1
|
Shaff N, Erhardt E, Nitschke S, Julio K, Wertz C, Vakhtin A, Caprihan A, Suarez‐Cedeno G, Deligtisch A, Richardson SP, Mayer AR, Ryman SG. Comparison of automated and manual quantification methods for neuromelanin-sensitive MRI in Parkinson's disease. Hum Brain Mapp 2024; 45:e26544. [PMID: 38041476 PMCID: PMC10789205 DOI: 10.1002/hbm.26544] [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: 06/30/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/03/2023] Open
Abstract
Neuromelanin-sensitive magnetic resonance imaging quantitative analysis methods have provided promising biomarkers that can noninvasively quantify degeneration of the substantia nigra in patients with Parkinson's disease. However, there is a need to systematically evaluate the performance of manual and automated quantification approaches. We evaluate whether spatial, signal-intensity, or subject specific abnormality measures using either atlas based or manually traced identification of the substantia nigra better differentiate patients with Parkinson's disease from healthy controls using logistic regression models and receiver operating characteristics. Inference was performed using bootstrap analyses to calculate 95% confidence interval bounds. Pairwise comparisons were performed by generating 10,000 permutations, refitting the models, and calculating a paired difference between metrics. Thirty-one patients with Parkinson's disease and 22 healthy controls were included in the analyses. Signal intensity measures significantly outperformed spatial and subject specific abnormality measures, with the top performers exhibiting excellent ability to differentiate patients with Parkinson's disease and healthy controls (balanced accuracy = 0.89; area under the curve = 0.81; sensitivity =0.86; and specificity = 0.83). Atlas identified substantia nigra metrics performed significantly better than manual tracing metrics. These results provide clear support for the use of automated signal intensity metrics and additional recommendations. Future work is necessary to evaluate whether the same metrics can best differentiate atypical parkinsonism, perform similarly in de novo and mid-stage cohorts, and serve as longitudinal monitoring biomarkers.
Collapse
Affiliation(s)
| | - Erik Erhardt
- Department of Mathematics and StatisticsUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | | | - Kayla Julio
- The Mind Research NetworkAlbuquerqueNew MexicoUSA
| | | | | | | | - Gerson Suarez‐Cedeno
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Amanda Deligtisch
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Sarah Pirio Richardson
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
- New Mexico VA Health Care SystemAlbuquerqueNew MexicoUSA
| | | | - Sephira G. Ryman
- The Mind Research NetworkAlbuquerqueNew MexicoUSA
- Nene and Jamie Koch Comprehensive Movement Disorder Center, Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| |
Collapse
|
2
|
Seada SA, van der Eerden AW, Boon AJW, Hernandez-Tamames JA. Quantitative MRI protocol and decision model for a 'one stop shop' early-stage Parkinsonism diagnosis: Study design. Neuroimage Clin 2023; 39:103506. [PMID: 37696098 PMCID: PMC10500558 DOI: 10.1016/j.nicl.2023.103506] [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: 03/30/2023] [Revised: 06/21/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
Differentiating among early-stage parkinsonisms is a challenge in clinical practice. Quantitative MRI can aid the diagnostic process, but studies with singular MRI techniques have had limited success thus far. Our objective is to develop a multi-modal MRI method for this purpose. In this review we describe existing methods and present a dedicated quantitative MRI protocol, a decision model and a study design to validate our approach ahead of a pilot study. We present example imaging data from patients and a healthy control, which resemble related literature.
Collapse
Affiliation(s)
- Samy Abo Seada
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Anke W van der Eerden
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Agnita J W Boon
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Juan A Hernandez-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Imaging Physics, TU Delft, The Netherlands.
| |
Collapse
|
3
|
Liu Q, Wang P, Liu C, Xue F, Wang Q, Chen Y, Hou R, Chen T. An investigation of neuromelanin distribution in substantia nigra and locus coeruleus in patients with Parkinson's disease using neuromelanin-sensitive MRI. BMC Neurol 2023; 23:301. [PMID: 37580712 PMCID: PMC10424360 DOI: 10.1186/s12883-023-03350-z] [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: 02/01/2023] [Accepted: 07/28/2023] [Indexed: 08/16/2023] Open
Abstract
Loss of neuromelanin in the midbrain is known in Parkinson's disease(PD), which can now be directly detected by neuromelanin-sensitive MRI(NM-MRI). This case-control study was to investigate the distribution of neuromelanin in the substantia nigra(SN) and the locus coeruleus(LC) using NM-MRI technique and evaluate its potential as a diagnostic marker for PD. 10 early PD patients(H&Y stage I, II), 11 progressive PD patients(H&Y stage III-V), and 10 healthy controls matched in age and gender were recruited. All participants completed clinical and psychometric assessments as well as NM-MRI scans. Neuromelanin signal intensities in SN and LC were measured by contrast-to-noise ratios(CNRs) derived from NM-MRI scans. There were significant decreases of CNRs in SNpc(including anterior, central, and posterior) and LC in PD patients compared to controls. There were also significant differences of CNR between the left and right sides. CNR in LC had a negative correlation with the Non-Motor Symptoms Scale(NMSS) score in PD patients(|R|=0.49), whereas CNR in SNpc did not correlate with Unified Parkinson Disease Rating Scale(UPDRS) score(|R|<0.3). The receiver operating characteristic(ROC) curves revealed that the CNR in LC had a high diagnostic specificity of 90.1% in progressive patients. This study provides new evidence for the asymmetric distribution of neuromelanin in SN and the LC of patients with PD. The neuromelanin loss is bilateral and more predominately in LC than that in SN. This distinct neuromelanin distribution pattern may offer a potential diagnostic marker and a potential neuropharmacological intervention target for PD patients.
Collapse
Affiliation(s)
- Qiang Liu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China
| | - Pan Wang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China
| | - Chenghe Liu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China
| | - Feng Xue
- Department of Radiology, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China
| | - Qian Wang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China
| | - Yuqing Chen
- School of Clinical Medicine Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Ruihua Hou
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Teng Chen
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan City, Shandong Province, China.
| |
Collapse
|
4
|
Nobileau A, Gaurav R, Chougar L, Faucher A, Valabrègue R, Mangone G, Leu-Semenescu S, Lejeune FX, Corvol JC, Arnulf I, Vidailhet M, Grabli D, Degos B, Lehéricy S. Neuromelanin-Sensitive Magnetic Resonance Imaging Changes in the Locus Coeruleus/Subcoeruleus Complex in Patients with Typical and Atypical Parkinsonism. Mov Disord 2023; 38:479-484. [PMID: 36592065 DOI: 10.1002/mds.29309] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The locus coeruleus/subcoeruleus complex (LC/LsC) is a structure comprising melanized noradrenergic neurons. OBJECTIVE To study the LC/LsC damage across Parkinson's disease (PD) and atypical parkinsonism in a large group of subjects. METHODS We studied 98 healthy control subjects, 47 patients with isolated rapid eye movement sleep behavior disorder (RBD), 75 patients with PD plus RBD, 142 patients with PD without RBD, 19 patients with progressive supranuclear palsy (PSP), and 19 patients with multiple system atrophy (MSA). Twelve patients with MSA had proven RBD. LC/LsC signal intensity was derived from neuromelanin magnetic resonance imaging using automated software. RESULTS The signal intensity was reduced in all parkinsonian syndromes compared with healthy control subjects, except in PD without RBD. The signal intensity decreased as age increased. Moreover, the signal intensity was lower in MSA than in isolated RBD and PD without RBD groups. In PD, the signal intensity correlated negatively with the percentage of REM sleep without atonia. There were no differences in signal intensity between PD plus RBD, PSP, and MSA. CONCLUSIONS Neuromelanin signal intensity was reduced in all parkinsonian disorders, except in PD without RBD. The presence of RBD in parkinsonian disorders appears to be associated with lower neuromelanin signal intensity. Furthermore, lower LC/LsC signal changes in PSP could be partly caused by the effect of age. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Alexis Nobileau
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- Department de Neuroradiology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Rahul Gaurav
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
| | - Lydia Chougar
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- Department de Neuroradiology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
| | - Alice Faucher
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, Paris, France
- Service de Neurologie, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Romain Valabrègue
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
| | - Graziella Mangone
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- Department de Neurology, Centre d'Investigation Clinique Neurosciences, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Smaranda Leu-Semenescu
- Sleep Disorder Unit, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - François-Xavier Lejeune
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean-Christophe Corvol
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- Department de Neurology, Centre d'Investigation Clinique Neurosciences, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Isabelle Arnulf
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
- Sleep Disorder Unit, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Marie Vidailhet
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
- Department de Neurology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - David Grabli
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- Department de Neurology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Bertrand Degos
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, Paris, France
- Service de Neurologie, Hôpital Avicenne, Hôpitaux Universitaires de Paris-Seine Saint Denis, Sorbonne Paris Nord, Bobigny, France
| | - Stéphane Lehéricy
- Paris Brain Institute (ICM), Sorbonne Université, INSERM U1127, CNRS 7225, Pitié-Salpêtrière Hospital, Paris, France
- ICM, Center for NeuroImaging Research, Paris, France
- Department de Neuroradiology, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
| |
Collapse
|
5
|
Langley J, Hwang KS, Hu XP, Huddleston DE. Nigral volumetric and microstructural measures in individuals with scans without evidence of dopaminergic deficit. Front Neurosci 2022; 16:1048945. [PMID: 36507343 PMCID: PMC9731284 DOI: 10.3389/fnins.2022.1048945] [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: 09/20/2022] [Accepted: 10/28/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Striatal dopamine transporter (DAT) imaging using 123I-ioflupane single photon positron emitted computed tomography (SPECT) (DaTScan, GE) identifies 5-20% of newly diagnosed Parkinson's disease (PD) subjects enrolling in clinical studies to have scans without evidence of dopaminergic deficit (SWEDD). These individuals meet diagnostic criteria for PD, but do not clinically progress as expected, and they are not believed to have neurodegenerative Parkinsonism. Inclusion of SWEDD participants in PD biomarker studies or therapeutic trials may therefore cause them to fail. DaTScan can identify SWEDD individuals, but it is expensive and not widely available; an alternative imaging approach is needed. Here, we evaluate the use of neuromelanin-sensitive, iron-sensitive, and diffusion contrasts in substantia nigra pars compacta (SNpc) to differentiate SWEDD from PD individuals. Methods Neuromelanin-sensitive, iron-sensitive, and diffusion imaging data for SWEDD, PD, and control subjects were downloaded from the Parkinson's progression markers initiative (PPMI) database. SNpc volume, SNpc iron (R 2), and SNpc free water (FW) were measured for each participant. Results Significantly smaller SNpc volume was seen in PD as compared to SWEDD (P < 10-3) and control (P < 10-3) subjects. SNpc FW was elevated in the PD group relative to controls (P = 0.017). No group difference was observed in SNpc R 2. Conclusion In conclusion, nigral volume and FW in the SWEDD group were similar to that of controls, while a reduction in nigral volume and increased FW were observed in the PD group relative to SWEDD and control participants. These results suggest that these MRI measures should be explored as a cost-effective alternative to DaTScan for evaluation of the nigrostriatal system.
Collapse
Affiliation(s)
- Jason Langley
- Center for Advanced Neuroimaging, University of California, Riverside, Riverside, CA, United States
| | - Kristy S. Hwang
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - Xiaoping P. Hu
- Center for Advanced Neuroimaging, University of California, Riverside, Riverside, CA, United States,Department of Bioengineering, University of California, Riverside, Riverside, CA, United States,*Correspondence: Xiaoping P. Hu,
| | - Daniel E. Huddleston
- Department of Neurology, Emory University, Atlanta, GA, United States,Daniel E. Huddleston,
| |
Collapse
|
6
|
Al Haddad R, Chamoun M, Tardif CL, Guimond S, Horga G, Rosa‐Neto P, Cassidy CM. Normative Values of Neuromelanin‐Sensitive
MRI
Signal in Older Adults Obtained Using a Turbo Spin Echo Sequence. J Magn Reson Imaging 2022. [DOI: 10.1002/jmri.28530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Rami Al Haddad
- The Institute of Mental Health Research University of Ottawa Ottawa Ontario Canada
| | - Mira Chamoun
- McGill University Research Centre for Studies in Aging Montreal Quebec Canada
| | | | - Synthia Guimond
- The Institute of Mental Health Research University of Ottawa Ottawa Ontario Canada
| | - Guillermo Horga
- Department of Psychiatry Columbia University New York City New York USA
| | - Pedro Rosa‐Neto
- McGill University Research Centre for Studies in Aging Montreal Quebec Canada
- Montreal Neurological Institute McGill University Montreal Quebec Canada
| | - Clifford M. Cassidy
- The Institute of Mental Health Research University of Ottawa Ottawa Ontario Canada
- McGill University Research Centre for Studies in Aging Montreal Quebec Canada
| |
Collapse
|
7
|
Chougar L, Arsovic E, Gaurav R, Biondetti E, Faucher A, Valabrègue R, Pyatigorskaya N, Dupont G, Lejeune FX, Cormier F, Corvol JC, Vidailhet M, Degos B, Grabli D, Lehéricy S. Regional Selectivity of Neuromelanin Changes in the Substantia Nigra in Atypical Parkinsonism. Mov Disord 2022; 37:1245-1255. [PMID: 35347754 DOI: 10.1002/mds.28988] [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: 11/01/2021] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Neurodegeneration in the substantia nigra pars compacta (SNc) in parkinsonian syndromes may affect the nigral territories differently. OBJECTIVE The objective of this study was to investigate the regional selectivity of neurodegenerative changes in the SNc in patients with Parkinson's disease (PD) and atypical parkinsonism using neuromelanin-sensitive magnetic resonance imaging (MRI). METHODS A total of 22 healthy controls (HC), 38 patients with PD, 22 patients with progressive supranuclear palsy (PSP), 20 patients with multiple system atrophy (MSA, 13 with the parkinsonian variant, 7 with the cerebellar variant), 7 patients with dementia with Lewy body (DLB), and 4 patients with corticobasal syndrome were analyzed. volume and signal-to-noise ratio (SNR) values of the SNc were derived from neuromelanin-sensitive MRI in the whole SNc. Analysis of signal changes was performed in the sensorimotor, associative, and limbic territories of the SNc. RESULTS SNc volume and corrected volume were significantly reduced in PD, PSP, and MSA versus HC. Patients with PSP had lower volume, corrected volume, SNR, and contrast-to-noise ratio than HC and patients with PD and MSA. Patients with PSP had greater SNR reduction in the associative region than HC and patients with PD and MSA. Patients with PD had reduced SNR in the sensorimotor territory, unlike patients with PSP. Patients with MSA did not differ from patients with PD. CONCLUSIONS This study provides the first MRI comparison of the topography of neuromelanin changes in parkinsonism. The spatial pattern of changes differed between PSP and synucleinopathies. These nigral topographical differences are consistent with the topography of the extranigral involvement in parkinsonian syndromes. © 2022 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
- Lydia Chougar
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inria, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, DMU DIAMENT, Department of Neuroradiology, F-75013, Paris, France, Paris, France.,ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France
| | - Emina Arsovic
- ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France.,Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, DMU DIAMENT, Department of Neuroradiology, F-75013, Paris, France, Paris, France
| | - Rahul Gaurav
- ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France.,Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France
| | - Emma Biondetti
- ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France.,Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France
| | - Alice Faucher
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, Paris, France.,Service de Neurologie, Hôpital Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis, APHP, Bobigny, France
| | - Romain Valabrègue
- ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France
| | - Nadya Pyatigorskaya
- ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France.,Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, DMU DIAMENT, Department of Neuroradiology, F-75013, Paris, France, Paris, France
| | - Gwendoline Dupont
- Centre hospitalier universitaire François Mitterrand, Département de Neurologie, Université de Bourgogne, Dijon, France
| | - François-Xavier Lejeune
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France.,ICM, Data and Analysis Core, Paris, France
| | - Florence Cormier
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France.,Clinique des mouvements anormaux, Département de Neurologie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Christophe Corvol
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France.,ICM, Centre d'Investigation Clinique Neurosciences, Paris, France
| | - Marie Vidailhet
- ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France.,Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France.,Clinique des mouvements anormaux, Département de Neurologie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Bertrand Degos
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, Université PSL, Paris, France.,Service de Neurologie, Hôpital Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis, APHP, Bobigny, France
| | - David Grabli
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, F-75013, Paris, France.,Clinique des mouvements anormaux, Département de Neurologie, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - Stéphane Lehéricy
- ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,ICM, Team "Movement Investigations and Therapeutics" (MOV'IT), Paris, France.,Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, AP-HP, Hôpital de la Pitié Salpêtrière, DMU DIAMENT, Department of Neuroradiology, F-75013, Paris, France, Paris, France
| |
Collapse
|
8
|
Fixemer S, Ameli C, Hammer G, Salamanca L, Uriarte Huarte O, Schwartz C, Gérardy JJ, Mechawar N, Skupin A, Mittelbronn M, Bouvier DS. Microglia phenotypes are associated with subregional patterns of concomitant tau, amyloid-β and α-synuclein pathologies in the hippocampus of patients with Alzheimer's disease and dementia with Lewy bodies. Acta Neuropathol Commun 2022; 10:36. [PMID: 35296366 PMCID: PMC8925098 DOI: 10.1186/s40478-022-01342-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/26/2022] Open
Abstract
The cellular alterations of the hippocampus lead to memory decline, a shared symptom between Alzheimer’s disease (AD) and dementia with Lewy Bodies (DLB) patients. However, the subregional deterioration pattern of the hippocampus differs between AD and DLB with the CA1 subfield being more severely affected in AD. The activation of microglia, the brain immune cells, could play a role in its selective volume loss. How subregional microglia populations vary within AD or DLB and across these conditions remains poorly understood. Furthermore, how the nature of the hippocampal local pathological imprint is associated with microglia responses needs to be elucidated. To this purpose, we employed an automated pipeline for analysis of 3D confocal microscopy images to assess CA1, CA3 and DG/CA4 subfields microglia responses in post-mortem hippocampal samples from late-onset AD (n = 10), DLB (n = 8) and age-matched control (CTL) (n = 11) individuals. In parallel, we performed volumetric analyses of hyperphosphorylated tau (pTau), amyloid-β (Aβ) and phosphorylated α-synuclein (pSyn) loads. For each of the 32,447 extracted microglia, 16 morphological features were measured to classify them into seven distinct morphological clusters. Our results show similar alterations of microglial morphological features and clusters in AD and DLB, but with more prominent changes in AD. We identified two distinct microglia clusters enriched in disease conditions and particularly increased in CA1 and DG/CA4 of AD and CA3 of DLB. Our study confirms frequent concomitance of pTau, Aβ and pSyn loads across AD and DLB but reveals a specific subregional pattern for each type of pathology, along with a generally increased severity in AD. Furthermore, pTau and pSyn loads were highly correlated across subregions and conditions. We uncovered tight associations between microglial changes and the subfield pathological imprint. Our findings suggest that combinations and severity of subregional pTau, Aβ and pSyn pathologies transform local microglia phenotypic composition in the hippocampus. The high burdens of pTau and pSyn associated with increased microglial alterations could be a factor in CA1 vulnerability in AD.
Collapse
|
9
|
Doppler CEJ, Kinnerup MB, Brune C, Farrher E, Betts M, Fedorova TD, Schaldemose JL, Knudsen K, Ismail R, Seger AD, Hansen AK, Stær K, Fink GR, Brooks DJ, Nahimi A, Borghammer P, Sommerauer M. Regional locus coeruleus degeneration is uncoupled from noradrenergic terminal loss in Parkinson's disease. Brain 2021; 144:2732-2744. [PMID: 34196700 DOI: 10.1093/brain/awab236] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/18/2021] [Accepted: 06/06/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies have reported substantial involvement of the noradrenergic system in Parkinson's disease. Neuromelanin-sensitive MRI sequences and PET tracers have become available to visualize the cell bodies in the locus coeruleus and the density of noradrenergic terminal transporters. Combining these methods, we investigated the relationship of neurodegeneration in these distinct compartments in Parkinson's disease. We examined 93 subjects (40 healthy controls and 53 Parkinson's disease patients) with neuromelanin-sensitive turbo spin-echo MRI and calculated locus coeruleus-to-pons signal contrasts. Voxels with the highest intensities were extracted from published locus coeruleus coordinates transformed to individual MRI. To also investigate a potential spatial pattern of locus coeruleus degeneration, we extracted the highest signal intensities from the rostral, middle, and caudal third of the locus coeruleus. Additionally, a study-specific probabilistic map of the locus coeruleus was created and used to extract mean MRI contrast from the entire locus coeruleus and each rostro-caudal subdivision. Locus coeruleus volumes were measured using manual segmentations. A subset of 73 subjects had 11C-MeNER PET to determine noradrenaline transporter density, and distribution volume ratios of noradrenaline transporter-rich regions were computed. Parkinson's disease patients showed reduced locus coeruleus MRI contrast independently of the selected method (voxel approaches: p < 0.0001, p < 0.001; probabilistic map: p < 0.05), specifically on the clinically-defined most affected side (p < 0.05), and reduced locus coeruleus volume (p < 0.0001). Reduced MRI contrast was confined to the middle and caudal locus coeruleus (voxel approach-rostral: p = 0.48, middle: p < 0.0001, and caudal: p < 0.05; probabilistic map-rostral: p = 0.90, middle: p < 0.01, and caudal: p < 0.05). The noradrenaline transporter density was lower in Parkinson's disease patients in all examined regions (group effect p < 0.0001). No significant correlation was observed between locus coeruleus MRI contrast and noradrenaline transporter density. In contrast, the individual ratios of noradrenaline transporter density and locus coeruleus MRI contrast were lower in Parkinson's disease patients in all examined regions (group effect p < 0.001). Our multimodal imaging approach revealed pronounced noradrenergic terminal loss relative to cellular locus coeruleus degeneration in Parkinson's disease; the latter followed a distinct spatial pattern with the middle-caudal portion being more affected than the rostral part. The data shed first light on the interaction between the axonal and cell body compartments and their differential susceptibility to neurodegeneration in Parkinson's disease, which may eventually direct research toward potential novel treatment approaches.
Collapse
Affiliation(s)
- Christopher E J Doppler
- Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, D-52425 Jülich, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, D-50937 Köln, Germany
| | - Martin B Kinnerup
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Corinna Brune
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, D-50937 Köln, Germany
| | - Ezequiel Farrher
- Institute of Neuroscience and Medicine (INM-4), Forschungszentrum Jülich, D-52425 Jülich, Germany
| | - Matthew Betts
- German Center for Neurodegenerative Diseases (DZNE), D-39120 Magdeburg, Germany.,Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, D-39120 Magdeburg, Germany.,Center for Behavioral Brain Sciences, University of Magdeburg, D-39120 Magdeburg, Germany
| | - Tatyana D Fedorova
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Jeppe L Schaldemose
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Karoline Knudsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Rola Ismail
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Aline D Seger
- Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, D-52425 Jülich, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, D-50937 Köln, Germany
| | - Allan K Hansen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Kristian Stær
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Gereon R Fink
- Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, D-52425 Jülich, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, D-50937 Köln, Germany
| | - David J Brooks
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark.,Division of Brain Sciences, Imperial College London, London SW7 2AZ, UK.,Institute of Translational and Clinical Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE1 7RU, UK
| | - Adjmal Nahimi
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Michael Sommerauer
- Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, D-52425 Jülich, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, D-50937 Köln, Germany.,Department of Nuclear Medicine and PET, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| |
Collapse
|
10
|
Feraco P, Gagliardo C, La Tona G, Bruno E, D’angelo C, Marrale M, Del Poggio A, Malaguti MC, Geraci L, Baschi R, Petralia B, Midiri M, Monastero R. Imaging of Substantia Nigra in Parkinson's Disease: A Narrative Review. Brain Sci 2021; 11:brainsci11060769. [PMID: 34207681 PMCID: PMC8230134 DOI: 10.3390/brainsci11060769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/02/2021] [Accepted: 06/05/2021] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder, characterized by motor and non-motor symptoms due to the degeneration of the pars compacta of the substantia nigra (SNc) with dopaminergic denervation of the striatum. Although the diagnosis of PD is principally based on a clinical assessment, great efforts have been expended over the past two decades to evaluate reliable biomarkers for PD. Among these biomarkers, magnetic resonance imaging (MRI)-based biomarkers may play a key role. Conventional MRI sequences are considered by many in the field to have low sensitivity, while advanced pulse sequences and ultra-high-field MRI techniques have brought many advantages, particularly regarding the study of brainstem and subcortical structures. Nowadays, nigrosome imaging, neuromelanine-sensitive sequences, iron-sensitive sequences, and advanced diffusion weighted imaging techniques afford new insights to the non-invasive study of the SNc. The use of these imaging methods, alone or in combination, may also help to discriminate PD patients from control patients, in addition to discriminating atypical parkinsonian syndromes (PS). A total of 92 articles were identified from an extensive review of the literature on PubMed in order to ascertain the-state-of-the-art of MRI techniques, as applied to the study of SNc in PD patients, as well as their potential future applications as imaging biomarkers of disease. Whilst none of these MRI-imaging biomarkers could be successfully validated for routine clinical practice, in achieving high levels of accuracy and reproducibility in the diagnosis of PD, a multimodal MRI-PD protocol may assist neuroradiologists and clinicians in the early and differential diagnosis of a wide spectrum of neurodegenerative disorders.
Collapse
Affiliation(s)
- Paola Feraco
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via S. Giacomo 14, 40138 Bologna, Italy;
- Neuroradiology Unit, S. Chiara Hospital, 38122 Trento, Italy;
| | - Cesare Gagliardo
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
- Correspondence:
| | - Giuseppe La Tona
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Eleonora Bruno
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Costanza D’angelo
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Maurizio Marrale
- Department of Physics and Chemistry, University of Palermo, 90128 Palermo, Italy;
| | - Anna Del Poggio
- Department of Neuroradiology and CERMAC, San Raffaele Scientific Institute, San Raffaele Vita-Salute University, 20132 Milan, Italy;
| | | | - Laura Geraci
- Diagnostic and Interventional Neuroradiology Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy;
| | - Roberta Baschi
- Section of Neurology, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (R.B.); (R.M.)
| | | | - Massimo Midiri
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Roberto Monastero
- Section of Neurology, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (R.B.); (R.M.)
| |
Collapse
|
11
|
Vedam-Mai V. Harnessing the immune system for the treatment of Parkinson's disease. Brain Res 2021; 1758:147308. [PMID: 33524380 DOI: 10.1016/j.brainres.2021.147308] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/11/2020] [Accepted: 01/16/2021] [Indexed: 01/03/2023]
Abstract
Current treatment options for Parkinson's disease (PD) typically aim to replace dopamine, and hence only provide symptomatic relief. However, in the long run, this approach alone loses its efficacy as it is associated with debilitating side effects. Hence there is an unmet clinical need for addressing levodopa resistant symptoms, and an urgency to develop therapies that can halt or prevent the course of PD. The premise that α-syn can transmit from cell-to-cell in a prion like manner has opened up the possibility for the use of immunotherapy in PD. There is evidence for inflammation in PD as is evidenced by microglial activation, as well as the involvement of the peripheral immune system in PD, and peripheral inflammation can exacerbate dopaminergic degeneration as seen in animal models of the disease. However, mechanisms that link the immune system with PD are not clear, and the sequence of immune responses with respect to PD are still unknown. Nevertheless, our present knowledge offers avenues for the development of immune-based therapies for PD. In order to successfully employ such strategies, we must comprehend the state of the peripheral immune system during the course of PD. This review describes the developments in the field of both active and passive immunotherapies in the treatment of PD, and highlights the crucial need for future research for clarifying the role of inflammation and immunity in this debilitating disease.
Collapse
|