We introduce a fast and robust spatial-spectral encoding method, which enables acquisition of high resolution short echo time (

We used proton magnetic resonance spectroscopic imaging (1H-MRSI) to assess the in vivo cortical and subcortical neuronal involvement in progressive supranuclear palsy, Parkinson's disease and corticobasal degeneration. This technique permitted the simultaneous measurement of compounds containing N-acetylaspartate (NA), choline (Cho), creatine-phosphocreatine (Cre) and lactate, from four 15-mm slices divided into 0.84-ml single-volume elements. The study included 12 patients with progressive supranuclear palsy, 10 with Parkinson's disease, nine with corticobasal degeneration and 11 age-matched normal control subjects. Regions of interest were selected from the brainstem, caudate, thalamus, lentiform nucleus, centrum semiovale, and from frontal, parietal, precentral, temporal and occipital cortices. Progressive supranuclear palsy patients, compared with control subjects, had significantly reduced NA/Cre in the brainstem, centrum semiovale, frontal and precentral cortex, and significantly reduced NA/Cho in the lentiform nucleus. Corticobasal degeneration patients, compared with control subjects, had significantly reduced NA/Cre in the centrum semiovale, and significantly reduced NA/Cho in the lentiform nucleus and parietal cortex. There were no significant differences between Parkinson's disease patients and control subjects, or between patients groups in any individual region of interest. In the parietal cortex of corticobasal degeneration patients, NA/Cho was significantly reduced contralateral to the most affected side. There were statistically significant group differences in the regional pattern of NA/Cre and NA/Cho reduction, comparing normal control subjects with all patient groups, Parkinson's disease with corticobasal degeneration, and Parkinson's disease with progressive supranuclear palsy. Although the occurrence of significant groups differences does not imply that it is possible to differentiate between individual patients using 1H-MRSI in progressive supranuclear palsy and corticobasal degeneration, detection of specific cortical and subcortical patterns of neuronal involvement is possible with this technique. We suggest that this regional pattern of neuronal involvement found in progressive supranuclear palsy and corticobasal degeneration may help in the diagnostic evaluation of affected individuals.

The authors used proton MRS to investigate neuropathologic correlates in nine patients with proteolipid protein (PLP) gene mutations who did not show cerebral atrophy on cranial MRI. When compared with 16 age-matched control participants, patients with PLP mutations had significant and widespread decreased brain N-acetyl aspartate, a neuronal marker. The authors conclude that PLP mutations cause neuroaxonal injury, which in turn contributes to the neurologic deficit observed in these patients.

Interferon beta (IFNβ) was the first specific disease-modifying treatment licensed for relapsing-remitting multiple sclerosis, and is still one of the most commonly prescribed treatments. A strong body of evidence supports the effectiveness of IFNβ preparations in reducing the annual relapse rate, magnetic resonance (MRI) disease activity and disease progression. However, the development of binding/neutralizing antibodies (BAbs/NAbs) during treatment negatively affects clinical and MRI outcomes. Therefore, guidelines for the clinical use for the detection of NAbs in MS may result in better treatment of these patients. In October 2012, a panel of Italian neurologists from 17 MS clinics convened in Milan to review and discuss data on NAbs and their clinical relevance in the treatment of MS. In this paper, we report the panel's recommendations for the use of IFNβ Nabs detection in the early identification of IFNβ non-responsiveness and the management of patients on IFNβ treatment in Italy, according to a model of therapeutically appropriate care.

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ObjectivesMagnetic resonance imaging (MRI) is an important tool for diagnosis and monitoring of disease course in multiple sclerosis (MS). However, its prognostic value for predicting disease worsening is still being debated. The aim of this study was to propose a deep learning algorithm to predict disease worsening at 2 years of follow-up on a multicenter cohort of MS patients collected from the Italian Neuroimaging Network Initiative using baseline MRI, and compare it with 2 expert physicians.Materials and MethodsFor 373 MS patients, baseline T2-weighted and T1-weighted brain MRI scans, as well as baseline and 2-year clinical and cognitive assessments, were collected from the Italian Neuroimaging Network Initiative repository. A deep learning architecture based on convolutional neural networks was implemented to predict: (1) clinical worsening (Expanded Disability Status Scale [EDSS]–based model), (2) cognitive deterioration (Symbol Digit Modalities Test [SDMT]–based model), or (3) both (EDSS + SDMT–based model). The method was tested on an independent data set and compared with the performance of 2 expert physicians.ResultsFor the test set, the convolutional neural network model showed high predictive accuracy for clinical (83.3%) and cognitive (67.7%) worsening, although the highest accuracy was reached when training the algorithm using both EDSS and SDMT information (85.7%). Artificial intelligence classification performance exceeded that of 2 expert physicians (70% of accuracy for the human raters).ConclusionsWe developed a robust and accurate model for predicting clinical and cognitive worsening of MS patients after 2 years, based on conventional T2-weighted and T1-weighted brain MRI scans obtained at baseline. This algorithm may be valuable for supporting physicians in their clinical practice for the earlier identification of MS patients at risk of disease worsening.

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A single blind placebo-controlled study has been performed in order to investigate objectively the acute tremorolytic effect of oral L-Dopa in ten parkinsonians chronically treated with L-Dopa. Finger tremor was assessed by means of a computerized accelerometer method, at rest and during maintenance of a fixed posture. Both resting and postural tremor were significantly influenced by L-Dopa. An "acute test" with oral L-Dopa, especially when different tremor components are investigated, may be useful for identifying objectively parkinsonians whose tremor does not respond to drug therapy or shows a deterioration of drug-responsiveness.