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Gao L, Gaurav R, Ziegner P, Ma J, Sun J, Chen J, Fang J, Fan Y, Bao Y, Zhang D, Chan P, Yang Q, Fan Z, Lehéricy S, Wu T. Regional nigral neuromelanin degeneration in asymptomatic leucine-rich repeat kinase 2 gene carrier using MRI. Sci Rep 2024; 14:10621. [PMID: 38729969 PMCID: PMC11087650 DOI: 10.1038/s41598-024-59074-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/07/2024] [Indexed: 05/12/2024] Open
Abstract
Asymptomatic Leucine-Rich Repeat Kinase 2 Gene (LRRK2) carriers are at risk for developing Parkinson's disease (PD). We studied presymptomatic substantia nigra pars compacta (SNc) regional neurodegeneration in asymptomatic LRRK2 carriers compared to idiopathic PD patients using neuromelanin-sensitive MRI technique (NM-MRI). Fifteen asymptomatic LRRK2 carriers, 22 idiopathic PD patients, and 30 healthy controls (HCs) were scanned using NM-MRI. We computed volume and contrast-to-noise ratio (CNR) derived from the whole SNc and the sensorimotor, associative, and limbic SNc regions. An analysis of covariance was performed to explore the differences of whole and regional NM-MRI values among the groups while controlling the effect of age and sex. In whole SNc, LRRK2 had significantly lower CNR than HCs but non-significantly higher volume and CNR than PD patients, and PD patients significantly lower volume and CNR compared to HCs. Inside SNc regions, there were significant group effects for CNR in all regions and for volumes in the associative region, with a trend in the sensorimotor region but no significant changes in the limbic region. PD had reduced volume and CNR in all regions compared to HCs. Asymptomatic LRRK2 carriers showed globally decreased SNc volume and CNR suggesting early nigral neurodegeneration in these subjects at risk of developing PD.
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Affiliation(s)
- Linlin Gao
- Department of General Practice, Tianjin Union Medical Center, Tianjin, China
| | - Rahul Gaurav
- Paris Brain Institute - ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France.
- Movement Investigations and Therapeutics Team (MOV'IT), Paris Brain Institute - ICM, Paris, France.
- Center for NeuroImaging Research (CENIR), Paris Brain Institute - ICM, Hôpital Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Pia Ziegner
- Paris Brain Institute - ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
- Center for NeuroImaging Research (CENIR), Paris Brain Institute - ICM, Hôpital Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75013, Paris, France
- Department of Neurology (H.J.), University Hospital of Heidelberg, Heidelberg, Germany
| | - Jinghong Ma
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Junyan Sun
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Jie Chen
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Jiliang Fang
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yangyang Fan
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Bao
- Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dongling Zhang
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing, China
| | - Piu Chan
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Qi Yang
- Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Zhaoyang Fan
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Stéphane Lehéricy
- Paris Brain Institute - ICM, INSERM U1127, CNRS UMR 7225, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France.
- Movement Investigations and Therapeutics Team (MOV'IT), Paris Brain Institute - ICM, Paris, France.
- Center for NeuroImaging Research (CENIR), Paris Brain Institute - ICM, Hôpital Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75013, Paris, France.
- Department of Neuroradiology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
| | - Tao Wu
- Department of Neurology, Center for Movement Disorders, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
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Outeiro TF, Alcalay RN, Antonini A, Attems J, Bonifati V, Cardoso F, Chesselet MF, Hardy J, Madeo G, McKeith I, Mollenhauer B, Moore DJ, Rascol O, Schlossmacher MG, Soreq H, Stefanis L, Ferreira JJ. Defining the Riddle in Order to Solve It: There Is More Than One "Parkinson's Disease". Mov Disord 2023. [PMID: 37156737 DOI: 10.1002/mds.29419] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND More than 200 years after James Parkinsondescribed a clinical syndrome based on his astute observations, Parkinson's disease (PD) has evolved into a complex entity, akin to the heterogeneity of other complex human syndromes of the central nervous system such as dementia, motor neuron disease, multiple sclerosis, and epilepsy. Clinicians, pathologists, and basic science researchers evolved arrange of concepts andcriteria for the clinical, genetic, mechanistic, and neuropathological characterization of what, in their best judgment, constitutes PD. However, these specialists have generated and used criteria that are not necessarily aligned between their different operational definitions, which may hinder progress in solving the riddle of the distinct forms of PD and ultimately how to treat them. OBJECTIVE This task force has identified current in consistencies between the definitions of PD and its diverse variants in different domains: clinical criteria, neuropathological classification, genetic subtyping, biomarker signatures, and mechanisms of disease. This initial effort for "defining the riddle" will lay the foundation for future attempts to better define the range of PD and its variants, as has been done and implemented for other heterogeneous neurological syndromes, such as stroke and peripheral neuropathy. We strongly advocate for a more systematic and evidence-based integration of our diverse disciplines by looking at well-defined variants of the syndrome of PD. CONCLUSION Accuracy in defining endophenotypes of "typical PD" across these different but interrelated disciplines will enable better definition of variants and their stratification in therapeutic trials, a prerequisite for breakthroughs in the era of precision medicine. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tiago F Outeiro
- Department of Experimental Neurodegeneration, Center for Biostructural Imaging of Neurodegeneration, University Medical Center Goettingen, Goettingen, Germany
- Max Planck Institute for Multidisciplinary Sciences, Goettingen, Germany
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Roy N Alcalay
- Neurological Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Angelo Antonini
- Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Johannes Attems
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Vincenzo Bonifati
- Department of Clinical Genetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Francisco Cardoso
- Movement Disorders Unit, Neurology Service, Internal Medicine Department, The Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - John Hardy
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, United Kingdom
- UK Dementia Research Institute at UCL and Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, United Kingdom
- Reta Lila Weston Institute, UCL Queen Square Institute of Neurology, London, United Kingdom
- UCL Movement Disorders Centre, University College London, London, United Kingdom
- Institute for Advanced Study, The Hong Kong University of Science and Technology, Hong Kong, China
| | | | - Ian McKeith
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Brit Mollenhauer
- Department of Neurology, University Medical Center, Göttingen, Germany
- Paracelsus-Elena-Klinik, Kassel, Germany
| | - Darren J Moore
- Department of Neurodegenerative Science, Van Andel Institute, Grand Rapids, Michigan, USA
| | - Olivier Rascol
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS-Park/FCRIN Network and Neuro Toul COEN Centre, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Michael G Schlossmacher
- Program in Neuroscience and Division of Neurology, The Ottawa Hospital, Ottawa, Ontario, Canada
- University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
| | - Hermona Soreq
- The Institute of Life Sciences and The Edmond and Lily Safra Center of Brain Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Leonidas Stefanis
- First Department of Neurology, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
- CNS-Campus Neurológico, Torres Vedras, Portugal
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Martínez M, Ariz M, Alvarez I, Castellanos G, Aguilar M, Hernández-Vara J, Caballol N, Garrido A, Bayés À, Vilas D, Marti MJ, Pastor P, de Solórzano CO, Pastor MA. Brainstem neuromelanin and iron MRI reveals a precise signature for idiopathic and LRRK2 Parkinson's disease. NPJ Parkinsons Dis 2023; 9:62. [PMID: 37061532 PMCID: PMC10105708 DOI: 10.1038/s41531-023-00503-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/24/2023] [Indexed: 04/17/2023] Open
Abstract
Neuromelanin (NM) loss in substantia nigra pars compacta (SNc) and locus coeruleus (LC) reflects neuronal death in Parkinson's disease (PD). Since genetically-determined PD shows varied clinical expressivity, we wanted to accurately quantify and locate brainstem NM and iron, to discover whether specific MRI patterns are linked to Leucine-rich repeat kinase 2 G2019S PD (LRRK2-PD) or idiopathic Parkinson's disease (iPD). A 3D automated MRI atlas-based segmentation pipeline (3D-ABSP) for NM/iron-sensitive MRI images topographically characterized the SNc, LC, and red nucleus (RN) neuronal loss and calculated NM/iron contrast ratio (CR) and normalized volume (nVol). Left-side NM nVol was larger in all groups. PD had lower NM CR and nVol in ventral-caudal SNc, whereas iron increased in lateral, medial-rostral, and caudal SNc. The SNc NM CR reduction was associated with psychiatric symptoms. LC CR and nVol discriminated better among subgroups: LRRK2-PD had similar LC NM CR and nVol as that of controls, and larger LC NM nVol and RN iron CR than iPD. PD showed higher iron SNc nVol than controls, especially among LRRK2-PD. ROC analyses showed an AUC > 0.92 for most pairwise subgroup comparisons, with SNc NM being the best discriminator between HC and PD. NM measures maintained their discriminator power considering the subgroup of PD patients with less than 5 years of disease duration. The SNc iron CR and nVol increase was associated with longer disease duration in PD patients. The 3D-ABSP sensitively identified NM and iron MRI patterns strongly correlated with phenotypic PD features.
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Affiliation(s)
- Martín Martínez
- Neuroimaging Laboratory, University of Navarra, School of Medicine, Pamplona, Spain
- School of Education and Psychology, University of Navarra, Pamplona, Spain
| | - Mikel Ariz
- Ciberonc and Solid Tumours and Biomarkers Program, CIMA University of Navarra, Pamplona, Spain
| | - Ignacio Alvarez
- Movement Disorders Unit, Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Gabriel Castellanos
- Department of Physiological Sciences, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Miquel Aguilar
- Movement Disorders Unit, Neurology, University Hospital Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - Jorge Hernández-Vara
- Neurology Department, Hospital Universitari Vall D´Hebron, Neurodegenerative Diseases Research Group, Vall D'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Núria Caballol
- Department of Neurology, Complex Hospitalari Moisès Broggi, Sant Joan Despí, Barcelona, Spain
- Parkinson and Movement disorders Unit, Hospital Quirón-Teknon, Barcelona, Spain
| | - Alicia Garrido
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, IDIBAPS, CIBERNED, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas: CB06/05/0018-ISCIII), ERN-RND Hospital Clínic i Provincial de Barcelona, Barcelona, Catalonia, Spain
- Department of Medicine & Institut de Neurociències of the University of Barcelona, Barcelona, Catalonia, Spain
| | - Àngels Bayés
- Parkinson and Movement disorders Unit, Hospital Quirón-Teknon, Barcelona, Spain
| | - Dolores Vilas
- Unit of Neurodegenerative diseases, Department of Neurology, University Hospital Germans Trias i Pujol, Badalona, Spain
- Neurosciences, The Germans Trias i Pujol Research Institute (IGTP) Badalona, Badalona, Catalonia, Spain
| | - Maria Jose Marti
- Parkinson's Disease and Movement Disorders Unit, Neurology Service, IDIBAPS, CIBERNED, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas: CB06/05/0018-ISCIII), ERN-RND Hospital Clínic i Provincial de Barcelona, Barcelona, Catalonia, Spain
- Department of Medicine & Institut de Neurociències of the University of Barcelona, Barcelona, Catalonia, Spain
| | - Pau Pastor
- Unit of Neurodegenerative diseases, Department of Neurology, University Hospital Germans Trias i Pujol, Badalona, Spain.
- Neurosciences, The Germans Trias i Pujol Research Institute (IGTP) Badalona, Badalona, Catalonia, Spain.
| | | | - Maria A Pastor
- Neuroimaging Laboratory, University of Navarra, School of Medicine, Pamplona, Spain.
- Neurosciences, School of Medicine, University of Navarra, Pamplona, Spain.
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Leitão R, Guerreiro C, Nunes RG, Gonçalves N, Galati G, Rosário M, Guedes LC, Ferreira JJ, Reimão S. Neuromelanin Magnetic Resonance Imaging of the Substantia Nigra in Huntington's Disease. J Huntingtons Dis 2021; 9:143-148. [PMID: 32065802 DOI: 10.3233/jhd-190388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Huntington's disease (HD) is an autosomal-dominant neurodegenerative disorder inducing motor, psychiatric changes and cognitive decline, characterized pathologically by striatal atrophy. Pathological changes in the extra-striatal structures, such as the substantia nigra (SN), and abnormalities in pre-synaptic striatal dopamine neurotransmission are also known to occur. Neuromelanin (NM)-sensitive magnetic resonance imaging (NM-MRI) is an innovative technique that was recently developed allowing the in vivo study of pathological changes in the dopaminergic neurons of the SN. OBJECTIVE To investigate the SN MR signal in HD patients. METHODS We performed a cross-sectional study using a specific T1-weighted MR sequence to visualize NM. The areas and signal intensity contrast ratios of the T1 hyperintense SN regions were obtained using a semi-automatic segmentation method. RESULTS A total of 8 HD patients and 12 healthy subjects were evaluated. The SN area was markedly reduced in the HD group compared with the control group (p = 0.02), even after normalization of the SN area with the midbrain area and age correction (p = 0.01). There was a significant reduction in the intensity contrast ratio of the hyperintense SN areas to crus cerebri in HD patients comparing with controls (p = 0.04) after correction for age. CONCLUSIONS NM-sensitive MR techniques were used for the first time to study the SN in HD patients, showing loss of NM in this region, supporting the implication of dopaminergic neuronal changes in disease pathology. Future research needs to be conducted to evaluate the potential of SN area and intensity contrast as biomarkers for HD.
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Affiliation(s)
- Ricardo Leitão
- ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Carla Guerreiro
- Neurological Imaging Department, Hospital de Santa Maria - CHULN, Lisbon, Portugal
| | - Rita G Nunes
- ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Nilza Gonçalves
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Giulia Galati
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Madalena Rosário
- Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria - CHULN, Lisbon, Portugal
| | - Leonor Correia Guedes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Department of Neuroscience and Mental Health, Neurology, Hospital de Santa Maria - CHULN, Lisbon, Portugal
| | - Joaquim J Ferreira
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,CNS - Campus Neurológico Sénior, Torres Vedras, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sofia Reimão
- Neurological Imaging Department, Hospital de Santa Maria - CHULN, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Thaler A. Structural and Functional MRI in Familial Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 142:261-287. [PMID: 30409255 DOI: 10.1016/bs.irn.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Between 10 and 15% of Parkinson disease (PD) cases can be traced to a genetically identified causative mutation which currently number over 40. This enables the study of both "at risk" populations for future development of PD and a unique sub-group of genetically determined patient population. Structural and functional magnetic imaging has the potential of assisting diagnosis, early detection and disease progression as it is relatively cheap and easy to implement. However, the large variety of imaging options and different analytical approaches hamper the pursuit of a unified imaging biomarker. This chapter details the current imaging options and summarizes the findings among both genetically determined patients with PD and their non-manifesting first degree relatives, speculating on possible compensational mechanisms while mapping future directions in order to better utilize MRI in the research of genetic PD.
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Affiliation(s)
- Avner Thaler
- Movement Disorders Unit, Neurological Institute, Tel Aviv Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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