In vivo Imaging of Brain Damage in HTLV-I Associated Tropical Spastic Paraparesis

htlv - i相关脊髓病/热带痉挛性麻痹（HAM/TSP）是一种慢性进行性中枢神经系统疾病，在中美洲和南美洲人群中尤为普遍，在巴西等国家，它会造成重大的社会和经济影响。尽管最常报道的中枢神经系统病理部位是胸椎水平的脊髓，但有证据表明，HTLV-I感染后的脑损伤，尽管不像脊髓受累那样明显，但可能是实质性的，甚至可能发生在无症状的HTLV-I携带者身上。本研究的目的是描述和量化巴西HAM/TSP患者脑白质和皮层的变化及其与认知功能障碍的关系。我们的研究计划取决于马萨诸塞州波士顿的麻省总医院（MGH）阿蒂努拉a .马蒂诺斯生物医学成像中心、巴西巴西巴西巴西州立大学（universsidade do Estado do里约热内卢de Janeiro）和临床诊断中心（CDPI）的研究人员之间的合作关系。这项合作工作提出将先进的多光谱磁共振图像采集和分析方法与临床神经学和认知评估技术相结合。该提案还寻求为巴西的神经成像专家和神经科医生提供必要的培训，以应用Athinoula A. Martinos生物医学成像中心开发的先进神经成像工具来研究这种在他们国家日益重要的脑部疾病。了解HAM/ tsp相关脑损伤的体内致病机制及其神经系统后果可能最终导致对这种地方性疾病及其许多临床表现的更有效的治疗和预防干预。本研究旨在利用先进的多光谱磁共振成像方法，对巴西htlf - i相关脊髓病/热带痉挛性截瘫（HAM/TSP）患者的体内脑病理变化及其与认知功能障碍的关系进行表征和量化。HAM/TSP是一种慢性进行性中枢神经系统疾病，在巴西尤为普遍，造成重大的社会和经济影响。该项目将通过马萨诸塞州波士顿的麻省总医院（MGH） Athinoula a . Martinos生物医学成像中心、巴西巴西里约热内卢州立大学（universsidade do Estado do里约热内卢de Janeiro）和临床诊断中心（CDPI）的研究人员之间的合作伙伴关系进行。了解HAM/ tsp相关脑损伤的体内致病机制及其神经系统后果可能最终导致对这种地方性疾病更有效的治疗和预防干预。

DESCRIPTION (provided by applicant): Abstract HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic, progressive disease of the CNS that is particularly prevalent among populations in Central and South America, where in countries like Brazil, it causes significant social and financial impact. Although the most frequently reported site of CNS pathology is the spinal cord at the thoracic level, there is evidence that brain damage following HTLV-I infection, although poorly and less characterized than spinal cord involvement, is potentially substantial and may occur even in asymptomatic HTLV-I carriers. The goals of this proposal are to characterize and quantify white matter and cortical changes in the brain and their relation to cognitive dysfunction in a Brazilian population of patients with HAM/TSP. Our study plan rests on the formation of a partnership between investigators at the Massachusetts General Hospital (MGH) Athinoula A. Martinos Center for Biomedical Imaging in Boston, MA, and the Clinica de Diagnostico por Imagem (CDPI) and the Universidade do Estado do Rio de Janeiro, Brazil. This collaborative work proposes to combine advanced multi-spectral MR image acquisition and analysis methods with clinical neurologic and cognitive assessment techniques. This proposal also seeks to provide the neuroimaging specialists and neurologists in Brazil with the training necessary to apply advanced neuroimaging tools developed at the Athinoula A. Martinos Center for Biomedical Imaging to study this brain disorder of emerging public importance in their country. Understanding the in vivo pathogenic mechanisms of HAM/TSP-associated brain damage and its neurologic consequences may ultimately lead to more effective therapeutic and preventive interventions of this endemic disorder and its many clinical manifestations PUBLIC HEALTH RELEVANCE: This proposal aims at characterizing and quantifying, using advanced multi-spectral MR image methods, in vivo brain pathological changes in a Brazilian population of patients with HTLV-I- associated myelopathy/tropical spastic paraparesis (HAM/TSP), and their relation to cognitive dysfunction. HAM/TSP is a chronic, progressive disease of the CNS that is particularly prevalent in Brazil where it causes significant social and financial impact. The project will be conducted through the formation of a partnership between investigators at the Massachusetts General Hospital (MGH) Athinoula A. Martinos Center for Biomedical Imaging in Boston, MA, and the Clinica de Diagnostico por Imagem (CDPI) and the Universidade do Estado do Rio de Janeiro, Brazil. Understanding the in vivo pathogenic mechanisms of HAM/TSP-associated brain damage and its neurologic consequences may ultimately lead to more effective therapeutic and preventive interventions of this endemic disorder.