No description available.

Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 146-157).

Magnetic resonance imaging is an essential tool for assessing soft tissues. The desire for increased signal-to-noise and improved tissue contrast has spurred development of imaging systems operating at magnetic fields exceeding 3.0 Tesla (T). Unfortunately, traditional imaging methods are of limited utility on these systems. Novel imaging methods are required to exploit the potential of high field systems and enable innovative clinical studies. This thesis presents methodological advances for human brain imaging at 4.7 T. These methods are applied to assess sub-cortical gray matter in multiple sclerosis (MS) patients. Safety concerns regarding energy deposition in the patient precludes the use of traditional fast spin echo (FSE) imaging at 4.7 T. Reduced and variable refocusing angles were employed to effectively moderate this energy deposition while maintaining high signal levels; an assortment of time-efficient FSE images are presented. Contrast changes were observed at low angles, but images maintained a clinically useful appearance. Heterogeneous transmit fields hinder the measurement of transverse relaxation times. A post-processing technique was developed to model the salient signal behaviour and enable accurate transverse relaxometry. This method is robust to transmit variations observed at 4.7 T and improves multislice imaging efficiency. Gradient echo sequences can exploit the magnetic susceptibility difference between tissues to enhance contrast, but are corrupted near air/tissue interfaces. A correction method was developed and employed to reliably produce a multitude of quantitative and qualitative image sets. Using these techniques, transverse relaxation times and susceptibility field shifts were measured in sub-cortical nuclei of relapsing-remitting MS patients. Abnormalities in the globus pallidus and pulvinar nucleus were observed in all quantitative methods; most other regions differed on one or more measures. Correlations with disease duration were not observed, reaffirming that the disease process commences prior to symptom onset. The methods presented in this thesis enable efficient qualitative and quantitative imaging at high field strength. Unique challenges, notably patient safety and field variability, were overcome via sequence implementation and data processing. These techniques enable visualization and measurement of unique contrast mechanisms, which reveal insight into neurodegenerative diseases, including widespread sub-cortical gray matter damage in MS.

No description available.

Neurodegeneration with Brain Iron Accumulation (NBIA) disorders, such as Phospholipase A2G6-Associated Neurodegeneration (PLAN) and Pantothenate Kinase-Associated Neurodegeneration (PKAN), are a group of rare early-onset, genetic disorders characterized by neurodegeneration and iron accumulation inside of the basal ganglia (BG), which is accompanied by progressive motor symptoms. In order to address the limitations in available models of NBIA, a B6.C3-Pla2g6m1J/CxRwb mouse model of PLAN was characterized. This model demonstrated key hallmarks of the disease presentation in NBIA, including a severe and early-onset motor deficit, neurodegeneration inside of the substantia nigra (SN) including a loss of dopaminergic function and the formation of abnormal spheroid inclusions as well as iron accumulation. The capture of these hallmarks of NBIA makes this an ideal animal research model for NBIA. Additionally, exploration of candidate systemic biomarkers of NBIA was performed in a case study of a patient with PLAN and in a cohort of 30 patients with PKAN. These investigations demonstrated reductions in transfer and slight, but not significant elevations in soluble transferrin receptor. No significant difference was seen in serum iron parameters. A systemic disease burden including chronic oxidative stress; elevated malondialdehyde, and inflammation; elevated C-reactive protein (CRP), IL-6 and TNFα was noted in both investigations. A number of candidate protein biomarkers including: fibrinogen, transthyretin, zinc alpha-2 glycoprotein and retinol binding protein were also identified. These markers correlated with measures of the severity of iron loading in the globus pallidus (GP); based on R2* magnetic resonance imaging (MRI) and the severity of motor symptoms (Barry-Albright Dystonia Rating Scale) making them potential candidates markers of dysfunction in NBIA. In the patient with PLAN, 37 weeks of therapy with the iron chelator deferiprone (DFP) as well as 20 months of therapy with the antioxidants alpha lipoic acid (ALA) and n-acetylcysteine (NAC) were efficacious in reducing the systemic oxidative and inflammatory disease burden, but it did not significantly alter the progression of the disease. In the antioxidant therapy, this efficacy was primarily due to ALA. When the cohort of patients with PKAN were treated with DFP for 18 months it was highly efficacious in lowering brain iron accumulation in the GP. No significant reduction in the speed of disease progression was seen in DFP treated patients compared to placebo based on initial analysis. Similar to the PLAN patient, DFP also mitigated the systemic disease burden in PKAN patients. In both cases DFP was well tolerated and had minimal impact on serum iron levels, TIBC and transferrin saturation. Collectively these investigations provide valuable insights into disease progression in NBIA. They also provide tools to aid further investigations in NBIA. These are provided in the form of a well-characterized B6.C3-Pla2g6m1J/CxRwb model of PLAN, which robustly captures the disease presentation seen in patients, as well as a panel of systemic blood-based markers of disease burden in NBIA and candidate markers of dysfunction in NBIA. These markers were used to assess two novel therapies in NBIA chelation with DFP and antioxidant therapy with ALA and NAC. / Graduate / 2019-04-19