Identifying the joint signature of brain atrophy and gene variant scores in Alzheimer's Disease.

The joint modeling of genetic data and brain imaging information allows for determining the pathophysiological pathways of neurodegenerative diseases such as Alzheimer's disease (AD). This task has typically been approached using mass-univariate methods that rely on a complete set of Single Nucleotide Polymorphisms (SNPs) to assess their association with selected image-derived phenotypes (IDPs). However, such methods are prone to multiple comparisons bias and, most importantly, fail to account for potential cross-feature interactions, resulting in insufficient detection of significant associations. Ways to overcome these limitations while reducing the number of traits aim at conveying genetic information at the gene level and capturing the integrated genetic effects of a set of genetic variants, rather than looking at each SNP individually. Their associations with brain IDPs are still largely unexplored in the current literature, though they can uncover new potential genetic determinants for brain modulations in the AD continuum. In this work, we explored an explainable multivariate model to analyze the genetic basis of the grey matter modulations, relying on the AD Neuroimaging Initiative (ADNI) phase 3 dataset. Cortical thicknesses and subcortical volumes derived from T1-weighted Magnetic Resonance were considered to describe the imaging phenotypes. At the same time the genetic counterpart was represented by gene variant scores extracted by the Sequence Kernel Association Test (SKAT) filtering model. Moreover, transcriptomic analysis was carried on to assess the expression of the resulting genes in the main brain structures as a form of validation. Results highlighted meaningful genotype-phenotype interactionsas defined by three latent components showing a significant difference in the projection scores between patients and controls. Among the significant associations, the model highlighted EPHX1 and BCAS1 gene variant scores involved in neurodegenerative and myelination processes, hence relevant for AD. In particular, the first was associated with decreased subcortical volumes and the second with decreasedtemporal lobe thickness. Noteworthy, BCAS1 is particularly expressed in the dentate gyrus. Overall, the proposed approach allowed capturing genotype-phenotype interactions in a restricted study cohort that was confirmed by transcriptomic analysis, offering insights into the underlying mechanisms of neurodegeneration in AD in line with previous findings and suggesting new potential disease biomarkers.

Unraveling the MRI-Based Microstructural Signatures Behind Primary Progressive and Relapsing-Remitting Multiple Sclerosis Phenotypes.

BACKGROUND: The mechanisms driving primary progressive and relapsing-remitting multiple sclerosis (PPMS/RRMS) phenotypes are unknown. Magnetic resonance imaging (MRI) studies support the involvement of gray matter (GM) in the degeneration, highlighting its damage as an early feature of both phenotypes. However, the role of GM microstructure is unclear, calling for new methods for its decryption. PURPOSE: To investigate the morphometric and microstructural GM differences between PPMS and RRMS to characterize GM tissue degeneration using MRI. STUDY TYPE: Prospective cross-sectional study. SUBJECTS: Forty-five PPMS (26 females) and 45 RRMS (32 females) patients. FIELD STRENGTH/SEQUENCE: 3T scanner. Three-dimensional (3D) fast field echo T1-weighted (T1-w), 3D turbo spin echo (TSE) T2-w, 3D TSE fluid-attenuated inversion recovery, and spin echo-echo planar imaging diffusion MRI (dMRI). ASSESSMENT: T1-w and dMRI data were employed for providing information about morphometric and microstructural features, respectively. For dMRI, both diffusion tensor imaging and 3D simple harmonics oscillator based reconstruction and estimation models were used for feature extraction from a predefined set of regions. A support vector machine (SVM) was used to perform patients' classification relying on all these measures. STATISTICAL TESTS: Differences between MS phenotypes were investigated using the analysis of covariance and statistical tests (P < 0.05 was considered statistically significant). RESULTS: All the dMRI indices showed significant microstructural alterations between the considered MS phenotypes, for example, the mode and the median of the return to the plane probability in the hippocampus. Conversely, thalamic volume was the only morphometric feature significantly different between the two MS groups. Ten of the 12 features retained by the selection process as discriminative across the two MS groups regarded the hippocampus. The SVM classifier using these selected features reached an accuracy of 70% and a precision of 69%. DATA CONCLUSION: We provided evidence in support of the ability of dMRI to discriminate between PPMS and RRMS, as well as highlight the central role of the hippocampus. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 3.

Microstructural MRI Correlates of Cognitive Impairment in Multiple Sclerosis: The Role of Deep Gray Matter.

Although cognitive impairment (CI) is frequently observed in people with multiple sclerosis (pwMS), its pathogenesis is still controversial. Conflicting results emerged concerning the role of microstructural gray matter (GM) damage especially when involving the deep GM structures. In this study, we aimed at evaluating whether differences in cortical and deep GM structures between apparently cognitively normal (ACN) and CI pwMS (36 subjects in total) are present, using an extensive set of diffusion MRI (dMRI) indices and conventional morphometry measures. The results revealed increased anisotropy and restriction over several deep GM structures in CI compared with ACN pwMS, while no changes in volume were present in the same areas. Conversely, reduced anisotropy/restriction values were detected in cortical regions, mostly the pericalcarine cortex and precuneus, combined with reduced thickness of the superior frontal gyrus and insula. Most of the dMRI metrics but none of the morphometric indices correlated with the Symbol Digit Modality Test. These results suggest that deep GM microstructural damage can be a strong anatomical substrate of CI in pwMS and might allow identifying pwMS at higher risk of developing CI.

Monte Carlo Simulations of Water Exchange Through Myelin Wraps: Implications for Diffusion MRI.

Diffusion magnetic resonance imaging (dMRI) yields parameters sensitive to brain tissue microstructure. A structurally important aspect of this microstructure is the myelin wrapping around the axons. This paper investigated the forward problem concerning whether water exchange via the spiraling structure of the myelin can meaningfully contribute to the signal in dMRI. Monte Carlo simulations were performed in a system with intra-axonal, myelin, and extra-axonal compartments. Diffusion in the myelin was simulated as a spiral wrapping the axon, with a custom number of wraps. Exchange (or intra-axonal residence) times were analyzed for various number of wraps and axon diameters. Pulsed gradient sequences were employed to simulate the dMRI signal, which was analyzed using different methods. Diffusional kurtosis imaging analysis yielded the radial diffusivity (RD) and radial kurtosis (RK), while the two-compartment Kärger model yielded estimates the intra-axonal volume fraction ( ν ic ) and exchange time ( τ ). Results showed that τ was on the sub-second level for geometries with axon diameters below 1.0 µ m and less than eight wraps. Otherwise, exchange was negligible compared to typical experimental durations, with τ of seconds or longer. In situations where exchange influenced the signal, estimates of RK and ν ic increased with the number of wraps, while RD decreased. τ estimates from simulated signals were in agreement with predicted ones. In conclusion, exchange through spiraling myelin permits sub-second τ for small diameters and low number of wraps. Such conditions may arise in the developing brain or in neurodegenerative disease, and thus the results could aid the interpretation of dMRI studies.

On the Viability of Diffusion MRI-Based Microstructural Biomarkers in Ischemic Stroke.

Recent tract-based analyses provided evidence for the exploitability of 3D-SHORE microstructural descriptors derived from diffusion MRI (dMRI) in revealing white matter (WM) plasticity. In this work, we focused on the main open issues left: (1) the comparative analysis with respect to classical tensor-derived indices, i.e., Fractional Anisotropy (FA) and Mean Diffusivity (MD); and (2) the ability to detect plasticity processes in gray matter (GM). Although signal modeling in GM is still largely unexplored, we investigated their sensibility to stroke-induced microstructural modifications occurring in the contralateral hemisphere. A more complete picture could provide hints for investigating the interplay of GM and WM modulations. Ten stroke patients and ten age/gender-matched healthy controls were enrolled in the study and underwent diffusion spectrum imaging (DSI). Acquisitions at three and two time points (tp) were performed on patients and controls, respectively. For all subjects and acquisitions, FA and MD were computed along with 3D-SHORE-based indices [Generalized Fractional Anisotropy (GFA), Propagator Anisotropy (PA), Return To the Axis Probability (RTAP), Return To the Plane Probability (RTPP), and Mean Square Displacement (MSD)]. Tract-based analysis involving the cortical, subcortical and transcallosal motor networks and region-based analysis in GM were successively performed, focusing on the contralateral hemisphere to the stroke. Reproducibility of all the indices on both WM and GM was quantitatively proved on controls. For tract-based, longitudinal group analyses revealed the highest significant differences across the subcortical and transcallosal networks for all the indices. The optimal regression model for predicting the clinical motor outcome at tp3 included GFA, PA, RTPP, and MSD in the subcortical network in combination with the main clinical information at baseline. Region-based analysis in the contralateral GM highlighted the ability of anisotropy indices in discriminating between groups mainly at tp1, while diffusivity indices appeared to be altered at tp2. 3D-SHORE indices proved to be suitable in probing plasticity in both WM and GM, further confirming their viability as a novel family of biomarkers in ischemic stroke in WM and revealing their potential exploitability in GM. Their combination with tensor-derived indices can provide more detailed insights of the different tissue modulations related to stroke pathology.

Ensemble average propagator-based detection of microstructural alterations after stroke.

PURPOSE: New analytical reconstruction techniques of diffusion weighted signal have been proposed. A previous work evidenced the exploitability of some indices derived from the simple harmonic oscillator-based reconstruction and estimation (3D-SHORE) model as numerical biomarkers of neural plasticity after stroke. Here, the analysis is extended to two additional indices: return to the plane/origin (RTPP/RTOP) probabilities. Moreover, several motor networks were introduced and the results were analyzed at different time scales. METHODS: Ten patients underwent three diffusion spectrum imaging (DSI) scans [1 week (tp1), 1 month (tp2) and 6 months (tp3) after stroke]. Ten matched controls underwent two DSI scans 1 month apart. 3D-SHORE was used for reconstructing the signal and the microstructural indices were derived. Tract-based analysis was performed along motor cortical, subcortical and transcallosal networks in the contralesional area. RESULTS: The optimal intra-class correlation coefficient (ICC) was obtained in the subcortical loop for propagator anisotropy (ICC [Formula: see text] 0.96), followed by generalized fractional anisotropy (ICC [Formula: see text] 0.94). The new indices reached the highest stability in the transcallosal network and performed well in the cortical and subcortical networks with the exception of RTOP in the cortical loop (ICC [Formula: see text] 0.59). They allowed discriminating patients from controls at the majority of the timescales. Finally, the regression model using indices calculated along the subcortical loop at tp1 resulted in the best prediction of clinical outcome. CONCLUSIONS: The whole set of microstructural indices provide measurements featuring high precision. The new indices allow discriminating patients from controls in all networks, except for RTPP in the cortical loop. Moreover, the 3D-SHORE indices in subcortical connections constitute a good regression model for predicting the clinical outcome at 6 months, supporting their suitability as numerical biomarkers for neuronal plasticity after stroke.

What lies beneath? Diffusion EAP-based study of brain tissue microstructure.

Diffusion weighted magnetic resonance signals convey information about tissue microstructure and cytoarchitecture. In the last years, many models have been proposed for recovering the diffusion signal and extracting information to constitute new families of numerical indices. Two main categories of reconstruction models can be identified in diffusion magnetic resonance imaging (DMRI): ensemble average propagator (EAP) models and compartmental models. From both, descriptors can be derived for elucidating the underlying microstructural architecture. While compartmental models indices directly quantify the fraction of different cell compartments in each voxel, EAP-derived indices are only a derivative measure and the effect of the different microstructural configurations on the indices is still unclear. In this paper, we analyze three EAP indices calculated using the 3D Simple Harmonic Oscillator based Reconstruction and Estimation (3D-SHORE) model and estimate their changes with respect to the principal microstructural configurations. We take advantage of the state of the art simulations to quantify the variations of the indices with the simulation parameters. Analysis of in-vivo data correlates the EAP indices with the microstructural parameters obtained from the Neurite Orientation Dispersion and Density Imaging (NODDI) model as a pseudo ground truth for brain data. Results show that the EAP derived indices convey information on the tissue microstructure and that their combined values directly reflect the configuration of the different compartments in each voxel.