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  • Cortical Lesions as Determinants of White Matter Lesion Formation and Cognitive Abnormalities in MS Rochester, Minn. The hallmark of MS is white matter lesion formation. However, there is increased evidence for gray matter (cortical) involvement and we hypothesize that these cortical lesions are present in patients even in early MS, and may directly determine the location of white matter lesion formation, as well as contribute to cognitive dysfunction in MS. Double inversion recovery (DIR) MRI sequences have been described in multiple adult multiple sclerosis studies to be sensitive for cortical lesions. These images can be obtained on 3 Tesla MRI scanners, using a non-invasive protocol that has been in place at Mayo Clinic. If such cortical lesions are truly present in early MS, we anticipate to capture a subset of those using DIR techniques, including a novel DIR sequence available to us through our collaboration with Dr. John Port in the Department of Radiology. We also are testing the hypothesis whether cortical lesions directly determine the location of white matter lesion formation, resulting in being directly connected to white matter lesions through white matter tracts, which would revolutionize our understanding of MS pathogeneses. This will be done using diffusion tensor imaging (DTI)-based tractography coupled with analysis of the DIR images. DTI is a standard MRI technique at Mayo Clinic . DTI images can make connecting nervous system tracts visible and will allow to see whether white and grey matter lesions are connected. In addition, as part of our MRI protocol, we will also obtain high resolution T1 weigthed images, which will enable cortical thickness measurements to be perfromed and correlated with the location of gray matter lesions.
  • Magnetic Resonance Spectroscopy (MRS) of 2-hydroxyglutarate (2HG) for Diagnosis and Follow-up of IDH-mutant Glioma Rochester, Minn.

    The purpose of this study is to develop an MRS-based measurement of 2-HG that is reliable, and to assess the reproducibility of the method(s) above on a cohort of patients with IDH mutant low grade gliomas.  
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