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

描述（由申请人提供）：摘要HTLV-1相关脊髓病/热带痉挛性下肢轻瘫（HAM/TSP）是一种慢性、进行性CNS疾病，在中美洲和南美洲人群中尤其普遍，在巴西等国家，它会造成重大的社会和经济影响。虽然最常报告的中枢神经系统病变部位是胸段脊髓，但有证据表明，HTLV-I感染后的脑损伤，尽管与脊髓受累相比表现较差且特征较弱，但可能是实质性的，甚至可能发生在无症状的HTLV-I携带者中。本提案的目标是表征和量化白色物质和皮质的变化，在巴西的HAM/TSP患者的认知功能障碍的关系。我们的研究计划依赖于马萨诸塞州总医院（MGH）Athinoula A研究者之间的合作关系。Martinos Center for Biomedical Imaging in Boston，MA，and Clinica de Diagnostico por Imagem（CDPI）and the Universidade do Estado do Rio de Janeiro，Brazil.这项合作工作提出将联合收割机先进的多光谱MR图像采集和分析方法与临床神经和认知评估技术相结合。该提案还旨在为巴西的神经成像专家和神经学家提供必要的培训，以应用Athinoula A开发的先进神经成像工具。Martinos生物医学成像中心研究这种在他们国家具有重要意义的大脑疾病。了解HAM/TSP相关脑损伤的体内致病机制及其神经学后果可能最终导致对这种地方性疾病及其许多临床表现进行更有效的治疗和预防干预。该提案旨在使用先进的多光谱MR图像方法，巴西HTLV-I相关性脊髓病/热带痉挛性轻瘫（HAM/TSP）患者群体的体内脑病理学变化及其与认知功能障碍的关系。HAM/TSP是一种慢性、进行性CNS疾病，在巴西特别流行，造成重大的社会和经济影响。该项目将通过马萨诸塞州总医院（MGH）Athinoula A的研究者之间建立伙伴关系来进行。Martinos Center for Biomedical Imaging in Boston，MA，and Clinica de Diagnostico por Imagem（CDPI）and the Universidade do Estado do Rio de Janeiro，Brazil.了解HAM/TSP相关脑损伤及其神经学后果的体内致病机制可能最终导致这种地方性疾病的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.