L’Imagerie par résonance magnétique (IRM) est un outil fondamental pour l’exploration in vivo du développement du cerveau chez le fœtus, le bébé et l’enfant. Elle fournit plusieurs paramètres quantitatifs qui reflètent les changements des propriétés tissulaires au cours du développement en fonction de différents processus de maturation. Cependant, l’évaluation fiable de la maturation de la substance blanche est encore une question ouverte: d'une part, aucun de ces paramètres ne peut décrire toute la complexité des changements sous-jacents; d'autre part, aucun d'eux n’est spécifique d’un processus de développement ou d’une propriété tissulaire particulière. L’implémentation d’approches multiparamétriques combinant les informations complémentaires issues des différents paramètres IRM devrait permettre d’améliorer notre compréhension du développement du cerveau. Dans ce travail de thèse, je présente deux exemples de telles approches et montre leur pertinence pour l'étude de la maturation des faisceaux de substance blanche. La première approche fournit une mesure globale de la maturation basée sur la distance de Mahalanobis calculée à partir des différents paramètres IRM (temps de relaxation T1 et T2, diffusivités longitudinale et transverse du tenseur de diffusion DTI) chez des nourrissons (âgés de 3 à 21 semaines) et des adultes. Cette approche offre une meilleure description de l’asynchronisme de maturation à travers les différents faisceaux que les approches uniparamétriques. De plus, elle permet d'estimer les délais relatifs de maturation entre faisceaux. La seconde approche vise à quantifier la myélinisation des tissus cérébraux, en calculant la fraction de molécules d’eau liées à la myéline (MWF) en chaque voxel des images. Cette approche est basée sur un modèle tissulaire avec trois composantes ayant des caractéristiques de relaxation spécifiques, lesquelles ont été pré-calibrées sur trois jeunes adultes sains. Elle permet le calcul rapide des cartes MWF chez les nourrissons et semble bien révéler la progression de la myélinisation à l’échelle cérébrale. La robustesse de cette approche a également été étudiée en simulations. Une autre question cruciale pour l'étude du développement de la substance blanche est l'identification des faisceaux dans le cerveau des enfants. Dans ce travail de thèse, je décris également la création d'un atlas préliminaire de connectivité structurelle chez des enfants âgés de 17 à 81 mois, permettant l'extraction automatique des faisceaux à partir des données de tractographie. Cette approche a démontré sa pertinence pour l'évaluation régionale de la maturation de la substance blanche normale chez l’enfant. Pour finir, j’envisage dans la dernière partie du manuscrit les applications potentielles des différentes méthodes précédemment décrites pour l’étude fine des réseaux de substance blanche dans le cadre de deux exemples spécifiques de pathologies : les épilepsies focales et la leucodystrophie métachromatique. / Magnetic Resonance Imaging (MRI) is a fundamental tool for in vivo investigation of brain development in newborns, infants and children. It provides several quantitative parameters that reflect changes in tissue properties during development depending on different undergoing maturational processes. However, reliable evaluation of the white matter maturation is still an open question: on one side, none of these parameters can describe the whole complexity of the undergoing changes; on the other side, neither of them is specific to any particular developmental process or tissue property. Developing multiparametric approaches combining complementary information from different MRI parameters is expected to improve our understanding of brain development. In this PhD work, I present two examples of such approaches and demonstrate their relevancy for investigation of maturation across different white matter bundles. The first approach provides a global measure of maturation based on the Mahalanobis distance calculated from different MRI parameters (relaxation times T1 and T2, longitudinal and transverse diffusivities from Diffusion Tensor Imaging, DTI) in infants (3-21 weeks) and adults. This approach provides a better description of the asynchronous maturation across the bundles than univariate approaches. Furthermore, it allows estimating the relative maturational delays between the bundles. The second approach aims at quantifying myelination of brain tissues by calculating Myelin Water Fraction (MWF) in each image voxel. This approach is based on a 3-component tissue model, with each model component having specific relaxation characteristics that were pre-calibrated in three healthy adult subjects. This approach allows fast computing of the MWF maps from infant data and could reveal progression of the brain myelination. The robustness of this approach was further investigated using computer simulations. Another important issue for studying white matter development in children is bundles identification. In the last part of this work I also describe creation of a preliminary atlas of white matter structural connectivity in children aged 17-81 months. This atlas allows automatic extraction of the bundles from tractography datasets. This approach demonstrated its relevance for evaluation of regional maturation of normal white matter in children. Finally, in the last part of the manuscript I describe potential future applications of the previously developed methods to investigation of the white matter in cases of two specific pathologies: focal epilepsy and metachromatic leukodystrophy.

No description available.

The nervous system, including the brain, is the most sophisticated organ in the mammalian body. In such a complex network, neuron-glial interaction is essential and controls most developmental processes, such as stem cell fate determination, migration, differentiation, synapse formation, ensheathment and myelination. Many of these events are critical for the developmental process and small errors can lead to growth retardation, malformation or disease. The understanding of the normal progress of nervous system development is fundamental and will help the discovery of new treatments for disease. This thesis discusses three types of neuron-glia interactions at different developmental stages; neural stem/progenitor cell (NSPC) differentiation, building and maintaining the structure of the sciatic nerve, and myelin formation. In Paper I we show that NSPCs, based upon their morphology and expression of specific protein markers, have the capacity to differentiate into cells of either the peripheral nervous system (PNS) or enteric nervous system (ENS) when grown with PNS or ENS primary cell cultures, or fed with conditioned medium from these. This indicates that soluble factors secreted from the PNS or ENS cultures are important for stem cell differentiation and fate determination. The adhesion protein neuronal cadherin (N-cadherin) is implicated in migration, differentiation and nerve outgrowth in the developing PNS. In Paper II N-cadherin was exclusively found in ensheathing glia (nonmyelinating Schwann cells, satellite cells and enteric glia) in contact with each other or with axons. Functional blocking of N-cadherin in dissociated fetal dorsal root ganglia (DRG) cultures led to a decrease in attachment between Schwann cells. N-cadherin-mediated adhesion of nonmyelinating Schwann cells may be important in encapsulating thin calibre axons and provide support to myelinating Schwann cells. In Paper III the inhibitory gamma aminobutyric acid (GABA) and GABAB receptors were studied in the Schwann cell of the adult sciatic nerve and DRG cultures. GABAB receptors were primarily expressed in nonmyelinating Schwann cells and protein levels decreased during development and myelination. Blocking the GABAB receptor in long-term DRG cultures led to decreased levels of mRNA markers for myelin. These results indicate that the GABA and GABAB receptors may be involved in Schwann cell myelination.

Deux méthodes d'imagerie par résonance magnétique sont proposées pour analyser in vivo le tissu cérébral de la matière blanche. La première méthode permet l'acquisition ultra-rapide de cartes des métabolites cérébraux par une lecture de l'espace réciproque répétée à des intervalles de quelques millisecondes à l'aide d'une nouvelle trajectoire excentrée, combinée à un gradient de retour. Une procédure de correction de phase, pour prévenir la formation d'artéfacts de repliement dans l'image et le spectre, est introduite sur la base de paramètres déterminés à partir du signal des protons de l'eau. Une acquisition des cartes métaboliques tridimensionnelles de la créatine, de la choline, du N-acétylaspartate, du glutamate et du myo-inositol ont été déterminées de manière fiable dans la substance blanche humaine à 3 Tesla avec une matrice de taille 32 × 32 × 16 et une résolution isotropique de 7 mm. La deuxième méthode permet l'acquisition d'un train de 32 images échantillonnées géométriquement le long d'une courbe de recroissance, en employant une série d'échos de gradient excités par un angle de bascule de 5° pour éviter des effets de saturation. Après transformée inverse de Laplace utilisant une régularisation spatiale, on obtient une distribution continue des temps de relaxation spin-réseau, T1. Dans la région de T1 entre 100 ms et 230 ms, on distingue un pic attribué à l'eau hydratant les membranes de la myéline. La fraction apparente de cette composante de l'eau de myéline augmente en fonction de l'intensité du champ magnétique, de 8,3 % à 3 Tesla, à 11,3 % à 4 Tesla, pour atteindre 15,0 % à 7 Tesla / Two magnetic resonance imaging methods are proposed for the in vivo investigation of human brain white matter tissue. The first method allows the ultra-fast acquisition of maps of brain metabolites by repeating the sampling of k-space at intervals of a few milliseconds, with a center-out trajectory combined with flyback gradients. A phase-correction procedure is introduced to prevent the formation of aliasing artifacts in the image and in the spectrum, on the basis of parameters determined from the signal of the ubiquitous water protons. An acquisition of threedimensional metabolite maps of creatine, choline, N-acetylaspartate, glutamate, and myo-inositol were determined reliably in human brain white matter at 3 Tesla with a 32 × 32 × 16 matrix and a 7-mm isotropic resolution. The second method enables the acquisition of a train of 32 images geometrically sampled along an inversion-recovery curve, using a series of gradient echoes excited by a low 5° flip angle to avoid saturation effects. After inverse Laplace transform, using a spatial regularization, a continuous distribution of the spin-lattice relaxation times, T1, is obtained. In the region of T1 between 100 ms and 230 ms, a small component is attributed to water hydrating myelin membranes. The apparent fraction of this myelin water component increases with the strength of the magnetic field, from 8.3% at 3 Tesla, to 11.3% at 4 Tesla, and 15.0% at 7 Tesla

This document is a critical synopsis of prior work by Michael Dwyer submitted in support of a PhD by published work. The selected work is focused on the application of quantitative magnet resonance imaging (MRI) analysis techniques to the study of multiple sclerosis (MS). MS is a debilitating disease with a multi-factorial pathology, progression, and clinical presentation. Its most salient feature is focal inflammatory lesions, but it also includes significant parenchymal atrophy and microstructural damage. As a powerful tool for in vivo investigation of tissue properties, MRI can provide important clinical and scientific information regarding these various aspects of the disease, but precise, accurate quantitative analysis techniques are needed to detect subtle changes and to cope with the vast amount of data produced in an MRI session. To address this, eight new techniques were developed by Michael Dwyer and his co-workers to better elucidate focal, atrophic, and occult/"invisible" pathology. These included: a method to better evaluate errors in lesion identification; a method to quantify differences in lesion distribution between scanner strengths; a method to measure optic nerve atrophy; a more precise method to quantify tissue-specific atrophy; a method sensitive to dynamic myelin changes; and a method to quantify iron in specific brain structures. Taken together, these new techniques are complementary and improve the ability of clinicians and researchers to reliably assess various key elements of MS pathology in vivo.

No description available.

To fully understand how the brain works, it is necessary to relate the brain’s function to its anatomy. Cortical anatomy is subject-specific. It is character- ized by the thickness and number of intracortical layers, which differ from one cortical area to the next. Each cortical area fulfills a certain function. With magnetic res- onance imaging (MRI) it is possible to study structure and function in-vivo within the same subject. The resolution of ultra-high field MRI at 7T allows to resolve intracortical anatomy. This opens the possibility to relate cortical function of a sub- ject to its corresponding individual structural area, which is one of the main goals of neuroimaging. To parcellate the cortex based on its intracortical structure in-vivo, firstly, im- ages have to be quantitative and homogeneous so that they can be processed fully- automatically. Moreover, the resolution has to be high enough to resolve intracortical layers. Therefore, the in-vivo MR images acquired for this work are quantitative T1 maps at 0.5 mm isotropic resolution. Secondly, computational tools are needed to analyze the cortex observer-independ- ently. The most recent tools designed for this task are presented in this thesis. They comprise the segmentation of the cortex, and the construction of a novel equi-volume coordinate system of cortical depth. The equi-volume model is not restricted to in- vivo data, but is used on ultra-high resolution post-mortem data from MRI as well. It could also be used on 3D volumes reconstructed from 2D histological stains. An equi-volume coordinate system yields firstly intracortical surfaces that follow anatomical layers all along the cortex, even within areas that are severely folded where previous models fail. MR intensities can be mapped onto these equi-volume surfaces to identify the location and size of some structural areas. Surfaces com- puted with previous coordinate systems are shown to cross into different anatomical layers, and therefore also show artefactual patterns. Secondly, with the coordinate system one can compute cortical traverses perpendicularly to the intracortical sur- faces. Sampling intensities along equi-volume traverses results in cortical profiles that reflect an anatomical layer pattern, which is specific to every structural area. It is shown that profiles constructed with previous coordinate systems of cortical depth disguise the anatomical layer pattern or even show a wrong pattern. In contrast to equi-volume profiles these profiles from previous models are not suited to analyze the cortex observer-independently, and hence can not be used for automatic delineations of cortical areas. Equi-volume profiles from four different structural areas are presented. These pro- files show area-specific shapes that are to a certain degree preserved across subjects. Finally, the profiles are used to classify primary areas observer-independently.:1 Introduction p. 1 2 Theoretical Background p. 5 2.1 Neuroanatomy of the human cerebral cortex . . . .p. 5 2.1.1 Macroscopical structure . . . . . . . . . . . .p. 5 2.1.2 Neurons: cell bodies and fibers . . . . . . . .p. 5 2.1.3 Cortical layers in cyto- and myeloarchitecture . . .p. 7 2.1.4 Microscopical structure: cortical areas and maps . .p. 11 2.2 Nuclear Magnetic Resonance . . . . . . . . . . . . . .p. 13 2.2.1 Proton spins in a static magnetic field B0 . . . . .p. 13 2.2.2 Excitation with B1 . . . . . . . . . . . . . . . . .p. 15 2.2.3 Relaxation times T1, T2 and T∗ 2 . . . . . . . . . .p. 16 2.2.4 The Bloch equations . . . . . . . . . . . . . . . . p. 17 2.3 Magnetic Resonance Imaging . . . . . . . . . . . . . .p. 20 2.3.1 Encoding of spatial location and k-space . . . . . .p. 20 2.3.2 Sequences and contrasts . . . . . . . . . . . . . . p. 22 2.3.3 Ultra-high resolution MRI . . . . . . . . . . . . . p. 24 2.3.4 Intracortical MRI: different contrasts and their sources p. 25 3 Image analysis with computed cortical laminae p. 29 3.1 Segmentation challenges of ultra-high resolution images p. 30 3.2 Reconstruction of cortical surfaces with the level set method p. 31 3.3 Myeloarchitectonic patterns on inflated hemispheres . . . . p. 33 3.4 Profiles revealing myeloarchitectonic laminar patterns . . .p. 36 3.5 Standard computational cortical layering models . . . . . . p. 38 3.6 Curvature bias of computed laminae and profiles . . . . . . p. 39 4 Materials and methods p. 41 4.1 Histology . . . . . p. 41 4.2 MR scanning . . . . p. 44 4.2.1 Ultra-high resolution post-mortem data p. 44 4.2.2 The MP2RAGE sequence . . . . . . . . p. 45 4.2.3 High-resolution in-vivo T1 maps . . . .p. 46 4.2.4 High-resolution in-vivo T∗ 2-weighted images p. 47 4.3 Image preprocessing and experiments . . . . . .p. 48 4.3.1 Fully-automatic tissue segmentation . . . . p. 48 4.3.2 Curvature Estimation . . . . . . . . . . . . p. 49 4.3.3 Preprocessing of post-mortem data . . . . . .p. 50 4.3.4 Experiments with occipital pole post-mortem data .p. 51 4.3.5 Preprocessing of in-vivo data . . . . . . . . . . p. 52 4.3.6 Evaluation experiments on in-vivo data . . . . . .p. 56 4.3.7 Application experiments on in-vivo data . . . . . p. 56 4.3.8 Software . . . . . . . . . . . . . . . . . . . . .p. 58 5 Computational cortical layering models p. 59 5.1 Implementation of standard models . .p. 60 5.1.1 The Laplace model . . . . . . . . .p. 60 5.1.2 The level set method . . . . . . . p. 61 5.1.3 The equidistant model . . . . . . .p. 62 5.2 The novel anatomically motivated equi-volume model p. 63 5.2.1 Bok’s equi-volume principle . . . . . .p. 63 5.2.2 Computational equi-volume layering . . p. 66 6 Validation of the novel equi-volume model p. 73 6.1 The equi-volume model versus previous models on post-mortem samples p. 73 6.1.1 Comparing computed surfaces and anatomical layers . . . . . . . . p. 73 6.1.2 Cortical profiles reflecting an anatomical layer . . . . . . . . .p. 79 6.2 The equi-volume model versus previous models on in-vivo data . . . .p. 82 6.2.1 Comparing computed surfaces and anatomical layers . . . . . . . . p. 82 6.2.2 Cortical profiles reflecting an anatomical layer . . . . . . . . .p. 85 6.3 Dependence of computed surfaces on cortical curvature . . . . .p. 87 6.3.1 Within a structural area . . . . . . . . . . . . . . . . . . p. 87 6.3.2 Artifactual patterns on inflated surfaces . . . . . . . . . .p. 87 7 Applying the equi-volume model: Analyzing cortical architecture in-vivo in different structural areas p. 91 7.1 Impact of resolution on cortical profiles . . . . . . . . . . . . . p. 91 7.2 Intersubject variability of cortical profiles . . . . . . . . . . . p. 94 7.3 Myeloarchitectonic patterns on inflated hemispheres . . . . . . .p. 95 7.3.1 Comparison of patterns with inflated labels . . . . . . . . . .p. 97 7.3.2 Patterns at different cortical depths . . . . . . . . . . . . .p. 97 7.4 Fully-automatic primary-area classification using cortical profiles p. 99 8 Discussion p. 105 8.1 The novel equi-volume model . . . . . . . . . . . . . . . . . . . . .p. 105 8.2 Analyzing cortical myeloarchitecture in-vivo with T1 maps . . . . . .p. 109 9 Conclusion and outlook p. 113 Bibliography p. 117 List of Figures p. 127

Transverse myelitis (TM) is a rare auto-immune inflammatory disease in which the patient’s immune system attacks their spinal cord resulting in an unpredictable degree of neurologic disability, ranging from complete recovery to quadriplegia. TM patients often experience insufficient assistance towards understanding causes of the illness and have little to depend on in trying to deal with it. This study explores psychological strengths and coping strategies used by TM patients in coping with the illness. A theoretical framework of positive psychology with a strong focus on seven constructs, namely positive coping, searching for meaning, benefit finding, hope, sense of humour, resilience, as well as religion and spirituality is presented. The main data collection strategy for this study was the gathering of stories as a form of conversation. These were subjected to thematic analysis by interpretative phenomenological analysis (IPA) focused on identifiable themes and patterns of living and behaviour. The emerging patterns and identified fortigenic qualities were then considered, analysed and argued in relation to corresponding coping strategies. A model for the psychological coping and well-being of TM patients, based on emphasising the positive and constructive and considering existing models and strategies for the well-being of patients, was developed. The strategic and therapeutic model is presented in easily understandable language for the benefit of any care-giver (e.g. family member, friend or nurse) or the patient him/herself. / Thesis (PhD)--University of Pretoria, 2013. / lk2013 / Psychology / unrestricted

Les syndromes démyélinisants acquis (SDA) pédiatriques sont un groupe de maladies qui affectent la substance blanche (SB) et la substance grise (SG) du système nerveux central (SNC) chez les enfants, et qui partagent certaines caractéristiques et mécanismes pathologiques. Les SDA peuvent être monophasiques ou récurrents. Les SDA comprennent des maladies telles que l'encéphalomyélite aiguë disséminée (EMDA), les troubles du spectre de la neuromyélite optique (TS-NMO), la sclérose en plaques (SEP) et le syndrome démyélinisant récurrent avec anticorps contre la glycoprotéine oligodendrocytique de myéline (anticorps anti-MOG). Ce dernier syndrome, appelé aussi maladie MOG+, a été reconnu récemment comme une entité distincte faisant partie des maladies démyélinisantes récurrentes chez les enfants. La maladie MOG+ présente des caractéristiques semblables à celles de la SEP; en effet, certains cas ont été déjà considérés comme une forme « atypique » de SEP. La maladie MOG+ et la SEP partagent des lésions dans la SB du SNC, mais la SEP est caractérisée aussi par des lésions corticales (LCs) cérébrales, insuffisamment étudiées dans la maladie MOG+. Par conséquent, le but de cette recherche a été de comparer les caractéristiques démographiques et des lésions cérébrales visibles sur des études d’imagerie par résonance magnétique (IRM) chez les enfants atteints de SEP et ceux atteints de la maladie MOG+. Pour atteindre cet objectif, nous avons utilisé des scans IRM 3T, incluant les contrastes pondérés T1, FLAIR et des images de transfert de magnétisation (ITM) de 14 enfants atteints de SEP et 13 enfants atteints de la maladie MOG+. Nous avons mesuré le nombre des LCs, le volume des lésions dans la SB et les valeurs normalisées d’ITM dans les LCs et les lésions de la SB. Nos résultats ont montré que les enfants atteints de la maladie MOG+ étaient plus jeunes au début de la maladie et que celle-ci présentait une durée plus longue que la maladie du groupe SEP. Quant aux lésions cérébrales, les LCs étaient présentes dans la maladie MOG+, mais leur nombre était significativement plus élevé dans le groupe SEP. Cependant, les valeurs normalisées d’ITM dans ces lésions (valeurs qui sont sensibles à la quantité de myéline) n'étaient pas significativement différentes entre les deux groupes. En plus, le volume des lésions de la SB était significativement plus élevé dans le groupe SEP et les valeurs normalisées d’ITM dans ces lésions, significativement inférieures comparativement à la maladie MOG+, témoignant ainsi d’une démyélinisation plus sévère et des différences potentielles dans les mécanismes de démyélinisation. / Pediatric Acquired Demyelinating Syndromes (ADS) are a group of diseases that affect the white matter (WM) and gray matter (GM) of the central nervous system (CNS) in children and that share similar pathological characteristics and mechanisms. ADS can be monophasic or recurrent. The ADS include diseases like acute disseminated encephalomyelitis (ADEM), neuromyelitis optic spectrum disorders (NMO-SD), multiple sclerosis (MS) and Relapsing Myelin Oligodendrocyte Glycoprotein (MOG) syndrome or MOG+ disease, which has been recently recognised as a distinct pathology and is part of the relapsing ADS in children. MOG+ disease shares features with MS; indeed, some MOG+ cases have been considered as an “atypical” form of MS until recently. Both MOG+ disease and MS present lesions in the WM of the CNS. MS is also characterized by focal brain cortical lesions (CL), which have not been extensively studied in MOG+ disease yet. For this reason, the aim of this research project was to compare the demographic and brain magnetic resonance imaging (MRI) characteristics of children with MS and children with MOG+ disease. To achieve our goal, we used 3T MRI including T1-weighted, FLAIR and magnetization transfer ratio (MTR) contrasts of 14 MS participants, and 13 relapsing MOG+ participants. CL counts, WM lesion volumes, normalized MTR values in CLs, and WM lesions were compared across groups. Our results show that children with MOG+ disease were younger at disease onset and had a longer disease duration compared to the MS group. CL were present in MOG+ participants, but counts were significantly higher in the MS group. However, their normalized-MTR values, which are sensitive to myelin, were not significantly different between both groups. WM lesion volumes were significantly higher in the MS group, but their normalized MTR values were significantly lower than in MOG+ WM lesions, likely reflecting more severe demyelination and potential differences in the demyelinating mechanism.

No / Recent studies have revealed extensive cortical demyelination in patients with progressive multiple sclerosis (MS). Demyelination in gray matter lesions is associated with activation of microglia. Macrophages and microglia are known to express myeloperoxidase (MPO) and generate reactive oxygen species during myelin phagocytosis in the white matter. In the present study we examined the extent of microglial activation in the cerebral cortex and the relationship of microglial activation and MPO activity to cortical demyelination. Twenty-one cases of neuropathologically confirmed multiple sclerosis, with 34 cortical lesions, were used to assess microglial activation. HLA-DR immunolabeling of activated microglia was significantly higher in demyelinated MS cortex than control cortex and, within the MS cohort, was significantly greater within cortical lesions than in matched non-demyelinated areas of cortex. In homogenates of MS cortex, cortical demyelination was associated with significantly elevated MPO activity. Immunohistochemistry revealed MPO in CD68-positive microglia within cortical plaques, particularly toward the edge of the plaques, but not in microglia in adjacent non-demyelinated cortex. Cortical demyelination in MS is associated with increased activity of MPO, which is expressed by a CD68-positive subset of activated microglia, suggesting that microglial production of reactive oxygen species is likely to be involved in cortical demyelination.