Skip to main content
Top
Published in: Neuroradiology 5/2013

01-05-2013 | Diagnostic Neuroradiology

Diffusion tensor imaging and brain volumetry in Fabry disease patients

Authors: Teemu Paavilainen, Virva Lepomäki, Jani Saunavaara, Ronald Borra, Pirjo Nuutila, Ilkka Kantola, Riitta Parkkola

Published in: Neuroradiology | Issue 5/2013

Login to get access

Abstract

Introduction

Fabry disease is a rare lysosomal storage disorder leading to cellular accumulation of globotriaosylceramide, especially in blood vessels. It is associated with severe early onset cerebrovascular disease and kidney and heart failure. The purpose of this study was to reveal possible disturbances in white matter integrity in Fabry disease patients using voxelwise diffusion-tensor imaging (DTI) analysis.

Methods

Twelve Fabry disease patients, along with 13 healthy controls, underwent DTI and structural MRI. Voxel-based analysis of the DTI data was performed to assess possible differences in DTI parameters between Fabry disease patients and healthy controls. A selective region of interest analysis was performed for healthy volunteers and Fabry disease patients having a mild burden of T2-hyperintense lesions. We also measured normalised brain tissue volumes and performed a voxel-based volume analysis for grey matter.

Results

Voxel-based analysis of DTI data showed areas of significantly reduced fractional anisotropy and increased mean diffusivity in patients with Fabry disease. Eight patients had a mild burden of white matter lesions on their T2 scans. Region of interest analysis on areas showing reduced fractional anisotropy in voxelwise analysis also revealed reduced fractional anisotropy values in this patient group compared to eight healthy volunteers. The brain volume analyses did not reveal significant differences between the Fabry disease patients and the controls.

Conclusion

These findings suggest a microstructural damage in brain white matter of Fabry disease patients, which can be revealed before excessive white matter lesions load is visible on conventional MR scans.
Literature
1.
go back to reference Meikle PJ, Hopwood JJ, Clague AE, Carey WF (1999) Prevalence of lysosomal storage disorders. JAMA 281:249–254PubMedCrossRef Meikle PJ, Hopwood JJ, Clague AE, Carey WF (1999) Prevalence of lysosomal storage disorders. JAMA 281:249–254PubMedCrossRef
2.
go back to reference Mehta A, Ricci R, Widmer U, Dehout F, de Lorenzo AG, Kampmann C, Linhart A, Sunder-Plassmann G, Ries M, Beck M (2004) Fabry disease defined: baseline clinical manifestations of 366 patients in the Fabry Outcome Survey. Eur J Clin Invest 34:236–242PubMedCrossRef Mehta A, Ricci R, Widmer U, Dehout F, de Lorenzo AG, Kampmann C, Linhart A, Sunder-Plassmann G, Ries M, Beck M (2004) Fabry disease defined: baseline clinical manifestations of 366 patients in the Fabry Outcome Survey. Eur J Clin Invest 34:236–242PubMedCrossRef
3.
go back to reference Moore DF, Kaneski CR, Askari H, Schiffmann R (2007) The cerebral vasculopathy of Fabry disease. J Neurol Sci 257:258–263PubMedCrossRef Moore DF, Kaneski CR, Askari H, Schiffmann R (2007) The cerebral vasculopathy of Fabry disease. J Neurol Sci 257:258–263PubMedCrossRef
4.
go back to reference Mehta A, Clarke JTR, Giugliani R, Elliott P, Linhart A, Beck M, Sunder-Plassmann G, Investigators FOS (2009) Natural course of Fabry disease: changing pattern of causes of death in FOS–Fabry Outcome Survey. J Med Genet 46:548–552PubMedCrossRef Mehta A, Clarke JTR, Giugliani R, Elliott P, Linhart A, Beck M, Sunder-Plassmann G, Investigators FOS (2009) Natural course of Fabry disease: changing pattern of causes of death in FOS–Fabry Outcome Survey. J Med Genet 46:548–552PubMedCrossRef
5.
go back to reference Moore DF, Altarescu G, Barker WC, Patronas NJ, Herscovitch P, Schiffmann R (2003) White matter lesions in Fabry disease occur in ‘prior’ selectively hypometabolic and hyperperfused brain regions. Brain Res Bull 62:231–240PubMedCrossRef Moore DF, Altarescu G, Barker WC, Patronas NJ, Herscovitch P, Schiffmann R (2003) White matter lesions in Fabry disease occur in ‘prior’ selectively hypometabolic and hyperperfused brain regions. Brain Res Bull 62:231–240PubMedCrossRef
6.
go back to reference Fellgiebel A, Muller MJ, Ginsberg L (2006) CNS manifestations of Fabry’s disease. Lancet Neurol 5:791–795PubMedCrossRef Fellgiebel A, Muller MJ, Ginsberg L (2006) CNS manifestations of Fabry’s disease. Lancet Neurol 5:791–795PubMedCrossRef
7.
go back to reference Reisin RC, Romero C, Marchesoni C, Napoli G, Kisinovsky I, Caceres G, Sevlever G (2011) Brain MRI findings in patients with Fabry disease. J Neurol Sci 305:41–44PubMedCrossRef Reisin RC, Romero C, Marchesoni C, Napoli G, Kisinovsky I, Caceres G, Sevlever G (2011) Brain MRI findings in patients with Fabry disease. J Neurol Sci 305:41–44PubMedCrossRef
8.
go back to reference van Straaten EC, Fazekas F, Rostrup E, Scheltens P, Schmidt R, Pantoni L, Inzitari D, Waldemar G, Erkinjuntti T, Mäntylä R, Wahlund LO, Barkhof F, LADIS Group (2006) Impact of white matter hyperintensities scoring method on correlations with clinical data: the LADIS study. Stroke 37:836–840PubMedCrossRef van Straaten EC, Fazekas F, Rostrup E, Scheltens P, Schmidt R, Pantoni L, Inzitari D, Waldemar G, Erkinjuntti T, Mäntylä R, Wahlund LO, Barkhof F, LADIS Group (2006) Impact of white matter hyperintensities scoring method on correlations with clinical data: the LADIS study. Stroke 37:836–840PubMedCrossRef
9.
go back to reference Pantoni L, Poggesi A, Basile AM, Pracucci G, Barkhof F, Chabriat H, Erkinjuntti T, Ferro JM, Hennerici M, O’Brien J, Schmidt R, Visser MC, Wahlund LO, Waldemar G, Wallin A, Inzitari D, LADIS Study Group (2006) Leukoaraiosis predicts hidden global functioning impairment in nondisabled older people: The LADIS (Leukoaraiosis and Disability in the Elderly) study. J Am Geriatr Soc 54:1095–1101PubMedCrossRef Pantoni L, Poggesi A, Basile AM, Pracucci G, Barkhof F, Chabriat H, Erkinjuntti T, Ferro JM, Hennerici M, O’Brien J, Schmidt R, Visser MC, Wahlund LO, Waldemar G, Wallin A, Inzitari D, LADIS Study Group (2006) Leukoaraiosis predicts hidden global functioning impairment in nondisabled older people: The LADIS (Leukoaraiosis and Disability in the Elderly) study. J Am Geriatr Soc 54:1095–1101PubMedCrossRef
10.
go back to reference Prins ND, van Straaten ECW, van Dijk EJ, Simoni M, van Schijndel RA, Vrooman HA, Koudstaal PJ, Scheltens P, Breteler MMB, Barkhof F (2004) Measuring progression of cerebral white matter lesions on MRI—visual rating and volumetrics. Neurology 62:1533–1539PubMedCrossRef Prins ND, van Straaten ECW, van Dijk EJ, Simoni M, van Schijndel RA, Vrooman HA, Koudstaal PJ, Scheltens P, Breteler MMB, Barkhof F (2004) Measuring progression of cerebral white matter lesions on MRI—visual rating and volumetrics. Neurology 62:1533–1539PubMedCrossRef
11.
go back to reference Nakayama N, Okumura A, Shinoda J, Yasokawa YT, Miwa K, Yoshimura SI, Iwama T (2006) Evidence for white matter disruption in traumatic brain injury without macroscopic lesions. J Neurol Neurosurg Psychiatry 77:850–855PubMedCrossRef Nakayama N, Okumura A, Shinoda J, Yasokawa YT, Miwa K, Yoshimura SI, Iwama T (2006) Evidence for white matter disruption in traumatic brain injury without macroscopic lesions. J Neurol Neurosurg Psychiatry 77:850–855PubMedCrossRef
12.
go back to reference Bodini B, Khaleeli Z, Cercignani M, Miller DH, Thompson AJ, Ciccarelli O (2009) Exploring the relationship between white matter and gray matter damage in early primary progressive multiple sclerosis: an in vivo study with TBSS and VBM. Hum Brain Mapp 30:2852–2861PubMedCrossRef Bodini B, Khaleeli Z, Cercignani M, Miller DH, Thompson AJ, Ciccarelli O (2009) Exploring the relationship between white matter and gray matter damage in early primary progressive multiple sclerosis: an in vivo study with TBSS and VBM. Hum Brain Mapp 30:2852–2861PubMedCrossRef
13.
go back to reference Virtanen SM, Lindroos MM, Majamaa K, Nuutila P, Borra RJ, Parkkola R (2011) Voxelwise analysis of diffusion tensor imaging and structural MR imaging in patients with the m.3243A > G mutation in mitochondrial DNA. AJNR Am J Neuroradiol 32:522–526PubMedCrossRef Virtanen SM, Lindroos MM, Majamaa K, Nuutila P, Borra RJ, Parkkola R (2011) Voxelwise analysis of diffusion tensor imaging and structural MR imaging in patients with the m.3243A > G mutation in mitochondrial DNA. AJNR Am J Neuroradiol 32:522–526PubMedCrossRef
14.
go back to reference Moore DF, Schiffmann R, Ulug AM (2002) Elevated CNS average diffusion constant in Fabry disease. Acta Paediatr Suppl 91:67–68PubMedCrossRef Moore DF, Schiffmann R, Ulug AM (2002) Elevated CNS average diffusion constant in Fabry disease. Acta Paediatr Suppl 91:67–68PubMedCrossRef
15.
go back to reference Fellgiebel A, Mazanek M, Whybra C, Beck M, Hartung R, Muller KM, Scheurich A, Dellani PR, Stoeter P, Muller MJ (2006) Pattern of microstructural brain tissue alterations in Fabry disease—a diffusion-tensor imaging study. J Neurol 253:780–787PubMedCrossRef Fellgiebel A, Mazanek M, Whybra C, Beck M, Hartung R, Muller KM, Scheurich A, Dellani PR, Stoeter P, Muller MJ (2006) Pattern of microstructural brain tissue alterations in Fabry disease—a diffusion-tensor imaging study. J Neurol 253:780–787PubMedCrossRef
16.
go back to reference Albrecht J, Dellani PR, Muller MJ, Schermuly I, Beck M, Stoeter P, Gerhard A, Fellgiebel A (2007) Voxel based analyses of diffusion tensor imaging in Fabry disease. J Neurol Neurosurg Psychiatry 78:964–969PubMedCrossRef Albrecht J, Dellani PR, Muller MJ, Schermuly I, Beck M, Stoeter P, Gerhard A, Fellgiebel A (2007) Voxel based analyses of diffusion tensor imaging in Fabry disease. J Neurol Neurosurg Psychiatry 78:964–969PubMedCrossRef
17.
go back to reference Fazekas F, Chawluk J, Alavi A, Hurtig H, Zimmermann R (1987) MR signal abnormalities at 1.5T in Alzheimer´s dementia and normal aging. AJR Am J Roentgenol 149:351–356PubMedCrossRef Fazekas F, Chawluk J, Alavi A, Hurtig H, Zimmermann R (1987) MR signal abnormalities at 1.5T in Alzheimer´s dementia and normal aging. AJR Am J Roentgenol 149:351–356PubMedCrossRef
18.
go back to reference Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F, Radner H, Lechner H (1993) Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology 43:1683–1689PubMedCrossRef Fazekas F, Kleinert R, Offenbacher H, Schmidt R, Kleinert G, Payer F, Radner H, Lechner H (1993) Pathologic correlates of incidental MRI white matter signal hyperintensities. Neurology 43:1683–1689PubMedCrossRef
19.
go back to reference Andréll P, Jensen C, Norrsell H, Ekre O, Ekholm S, Norrsell U, Eliasson T, Mannheimer C, Blomstrand C (2005) White matter disease in magnetic resonance imaging predicts cerebral complications after coronary artery bypass grafting. Ann Thorac Surg 79:74–79PubMedCrossRef Andréll P, Jensen C, Norrsell H, Ekre O, Ekholm S, Norrsell U, Eliasson T, Mannheimer C, Blomstrand C (2005) White matter disease in magnetic resonance imaging predicts cerebral complications after coronary artery bypass grafting. Ann Thorac Surg 79:74–79PubMedCrossRef
20.
go back to reference Smith SM, Jenkinson M, Johansen-Berg H, Rueckert D, Nichols TE, Mackay CE, Watkins KE, Ciccarelli O, Cader MZ, Matthews PM, Behrens TEJ (2006) Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data. NeuroImage 31:1487–1505PubMedCrossRef Smith SM, Jenkinson M, Johansen-Berg H, Rueckert D, Nichols TE, Mackay CE, Watkins KE, Ciccarelli O, Cader MZ, Matthews PM, Behrens TEJ (2006) Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data. NeuroImage 31:1487–1505PubMedCrossRef
24.
go back to reference Smith SM, De Stefano N, Jenkinson M, Matthews PM (2001) Normalized accurate measurement of longitudinal brain change. J Comput Assist Tomogr 25:466–475PubMedCrossRef Smith SM, De Stefano N, Jenkinson M, Matthews PM (2001) Normalized accurate measurement of longitudinal brain change. J Comput Assist Tomogr 25:466–475PubMedCrossRef
25.
go back to reference Jenkinson M, Smith S (2001) A global optimisation method for robust affine registration of brain images. Med Image Anal 5:143–156PubMedCrossRef Jenkinson M, Smith S (2001) A global optimisation method for robust affine registration of brain images. Med Image Anal 5:143–156PubMedCrossRef
26.
go back to reference Jenkinson M, Bannister P, Brady M, Smith S (2002) Improved optimization for the robust and accurate linear registration and motion correction of brain images. NeuroImage 17:825–841PubMedCrossRef Jenkinson M, Bannister P, Brady M, Smith S (2002) Improved optimization for the robust and accurate linear registration and motion correction of brain images. NeuroImage 17:825–841PubMedCrossRef
27.
go back to reference Zhang YY, Brady M, Smith S (2001) Segmentation of brain MR images through a hidden Markov random field model and the expectation-maximization algorithm. IEEE Trans Med Imaging 20:45–57PubMedCrossRef Zhang YY, Brady M, Smith S (2001) Segmentation of brain MR images through a hidden Markov random field model and the expectation-maximization algorithm. IEEE Trans Med Imaging 20:45–57PubMedCrossRef
28.
29.
go back to reference Good CD, Johnsrude IS, Ashburner J, Henson RNA, Friston KJ, Frackowiak RSJ (2001) A voxel-based morphometric study of ageing in 465 normal adult human brains. NeuroImage 14:21–36PubMedCrossRef Good CD, Johnsrude IS, Ashburner J, Henson RNA, Friston KJ, Frackowiak RSJ (2001) A voxel-based morphometric study of ageing in 465 normal adult human brains. NeuroImage 14:21–36PubMedCrossRef
30.
go back to reference Rueckert D, Sonoda LI, Hayes C, Hill DLG, Leach MO, Hawkes DJ (1999) Non-rigid registration using free-form deformations: application to breast MR images. IEEE Trans Med Imaging 18:712–721PubMedCrossRef Rueckert D, Sonoda LI, Hayes C, Hill DLG, Leach MO, Hawkes DJ (1999) Non-rigid registration using free-form deformations: application to breast MR images. IEEE Trans Med Imaging 18:712–721PubMedCrossRef
31.
go back to reference Nichols TE, Holmes AP (2002) Nonparametric permutation tests for functional neuroimaging: a primer with examples. Hum Brain Mapp 15:1–25PubMedCrossRef Nichols TE, Holmes AP (2002) Nonparametric permutation tests for functional neuroimaging: a primer with examples. Hum Brain Mapp 15:1–25PubMedCrossRef
32.
go back to reference Smith SM, Nichols TE (2009) Threshold-free cluster enhancement: addressing problems of smoothing, threshold dependence and localisation in cluster inference. NeuroImage 44:83–98PubMedCrossRef Smith SM, Nichols TE (2009) Threshold-free cluster enhancement: addressing problems of smoothing, threshold dependence and localisation in cluster inference. NeuroImage 44:83–98PubMedCrossRef
33.
go back to reference Okeda R, Nisihara M (2008) An autopsy case of Fabry disease with neuropathological investigation of the pathogenesis of associated dementia. Neuropathology 28:532–540PubMedCrossRef Okeda R, Nisihara M (2008) An autopsy case of Fabry disease with neuropathological investigation of the pathogenesis of associated dementia. Neuropathology 28:532–540PubMedCrossRef
34.
go back to reference Song SK, Sun SW, Ramsbottom MJ, Chang C, Russell J, Cross AH (2002) Dysmyelination revealed through MRI as increased radial (but unchanged axial) diffusion of water. NeuroImage 17:1429–1436PubMedCrossRef Song SK, Sun SW, Ramsbottom MJ, Chang C, Russell J, Cross AH (2002) Dysmyelination revealed through MRI as increased radial (but unchanged axial) diffusion of water. NeuroImage 17:1429–1436PubMedCrossRef
35.
go back to reference Wheeler-Kingshott CAM, Cercignani M (2009) About “axial” and “radial” diffusivities. Magn Reson Med 61:1255–1260PubMedCrossRef Wheeler-Kingshott CAM, Cercignani M (2009) About “axial” and “radial” diffusivities. Magn Reson Med 61:1255–1260PubMedCrossRef
36.
go back to reference Tedeschi G, Bonavita S, Banerjee TK, Virta A, Schiffmann R (1999) Diffuse central neuronal involvement in Fabry disease—a proton MRS imaging study. Neurology 52:1663–1667PubMedCrossRef Tedeschi G, Bonavita S, Banerjee TK, Virta A, Schiffmann R (1999) Diffuse central neuronal involvement in Fabry disease—a proton MRS imaging study. Neurology 52:1663–1667PubMedCrossRef
37.
go back to reference Focke N, Yogarajah M, Bonelli S, Bartlett P, Symms M, Duncan J (2008) Voxel-based diffusion tensor imaging in patients with mesial temporal lobe epilepsy and hippocampal sclerosis. NeuroImage 40:728–737PubMedCrossRef Focke N, Yogarajah M, Bonelli S, Bartlett P, Symms M, Duncan J (2008) Voxel-based diffusion tensor imaging in patients with mesial temporal lobe epilepsy and hippocampal sclerosis. NeuroImage 40:728–737PubMedCrossRef
38.
go back to reference Fox NC, Schott JM (2004) Imaging cerebral atrophy: normal ageing to Alzheimer’s disease. Lancet 363:392–394PubMedCrossRef Fox NC, Schott JM (2004) Imaging cerebral atrophy: normal ageing to Alzheimer’s disease. Lancet 363:392–394PubMedCrossRef
39.
40.
go back to reference Walters RJL, Fox NC, Schott JM, Crum WR, Stevens JM, Rossor MN, Thomas DJ (2003) Transient ischaemic attacks are associated with increased rates of global cerebral atrophy. J Neurol Neurosurg Psychiatry 74:213–216PubMedCrossRef Walters RJL, Fox NC, Schott JM, Crum WR, Stevens JM, Rossor MN, Thomas DJ (2003) Transient ischaemic attacks are associated with increased rates of global cerebral atrophy. J Neurol Neurosurg Psychiatry 74:213–216PubMedCrossRef
41.
go back to reference Marino S, Borsini W, Buchner S, Mortilla M, Stromillo ML, Battaglini M, Giorgio A, Bramanti P, Federico A, De Stefano N (2006) Diffuse structural and metabolic brain changes in Fabry disease. J Neurol 253:434–440PubMedCrossRef Marino S, Borsini W, Buchner S, Mortilla M, Stromillo ML, Battaglini M, Giorgio A, Bramanti P, Federico A, De Stefano N (2006) Diffuse structural and metabolic brain changes in Fabry disease. J Neurol 253:434–440PubMedCrossRef
42.
go back to reference Fellgiebel A, Wolf DO, Kolodny E, Müller MJ (2012) Hippocampal atrophy as a surrogate neuronal involvement in Fabry disease. J Inherit Metab Dis 35:363–367PubMedCrossRef Fellgiebel A, Wolf DO, Kolodny E, Müller MJ (2012) Hippocampal atrophy as a surrogate neuronal involvement in Fabry disease. J Inherit Metab Dis 35:363–367PubMedCrossRef
43.
go back to reference Hsu JL, Leemans A, Bai CH, Lee CH, Tsai YF, Chiu HC, Chen WH (2008) Gender differences and age-related white matter changes of the human brain: a diffusion tensor imaging study. NeuroImage 39:566–577PubMedCrossRef Hsu JL, Leemans A, Bai CH, Lee CH, Tsai YF, Chiu HC, Chen WH (2008) Gender differences and age-related white matter changes of the human brain: a diffusion tensor imaging study. NeuroImage 39:566–577PubMedCrossRef
44.
go back to reference Lebel C, Gee M, Camicoli R, Wieler M, Martin W, Beaulieu C (2012) Diffusion tensor imaging of white matter tract evolution over the lifespan. NeuroImage 60:340–352PubMedCrossRef Lebel C, Gee M, Camicoli R, Wieler M, Martin W, Beaulieu C (2012) Diffusion tensor imaging of white matter tract evolution over the lifespan. NeuroImage 60:340–352PubMedCrossRef
45.
go back to reference Rametti G, Carrillo B, Gomez-Gil E, Junque C, Zubiarre-Elorza L, Segovia S, Gomez A, Guillamon A (2011) The microstructure of white matter in male to female transsexuals before cross-sex hormonal treatment. A DTI study. J Psychiatr Res 45:949–954PubMedCrossRef Rametti G, Carrillo B, Gomez-Gil E, Junque C, Zubiarre-Elorza L, Segovia S, Gomez A, Guillamon A (2011) The microstructure of white matter in male to female transsexuals before cross-sex hormonal treatment. A DTI study. J Psychiatr Res 45:949–954PubMedCrossRef
Metadata
Title
Diffusion tensor imaging and brain volumetry in Fabry disease patients
Authors
Teemu Paavilainen
Virva Lepomäki
Jani Saunavaara
Ronald Borra
Pirjo Nuutila
Ilkka Kantola
Riitta Parkkola
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 5/2013
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-012-1131-8

Other articles of this Issue 5/2013

Neuroradiology 5/2013 Go to the issue