Assessment of Disease Severity in Late Infantile Neuronal Ceroid Lipofuscinosis Using Multiparametric MR Imaging

作者：Dyke J P^*; Sondhi D; Voss H U; Shungu D C; Mao X; Yohay K; Worgall S; Hackett N R; Hollmann C; Yeotsas M E; Jeong A L; Van de Graaf B; Cao I; Kaminsky S M; Heier L A; Rudser K D; Souweidane M M; Kaplitt M G; Kosofsky B; Crystal R G; Ballon D

来源：American Journal of Neuroradiology, 2013, 34(4): 884-889.

DOI：10.3174/ajnr.A3297

BACKGROUND AND PURPOSE: LINCL is a uniformly fatal lysosomal storage disease resulting from mutations in the CLN2 gene that encodes for tripeptidyl peptidase 1, a lysosomal enzyme necessary for the degradation of products of cellular metabolism. With the goal of developing quantitative noninvasive imaging biomarkers sensitive to disease progression, we evaluated a 5-component MR imaging metric and tested its correlation with a clinically derived disease-severity score.
MATERIALS AND METHODS: MR imaging parameters were measured across the brain, including quantitative measures of the ADC, FA, nuclear spin-spin relaxation times (T2), volume percentage of CSF (%CSF), and NAA/Cr ratios. Thirty MR imaging datasets were prospectively acquired from 23 subjects with LINCL (2.5-8.4 years of age; 8 male/15 female). Whole-brain histograms were created, and the mode and mean values of the histograms were used to characterize disease severity.
RESULTS: Correlation of single MR imaging parameters against the clinical disease-severity scale yielded linear regressions with R-2 ranging from 0.25 to 0.70. Combinations of the 5 biomarkers were evaluated by using PCA. The best combination included ADC, %CSF, and NAA/Cr (R-2 = 0.76, P<.001).
CONCLUSIONS: The multiparametric disease-severity score obtained from the combination of ADC, %CSF, and NAA/Cr whole-brain MR imaging techniques provided a robust measure of disease severity, which may be useful in clinical therapeutic trials of LINCL in which an objective assessment of therapeutic response is desired.

• 出版日期2013-4