The correspondence between morphometric MRI and metabolic profile in Rasmussen’s encephalitis

• Published in: NeuroImage clinical Vol. 33; p. 102918
• Main Authors: Tang, Chongyang, Ren, Peng, Ma, Kaiqiang, Li, Siyang, Wang, Xiongfei, Guan, Yuguang, Zhou, Jian, Li, Tianfu, Liang, Xia, Luan, Guoming
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.01.2022; Elsevier
• Subjects: Atrophy - pathology; Encephalitis - diagnostic imaging; Encephalitis - pathology; Gray Matter - diagnostic imaging; Gray Matter - pathology; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Metabolome; Neurotransmitter; Positron emission tomography; Radiology; Rasmussen’s encephalitis; Regular; Voxel-based morphometry; FDG-PET; TIV; VBM; MRI; GM; Voxel-based morphometry; SPECT; TPM; SPM; RE; Magnetic resonance imaging; Neurotransmitter; EPC; FLAIR; Rasmussen’s encephalitis; Positron emission tomography; ASDs; magnetic resonance imaging; anti-seizure drugs; total intracranial volume; fluid-attenuated inversion recovery; Fluorodeoxyglucose-positron emission tomography; single photon computed emission tomography; voxel-based morphometry; Statistic Parametric Mapping; gray matter; tissue probability map; epilepsia partialis continua; Rasmussen's encephalitis
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2021.102918

•The GM atrophy located in the insular and temporal cortices of the affected side.•Positive correlation was found in the brain region featuring MRI atrophy and FDG-PET.•GM atrophy was spatially correlated with dopaminergic and serotonergic mapping in RE. Volumetric magnetic resonance imaging (MRI) atrophy is a hallmark of Rasmussen’s encephalitis (RE). Here, we aim to investigate voxel-wise gray matter (GM) atrophy in RE, and its associations with glucose hypometabolism and neurotransmitter distribution utilizing MRI and PET data. In this study, fifteen RE patients and fourteen MRI normal subjects were included in this study. Voxel-wise GM volume and glucose metabolic uptake were evaluated using structural MRI and FDG-PET images, respectively. Spatial Spearman’s correlation was performed between GM atrophy of RE with FDG uptake alterations, and neurotransmitter distributions provided in the JuSpace toolbox. Compared with the control group, RE patients displayed extensive GM volume loss not only in the ipsilateral hemisphere, but also in the frontal lobe, basal ganglia, and cerebellum in the contralateral hemisphere. Within the RE group, the insular and temporal cortices exhibited significantly more GM atrophy on the ipsilesional than the contralesional side. FDG-PET data revealed significant hypometabolism in areas surrounding the insular cortices in the ipsilesional hemisphere. RE-related GM volumetric atrophy was spatially correlated with hypomebolism in FDG uptake, and with spatial distribution of the dopaminergic and serotonergic neurotransmitter systems. The spatial concordance of morphological changes with metabolic abnormalities suggest FDG-PET offers potential value for RE diagnosis. The GM alterations associated with neurotransmitter distribution map could provide novel insight in understanding the neuropathological mechanisms and clinical feature of RE.