A feasibility study of quantifying longitudinal brain changes in herpes simplex virus (HSV) encephalitis using magnetic resonance imaging (MRI) and stereology

Sylviane Defres; Simon S. Keller; Kumar Das; Rishma Vidyasagar; Laura M. Parkes; Girvan Burnside; Michael Griffiths; Michael Kopelman; Neil Roberts; Tom Solomon; Ruth Backman; Gus Baker; Nicholas Beeching; Rachel Breen; David Brown; Chris Cheyne; Enitan Carrol; Nick Davies; Ava Easton; Martin Eccles; Robbie Foy; Marta Garcia-Finana; Julia Granerod; Julia Griem; Alison Gummery; Lara Harris; Helen Hickey; Helen Hill; Ann Jacoby; Hayley Hardwick; Ciara Kierans; Jessie Cooper; Rachel Kneen; Gill Lancaster; Michael Levin; Rebecca McDonald; Antonieta Medina-Lara; Esse Menson; Benedict Michael; Natalie Martin; Manish Sadarangani; Andrew Pennington; Andrew Pollard; Julie Riley; Anne Christine Salter; Maria Thornton; Angela Vincent; Charles Warlow

doi:10.1371/journal.pone.0170215

A feasibility study of quantifying longitudinal brain changes in herpes simplex virus (HSV) encephalitis using magnetic resonance imaging (MRI) and stereology

Sylviane Defres, Simon S. Keller, Kumar Das, Rishma Vidyasagar, Laura M. Parkes, Girvan Burnside, Michael Griffiths, Michael Kopelman, Neil Roberts, Tom Solomon, Ruth Backman, Gus Baker, Nicholas Beeching, Rachel Breen, David Brown, Chris Cheyne, Enitan Carrol, Nick Davies, Ava Easton, Martin EcclesRobbie Foy, Marta Garcia-Finana, Julia Granerod, Julia Griem, Alison Gummery, Lara Harris, Helen Hickey, Helen Hill, Ann Jacoby, Hayley Hardwick, Ciara Kierans, Jessie Cooper, Rachel Kneen, Gill Lancaster, Michael Levin, Rebecca McDonald, Antonieta Medina-Lara, Esse Menson, Benedict Michael, Natalie Martin, Manish Sadarangani, Andrew Pennington, Andrew Pollard, Julie Riley, Anne Christine Salter, Maria Thornton, Angela Vincent, Charles Warlow

Research output: Contribution to journal › Article › peer-review

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Abstract

Objectives To assess whether it is feasible to quantify acute change in temporal lobe volume and total oedema volumes in herpes simplex virus (HSV) encephalitis as a preliminary to a trial of corticosteroid therapy. Methods The study analysed serially acquired magnetic resonance images (MRI), of patients with acute HSV encephalitis who had neuroimaging repeated within four weeks of the first scan. We performed volumetric measurements of the left and right temporal lobes and of cerebral oedema visible on T2 weighted Fluid Attenuated Inversion Recovery (FLAIR) images using stereology in conjunction with point counting. Results Temporal lobe volumes increased on average by 1.6% (standard deviation (SD 11%) in five patients who had not received corticosteroid therapy and decreased in two patients who had received corticosteroids by 8.5%. FLAIR hyperintensity volumes increased by 9% in patients not receiving treatment with corticosteroids and decreased by 29% in the two patients that had received corticosteroids. Conclusions This study has shown it is feasible to quantify acute change in temporal lobe and total oedema volumes in HSV encephalitis and suggests a potential resolution of swelling in response to corticosteroid therapy. These techniques could be used as part of a randomized control trial to investigate the efficacy of corticosteroids for treating HSV encephalitis in conjunction with assessing clinical outcomes and could be of potential value in helping to predict the clinical outcomes of patients with HSV encephalitis.

Original language	English
Article number	e0170215
Journal	PLoS ONE
Volume	12
Issue number	1
DOIs	https://doi.org/10.1371/journal.pone.0170215
Publication status	Published - 1 Jan 2017
Externally published	Yes

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10.1371/journal.pone.0170215Licence: CC BY

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Defres, S., Keller, S. S., Das, K., Vidyasagar, R., Parkes, L. M., Burnside, G., Griffiths, M., Kopelman, M., Roberts, N., Solomon, T., Backman, R., Baker, G., Beeching, N., Breen, R., Brown, D., Cheyne, C., Carrol, E., Davies, N., Easton, A., ... Warlow, C. (2017). A feasibility study of quantifying longitudinal brain changes in herpes simplex virus (HSV) encephalitis using magnetic resonance imaging (MRI) and stereology. PLoS ONE, 12(1), Article e0170215. https://doi.org/10.1371/journal.pone.0170215

@article{1088d11b8f6943d4a2b023da627a204b,

title = "A feasibility study of quantifying longitudinal brain changes in herpes simplex virus (HSV) encephalitis using magnetic resonance imaging (MRI) and stereology",

abstract = "Objectives To assess whether it is feasible to quantify acute change in temporal lobe volume and total oedema volumes in herpes simplex virus (HSV) encephalitis as a preliminary to a trial of corticosteroid therapy. Methods The study analysed serially acquired magnetic resonance images (MRI), of patients with acute HSV encephalitis who had neuroimaging repeated within four weeks of the first scan. We performed volumetric measurements of the left and right temporal lobes and of cerebral oedema visible on T2 weighted Fluid Attenuated Inversion Recovery (FLAIR) images using stereology in conjunction with point counting. Results Temporal lobe volumes increased on average by 1.6\% (standard deviation (SD 11\%) in five patients who had not received corticosteroid therapy and decreased in two patients who had received corticosteroids by 8.5\%. FLAIR hyperintensity volumes increased by 9\% in patients not receiving treatment with corticosteroids and decreased by 29\% in the two patients that had received corticosteroids. Conclusions This study has shown it is feasible to quantify acute change in temporal lobe and total oedema volumes in HSV encephalitis and suggests a potential resolution of swelling in response to corticosteroid therapy. These techniques could be used as part of a randomized control trial to investigate the efficacy of corticosteroids for treating HSV encephalitis in conjunction with assessing clinical outcomes and could be of potential value in helping to predict the clinical outcomes of patients with HSV encephalitis.",

author = "Sylviane Defres and Keller, \{Simon S.\} and Kumar Das and Rishma Vidyasagar and Parkes, \{Laura M.\} and Girvan Burnside and Michael Griffiths and Michael Kopelman and Neil Roberts and Tom Solomon and Ruth Backman and Gus Baker and Nicholas Beeching and Rachel Breen and David Brown and Chris Cheyne and Enitan Carrol and Nick Davies and Ava Easton and Martin Eccles and Robbie Foy and Marta Garcia-Finana and Julia Granerod and Julia Griem and Alison Gummery and Lara Harris and Helen Hickey and Helen Hill and Ann Jacoby and Hayley Hardwick and Ciara Kierans and Jessie Cooper and Rachel Kneen and Gill Lancaster and Michael Levin and Rebecca McDonald and Antonieta Medina-Lara and Esse Menson and Benedict Michael and Natalie Martin and Manish Sadarangani and Andrew Pennington and Andrew Pollard and Julie Riley and Salter, \{Anne Christine\} and Maria Thornton and Angela Vincent and Charles Warlow",

year = "2017",

month = jan,

day = "1",

doi = "10.1371/journal.pone.0170215",

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volume = "12",

journal = "PLoS ONE",

publisher = "Public Library of Science",

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Defres, S, Keller, SS, Das, K, Vidyasagar, R, Parkes, LM, Burnside, G, Griffiths, M, Kopelman, M, Roberts, N, Solomon, T, Backman, R, Baker, G, Beeching, N, Breen, R, Brown, D, Cheyne, C, Carrol, E, Davies, N, Easton, A, Eccles, M, Foy, R, Garcia-Finana, M, Granerod, J, Griem, J, Gummery, A, Harris, L, Hickey, H, Hill, H, Jacoby, A, Hardwick, H, Kierans, C, Cooper, J, Kneen, R, Lancaster, G, Levin, M, McDonald, R, Medina-Lara, A, Menson, E, Michael, B, Martin, N, Sadarangani, M, Pennington, A, Pollard, A, Riley, J, Salter, AC, Thornton, M, Vincent, A & Warlow, C 2017, 'A feasibility study of quantifying longitudinal brain changes in herpes simplex virus (HSV) encephalitis using magnetic resonance imaging (MRI) and stereology', PLoS ONE, vol. 12, no. 1, e0170215. https://doi.org/10.1371/journal.pone.0170215

TY - JOUR

T1 - A feasibility study of quantifying longitudinal brain changes in herpes simplex virus (HSV) encephalitis using magnetic resonance imaging (MRI) and stereology

AU - Defres, Sylviane

AU - Keller, Simon S.

AU - Das, Kumar

AU - Vidyasagar, Rishma

AU - Parkes, Laura M.

AU - Burnside, Girvan

AU - Griffiths, Michael

AU - Kopelman, Michael

AU - Roberts, Neil

AU - Solomon, Tom

AU - Backman, Ruth

AU - Baker, Gus

AU - Beeching, Nicholas

AU - Breen, Rachel

AU - Brown, David

AU - Cheyne, Chris

AU - Carrol, Enitan

AU - Davies, Nick

AU - Easton, Ava

AU - Eccles, Martin

AU - Foy, Robbie

AU - Garcia-Finana, Marta

AU - Granerod, Julia

AU - Griem, Julia

AU - Gummery, Alison

AU - Harris, Lara

AU - Hickey, Helen

AU - Hill, Helen

AU - Jacoby, Ann

AU - Hardwick, Hayley

AU - Kierans, Ciara

AU - Cooper, Jessie

AU - Kneen, Rachel

AU - Lancaster, Gill

AU - Levin, Michael

AU - McDonald, Rebecca

AU - Medina-Lara, Antonieta

AU - Menson, Esse

AU - Michael, Benedict

AU - Martin, Natalie

AU - Sadarangani, Manish

AU - Pennington, Andrew

AU - Pollard, Andrew

AU - Riley, Julie

AU - Salter, Anne Christine

AU - Thornton, Maria

AU - Vincent, Angela

AU - Warlow, Charles

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives To assess whether it is feasible to quantify acute change in temporal lobe volume and total oedema volumes in herpes simplex virus (HSV) encephalitis as a preliminary to a trial of corticosteroid therapy. Methods The study analysed serially acquired magnetic resonance images (MRI), of patients with acute HSV encephalitis who had neuroimaging repeated within four weeks of the first scan. We performed volumetric measurements of the left and right temporal lobes and of cerebral oedema visible on T2 weighted Fluid Attenuated Inversion Recovery (FLAIR) images using stereology in conjunction with point counting. Results Temporal lobe volumes increased on average by 1.6% (standard deviation (SD 11%) in five patients who had not received corticosteroid therapy and decreased in two patients who had received corticosteroids by 8.5%. FLAIR hyperintensity volumes increased by 9% in patients not receiving treatment with corticosteroids and decreased by 29% in the two patients that had received corticosteroids. Conclusions This study has shown it is feasible to quantify acute change in temporal lobe and total oedema volumes in HSV encephalitis and suggests a potential resolution of swelling in response to corticosteroid therapy. These techniques could be used as part of a randomized control trial to investigate the efficacy of corticosteroids for treating HSV encephalitis in conjunction with assessing clinical outcomes and could be of potential value in helping to predict the clinical outcomes of patients with HSV encephalitis.

AB - Objectives To assess whether it is feasible to quantify acute change in temporal lobe volume and total oedema volumes in herpes simplex virus (HSV) encephalitis as a preliminary to a trial of corticosteroid therapy. Methods The study analysed serially acquired magnetic resonance images (MRI), of patients with acute HSV encephalitis who had neuroimaging repeated within four weeks of the first scan. We performed volumetric measurements of the left and right temporal lobes and of cerebral oedema visible on T2 weighted Fluid Attenuated Inversion Recovery (FLAIR) images using stereology in conjunction with point counting. Results Temporal lobe volumes increased on average by 1.6% (standard deviation (SD 11%) in five patients who had not received corticosteroid therapy and decreased in two patients who had received corticosteroids by 8.5%. FLAIR hyperintensity volumes increased by 9% in patients not receiving treatment with corticosteroids and decreased by 29% in the two patients that had received corticosteroids. Conclusions This study has shown it is feasible to quantify acute change in temporal lobe and total oedema volumes in HSV encephalitis and suggests a potential resolution of swelling in response to corticosteroid therapy. These techniques could be used as part of a randomized control trial to investigate the efficacy of corticosteroids for treating HSV encephalitis in conjunction with assessing clinical outcomes and could be of potential value in helping to predict the clinical outcomes of patients with HSV encephalitis.

U2 - 10.1371/journal.pone.0170215

DO - 10.1371/journal.pone.0170215

M3 - Article

VL - 12

JO - PLoS ONE

JF - PLoS ONE

IS - 1

M1 - e0170215

ER -

A feasibility study of quantifying longitudinal brain changes in herpes simplex virus (HSV) encephalitis using magnetic resonance imaging (MRI) and stereology

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