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Assessment of disease severity in late infantile neuronal ceroid lipofuscinosis using multiparametric MR imaging Dyke JP; Sondhi D; Voss HU; Shungu DC; Mao X; Yohay K; Worgall S; Hackett NR; Hollmann C; Yeotsas ME; Jeong AL; Van de Graaf B; Cao I; Kaminsky SM; Heier LA; Rudser KD; Souweidane MM; Kaplitt MG; Kosofsky B; Crystal RG; Ballon DAJNR Am J Neuroradiol 2013[Apr]; 34 (4): 884-9BACKGROUND 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 R2 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 (R2=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.|*Severity of Illness Index[MESH]|Age Factors[MESH]|Aminopeptidases/genetics[MESH]|Artifacts[MESH]|Biomarkers/metabolism[MESH]|Brain/metabolism/*pathology[MESH]|Child[MESH]|Child, Preschool[MESH]|Databases, Factual[MESH]|Dipeptidyl-Peptidases and Tripeptidyl-Peptidases/genetics[MESH]|Disease Progression[MESH]|Female[MESH]|Humans[MESH]|Magnetic Resonance Imaging/*methods[MESH]|Male[MESH]|Neuronal Ceroid-Lipofuscinoses/genetics/*pathology[MESH]|Serine Proteases/genetics[MESH]|Tripeptidyl-Peptidase 1[MESH] |
