The Buffalo Neuroimaging Analysis Center (BNAC) strives to extend the boundaries of current knowledge about neurological diseases and disorders through innovative research techniques and the application of bioinformatics resources.
- In 2016, Dr. Zivadinov authored a paper that was published in Multiple Sclerosis called “Leptomeningeal Contrast Enhancement (LM CE) is Associated with the Progression of Cortical Atrophy in MS; A retrospective, pilot, observational longitudinal study.” During the study, we learned that Leptomeningeal Contrast Enhancement can be a living biomarker of cortical pathology (brain atrophy) in Multiple Sclerosis patients. 50 patients were followed for five years. At the end of five years, all of the patients were scanned using 3-D fluid-attenuated inversion recovery magnetic resonance imaging. In total, 25 patients (50%) of MS patients had LM CE at the five year follow-up. Hence, it can be assumed that the presence of LM CE is associated with the progression of cortical atrophy.
- The NeuroSTREAM analysis tool has been substantially updated with a multi-atlas algorithm to provide more accurate and robust atrophy measures. To build a comprehensive normative database, it has been run on over 14,000 baseline and follow-up MRI scans from 2,140 people with MS, 200 people with CIS and 381 healthy individuals. This normative data is in the process of being incorporated into an interactive, web-based predictive modeling system. In the meantime, the NeuroSTREAM method has also been applied to a prospectively collected real-world multi-center study of clinical routine imaging in MS (MS-MRIUS). In this large, heterogeneous dataset, NeuroSTREAM was the only atrophy measure that produced significant and clinically-correlated results.
- In 2016, BNAC served as a centralized imaging center for 2 clinical trials focusing on stroke prevalence in subjects undergoing transcatheter aortic valve implantation (TAVI) One was published in JAMA, the “Effect of a Cerebral Protection Device on Brain Lesions Following Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis: The CLEAN-TAVI Randomized Clinical Trial”, while the other called “Cerebral embolic protection during transcatheter aortic valve replacement” was published in J Am Coll Cardiol and is under approval by the Food and Drug Administration. Even after TAVI, stroke still remains a major predictor of mortality in humans. It was proposed that cerebral protection devices may reduce brain injury as determined by diffusion-weighted magnetic resonance imaging (DWMRI). In the two trials, we studied the effect of a cerebral protection device on the number and volume of cerebral lesions in patients under-going TAVI. The primary end point was the numerical difference in new positive post-procedure DWMRI brain lesions at two days after TAVI in potentially protected territories. The first hierarchical secondary outcome was the difference in volume of new lesions after TAVI in potentially protected territories.
- Another significant study that BNAC worked on this year was called “Cerebral Microbleeds in Multiple Sclerosis; A case-controlled study.” It was published in Radiology. Cerebral microbleeds have been documented to be associated with aging and neurodegenerative disorders. No previous studies have investigated Cerebral Microbleeds (CMB) in terms of their prevalence to MS patients. We scanned a number of MS patients here in Buffalo by means of a 3T MRI and they were also given clinical examinations. CMB number was assessed on susceptibility-weighted minimum intensity projections using the Microbleed Anatomical Rating Scale. Our results concluded that more MS patients had CMBs compared to healthy controls. The presence of CMBs also put patients at risk for more physical disability as well as deteriorated auditory/verbal learning and memory in MS patients.
- In 2016, we concluded a study called “Humoral Response to EBV is Associated with Cortical Atrophy and Lesion Burden in MS patients” which was published in Neurology, Neuroimmunology and Neuroinflammation. Because dysregulated Epstein-Barr virus (EBV)-infected B cells may induce meningeal inflammation, which contributes to cortical pathology in MS, we investigated associations between antibody responses to EBV and the development of cortical pathology in MS. All participants were scanned on 3T MRI. Serum samples were analyzed for IgG antibodies against EBV viral capsid antigen (VCA) and EBV nuclear antigen-1 (EBNA-1), and their quartiles were determined on the whole study sample. We found that more than 30% of patients with MS and CIS presented with the highest quartile of anti-EBV-VCA and -EBNA-1 status compared to ≤10% of healthy controls. Humoral response to anti-EBV-VCA and -EBNA-1 is associated with more advanced cortical atrophy, accumulation of chronic T1 black holes and focal white matter lesions in patients with MS.
- CEG Study: Throughout 2016, The Buffalo Neuroimaging Analysis Center (BNAC) continued actively enrolling subjects in the CEG-MS study. With the help of Dr. Dejan Jakimovski and Dr.Ivo Paunkoski as new fellows, together with Dr.Sirin Gandhi, the recruitment process went as planned. Following interim analysis, the CEG-MS study yielded several published journal and conference papers. Notable papers accepted in high impact factor journals like Multiple Sclerosis Journal (MSJ) and Radiology as well as conference abstracts in the American Academy of Neurology (AAN), ECTRIMS (European Committee for Treatment and Research In Multiple Sclerosis) and The International Society for Neurovascular Diseases (ISNVD) further demonstrate the uniqueness and strength of this long-term follow-up study. With the increasing number of enrolled patients, we are looking forward to an exciting 2017 that will vastly contribute in understanding the cardiovascular, environmental and genetic influences on the pathophysiology and progression of MS.
- BNAC is a leader in the development of new analysis techniques geared toward obtaining a more complete understanding of underlying disease processes. To view the latest developments of BNAC’s research studies on quantitative magnetic resonance, ultrasound and optic coherence tomography imaging findings in multiple sclerosis (MS), Parkinson’s and Alzheimer’s diseases as well as aging, click here.
- BNAC is investigating the role that extracranial venous abnormalities play in the pathophysiology of neurologic disorders. To see the latest updates in the extracranial venous system research, click here.
- BNAC is a dedicated research center for quantitative analysis of MRI for clinical research including Phase I, II, III, and IV clinical trials and investigator-led research studies on multiple sclerosis, stroke, Parkinon’s disease, Alzheimer’s disease and other neurodegenerative diseases. BNAC ensures fast contracting, ethical committee approval and start-up processes, and is structured to manage multiple projects with tens of thousands of scans. BNAC brings to every clinical trial a high degree of professionalism and integrity that stipulates unequivocal respect for deadlines and commitments.
1. Buffalo, NY – February 4, 2014. BNAC part in the GALA study that prompts change in FDA labelling for glatiramer acetate (Copaxone©)
On the basis of results from the GALA study group, which included UB Dept. of Neurology Professor of Neurology Robert Zivadinov, MD, PhD, the FDA has approved three-times weekly glatiramer acetate (Copaxone©) injections for relapsing-remitting multiple sclerosis. Prior approved dosing required daily injections. The study, which was conducted across 17 countries and involved more than 1400 patients, showed that the three-times weekly regimen is safe and effective, with the advantage of fewer injections. The GALA study was published in the June 2013 issue of Annals of Neurology. Dr. Zivadinov directs the BNAC which performed the MRI analysis for the trial.