European Radiology

, Volume 27, Issue 5, pp 2206–2215 | Cite as

Multifrequency magnetic resonance elastography of the brain reveals tissue degeneration in neuromyelitis optica spectrum disorder

  • Kaspar-Josche StreitbergerEmail author
  • Andreas Fehlner
  • Florence Pache
  • Anna Lacheta
  • Sebastian Papazoglou
  • Judith Bellmann-Strobl
  • Klemens Ruprecht
  • Alexander Brandt
  • Jürgen Braun
  • Ingolf Sack
  • Friedemann Paul
  • Jens Wuerfel



Application of multifrequency magnetic resonance elastography (MMRE) of the brain parenchyma in patients with neuromyelitis optica spectrum disorder (NMOSD) compared to age matched healthy controls (HC).


15 NMOSD patients and 17 age- and gender-matched HC were examined using MMRE. Two three-dimensional viscoelastic parameter maps, the magnitude |G*| and phase angle φ of the complex shear modulus were reconstructed by simultaneous inversion of full wave-field data in 1.9-mm isotropic resolution at 7 harmonic drive frequencies from 30 to 60 Hz.


In NMOSD patients, a significant reduction of |G*| was observed within the white matter fraction (p = 0.017), predominantly within the thalamic regions (p = 0.003), compared to HC. These parameters exceeded the reduction in brain volume measured in patients versus HC (p = 0.02 whole-brain volume reduction). Volumetric differences in white matter fraction and the thalami were not detectable between patients and HC. However, phase angle φ was decreased in patients within the white matter (p = 0.03) and both thalamic regions (p = 0.044).


MMRE reveals global tissue degeneration with accelerated softening of the brain parenchyma in patients with NMOSD. The predominant reduction of stiffness is found within the thalamic region and related white matter tracts, presumably reflecting Wallerian degeneration.

Key Points

Magnetic resonance elastography reveals diffuse cerebral tissue changes in patients with NMOSD.

Premature tissue softening in NMOSD patients indicates tissue degeneration.

Hypothesis of a widespread cerebral neurodegeneration in form of diffuse tissue alteration.


Multifrequency magnetic resonance elastography MMRE MDEV inversion Brain tissue Neuromyelitis optica 



Aquaporin 4 channel

MDEV inversion

Multifrequency dual elasco-visco inversion


Multifrequency magnetic resonance elastography


Neuromyelitis optica


Neuromyelitis optica spectrum disorder



AF acknowledges a scholarship of the Hanns Seidel Foundation. This work was supported by the German Research Foundation (DFG Exc 257 to FP, DFG 901/17 to IS) and by Bundesministerium für Bildung und Forschung (Competence Network Multiple Sclerosis to FP, FP, KR). The authors thank Susan Pikol and Cynthia Kraut for excellent technical assistance.

The scientific guarantor of this publication is Jens Würfel. The authors of this manuscript declare relationships with the following companies: Alexion, Chugai, Biogen, MedImmune, Teva, MerckSerono, Bayer, Novartis, Roche, SanofiGenzyme, Shire. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported in Pache F, Zimmermann H, Finke C, et al. (2016) Brain parenchymal damage in neuromyelitis optica spectrum disorder - A multimodal MRI study. Eur Radiol online first: 24 March 2016. DOI  10.1007/s00330-016-4282-x

Methodology: prospective, case-control study, observational, performed at one institution


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Kaspar-Josche Streitberger
    • 1
    • 2
    Email author
  • Andreas Fehlner
    • 1
  • Florence Pache
    • 2
    • 3
  • Anna Lacheta
    • 3
  • Sebastian Papazoglou
    • 3
  • Judith Bellmann-Strobl
    • 4
  • Klemens Ruprecht
    • 2
  • Alexander Brandt
    • 3
  • Jürgen Braun
    • 5
  • Ingolf Sack
    • 1
  • Friedemann Paul
    • 2
    • 3
    • 4
  • Jens Wuerfel
    • 3
    • 4
    • 6
  1. 1.Department of RadiologyCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Neurology with Experimental NeurologyCharité – Universitätsmedizin BerlinBerlinGermany
  3. 3.NeuroCure Clinical Research CenterCharité – Universitätsmedizin BerlinBerlinGermany
  4. 4.Experimental and Clinical Research CenterMax Delbrueck Center for Molecular Medicine and Charité – Universitätsmedizin BerlinBerlinGermany
  5. 5.Institute of Medical InformaticsCharité – Universitätsmedizin BerlinBerlinGermany
  6. 6.Medical Image Analysis Center (MIAC AG)BaselSwitzerland

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