1
|
Qian ZM, Li W, Guo Q. Ferroportin1 in the brain. Ageing Res Rev 2023; 88:101961. [PMID: 37236369 DOI: 10.1016/j.arr.2023.101961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/20/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023]
Abstract
Despite years of research, it remains unclear why certain brain regions of patients with neurodegenerative diseases (NDs) have abnormally high levels of iron, although it has long been suggested that disrupted expression of iron-metabolizing proteins due to genetic or non-genetic factors is responsible for the enhancement in brain iron contents. In addition to the increased expression of cell-iron importers lactoferrin (lactotransferrin) receptor (LfR) in Parkinson's disease (PD) and melanotransferrin (p97) in Alzheimer's disease (AD), some investigations have suggested that cell-iron exporter ferroportin 1 (Fpn1) may be also associated with the elevated iron observed in the brain. The decreased expression of Fpn1 and the resulting decrease in the amount of iron excreted from brain cells has been thought to be able to enhance iron levels in the brain in AD, PD and other NDs. Cumulative results also suggest that the reduction of Fpn1 can be induced by hepcidin-dependent and -independent pathways. In this article, we discuss the current understanding of Fpn1 expression in the brain and cell lines of rats, mice and humans, with emphasis on the potential involvement of reduced Fpn1 in brain iron enhancement in patients with AD, PD and other NDs.
Collapse
Affiliation(s)
- Zhong-Ming Qian
- Department of Neurology, Affiliated Hospital of Nantong University, and Institute of Translational and Precision Medicine, Nantong University, 19 Qi Xiu Road, Nantong, Jiangsu China 226019.
| | - Wei Li
- Department of Neurology, Affiliated Hospital of Nantong University, and Institute of Translational and Precision Medicine, Nantong University, 19 Qi Xiu Road, Nantong, Jiangsu China 226019
| | - Qian Guo
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, 881 Yonghe Road, Nantong, Jiangsu 226001, China; Shanghai Engineering Research Center of Organ Repair, School of Medicine, Shanghai University, 99 Shangda Road, Shanghai 200444, China.
| |
Collapse
|
2
|
Wang EW, Brown GL, Lewis MM, Jellen LC, Pu C, Johnson ML, Chen H, Kong L, Du G, Huang X. Susceptibility Magnetic Resonance Imaging Correlates with Glial Density and Tau in the Substantia Nigra Pars Compacta. Mov Disord 2023; 38:464-473. [PMID: 36598274 PMCID: PMC10445152 DOI: 10.1002/mds.29311] [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: 08/28/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Susceptibility magnetic resonance imaging (MRI) is sensitive to iron-related changes in the substantia nigra pars compacta (SNc), the key pathologic locus of parkinsonisms. It is unclear, however, if iron deposition in the SNc is associated with its neurodegeneration. OBJECTIVE The objective of this study was to test whether susceptibility MRI metrics in parkinsonisms are associated with SNc neuropathologic features of dopaminergic neuron loss, gliosis, and α-synuclein and tau burden. METHODS This retrospective study included 27 subjects with both in vivo MRI and postmortem data. Multigradient echo imaging was used to derive the apparent transverse relaxation rate (R2*) and quantitative susceptibility mapping (QSM) in the SNc. Archived midbrain slides that were stained with hematoxylin and eosin, anti-α-synuclein, and anti-tau were digitized to quantify neuromelanin-positive neuron density, glial density, and the percentages of area occupied by positive α-synuclein and tau staining. MRI-histology associations were examined using Pearson correlations and regression. RESULTS Twenty-four subjects had postmortem parkinsonism diagnoses (Lewy body disorder, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration), two had only Alzheimer's neuropathology, and one exhibited only mild atrophy. Among all subjects, both R2* and QSM were associated with glial density (r ≥ 0.67; P < 0.001) and log-transformed tau burden (r ≥ 0.53; P ≤ 0.007). Multiple linear regression identified glial density and log-transformed tau as determinants for both MRI metrics (R2 ≥ 0.580; P < 0.0001). Neither MRI metric was associated with neuron density or α-synuclein burden. CONCLUSIONS R2* and QSM are associated with both glial density and tau burden, key neuropathologic features in the parkinsonism SNc. © 2023 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Ernest W. Wang
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Gregory L. Brown
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Mechelle M. Lewis
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Leslie C. Jellen
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Cunfeng Pu
- Department of Pathology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Melinda L. Johnson
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hairong Chen
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Lan Kong
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Guangwei Du
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Xuemei Huang
- Department of Neurology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Departments of Neurosurgery and Radiology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| |
Collapse
|
3
|
Hu R, Gao B, Tian S, Liu Y, Jiang Y, Li W, Li Y, Song Q, Wang W, Miao Y. Regional high iron deposition on quantitative susceptibility mapping correlates with cognitive decline in type 2 diabetes mellitus. Front Neurosci 2023; 17:1061156. [PMID: 36793541 PMCID: PMC9922715 DOI: 10.3389/fnins.2023.1061156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023] Open
Abstract
Objective To quantitatively evaluate the iron deposition and volume changes in deep gray nuclei according to threshold-method of quantitative susceptibility mapping (QSM) acquired by strategically acquired gradient echo (STAGE) sequence, and to analyze the correlation between the magnetic susceptibility values (MSV) and cognitive scores in type 2 diabetes mellitus (T2DM) patients. Methods Twenty-nine patients with T2DM and 24 healthy controls (HC) matched by age and gender were recruited in this prospective study. QSM images were used to evaluate whole-structural volumes (Vwh), regional magnetic susceptibility values (MSVRII), and volumes (VRII) in high-iron regions in nine gray nuclei. All QSM data were compared between groups. Receiver operating characteristic (ROC) analysis was used to assess the discriminating ability between groups. The predictive model from single and combined QSM parameters was also established using logistic regression analysis. The correlation between MSVRII and cognitive scores was further analyzed. Multiple comparisons of all statistical values were corrected by false discovery rate (FDR). A statistically significant P-value was set at 0.05. Results Compared with HC group, the MSVRII of all gray matter nuclei in T2DM were increased by 5.1-14.8%, with significant differences found in bilateral head of caudate nucleus (HCN), right putamen (PUT), right globus pallidus (GP), and left dentate nucleus (DN) (P < 0.05). The Vwh of most gray nucleus in T2DM group were decreased by 1.5-16.9% except bilateral subthalamic nucleus (STN). Significant differences were found in bilateral HCN, bilateral red nucleus (RN), and bilateral substantia nigra (SN) (P < 0.05). VRII was increased in bilateral GP, bilateral PUT (P < 0.05). VRII/Vwh was also increased in bilateral GP, bilateral PUT, bilateral SN, left HCN and right STN (P < 0.05). Compared with the single QSM parameter, the combined parameter showed the largest area under curve (AUC) of 0.86, with a sensitivity of 87.5% and specificity of 75.9%. The MSVRII in the right GP was strongly associated with List A Long-delay free recall (List A LDFR) scores (r = -0.590, P = 0.009). Conclusion In T2DM patients, excessive and heterogeneous iron deposition as well as volume loss occurs in deep gray nuclei. The MSV in high iron regions can better evaluate the distribution of iron, which is related to the decline of cognitive function.
Collapse
|
4
|
Association between Beta Oscillations from Subthalamic Nucleus and Quantitative Susceptibility Mapping in Deep Gray Matter Structures in Parkinson's Disease. Brain Sci 2023; 13:brainsci13010081. [PMID: 36672062 PMCID: PMC9857066 DOI: 10.3390/brainsci13010081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/15/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
This study aimed to investigate the association between beta oscillations and brain iron deposition. Beta oscillations were filtered from the microelectrode recordings of local field potentials (LFP) in the subthalamic nucleus (STN), and the ratio of the power spectral density of beta oscillations (PSDXb) to that of the LFP signals was calculated. Iron deposition in the deep gray matter (DGM) structures was indirectly assessed using quantitative susceptibility mapping (QSM). The Unified Parkinson's Disease Rating Scale (UPDRS), part III, was used to assess the severity of symptoms. Spearman correlation coefficients were applied to assess the associations of PSDXb with QSM values in the DGM structures and the severity of symptoms. PSDXb showed a significant positive correlation with the average QSM values in DGM structures, including caudate and substantia nigra (SN) (p = 0.008 and 0.044). Similarly, the PSDXb showed significant negative correlations with the severity of symptoms, including axial symptoms and the gait in the medicine-off state (p = 0.006 for both). The abnormal iron metabolism in the SN and striatum pathways may be one of the underlying mechanisms for the occurrence of abnormal beta oscillations in the STN, and beta oscillations may serve as important pathophysiological biomarkers of PD.
Collapse
|
5
|
Ravanfar P, Syeda WT, Jayaram M, Rushmore RJ, Moffat B, Lin AP, Lyall AE, Merritt AH, Yaghmaie N, Laskaris L, Luza S, Opazo CM, Liberg B, Chakravarty MM, Devenyi GA, Desmond P, Cropley VL, Makris N, Shenton ME, Bush AI, Velakoulis D, Pantelis C. In Vivo 7-Tesla MRI Investigation of Brain Iron and Its Metabolic Correlates in Chronic Schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:86. [PMID: 36289238 PMCID: PMC9605948 DOI: 10.1038/s41537-022-00293-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Brain iron is central to dopaminergic neurotransmission, a key component in schizophrenia pathology. Iron can also generate oxidative stress, which is one proposed mechanism for gray matter volume reduction in schizophrenia. The role of brain iron in schizophrenia and its potential link to oxidative stress has not been previously examined. In this study, we used 7-Tesla MRI quantitative susceptibility mapping (QSM), magnetic resonance spectroscopy (MRS), and structural T1 imaging in 12 individuals with chronic schizophrenia and 14 healthy age-matched controls. In schizophrenia, there were higher QSM values in bilateral putamen and higher concentrations of phosphocreatine and lactate in caudal anterior cingulate cortex (caCC). Network-based correlation analysis of QSM across corticostriatal pathways as well as the correlation between QSM, MRS, and volume, showed distinct patterns between groups. This study introduces increased iron in the putamen in schizophrenia in addition to network-wide disturbances of iron and metabolic status.
Collapse
Affiliation(s)
- Parsa Ravanfar
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Warda T Syeda
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Mahesh Jayaram
- Department of Psychiatry, The University of Melbourne and Melbourne Health, Parkville, Australia
| | - R Jarrett Rushmore
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Center for Morphometric Analysis (CMA), Massachusetts General Hospital, Charlestown, MA, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Bradford Moffat
- Melbourne Brain Centre Imaging Unit, Department of Radiology, University of Melbourne, Parkville, VIC, Australia
| | - Alexander P Lin
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Amanda E Lyall
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Antonia H Merritt
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Negin Yaghmaie
- Melbourne Brain Centre Imaging Unit, Department of Radiology, University of Melbourne, Parkville, VIC, Australia
- Department of Biomedical Engineering, The University of Melbourne, Parkville, VIC, Australia
| | - Liliana Laskaris
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Sandra Luza
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience & Mental Health, and The University of Melbourne, Parkville, VIC, Australia
| | - Carlos M Opazo
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience & Mental Health, and The University of Melbourne, Parkville, VIC, Australia
| | - Benny Liberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - M Mallar Chakravarty
- Cerebral Imaging Center, Douglas Research Centre, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Gabriel A Devenyi
- Cerebral Imaging Center, Douglas Research Centre, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Patricia Desmond
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Center for Morphometric Analysis (CMA), Massachusetts General Hospital, Charlestown, MA, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ashley I Bush
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience & Mental Health, and The University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
- Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| |
Collapse
|
6
|
Foley PB, Hare DJ, Double KL. A brief history of brain iron accumulation in Parkinson disease and related disorders. J Neural Transm (Vienna) 2022; 129:505-520. [PMID: 35534717 PMCID: PMC9188502 DOI: 10.1007/s00702-022-02505-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/22/2022] [Indexed: 12/21/2022]
Abstract
Iron has a long and storied history in Parkinson disease and related disorders. This essential micronutrient is critical for normal brain function, but abnormal brain iron accumulation has been associated with extrapyramidal disease for a century. Precisely why, how, and when iron is implicated in neuronal death remains the subject of investigation. In this article, we review the history of iron in movement disorders, from the first observations in the early twentieth century to recent efforts that view extrapyramidal iron as a novel therapeutic target and diagnostic indicator.
Collapse
Affiliation(s)
| | - Dominic J. Hare
- Atomic Medicine Initiative, University of Technology, Sydney, Australia
| | - Kay L. Double
- Brain and Mind Centre and School of Medical Sciences (Neuroscience), Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| |
Collapse
|
7
|
Foley PB, Hare DJ, Double KL. A brief history of brain iron accumulation in Parkinson disease and related disorders. J Neural Transm (Vienna) 2022; 129:505-520. [PMID: 35534717 DOI: 10.1007/s00702-022-025055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/22/2022] [Indexed: 05/26/2023]
Abstract
Iron has a long and storied history in Parkinson disease and related disorders. This essential micronutrient is critical for normal brain function, but abnormal brain iron accumulation has been associated with extrapyramidal disease for a century. Precisely why, how, and when iron is implicated in neuronal death remains the subject of investigation. In this article, we review the history of iron in movement disorders, from the first observations in the early twentieth century to recent efforts that view extrapyramidal iron as a novel therapeutic target and diagnostic indicator.
Collapse
Affiliation(s)
| | - Dominic J Hare
- Atomic Medicine Initiative, University of Technology, Sydney, Australia
| | - Kay L Double
- Brain and Mind Centre and School of Medical Sciences (Neuroscience), Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| |
Collapse
|
8
|
Prado-Rico JM, Lee EY, Wang EW, Yanosky JD, Kong L, Chen H, Navas-Acien A, Du G, Lewis MM, Mailman RB, Huang X. Higher R2* in the Red Nucleus Is Associated With Lead Exposure in an Asymptomatic Welder Cohort. Toxicol Sci 2022; 187:345-354. [PMID: 35357496 PMCID: PMC9154244 DOI: 10.1093/toxsci/kfac035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lead is a nonessential metal and may be a coexposure in welding fumes. Preclinical data indicate lead may affect iron regulation. The current study investigated blood lead concentrations and their association with brain iron accumulation in workers with chronic welding fume exposure, with a focus on iron-rich subcortical regions of the cerebellum and basal ganglia. Occupational exposure, whole blood metal, and brain MRI data were obtained from 29 controls and 42 welders. R2* (1/T2*) and R1 (T1 relaxation rate) values were used to estimate brain iron and manganese content, respectively. Blood metals and brain R2* (in the red nucleus [RN], dentate nucleus, caudate, putamen, globus pallidus, and substantia nigra) were compared between groups. Associations between brain R2* values and exposure metrics were tested within each group, and analyses were adjusted for potential confounders. Welders had significantly higher levels of whole blood lead, manganese, iron, and copper. Welders also had higher R2* RN (p = .002), but not R1. A 2nd-order polynomial modeled the association between R2* RN and a long-term welding exposure metric. In welders, but not controls, R2* RN was associated positively with whole blood lead (r = 0.54, p = .003), and negatively with whole blood manganese (r = -0.43, p = .02). Higher blood Pb and lower blood Mn independently accounted for variance in high RN R2*. Together, these data suggest that higher RN R2* values may mark lead exposure in welders. Because lead is a known neurotoxicant, additional studies are warranted to confirm this finding, and ascertain its scientific and public/occupational health implications.
Collapse
Affiliation(s)
- Janina Manzieri Prado-Rico
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Eun-Young Lee
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Ernest W Wang
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Jeff D Yanosky
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Lan Kong
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Hairong Chen
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - Guangwei Du
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Mechelle M Lewis
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Richard B Mailman
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| | - Xuemei Huang
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
- Department of Radiology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033-0850, USA
| |
Collapse
|
9
|
Advanced brain aging in multiple system atrophy compared to Parkinson's disease. Neuroimage Clin 2022; 34:102997. [PMID: 35397330 PMCID: PMC8987993 DOI: 10.1016/j.nicl.2022.102997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/07/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022]
Abstract
MSA, but not PD, exhibits advanced brain aging in gray matter and white matter. Brain age of gray matter is correlated with that of white matter in PD. Brain age measures can partly reveal associations with symptom severity. Brain features underlying brain age difference between MSA and PD are identified.
Multiple system atrophy (MSA) and Parkinson’s disease (PD) belong to alpha-synucleinopathy, but they have very different clinical courses and prognoses. An imaging biomarker that can differentiate between the two diseases early in the disease course is desirable for appropriate treatment. Neuroimaging-based brain age paradigm provides an individualized marker to differentiate aberrant brain aging patterns in neurodegenerative diseases. In this study, patients with MSA (N = 23), PD (N = 33), and healthy controls (N = 34; HC) were recruited. A deep learning approach was used to estimate brain-predicted age difference (PAD) of gray matter (GM) and white matter (WM) based on image features extracted from T1-weighted and diffusion-weighted magnetic resonance images, respectively. Spatial normative models of image features were utilized to quantify neuroanatomical impairments in patients, which were then used to estimate the contributions of image features to brain age measures. For PAD of GM (GM-PAD), patients with MSA had significantly older brain age (9.33 years) than those with PD (0.75 years; P = 0.002) and HC (-1.47 years; P < 0.001), and no significant difference was found between PD and HC (P = 1.000). For PAD of WM (WM-PAD), it was significantly greater in MSA (9.27 years) than that in PD (1.90 years; P = 0.037) and HC (-0.74 years; P < 0.001); there was no significant difference between PD and HC (P = 0.087). The most salient image features that contributed to PAD in MSA and PD were different. For GM, they were the orbitofrontal regions and the cuneus in MSA and PD, respectively, and for WM, they were the central corpus callosum and the uncinate fasciculus in MSA and PD, respectively. Our results demonstrated that MSA revealed significantly greater PAD than PD, which might be related to markedly different neuroanatomical contributions to brain aging. The image features with distinct contributions to brain aging might be of value in the differential diagnosis of MSA and PD.
Collapse
|
10
|
Brown G, Du G, Farace E, Lewis MM, Eslinger PJ, McInerney J, Kong L, Li R, Huang X, De Jesus S. Subcortical Iron Accumulation Pattern May Predict Neuropsychological Outcomes After Subthalamic Nucleus Deep Brain Stimulation: A Pilot Study. JOURNAL OF PARKINSON'S DISEASE 2022; 12:851-863. [PMID: 34974437 PMCID: PMC9181238 DOI: 10.3233/jpd-212833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND: Neuropsychological outcomes after deep brain stimulation (DBS) are variable and may arise from the heterogeneous neuropathological processes in Parkinson’s disease (PD). OBJECTIVE: To explore if brain iron accumulation patterns and its region-specific alterations relate to neuropsychological outcomes post-DBS. METHODS: Thirty-two PD subjects were identified from our database with susceptibility MRI prior to bilateral subthalamic nucleus (STN) DBS between 2011–2016. Demographic (age, sex, education), clinical information (disease duration, neuropsychological scores), and R2* (susceptibility MRI measure reflecting iron) in 11 subcortical regions of interest were obtained. Neuropsychological outcomes were defined as changes in psychomotor speed, executive function, attention, memory, and depression by subtracting pre- and post-DBS scores. A penalized logistic analysis was used to identify the best pre-DBS clinical and R2* predictors for each neuropsychological domain. Pearson’s partial correlations explored R2* associations with neuropsychological outcomes. RESULTS: Combined clinical and MRI metrics were associated better with neuropsychological outcomes (R2≥0.373, p-value≤0.008) than either alone. Adding R2* metrics increased prediction of executive function (R2=0.455, p=0.008) and attention (R2=0.182, p=0.018) outcomes over clinical metrics alone. Specifically, R2* in the substantia nigra, caudate, STN, and hippocampus improved prediction of executive function, and in the putamen for attention. Interestingly, higher caudate R2* correlated with better executive function (p=0.043), whereas higher putamen R2* associated with worsening attention (p=0.018). CONCLUSIONS: Brain iron accumulation patterns, captured by susceptibility MRI, may add value to clinical evaluation in predicting neuropsychological outcomes post-DBS in PD. Further studies are warranted to validate these findings and understand the region-specific relationships between iron and DBS outcomes.
Collapse
Affiliation(s)
- Gregory Brown
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Elana Farace
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mechelle M Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Paul J Eslinger
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - James McInerney
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Lan Kong
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Runze Li
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Statistics, Pennsylvania State University, University Park, PA, USA
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Sol De Jesus
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| |
Collapse
|
11
|
Jellen LC, Lewis MM, Du G, Wang X, Galvis MLE, Krzyzanowski S, Capan CD, Snyder AM, Connor JR, Kong L, Mailman RB, Brundin P, Brundin L, Huang X. Low plasma serotonin linked to higher nigral iron in Parkinson's disease. Sci Rep 2021; 11:24384. [PMID: 34934078 PMCID: PMC8692322 DOI: 10.1038/s41598-021-03700-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/18/2021] [Indexed: 12/30/2022] Open
Abstract
A growing body of evidence suggests nigral iron accumulation plays an important role in the pathophysiology of Parkinson's disease (PD), contributing to dopaminergic neuron loss in the substantia nigra pars compacta (SNc). Converging evidence suggests this accumulation might be related to, or increased by, serotonergic dysfunction, a common, often early feature of the disease. We investigated whether lower plasma serotonin in PD is associated with higher nigral iron. We obtained plasma samples from 97 PD patients and 89 controls and MRI scans from a sub-cohort (62 PD, 70 controls). We measured serotonin concentrations using ultra-high performance liquid chromatography and regional iron content using MRI-based quantitative susceptibility mapping. PD patients had lower plasma serotonin (p < 0.0001) and higher nigral iron content (SNc: p < 0.001) overall. Exclusively in PD, lower plasma serotonin was correlated with higher nigral iron (SNc: r(58) = - 0.501, p < 0.001). This correlation was significant even in patients newly diagnosed (< 1 year) and stronger in the SNc than any other region examined. This study reveals an early, linear association between low serotonin and higher nigral iron in PD patients, which is absent in controls. This is consistent with a serotonin-iron relationship in the disease process, warranting further studies to determine its cause and directionality.
Collapse
Affiliation(s)
- Leslie C Jellen
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mechelle M Lewis
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Xi Wang
- Public Health Sciences, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Martha L Escobar Galvis
- Parkinson's Disease Center, Department of Neurodegenerative Science, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI, 49503, USA
| | - Stanislaw Krzyzanowski
- Parkinson's Disease Center, Department of Neurodegenerative Science, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI, 49503, USA
| | - Colt D Capan
- Parkinson's Disease Center, Department of Neurodegenerative Science, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI, 49503, USA
| | - Amanda M Snyder
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - James R Connor
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Lan Kong
- Public Health Sciences, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Richard B Mailman
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Patrik Brundin
- Parkinson's Disease Center, Department of Neurodegenerative Science, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI, 49503, USA
| | - Lena Brundin
- Parkinson's Disease Center, Department of Neurodegenerative Science, Van Andel Institute, 333 Bostwick Ave NE, Grand Rapids, MI, 49503, USA.
- Division of Psychiatry and Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA.
| | - Xuemei Huang
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA.
- Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA.
- Departments of Neurosurgery and Radiology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA.
- Department of Kinesiology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA.
- Translational Brain Research Center, Penn State University-Hershey Medical Center, 500 University Dr., Mail Code H037, Hershey, PA, 17033, USA.
| |
Collapse
|
12
|
Chen Q, Boeve BF, Forghanian-Arani A, Senjem ML, Jack CR, Przybelski SA, Lesnick TG, Kremers WK, Fields JA, Schwarz CG, Gunter JL, Trzasko JD, Graff-Radford J, Savica R, Knopman DS, Dickson DW, Ferman TJ, Graff-Radford N, Petersen RC, Kantarci K. MRI quantitative susceptibility mapping of the substantia nigra as an early biomarker for Lewy body disease. J Neuroimaging 2021; 31:1020-1027. [PMID: 34033185 PMCID: PMC8440493 DOI: 10.1111/jon.12878] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/10/2021] [Accepted: 05/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Neurodegeneration of the substantia nigra in Lewy body disease is associated with iron deposition, which increases the magnetic susceptibility of the substantia nigra on MRI. Our objective was to measure iron deposition in the substantia nigra in patients with probable dementia with Lewy bodies (pDLB) and patients who are at risk for pDLB by quantitative susceptibility mapping (QSM). METHODS Participants included pDLB (n = 36), mild cognitive impairment with at least one core feature of DLB (MCI-LB; n = 15), idiopathic rapid eye movement sleep behavior disorder (iRBD; n = 11), and an age-and gender-matched clinically unimpaired control group (n = 102). QSM was derived from multi-echo 3D gradient recalled echo MRI at 3T, and groups were compared on mean susceptibility values of the substantia nigra and its relation to parkinsonism severity. RESULTS Patients with pDLB had higher susceptibility in the substantia nigra compared to controls (p< 0.001) and MCI-LB (p = 0.043). The susceptibility of substantia nigra showed an increasing trend from controls to iRBD and MCI-LB, and to pDLB (p< 0.001). Parkinsonism severity was not associated with the mean susceptibility in the substantia nigra in the patient groups. CONCLUSIONS Our data suggested that QSM is sensitive to the increased magnetic susceptibility due to higher iron content in the substantia nigra in pDLB. The trend of increasing susceptibility from controls to iRBD and MCI-LB, and to pDLB suggests that iron deposition in the substantia nigra starts to increase as early as the prodromal stage in DLB and continues to increase as the disease progresses, independent of parkinsonism severity.
Collapse
Affiliation(s)
- Qin Chen
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | - Scott A. Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Timothy G. Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Walter K. Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | | | - Tanis J. Ferman
- Department of Psychology and Psychiatry, Mayo Clinic, Jacksonville, Florida
| | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
13
|
Poston KL, Ua Cruadhlaoich MAI, Santoso LF, Bernstein JD, Liu T, Wang Y, Rutt B, Kerchner GA, Zeineh MM. Substantia Nigra Volume Dissociates Bradykinesia and Rigidity from Tremor in Parkinson's Disease: A 7 Tesla Imaging Study. JOURNAL OF PARKINSONS DISEASE 2021; 10:591-604. [PMID: 32250317 PMCID: PMC7242837 DOI: 10.3233/jpd-191890] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: In postmortem analysis of late stage Parkinson’s disease (PD) neuronal loss in the substantial nigra (SN) correlates with the antemortem severity of bradykinesia and rigidity, but not tremor. Objective: To investigate the relationship between midbrain nuclei volume as an in vivo biomarker for surviving neurons in mild-to-moderate patients using 7.0 Tesla MRI. Methods: We performed ultra-high resolution quantitative susceptibility mapping (QSM) on the midbrain in 32 PD participants with less than 10 years duration and 8 healthy controls. Following blinded manual segmentation, the individual volumes of the SN, subthalamic nucleus, and red nucleus were measured. We then determined the associations between the midbrain nuclei and clinical metrics (age, disease duration, MDS-UPDRS motor score, and subscores for bradykinesia/rigidity, tremor, and postural instability/gait difficulty). Results: We found that smaller SN correlated with longer disease duration (r = –0.49, p = 0.004), more severe MDS-UPDRS motor score (r = –0.42, p = 0.016), and more severe bradykinesia-rigidity subscore (r = –0.47, p = 0.007), but not tremor or postural instability/gait difficulty subscores. In a hemi-body analysis, bradykinesia-rigidity severity only correlated with SN contralateral to the less-affected hemi-body, and not contralateral to the more-affected hemi-body, possibly reflecting the greatest change in dopamine neuron loss early in disease. Multivariate generalized estimating equation model confirmed that bradykinesia-rigidity severity, age, and disease duration, but not tremor severity, predicted SN volume. Conclusions: In mild-to-moderate PD, SN volume relates to motor manifestations in a motor domain-specific and laterality-dependent manner. Non-invasive in vivo 7.0 Tesla QSM may serve as a biomarker in longitudinal studies of SN atrophy and in studies of people at risk for developing PD.
Collapse
Affiliation(s)
- Kathleen L Poston
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Matthew A I Ua Cruadhlaoich
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Laura F Santoso
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.,School of Medicine, University of Massachusetts, Worcester, MA, USA.,California Institute of Technology, Pasadena, CA, USA
| | - Jeffrey D Bernstein
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.,School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Tian Liu
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Yi Wang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Brian Rutt
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Geoffrey A Kerchner
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael M Zeineh
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|
14
|
Feraco P, Gagliardo C, La Tona G, Bruno E, D’angelo C, Marrale M, Del Poggio A, Malaguti MC, Geraci L, Baschi R, Petralia B, Midiri M, Monastero R. Imaging of Substantia Nigra in Parkinson's Disease: A Narrative Review. Brain Sci 2021; 11:brainsci11060769. [PMID: 34207681 PMCID: PMC8230134 DOI: 10.3390/brainsci11060769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/02/2021] [Accepted: 06/05/2021] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder, characterized by motor and non-motor symptoms due to the degeneration of the pars compacta of the substantia nigra (SNc) with dopaminergic denervation of the striatum. Although the diagnosis of PD is principally based on a clinical assessment, great efforts have been expended over the past two decades to evaluate reliable biomarkers for PD. Among these biomarkers, magnetic resonance imaging (MRI)-based biomarkers may play a key role. Conventional MRI sequences are considered by many in the field to have low sensitivity, while advanced pulse sequences and ultra-high-field MRI techniques have brought many advantages, particularly regarding the study of brainstem and subcortical structures. Nowadays, nigrosome imaging, neuromelanine-sensitive sequences, iron-sensitive sequences, and advanced diffusion weighted imaging techniques afford new insights to the non-invasive study of the SNc. The use of these imaging methods, alone or in combination, may also help to discriminate PD patients from control patients, in addition to discriminating atypical parkinsonian syndromes (PS). A total of 92 articles were identified from an extensive review of the literature on PubMed in order to ascertain the-state-of-the-art of MRI techniques, as applied to the study of SNc in PD patients, as well as their potential future applications as imaging biomarkers of disease. Whilst none of these MRI-imaging biomarkers could be successfully validated for routine clinical practice, in achieving high levels of accuracy and reproducibility in the diagnosis of PD, a multimodal MRI-PD protocol may assist neuroradiologists and clinicians in the early and differential diagnosis of a wide spectrum of neurodegenerative disorders.
Collapse
Affiliation(s)
- Paola Feraco
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via S. Giacomo 14, 40138 Bologna, Italy;
- Neuroradiology Unit, S. Chiara Hospital, 38122 Trento, Italy;
| | - Cesare Gagliardo
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
- Correspondence:
| | - Giuseppe La Tona
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Eleonora Bruno
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Costanza D’angelo
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Maurizio Marrale
- Department of Physics and Chemistry, University of Palermo, 90128 Palermo, Italy;
| | - Anna Del Poggio
- Department of Neuroradiology and CERMAC, San Raffaele Scientific Institute, San Raffaele Vita-Salute University, 20132 Milan, Italy;
| | | | - Laura Geraci
- Diagnostic and Interventional Neuroradiology Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy;
| | - Roberta Baschi
- Section of Neurology, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (R.B.); (R.M.)
| | | | - Massimo Midiri
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Roberto Monastero
- Section of Neurology, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (R.B.); (R.M.)
| |
Collapse
|
15
|
Bae YJ, Kim JM, Sohn CH, Choi JH, Choi BS, Song YS, Nam Y, Cho SJ, Jeon B, Kim JH. Imaging the Substantia Nigra in Parkinson Disease and Other Parkinsonian Syndromes. Radiology 2021; 300:260-278. [PMID: 34100679 DOI: 10.1148/radiol.2021203341] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Parkinson disease is characterized by dopaminergic cell loss in the substantia nigra of the midbrain. There are various imaging markers for Parkinson disease. Recent advances in MRI have enabled elucidation of the underlying pathophysiologic changes in the nigral structure. This has contributed to accurate and early diagnosis and has improved disease progression monitoring. This article aims to review recent developments in nigral imaging for Parkinson disease and other parkinsonian syndromes, including nigrosome imaging, neuromelanin imaging, quantitative iron mapping, and diffusion-tensor imaging. In particular, this article examines nigrosome imaging using 7-T MRI and 3-T susceptibility-weighted imaging. Finally, this article discusses volumetry and its clinical importance related to symptom manifestation. This review will improve understanding of recent advancements in nigral imaging of Parkinson disease. Published under a CC BY 4.0 license.
Collapse
Affiliation(s)
- Yun Jung Bae
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Jong-Min Kim
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Chul-Ho Sohn
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Ji-Hyun Choi
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Byung Se Choi
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Yoo Sung Song
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Yoonho Nam
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Se Jin Cho
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Beomseok Jeon
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Jae Hyoung Kim
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| |
Collapse
|
16
|
Lee EY, Flynn MR, Du G, Lewis MM, Goldenberg M, Kong L, Mailman RB, Hong YS, Huang X. Nigral MRI features of asymptomatic welders. Parkinsonism Relat Disord 2021; 85:37-43. [PMID: 33691274 DOI: 10.1016/j.parkreldis.2021.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 02/05/2021] [Accepted: 02/14/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Manganese (Mn)-induced parkinsonism involves motor symptoms similar to those observed in Parkinson's disease (PD). Previous literature suggests that chronic Mn- exposure may increase PD risk, although Mn-induced clinical syndromes are considered atypical for PD. This study investigated whether asymptomatic welders display differences in the substantia nigra (SN), the key pathological locus of PD. METHOD Brain MRI data and occupational exposure history were obtained in welders (N = 43) and matched controls (N = 31). Diffusion tensor imaging fractional anisotropy (FA; estimate of microstructural integrity) and R2* (estimate of iron and other PD-related brain differences) values in the SN pars compacta (SNc), SN reticulata (SNr), and globus pallidus (GP) were compared between the two groups. The MRI markers of the SN and GP within welders were related to exposure estimates. RESULTS Compared to controls, welders who had chronic, but low-level, Mn-exposure had similar FA and R2* values in both SN regions (p's > 0.082), but significantly lower FA (p = 0.0013), although not R2* (p = 0.553), in the GP. In welders, FA values in the SN and GP showed a second-order polynomial relationship with cumulative lifetime welding exposure (p's < 0.03). CONCLUSION Neurotoxic processes associated with Mn-exposure may be different from those in PD when the exposure-level is relatively low. Greater welding duration and level, however, were associated with FA differences in the GP and SN, indicating that welding exposures above a certain level may induce neurotoxicity in the SN, a finding that should be explored further in future studies.
Collapse
Affiliation(s)
- Eun-Young Lee
- Department of Health Care and Science, Dong-A University, Busan, South Korea.
| | - Michael R Flynn
- Department of Kinesiology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Environmental Sciences, University of North Carolina, Chapel Hill, NC, 27599, USA.
| | - Guangwei Du
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
| | - Mechelle M Lewis
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
| | - Michael Goldenberg
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
| | - Lan Kong
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
| | - Richard B Mailman
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
| | - Young-Seoub Hong
- Department of Preventive Medicine, Dong-A University College of Medicine, Busan, South Korea.
| | - Xuemei Huang
- Department of Neurology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Pharmacology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Radiology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Neurosurgery, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Kinesiology, The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; Department of Environmental Sciences, University of North Carolina, Chapel Hill, NC, 27599, USA.
| |
Collapse
|
17
|
Ravanfar P, Loi SM, Syeda WT, Van Rheenen TE, Bush AI, Desmond P, Cropley VL, Lane DJR, Opazo CM, Moffat BA, Velakoulis D, Pantelis C. Systematic Review: Quantitative Susceptibility Mapping (QSM) of Brain Iron Profile in Neurodegenerative Diseases. Front Neurosci 2021; 15:618435. [PMID: 33679303 PMCID: PMC7930077 DOI: 10.3389/fnins.2021.618435] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/07/2021] [Indexed: 12/11/2022] Open
Abstract
Iron has been increasingly implicated in the pathology of neurodegenerative diseases. In the past decade, development of the new magnetic resonance imaging technique, quantitative susceptibility mapping (QSM), has enabled for the more comprehensive investigation of iron distribution in the brain. The aim of this systematic review was to provide a synthesis of the findings from existing QSM studies in neurodegenerative diseases. We identified 80 records by searching MEDLINE, Embase, Scopus, and PsycInfo databases. The disorders investigated in these studies included Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Wilson's disease, Huntington's disease, Friedreich's ataxia, spinocerebellar ataxia, Fabry disease, myotonic dystrophy, pantothenate-kinase-associated neurodegeneration, and mitochondrial membrane protein-associated neurodegeneration. As a general pattern, QSM revealed increased magnetic susceptibility (suggestive of increased iron content) in the brain regions associated with the pathology of each disorder, such as the amygdala and caudate nucleus in Alzheimer's disease, the substantia nigra in Parkinson's disease, motor cortex in amyotrophic lateral sclerosis, basal ganglia in Huntington's disease, and cerebellar dentate nucleus in Friedreich's ataxia. Furthermore, the increased magnetic susceptibility correlated with disease duration and severity of clinical features in some disorders. Although the number of studies is still limited in most of the neurodegenerative diseases, the existing evidence suggests that QSM can be a promising tool in the investigation of neurodegeneration.
Collapse
Affiliation(s)
- Parsa Ravanfar
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Samantha M Loi
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Warda T Syeda
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ashley I Bush
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience & Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Patricia Desmond
- Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, The University of Melbourne, Parkville, VIC, Australia.,Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Darius J R Lane
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience & Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Carlos M Opazo
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Bradford A Moffat
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, The University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
18
|
Lee H, Lee MJ, Kim EJ, Huh GY, Lee JH, Cho H. Iron accumulation in the oculomotor nerve of the progressive supranuclear palsy brain. Sci Rep 2021; 11:2950. [PMID: 33536537 PMCID: PMC7859181 DOI: 10.1038/s41598-021-82469-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/04/2021] [Indexed: 12/11/2022] Open
Abstract
Abnormal iron accumulation around the substantia nigra (SN) is a diagnostic indicator of Parkinsonism. This study aimed to identify iron-related microarchitectural changes around the SN of brains with progressive supranuclear palsy (PSP) via postmortem validations and in vivo magnetic resonance imaging (MRI). 7 T high-resolution MRI was applied to two postmortem brain tissues, from one normal brain and one PSP brain. Histopathological examinations were performed to demonstrate the molecular origin of the high-resolution postmortem MRI findings, by using ferric iron staining, myelin staining, and two-dimensional laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) imaging. In vivo iron-related MRI was performed on five healthy controls, five patients with Parkinson’s disease (PD), and five patients with PSP. In the postmortem examination, excessive iron deposition along the myelinated fiber at the anterior SN and third cranial nerve (oculomotor nerve) fascicles of the PSP brain was verified by LA-ICP-MS. This region corresponded to those with high R2* values and positive susceptibility from quantitative susceptibility mapping (QSM), but was less sensitive in Perls’ Prussian blue staining. In in vivo susceptibility-weighted imaging, hypointense pixels were observed in the region between the SN and red nucleus (RN) in patients with PSP, but not in healthy controls and patients with PD. R2* and QSM values of such region were significantly higher in patients with PSP compared to those in healthy controls and patients with PD as well (vs. healthy control: p = 0.008; vs. PD: p = 0.008). Thus, excessive iron accumulation along the myelinated fibers at the anterior SN and oculomotor nerve fascicles may be a pathological characteristic and crucial MR biomarker in a brain with PSP.
Collapse
Affiliation(s)
- Hansol Lee
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50, UNIST-Gil, Eonyang-eup, Ulju-gun, Ulsan, South Korea
| | - Myung Jun Lee
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - Eun-Joo Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea
| | - Gi Yeong Huh
- Department of Forensic Medicine, Pusan National University School of Medicine, Yangsan, South Korea
| | - Jae-Hyeok Lee
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea.
| | - HyungJoon Cho
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, 50, UNIST-Gil, Eonyang-eup, Ulju-gun, Ulsan, South Korea.
| |
Collapse
|
19
|
Brown GL, Camacci ML, Kim SD, Grillo S, Nguyen JV, Brown DA, Ullah SP, Lewis MM, Du G, Kong L, Sundstrom JM, Huang X, Bowie EM. Choroidal Thickness Correlates with Clinical and Imaging Metrics of Parkinson's Disease: A Pilot Study. JOURNAL OF PARKINSON'S DISEASE 2021; 11:1857-1868. [PMID: 34275909 PMCID: PMC8530855 DOI: 10.3233/jpd-212676] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Parkinson's disease (PD) is marked clinically by motor symptoms and pathologically by Lewy bodies and dopamine neuron loss in the substantia nigra pars compacta (SNc). Higher iron accumulation, assessed by susceptibility MRI, also is observed as PD progresses. Recently, evidence has suggested that PD affects the retina. OBJECTIVE To better understand retinal alterations in PD and their association to clinical and SNc iron-related imaging metrics. METHODS Ten PD and 12 control participants (2 eyes each) from an ongoing PD imaging biomarker study underwent enhanced depth imaging optical coherence tomography evaluation. Choroidal (vascular) thickness and nerve layers were measured in 4 subregions [superior, temporal, inferior, and nasal] and at 3 foveal distances (1, 1.5, and 3 mm). These metrics were compared between PD and control groups. For significantly different metrics, their associations with clinical [levodopa equivalent daily dosage (LEDD), motor and visuospatial function] and SNc susceptibility MRI metrics [R2* and quantitative susceptibility mapping (QSM)] were explored. RESULTS Compared to control participants, PD participants had a thicker choroid (p = 0.005), but no changes in nerve layers. Higher mean choroidal thickness was associated with lower LEDD (p < 0.01) and better visuospatial function (p < 0.05). Subregion analyses revealed higher choroidal thickness correlated with lower LEDD and better motor and visuospatial measures. Higher mean choroidal thickness also was associated with lower nigral iron MRI (p < 0.05). CONCLUSION A small cohort of PD research participants displayed higher choroidal thickness that was related to better clinical performance and less nigral pathology. These intriguing findings warrant further investigation.
Collapse
Affiliation(s)
- Gregory L. Brown
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mona L. Camacci
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Sean D. Kim
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Stephanie Grillo
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - James V. Nguyen
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Douglas A. Brown
- Department of Ophthalmology, Temple University-Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Sarah P. Ullah
- Department of Ophthalmology, Pittsburgh University School of Medicine, Pittsburgh, PA, USA
| | - Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Lan Kong
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Jeffrey M. Sundstrom
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Ophthalmology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Kinesiology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Esther M. Bowie
- Department of Ophthalmology, Temple University-Lewis Katz School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
20
|
Mailman RB, Yang Y, Huang X. D 1, not D 2, dopamine receptor activation dramatically improves MPTP-induced parkinsonism unresponsive to levodopa. Eur J Pharmacol 2020; 892:173760. [PMID: 33279520 DOI: 10.1016/j.ejphar.2020.173760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 11/15/2022]
Abstract
Levodopa is the standard-of-care for Parkinson's disease, but continued loss of dopamine neurons with disease progression decreases its bioconversion to dopamine, leading to increased side effects and decreased efficacy. In theory, dopamine agonists could equal levodopa, but no approved oral "dopamine agonist" matches the efficacy of levodopa. There are consistent data in both primate models and in Parkinson's disease showing that selective high intrinsic activity D1 agonists can equal levodopa in efficacy. There are, however, no data on whether such compounds would be effective in severe disease when levodopa efficacy is low or absent. We compared two approved antiparkinson drugs (levodopa and the D2/3 agonist bromocriptine) with the experimental selective D1 full agonist dihydrexidine in two severely parkinsonian MPTP-treated non-human primates. Bromocriptine caused no discernible improvement in parkinsonian signs, whereas levodopa caused a small transient improvement in one of the two subjects. Conversely, the full D1 agonist dihydrexidine caused a dramatic improvement in both subjects, decreasing parkinsonian signs by ca. 75%. No attenuation of dihydrexidine effects was observed when the two subjects were pretreated with the D2 antagonist remoxipride. These data provide evidence that selective D1 agonists may provide profound antiparkinson symptomatic relief even when the degree of nigrostriatal degeneration is so severe that current drugs are ineffective. Until effective disease-modifying therapies are discovered, high intrinsic activity D1 agonists may offer a major therapeutic advance in improving the quality of life, and potentially the longevity, of late stage Parkinson's patients.
Collapse
Affiliation(s)
- Richard B Mailman
- Departments of Pharmacology and NeurologyPenn State University College of Medicine Hershey PA 17033, USA.
| | - Yang Yang
- Departments of Pharmacology and NeurologyPenn State University College of Medicine Hershey PA 17033, USA.
| | - Xuemei Huang
- Departments of Pharmacology and NeurologyPenn State University College of Medicine Hershey PA 17033, USA.
| |
Collapse
|
21
|
Heilman PL, Wang EW, Lewis MM, Krzyzanowski S, Capan CD, Burmeister AR, Du G, Escobar Galvis ML, Brundin P, Huang X, Brundin L. Tryptophan Metabolites Are Associated With Symptoms and Nigral Pathology in Parkinson's Disease. Mov Disord 2020; 35:2028-2037. [PMID: 32710594 PMCID: PMC7754343 DOI: 10.1002/mds.28202] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 01/16/2023] Open
Abstract
Background The objective of this study was to determine whether neurotoxic kynurenine metabolites, induced by inflammation, in plasma and cerebrospinal fluid (CSF) are associated with symptom severity and nigral pathology in Parkinson's disease (PD). Methods Clinical and MRI data were obtained from 97 PD and 89 controls. We used ultra‐performance liquid chromatography to quantify kynurenine metabolites and high‐sensitivity multiplex assays to quantify inflammation in plasma and CSF. We evaluated group‐wise differences as well as associations between the biomarkers, motor and nonmotor symptoms, and nigral R2* (MRI metric reflecting iron content). Results PD subjects had >100% higher 3‐hydroxykynurenine and 14% lower 3‐hydroxyanthranilic acid in plasma. The 3‐HK in plasma was closely associated with both symptom severity and disease duration. PD subjects also had 23% lower kynurenic acid in the CSF. Higher CSF levels of the excitotoxin quinolinic acid were associated with more severe symptoms, whereas lower levels of the neuroprotective kynurenic acid were linked to olfactory deficits. An elevated quinolinic acid/picolinic acid ratio in the CSF correlated with higher R2* values in the substantia nigra in the entire cohort. Plasma C‐reactive protein and serum amyloid alpha were associated with signs of increased kynurenine pathway activity in the CSF of PD patients, but not in controls. Conclusions In PD, the kynurenine pathway metabolite levels are altered in both the periphery and the central nervous system, and these changes are associated with symptom severity. Replication studies are warranted in other cohorts, and these can also explore if kynurenine metabolites might be PD biomarkers and/or are involved in PD pathogenesis. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Patrick L Heilman
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, Michigan, USA
| | - Ernest W Wang
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA
| | - Mechelle M Lewis
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA
| | | | - Colt D Capan
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, Michigan, USA
| | - Amanda R Burmeister
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, Michigan, USA
| | - Guangwei Du
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA
| | | | - Patrik Brundin
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, Michigan, USA
| | - Xuemei Huang
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA.,Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA.,Department of Radiology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA.,Department of Kinesiology, Penn State University-Milton S. Hershey Medical Center, Hersey Pennsylvania, USA
| | - Lena Brundin
- Center for Neurodegenerative Science, Van Andel Institute, Grand Rapids, Michigan, USA.,Division of Psychiatry & Behavioral Medicine, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| |
Collapse
|
22
|
α-Synuclein Induces Progressive Changes in Brain Microstructure and Sensory-Evoked Brain Function That Precedes Locomotor Decline. J Neurosci 2020; 40:6649-6659. [PMID: 32669353 PMCID: PMC7486650 DOI: 10.1523/jneurosci.0189-20.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/13/2020] [Accepted: 06/08/2020] [Indexed: 02/06/2023] Open
Abstract
In vivo functional and structural brain imaging of synucleinopathies in humans have provided a rich new understanding of the affected networks across the cortex and subcortex. Despite this progress, the temporal relationship between α-synuclein (α-syn) pathology and the functional and structural changes occurring in the brain is not well understood. Here, we examine the temporal relationship between locomotor ability, brain microstructure, functional brain activity, and α-syn pathology by longitudinally conducting rotarod, diffusion magnetic resonance imaging (MRI), resting-state functional MRI (fMRI), and sensory-evoked fMRI on 20 mice injected with α-syn fibrils and 20 PBS-injected mice at three timepoints (10 males and 10 females per group). Intramuscular injection of α-syn fibrils in the hindlimb of M83+/- mice leads to progressive α-syn pathology along the spinal cord, brainstem, and midbrain by 16 weeks post-injection. Our results suggest that peripheral injection of α-syn has acute systemic effects on the central nervous system such that structural and resting-state functional activity changes occur in the brain by four weeks post-injection, well before α-syn pathology reaches the brain. At 12 weeks post-injection, a separate and distinct pattern of structural and sensory-evoked functional brain activity changes was observed that are co-localized with previously reported regions of α-syn pathology and immune activation. Microstructural changes in the pons at 12 weeks post-injection were found to predict survival time and preceded measurable locomotor deficits. This study provides preliminary evidence for diffusion and fMRI markers linked to the progression of synuclein pathology and has translational importance for understanding synucleinopathies in humans.SIGNIFICANCE STATEMENT α-Synuclein (α-syn) pathology plays a critical role in neurodegenerative diseases such as Parkinson's disease, dementia with Lewy bodies, and multiple system atrophy. The longitudinal effects of α-syn pathology on locomotion, brain microstructure, and functional brain activity are not well understood. Using high field imaging, we show preliminary evidence that peripheral injection of α-syn fibrils induces unique patterns of functional and structural changes that occur at different temporal stages of α-syn pathology progression. Our results challenge existing assumptions that α-syn pathology must precede changes in brain structure and function. Additionally, we show preliminary evidence that diffusion and functional magnetic resonance imaging (fMRI) are capable of resolving such changes and thus should be explored further as markers of disease progression.
Collapse
|
23
|
Birkl C, Birkl-Toeglhofer AM, Kames C, Goessler W, Haybaeck J, Fazekas F, Ropele S, Rauscher A. The influence of iron oxidation state on quantitative MRI parameters in post mortem human brain. Neuroimage 2020; 220:117080. [PMID: 32585344 DOI: 10.1016/j.neuroimage.2020.117080] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/13/2022] Open
Abstract
A variety of Magnetic Resonance Imaging (MRI) techniques are known to be sensitive to brain iron content. In principle, iron sensitive MRI techniques are based on local magnetic field variations caused by iron particles in tissue. The purpose of this study was to investigate the sensitivity of MR relaxation and magnetization transfer parameters to changes in iron oxidation state compared to changes in iron concentration. Therefore, quantitative MRI parameters including R1, R2, R2∗, quantitative susceptibility maps (QSM) and magnetization transfer ratio (MTR) of post mortem human brain tissue were acquired prior and after chemical iron reduction to change the iron oxidation state and chemical iron extraction to decrease the total iron concentration. All assessed parameters were shown to be sensitive to changes in iron concentration whereas only R2, R2∗ and QSM were also sensitive to changes in iron oxidation state. Mass spectrometry confirmed that iron accumulated in the extraction solution but not in the reduction solution. R2∗ and QSM are often used as markers for iron content. Changes in these parameters do not necessarily reflect variations in iron content but may also be a result of changes in the iron's oxygenation state from ferric towards more ferrous iron or vice versa.
Collapse
Affiliation(s)
- Christoph Birkl
- UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada; Department of Neuroradiology, Medical University of Innsbruck, Austria; Department of Neurology, Medical University of Graz, Austria.
| | - Anna Maria Birkl-Toeglhofer
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Austria; Diagnostic and Research Institute of Pathology, Medical University of Graz, Austria
| | - Christian Kames
- UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada; Department of Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Walter Goessler
- Institute of Chemistry, Analytical Chemistry, University of Graz, Austria
| | - Johannes Haybaeck
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Austria; Diagnostic and Research Institute of Pathology, Medical University of Graz, Austria
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Austria
| | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Austria
| | - Alexander Rauscher
- UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada; Department of Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada; Department of Pediatrics (Division of Neurology), University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
24
|
Ryman SG, Poston KL. MRI biomarkers of motor and non-motor symptoms in Parkinson's disease. Parkinsonism Relat Disord 2020; 73:85-93. [PMID: 31629653 PMCID: PMC7145760 DOI: 10.1016/j.parkreldis.2019.10.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/03/2019] [Accepted: 10/05/2019] [Indexed: 12/19/2022]
Abstract
Parkinson's disease is a heterogeneous disorder with both motor and non-motor symptoms that contribute to functional impairment. To develop effective, disease modifying treatments for these symptoms, biomarkers are necessary to detect neuropathological changes early in the disease course and monitor changes over time. Advances in MRI scan sequences and analytical techniques present numerous promising metrics to detect changes within the nigrostriatal system, implicated in the cardinal motor symptoms of the disease, and detect broader dysfunction involved in the non-motor symptoms, such as cognitive impairment. There is emerging evidence that iron sensitive, neuromelanin sensitive, diffusion sensitive, and resting state functional magnetic imaging measures can capture changes within the nigrostriatal system. Iron, neuromelanin, and diffusion sensitive measures demonstrate high specificity and sensitivity in distinguishing Parkinson's disease relative to controls, with inconsistent results differentiating Parkinson's disease relative to atypical parkinsonian disorders. They may also serve as useful monitoring biomarkers, with each possibly detecting different aspects of the disease course (early nigrosome changes versus broader substantia nigra changes). Investigations of non-motor symptoms, such as cognitive impairment, require careful consideration of the nature of cognitive deficits to characterize regional and network specific impairment. While the early, executive dysfunction observed is consistent with nigrostriatal degeneration, the memory and visuospatial impairments, the harbingers of a dementia process reflect dopaminergic independent dysfunction involving broader regions of the brain.
Collapse
Affiliation(s)
- Sephira G Ryman
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, 300 Pasteur Dr. Room A343. MC-5235, Stanford, CA, 94305, USA.
| | - Kathleen L Poston
- Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford University, 300 Pasteur Dr. Room A343. MC-5235, Stanford, CA, 94305, USA.
| |
Collapse
|
25
|
Perlmutter JS, Stoessl AJ. Striatal DAT SPECT: Caveat Emptor! Mov Disord 2019; 34:1430-1432. [PMID: 31769089 DOI: 10.1002/mds.27811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/08/2019] [Accepted: 07/14/2019] [Indexed: 12/17/2022] Open
Affiliation(s)
- Joel S Perlmutter
- Departments of Neurology, Radiology, Neuroscience and Programs in Physical Therapy and Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - A Jon Stoessl
- Division of Neurology & Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
26
|
Vaillancourt DE, Lehericy S. Illuminating basal ganglia and beyond in Parkinson's disease. Mov Disord 2019; 33:1373-1375. [PMID: 30311976 DOI: 10.1002/mds.27483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/08/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- David E Vaillancourt
- Department of Applied Physiology and Kinesiology, Biomedical Engineering, Neurology, University of Florida, Gainesville, Florida, USA
| | - Stéphane Lehericy
- Institut du Cerveau et de la Moelle - ICM, Centre de NeuroImagerie de Recherche - CENIR, Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| |
Collapse
|
27
|
Qian ZM, Ke Y. Hepcidin and its therapeutic potential in neurodegenerative disorders. Med Res Rev 2019; 40:633-653. [PMID: 31471929 DOI: 10.1002/med.21631] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/18/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022]
Abstract
Abnormally high brain iron, resulting from the disrupted expression or function of proteins involved in iron metabolism in the brain, is an initial cause of neuronal death in neuroferritinopathy and aceruloplasminemia, and also plays a causative role in at least some of the other neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, Huntington's disease, and Friedreich's ataxia. As such, iron is believed to be a novel target for pharmacological intervention in these disorders. Reducing iron toward normal levels or hampering the increases in iron associated with age in the brain is a promising therapeutic strategy for all iron-related neurodegenerative disorders. Hepcidin is a crucial regulator of iron homeostasis in the brain. Recent studies have suggested that upregulating brain hepcidin levels can significantly reduce brain iron content through the regulation of iron transport protein expression in the blood-brain barrier and in neurons and astrocytes. In this review, we focus on the discussion of the therapeutic potential of hepcidin in iron-associated neurodegenerative diseases and also provide a systematic overview of recent research progress on how misregulated brain iron metabolism is involved in the development of multiple neurodegenerative disorders.
Collapse
Affiliation(s)
- Zhong-Ming Qian
- Institute of Translational & Precision Medicine, Nantong University, Nantong, Jiangsu, China.,Laboratory of Neuropharmacology, School of Pharmacy & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ya Ke
- School of Biomedical Sciences and Gerald Choa Neuroscience Centre, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
| |
Collapse
|
28
|
Prange S, Metereau E, Thobois S. Structural Imaging in Parkinson’s Disease: New Developments. Curr Neurol Neurosci Rep 2019; 19:50. [DOI: 10.1007/s11910-019-0964-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
29
|
Bergsland N, Zivadinov R, Schweser F, Hagemeier J, Lichter D, Guttuso T. Ventral posterior substantia nigra iron increases over 3 years in Parkinson's disease. Mov Disord 2019; 34:1006-1013. [PMID: 31180615 DOI: 10.1002/mds.27730] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is characterized in part by the progressive accumulation of iron within the substantia nigra (SN); however, its spatial and temporal dynamics remain relatively poorly understood. OBJECTIVES The objective of this study was to investigate spatial patterns and temporal evolution of SN iron accumulation in PD. METHODS A total of 18 PD patients (mean disease duration = 6.2 years) receiving dopaminergic therapy and 16 healthy controls were scanned with 3T MRI at baseline and 3 years later using quantitative susceptibility mapping, an indirect marker of iron content. Iron was assessed separately in the posterior SN and anterior SN at the ventral and dorsal levels of the SN. The results were corrected for the false discovery rate. RESULTS A significant group effect was found for the ventral posterior SN (P < .001) and anterior SN (P = .042) quantitative susceptibility mapping as well as significant group x time interaction effects (P = .02 and P = .043, respectively). In addition, a significant intragroup change during 3 years of follow-up was found only in the ventral posterior SN of PD (P = .012), but not healthy controls. No significant effects were detected for any dorsal SN measures. No associations were identified with clinical measures. CONCLUSIONS We found both cross-sectional and longitudinal SN iron changes to be confined to its more ventral location in PD. Because pathology studies also show the ventral SN to degenerate early and to the greatest extent in PD, the assessment of iron levels by quantitative susceptibility mapping in this area may potentially represent a disease progression biomarker in PD. © 2019 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Robert Zivadinov
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.,Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Ferdinand Schweser
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA.,Center for Biomedical Imaging, Clinical and Translational Science Institute, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - David Lichter
- Movement Disorder Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Thomas Guttuso
- Movement Disorder Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
| |
Collapse
|
30
|
T2*-weighted MRI values correlate with motor and cognitive dysfunction in Parkinson's disease. Neurobiol Aging 2019; 80:91-98. [PMID: 31103636 DOI: 10.1016/j.neurobiolaging.2019.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 11/20/2022]
Abstract
Brain iron load is one of the main neuropathologic hallmarks of Parkinson's disease (PD). Previous studies indicated that iron in the substantia nigra (SN) is related to disease duration and motor impairment. We explore, through a cross-sectional study, the association between brain iron distribution, evaluated by T2*-weighted magnetic resonance imaging (T2*), and clinical features in a cohort of patients with PD. Thirty-two patients with PD, compared with 10 control subjects, were evaluated for motor and cognitive features (attention and working memory, executive functions, language, memory, and visuospatial function). They underwent a magnetic resonance imaging protocol including T2* analysis of specific brain regions of interest to measure iron load compared with healthy control subjects. We found that iron content of the SN correlated positively with both disease duration and Unified Parkinson's Disease Rating Scale III off score. Montreal Cognitive Assessment, Spatial Span, and Graded Naming Test scores were inversely associated with iron load of the SN, whereas Wechsler Adult Intelligence Scale-IV Similarities score showed an inverse relationship with iron content in all the regions of interest examined. Our findings suggest a relationship between topographic brain iron distribution and cognitive domain impairment.
Collapse
|
31
|
Chelban V, Bocchetta M, Hassanein S, Haridy NA, Houlden H, Rohrer JD. An update on advances in magnetic resonance imaging of multiple system atrophy. J Neurol 2019; 266:1036-1045. [PMID: 30460448 PMCID: PMC6420901 DOI: 10.1007/s00415-018-9121-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/11/2018] [Indexed: 02/08/2023]
Abstract
In this review, we describe how different neuroimaging tools have been used to identify novel MSA biomarkers, highlighting their advantages and limitations. First, we describe the main structural MRI changes frequently associated with MSA including the 'hot cross-bun' and 'putaminal rim' signs as well as putaminal, pontine, and middle cerebellar peduncle (MCP) atrophy. We discuss the sensitivity and specificity of different supra- and infratentorial changes in differentiating MSA from other disorders, highlighting those that can improve diagnostic accuracy, including the MCP width and MCP/superior cerebellar peduncle (SCP) ratio on T1-weighted imaging, raised putaminal diffusivity on diffusion-weighted imaging, and increased T2* signal in the putamen, striatum, and substantia nigra on susceptibility-weighted imaging. Second, we focus on recent advances in structural and functional MRI techniques including diffusion tensor imaging (DTI), resting-state functional MRI (fMRI), and arterial spin labelling (ASL) imaging. Finally, we discuss new approaches for MSA research such as multimodal neuroimaging strategies and how such markers may be applied in clinical trials to provide crucial data for accurately selecting patients and to act as secondary outcome measures.
Collapse
Affiliation(s)
- Viorica Chelban
- Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Department of Neurology and Neurosurgery, Institute of Emergency Medicine, Toma Ciorbă 1, 2052, Chisinau, Moldova
| | - Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK
| | - Sara Hassanein
- Diagnostic Radiology department, Faculty of Medicine Assiut University, Assiut, Egypt
- Department of Brain, Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK
| | - Nourelhoda A Haridy
- Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Assiut, Egypt
| | - Henry Houlden
- Department of Neuromuscular Diseases, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N 3BG, London, UK.
| |
Collapse
|
32
|
Wang EW, Du G, Lewis MM, Lee EY, De Jesus S, Kanekar S, Kong L, Huang X. Multimodal MRI evaluation of parkinsonian limbic pathologies. Neurobiol Aging 2019; 76:194-200. [PMID: 30739076 PMCID: PMC6461740 DOI: 10.1016/j.neurobiolaging.2019.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/18/2018] [Accepted: 01/05/2019] [Indexed: 01/22/2023]
Abstract
Previous multimodal magnetic resonance imaging (MRI) studies of parkinsonian syndromes have focused primarily on motor-related basal ganglia structures. The present study investigated MRI changes in nonmotor-related limbic structures in 35 Parkinson's disease, 16 multiple system atrophy parkinsonian subtype, 17 progressive supranuclear palsy, and 37 control subjects. Mean diffusivity (MD), fractional anisotropy, transverse relaxation rate (R2*), quantitative susceptibility mapping, and volume measurements were obtained from the amygdala, hippocampus, and nucleus accumbens (NAc) to examine differences between groups and to test for associations with clinical scores. Compared with controls, Parkinson's disease subjects had lower NAc volume; multiple system atrophy parkinsonian subtype subjects had higher NAc transverse relaxation rate; and progressive supranuclear palsy subjects had higher amygdala and hippocampus MD and lower hippocampus fractional anisotropy (p's ≤ 0.008). Among parkinsonian subjects, amygdala and hippocampus MD associated positively with Unified Parkinson's Disease Rating Scale nonmotor and activities of daily living scores (p's ≤ 0.005). Together, these findings support the inclusion of limbic structures in future MRI studies of parkinsonian syndromes.
Collapse
Affiliation(s)
- Ernest W Wang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Mechelle M Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA; Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Eun-Young Lee
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA; Department of Health Care and Science, Dong-A University, Busan, South-Korea
| | - Sol De Jesus
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Sangam Kanekar
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Lan Kong
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA; Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA; Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA; Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA; Department of Kinesiology, Penn State University-Milton S. Hershey Medical Center, Hershey, PA, USA.
| |
Collapse
|
33
|
Lee JH, Lee MS. Brain Iron Accumulation in Atypical Parkinsonian Syndromes: in vivo MRI Evidences for Distinctive Patterns. Front Neurol 2019; 10:74. [PMID: 30809185 PMCID: PMC6379317 DOI: 10.3389/fneur.2019.00074] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/21/2019] [Indexed: 12/13/2022] Open
Abstract
Recent data suggest mechanistic links among perturbed iron homeostasis, oxidative stress, and misfolded protein aggregation in neurodegenerative diseases. Iron overload and toxicity toward dopaminergic neurons have been established as playing a role in the pathogenesis of Parkinson's disease (PD). Brain iron accumulation has also been documented in atypical parkinsonian syndromes (APS), mainly comprising multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). Iron-sensitive magnetic resonance imaging (MRI) has been applied to identify iron-related signal changes for the diagnosis and differentiation of these disorders. Topographic patterns of widespread iron deposition in deep brain nuclei have been described as differing between patients with MSA and PSP and those with PD. A disease-specific increase of iron occurs in the brain regions mainly affected by underlying disease pathologies. However, whether iron changes are a primary pathogenic factor or an epiphenomenon of neuronal degeneration has not been fully elucidated. Moreover, the clinical implications of iron-related pathology in APS remain unclear. In this review study, we collected data from qualitative and quantitative MRI studies on brain iron accumulation in APS to identify disease-related patterns and the potential role of iron-sensitive MRI.
Collapse
Affiliation(s)
- Jae-Hyeok Lee
- Department of Neurology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea
| | - Myung-Sik Lee
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| |
Collapse
|
34
|
Du G, Lewis MM, Sica C, Kong L, Huang X. Magnetic resonance T1w/T2w ratio: A parsimonious marker for Parkinson disease. Ann Neurol 2019; 85:96-104. [PMID: 30408230 PMCID: PMC6342624 DOI: 10.1002/ana.25376] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 10/30/2018] [Accepted: 10/31/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Newer magnetic resonance imaging (MRI) techniques have shown promise in capturing early Parkinson disease (PD)-related changes in the substantia nigra pars compacta (SNc), the key pathological loci. Their translational value, however, is hindered by technical complexity and inconsistent results. METHODS A novel yet simple MRI contrast, the T1w/T2w ratio, was used to study 76 PD patients and 70 controls. The T1w/T2w ratio maps were analyzed using both voxel-based and region-of-interest approaches in normalized space. The sensitivity and specificity of the SNc T1w/T2w ratio in discriminating between PD and controls also were assessed. In addition, its diagnostic performance was tested in a subgroup of PD patients with disease duration ≤2 years (PDE). A second independent cohort of 73 PD patients and 49 controls was used for validation. RESULTS Compared to controls, PD patients showed a higher T1w/T2w ratio in both the right (cluster size = 164mm3 , p < 0.0001) and left (cluster size = 213mm3 , p < 0.0001) midbrain that was located ventrolateral to the red nucleus and corresponded to the SNc. The region-of-interest approach confirmed the group difference in the SNc T1w/T2w ratio between PD and controls (p < 0.0001). The SNc T1w/T2w ratio had high sensitivity (0.908) and specificity (0.80) to separate PD and controls (area under the curve [AUC] = 0.926), even for PDE patients (AUC = 0.901, sensitivity = 0.857, specificity = 0.857). These results were validated in the second cohort. INTERPRETATION The T1w/T2w ratio can detect PD-related changes in the SNc and may be used as a novel, parsimonious in vivo biomarker for the disease, particularly for early stage patients, with high translational value for clinical practice and research. ANN NEUROL 2019;85:96-104.
Collapse
Affiliation(s)
- Guangwei Du
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, US
| | - Mechelle M. Lewis
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, US
| | - Christopher Sica
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, US
| | - Lan Kong
- Department of Public Health Sciences, Penn State Hershey Medical Center, Hershey, PA, US
| | - Xuemei Huang
- Department of Neurology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Pharmacology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Neurosurgery, Penn State Hershey Medical Center, Hershey, PA, US
- Department of Kinesiology, Penn State Hershey Medical Center, Hershey, PA, US
| |
Collapse
|
35
|
Balážová Z, Nováková M, Minsterová A, Rektorová I. Structural and Functional Magnetic Resonance Imaging of Dementia With Lewy Bodies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 144:95-141. [PMID: 30638458 DOI: 10.1016/bs.irn.2018.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease (AD). Although diagnosis may be challenging, there is increasing evidence that the use of biomarkers according to 2017 revised criteria for diagnosis and management of dementia with Lewy bodies can increase diagnostic accuracy. Apart from nuclear medicine techniques, various magnetic resonance imaging (MRI) techniques have been utilized in attempt to enhance diagnostic accuracy. This chapter reviews structural, functional and diffusion MRI studies in DLB cohorts being compared to healthy controls, AD or dementia in Parkinson's disease (PDD). We also included relatively new MRI methods that may have potential to identify early DLB subjects and aim at examining brain iron and neuromelanin.
Collapse
Affiliation(s)
- Zuzana Balážová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; Department of Radiology and Nuclear Medicine, University Hospital Brno, Faculty of Medicine, Brno, Czech Republic
| | - Marie Nováková
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Alžběta Minsterová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Irena Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| |
Collapse
|
36
|
Du G, Lewis MM, Sica C, He L, Connor JR, Kong L, Mailman RB, Huang X. Distinct progression pattern of susceptibility MRI in the substantia nigra of Parkinson's patients. Mov Disord 2018; 33:1423-1431. [PMID: 29756399 DOI: 10.1002/mds.27318] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/13/2017] [Accepted: 12/31/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Susceptibility MRI may capture Parkinson's disease-related pathology. This study delineated longitudinal changes in different substantia nigra regions. METHODS Seventy-two PD patients and 62 controls were studied at both baseline and after 18 months with MRI. R2* and quantitative susceptibility mapping values from the substantia nigra pars compacta and substantia nigra pars reticulata were calculated. Mixed-effects models compared controls with PD or PD subgroups having different disease durations: early (<1 year), middle (<5 years, middle-stage PD), and late (>5 years, late-stage PD). Pearson's correlation assessed associations between imaging and clinical measures. RESULTS At baseline, R2* and quantitative susceptibility mapping were higher in both the substantia nigra pars compacta and substantia nigra pars reticulata in all PD patients (group effect, P ≤ 0.003). Longitudinally, the substantia nigra pars compacta R2* showed a faster increase in PD compared with controls (time × group, P = 0.002), whereas quantitative susceptibility mapping did not (P = 0.668). The substantia nigra pars reticulata R2* and quantitative susceptibility mapping did not differ between PD and controls (time × group, P ≥ 0.084), although both decreased longitudinally (time effect, P ≤ 0.004). Baseline substantia nigra pars compacta R2* was higher in all PD subgroups (group, P ≤ 0.006), but showed a significantly faster increase only in later-stage PD (time × group, P < 0.0001) that correlated with changes in nonmotor symptoms (r = 0.746, P = 0.002). Baseline substantia nigra pars reticulata quantitative susceptibility mapping was higher in middle-stage PD and later-stage PD (group, P ≤ 0.002), but showed a longitudinal decrease (time × group, P = 0.004) only in later-stage PD that correlated with changes in motor signs (r = 0.837, P < 0.001). CONCLUSION Susceptibility MRI revealed distinct patterns of PD progression in the substantia nigra pars compacta and substantia nigra pars reticulata. The different patterns are particularly clear in later-stage patients. These findings may resolve past controversies and have implications in the pathophysiological processes during PD progression. © 2018 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Guangwei Du
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Mechelle M Lewis
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Christopher Sica
- Department of Radiology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Lu He
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - James R Connor
- Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Lan Kong
- Department of Public Health Sciences, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Richard B Mailman
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Xuemei Huang
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Radiology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Kinesiology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| |
Collapse
|