1
|
Müller J, Lu PJ, Cagol A, Ruberte E, Shin HG, Ocampo-Pineda M, Chen X, Tsagkas C, Barakovic M, Galbusera R, Weigel M, Schaedelin SA, Wang Y, Nguyen TD, Spincemaille P, Kappos L, Kuhle J, Lee J, Granziera C. Quantifying Remyelination Using χ-Separation in White Matter and Cortical Multiple Sclerosis Lesions. Neurology 2024; 103:e209604. [PMID: 39213476 PMCID: PMC11362958 DOI: 10.1212/wnl.0000000000209604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/20/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Myelin and iron play essential roles in remyelination processes of multiple sclerosis (MS) lesions. χ-separation, a novel biophysical model applied to multiecho T2*-data and T2-data, estimates the contribution of myelin and iron to the obtained susceptibility signal. We used this method to investigate myelin and iron levels in lesion and nonlesion brain areas in patients with MS and healthy individuals. METHODS This prospective MS cohort study included patients with MS fulfilling the McDonald Criteria 2017 and healthy individuals, aged 18 years or older, with no other neurologic comorbidities. Participants underwent MRI at baseline and after 2 years, including multiecho GRE-(T2*) and FAST-(T2) sequences. Using χ-separation, we generated myelin-sensitive and iron-sensitive susceptibility maps. White matter lesions (WMLs), cortical lesions (CLs), surrounding normal-appearing white matter (NAWM), and normal-appearing gray matter were segmented on fluid-attenuated inversion recovery and magnetization-prepared 2 rapid gradient echo images, respectively. Cross-sectional group comparisons used Wilcoxon rank-sum tests, longitudinal analyses applied Wilcoxon signed-rank tests. Associations with clinical outcomes (disease phenotype, age, sex, disease duration, disability measured by Expanded Disability Status Scale [EDSS], neurofilament light chain levels, and T2-lesion number and volume) were assessed using linear regression models. RESULTS Of 168 patients with MS (median [interquartile range (IQR)] age 47.0 [21.7] years; 101 women; 6,898 WMLs, 775 CLs) and 103 healthy individuals (age 33.0 [10.5] years, 57 women), 108 and 62 were followed for a median of 2 years, respectively (IQR 0.1; 5,030 WMLs, 485 CLs). At baseline, WMLs had lower myelin (median 0.025 [IQR 0.015] parts per million [ppm]) and iron (0.017 [0.015] ppm) than the corresponding NAWM (myelin 0.030 [0.012]; iron 0.019 [0.011] ppm; both p < 0.001). After 2 years, both myelin (0.027 [0.014] ppm) and iron had increased (0.018 [0.015] ppm; both p < 0.001). Younger age (p < 0.001, b = -5.111 × 10-5), lower disability (p = 0.04, b = -2.352 × 10-5), and relapsing-remitting phenotype (RRMS, 0.003 [0.01] vs primary progressive 0.002 [IQR 0.01], p < 0.001; vs secondary progressive 0.0004 [IQR 0.01], p < 0.001) at baseline were associated with remyelination. Increment of myelin correlated with clinical improvement measured by EDSS (p = 0.015, b = -6.686 × 10-4). DISCUSSION χ-separation, a novel mathematical model applied to multiecho T2*-images and T2-images shows that young RRMS patients with low disability exhibit higher remyelination capacity, which correlated with clinical disability over a 2-year follow-up.
Collapse
Affiliation(s)
- Jannis Müller
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Po-Jui Lu
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Alessandro Cagol
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Esther Ruberte
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Hyeong-Geol Shin
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Mario Ocampo-Pineda
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Xinjie Chen
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Charidimos Tsagkas
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Muhamed Barakovic
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Riccardo Galbusera
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Matthias Weigel
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Sabine A Schaedelin
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Yi Wang
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Thanh D Nguyen
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Pascal Spincemaille
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Ludwig Kappos
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Jens Kuhle
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Jongho Lee
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| | - Cristina Granziera
- From the Translational Imaging in Neurology (ThINk) Basel (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., S.A.S., L.K., C.G.), Department of Biomedical Engineering, Faculty of Medicine, and Neurologic Clinic and Policlinic, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB) (J.M., P.-J.L., A.C., E.R., M.O.-P., X.C., C.T., M.B., R.G., M.W., L.K., J.K., C.G.), University Hospital Basel and University of Basel, Switzerland; Department of Health Sciences (A.C.), University of Genova, Italy; Laboratory for Imaging Science and Technology (H.-G.S., J.L.), Department of Electrical and Computer Engineering, Seoul National University, South Korea; Division of Radiological Physics (M.W.), Department of Radiology, University Hospital Basel; Department of Clinical Research (S.A.S.), Clinical Trial Unit, University Hospital Basel, Switzerland; and Department of Radiology (Y.W., T.D.N., P.S.), Weill Medical College of Cornell University, New York, NY
| |
Collapse
|
2
|
Gustavsson J, Ištvánfyová Z, Papenberg G, Falahati F, Laukka EJ, Lehtisalo J, Mangialasche F, Kalpouzos G. Lifestyle, biological, and genetic factors related to brain iron accumulation across adulthood. Neurobiol Aging 2024; 144:56-67. [PMID: 39277972 DOI: 10.1016/j.neurobiolaging.2024.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 09/04/2024] [Accepted: 09/06/2024] [Indexed: 09/17/2024]
Abstract
Iron is necessary for many neurobiological mechanisms, but its overaccumulation can be harmful. Factors triggering age-related brain iron accumulation remain largely unknown and longitudinal data are insufficient. We examined associations between brain iron load and accumulation and, blood markers of iron metabolism, cardiovascular health, lifestyle factors (smoking, alcohol use, physical activity, diet), and ApoE status using longitudinal data from the IronAge study (n = 208, age = 20-79, mean follow-up time = 2.75 years). Iron in cortex and basal ganglia was estimated with magnetic resonance imaging using quantitative susceptibility mapping (QSM). Our results showed that (1) higher peripheral iron levels (i.e., composite score of blood iron markers) were related to greater iron load in the basal ganglia; (2) healthier diet was related to higher iron levels in the cortex and basal ganglia, although for the latter the association was significant only in younger adults (age = 20-39); (3) worsening cardiovascular health was related to increased iron accumulation; (4) younger ApoE ε4 carriers accumulated more iron in basal ganglia than younger non-carriers. Our results demonstrate that modifiable factors, including lifestyle, cardiovascular, and physiological ones, are linked to age-related brain iron content and accumulation, contributing novel information on potential targets for interventions in preventing brain iron-overload.
Collapse
Affiliation(s)
- Jonatan Gustavsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden.
| | - Zuzana Ištvánfyová
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden; Karolinska University Hospital, Stockholm, Sweden
| | - Goran Papenberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| | - Farshad Falahati
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| | - Erika J Laukka
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Jenni Lehtisalo
- Finnish Institute for Health and Welfare, Helsinki, Finland; University of Eastern Finland, Kuopio, Finland
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Grégoria Kalpouzos
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden
| |
Collapse
|
3
|
Wang N, Liao C, Cao X, Nishimura M, Brackenier YWE, Yurt M, Gao M, Abraham D, Alkan C, Iyer SS, Zhou Z, Jeong H, Kerr A, Haldar JP, Setsompop K. Spherical echo-planar time-resolved imaging (sEPTI) for rapid 3D quantitative T 2 * and susceptibility imaging. Magn Reson Med 2024. [PMID: 39250435 DOI: 10.1002/mrm.30255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/28/2024] [Accepted: 07/31/2024] [Indexed: 09/11/2024]
Abstract
PURPOSE To develop a 3D spherical EPTI (sEPTI) acquisition and a comprehensive reconstruction pipeline for rapid high-quality whole-brain submillimeterT 2 * $$ {\mathrm{T}}_2^{\ast } $$ and QSM quantification. METHODS For the sEPTI acquisition, spherical k-space coverage is utilized with variable echo-spacing and maximum kx ramp-sampling to improve efficiency and signal incoherency compared to existing EPTI approaches. For reconstruction, an iterative rank-shrinking B0 estimation and odd-even high-order phase correction algorithms were incorporated into the reconstruction to better mitigate artifacts from field imperfections. A physics-informed unrolled network was utilized to boost the SNR, where 1-mm and 0.75-mm isotropic whole-brain imaging were performed in 45 and 90 s at 3 T, respectively. These protocols were validated through simulations, phantom, and in vivo experiments. Ten healthy subjects were recruited to provide sufficient data for the unrolled network. The entire pipeline was validated on additional five healthy subjects where different EPTI sampling approaches were compared. Two additional pediatric patients with epilepsy were recruited to demonstrate the generalizability of the unrolled reconstruction. RESULTS sEPTI achieved 1.4× $$ \times $$ faster imaging with improved image quality and quantitative map precision compared to existing EPTI approaches. The B0 update and the phase correction provide improved reconstruction performance with lower artifacts. The unrolled network boosted the SNR, achieving high-qualityT 2 * $$ {\mathrm{T}}_2^{\ast } $$ and QSM quantification with single average data. High-quality reconstruction was also obtained in the pediatric patients using this network. CONCLUSION sEPTI achieved whole-brain distortion-free multi-echo imaging andT 2 * $$ {\mathrm{T}}_2^{\ast } $$ and QSM quantification at 0.75 mm in 90 s which has the potential to be useful for wide clinical applications.
Collapse
Affiliation(s)
- Nan Wang
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Congyu Liao
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Xiaozhi Cao
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Mark Nishimura
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | | | - Mahmut Yurt
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Mengze Gao
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Daniel Abraham
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Cagan Alkan
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Siddharth Srinivasan Iyer
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Electrical Engineering and Computer Science, MIT, Cambridge, Massachusetts, USA
| | - Zihan Zhou
- Department of Radiology, Stanford University, Stanford, California, USA
| | | | - Adam Kerr
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
- Cognitive and Neurobiological Imaging Center, Stanford University, Stanford, California, USA
| | - Justin P Haldar
- Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, California, USA
| | - Kawin Setsompop
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
| |
Collapse
|
4
|
Elkady AM, Elliott C, Fetco D, Araujo D, Karimaghaloo Z, Ganzetti M, Clayton D, Craveiro L, Kazlauskaite A, Narayanan S, Arnold DL, Rudko DA. Longitudinal Multiparametric Quantitative MRI Evaluation of Acute and Chronic Multiple Sclerosis Paramagnetic Rim Lesions. J Magn Reson Imaging 2024. [PMID: 39239775 DOI: 10.1002/jmri.29583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 08/07/2024] [Accepted: 08/07/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Multiple sclerosis (MS) paramagnetic rim lesions (PRLs) are markers of chronic active biology and exhibit complex iron and myelin changes that may complicate quantification when using conventional MRI approaches. PURPOSE To conduct a multiparametric MRI analysis of PRLs. STUDY TYPE Retrospective/longitudinal. SUBJECTS Ninety-five progressive MS subjects with at least one persistent PRL who were enrolled in the CONSONANCE trial. FIELD STRENGTH/SEQUENCE 3-T/Susceptibility-weighted, T1-weighted, T2-weighted, and fluid-attenuated inversion recovery. ASSESSMENT Acute/chronic PRLs and non-PRLs were measured at screening, 24, 48, and 96 weeks using quantitative magnetic susceptibility (QS), R2*, and standardized T1w/T2w ratio (sT1w/T2w). PRL analyses were performed for whole lesion, core, and rim. The correlations between PRL core and rim sT1w/T2w, QS, and R2* were assessed. STATISTICAL TESTS Linear mixed models. A P-value <0.05 was considered significant. RESULTS There was a significant decrease in sT1w/T2w (-0.24 ± -5.3 × 10-3) and R2* (-3.6 ± 2.2 Hz) but a significant increase in QS (+21 ± 1.3 ppb) using whole-lesion analysis of chronic PRLs compared to non-PRLs at screening. Tissue damage accumulated at the 96-week time point was more evident in acute/chronic PRLs compared to acute/chronic non-PRLs (ΔsT1w/T2w = -0.21/-0.24 ± 0.033/0.0053; ΔR2* = -4.4/-3.6 ± 1.4/2.2 Hz). New, acute PRL sT1w/T2w significantly increased in lesion core (+4.3 × 10-3 ± 1.2 × 10-4) and rim (+5.6 × 10-3 ± 1.2 × 10-4) 24 weeks post lesion inception, suggestive of partial recovery. Chronic PRLs, contrastingly, showed significant decreases in sT1w/T2w over the initial 24 weeks for both core (-2.1 × 10-4 ± 2.0 × 10-5) and rim (-2.4 × 10-4 ± 2.0 × 10-5), indicative of irreversible tissue damage. Significant positive correlations between PRL core and rim sT1w/T2w (R2 = 0.53), R2* (R2 = 0.69) and QS (R2 = 0.52) were observed. DATA CONCLUSION Multiparametric assessment of PRLs has the potential to be a valuable tool for assessing complex iron and myelin changes in chronic active PRLs of progressive MS patients. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 3.
Collapse
Affiliation(s)
- Ahmed M Elkady
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- NeuroRx Research, Montreal, Quebec, Canada
| | | | - Dumitru Fetco
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- NeuroRx Research, Montreal, Quebec, Canada
| | - David Araujo
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
- NeuroRx Research, Montreal, Quebec, Canada
| | | | | | | | | | | | - Sridar Narayanan
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- NeuroRx Research, Montreal, Quebec, Canada
| | - Douglas L Arnold
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- NeuroRx Research, Montreal, Quebec, Canada
| | - David A Rudko
- McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- Department of Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
5
|
Fan SP, Chen YF, Li CH, Kuo YC, Lee NC, Chien YH, Hwu WL, Tseng TC, Su TH, Hsu CT, Chen HL, Lin CH, Ni YH. Topographical metal burden correlates with brain atrophy and clinical severity in Wilson's disease. Neuroimage 2024; 299:120829. [PMID: 39233127 DOI: 10.1016/j.neuroimage.2024.120829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 08/30/2024] [Accepted: 09/01/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Quantitative susceptibility mapping (QSM) is a post-processing technique that creates brain susceptibility maps reflecting metal burden through tissue magnetic susceptibility. We assessed topographic differences in magnetic susceptibility between participants with and without Wilson's disease (WD), correlating these findings with clinical severity, brain volume, and biofluid copper and iron indices. METHODS A total of 43 patients with WD and 20 unaffected controls, were recruited. QSM images were derived from a 3T MRI scanner. Clinical severity was defined using the minimal Unified Wilson's Disease Rating Scale (M-UWDRS) and Montreal Cognitive Assessment scoring. Differences in magnetic susceptibilities between groups were evaluated using general linear regression models, adjusting for age and sex. Correlations between the susceptibilities and clinical scores were analyzed using Spearman's method. RESULTS In age- and sex-adjusted analyses, magnetic susceptibility values were increased in WD patients compared with controls, including caudate nucleus, putamen, globus pallidus, and substantia nigra (all p < 0.01). Putaminal susceptibility was greater with an initial neuropsychiatric presentation (n = 25) than with initial hepatic dysfunction (n = 18; p = 0.04). Susceptibility changes correlated negatively with regional brain volume in almost all topographic regions. Serum ferritin, but not serum copper or ceruloplasmin, correlated positively with magnetic susceptibility level in the caudate nucleus (p = 0.04), putamen (p = 0.04) and the hippocampus (p = 0.03). The dominance of magnetic susceptibility in cortical over subcortical regions correlated with M-UWDRS scores (p < 0.01). CONCLUSION The magnetic susceptibility changes could serve as a surrogate marker for patients with WD.
Collapse
Affiliation(s)
- Sung-Pin Fan
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Fang Chen
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-Hsuan Li
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Yih-Chih Kuo
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Ni-Chung Lee
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Yin-Hsiu Chien
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Wuh-Liang Hwu
- Department of Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Tai-Chung Tseng
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Tung-Hung Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Ting Hsu
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Huey-Ling Chen
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Chin-Hsien Lin
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Institute of Biochemistry and Molecular Biology, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
| | - Yen-Hsuan Ni
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
6
|
Spence H, Mengoa-Fleming S, Sneddon AA, McNeil CJ, Waiter GD. Associations between sex, systemic iron and inflammatory status and subcortical brain iron. Eur J Neurosci 2024; 60:5069-5085. [PMID: 39113267 DOI: 10.1111/ejn.16467] [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: 01/12/2024] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 09/04/2024]
Abstract
Brain iron increases in several neurodegenerative diseases are associated with disease progression. However, the causes of increased brain iron remain unclear. This study investigates relationships between subcortical iron, systemic iron and inflammatory status. Brain magnetic resonance imaging (MRI) scans and blood plasma samples were collected from cognitively healthy females (n = 176, mean age = 61.4 ± 4.5 years, age range = 28-72 years) and males (n = 152, mean age = 62.0 ± 5.1 years, age range = 32-74 years). Regional brain iron was quantified using quantitative susceptibility mapping. To assess systemic iron, haematocrit, ferritin and soluble transferrin receptor were measured, and total body iron index was calculated. To assess systemic inflammation, C-reactive protein (CRP), neutrophil:lymphocyte ratio (NLR), macrophage colony-stimulating factor 1 (MCSF), interleukin 6 (IL6) and interleukin 1β (IL1β) were measured. We demonstrated that iron levels in the right hippocampus were higher in males compared with females, while iron in the right caudate was higher in females compared with males. There were no significant associations observed between subcortical iron levels and blood markers of iron and inflammatory status indicating that such blood measures are not markers of brain iron. These results suggest that brain iron may be regulated independently of blood iron and so directly targeting global iron change in the treatment of neurodegenerative disease may have differential impacts on blood and brain iron.
Collapse
Affiliation(s)
- Holly Spence
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Stephanie Mengoa-Fleming
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Christopher J McNeil
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Gordon D Waiter
- Aberdeen Biomedical Imaging Centre, Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| |
Collapse
|
7
|
Yao J, Li Z, Zhou Z, Bao A, Wang Z, Wei H, He H. Distinct regional vulnerability to Aβ and iron accumulation in post mortem AD brains. Alzheimers Dement 2024. [PMID: 39175425 DOI: 10.1002/alz.14188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/02/2024] [Accepted: 07/12/2024] [Indexed: 08/24/2024]
Abstract
INTRODUCTION The paramagnetic iron, diamagnetic amyloid beta (Aβ) plaques and their interaction are crucial in Alzheimer's disease (AD) pathogenesis, complicating non-invasive magnetic resonance imaging for prodromal AD detection. METHODS We used a state-of-the-art sub-voxel quantitative susceptibility mapping method to simultaneously measure Aβ and iron levels in post mortem human brains, validated by histology. Further transcriptomic analysis using Allen Human Brain Atlas elucidated the underlying biological processes. RESULTS Regional increased paramagnetic and diamagnetic susceptibility were observed in medial prefrontal, medial parietal, and para-hippocampal cortices associated with iron deposition (R = 0.836, p = 0.003) and Aβ accumulation (R = 0.853, p = 0.002) in AD brains. Higher levels of gene expression relating to cell cycle, post-translational protein modifications, and cellular response to stress were observed. DISCUSSION These findings provide quantitative insights into the variable vulnerability of cortical regions to higher levels of Aβ aggregation, iron overload, and subsequent neurodegeneration, indicating changes preceding clinical symptoms. HIGHLIGHTS The vulnerability of distinct brain regions to amyloid beta (Aβ) and iron accumulation varies. Histological validation was performed on stained sections of ex-vivo human brains. Regional variations in susceptibility were linked to gene expression profiles. Iron and Aβ levels in ex-vivo brains were simultaneously quantified.
Collapse
Affiliation(s)
- Junye Yao
- Center for Brain Imaging Science and Technology, Zhejiang University, Hangzhou, China
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Zhenghao Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Zihan Zhou
- Center for Brain Imaging Science and Technology, Zhejiang University, Hangzhou, China
- Stanford University Graduate School of Education, Department of Radiology, Stanford University, Stanford, California, USA
| | - Aimin Bao
- National Human Brain Bank for Health and Disease, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
| | - Zheng Wang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
- School of Biomedical Engineering, Hainan University, Haikou, China
| | - Hongjiang Wei
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Hongjian He
- Center for Brain Imaging Science and Technology, Zhejiang University, Hangzhou, China
- School of Physics, Zhejiang University, Hangzhou, China
- State Key Laboratory of Brain-Machine Intelligence, Zhejiang University, Hangzhou, China
| |
Collapse
|
8
|
Kataike VM, Desmond PM, Steward C, Mitchell PJ, Davey C, Yassi N, Bivard A, Parsons MW, Campbell BCV, Ng F, Venkatraman V. Iron changes within infarct tissue in ischemic stroke patients after successful reperfusion quantified using QSM. Neuroradiology 2024:10.1007/s00234-024-03444-6. [PMID: 39172165 DOI: 10.1007/s00234-024-03444-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 08/11/2024] [Indexed: 08/23/2024]
Abstract
PURPOSE For nearly half of patients who undergo Endovascular Thrombectomy following ischemic stroke, successful recanalisation does not guarantee a good outcome. Understanding the underlying tissue changes in the infarct tissue with the help of biomarkers specific to ischemic stroke could offer valuable insights for better treatment and patient management decisions. Using quantitative susceptibility mapping (QSM) MRI to measure cerebral iron concentration, this study aims to track the progression of iron within the infarct lesion after successful reperfusion. METHODS In a prospective study of 87 ischemic stroke patients, successfully reperfused patients underwent MRI scans at 24-to-72 h and 3 months after reperfusion. QSM maps were generated from gradient-echo MRI images. QSM values, measured in parts per billion (ppb), were extracted from ROIs defining the infarct and mirror homolog in the contralateral hemisphere and were compared cross-sectionally and longitudinally. RESULTS QSM values in the infarct ROIs matched those of the contralateral ROIs at 24-to-72 h, expressed as median (interquartile range) ppb [0.71(-7.67-10.09) vs. 2.20(-10.50-14.05) ppb, p = 0.55], but were higher at 3 months [10.68(-2.30-21.10) vs. -1.27(-12.98-9.82) ppb, p < 0.001]. The infarct QSM values at 3 months were significantly higher than those at 24-to-72 h [10.41(-2.50-18.27) ppb vs. 1.68(-10.36-12.25) ppb, p < 0.001]. Infarct QSM at 24-to-72 h and patient outcome measured at three months did not demonstrate a significant association. CONCLUSION Following successful endovascular reperfusion, iron concentration in infarct tissue, as measured by QSM increases over time compared to that in healthy tissue. However, its significance warrants further investigation.
Collapse
Affiliation(s)
| | - Patricia M Desmond
- Department of Radiology, The University of Melbourne, Parkville, VIC, 3050, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Christopher Steward
- Department of Radiology, The University of Melbourne, Parkville, VIC, 3050, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Peter J Mitchell
- Department of Radiology, The University of Melbourne, Parkville, VIC, 3050, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Christian Davey
- Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Parkville, VIC, Australia
| | - Nawaf Yassi
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria, Australia
| | - Andrew Bivard
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Mark W Parsons
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Department of Neurology, University of New South Wales Southwestern Sydney Clinical School, Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Bruce C V Campbell
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Felix Ng
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Vijay Venkatraman
- Department of Radiology, The University of Melbourne, Parkville, VIC, 3050, Australia
- Department of Medical Imaging, The Royal Melbourne Hospital, Parkville, VIC, Australia
| |
Collapse
|
9
|
Qiu L, Zhao Z, Bao L. SIPAS: A comprehensive susceptibility imaging process and analysis studio. Neuroimage 2024; 297:120697. [PMID: 38908725 DOI: 10.1016/j.neuroimage.2024.120697] [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: 02/07/2024] [Revised: 06/10/2024] [Accepted: 06/18/2024] [Indexed: 06/24/2024] Open
Abstract
Quantitative susceptibility mapping (QSM) is a rising MRI-based technology and quite a few QSM-related algorithms have been proposed to reconstruct maps of tissue susceptibility distribution from phase images. In this paper, we develop a comprehensive susceptibility imaging process and analysis studio (SIPAS) that can accomplish reliable QSM processing and offer a standardized evaluation system. Specifically, SIPAS integrates multiple methods for each step, enabling users to select algorithm combinations according to data conditions, and QSM maps could be evaluated by two aspects, including image quality indicators within all voxels and region-of-interest (ROI) analysis. Through a sophisticated design of user-friendly interfaces, the results of each procedure are able to be exhibited in axial, coronal, and sagittal views in real-time, meanwhile ROIs can be displayed in 3D rendering visualization. The accuracy and compatibility of SIPAS are demonstrated by experiments on multiple in vivo human brain datasets acquired from 3T, 5T, and 7T MRI scanners of different manufacturers. We also validate the QSM maps obtained by various algorithm combinations in SIPAS, among which the combination of iRSHARP and SFCR achieves the best results on its evaluation system. SIPAS is a comprehensive, sophisticated, and reliable toolkit that may prompt the QSM application in scientific research and clinical practice.
Collapse
Affiliation(s)
- Lichu Qiu
- Department of Electronic Science, Xiamen University, Xiamen 36100, China
| | - Zijun Zhao
- Department of Electronic Science, Xiamen University, Xiamen 36100, China
| | - Lijun Bao
- Department of Electronic Science, Xiamen University, Xiamen 36100, China.
| |
Collapse
|
10
|
Walter U, Buchmann J, Sülldorf A, Dück A, Russnak A, Hässler F, Berger C. Transcranial sonography of subcortical structures in tic/tourette disorder. J Psychiatr Res 2024; 176:18-22. [PMID: 38830296 DOI: 10.1016/j.jpsychires.2024.05.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/05/2024]
Abstract
Functional neuroimaging studies demonstrate disinhibition of the cortico-striatal-thalamo-cortical circuit. However, structural imaging studies revealed conflicting results, some suggesting smaller volumes of the caudate nucleus (CN) in children with Gilles de la Tourette syndrome (TS). Here we wanted to find out whether transcranial sonography (TCS) detects alterations of raphe nuclei, substantia nigra, lenticular nucleus (LN), or CN in children with Tic disorder or TS (TIC/TS).The study included 25 treatment-naive children (age: 12.2 ± 2.5 years) with a DSM-V based diagnosis of Tic disorder or TS (10 subjects), without other psychiatric or neurologic diagnosis, and 25 healthy controls (age: 12.17 ± 2.57 years), matched for age and sex. Parental rating of behavioral, emotional abnormalities, somatic complaints and social competencies of the participants were assessed using the Child Behavior Check List (CBCL/4-18R). TCS of deep brain structures was conducted through the preauricular acoustic bone windows using a 2.5-MHz phased-array ultrasound system. Fisher's exact test and Mann-Whitney-U test were used for comparisons between TIC/TS patients and healthy volunteers. The number of participants with hyperechogenic area of left CN in the TIC/TS sample was increased, compared to the healthy control group. TIC/TS patients with hyperechogenic CN showed an increased occurrence of thought- and obsessive-compulsive problems. This TCS study revealed pathologic structural changes in CN, its higher occurrence in TIC/TS compared to healthy controls and the relation to comorbidity of thought problems. Further research should focus on the molecular cause of these alterations, probably the disturbed iron metabolism.
Collapse
Affiliation(s)
- Uwe Walter
- Department of Neurology, Rostock University Medical Center, Rostock, Germany
| | - Johannes Buchmann
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Anne Sülldorf
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Alexander Dück
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Antonia Russnak
- Department of Neurology, Rostock University Medical Center, Rostock, Germany
| | - Frank Hässler
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Christoph Berger
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany.
| |
Collapse
|
11
|
Lau K, Kotzur R, Richter F. Blood-brain barrier alterations and their impact on Parkinson's disease pathogenesis and therapy. Transl Neurodegener 2024; 13:37. [PMID: 39075566 PMCID: PMC11285262 DOI: 10.1186/s40035-024-00430-z] [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: 03/20/2024] [Accepted: 07/11/2024] [Indexed: 07/31/2024] Open
Abstract
There is increasing evidence for blood-brain barrier (BBB) alterations in Parkinson's disease (PD), the second most common neurodegenerative disorder with rapidly rising prevalence. Altered tight junction and transporter protein levels, accumulation of α-synuclein and increase in inflammatory processes lead to extravasation of blood molecules and vessel degeneration. This could result in a self-perpetuating pathophysiology of inflammation and BBB alteration, which contribute to neurodegeneration. Toxin exposure or α-synuclein over-expression in animal models has been shown to initiate similar pathologies, providing a platform to study underlying mechanisms and therapeutic interventions. Here we provide a comprehensive review of the current knowledge on BBB alterations in PD patients and how rodent models that replicate some of these changes can be used to study disease mechanisms. Specific challenges in assessing the BBB in patients and in healthy controls are discussed. Finally, a potential role of BBB alterations in disease pathogenesis and possible implications for therapy are explored. The interference of BBB alterations with current and novel therapeutic strategies requires more attention. Brain region-specific BBB alterations could also open up novel opportunities to target specifically vulnerable neuronal subpopulations.
Collapse
Affiliation(s)
- Kristina Lau
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
- Center for Systems Neuroscience, Hannover, Germany
| | - Rebecca Kotzur
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany
| | - Franziska Richter
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Foundation, Bünteweg 17, 30559, Hannover, Germany.
- Center for Systems Neuroscience, Hannover, Germany.
| |
Collapse
|
12
|
Andersson Forsman O, Sjöström H, Svenningsson P, Granberg T. Combined MR quantitative susceptibility mapping and multi-shell diffusion in Parkinson's disease. J Neuroimaging 2024. [PMID: 39004781 DOI: 10.1111/jon.13222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 07/05/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND AND PURPOSE Quantitative susceptibility mapping (QSM), neurite orientation dispersion and density imaging (NODDI), and the g-ratio have separately shown differences between Parkinson's disease (PD) and healthy controls. The g-ratio has, however, not been studied in PD in the substantia nigra (SN) and the putamen. A combination of these methods could also potentially be a complementary imaging biomarker for PD. This study aimed to assess the diagnostic performance of QSM, NODDI, the g-ratio, and a combined QSM-NODDI imaging marker in the SN and putamen of PD patients. METHODS In this prospective study, the diagnostic performance of median region of interest values was compared in a cohort of 15 participants with PD and 14 healthy controls after manual segmentation. The diagnostic performance was assessed using the area under curve (AUC) for the receiving operator characteristic. RESULTS Median QSM in the contralateral SN identified PD with AUC 0.77, and median isotropic volume fraction identified PD in the ipsilateral SN with AUC 0.68. A combined NODDI-QSM marker improved diagnostic performance (AUC 0.80). No significant differences were found in the g-ratio. CONCLUSION A combination of median QSM and median isotropic volume fraction improves the differentiation of PD from healthy controls and is a potential biomarker in the diagnostics of PD. This confirms previously reported results indicating that combining QSM and NODDI modestly improves differentiation of PD.
Collapse
Affiliation(s)
| | - Henrik Sjöström
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Neurology, Academic Specialist Center, Stockholm, Sweden
| | - Per Svenningsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Neurology, Academic Specialist Center, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Tobias Granberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
13
|
Stirnberg R, Deistung A, Reichenbach JR, Breteler MMB, Stöcker T. Rapid submillimeter QSM and R 2* mapping using interleaved multishot 3D-EPI at 7 and 3 Tesla. Magn Reson Med 2024. [PMID: 38988040 DOI: 10.1002/mrm.30216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 06/05/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE To explore the high signal-to-noise ratio (SNR) efficiency of interleaved multishot 3D-EPI with standard image reconstruction for fast and robust high-resolution whole-brain quantitative susceptibility (QSM) andR 2 ∗ $$ {R}_2^{\ast } $$ mapping at 7 and 3T. METHODS Single- and multi-TE segmented 3D-EPI is combined with conventional CAIPIRINHA undersampling for up to 72-fold effective gradient echo (GRE) imaging acceleration. Across multiple averages, scan parameters are varied (e.g., dual-polarity frequency-encoding) to additionally correct forB 0 $$ {\mathrm{B}}_0 $$ -induced artifacts, geometric distortions and motion retrospectively. A comparison to established GRE protocols is made. Resolutions range from 1.4 mm isotropic (1 multi-TE average in 36 s) up to 0.4 mm isotropic (2 single-TE averages in approximately 6 min) with whole-head coverage. RESULTS Only 1-4 averages are needed for sufficient SNR with 3D-EPI, depending on resolution and field strength. Fast scanning and small voxels together with retrospective corrections result in substantially reduced image artifacts, which improves susceptibility andR 2 ∗ $$ {R}_2^{\ast } $$ mapping. Additionally, much finer details are obtained in susceptibility-weighted image projections through significantly reduced partial voluming. CONCLUSION Using interleaved multishot 3D-EPI, single-TE and multi-TE data can readily be acquired 10 times faster than with conventional, accelerated GRE imaging. Even 0.4 mm isotropic whole-head QSM within 6 min becomes feasible at 7T. At 3T, motion-robust 0.8 mm isotropic whole-brain QSM andR 2 ∗ $$ {R}_2^{\ast } $$ mapping with no apparent distortion in less than 7 min becomes clinically feasible. Stronger gradient systems may allow for even higher effective acceleration rates through larger EPI factors while maintaining optimal contrast.
Collapse
Affiliation(s)
- Rüdiger Stirnberg
- MR Physics, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Andreas Deistung
- Clinic and Outpatient Clinic for Radiology, University Hospital Halle (Saale), University Medicine Halle, Halle (Saale), Germany
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Monique M B Breteler
- Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Faculty of Medicine, Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University of Bonn, Bonn, Germany
| | - Tony Stöcker
- MR Physics, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Physics and Astronomy, University of Bonn, Bonn, Germany
| |
Collapse
|
14
|
Zarkali A, Thomas GEC, Zetterberg H, Weil RS. Neuroimaging and fluid biomarkers in Parkinson's disease in an era of targeted interventions. Nat Commun 2024; 15:5661. [PMID: 38969680 PMCID: PMC11226684 DOI: 10.1038/s41467-024-49949-9] [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: 07/26/2023] [Accepted: 06/19/2024] [Indexed: 07/07/2024] Open
Abstract
A major challenge in Parkinson's disease is the variability in symptoms and rates of progression, underpinned by heterogeneity of pathological processes. Biomarkers are urgently needed for accurate diagnosis, patient stratification, monitoring disease progression and precise treatment. These were previously lacking, but recently, novel imaging and fluid biomarkers have been developed. Here, we consider new imaging approaches showing sensitivity to brain tissue composition, and examine novel fluid biomarkers showing specificity for pathological processes, including seed amplification assays and extracellular vesicles. We reflect on these biomarkers in the context of new biological staging systems, and on emerging techniques currently in development.
Collapse
Affiliation(s)
- Angeliki Zarkali
- Dementia Research Centre, Institute of Neurology, UCL, London, UK.
| | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Rimona S Weil
- Dementia Research Centre, Institute of Neurology, UCL, London, UK
- Department of Advanced Neuroimaging, UCL, London, UK
- Movement Disorders Centre, UCL, London, UK
| |
Collapse
|
15
|
Ghaderi S, Fatehi F, Kalra S, Mohammadi S, Batouli SAH. Quantitative susceptibility mapping in amyotrophic lateral sclerosis: automatic quantification of the magnetic susceptibility in the subcortical nuclei. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-12. [PMID: 38957123 DOI: 10.1080/21678421.2024.2372648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
Objective: Previous studies have suggested a link between dysregulation of cortical iron levels and neuronal loss in amyotrophic lateral sclerosis (ALS) patients. However, few studies have reported differences in quantitative susceptibility mapping (QSM) values in subcortical nuclei between patients with ALS and healthy controls (HCs). Methods: MRI was performed using a 3 Tesla Prisma scanner (64-channel head coil), including 3D T1-MPRAGE and multi-echo 3D GRE for QSM reconstruction. Automated QSM segmentation was used to measure susceptibility values in the subcortical nuclei, which were compared between the groups. Correlations with clinical scales were analyzed. Group comparisons were performed using independent t-tests, with p < 0.05 considered significant. Correlations were assessed using Pearson's correlation, with p < 0.05 considered significant. Cohen's d was reported to compare the standardized mean difference (SMD) of QSM. Results: Twelve patients with limb-onset ALS (mean age 48.7 years, 75% male) and 13 age-, sex-, and handedness-matched HCs (mean age 44.6 years, 69% male) were included. Compared to HCs, ALS patients demonstrated significantly lower susceptibility in the left caudate nucleus (CN) (SMD = -0.845), right CN (SMD = -0.851), whole CN (SMD = -1.016), and left subthalamic nucleus (STN) (SMD = -1.000). Susceptibility in the left putamen (SMD = -0.857), left thalamus (SMD = -1.081), and whole thalamus (SMD = -0.968) was significantly higher in the patients. The susceptibility of the substantia nigra (SN), CN, and pulvinar was positively correlated with disease duration. Conclusions: QSM detects abnormal iron accumulation patterns in the subcortical gray matter of ALS patients, which correlates with disease characteristics, supporting its potential as a neuroimaging biomarker.
Collapse
Affiliation(s)
- Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neurology Department, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sanjay Kalra
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada, and
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada
| | - Sana Mohammadi
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
16
|
Gong W, Fu Y, Wu BS, Du J, Yang L, Zhang YR, Chen SD, Kang J, Mao Y, Dong Q, Tan L, Feng J, Cheng W, Yu JT. Whole-exome sequencing identifies protein-coding variants associated with brain iron in 29,828 individuals. Nat Commun 2024; 15:5540. [PMID: 38956042 PMCID: PMC11219919 DOI: 10.1038/s41467-024-49702-2] [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: 04/12/2024] [Accepted: 06/16/2024] [Indexed: 07/04/2024] Open
Abstract
Iron plays a fundamental role in multiple brain disorders. However, the genetic underpinnings of brain iron and its implications for these disorders are still lacking. Here, we conduct an exome-wide association analysis of brain iron, measured by quantitative susceptibility mapping technique, across 26 brain regions among 26,789 UK Biobank participants. We find 36 genes linked to brain iron, with 29 not being previously reported, and 16 of them can be replicated in an independent dataset with 3,039 subjects. Many of these genes are involved in iron transport and homeostasis, such as FTH1 and MLX. Several genes, while not previously connected to brain iron, are associated with iron-related brain disorders like Parkinson's (STAB1, KCNA10), Alzheimer's (SHANK1), and depression (GFAP). Mendelian randomization analysis reveals six causal relationships from regional brain iron to brain disorders, such as from the hippocampus to depression and from the substantia nigra to Parkinson's. These insights advance our understanding of the genetic architecture of brain iron and offer potential therapeutic targets for brain disorders.
Collapse
Affiliation(s)
- Weikang Gong
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, OX3 9DU, UK.
| | - Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, 266071, Qingdao, China
| | - Bang-Sheng Wu
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Jingnan Du
- Department of Psychology, Center for Brain Science, Harvard University, Cambridge, MA, 02138, USA
| | - Liu Yang
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Ya-Ru Zhang
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Shi-Dong Chen
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - JuJiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, 200433, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, 200433, Shanghai, China
| | - Ying Mao
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Qiang Dong
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, 266071, Qingdao, China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, 200433, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, 200433, Shanghai, China
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Wei Cheng
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, 200433, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Fudan University, 200433, Shanghai, China.
| | - Jin-Tai Yu
- School of Data Science, Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
| |
Collapse
|
17
|
Langley J, Bennett IJ, Hu XP. Examining iron-related off-target binding effects of 18F-AV1451 PET in the cortex of Aβ+ individuals. Eur J Neurosci 2024; 60:3614-3628. [PMID: 38722153 DOI: 10.1111/ejn.16362] [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: 02/10/2023] [Revised: 12/22/2023] [Accepted: 04/01/2024] [Indexed: 07/06/2024]
Abstract
The presence of neurofibrillary tangles containing hyper-phosphorylated tau is a characteristic of Alzheimer's disease (AD) pathology. The positron emission tomography (PET) radioligand sensitive to tau neurofibrillary tangles (18F-AV1451) also binds with iron. This off-target binding effect may be enhanced in older adults on the AD spectrum, particularly those with amyloid-positive biomarkers. Here, we examined group differences in 18F-AV1451 PET after controlling for iron-sensitive measures from magnetic resonance imaging (MRI) and its relationships to tissue microstructure and cognition in 40 amyloid beta positive (Aβ+) individuals, 20 amyloid beta negative (Aβ-) with MCI and 31 Aβ- control participants. After controlling for iron, increased 18F-AV1451 PET uptake was found in the temporal lobe and hippocampus of Aβ+ participants compared to Aβ- MCI and control participants. Within the Aβ+ group, significant correlations were seen between 18F-AV1451 PET uptake and tissue microstructure and these correlations remained significant after controlling for iron. These findings indicate that off-target binding of iron to the 18F-AV1451 ligand may not affect its sensitivity to Aβ status or cognition in early-stage AD.
Collapse
Affiliation(s)
- Jason Langley
- Center for Advanced Neuroimaging, University of California Riverside, Riverside, California, USA
| | - Ilana J Bennett
- Department of Psychology, University of California Riverside, Riverside, California, USA
| | - Xiaoping P Hu
- Center for Advanced Neuroimaging, University of California Riverside, Riverside, California, USA
- Department of Bioengineering, University of California Riverside, Riverside, California, USA
| |
Collapse
|
18
|
Harding IH, Nur Karim MI, Selvadurai LP, Corben LA, Delatycki MB, Monti S, Saccà F, Georgiou-Karistianis N, Cocozza S, Egan GF. Localized Changes in Dentate Nucleus Shape and Magnetic Susceptibility in Friedreich Ataxia. Mov Disord 2024; 39:1109-1118. [PMID: 38644761 DOI: 10.1002/mds.29816] [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: 11/13/2023] [Revised: 03/07/2024] [Accepted: 04/01/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND The dentate nuclei of the cerebellum are key sites of neuropathology in Friedreich ataxia (FRDA). Reduced dentate nucleus volume and increased mean magnetic susceptibility, a proxy of iron concentration, have been reported by magnetic resonance imaging studies in people with FRDA. Here, we investigate whether these changes are regionally heterogeneous. METHODS Quantitative susceptibility mapping data were acquired from 49 people with FRDA and 46 healthy controls. The dentate nuclei were manually segmented and analyzed using three dimensional vertex-based shape modeling and voxel-based assessments to identify regional changes in morphometry and susceptibility, respectively. RESULTS Individuals with FRDA, relative to healthy controls, showed significant bilateral surface contraction most strongly at the rostral and caudal boundaries of the dentate nuclei. The magnitude of this surface contraction correlated with disease duration, and to a lesser extent, ataxia severity. Significantly greater susceptibility was also evident in the FRDA cohort relative to controls, but was instead localized to bilateral dorsomedial areas, and also correlated with disease duration and ataxia severity. CONCLUSIONS Changes in the structure of the dentate nuclei in FRDA are not spatially uniform. Atrophy is greatest in areas with high gray matter density, whereas increases in susceptibility-reflecting iron concentration, demyelination, and/or gliosis-predominate in the medial white matter. These findings converge with established histological reports and indicate that regional measures of dentate nucleus substructure are more sensitive measures of disease expression than full-structure averages. Biomarker development and therapeutic strategies that directly target the dentate nuclei, such as gene therapies, may be optimized by targeting these areas of maximal pathology. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Ian H Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Muhammad Ikhsan Nur Karim
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Louisa P Selvadurai
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Australia
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Martin B Delatycki
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia
- Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Serena Monti
- Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy
| | - Francesco Saccà
- Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Nellie Georgiou-Karistianis
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gary F Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| |
Collapse
|
19
|
Casanova F, Tian Q, Williamson DS, Qian Y, Zweibaum D, Ding J, Atkins JL, Melzer D, Ferrucci L, Pilling LC. MRI-derived brain iron, grey matter volume, and risk of dementia and Parkinson's disease: Observational and genetic analysis in the UK Biobank cohort. Neurobiol Dis 2024; 197:106539. [PMID: 38789058 DOI: 10.1016/j.nbd.2024.106539] [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: 03/18/2024] [Revised: 05/08/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Iron overload is observed in neurodegenerative diseases, especially Alzheimer's disease (AD) and Parkinson's disease (PD). Homozygotes for the iron-overload (haemochromatosis) causing HFE p.C282Y variant have increased risk of dementia and PD. Whether brain iron deposition is causal or secondary to the neurodegenerative processes in the general population is unclear. METHODS We analysed 39,533 UK Biobank participants of European genetic ancestry with brain MRI data. We studied brain iron estimated by R2* and quantitative susceptibility mapping (QSM) in 8 subcortical regions: accumbens, amygdala, caudate, hippocampus, pallidum, putamen, substantia nigra, and thalamus. We performed genome-wide associations studies (GWAS) and used Mendelian Randomization (MR) methods to estimate the causal effect of brain iron on grey matter volume, and risk of AD, non-AD and PD. We also used MR to test whether genetic liability to AD or PD causally increased brain iron (R2* and QSM). FINDINGS In GWAS of R2* and QSM we replicated 83% of previously reported genetic loci and identified 174 further loci across all eight brain regions. Higher genetically predicted brain iron, using both R2* and QSM, was associated with lower grey matter volumes in the caudate, putamen and thalamus (e.g., Beta-putamenQSM: -0.37, p = 2*10-46). Higher genetically predicted thalamus R2* was associated with increased risk of non-AD dementia (OR 1.36(1.16;1.60), p = 2*10-4) but not AD (p > 0.05). In males, genetically predicted putamen R2* increased non-AD dementia risk, but not in females. Higher genetically predicted iron in the caudate, putamen, and substantia nigra was associated with an increased risk of PD (Odds Ratio QSM ∼ substantia-nigra 1.21(1.07;1.37), p = 0.003). Genetic liability to AD or PD was not associated with R2* or QSM in the dementia or PD-associated regions. INTERPRETATION Our genetic analysis supports a causal effect of higher iron deposition in specific subcortical brain regions for Parkinson's disease, grey matter volume, and non-Alzheimer's dementia.
Collapse
Affiliation(s)
- Francesco Casanova
- Department of Clinical and Biomedical Sciences, University of Exeter, Magdalen Road, Exeter, Devon EX1 2LU, UK
| | - Qu Tian
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, 251 Bayview Blvd., Suite 100, Baltimore, MD 21224, USA
| | - Daniel S Williamson
- Department of Clinical and Biomedical Sciences, University of Exeter, Magdalen Road, Exeter, Devon EX1 2LU, UK; Department of Medical Imaging, University of Exeter, Magdalen Road, Exeter, Devon EX1 2LU, UK
| | - Yong Qian
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, 251 Bayview Blvd., Suite 100, Baltimore, MD 21224, USA
| | - David Zweibaum
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, 251 Bayview Blvd., Suite 100, Baltimore, MD 21224, USA
| | - Jun Ding
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, 251 Bayview Blvd., Suite 100, Baltimore, MD 21224, USA
| | - Janice L Atkins
- Department of Clinical and Biomedical Sciences, University of Exeter, Magdalen Road, Exeter, Devon EX1 2LU, UK
| | - David Melzer
- Department of Clinical and Biomedical Sciences, University of Exeter, Magdalen Road, Exeter, Devon EX1 2LU, UK
| | - Luigi Ferrucci
- Translational Gerontology Branch Longitudinal Studies Section, National Institute on Aging, 251 Bayview Blvd., Suite 100, Baltimore, MD 21224, USA.
| | - Luke C Pilling
- Department of Clinical and Biomedical Sciences, University of Exeter, Magdalen Road, Exeter, Devon EX1 2LU, UK.
| |
Collapse
|
20
|
Young G, Nguyen VS, Howlett-Prieto Q, Abuaf AF, Carroll TJ, Kawaji K, Javed A. T1 mapping from routine 3D T1-weighted inversion recovery sequences in clinical practice: comparison against reference inversion recovery fast field echo T1 scans and feasibility in multiple sclerosis. Neuroradiology 2024:10.1007/s00234-024-03400-4. [PMID: 38880824 DOI: 10.1007/s00234-024-03400-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 06/06/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND AND PURPOSE Quantitative T1 mapping can be an essential tool for assessing tissue injury in multiple sclerosis (MS). We introduce T1-REQUIRE, a method that converts a single high-resolution anatomical 3D T1-weighted Turbo Field Echo (3DT1TFE) scan into a parametric T1 map that could be used for quantitative assessment of tissue damage. We present the accuracy and feasibility of this method in MS. METHODS 14 subjects with relapsing-remitting MS and 10 healthy subjects were examined. T1 maps were generated from 3DT1TFE images using T1-REQUIRE, which estimates T1 values using MR signal equations and internal tissue reference T1 values. Estimated T1 of lesions, white, and gray matter regions were compared with reference Inversion-Recovery Fast Field Echo T1 values and analyzed via correlation and Bland-Altman (BA) statistics. RESULTS 159 T1-weighted (T1W) hypointense MS lesions and 288 gray matter regions were examined. T1 values for MS lesions showed a Pearson's correlation of r = 0.81 (p < 0.000), R2 = 0.65, and Bias = 4.18%. BA statistics showed a mean difference of -53.95 ms and limits of agreement (LOA) of -344.20 and 236.30 ms. Non-lesional normal-appearing white matter had a correlation coefficient of r = 0.82 (p < 0.000), R2 = 0.67, Bias = 8.78%, mean difference of 73.87 ms, and LOA of -55.67 and 203.41 ms. CONCLUSIONS We demonstrate the feasibility of retroactively derived high-resolution T1 maps from routinely acquired anatomical images, which could be used to quantify tissue pathology in MS. The results of this study will set the stage for testing this method in larger clinical studies for examining MS disease activity and progression.
Collapse
Affiliation(s)
- Griffin Young
- Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Vivian S Nguyen
- Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Quentin Howlett-Prieto
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Timothy J Carroll
- Department of Radiology, The University of Chicago, Chicago, IL, USA
| | - Keigo Kawaji
- Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Adil Javed
- Department of Neurology, The University of Chicago, Chicago, IL, 5841 South Maryland Avenue, MC2030, 60637, USA.
| |
Collapse
|
21
|
Cohen Z, Lau L, Ahmed M, Jack CR, Liu C. Quantitative susceptibility mapping in the brain reflects spatial expression of genes involved in iron homeostasis and myelination. Hum Brain Mapp 2024; 45:e26688. [PMID: 38896001 PMCID: PMC11187871 DOI: 10.1002/hbm.26688] [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: 03/01/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 06/21/2024] Open
Abstract
Quantitative susceptibility mapping (QSM) is an MRI modality used to non-invasively measure iron content in the brain. Iron exhibits a specific anatomically varying pattern of accumulation in the brain across individuals. The highest regions of accumulation are the deep grey nuclei, where iron is stored in paramagnetic molecule ferritin. This form of iron is considered to be what largely contributes to the signal measured by QSM in the deep grey nuclei. It is also known that QSM is affected by diamagnetic myelin contents. Here, we investigate spatial gene expression of iron and myelin related genes, as measured by the Allen Human Brain Atlas, in relation to QSM images of age-matched subjects. We performed multiple linear regressions between gene expression and the average QSM signal within 34 distinct deep grey nuclei regions. Our results show a positive correlation (p < .05, corrected) between expression of ferritin and the QSM signal in deep grey nuclei regions. We repeated the analysis for other genes that encode proteins thought to be involved in the transport and storage of iron in the brain, as well as myelination. In addition to ferritin, our findings demonstrate a positive correlation (p < .05, corrected) between the expression of ferroportin, transferrin, divalent metal transporter 1, several gene markers of myelinating oligodendrocytes, and the QSM signal in deep grey nuclei regions. Our results suggest that the QSM signal reflects both the storage and active transport of iron in the deep grey nuclei regions of the brain.
Collapse
Affiliation(s)
- Zoe Cohen
- Department of Electrical Engineering and Computer SciencesUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Laurance Lau
- Department of Electrical Engineering and Computer SciencesUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Maruf Ahmed
- Department of Electrical Engineering and Computer SciencesUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| | - Clifford R. Jack
- Mayo Foundation for Medical Education and ResearchRochesterMinnesotaUSA
| | - Chunlei Liu
- Department of Electrical Engineering and Computer SciencesUniversity of California, BerkeleyBerkeleyCaliforniaUSA
- Helen Wills Neuroscience InstituteUniversity of California, BerkeleyBerkeleyCaliforniaUSA
| |
Collapse
|
22
|
Taleb S, Varela-Mattatall G, Allen A, Haast R, Khan AR, Kalia V, Howard JL, MacDonald SJ, Menon RS, Lanting BA, Teeter MG. Assessing brain integrity in patients with long-term and well-functioning metal-based hip implants. J Orthop Res 2024; 42:1292-1302. [PMID: 38235918 DOI: 10.1002/jor.25785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024]
Abstract
Production of metal debris from implant wear and corrosion processes is now a well understood occurrence following hip arthroplasty. Evidence has shown that metal ions can enter the bloodstream and travel to distant organs including the brain, and in extreme cases, can induce sensorial and neurological diseases. Our objective was tosimultaneously analyze brain anatomy and physiology in patients with long-term and well-functioning implants. Included were subjects who had received total hip or hip resurfacing arthroplastywith an implantation time of a minimum of 7 years (n = 28) and age- and sex-matched controls (n = 32). Blood samples were obtained to measure ion concentrations of cobalt and chromium, and the Montreal Cognitive Assessment was performed. 3T MRI brain scans were completed with an MPRAGE sequence for ROI segmentation and multiecho gradient echo sequences to generate QSM and R2* maps. Mean QSM and R2* values were recorded for five deep brain and four middle and cortical brain structures on both hemispheres: pallidum, putamen, caudate, amygdala, hippocampus, anterior cingulate, inferior temporal, and cerebellum. No differences in QSM or R2* or cognition scores were found between both groups (p > 0.6654). No correlation was found between susceptibility and blood ion levels for cobalt or chromium in any region of the brain. No correlation was found between blood ion levels and cognition scores. Clinical significance: Results suggest that metal ions released by long-term and well-functioning implants do not affect brain integrity.
Collapse
Affiliation(s)
- Shahnaz Taleb
- Schulich School of Medicine & Dentistry, Imaging Group, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Gabriel Varela-Mattatall
- Schulich School of Medicine & Dentistry, Imaging Group, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Abbigail Allen
- Department of Surgery, London Health Sciences Centre, Division of Orthopaedic Surgery, London, Ontario, Canada
| | - Roy Haast
- Schulich School of Medicine & Dentistry, Imaging Group, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Ali R Khan
- Schulich School of Medicine & Dentistry, Imaging Group, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Vishal Kalia
- Department of Medical Imaging, Schulich School of Medicine & Dentistry, Division of Musculoskeletal Imaging, Western University, London, Ontario, Canada
| | - James L Howard
- Department of Surgery, London Health Sciences Centre, Division of Orthopaedic Surgery, London, Ontario, Canada
| | - Steven J MacDonald
- Department of Surgery, London Health Sciences Centre, Division of Orthopaedic Surgery, London, Ontario, Canada
| | - Ravi S Menon
- Schulich School of Medicine & Dentistry, Imaging Group, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Brent A Lanting
- Department of Surgery, London Health Sciences Centre, Division of Orthopaedic Surgery, London, Ontario, Canada
| | - Matthew G Teeter
- Schulich School of Medicine & Dentistry, Imaging Group, Robarts Research Institute, Western University, London, Ontario, Canada
| |
Collapse
|
23
|
Öz G, Cocozza S, Henry PG, Lenglet C, Deistung A, Faber J, Schwarz AJ, Timmann D, Van Dijk KRA, Harding IH. MR Imaging in Ataxias: Consensus Recommendations by the Ataxia Global Initiative Working Group on MRI Biomarkers. CEREBELLUM (LONDON, ENGLAND) 2024; 23:931-945. [PMID: 37280482 PMCID: PMC11102392 DOI: 10.1007/s12311-023-01572-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/08/2023]
Abstract
With many viable strategies in the therapeutic pipeline, upcoming clinical trials in hereditary and sporadic degenerative ataxias will benefit from non-invasive MRI biomarkers for patient stratification and the evaluation of therapies. The MRI Biomarkers Working Group of the Ataxia Global Initiative therefore devised guidelines to facilitate harmonized MRI data acquisition in clinical research and trials in ataxias. Recommendations are provided for a basic structural MRI protocol that can be used for clinical care and for an advanced multi-modal MRI protocol relevant for research and trial settings. The advanced protocol consists of modalities with demonstrated utility for tracking brain changes in degenerative ataxias and includes structural MRI, magnetic resonance spectroscopy, diffusion MRI, quantitative susceptibility mapping, and resting-state functional MRI. Acceptable ranges of acquisition parameters are provided to accommodate diverse scanner hardware in research and clinical contexts while maintaining a minimum standard of data quality. Important technical considerations in setting up an advanced multi-modal protocol are outlined, including the order of pulse sequences, and example software packages commonly used for data analysis are provided. Outcome measures most relevant for ataxias are highlighted with use cases from recent ataxia literature. Finally, to facilitate access to the recommendations by the ataxia clinical and research community, examples of datasets collected with the recommended parameters are provided and platform-specific protocols are shared via the Open Science Framework.
Collapse
Affiliation(s)
- Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, 2021 Sixth Street Southeast, Minneapolis, MN, 55455, USA.
| | - Sirio Cocozza
- UNINA Department of Advanced Biomedical Sciences, University of Naples Federico II , Naples, Italy
| | - Pierre-Gilles Henry
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, 2021 Sixth Street Southeast, Minneapolis, MN, 55455, USA
| | - Christophe Lenglet
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, 2021 Sixth Street Southeast, Minneapolis, MN, 55455, USA
| | - Andreas Deistung
- Department for Radiation Medicine, University Clinic and Outpatient Clinic for Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Jennifer Faber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | | | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Koene R A Van Dijk
- Digital Sciences and Translational Imaging, Early Clinical Development, Pfizer, Inc., Cambridge, MA, USA
| | - Ian H Harding
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| |
Collapse
|
24
|
Huang Y, Chen L, Li X, Liu J. Improved test-retest reliability of R 2 * $$ {\mathrm{R}}_2^{\ast } $$ and susceptibility quantification using multishot multi-echo 3D EPI. Magn Reson Med 2024; 91:2310-2319. [PMID: 38156825 PMCID: PMC10997481 DOI: 10.1002/mrm.29992] [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: 08/04/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE This study aimed to evaluate the potential of 3D EPI for improving the reliability ofT 2 * $$ {\mathrm{T}}_2^{\ast } $$ -weighted data and quantification ofR 2 * $$ {\mathrm{R}}_2^{\ast } $$ decay rate and susceptibility (χ) compared with conventional gradient-echo (GRE)-based acquisition. METHODS Eight healthy subjects in a wide age range were recruited. Each subject received repeated scans for both GRE and EPI acquisitions with an isotropic 1 mm resolution at 3 T. Maps ofR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and χ were quantified, and their interscan differences were used to evaluate the test-retest reliability. Interprotocol differences ofR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and χ between GRE and EPI were also measured voxel by voxel and in selected regions of interest to test the consistency between the two acquisition methods. RESULTS The quantifications ofR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and χ using EPI protocols showed increased test-retest reliability with higher EPI factors up to 5 as performed in the experiment and were consistent with those based on GRE. CONCLUSION The result suggests that multishot multi-echo 3D EPI can be a useful alternative acquisition method forT 2 * $$ {\mathrm{T}}_2^{\ast } $$ -weighted MRI and quantification ofR 2 * $$ {\mathrm{R}}_2^{\ast } $$ and χ with reduced scan time, improved test-retest reliability, and similar accuracy compared with commonly used 3D GRE.
Collapse
Affiliation(s)
- Yujia Huang
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Lin Chen
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Xu Li
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Jiaen Liu
- Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, TX, USA
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
25
|
Almeida AJD, Hobson BA, Saito N, Bruun DA, Porter VA, Harvey DJ, Garbow JR, Chaudhari AJ, Lein PJ. Quantitative T 2 mapping-based longitudinal assessment of brain injury and therapeutic rescue in the rat following acute organophosphate intoxication. Neuropharmacology 2024; 249:109895. [PMID: 38437913 PMCID: PMC11227117 DOI: 10.1016/j.neuropharm.2024.109895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/07/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
Acute intoxication with organophosphate (OP) cholinesterase inhibitors poses a significant public health risk. While currently approved medical countermeasures can improve survival rates, they often fail to prevent chronic neurological damage. Therefore, there is need to develop effective therapies and quantitative metrics for assessing OP-induced brain injury and its rescue by these therapies. In this study we used a rat model of acute intoxication with the OP, diisopropylfluorophosphate (DFP), to test the hypothesis that T2 measures obtained from brain magnetic resonance imaging (MRI) scans provide quantitative metrics of brain injury and therapeutic efficacy. Adult male Sprague Dawley rats were imaged on a 7T MRI scanner at 3, 7 and 28 days post-exposure to DFP or vehicle (VEH) with or without treatment with the standard of care antiseizure drug, midazolam (MDZ); a novel antiseizure medication, allopregnanolone (ALLO); or combination therapy with MDZ and ALLO (DUO). Our results show that mean T2 values in DFP-exposed animals were: (1) higher than VEH in all volumes of interest (VOIs) at day 3; (2) decreased with time; and (3) decreased in the thalamus at day 28. Treatment with ALLO or DUO, but not MDZ alone, significantly decreased mean T2 values relative to untreated DFP animals in the piriform cortex at day 3. On day 28, the DUO group showed the most favorable T2 characteristics. This study supports the utility of T2 mapping for longitudinally monitoring brain injury and highlights the therapeutic potential of ALLO as an adjunct therapy to mitigate chronic morbidity associated with acute OP intoxication.
Collapse
Affiliation(s)
- Alita Jesal D Almeida
- Department of Biomedical Engineering, University of California-Davis College of Engineering, Davis, CA, 95616, USA; Department of Radiology, University of California-Davis School of Medicine, Sacramento, CA, 95817, USA.
| | - Brad A Hobson
- Center for Molecular and Genomic Imaging, Department of Biomedical Engineering, University of California-Davis College of Engineering, Davis, CA, 95616, USA.
| | - Naomi Saito
- Department of Public Health Sciences, University of California-Davis School of Medicine, Davis, CA, 95616, USA
| | - Donald A Bruun
- Department of Molecular Biosciences, University of California-Davis School of Veterinary Medicine, Davis, CA, 95616, USA.
| | - Valerie A Porter
- Department of Biomedical Engineering, University of California-Davis College of Engineering, Davis, CA, 95616, USA; Department of Radiology, University of California-Davis School of Medicine, Sacramento, CA, 95817, USA.
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California-Davis School of Medicine, Davis, CA, 95616, USA.
| | - Joel R Garbow
- Department of Radiology, Washington University School of Medicine, St Louis, MO, 63110, USA.
| | - Abhijit J Chaudhari
- Department of Radiology, University of California-Davis School of Medicine, Sacramento, CA, 95817, USA; Center for Molecular and Genomic Imaging, Department of Biomedical Engineering, University of California-Davis College of Engineering, Davis, CA, 95616, USA.
| | - Pamela J Lein
- Department of Molecular Biosciences, University of California-Davis School of Veterinary Medicine, Davis, CA, 95616, USA.
| |
Collapse
|
26
|
Du L, Ye F, Gao W, Yang A, Luan J, Xu M, Lv K, Hu P, Liu B, Yu H, Wang Y, Huang W, Shu N, Ouyang G, Yin Q, Shmuel A, Wang Y, Zhang Q, Xu P, Ma G. Decreased brain iron deposition based on quantitative susceptibility mapping correlates with reduced neurodevelopmental status in children with autism spectrum disorder. Cereb Cortex 2024; 34:63-71. [PMID: 38696609 DOI: 10.1093/cercor/bhae081] [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: 10/30/2023] [Revised: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 05/04/2024] Open
Abstract
To investigate potential correlations between the susceptibility values of certain brain regions and the severity of disease or neurodevelopmental status in children with autism spectrum disorder (ASD), 18 ASD children and 15 healthy controls (HCs) were recruited. The neurodevelopmental status was assessed by the Gesell Developmental Schedules (GDS) and the severity of the disease was evaluated by the Autism Behavior Checklist (ABC). Eleven brain regions were selected as regions of interest and the susceptibility values were measured by quantitative susceptibility mapping. To evaluate the diagnostic capacity of susceptibility values in distinguishing ASD and HC, the receiver operating characteristic (ROC) curve was computed. Pearson and Spearman partial correlation analysis were used to depict the correlations between the susceptibility values, the ABC scores, and the GDS scores in the ASD group. ROC curves showed that the susceptibility values of the left and right frontal white matter had a larger area under the curve in the ASD group. The susceptibility value of the right globus pallidus was positively correlated with the GDS-fine motor scale score. These findings indicated that the susceptibility value of the right globus pallidus might be a viable imaging biomarker for evaluating the neurodevelopmental status of ASD children.
Collapse
Affiliation(s)
- Lei Du
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
- Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian, Beijing 100142, China
| | - Fang Ye
- Department of Pediatrics, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Wenwen Gao
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
- Department of Radiology, the Sixth Medical Center of People's Liberation Army (PLA) General Hospital, No. 6 Fucheng Road, Haidian, Beijing 100048, China
| | - Aocai Yang
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Jixin Luan
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Manxi Xu
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Kuan Lv
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Pianpian Hu
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Bing Liu
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Hongwei Yu
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Yuli Wang
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Weijie Huang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, No. 19 Xinjiekouwai Road, Haidian, Beijing 100875, China
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, No. 19 Xinjiekouwai Road, Haidian, Beijing 100875, China
| | - Gaoxiang Ouyang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, No. 19 Xinjiekouwai Road, Haidian, Beijing 100875, China
| | - Qian Yin
- School of Artificial Intelligence, Beijing Normal University, No. 19 Xinjiekouwai Road, Haidian, Beijing 100875, China
| | - Amir Shmuel
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 45 Sherbrooke St W, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, Physiology, and Biomedical Engineering, McGill University, 45 Sherbrooke St W, Montreal, QC, Canada
| | - Yunfeng Wang
- Department of Pediatrics, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Qi Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Pengfei Xu
- Department of Pediatrics, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| | - Guolin Ma
- Department of Radiology, China-Japan Friendship Hospital, No. 2 East Yinghua Road, Chaoyang, Beijing 100029, China
| |
Collapse
|
27
|
Yan S, Lu J, Li Y, Cho J, Zhang S, Zhu W, Wang Y. Spatiotemporal patterns of brain iron-oxygen metabolism in patients with Parkinson's disease. Eur Radiol 2024; 34:3074-3083. [PMID: 37853173 DOI: 10.1007/s00330-023-10283-1] [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: 05/18/2023] [Revised: 07/21/2023] [Accepted: 08/08/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVES Iron deposition and mitochondrial dysfunction are closely associated with the genesis and progression of Parkinson's disease (PD). This study aims to extract susceptibility and oxygen extraction fraction (OEF) values of deep grey matter (DGM) to explore spatiotemporal progression patterns of brain iron-oxygen metabolism in PD. METHODS Ninety-five PD patients and forty healthy controls (HCs) were included. Quantitative susceptibility mapping (QSM) and OEF maps were computed from MRI multi-echo gradient echo data. Analysis of covariance (ANCOVA) was used to compare mean susceptibility and OEF values in DGM between early-stage PD (ESP), advanced-stage PD (ASP) patients and HCs. Then Granger causality analysis on the pseudo-time-series of MRI data was applied to assess the causal effect of early altered nuclei on iron content and oxygen extraction in other DGM nuclei. RESULTS The susceptibility values in substantia nigra (SN), red nucleus, and globus pallidus (GP) significantly increased in PD patients compared with HCs, while the iron content in GP did not elevate obviously until the late stage. The mean OEF values for the caudate nucleus, putamen, and dentate nucleus were higher in ESP patients than in ASP patients or/and HCs. We also found that iron accumulation progressively expands from the midbrain to the striatum. These alterations were correlated with clinical features and improved AUC for early PD diagnosis to 0.824. CONCLUSIONS Abnormal cerebral iron deposition and tissue oxygen utilization in PD measured by QSM and OEF maps could reflect pathological alterations in neurodegenerative processes and provide valuable indicators for disease identification and management. CLINICAL RELEVANCE STATEMENT Noninvasive assessment of cerebral iron-oxygen metabolism may serve as clinical evidence of pathological changes in PD and improve the validity of diagnosis and disease monitoring. KEY POINTS • Quantitative susceptibility mapping and oxygen extraction fraction maps indicated the cerebral pathology of abnormal iron accumulation and oxygen metabolism in Parkinson's disease. • Iron deposition is mainly in the midbrain, while altered oxygen metabolism is concentrated in the striatum and cerebellum. • The susceptibility and oxygen extraction fraction values in subcortical nuclei were associated with clinical severity.
Collapse
Affiliation(s)
- Su Yan
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Avenue, Wuhan, 430030, China
| | - Jun Lu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Avenue, Wuhan, 430030, China
- Department of CT & MRI, The First Affiliated Hospital, College of Medicine, Shihezi University, 107 North Second Road, Shihezi, China
| | - Yuanhao Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Avenue, Wuhan, 430030, China
| | - Junghun Cho
- Department of Biomedical Engineering, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Shun Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Avenue, Wuhan, 430030, China
| | - Wenzhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Avenue, Wuhan, 430030, China.
| | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
- Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| |
Collapse
|
28
|
Morandini HAE, Watson PA, Barbaro P, Rao P. Brain iron concentration in childhood ADHD: A systematic review of neuroimaging studies. J Psychiatr Res 2024; 173:200-209. [PMID: 38547742 DOI: 10.1016/j.jpsychires.2024.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/23/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024]
Abstract
Iron deficiency may play a role in the pathophysiology of Attention Deficit/Hyperactivity Disorder (ADHD). Due to its preponderant function in monoamine catecholamine and myelin synthesis, brain iron concentration may be of primary interest in the investigation of iron dysregulation in ADHD. This study reviewed current evidence of brain iron abnormalities in children and adolescents with ADHD using magnetic resonance imaging methods, such as relaxometry and quantitative susceptibility mapping, to assess brain iron estimates. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed for studies published between January 1, 2008 and July 7, 2023 in Medline, Scopus and Proquest. Regions of interest, brain iron index values and phenotypical information were extracted from the relevant studies. Risk of bias was assessed using a modified version of the National Heart, Lung, and Blood Institute quality assessment tool. Seven cross-sectional studies comparing brain iron estimates in children with ADHD with neurotypical children were included. Significantly reduced brain iron content in medication-naïve children with ADHD was a consistent finding. Two studies found psychostimulant use may increase and normalize brain iron concentration in children with ADHD. The findings were consistent across the studies despite differing methodologies and may lay the early foundation for the recognition of a potential biomarker in ADHD, although longitudinal prospective neuroimaging studies using larger sample sizes are required. Lastly, the effects of iron supplementation on brain iron concentration in children with ADHD need to be elucidated.
Collapse
Affiliation(s)
- Hugo A E Morandini
- Complex Attention and Hyperactivity Disorders Service, Child and Adolescent Health Services, Perth, WA, Australia; Division of Psychiatry, UWA Medical School, Faculty of Health & Medical Sciences, The University of Western Australia, Australia.
| | - Prue A Watson
- Complex Attention and Hyperactivity Disorders Service, Child and Adolescent Health Services, Perth, WA, Australia
| | - Parma Barbaro
- Complex Attention and Hyperactivity Disorders Service, Child and Adolescent Health Services, Perth, WA, Australia
| | - Pradeep Rao
- Complex Attention and Hyperactivity Disorders Service, Child and Adolescent Health Services, Perth, WA, Australia; Division of Psychiatry, UWA Medical School, Faculty of Health & Medical Sciences, The University of Western Australia, Australia; Telethon Kids Institute, Perth, Australia
| |
Collapse
|
29
|
Joshi J, Yao M, Kakazu A, Ouyang Y, Duan W, Aggarwal M. Distinguishing microgliosis and tau deposition in the mouse brain using paramagnetic and diamagnetic susceptibility source separation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.11.588962. [PMID: 38659855 PMCID: PMC11042227 DOI: 10.1101/2024.04.11.588962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Tauopathies, including Alzheimer's disease (AD), are neurodegenerative disorders characterized by hyperphosphorylated tau protein aggregates in the brain. In addition to protein aggregates, microglia-mediated inflammation and iron dyshomeostasis are other pathological features observed in AD and other tauopathies. It is known that these alterations at the subcellular level occur much before the onset of macroscopic tissue atrophy or cognitive deficits. The ability to detect these microstructural changes with MRI therefore has substantive importance for improved characterization of disease pathogenesis. In this study, we demonstrate that quantitative susceptibility mapping (QSM) with paramagnetic and diamagnetic susceptibility source separation has the potential to distinguish neuropathological alterations in a transgenic mouse model of tauopathy. 3D multi-echo gradient echo data were acquired from fixed brains of PS19 (Tau) transgenic mice and age-matched wild-type (WT) mice (n = 5 each) at 11.7 T. The multi-echo data were fit to a 3-pool complex signal model to derive maps of paramagnetic component susceptibility (PCS) and diamagnetic component susceptibility (DCS). Group-averaged signal fraction and composite susceptibility maps showed significant region-specific differences between the WT and Tau mouse brains. Significant bilateral increases in PCS and |DCS| were observed in specific hippocampal and cortical sub-regions of the Tau mice relative to WT controls. Comparison with immunohistological staining for microglia (Iba1) and phosphorylated-tau (AT8) further indicated that the PCS and DCS differences corresponded to regional microgliosis and tau deposition in the PS19 mouse brains, respectively. The results demonstrate that quantitative susceptibility source separation may provide sensitive imaging markers to detect distinct pathological alterations in tauopathies.
Collapse
Affiliation(s)
- Jayvik Joshi
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Minmin Yao
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron Kakazu
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yuxiao Ouyang
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Wenzhen Duan
- Division of Neurobiology, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Manisha Aggarwal
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
30
|
Chen H, Yang A, Huang W, Du L, Liu B, Lv K, Luan J, Hu P, Shmuel A, Shu N, Ma G. Associations of quantitative susceptibility mapping with cortical atrophy and brain connectome in Alzheimer's disease: A multi-parametric study. Neuroimage 2024; 290:120555. [PMID: 38447683 DOI: 10.1016/j.neuroimage.2024.120555] [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: 11/11/2023] [Revised: 01/07/2024] [Accepted: 02/24/2024] [Indexed: 03/08/2024] Open
Abstract
Aberrant susceptibility due to iron level abnormality and brain network disconnections are observed in Alzheimer's disease (AD), with disrupted iron homeostasis hypothesized to be linked to AD pathology and neuronal loss. However, whether associations exist between abnormal quantitative susceptibility mapping (QSM), brain atrophy, and altered brain connectome in AD remains unclear. Based on multi-parametric brain imaging data from 30 AD patients and 26 healthy controls enrolled at the China-Japan Friendship Hospital, we investigated the abnormality of the QSM signal and volumetric measure across 246 brain regions in AD patients. The structural and functional connectomes were constructed based on diffusion MRI tractography and functional connectivity, respectively. The network topology was quantified using graph theory analyses. We identified seven brain regions with both reduced cortical thickness and abnormal QSM (p < 0.05) in AD, including the right superior frontal gyrus, left superior temporal gyrus, right fusiform gyrus, left superior parietal lobule, right superior parietal lobule, left inferior parietal lobule, and left precuneus. Correlations between cortical thickness and network topology computed across patients in the AD group resulted in statistically significant correlations in five of these regions, with higher correlations in functional compared to structural topology. We computed the correlation between network topological metrics, QSM value and cortical thickness across regions at both individual and group-averaged levels, resulting in a measure we call spatial correlations. We found a decrease in the spatial correlation of QSM and the global efficiency of the structural network in AD patients at the individual level. These findings may provide insights into the complex relationships among QSM, brain atrophy, and brain connectome in AD.
Collapse
Affiliation(s)
- Haojie Chen
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; BABRI Centre, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Aocai Yang
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China; China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weijie Huang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; BABRI Centre, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Lei Du
- Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Bing Liu
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China; China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Kuan Lv
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Jixin Luan
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China; China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Pianpian Hu
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Amir Shmuel
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada; Departments of Neurology and Neurosurgery, Physiology, and Biomedical Engineering, McGill University, Montreal, QC, Canada
| | - Ni Shu
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; BABRI Centre, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China.
| | - Guolin Ma
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China; China-Japan Friendship Hospital (Institute of Clinical Medical Sciences), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
| |
Collapse
|
31
|
Chen H, Xu J, Li W, Hu Z, Ke Z, Qin R, Xu Y. The characteristic patterns of individual brain susceptibility networks underlie Alzheimer's disease and white matter hyperintensity-related cognitive impairment. Transl Psychiatry 2024; 14:177. [PMID: 38575556 PMCID: PMC10994911 DOI: 10.1038/s41398-024-02861-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024] Open
Abstract
Excessive iron accumulation in the brain cortex increases the risk of cognitive deterioration. However, interregional relationships (defined as susceptibility connectivity) of local brain iron have not been explored, which could provide new insights into the underlying mechanisms of cognitive decline. Seventy-six healthy controls (HC), 58 participants with mild cognitive impairment due to probable Alzheimer's disease (MCI-AD) and 66 participants with white matter hyperintensity (WMH) were included. We proposed a novel approach to construct a brain susceptibility network by using Kullback‒Leibler divergence similarity estimation from quantitative susceptibility mapping and further evaluated its topological organization. Moreover, sparse logistic regression (SLR) was applied to classify MCI-AD from HC and WMH with normal cognition (WMH-NC) from WMH with MCI (WMH-MCI).The altered susceptibility connectivity in the MCI-AD patients indicated that relatively more connectivity was involved in the default mode network (DMN)-related and visual network (VN)-related connectivity, while more altered DMN-related and subcortical network (SN)-related connectivity was found in the WMH-MCI patients. For the HC vs. MCI-AD classification, the features selected by the SLR were primarily distributed throughout the DMN-related and VN-related connectivity (accuracy = 76.12%). For the WMH-NC vs. WMH-MCI classification, the features with high appearance frequency were involved in SN-related and DMN-related connectivity (accuracy = 84.85%). The shared and specific patterns of the susceptibility network identified in both MCI-AD and WMH-MCI may provide a potential diagnostic biomarker for cognitive impairment, which could enhance the understanding of the relationships between brain iron burden and cognitive decline from a network perspective.
Collapse
Affiliation(s)
- Haifeng Chen
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Jingxian Xu
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Weikai Li
- School of Mathematics and Statistics, Chongqing Jiaotong University, Chongqing, China
- MIIT Key Laboratory of Pattern Analysis and Machine Intelligence, Nanjing, China
| | - Zheqi Hu
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Zhihong Ke
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Ruomeng Qin
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China
| | - Yun Xu
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
- Department of Neurology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.
- Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, China.
- Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, China.
| |
Collapse
|
32
|
Everett J, Brooks J, Tjendana Tjhin V, Lermyte F, Hands-Portman I, Plascencia-Villa G, Perry G, Sadler PJ, O’Connor PB, Collingwood JF, Telling ND. Label-Free In Situ Chemical Characterization of Amyloid Plaques in Human Brain Tissues. ACS Chem Neurosci 2024; 15:1469-1483. [PMID: 38501754 PMCID: PMC10995949 DOI: 10.1021/acschemneuro.3c00756] [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: 11/22/2023] [Revised: 02/20/2024] [Accepted: 03/01/2024] [Indexed: 03/20/2024] Open
Abstract
The accumulation of amyloid plaques and increased brain redox burdens are neuropathological hallmarks of Alzheimer's disease. Altered metabolism of essential biometals is another feature of Alzheimer's, with amyloid plaques representing sites of disturbed metal homeostasis. Despite these observations, metal-targeting disease treatments have not been therapeutically effective to date. A better understanding of amyloid plaque composition and the role of the metals associated with them is critical. To establish this knowledge, the ability to resolve chemical variations at nanometer length scales relevant to biology is essential. Here, we present a methodology for the label-free, nanoscale chemical characterization of amyloid plaques within human Alzheimer's disease tissue using synchrotron X-ray spectromicroscopy. Our approach exploits a C-H carbon absorption feature, consistent with the presence of lipids, to visualize amyloid plaques selectively against the tissue background, allowing chemical analysis to be performed without the addition of amyloid dyes that alter the native sample chemistry. Using this approach, we show that amyloid plaques contain elevated levels of calcium, carbonates, and iron compared to the surrounding brain tissue. Chemical analysis of iron within plaques revealed the presence of chemically reduced, low-oxidation-state phases, including ferromagnetic metallic iron. The zero-oxidation state of ferromagnetic iron determines its high chemical reactivity and so may contribute to the redox burden in the Alzheimer's brain and thus drive neurodegeneration. Ferromagnetic metallic iron has no established physiological function in the brain and may represent a target for therapies designed to lower redox burdens in Alzheimer's disease. Additionally, ferromagnetic metallic iron has magnetic properties that are distinct from the iron oxide forms predominant in tissue, which might be exploitable for the in vivo detection of amyloid pathologies using magnetically sensitive imaging. We anticipate that this label-free X-ray imaging approach will provide further insights into the chemical composition of amyloid plaques, facilitating better understanding of how plaques influence the course of Alzheimer's disease.
Collapse
Affiliation(s)
- James Everett
- School
of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University, Thornburrow Drive,Stoke-on-Trent,Staffordshire ST4 7QB, U.K.
- School
of Engineering, University of Warwick, Library Road,Coventry CV4 7AL, U.K.
| | - Jake Brooks
- School
of Engineering, University of Warwick, Library Road,Coventry CV4 7AL, U.K.
| | - Vindy Tjendana Tjhin
- School
of Engineering, University of Warwick, Library Road,Coventry CV4 7AL, U.K.
| | - Frederik Lermyte
- School
of Engineering, University of Warwick, Library Road,Coventry CV4 7AL, U.K.
- Department
of Chemistry, Technical University of Darmstadt, Alarich-Weiss-Strasse 4, 64287 Darmstadt, Germany
| | - Ian Hands-Portman
- School
of Life Sciences, University of Warwick, Gibbet Hill Campus,Coventry CV4 7AL, U.K.
| | - Germán Plascencia-Villa
- Department
of Developmental and Regenerative Biology, The University of Texas at San Antonio (UTSA), San Antonio, Texas 78249, United States
| | - George Perry
- Department
of Developmental and Regenerative Biology, The University of Texas at San Antonio (UTSA), San Antonio, Texas 78249, United States
| | - Peter J. Sadler
- Department
of Chemistry, University of Warwick, Library Road,Coventry CV4 7AL, U.K.
| | - Peter B. O’Connor
- Department
of Chemistry, University of Warwick, Library Road,Coventry CV4 7AL, U.K.
| | | | - Neil D. Telling
- School
of Pharmacy and Bioengineering, Guy Hilton Research Centre, Keele University, Thornburrow Drive,Stoke-on-Trent,Staffordshire ST4 7QB, U.K.
| |
Collapse
|
33
|
Yang J, Lv M, Han L, Li Y, Liu Y, Guo H, Feng H, Wu Y, Zhong J. Evaluation of brain iron deposition in different cerebral arteries of acute ischaemic stroke patients using quantitative susceptibility mapping. Clin Radiol 2024; 79:e592-e598. [PMID: 38320942 DOI: 10.1016/j.crad.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/05/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024]
Abstract
AIM To investigate differences in iron deposition between infarct and normal cerebral arterial regions in acute ischaemic stroke (AIS) patients using quantitative susceptibility mapping (QSM). MATERIALS AND METHODS Forty healthy controls and 40 AIS patients were recruited, and their QSM images were obtained. There were seven regions of interest (ROIs) in AIS patients, including the infarct regions of responsible arteries (R1), the non-infarct regions of responsible arteries (R2), the contralateral symmetrical sites of lesions (R3), and the non-responsible cerebral arterial regions (R4, R5, R6, R7). For the healthy controls, the cerebral arterial regions corresponding to the AIS patient group were selected as ROIs. The differences in corresponding ROI susceptibilities between AIS patients and healthy controls and the differences in susceptibilities between infarcted and non-infarct regions in AIS patients were compared. RESULTS The susceptibilities of infarct regions in AIS patients were significantly higher than those in healthy controls (p<0.0001). There was no significant difference in non-infarct regions between the two groups (p>0.05). The susceptibility of the infarct regions in AIS patients was significantly higher than those of the non-infarct region of responsible artery and non-responsible cerebral arterial regions (p<0.01). CONCLUSIONS Abnormal iron deposition detected by QSM in the infarct regions of AIS patients may not affect iron levels in the non-infarct regions of responsible arteries and normal cerebral arteries, which may open the door for potential new diagnostic and treatment strategies.
Collapse
Affiliation(s)
- J Yang
- Department of Radiology, Zigong First People's Hospital, Zigong, China
| | - M Lv
- Department of Radiology, Zigong First People's Hospital, Zigong, China
| | - L Han
- North Sichuan Medical College, Nanchong, China
| | - Y Li
- Department of Radiology, Zigong First People's Hospital, Zigong, China
| | - Y Liu
- Department of Radiology, Zigong First People's Hospital, Zigong, China
| | - H Guo
- Department of Radiology, Zigong First People's Hospital, Zigong, China
| | - H Feng
- Department of Radiology, Zigong First People's Hospital, Zigong, China
| | - Y Wu
- MR Scientific Marketing, SIEMENS Healthineers Ltd., Shanghai, China
| | - J Zhong
- Department of Radiology, Zigong First People's Hospital, Zigong, China.
| |
Collapse
|
34
|
Varga Z, Keller J, Robinson SD, Serranova T, Nepozitek J, Zogala D, Trnka J, Ruzicka E, Sonka K, Dusek P. Whole brain pattern of iron accumulation in REM sleep behavior disorder. Hum Brain Mapp 2024; 45:e26675. [PMID: 38590155 PMCID: PMC11002348 DOI: 10.1002/hbm.26675] [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: 10/17/2023] [Revised: 03/10/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
Isolated REM sleep behavior disorder (iRBD) is an early stage of synucleinopathy with most patients progressing to Parkinson's disease (PD) or related conditions. Quantitative susceptibility mapping (QSM) in PD has identified pathological iron accumulation in the substantia nigra (SN) and variably also in basal ganglia and cortex. Analyzing whole-brain QSM across iRBD, PD, and healthy controls (HC) may help to ascertain the extent of neurodegeneration in prodromal synucleinopathy. 70 de novo PD patients, 70 iRBD patients, and 60 HCs underwent 3 T MRI. T1 and susceptibility-weighted images were acquired and processed to space standardized QSM. Voxel-based analyses of grey matter magnetic susceptibility differences comparing all groups were performed on the whole brain and upper brainstem levels with the statistical threshold set at family-wise error-corrected p-values <.05. Whole-brain analysis showed increased susceptibility in the bilateral fronto-parietal cortex of iRBD patients compared to both PD and HC. This was not associated with cortical thinning according to the cortical thickness analysis. Compared to iRBD, PD patients had increased susceptibility in the left amygdala and hippocampal region. Upper brainstem analysis revealed increased susceptibility within the bilateral SN for both PD and iRBD compared to HC; changes were located predominantly in nigrosome 1 in the former and nigrosome 2 in the latter group. In the iRBD group, abnormal dopamine transporter SPECT was associated with increased susceptibility in nigrosome 1. iRBD patients display greater fronto-parietal cortex involvement than incidental early-stage PD cohort indicating more widespread subclinical neuropathology. Dopaminergic degeneration in the substantia nigra is paralleled by susceptibility increase, mainly in nigrosome 1.
Collapse
Affiliation(s)
- Zsoka Varga
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| | - Jiri Keller
- Radiodiagnostic DepartmentNa Homolce HospitalPragueCzech Republic
| | - Simon Daniel Robinson
- Department of Biomedical Imaging and Image‐guided TherapyMedical University of ViennaAustria
| | - Tereza Serranova
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| | - Jiri Nepozitek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| | - David Zogala
- Department of Nuclear Medicine, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| | - Jiri Trnka
- Department of Nuclear Medicine, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| | - Evzen Ruzicka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| | - Karel Sonka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| | - Petr Dusek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
- Department of Radiology, First Faculty of MedicineCharles University and General University Hospital in PragueCzech Republic
| |
Collapse
|
35
|
Liu M, Zhao S, Chen Z. Interscanner reproducibility of volumetric quantitative susceptibility mapping about cerebral subcortical gray nuclei at different MR vendors with the same magnetic strength. Brain Behav 2024; 14:e3473. [PMID: 38594225 PMCID: PMC11004039 DOI: 10.1002/brb3.3473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/05/2024] [Accepted: 03/16/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND AND PURPOSE Quantitative susceptibility mapping (QSM) technique was a new quantitative magnetic resonance imaging technique to evaluate the cerebral iron deposition in clinical practice. The current study was aimed to investigate the reproducibility of the volumetric susceptibility value of the subcortical gray nuclei at two different MR vendor with the same magnetic strength. METHODS Cerebral magnitude and phase images of 21 normal subjects were acquired from a 3D multiecho enhanced gradient recalled echo sequence at two different 3.0T MR scanner, and then the magnetic susceptibility images were generated by STI software. The brain structural images were coregistered with magnitude images and generated the normalized parameters, and then generated the normalized susceptibility images. The subcortical gray nuclei template was applied to extract the volumetric susceptibility value of the target nuclei. RESULTS ICC value (95% CI) of the caudate, putamen and GP were 0.847 (0.660-0.935), 0.848 (0.663-0.935) and 0.838 (0.643-0.931), respectively. The ICC value of the thalamus was 0.474 (0.064-0.747). Ninety-five point two percent (20/21) of the difference points of the susceptibility located between the 95% LA for the caudate at the two different 3.0T MR scanner, while the less than 95% of the difference points of the susceptibility value located between the 95% LA for the putamen, globus pallidus and thalamus. CONCLUSION The current study identified that the caudate had the stable reproducibility of the magnetic susceptibility value, and the other basal ganglion nuclei should be cautious for the quantitative evaluation of the magnetic susceptibility value at different 3.0T MR scanner.
Collapse
Affiliation(s)
- Mengqi Liu
- Department of RadiologyHainan Hospital of PLA General HospitalSanyaChina
- Department of RadiologyFirst Medical Center of PLA General HospitalBeijingChina
| | - Shuqiang Zhao
- Department of RadiologyHainan Hospital of PLA General HospitalSanyaChina
| | - Zhiye Chen
- Department of RadiologyHainan Hospital of PLA General HospitalSanyaChina
| |
Collapse
|
36
|
Guan X, Lancione M, Ayton S, Dusek P, Langkammer C, Zhang M. Neuroimaging of Parkinson's disease by quantitative susceptibility mapping. Neuroimage 2024; 289:120547. [PMID: 38373677 DOI: 10.1016/j.neuroimage.2024.120547] [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: 07/30/2023] [Revised: 02/02/2024] [Accepted: 02/17/2024] [Indexed: 02/21/2024] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disease, and apart from a few rare genetic causes, its pathogenesis remains largely unclear. Recent scientific interest has been captured by the involvement of iron biochemistry and the disruption of iron homeostasis, particularly within the brain regions specifically affected in PD. The advent of Quantitative Susceptibility Mapping (QSM) has enabled non-invasive quantification of brain iron in vivo by MRI, which has contributed to the understanding of iron-associated pathogenesis and has the potential for the development of iron-based biomarkers in PD. This review elucidates the biochemical underpinnings of brain iron accumulation, details advancements in iron-sensitive MRI technologies, and discusses the role of QSM as a biomarker of iron deposition in PD. Despite considerable progress, several challenges impede its clinical application after a decade of QSM studies. The initiation of multi-site research is warranted for developing robust, interpretable, and disease-specific biomarkers for monitoring PD disease progression.
Collapse
Affiliation(s)
- Xiaojun Guan
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Joint Laboratory of Clinical Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31009, China
| | - Marta Lancione
- Laboratory of Medical Physics and Magnetic Resonance, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Scott Ayton
- Florey Institute, The University of Melbourne, Australia
| | - Petr Dusek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czechia; Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Auenbruggerplatz 22, Prague 8036, Czechia
| | | | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Joint Laboratory of Clinical Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31009, China.
| |
Collapse
|
37
|
Voon CC, Wiltgen T, Wiestler B, Schlaeger S, Mühlau M. Quantitative susceptibility mapping in multiple sclerosis: A systematic review and meta-analysis. Neuroimage Clin 2024; 42:103598. [PMID: 38582068 PMCID: PMC11002889 DOI: 10.1016/j.nicl.2024.103598] [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: 12/21/2023] [Revised: 03/07/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Quantitative susceptibility mapping (QSM) is a quantitative measure based on magnetic resonance imaging sensitive to iron and myelin content. This makes QSM a promising non-invasive tool for multiple sclerosis (MS) in research and clinical practice. OBJECTIVE We performed a systematic review and meta-analysis on the use of QSM in MS. METHODS Our review was prospectively registered on PROSPERO (CRD42022309563). We searched five databases for studies published between inception and 30th April 2023. We identified 83 English peer-reviewed studies that applied QSM images on MS cohorts. Fifty-five included studies had at least one of the following outcome measures: deep grey matter QSM values in MS, either compared to healthy controls (HC) (k = 13) or correlated with the score on the Expanded Disability Status Scale (EDSS) (k = 7), QSM lesion characteristics (k = 22) and their clinical correlates (k = 17), longitudinal correlates (k = 11), histological correlates (k = 7), or correlates with other imaging techniques (k = 12). Two meta-analyses on deep grey matter (DGM) susceptibility data were performed, while the remaining findings could only be analyzed descriptively. RESULTS After outlier removal, meta-analyses demonstrated a significant increase in the basal ganglia susceptibility (QSM values) in MS compared to HC, caudate (k = 9, standardized mean difference (SDM) = 0.54, 95 % CI = 0.39-0.70, I2 = 46 %), putamen (k = 9, SDM = 0.38, 95 % CI = 0.19-0.57, I2 = 59 %), and globus pallidus (k = 9, SDM = 0.48, 95 % CI = 0.28-0.67, I2 = 60 %), whereas thalamic QSM values exhibited a significant reduction (k = 12, SDM = -0.39, 95 % CI = -0.66--0.12, I2 = 84 %); these susceptibility differences in MS were independent of age. Further, putamen QSM values positively correlated with EDSS (k = 4, r = 0.36, 95 % CI = 0.16-0.53, I2 = 0 %). Regarding rim lesions, four out of seven studies, representing 73 % of all patients, reported rim lesions to be associated with more severe disability. Moreover, lesion development from initial detection to the inactive stage is paralleled by increasing, plateauing (after about two years), and gradually decreasing QSM values, respectively. Only one longitudinal study provided clinical outcome measures and found no association. Histological data suggest iron content to be the primary source of QSM values in DGM and at the edges of rim lesions; further, when also considering data from myelin water imaging, the decrease of myelin is likely to drive the increase of QSM values within WM lesions. CONCLUSIONS We could provide meta-analytic evidence for DGM susceptibility changes in MS compared to HC; basal ganglia susceptibility is increased and, in the putamen, associated with disability, while thalamic susceptibility is decreased. Beyond these findings, further investigations are necessary to establish the role of QSM in MS for research or even clinical routine.
Collapse
Affiliation(s)
- Cui Ci Voon
- Dept. of Neurology, School of Medicine and Health, Technical University of Munich, Munich, Germany; TUM-Neuroimaging Center, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Tun Wiltgen
- Dept. of Neurology, School of Medicine and Health, Technical University of Munich, Munich, Germany; TUM-Neuroimaging Center, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Benedikt Wiestler
- Dept. of Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Sarah Schlaeger
- Dept. of Neuroradiology, School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Mark Mühlau
- Dept. of Neurology, School of Medicine and Health, Technical University of Munich, Munich, Germany; TUM-Neuroimaging Center, School of Medicine and Health, Technical University of Munich, Munich, Germany.
| |
Collapse
|
38
|
Thomas GE, Hannaway N, Zarkali A, Shmueli K, Weil RS. Longitudinal Associations of Magnetic Susceptibility with Clinical Severity in Parkinson's Disease. Mov Disord 2024; 39:546-559. [PMID: 38173297 PMCID: PMC11141787 DOI: 10.1002/mds.29702] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Dementia is common in Parkinson's disease (PD), but there is wide variation in its timing. A critical gap in PD research is the lack of quantifiable markers of progression, and methods to identify early stages of dementia. Atrophy-based magnetic resonance imaging (MRI) has limited sensitivity in detecting or tracking changes relating to PD dementia, but quantitative susceptibility mapping (QSM), sensitive to brain tissue iron, shows potential for these purposes. OBJECTIVE The objective of the paper is to study, for the first time, the longitudinal relationship between cognition and QSM in PD in detail. METHODS We present a longitudinal study of clinical severity in PD using QSM, including 59 PD patients (without dementia at study onset), and 22 controls over 3 years. RESULTS In PD, increased baseline susceptibility in the right temporal cortex, nucleus basalis of Meynert, and putamen was associated with greater cognitive severity after 3 years; and increased baseline susceptibility in basal ganglia, substantia nigra, red nucleus, insular cortex, and dentate nucleus was associated with greater motor severity after 3 years. Increased follow-up susceptibility in these regions was associated with increased follow-up cognitive and motor severity, with further involvement of hippocampus relating to cognitive severity. However, there were no consistent increases in susceptibility over 3 years. CONCLUSIONS Our study suggests that QSM may predict changes in cognitive severity many months prior to overt cognitive involvement in PD. However, we did not find robust longitudinal changes in QSM over the course of the study. Additional tissue metrics may be required together with QSM for it to monitor progression in clinical practice and therapeutic trials. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
| | - Naomi Hannaway
- Dementia Research CentreUCL Institute of NeurologyLondonUK
| | | | - Karin Shmueli
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUK
| | - Rimona S. Weil
- Dementia Research CentreUCL Institute of NeurologyLondonUK
- Wellcome Centre for Human NeuroimagingUniversity College LondonLondonUK
- Movement Disorders ConsortiumUniversity College LondonLondonUK
| |
Collapse
|
39
|
Voltin J, Nunn LM, Watson Z, Brasher ZE, Adisetiyo V, Hanlon CA, Nietert PJ, McRae-Clark AL, Jensen JH. Comparison of three magnetic resonance imaging measures of brain iron in healthy and cocaine use disorder participants. NMR IN BIOMEDICINE 2024; 37:e5072. [PMID: 38009303 PMCID: PMC10922943 DOI: 10.1002/nbm.5072] [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] [Received: 06/29/2023] [Revised: 09/28/2023] [Accepted: 10/23/2023] [Indexed: 11/28/2023]
Abstract
Several magnetic resonance imaging (MRI) measures for quantifying endogenous nonheme brain iron have been proposed. These correspond to distinct physical properties with varying sensitivities and specificities to iron. Moreover, they may depend not only on tissue iron concentration, but also on the intravoxel spatial pattern of iron deposition, which is complex in many brain regions. Here, the three MRI brain iron measures of R 2 * , magnetic field correlation (MFC), and magnetic susceptibility are compared in several deep gray matter regions for both healthy participants (HPs) and individuals with cocaine use disorder (CUD). Their concordance is assessed from their correlations with each other and their relative dependencies on age. In addition, associations between the iron measures and microstructure in adjacent white matter regions are investigated by calculating their correlations with diffusion MRI measures from the internal capsule, and associations with cognition are determined by using results from a battery of standardized tests relevant to CUD. It is found that all three iron measures are strongly correlated with each other for the considered gray matter regions, but with correlation coefficients substantially less than one indicating important differences. The age dependencies of all three measures are qualitatively similar in most regions, except for the red nucleus, where the susceptibility has a significantly stronger correlation with age than R 2 * . Weak to moderate correlations are seen for the iron measures with several of the diffusion and cognitive measures, with the strongest correlations being obtained for R 2 * . The iron measures differ little between the HP and CUD groups, although susceptibility is significantly lower in the red nucleus for the CUD group. For the comparisons made, the iron measures behave similarly in most respects, but with notable quantitative differences. It is suggested that these differences may be, in part, attributable to a higher sensitivity to the spatial pattern of iron deposition for R 2 * and MFC than for susceptibility. This is supported most strongly by a sharp contrast between the values of the iron measures in the globus pallidus relative to those in the red nucleus. The observed correlations of the iron measures with diffusion and cognitive scores point to possible connections between gray matter iron, white matter microstructure, and cognition.
Collapse
Affiliation(s)
- Joshua Voltin
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Lisa M. Nunn
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, South Carolina
| | - Zoe Watson
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, South Carolina
| | - Zoe E. Brasher
- Department of Behavioral Science and Neuroscience, Duke University Medical Center, Durham, North Carolina
| | - Vitria Adisetiyo
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Colleen A. Hanlon
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, South Carolina
| | - Paul J. Nietert
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Aimee L. McRae-Clark
- Department of Psychiatry and Behavioral Science, Medical University of South Carolina, Charleston, South Carolina
| | - Jens H. Jensen
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, South Carolina
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
40
|
Ghaderi S, Mohammadi S, Nezhad NJ, Karami S, Sayehmiri F. Iron quantification in basal ganglia: quantitative susceptibility mapping as a potential biomarker for Alzheimer's disease - a systematic review and meta-analysis. Front Neurosci 2024; 18:1338891. [PMID: 38469572 PMCID: PMC10925682 DOI: 10.3389/fnins.2024.1338891] [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: 11/15/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024] Open
Abstract
Introduction Alzheimer's disease (AD), characterized by distinctive pathologies such as amyloid-β plaques and tau tangles, also involves deregulation of iron homeostasis, which may accelerate neurodegeneration. This meta-analysis evaluated the use of quantitative susceptibility mapping (QSM) to detect iron accumulation in the deep gray matter (DGM) of the basal ganglia in AD, contributing to a better understanding of AD progression, and potentially leading to new diagnostic and therapeutic approaches. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched the PubMed, Scopus, Web of Sciences, and Google Scholar databases up to October 2023 for studies employing QSM in AD research. Eligibility criteria were based on the PECO framework, and we included studies assessing alterations in magnetic susceptibility indicative of iron accumulation in the DGM of patients with AD. After initial screening and quality assessment using the Newcastle-Ottawa Scale, a meta-analysis was conducted to compare iron levels between patients with AD and healthy controls (HCs) using a random-effects model. Results The meta-analysis included nine studies comprising 267 patients with AD and 272 HCs. There were significantly higher QSM values, indicating greater iron deposition, in the putamen (standardized mean difference (SMD) = 1.23; 95% CI: 0.62 to 1.84; p = 0.00), globus pallidus (SMD = 0.79; 95% CI: 0.07 to 1.52; p = 0.03), and caudate nucleus (SMD = 0.72; 95% CI: 0.39 to 1.06; p = 0.00) of AD patients compared to HCs. However, no significant differences were found in the thalamus (SMD = 1.00; 95% CI: -0.42 to 2.43; p = 0.17). The sensitivity analysis indicated that no single study impacted the overall results. Age was identified as a major contributor to heterogeneity across all basal ganglia nuclei in subgroup analysis. Older age (>69 years) and lower male percentage (≤30%) were associated with greater putamen iron increase in patients with AD. Conclusion The study suggests that excessive iron deposition is linked to the basal ganglia in AD, especially the putamen. The study underscores the complex nature of AD pathology and the accumulation of iron, influenced by age, sex, and regional differences, necessitating further research for a comprehensive understanding.
Collapse
Affiliation(s)
- Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sana Mohammadi
- Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nahid Jashire Nezhad
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Shaghayegh Karami
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Sayehmiri
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| |
Collapse
|
41
|
Alushaj E, Handfield-Jones N, Kuurstra A, Morava A, Menon RS, Owen AM, Sharma M, Khan AR, MacDonald PA. Increased iron in the substantia nigra pars compacta identifies patients with early Parkinson'sdisease: A 3T and 7T MRI study. Neuroimage Clin 2024; 41:103577. [PMID: 38377722 PMCID: PMC10944193 DOI: 10.1016/j.nicl.2024.103577] [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: 08/07/2023] [Revised: 12/19/2023] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
Degeneration in the substantia nigra (SN) pars compacta (SNc) underlies motor symptoms in Parkinson's disease (PD). Currently, there are no neuroimaging biomarkers that are sufficiently sensitive, specific, reproducible, and accessible for routine diagnosis or staging of PD. Although iron is essential for cellular processes, it also mediates neurodegeneration. MRI can localize and quantify brain iron using magnetic susceptibility, which could potentially provide biomarkers of PD. We measured iron in the SNc, SN pars reticulata (SNr), total SN, and ventral tegmental area (VTA), using quantitative susceptibility mapping (QSM) and R2* relaxometry, in PD patients and age-matched healthy controls (HCs). PD patients, diagnosed within five years of participation and HCs were scanned at 3T (22 PD and 23 HCs) and 7T (17 PD and 21 HCs) MRI. Midbrain nuclei were segmented using a probabilistic subcortical atlas. QSM and R2* values were measured in midbrain subregions. For each measure, groups were contrasted, with Age and Sex as covariates, and receiver operating characteristic (ROC) curve analyses were performed with repeated k-fold cross-validation to test the potential of our measures to classify PD patients and HCs. Statistical differences of area under the curves (AUCs) were compared using the Hanley-MacNeil method (QSM versus R2*; 3T versus 7T MRI). PD patients had higher QSM values in the SNc at both 3T (padj = 0.001) and 7T (padj = 0.01), but not in SNr, total SN, or VTA, at either field strength. No significant group differences were revealed using R2* in any midbrain region at 3T, though increased R2* values in SNc at 7T MRI were marginally significant in PDs compared to HCs (padj = 0.052). ROC curve analyses showed that SNc iron measured with QSM, distinguished early PD patients from HCs at the single-subject level with good diagnostic accuracy, using 3T (mean AUC = 0.83, 95 % CI = 0.82-0.84) and 7T (mean AUC = 0.80, 95 % CI = 0.79-0.81) MRI. Mean AUCs reported here are from averages of tests in the hold-out fold of cross-validated samples. The Hanley-MacNeil method demonstrated that QSM outperforms R2* in discriminating PD patients from HCs at 3T, but not 7T. There were no significant differences between 3T and 7T in diagnostic accuracy of QSM values in SNc. This study highlights the importance of segmenting midbrain subregions, performed here using a standardized atlas, and demonstrates high accuracy of SNc iron measured with QSM at 3T MRI in identifying early PD patients. QSM measures of SNc show potential for inclusion in neuroimaging diagnostic biomarkers of early PD. An MRI diagnostic biomarker of PD would represent a significant clinical advance.
Collapse
Affiliation(s)
- Erind Alushaj
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada; Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada
| | - Nicholas Handfield-Jones
- Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 3K7, Canada; Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada
| | - Alan Kuurstra
- Robarts Research Institute, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Anisa Morava
- School of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario N6A 3K7, Canada
| | - Ravi S Menon
- Robarts Research Institute, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Adrian M Owen
- Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada; Department of Physiology and Pharmacology, Western University, London, Ontario N6A 3K7, Canada
| | - Manas Sharma
- Department of Radiology, Western University, London, Ontario N6A 3K7, Canada; Department of Clinical Neurological Sciences, Western University, London, Ontario N6A 3K7, Canada
| | - Ali R Khan
- Robarts Research Institute, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Penny A MacDonald
- Western Institute for Neuroscience, Western University, London, Ontario N6A 3K7, Canada; Department of Clinical Neurological Sciences, Western University, London, Ontario N6A 3K7, Canada.
| |
Collapse
|
42
|
Ficiarà E, Stura I, Vernone A, Silvagno F, Cavalli R, Guiot C. Iron Overload in Brain: Transport Mismatches, Microbleeding Events, and How Nanochelating Therapies May Counteract Their Effects. Int J Mol Sci 2024; 25:2337. [PMID: 38397013 PMCID: PMC10889007 DOI: 10.3390/ijms25042337] [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: 01/11/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Iron overload in many brain regions is a common feature of aging and most neurodegenerative diseases. In this review, the causes, mechanisms, mathematical models, and possible therapies are summarized. Indeed, physiological and pathological conditions can be investigated using compartmental models mimicking iron trafficking across the blood-brain barrier and the Cerebrospinal Fluid-Brain exchange membranes located in the choroid plexus. In silico models can investigate the alteration of iron homeostasis and simulate iron concentration in the brain environment, as well as the effects of intracerebral iron chelation, determining potential doses and timing to recover the physiological state. Novel formulations of non-toxic nanovectors with chelating capacity are already tested in organotypic brain models and could be available to move from in silico to in vivo experiments.
Collapse
Affiliation(s)
- Eleonora Ficiarà
- School of Pharmacy, University of Camerino, 62032 Camerino, MC, Italy;
| | - Ilaria Stura
- Department of Neurosciences, Università degli Studi di Torino, 10125 Torino, TO, Italy; (A.V.); (C.G.)
| | - Annamaria Vernone
- Department of Neurosciences, Università degli Studi di Torino, 10125 Torino, TO, Italy; (A.V.); (C.G.)
| | - Francesca Silvagno
- Department of Oncology, Università degli Studi di Torino, 10126 Torino, TO, Italy;
| | - Roberta Cavalli
- Department of Drug Science and Technology, Università degli Studi di Torino, 10125 Torino, TO, Italy;
| | - Caterina Guiot
- Department of Neurosciences, Università degli Studi di Torino, 10125 Torino, TO, Italy; (A.V.); (C.G.)
| |
Collapse
|
43
|
Mathew RS, Paluru N, Yalavarthy PK. Model resolution-based deconvolution for improved quantitative susceptibility mapping. NMR IN BIOMEDICINE 2024; 37:e5055. [PMID: 37803940 DOI: 10.1002/nbm.5055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/22/2023] [Accepted: 09/02/2023] [Indexed: 10/08/2023]
Abstract
Quantitative susceptibility mapping (QSM) utilizes the relationship between the measured local field and the unknown susceptibility map to perform dipole deconvolution. The aim of this work is to introduce and systematically evaluate the model resolution-based deconvolution for improved estimation of the susceptibility map obtained using the thresholded k-space division (TKD). A two-step approach has been proposed, wherein the first step involves the TKD susceptibility map computation and the second step involves the correction of this susceptibility map using the model-resolution matrix. The TKD-estimated susceptibility map can be expressed as the weighted average of the true susceptibility map, where the weights are determined by the rows of the model-resolution matrix, and hence a deconvolution of the TKD susceptibility map using the model-resolution matrix yields a better approximation to the true susceptibility map. The model resolution-based deconvolution is realized using closed-form, iterative, and sparsity-regularized implementations. The proposed approach was compared with L2 regularization, TKD, rescaled TKD in superfast dipole inversion, the modulated closed-form method, and iterative dipole inversion, as well as sparsity-regularized dipole inversion. It was observed that the proposed approach showed a substantial reduction in the streaking artifacts across 94 test volumes considered in this study. The proposed approach also showed better error reduction and edge preservation compared with other approaches. The proposed model resolution-based deconvolution compensates for the truncation of zero coefficients in the dipole kernel at the magic angle and hence provides a closer approximation to the true susceptibility map compared with other direct methods.
Collapse
Affiliation(s)
- Raji Susan Mathew
- Department of Computational and Data Sciences, Indian Institute of Science, Bangalore, Karnataka, India
| | - Naveen Paluru
- Department of Computational and Data Sciences, Indian Institute of Science, Bangalore, Karnataka, India
| | - Phaneendra K Yalavarthy
- Department of Computational and Data Sciences, Indian Institute of Science, Bangalore, Karnataka, India
| |
Collapse
|
44
|
Krishnan S, George SS, Radhakrishnan V, Raghavan S, Thomas B, Thulaseedharan JV, Puthenveedu DK. Quantitative susceptibility mapping from basal ganglia and related structures: correlation with disease severity in progressive supranuclear palsy. Acta Neurol Belg 2024; 124:151-160. [PMID: 37580639 DOI: 10.1007/s13760-023-02352-5] [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: 01/10/2023] [Accepted: 07/31/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE We examined whether mean magnetic susceptibility values from deep gray matter structures in patients with progressive supranuclear palsy (PSP) differed from those in patients with Parkinson's disease (PD) and healthy volunteers, and correlated with the PSP rating scale. METHODS Head of caudate nucleus, putamen, globus pallidus, substantia nigra and red nucleus were the regions of interest. Mean susceptibility values from these regions in PSP patients were estimated using quantitative susceptibility mapping. Correlations with clinical severity of disease as measured by the PSP rating scale were examined. The mean susceptibility values were also compared with those from healthy volunteers and age- and disease duration-matched patients with PD. RESULTS Data from 26 healthy volunteers, 26 patients with PD and 27 patients with PSP, were analysed. Patients with PSP had higher mean susceptibility values from all regions of interest when compared to both the other groups. The PSP rating scale scores correlated strongly with mean susceptibility values from the red nucleus and moderately with those from the putamen and substantia nigra. The scores did not correlate with mean susceptibility values from the caudate nucleus or globus pallidus. In patients with PD, the motor deficits correlated moderately with mean susceptibility values from substantia nigra. CONCLUSIONS In patients with PSP, mean susceptibility values indicating the severity of mineralization of basal ganglia and related structures correlate with disease severity, the correlation of red nucleus being the strongest. Further studies are warranted to explore whether mean susceptibility values could serve as biomarkers for PSP.
Collapse
Affiliation(s)
- Syam Krishnan
- Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
| | - Sneha Susan George
- Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Vineeth Radhakrishnan
- Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Sheelakumari Raghavan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Bejoy Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Jissa Vinoda Thulaseedharan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Divya Kalikavil Puthenveedu
- Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| |
Collapse
|
45
|
Satoh R, Ali F, Botha H, Lowe VJ, Josephs KA, Whitwell JL. Direct comparison between 18F-Flortaucipir tau PET and quantitative susceptibility mapping in progressive supranuclear palsy. Neuroimage 2024; 286:120509. [PMID: 38184157 PMCID: PMC10868646 DOI: 10.1016/j.neuroimage.2024.120509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024] Open
Abstract
PURPOSE The pattern of flortaucipir tau PET uptake is topographically similar to the pattern of magnetic susceptibility in progressive supranuclear palsy (PSP); both with increased signal in subcortical structures such as the basal ganglia and midbrain, suggesting that they may be closely related. However, their relationship remains unknown since no studies have directly compared these two modalities in the same PSP cohort. We hypothesized that some flortaucipir uptake in PSP is associated with magnetic susceptibility, and hence iron deposition. The aim of this study was to evaluate the regional relationship between flortaucipir uptake and magnetic susceptibility and to examine the effects of susceptibility on flortaucipir uptake in PSP. METHODS Fifty PSP patients and 67 cognitively normal controls were prospectively recruited and underwent three Tesla MRI and flortaucipir tau PET scans. Quantitative susceptibility maps were reconstructed from multi-echo gradient-echo MRI images. Region of interest (ROI) analysis was performed to obtain flortaucipir and susceptibility values in the subcortical regions. Relationships between flortaucipir and susceptibility signals were evaluated using partial correlation analysis in the subcortical ROIs and voxel-based analysis in the whole brain. The effects of susceptibility on flortaucipir uptake were examined by using the framework of mediation analysis. RESULTS Both flortaucipir and susceptibility were greater in PSP compared to controls in the putamen, pallidum, subthalamic nucleus, red nucleus, and cerebellar dentate (p<0.05). The ROI-based and voxel-based analyses showed that these two signals were positively correlated in these five regions (r = 0.36-0.59, p<0.05). Mediation analysis showed that greater flortaucipir uptake was partially explained by susceptibility in the putamen, pallidum, subthalamic nucleus, and red nucleus, and fully explained in the cerebellar dentate. CONCLUSIONS These results suggest that some of the flortaucipir uptake in subcortical regions in PSP is related to iron deposition. These findings will contribute to our understanding of the mechanisms underlying flortaucipir tau PET findings in PSP and other neurodegenerative diseases.
Collapse
Affiliation(s)
- Ryota Satoh
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Farwa Ali
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, 200 1st St SW, 55905, Rochester, MN, USA
| | | | - Jennifer L Whitwell
- Department of Radiology, Mayo Clinic, 200 1st St SW, 55905, Rochester, MN, USA.
| |
Collapse
|
46
|
Petronek MS, Bodeker KL, Lee CY, Teferi N, Eschbacher KL, Jones KA, Loeffler BT, Smith BJ, Buatti JM, Magnotta VA, Allen BG. Iron-based biomarkers for personalizing pharmacological ascorbate therapy in glioblastoma: insights from a phase 2 clinical trial. J Neurooncol 2024; 166:493-501. [PMID: 38285244 DOI: 10.1007/s11060-024-04571-z] [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: 12/08/2023] [Accepted: 01/11/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Pharmacological ascorbate (intravenous delivery reaching plasma concentrations ≈ 20 mM; P-AscH-) has emerged as a promising therapeutic strategy for glioblastoma. Recently, a single-arm phase 2 clinical trial demonstrated a significant increase in overall survival when P-AscH- was combined with temozolomide and radiotherapy. As P-AscH- relies on iron-dependent mechanisms, this study aimed to assess the predictive potential of both molecular and imaging-based iron-related markers to enhance the personalization of P-AscH- therapy in glioblastoma participants. METHODS Participants (n = 55) with newly diagnosed glioblastoma were enrolled in a phase 2 clinical trial conducted at the University of Iowa (NCT02344355). Tumor samples obtained during surgical resection were processed and stained for transferrin receptor and ferritin heavy chain expression. A blinded pathologist performed pathological assessment. Quantitative susceptibility mapping (QSM) measures were obtained from pre-radiotherapy MRI scans following maximal safe surgical resection. Circulating blood iron panels were evaluated prior to therapy through the University of Iowa Diagnostic Laboratory. RESULTS Through univariate analysis, a significant inverse association was observed between tumor transferrin receptor expression and overall and progression-free survival. QSM measures exhibited a significant, positive association with progression-free survival. Subjects were actively followed until disease progression and then were followed through chart review or clinical visits for overall survival. CONCLUSIONS This study analyzes iron-related biomarkers in the context of P-AscH- therapy for glioblastoma. Integrating molecular, systemic, and imaging-based markers offers a multifaceted approach to tailoring treatment strategies, thereby contributing to improved patient outcomes and advancing the field of glioblastoma therapy.
Collapse
Affiliation(s)
- M S Petronek
- Department of Radiation Oncology, Division of Free Radical and Radiation Biology, University of Iowa, Iowa City, IA, USA.
| | - K L Bodeker
- Department of Radiation Oncology, Division of Free Radical and Radiation Biology, University of Iowa, Iowa City, IA, USA
| | - C Y Lee
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - N Teferi
- Department of Radiation Oncology, Division of Free Radical and Radiation Biology, University of Iowa, Iowa City, IA, USA
| | - K L Eschbacher
- Department of Pathology, University of Iowa, Iowa City, IA, USA
| | - K A Jones
- Department of Pathology, Division of Neuropathology, Duke University, Durham, NC, USA
| | - B T Loeffler
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - B J Smith
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - J M Buatti
- Department of Radiation Oncology, Division of Free Radical and Radiation Biology, University of Iowa, Iowa City, IA, USA
| | - V A Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, USA
| | - B G Allen
- Department of Radiation Oncology, Division of Free Radical and Radiation Biology, University of Iowa, Iowa City, IA, USA
| |
Collapse
|
47
|
Khormi I, Al-Iedani O, Alshehri A, Ramadan S, Lechner-Scott J. MR myelin imaging in multiple sclerosis: A scoping review. J Neurol Sci 2023; 455:122807. [PMID: 38035651 DOI: 10.1016/j.jns.2023.122807] [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: 07/24/2023] [Revised: 10/20/2023] [Accepted: 11/19/2023] [Indexed: 12/02/2023]
Abstract
The inability of disease-modifying therapies to stop the progression of multiple sclerosis (MS), has led to the development of a new therapeutic strategy focussing on myelin repair. While conventional MRI lacks sensitivity for quantifying myelin damage, advanced MRI techniques are proving effective. The development of targeted therapeutics requires histological validation of myelin imaging results, alongside the crucial task of establishing correlations between myelin imaging results and clinical assessments, so that the effectiveness of therapeutic interventions can be evaluated. The aims of this scoping review were to identify myelin imaging methods - some of which have been histologically validated, and to determine how these approaches correlate with clinical assessments of people with MS (pwMS), thus allowing for effective therapeutic evaluation. A search of two databases was undertaken for publications relating to studies on adults MS using either MRI/MR-histology of the MS brain in the range 1990-to-2022. The myelin imaging methods specified were relaxometry, magnetization transfer, and quantitative susceptibility. Relaxometry was used most frequently, with myelin water fraction (MWF) being the primary metric. Studies conducted on tissue from various regions of the brain showed that MWF was significantly lower in pwMS than in healthy controls. Magnetization transfer ratio indicated that the macromolecular content of lesions was lower than that of normal-appearing tissue. Higher magnetic susceptibility of lesions were indicative of myelin breakdown and iron accumulation. Several myelin imaging metrics were correlated with disability, disease severity and duration. Many studies showed a good correlation between myelin measured histologically and by MR myelin imaging techniques.
Collapse
Affiliation(s)
- Ibrahim Khormi
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia; College of Applied Medical Sciences, University of Jeddah, Jeddah, Saudi Arabia
| | - Oun Al-Iedani
- Hunter Medical Research Institute, New Lambton Heights, Australia; School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Abdulaziz Alshehri
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia; Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Saadallah Ramadan
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Australia.
| | - Jeannette Lechner-Scott
- Hunter Medical Research Institute, New Lambton Heights, Australia; Department of Neurology, John Hunter Hospital, New Lambton Heights, Australia; School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia
| |
Collapse
|
48
|
Bachrata B, Bollmann S, Jin J, Tourell M, Dal-Bianco A, Trattnig S, Barth M, Ropele S, Enzinger C, Robinson SD. Super-resolution QSM in little or no additional time for imaging (NATIve) using 2D EPI imaging in 3 orthogonal planes. Neuroimage 2023; 283:120419. [PMID: 37871759 DOI: 10.1016/j.neuroimage.2023.120419] [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: 05/16/2023] [Revised: 09/22/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023] Open
Abstract
Quantitative Susceptibility Mapping has the potential to provide additional insights into neurological diseases but is typically based on a quite long (5-10 min) 3D gradient-echo scan which is highly sensitive to motion. We propose an ultra-fast acquisition based on three orthogonal (sagittal, coronal and axial) 2D simultaneous multi-slice EPI scans with 1 mm in-plane resolution and 3 mm thick slices. Images in each orientation are corrected for susceptibility-related distortions and co-registered with an iterative non-linear Minimum Deformation Averaging (Volgenmodel) approach to generate a high SNR, super-resolution data set with an isotropic resolution of close to 1 mm. The net acquisition time is 3 times the volume acquisition time of EPI or about 12 s, but the three volumes could also replace "dummy scans" in fMRI, making it feasible to acquire QSM in little or No Additional Time for Imaging (NATIve). NATIve QSM values agreed well with reference 3D GRE QSM in the basal ganglia in healthy subjects. In patients with multiple sclerosis, there was also a good agreement between the susceptibility values within lesions and control ROIs and all lesions which could be seen on 3D GRE QSMs could also be visualized on NATIve QSMs. The approach is faster than conventional 3D GRE by a factor of 25-50 and faster than 3D EPI by a factor of 3-5. As a 2D technique, NATIve QSM was shown to be much more robust to motion than the 3D GRE and 3D EPI, opening up the possibility of studying neurological diseases involving iron accumulation and demyelination in patients who find it difficult to lie still for long enough to acquire QSM data with conventional methods.
Collapse
Affiliation(s)
- Beata Bachrata
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Karl Landsteiner Institute for Clinical Molecular MR in Musculoskeletal Imaging, Vienna, Austria; Department of Medical Engineering, Carinthia University of Applied Sciences, Klagenfurt, Austria
| | - Steffen Bollmann
- Centre of Advanced Imaging, University of Queensland, Brisbane, Australia; ARC Training Centre for Innovation in Biomedical Imaging Technology, University of Queensland, Brisbane, Australia; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Jin Jin
- Centre of Advanced Imaging, University of Queensland, Brisbane, Australia; Siemens Healthcare Pty Ltd, Australia
| | - Monique Tourell
- Centre of Advanced Imaging, University of Queensland, Brisbane, Australia; ARC Training Centre for Innovation in Biomedical Imaging Technology, University of Queensland, Brisbane, Australia
| | - Assunta Dal-Bianco
- Department of Neurology, Medical University of Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Karl Landsteiner Institute for Clinical Molecular MR in Musculoskeletal Imaging, Vienna, Austria
| | - Markus Barth
- Centre of Advanced Imaging, University of Queensland, Brisbane, Australia; ARC Training Centre for Innovation in Biomedical Imaging Technology, University of Queensland, Brisbane, Australia; School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Stefan Ropele
- Department of Neurology, Medical University of Graz, Austria
| | | | - Simon Daniel Robinson
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Centre of Advanced Imaging, University of Queensland, Brisbane, Australia; Department of Neurology, Medical University of Graz, Austria.
| |
Collapse
|
49
|
Satoh R, Weigand SD, Pham T, Ali F, Arani A, Senjem ML, Jack CR, Whitwell JL, Josephs KA. Magnetic Susceptibility in Progressive Supranuclear Palsy Variants, Parkinson's Disease, and Corticobasal Syndrome. Mov Disord 2023; 38:2282-2290. [PMID: 37772771 PMCID: PMC10840892 DOI: 10.1002/mds.29613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Previous studies have shown that magnetic susceptibility is increased in several subcortical regions in progressive supranuclear palsy (PSP). However, it is still unclear how subcortical and cortical susceptibilities vary across different PSP variants, Parkinson's disease (PD), and corticobasal syndrome (CBS). OBJECTIVE This study aims to clarify the susceptibility profiles in the subcortical and cortical regions in different PSP variants, PD, and CBS. METHODS Sixty-four patients, 20 PSP-Richardson syndrome (PSP-RS), 9 PSP-parkinsonism (PSP-P), 7 PSP-progressive gait freezing, 4 PSP-postural instability, 11 PD, and 13 CBS, and 20 cognitively normal control subjects underwent a 3-Tesla magnetic resonance imaging scan to reconstruct quantitative susceptibility maps. Region-of-interest analysis was performed to obtain susceptibility in several subcortical and cortical regions. Bayesian linear mixed effect models were used to estimate susceptibility within group and differences between groups. RESULTS In the subcortical regions, patients with PSP-RS and PSP-P showed greater susceptibility than control subjects in the pallidum, substantia nigra, red nucleus, and cerebellar dentate (P < 0.05). Patients with PSP-RS also showed greater susceptibility than patients with PSP-progressive gait freezing, PD, and CBS in the red nucleus and cerebellar dentate, and patients with PSP-P showed greater susceptibility than PD in the red nucleus. Patients with PSP-postural instability and CBS showed greater susceptibility than control subjects in the pallidum and substantia nigra. No significant differences were observed in any cortical region. CONCLUSIONS The PSP variants and CBS had different patterns of magnetic susceptibility in the subcortical regions. The findings will contribute to our understanding about iron profiles and pathophysiology of PSP and may provide a potential biomarker to differentiate PSP variants, PD, and CBS. © 2023 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Ryota Satoh
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Stephen D Weigand
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, 55905, USA
| | - Thu Pham
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Farwa Ali
- Department of Neurology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Arvin Arani
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Matthew L. Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | | | | |
Collapse
|
50
|
Madden DJ, Merenstein JL. Quantitative susceptibility mapping of brain iron in healthy aging and cognition. Neuroimage 2023; 282:120401. [PMID: 37802405 PMCID: PMC10797559 DOI: 10.1016/j.neuroimage.2023.120401] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/14/2023] [Accepted: 09/30/2023] [Indexed: 10/10/2023] Open
Abstract
Quantitative susceptibility mapping (QSM) is a magnetic resonance imaging (MRI) technique that can assess the magnetic properties of cerebral iron in vivo. Although brain iron is necessary for basic neurobiological functions, excess iron content disrupts homeostasis, leads to oxidative stress, and ultimately contributes to neurodegenerative disease. However, some degree of elevated brain iron is present even among healthy older adults. To better understand the topographical pattern of iron accumulation and its relation to cognitive aging, we conducted an integrative review of 47 QSM studies of healthy aging, with a focus on five distinct themes. The first two themes focused on age-related increases in iron accumulation in deep gray matter nuclei versus the cortex. The overall level of iron is higher in deep gray matter nuclei than in cortical regions. Deep gray matter nuclei vary with regard to age-related effects, which are most prominent in the putamen, and age-related deposition of iron is also observed in frontal, temporal, and parietal cortical regions during healthy aging. The third theme focused on the behavioral relevance of iron content and indicated that higher iron in both deep gray matter and cortical regions was related to decline in fluid (speed-dependent) cognition. A handful of multimodal studies, reviewed in the fourth theme, suggest that iron interacts with imaging measures of brain function, white matter degradation, and the accumulation of neuropathologies. The final theme concerning modifiers of brain iron pointed to potential roles of cardiovascular, dietary, and genetic factors. Although QSM is a relatively recent tool for assessing cerebral iron accumulation, it has significant promise for contributing new insights into healthy neurocognitive aging.
Collapse
Affiliation(s)
- David J Madden
- Brain Imaging and Analysis Center, Duke University Medical Center, Box 3918, Durham, NC 27710, USA; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA; Center for Cognitive Neuroscience, Duke University, Durham, NC 27708, USA.
| | - Jenna L Merenstein
- Brain Imaging and Analysis Center, Duke University Medical Center, Box 3918, Durham, NC 27710, USA
| |
Collapse
|