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Research ArticleBrain
Open Access

Multiparameter MR Imaging in the 6-OPRI Variant of Inherited Prion Disease

E. De Vita, G.R. Ridgway, R.I. Scahill, D. Caine, P. Rudge, T.A. Yousry, S. Mead, J. Collinge, H.R. Jäger, J.S. Thornton and H. Hyare
American Journal of Neuroradiology September 2013, 34 (9) 1723-1730; DOI: https://doi.org/10.3174/ajnr.A3504
E. De Vita
aFrom the Lysholm Department of Neuroradiology (E.D., T.A.Y., H.R.J., J.S.T.)
cNeuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (E.D., T.A.Y., H.R.J., J.S.T.)
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G.R. Ridgway
dDementia Research Centre (G.R.R.)
eWellcome Trust Centre for Neuroimaging (G.R.R.)
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R.I. Scahill
fTRACK-HD (R.I.S.)
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D. Caine
bNational Prion Clinic (D.C., P.R., S.M., J.C., H.H.), National Hospital for Neurology and Neurosurgery, London, United Kingdom
gMRC Prion Unit, Department of Neurodegenerative Disease (D.C., P.R., S.M., J.C., H.H.), University College London Institute of Neurology, London, United Kingdom.
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P. Rudge
bNational Prion Clinic (D.C., P.R., S.M., J.C., H.H.), National Hospital for Neurology and Neurosurgery, London, United Kingdom
gMRC Prion Unit, Department of Neurodegenerative Disease (D.C., P.R., S.M., J.C., H.H.), University College London Institute of Neurology, London, United Kingdom.
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T.A. Yousry
aFrom the Lysholm Department of Neuroradiology (E.D., T.A.Y., H.R.J., J.S.T.)
cNeuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (E.D., T.A.Y., H.R.J., J.S.T.)
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S. Mead
bNational Prion Clinic (D.C., P.R., S.M., J.C., H.H.), National Hospital for Neurology and Neurosurgery, London, United Kingdom
gMRC Prion Unit, Department of Neurodegenerative Disease (D.C., P.R., S.M., J.C., H.H.), University College London Institute of Neurology, London, United Kingdom.
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J. Collinge
bNational Prion Clinic (D.C., P.R., S.M., J.C., H.H.), National Hospital for Neurology and Neurosurgery, London, United Kingdom
gMRC Prion Unit, Department of Neurodegenerative Disease (D.C., P.R., S.M., J.C., H.H.), University College London Institute of Neurology, London, United Kingdom.
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H.R. Jäger
aFrom the Lysholm Department of Neuroradiology (E.D., T.A.Y., H.R.J., J.S.T.)
cNeuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (E.D., T.A.Y., H.R.J., J.S.T.)
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J.S. Thornton
aFrom the Lysholm Department of Neuroradiology (E.D., T.A.Y., H.R.J., J.S.T.)
cNeuroradiological Academic Unit, Department of Brain Repair and Rehabilitation (E.D., T.A.Y., H.R.J., J.S.T.)
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H. Hyare
bNational Prion Clinic (D.C., P.R., S.M., J.C., H.H.), National Hospital for Neurology and Neurosurgery, London, United Kingdom
gMRC Prion Unit, Department of Neurodegenerative Disease (D.C., P.R., S.M., J.C., H.H.), University College London Institute of Neurology, London, United Kingdom.
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    Fig 1.

    SPM-t maps for patients with the 6-OPRI mutation compared with control participants. SPM-t maps showing significant differences between symptomatic patients with the 6-OPRI mutation (n = 9) and healthy control participants (n = 16) for family-wise error P < .05. A, gray matter: controls >6-OPRI, t ≥ 6.60. B, WM: controls >6-OPRI, t ≥ 6.07. C, MTR: controls >6-OPRI, t ≥ 6.86. D, MD (b = 1000 s/mm2): controls <6-OPRI, t ≥ 7.03. E, MD (b = 3000 s/mm2): controls <6-OPRI, t ≥ 6.96. The color bar represents the t value range.

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    Fig 2.

    Effect size maps for all patients compared with control participants and patients with 6-OPRI compared with control participants. Effect size maps demonstrating the percentage difference between patients with 6-OPRI and controls in (A) gray matter volume and (B) WM volume calculated as 100*(controls-all patients)/controls displayed in the Montreal Neurological Institute space.

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    Table 1:

    Patient demographics and clinical data

    Control Group6-OPRI GroupP Value
    N16 (8 M)9 (4 M)−
    Age (y)37.1 ± 10.738.1 ± 3.6ns
    MMSE30 (30–30)19 (11–27)<.001
    CDR−8 (2–14).002a
    • Note:—CDR indicates Clinical Dementia Rating Scale; M, male; N, number; MMSE, Mini-Mental State Examination; ns, not significant (P≥0.1); 6-OPRI, 6-octapeptide repeat insertion. Age values are mean ± SD. MMSE and CDR values are median (range).

    • ↵a All comparisons were performed with the Mann-Whitney U test, except for CDR, for which the Wilcoxon test vs CDR = 0 was performed.

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    Table 2:

    Significant clusters for WM VBM (Controls > 6-OPRI)

    kPeak P Value (FWE corr)Peak TPeak ZxyzDescription
    175<.00110.596.16−34−4−31L temporal fusiform and parahippocampal gyri
    176.0037.615.22−52−43−3L middle temporal gyrus
    .0057.375.12−56−42−12L middle temporal gyrus
    7.0176.664.83−54−29−8L middle temporal gyrus
    6.0196.614.81−39−5730L angular gyrus
    46.0067.255.08−25−31−13L hippocampus
    45.0077.165.04−26−29−8L hippocampus and L parahippocampal gyrus
    .036.354.69−20−346L thalamus
    18.0356.274.66−136−3L pallidum
    97.0018.255.4557−35−13R middle temporal gyrus
    .0176.674.8349−39−9R inferior temporal gyrus
    .0186.664.8347−48−11R inferior temporal gyrus
    148.0027.825.2937−12−22R temporal fusiform gyrus
    .0037.725.2637−29−13R temporal fusiform gyrus
    57.0097.014.9826−31−6R hippocampus
    60.0126.864.92138−3R pallidum
    27.0047.585.212−2219Midline-body of corpus callosum
    3.0346.294.66−5−1930L body of corpus callosum
    10.0226.544.785−1730R body of corpus callosum
    • Note:—FWE corr indicates family-wise error corrected; L, left; MNI, Montreal Neurological Institute; R, right. k is the number of voxels within each cluster. All clusters of voxels above a voxel-level threshold FWE P ≤ .05 of size k > 2 are shown. For the largest clusters, the table shows up to 3 local maxima more than 8 mm apart. The x, y, and z coordinates are in the MNI space. Peak-t and Peak-z values are within each cluster.

    • View popup
    Table 3:

    Mean values for tissue segment volumes, MTR, MD (b = 1000 s/mm2), and MD (b = 3000 s/mm2) in selected ROIs

    Brain RegionControl Group6-OPRI GroupP Valueb
    Right thalamus
        WM (tv)a0.66 ± 0.070.57 ± 0.05.002
        MTR (%)40.6 ± 1.238.9 ± 1.1.002
        MD1K (×10−3mm2/s)0.81 ± 0.030.88 ± 0.05<.001
        MD3K (× 10−3mm2/s)0.63 ± 0.010.67 ± 0.03<.001
    Right caudate
        GM (tv)0.74 ± 0.070.50 ± 0.08<.001
        MTR (%)37.6 ± 1.133.8 ± 2.2<.001
        MD1K (× 10−3mm2/s)0.79 ± 0.030.88 ± 0.10.001
        MD3K (× 10−3mm2/s)0.63 ± 0.020.64 ± 0.03NS
    Right putamen
        GM (tv)0.92 ± 0.120.60 ± 0.12<.001
        MTR (%)38.6 ± 1.036.8 ± 1.1.001
        MD1k (× 10−3mm2/s)0.78 ± 0.020.83 ± 0.07.008
        MD3k (× 10−3mm2/s)0.65 ± 0.010.63 ± 0.03.04
    • Note:—GM indicates gray matter; MD1k, mean diffusivity (b=1000 s/mm2); MD3k, mean diffusivity (b=3000 s/mm2); NS, not significant (p ≥0.1); tv, modulated tissue segment fractional volume. Values are mean ± SD over subject group of the individual ROI means.

    • ↵a WM is reported here because the SPM8 segmentation routine classifies the thalamus as a predominantly WM structure.

    • ↵b P values are reported for the Mann-Whitney U test.

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American Journal of Neuroradiology: 34 (9)
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E. De Vita, G.R. Ridgway, R.I. Scahill, D. Caine, P. Rudge, T.A. Yousry, S. Mead, J. Collinge, H.R. Jäger, J.S. Thornton, H. Hyare
Multiparameter MR Imaging in the 6-OPRI Variant of Inherited Prion Disease
American Journal of Neuroradiology Sep 2013, 34 (9) 1723-1730; DOI: 10.3174/ajnr.A3504

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Multiparameter MR Imaging in the 6-OPRI Variant of Inherited Prion Disease
E. De Vita, G.R. Ridgway, R.I. Scahill, D. Caine, P. Rudge, T.A. Yousry, S. Mead, J. Collinge, H.R. Jäger, J.S. Thornton, H. Hyare
American Journal of Neuroradiology Sep 2013, 34 (9) 1723-1730; DOI: 10.3174/ajnr.A3504
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