Ho Chi Joseph Lai1, Tian Yang2, Jianpan Huang1, Yang Liu1, Youngjin Lee2, and Wai Yan Kannie Chan1,3,4,5
1Department of Biomedical Engineering, City University of Hong Kong, Hong Kong, Hong Kong, 2Department of Neuroscience, City University of Hong Kong, Hong Kong, Hong Kong, 3Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, United States, 4City University of Hong Kong Shenzhen Research Institute, Shenzhen, China, 5Hong Kong Centre for Cerebro-Cardiovascular Health Engineering, Hong Kong, Hong Kong
Synopsis
We have shown that
CEST (APTw and rNOE) contrast demonstrated distinctive changes of ICH mouse
brains longitudinally1. As demonstrated by our published work2, the rNOE changes could be primarily
associated with changes in myelin. Here, we studied the APTw and rNOE contrast
after ICH up to 14 days, and under DFX treatment. We observed regional changes
of APTw and rNOE contrast in the core and peri-hematoma regions, especially the
significant difference (P<0.05) on day 3 with and without DFX treatment. Our
immunohistochemistry data indicated that rNOE contrast correlated with myelin,
which supports that rNOE could detect myelin pathology during ICH.
Introduction
We demonstrated that APTw and rNOE contrast
of ICH could indicate distinctive pathology1. Since the molecular mechanism of injury in ICH is not fully
revealed, here we would like to further study the underlying neuropathology
indicated by CEST MRI at 3T. Lipid plays an important role during the
evolvement of ICH, especially lipid peroxidation, which could cause white
matter injury in the brain3. In our recent published work2, we demonstrated that rNOE could detect
myelin-related neuropathology. We hypothesized that rNOE could detect lipid-related
pathology or lipid peroxidation in ICH to identify the injury in the brain
during ICH.
In this study, we imaged the ICH mice with and without DFX treatment
using CEST MRI, and we analyzed the changes of APTw and rNOE contrast over two
weeks after ICH induction. Since the iron content in hematoma could attenuate
the CEST contrast, we studied the effect of iron on CEST contrast in vitro and compare CEST contrast in
ICH mice with DFX, i.e. iron chelation treatment. This is to study the feasibility
of imaging changes in hematoma using CEST and the detection of related
neuropathology. After that, representative mice from each time point were
sacrificed for immunohistochemical studies, including the protein and myelin
pathology3. Methods
C57BL/6 mice (8-10 weeks, Jackson
Laboratory) were induced with ICH by following a reported protocol4. Half
of the ICH mice were randomly selected for iron chelation treatment5. Deferoxamine (DFX, Sigma) was delivered by
intraperitoneal injection 6hr after the stroke induction and repeated
every 12hr for 7 consecutive days, with 200mg/kg per dose. The control mice
were injected with the same volume of saline.
The ICH mice were imaged by a horizontal bore 3T Bruker BioSpec
scanner over 2weeks. The scanning parameters were based on the protocol from
our group6. The imaging
parameters were as follows: TR=6000ms; TE=6ms; FOV=20×20mm; matrix=96×96;
thickness=1.5mm; RARE factor=32; B1=0.8μT and saturation time=3s. Frequency
offsets of the Z-spectrum included ±15ppm, ±10ppm, ±9ppm, and distributed
between ±8ppm with 0.25ppm step size. ROIs for the core and peri-hematoma were
drawn based on the corresponding T2-weighted images.
Representative mice were sacrificed at specific time points for the
immunohistochemical study. Two
immunohistochemical staining methods, Myelin Basic Protein (MBP)7 and FluoroMyelin™ (FM, ThermoFisher)8, were co-stained and the brain sections
were imaged with fluorescence microscopy to reveal the pathological changes of
myelin after ICH.
All statistical
analysis was done by GraphPad Prism software, version 8.0 (GraphPad Software
Inc.), and considered statistically significant for P<0.05 by two-tailed
Student’s t-test. Results and Discussion
In Fig. 1A, we observed distinctive changes
in rNOE and APTw contrast within hematoma over two weeks. Since the iron
content could have an effect on the CEST contrast, we applied DFX treatment to
further study the CEST contrast in hematoma5. We observed a significant decrease in the rNOE signal on day 3,
while rNOE in the DFX group is significantly lower than that in the control
group (P<0.05) (Fig. 1B). Interestingly, the changes in the APTw (Fig. 1C)
were not obvious. In addition, we found that there is an observable difference
between the core and periphery of the hematoma, hence we performed a separate
ROI analysis on these two regions (Fig. 2C, D). The DFX-treated group showed a
significant decrease in rNOE contrast on day 3 for both core and peri-hematoma,
which corresponds to a 26.8% and 27.3% drop, respectively. Yet, no significant
difference was observed at other time points. rNOE is sensitive to lipids and proteins,
which are the major components of myelin. During hematoma evolution3, the observed decrease on day 3 could be due to the loss of myelin,
while the noticeable difference in rNOE between the core and peri-hematoma on
day 7 in DFX group could indicate the change in myelin-related lipids or protein
during regeneration. This is also supported by our immunohistochemistry (Fig. 3).
Both lipid (FM) and protein (MBP)
components of myelin showed a decrease on day 3 in DFX, while a
distinctive contrast between the core and peri-hematoma was observed on day 7
(Fig. 3B).
We further studied the correlation between
the rNOE contrast and FM (Fig. 4). We observed a strong correlation (R=0.816,
***P<0.0001), which could indicate the rNOE signal change came from the
myelin lipid. In contrast, the MBP intensities in Fig. 4B did not show a significant
correlation (R=0.285, P=0.2852). This validated
our rNOE findings, which could detect ICH pathology related to myelin.Conclusion
rNOE and
APTw significantly decreased on day 3 after ICH. rNOE detected a 27% decrease
in ICH mice after DFX treatment on day 3. As validated by the myelin-specific
immunohistochemistry, rNOE correlated with the amount of myelin lipid in
hematoma. Moreover, a slightly higher rNOE contrast in the core than in the
peri-hematoma was observed on day 7 in the DFX group but not in the control group,
which could indicate myelin-related changes during recovery. This supports that
rNOE could detect myelin-related neuropathology in ICH at 3T and indicate recovery
after ICH. Nevertheless, these findings demonstrated that rNOE and APTw could detect
specific molecular changes during ICH and after DFX treatment.
Acknowledgements
We are grateful to
receive funding support from the Research Grants
Council: 11102218; City University of Hong Kong: 7005210, 7005433, 9680247,
9667198 and 9609307; National Natural Science Foundation of China: 81871409.References
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