CASE REPORT article
Front. Neurosci.
Sec. Brain Imaging Methods
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1656655
This article is part of the Research TopicPushing boundaries with ultra-high field MRI: innovations and applications in neuroscienceView all 3 articles
Hypertrophic Olivary Degeneration: a 7 Tesla Advanced Imaging Case Report
Provisionally accepted
Tommaso Calzoni1
Graziella Donatelli2*
Gianmichele Migaleddu3
Marta Lancione4
Paolo Cecchi2
Laura Biagi4
Michele Caniglia3Roberto Ceravolo5Mirco Cosottini5- 1University of Pisa, Pisa, Italy
- 2Imago 7 Research Foundation, Pisa, Italy
- 3Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
- 4IRCCS Fondazione Stella Maris, Calambrone, Italy
- 5Universita degli Studi di Pisa, Pisa, Italy
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Introduction: A 50-years-old patient developed ataxia, nystagmus and palatal tremor. Conventional MRI revealed inferior olivary nuclei enlargement and hyperintensity in T2-weighted images, posing diagnosis of hypertrophic olivary degeneration (HOD). The patient's past medical history reported proton-therapy for an VIII cranial-nerve Schwannoma. Here we aimed to investigate the potential alterations involving tracts and nuclei composing the dentato-rubro-olivary pathway (Guillain-Mollaret triangle) using an advanced ultra-high field (7T) MRI protocol. Materials and Methods: The patient underwent a brain 7T-MRI exam including a multi-echo gradient-echo sequence for quantitative susceptibility mapping and diffusion tensor imaging (DTI). The DTI dataset was elaborated for tractography and computation of tensor metrics. Results: 7T-MRI allowed the depiction of the brainstem tracts and nuclei composing the Guillain-Mollaret triangle. Both qualitative and quantitative analysis of these structures demonstrated damage to the right red nucleus and to the dentato-rubral tracts bilaterally. These findings are consistent with the pathophysiology of HOD and were confirmed in a follow-up MRI. Discussion: This study highlights the capability of 7T-MRI to depict and investigate brainstem substructures such as tracts and nuclei. To the best of our knowledge, this is the first study to depict all tracts composing the Guillain-Mollaret triangle and directly document their alterations in HOD.
Keywords: 7 Tesla (7T), MRI, Hypertrophic olivary degeneration (HOD), Guillain Mollaret triangle, Quantitative susceptibility mapping (QSM), Diffusion tensor imaging (DTI), Tractograhpy, ultra high field Magnetic Resonance
Received: 30 Jun 2025; Accepted: 08 Aug 2025.
Copyright: © 2025 Calzoni, Donatelli, Migaleddu, Lancione, Cecchi, Biagi, Caniglia, Ceravolo and Cosottini. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Graziella Donatelli, Imago 7 Research Foundation, Pisa, Italy
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