Magnetization transfer ratio quantifies polyneuropathy in hereditary transthyretin amyloidosis

Objective To quantify peripheral nerve lesions in symptomatic and asymptomatic hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PNP) by analyzing the magnetization transfer ratio (MTR) of the sciatic nerve, and to test its potential as a novel biomarker for macromolecular changes. Met...

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Hauptverfasser: Hayes, Jennifer (VerfasserIn) , Hegenbart, Ute (VerfasserIn) , Kimmich, Christoph (VerfasserIn) , Hund, Ernst (VerfasserIn) , Purrucker, Jan (VerfasserIn) , Hayes, John M. (VerfasserIn) , Lentz, Stephen I. (VerfasserIn) , Sam, Georges (VerfasserIn) , Jende, Johann (VerfasserIn) , Schönland, Stefan (VerfasserIn) , Bendszus, Martin (VerfasserIn) , Heiland, Sabine (VerfasserIn) , Weiler, Markus (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 2020
In: Annals of Clinical and Translational Neurology
Year: 2020, Jahrgang: 7, Heft: 5, Pages: 799-807
ISSN:2328-9503
DOI:10.1002/acn3.51049
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/acn3.51049
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/acn3.51049
Volltext
Verfasserangaben:Jennifer Kollmer, Ute Hegenbart, Christoph Kimmich, Ernst Hund, Jan C. Purrucker, John M. Hayes, Stephen I. Lentz, Georges Sam, Johann M. E. Jende, Stefan O. Schönland, Martin Bendszus, Sabine Heiland & Markus Weiler

MARC

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520 |a Objective To quantify peripheral nerve lesions in symptomatic and asymptomatic hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PNP) by analyzing the magnetization transfer ratio (MTR) of the sciatic nerve, and to test its potential as a novel biomarker for macromolecular changes. Methods Twenty-five patients with symptomatic ATTRv-PNP, 30 asymptomatic carriers of the mutant transthyretin gene (mutTTR), and 20 age-/sex-matched healthy controls prospectively underwent magnetization transfer contrast imaging at 3 Tesla. Two axial three-dimensional gradient echo sequences with and without an off-resonance saturation rapid frequency pulse were conducted at the right distal thigh. Sciatic nerve regions of interest were manually drawn on 10 consecutive axial slices in the images without off-resonance saturation, and then transferred to the corresponding slices that were generated by the sequence with the off-resonance saturation pulse. Subsequently, the MTR and cross-sectional area (CSA) of the sciatic nerve were evaluated. Detailed neurologic and electrophysiologic examinations were conducted in all ATTRv-PNP patients and mutTTR-carriers. Results Sciatic nerve MTR and CSA reliably differentiated between ATTRv-PNP, mutTTR-carriers, and controls. MTR was lower in ATTRv-PNP (26.4 ± 0.7; P < 0.0001) and in mutTTR-carriers (32.6 ± 0.8; P = 0.0005) versus controls (39.4 ± 2.1), and was also lower in ATTRv-PNP versus mutTTR-carriers (P = 0.0009). MTR correlated negatively with the NIS-LL and positively with CMAPs and SNAPs. CSA was higher in ATTRv-PNP (34.3 ± 1.7 mm3) versus mutTTR-carriers (26.0 ± 1.1 mm3; P = 0.0005) and versus controls (20.4 ± 1.2 mm3; P < 0.0001). CSA was also higher in mutTTR-carriers versus controls. Interpretation MTR is a novel imaging marker that can quantify macromolecular changes in ATTRv-PNP and differentiate between symptomatic ATTRv-PNP and asymptomatic mutTTR-carriers and correlates with electrophysiology. 
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