined by virtual histology method.

Results: The unique virtual histology was glial cells for MS, astrocytes for AQP4+ NMOSD and oligodendrocytes for MOGAD. The neuronal and endothelial cells were shared potential targets.

Impact: It might help to optimize therapy.

Min Guo¹, Zhizheng Zhuo¹, Minghao Wu¹, Jun Sun¹, Yu-Xin Yang², Yunyun Duan¹, and Yaou Liu^1
1Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, ²United Imaging Research Institute of Intelligent Imaging, Beijing, China

Keywords: Neuroinflammation, Genetics

Motivation: Determining the potential transcriptomic signatures driving cortical thinning in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS).

Goal(s): To compare the cortical atrophy patterns and the underlying molecular mechanisms between NMOSD and MS.

Approach: A partial least squares (PLS) regression model was used to associate the CTh alteration profile with the expression of genes from the Allen Human Brain Atlas (AHBA) database, then Metascape analysis was performed to identify the functional biological processes.

Results: Distinct cortical atrophy patterns and underlying cell signaling pathways were observed in NMOSD and MS.

Impact: The distinct cortical atrophy patterns will help in differential diagnosis of NOMOSD and MS. The identified genes and signaling pathways will help understand the pathological mechanism of both diseases and provide potential therapeutic targets.  

Kosei Hirata^1,2, Kiwamu Matsuoka¹, Kenji Tagai¹, Hironobu Endo¹, Harutsugu Tatebe¹, Maiko Ono¹, Naomi Kokubo¹, Yuko Kataoka¹, Asaka Oyama¹, Hitoshi Shinoto¹, Keisuke Takahata¹, Takayuki Obata¹, Masoumeh Dehghani³, Jamie Near^3,4, Kazunari Kawamura¹, Ming-Rong Zhang¹, Hitoshi Shimada^1,5, Hiroshi Shimizu⁵, Hiroshi Shimizu⁵, Takanori Yokota², Takahiko Tokuda¹, Makoto Higuchi¹, and Yuhei Takado^1
1National Institutes for Quantum Science and Technology, Chiba, Japan, ²Tokyo Medical and Dental University, Tokyo, Japan, ³Sunnybrook Research Institute, Tronto, ON, Canada, ⁴University of Toronto, Tronto, ON, Canada, ⁵Niigata University, Niigata, Japan

Keywords: Dementia, Neuro, magnetic resonance spectroscopy, progressive supranuclear palsy, astrocyte reactivity

Motivation: Although astrocytic pathology is a pathological hallmark of progressive supranuclear palsy (PSP), the role of astrocytes in the pathophysiology of PSP is not fully understood.

Goal(s): This study aimed to evaluate astrocyte reactivity in vivo in patients with PSP.

Approach: Astrocyte reactivity was assessed by magnetic resonance spectroscopy and plasma biomarkers, which were verified via tau-PET and histopathological analysis.

Results: Our results suggest that, in the anterior cingulate cortex, astrocyte reactivity precedes pronounced tau deposition and neurodegenerative processes and modulates brain function in PSP. Elevated myo-inositol was associated with high lactate levels, suggesting a link between reactive astrocytes and brain energy metabolism changes.

Impact: This study assessed astrocyte reactivity in vivo using magnetic resonance spectroscopy and plasma biomarkers, providing insights into the involvement of astrocytes in the pathogenesis of progressive supranuclear palsy.

Hyeong-Geol Shin^1,2, Woojun Kim³, Hyun-soo Lee⁴, Jiwoong Kim⁵, Yoonho Nam⁶, Xu Li^1,2, Peter van Zijl^1,2, Jongho Lee⁷, and Jinhee Jang^8
1Radiology, Johns Hopkins University, Baltimore, MD, United States, ²Kennedy Krieger Institute, Baltimore, MD, United States, ³Neurology, Seoul St. Mary's Hospital, Seoul, Korea, Republic of, ⁴Siemens Healthineers, Seoul, Korea, Republic of, ⁵Mathematics and Statistics, University of South Florida, Tampa, FL, United States, ⁶Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Korea, Republic of, ⁷Electrical and Computer Engineering, Seoul National University, Seoul, Korea, Republic of, ⁸Radiology, Seoul St. Mary's Hospital, Seoul, Korea, Republic of

Keywords: Multiple Sclerosis, Multiple Sclerosis, 𝜒-separation

Motivation: In multiple sclerosis (MS) lesion, factors influencing myelin dynamics and future remyelination are under active investigation.

Goal(s): To assess dynamic changes of MS lesions from their early stage and explore the factors related to their future remyelination outcomes.

Approach: Longitudinal changes of MRI phenotypes in MS lesions were assessed from their early stage, particularly focusing on longitudinal alternations in diamagnetic myelin and paramagnetic iron signals using susceptibility source-separation (chi[𝜒]-separation).
.

Results: 26 lesions show remyelination and 36 did not. The hyperintensity in paramagnetic iron signal (hyper-paramagnetic sign, HPS) at early stage of lesion development was significantly associated to future remyelination. 

Impact: Iron deposition sign in early-stage MS lesion, which detected by added sensitivity of 𝜒-separation to iron and myelin, can offer potential imaging marker for the impaired remyelination capability in MS pathology.

Alessandro Cagol^1,2,3,4, Mario Ocampo-Pineda^1,2,3, Batuhan Ayci^1,5, Pascal Benkert⁶, Po-Jui Lu^1,2,3, Matthias Weigel^1,2,3,7, Lester Melie-Garcia^1,2,3, Xinjie Chen^1,2,3, Antoine Lutti⁸, Thanh D. Nguyen⁹, Yi Wang⁹, Jongho Lee¹⁰, Jens Kuhle^2,3, Ludwig Kappos^1,2,3, Maria Pia Sormani⁴, and Cristina Granziera^1,2,3
1Translational Imaging in Neurology (ThINk) Basel, Department of Biomedical Engineering, University Hospital Basel and University of Basel, Basel, Switzerland, ²Department of Neurology, University Hospital Basel, Basel, Switzerland, ³Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland, ⁴Department of Health Sciences, University of Genova, Genova, Italy, ⁵Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey, ⁶Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland, ⁷Division of Radiological Physics, Department of Radiology, University Hospital Basel, Basel, Switzerland, ⁸Laboratory for Research in Neuroimaging, Department of Clinical Neuroscience, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland, ⁹Department of Radiology, Weill Cornell Medical College, New York, NY, United States, ¹⁰Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea, Republic of

Keywords: Multiple Sclerosis, Multiple Sclerosis, Paramagnetic rim lesions; quantitative MRI

Motivation: Paramagnetic rim lesions (PRLs), a subset of chronic active lesions identifiable through susceptibility-based imaging, are linked to insidious disease progression in multiple sclerosis (MS). However, data on local microstructural changes in PRLs remain limited.
 

Goal(s): To comprehensively characterize pathological alterations within PRLs and the surrounding perilesional tissue.
 

Approach: Employing multiparametric quantitative 3T MRI on 175 people with MS, we obtained contrasts sensitive to tissue microstructural damage.
 

Results: PRLs exhibited more pronounced pathological alterations compared to other white matter lesions, displaying enhanced demyelination, neuro-axonal loss, and iron accumulation. Remarkably, these alterations extended into the perilesional tissue appearing normal on conventional MRI.
 

Impact: In people with multiple sclerosis, paramagnetic rim lesions (PRLs) exhibit pronounced microstructural quantitative MRI alterations. This strengthens PRLs as reliable biomarkers for lesions with smoldering degenerative activity, and offers potential insights into their association with a more severe disease course.

Yan Xie¹ and Wenzhen Zhu^1
1Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Keywords: Multiple Sclerosis, Multiple Sclerosis

Motivation: Multiple sclerosis (MS) lesions with different pathologic conditions could be distinguished by MRI. There may be differences in oxygen metabolism in different types of lesions.

Goal(s): To explore the oxygen metabolism of different types of lesions in MS patients by oxygen extraction fraction (OEF) both cross-sectionally and longitudinally.

Approach: The OEF map was reconstructed from a 3D multi-echo gradient echo scan. White matter lesions were classified into four types based on contrast-enhanced T1WI and quantitative susceptibility mapping.

Results: There were differences in OEF among different types of MS lesions. The OEF in the lesion and the lesion type may change as time progresses.

Impact: This study revealed tissue damage and oxygen metabolism level in different types of MS lesions. The OEF may contribute to further understanding of the pathological mechanisms in MS lesion evolution.

Dejun She¹, Yalan Yan¹, Xiance Zhao², and Dairong Cao^1
1The First Affiliated Hospital of Fujian Medical University, Fuzhou, China, ²Philips Healthcare, Shanghai, China, Shanghai, China

Keywords: Neuroinflammation, Neuroinflammation

Motivation: Despite the crucial role of imaging in localizing lesions, excluding causes, and guiding surgery, there remains a paucity of reports pertaining to the radiological manifestations in patients with herpetic neuralgia.

Goal(s): To investigate the correlation between the volume and T2 signal intensity (SI) of the ganglia in 3T MRN with clinical and serological parameters in herpetic neuralgia patients.

Approach: With 18 patients examined by MRN. Volume, T2 signal measurements of the T1-T12 ganglia were performed manually for each patient.

Results: The changes in ganglion volume observed on MRN may reflect disease progression. Among all serological indicators, ESR was correlated with the volume ratio.

Impact: This study is the first to quantify ganglia in herpetic neuralgia patients, and the first to investigate the correlation between ganglia volume and serological data. In herpetic neuralgia patients, these MRN findings will contribute to the diagnosis and management.

Ai Guo¹, Zhe Zhang¹, Ge-Hong Dong¹, Yuan Li², Lei Su³, Chenyang Gao³, Mengting Zhang¹, Xiaoyu Shi¹, Huabing Wang¹, Xinghu Zhang¹, De-Hong Lu¹, Ying Fu⁴, Jing Jing¹, Fu-Dong Shi¹, and De-cai Tian^1
1Beijing Tiantan Hospital, Beijing, China, ²MR research collaboration team, siemens healthineers, Beijing, China, ³Tianjin General Hospital, Tianjin, China, ⁴The First Affiliated Hospital of Fujian Medical University, Fuzhou, China

Keywords: Neuroinflammation, Neuroinflammation

Motivation: PACNS entails a biopsy for diagnosis, but only with an intermediate sensitivity.  It is necessary to revisit PACNS with advanced imaging technique to provide a non-invasive diagnostic standard. 

Goal(s): We aim to find more pathological details with enough sensitivity and specificity to provide potential biomarkers for PACNS.   

Approach: 21 patients with small-vessel PACNS were included in this study. T1-MPRAGE, T2 T2*W, and SWI images were collected.

Results: Our study highlighted the image features of patients with small-vessel PACNS with coral-like signs through 7T MRI. Due to the small patient cohort, no specific clinical differences between hemorrhagic and non-hemorrhagic patients were found.

Impact: The signal characteristics of the coral-like sign represent cerebral cortical microhemorrhages with atrophy, which could be an important MRI pattern of small-vessel PACNS.

Eleonora Lupi¹, Marta Gaviraghi¹, Elena Grosso¹, Anita Monteverdi², Marco Battiston³, Francesco Grussu^3,4, Baris Kanber^3,5, Ferran Prados Carrasco^3,5,6, Janine Makaronidis^7,8, Rebecca S Samson³, Marios C Yiannakas³, Egidio D’Angelo^1,2, Fulvia Palesi^1,2, and Claudia A. M. Gandini Wheeler-Kingshott^1,2,3
1Department of Brain & Behavioral Sciences, University of Pavia, Pavia, Italy, ²Digital Neuroscience Centre, IRCCS Mondino Foundation, Pavia, Italy, ³NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom, ⁴Radiomics Group, Vall d’Hebron Institute of Oncology, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain, ⁵Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom, ⁶E-Health Center, Universitat Oberta de Catalunya, Barcelona, Spain, ⁷Centre for Obesity Research, Department of Medicine, University College London, London, United Kingdom, ⁸National Institute of Health Research, UCLH Biomedical Research Centre, London, United Kingdom

Keywords: White Matter, COVID-19, Neuroinflammation, Voxel Based Analysis, g-ratio

Motivation: Voxel Based Analysis (VBA) can be a powerful tool to detect localized alterations. 

Goal(s): Here VBA was used to understand the underpinnings of COVID-19-related anosmia. 

Approach: Quantitative magnetization transfer and diffusion-weighted imaging derived maps were used to detect pathological changes affecting white matter structures. 

Results: Microstructural differences were detected between healthy controls and subjects experiencing anosmia or those who recovered from it. Results highlighted the presence of widespread inflammation in persistent anosmia subjects, with myelin damage and possible repair in those who recovered. Myelin alterations involved the olfactory circuit, as well as other brain regions, providing insights into possible mechanisms of COVID-19-related anosmia. 

Impact: Voxel Based Analysis is a powerful tool to highlight local tissue disruption linked to neuroinflammatory processes. Here VBA provided an insight into microstructure and myelin changes associated to COVID-19-related persistent or recovered anosmia symptoms. 

Anja van der Kolk