Transcript What can MRI do for ataxias

Gülin Öz
WHAT CAN MRI DO FOR ATAXIAS?
DISCLAIMER
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
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The information provided by speakers in any
presentation made as part of the 2012 NAF Annual
Membership Meeting is for informational use only.
NAF encourages all attendees to consult with their
primary care provider, neurologist, or other health care
provider about any advice, exercise, therapies,
medication, treatment, nutritional supplement, or
regimen that may have been mentioned as part of any
presentation.
Products or services mentioned during these
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PRESENTER DISCLOSURES
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Speaker: Gülin Öz
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No relationships to disclose or list
Conventional MRI
is a picture of water
 No radioactivity
An MRI is a picture of
the protons in water.
Hydrogen is a
spinning proton.
Oxygen
H2O
O
H
H
MRI SCANNERS
Tesla = strength of
magnetic field
 Clinical MRI Scanners 0.5 - 1.5 Tesla
 High field MRI Scanners 3 - 7 Tesla
Clearer images, more detailed info
Versatility of MRI
• MRI can non-invasively image:
 anatomy
 blood vessels / flow
 brain networks
 brain activation
 biochemistry:
• chemical levels
• metabolic rates
Imaging Anatomy
Images provided by J. T. Vaughan, Ph.D.
Imaging Blood Vessels
MRA:
Magnetic
Resonance
Angiography
Imaging Connectivity: Diffusion Imaging
Functional MRI (fMRI)
 BOLD (blood oxygenation dependent) effect
 Blood flow ↑
 Deoxyhemoglobin ↓
 Signal ↑
MR Spectroscopy (MRS)
MR spectrum
MR image
Concentration of metabolites
N-acetylaspartate
glutamate
glutamine
inositol
10.0 mmol/g
7.6 mmol/g
1.3 mmol/g
5.4 mmol/g
Use of MRI in ataxias
• MRI is currently used in clinical care of
ataxias as..
..diagnostic aid (detection of cerebellar
atrophy)
ATROPHY in SCAs
control
SCA2
MRI research in ataxias
• Recent focus areas:
 anatomy / quantitative morphology
 brain networks
 brain chemistry
MORPHOLOGIC IMAGING in SCAs
 Different patterns of atrophy in different ataxias
 Degree of tissue loss reflects disease severity
Schulz et al, 2010
DIFFUSION IMAGING IN ATAXIA
 Loss of connectivity can be detected & quantified
Prakash et al, 2009
NEUROCHEMICAL CHANGES IN SPORADIC ATAXIA
Control
4
MSA/C
3
2
1
ppm
myo-inositol
N-acetylaspartate
4
3
2
1
ppm
 Chemical changes can be detected & quantified
Oz et al, 2011
TREATMENT MONITORING WITH MRS
Research with SCA1 mice
Treatment
[Taurine] (μmol/g)
11
10
healthy mice
9
treated mice with ataxia
8
mice with ataxia
7
6
6
12
Age (weeks)
 Chemical levels can be used to monitor disease reversal
Oz et al, 2011
Future of MRI in ataxias
• Novel MRI technology can help with:
 understanding disease processes
 differential diagnosis
 monitoring drug effects in clinical trials
(serial testing no problem – no radioactivity)
Useful Website about MRI
 Basics of MRI by Joseph Hornak:
http://www.cis.rit.edu/htbooks/mri/
(includes section ‘Your MRI Exam’)
Check out research studies @
 NAF website (www.ataxia.org)
 CRC-SCA website
(http://rarediseasesnetwork.epi.usf.edu/CRC‐SCA/)