Radiological features of poliomyelitis: cerebral changes decades after the original infection

Published: 1 April 2021| Version 1 | DOI: 10.17632/dys423mzjp.1
Stacey Li Hi Shing, Jasmin Lope, Mary Clare McKenna, Rangariroyashe H. Chipika, Orla Hardiman, Peter Bede


Corresponding author: Peter Bede, Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin 2, Ireland Abstract Cerebral changes are seldom evaluated radiologically in poliomyelitis survivors despite widespread motor and extra-motor complaints. [1] While acute poliomyelitis infection manifests as a lower motor neuron syndrome with flaccid paralysis, a multitude of additional symptoms have been reported by poliomyelitis survivors, decades after the original infection. In a prospective, single-centre neuroimaging study, cerebral changes were evaluated in a cohort of 36 poliomyelitis survivors. [2] A standardised quantitative neuroimaging protocol was implemented on 3 Tesla Philips Achieva system. Data were acquired using an 8-channel receive-only head coil. A 3D Inversion Recovery prepared Spoiled Gradient Recalled echo (IR-SPGR) sequence was utilised to acquire T1-weighted images with a spatial resolution of 1 mm3, field-of-view (FOV) of 256 x 256 x 160 mm, flip angle = 8°, SENSE factor = 1.5, TR/TE = 8.5/3.9 ms, TI =1060 ms, and an acquisition time of 7 min 30 s. A spin-echo echo planar imaging (SE-EPI) sequence was used to acquire diffusion tensor images (DTI) with a 32-direction Stejskal-Tanner diffusion encoding scheme. Spatial resolution = 2.5 mm3, FOV = 245 x 245 x 150 mm, 60 slices acquired without inter-slice gap, TR/TE = 7639 / 59 ms, SENSE factor = 2.5, b-values = 0, 1100 s/mm2, with SPIR fat suppression, dynamic stabilisation and a total acquisition time of 5 min 41 s. To assess vascular white matter lesion load, FLAIR images were also acquired in axial orientation with an Inversion Recovery Turbo Spin Echo (IR-TSE) sequence: FOV = 230 x 183 x 150 mm. Data from poliomyelitis survivors were quantitatively interpreted with reference to healthy controls and patients with amyotrophic lateral sclerosis. Standard morphometry and tract-based spatial statistics are reported in our original communication. [2] We present additional raw, region-of-interest (ROI) grey and white metrics to complement our voxelwise statistics. Grey matter metrics are presented as partial volume data and the following white matter diffusivity metrics are provided: axial diffusivity (AD), fractional anisotropy (FA), radial diffusivity (RD). Methods for quality control, pre-processing, spatial registration and retrieving ROI metrics are reported in the original research papers. [2, 3] References 1. Li Hi Shing, S., et al., Post-polio Syndrome: More Than Just a Lower Motor Neuron Disease. Front Neurol, 2019. 10: p. 773. 2. Li Hi Shing, S., et al., Increased cerebral integrity metrics in poliomyelitis survivors: putative adaptation to longstanding lower motor neuron degeneration. Journal of the Neurological Sciences, 2021: p. 117361. 3. Li Hi Shing, S., et al., Extra-motor manifestations in post-polio syndrome (PPS): fatigue, cognitive symptoms and radiological features. Neurol Sci, 2021.



Clinical Neurology, Digital Radiology