Development of High-Speed and Quantitative Neuro MRI Technologies for Challenging Patient Populations

项目摘要 所提出的技术有效地解决了当前MRI协议中的显著缺点， 这是现有协议无法获得一套完整的高分辨率，无伪影，多， 来自具有挑战性的患者的对比和定量MR图像（例如，帕金森病（PD）患者; 中风患者;儿科人群）。在这里，我们将开发和整合 多学科方法，以最大限度地提高先进MRI技术的临床应用的可转化性， 挑战患者目标1A）我们将结合快速扫描策略，运动校正和失真- 校正模块到我们最近开发的多路敏感性编码（MUSE）DTI和功能磁共振成像中， 新的方式，以实现高分辨率的连通性映射（在0.85毫米的各向同性分辨率，相比之下， 1.5mm至4 mm，这是传统DTI和fMRI协议的标准）。在这项决议中，至关重要 网络节点（例如，运动和非运动亚区的丘脑底核（ESTA））和途径， 对病人护理很重要（例如，用于脑深部刺激的改进的MRI引导）可以可靠得多 解决了目的1B）我们将开发一种创新的多回波通路MRI方法，以显著降低 多重对比MRI和参数成像的扫描时间（例如，同时实现T1和T2参数 3分钟内的标测：比常规方案提高~ 4倍）。目标1C）我们将发展运动 伪影校正方案，适用于高分辨率多对比度MRI在具有挑战性的患者。 目的2A）我们计划首先以两种方式在健康成年志愿者中评估MRI技术。一是数据 用我们的方法和传统的，更耗时的协议获得的将进行定量比较。 第二，只能从我们的高分辨率数据中产生的新知识（例如，成像马达- 将使用θ-突发经颅磁模拟（TMS）神经元检查来确认 运动神经网络的调节。目的2B）我们计划评估PD中提出的成像技术 患者以三种方式首先，在横断面研究中，我们将从1） PD转换的高风险人群（有阳性家族史、嗅觉减退、快速眼球运动 睡眠行为障碍、便秘和工具性日常活动障碍），2）早期PD 3）晚期PD患者（Hoehn和Yahr量表3和4） 4）。将评估三个人群的大脑结构和功能差异。第二，在一个 纵向研究，从第2年和第3年转化为PD的高风险受试者中获得的成像数据 5的项目将进行比较，以测量前驱脑信号异常及其相关性， 纵向行为和MRI信号变化。第三，我们将比较从PD获得的成像数据， 患者和非PD患者（主要是特发性震颤），以评估鉴别诊断的准确性， 提出的成像技术。

Project Summary The proposed technologies effectively address a significant shortcoming in current MRI protocols, that is the incapability of existing protocols to acquire a complete set of high-resolution, artifact-free, multi- contrast and quantitative MR images from challenging patients (e.g., Parkinson’s disease (PD) patients; stroke patients; pediatric populations) within clinically-feasible time. Here we will develop and integrate multidisciplinary approaches to maximize the translatability of advanced MRI technologies to clinical uses for challenging patients. Aim 1A) We will incorporate fast scan strategies, motion-correction and distortion- correction modules into our recently developed multiplexed sensitivity encoded (MUSE) DTI and fMRI in a novel way, to enable high-resolution connectivity mapping (at 0.85 mm isotropic resolution, in contrast to 1.5mm to 4mm that are standard with conventional DTI and fMRI protocols). At this resolution, critical network nodes (e.g., motor and non-motor subregions of subthalamic nucleus (STN)) and pathways that are important for patient care (e.g., improved MRI guidance for deep brain stimulation) can be much more reliably resolved. Aim 1B) We will develop an innovative multi-echo-pathway MRI method to significantly reduce the scan time of multi-contrast MRI and parametric imaging (e.g., achieving simultaneous T1 and T2 parametric mapping within 3 min: ~ 4-fold improvement than conventional protocols). Aim 1C) We will develop motion artifact correction schemes that are suitable for high-resolution multi-contrast MRI in challenging patients. Aim 2A) We plan to first evaluate the MRI technologies in healthy adult volunteers in two ways. First, data obtained with our methods and conventional, more time-consuming protocols will be quantitatively compared. Second, new knowledge that can only be produced from our high-resolution data (e.g., imaging motor- subregions of STN) will be confirmed with theta-burst transcranial magnetic simulation (TMS) neuro- modulation of motor networks. Aim 2B) We plan to evaluate the proposed imaging technologies in PD patients in three ways. First, in a cross-sectional study, we will acquire and compare imaging data from 1) those who are at high risk of PD conversion (with positive family history, hyposmia, rapid eye movement sleep behavior disorder, constipation, and impairments in instrumental daily activities), 2) early-stage PD patients (Hoehn and Yahr scale 1 and 2), and 3) advanced-stage PD patients (Hoehn and Yahr scale 3 and 4). Difference in brain structure and function across three populations will be assessed. Second, in a longitudinal study, imaging data obtained from subjects with high risk of conversion to PD in year 2 and year 5 of the project will be compared to measure prodromal brain signal abnormalities and their correlation with longitudinal behavioral and MRI signal changes. Third, we will compare imaging data obtained from PD patients and non-PD patients (mainly essential tremor) to evaluate the differential diagnosis accuracy of the proposed imaging technologies.