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Rong D, Hu CP, Yang J, Guo Z, Liu W, Yu M. Consistent abnormal activity in the putamen by dopamine modulation in Parkinson's disease: A resting-state neuroimaging meta-analysis. Brain Res Bull 2024; 210:110933. [PMID: 38508469 DOI: 10.1016/j.brainresbull.2024.110933] [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: 11/09/2023] [Revised: 02/16/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE This study aimed to elucidate brain areas mediated by oral anti-parkinsonian medicine that consistently show abnormal resting-state activation in PD and to reveal their functional connectivity profiles using meta-analytic approaches. METHODS Searches of the PubMed, Web of Science databases identified 78 neuroimaging studies including PD OFF state (PD-OFF) versus (vs.) PD ON state (PD-ON) or PD-ON versus healthy controls (HCs) or PD-OFF versus HCs data. Coordinate-based meta-analysis and functional meta-analytic connectivity modeling (MACM) were performed using the activation likelihood estimation algorithm. RESULTS Brain activation in PD-OFF vs. PD-ON was significantly changed in the right putamen and left inferior parietal lobule (IPL). Contrast analysis indicated that PD-OFF vs. HCs had more consistent activation in the right paracentral lobule, right middle frontal gyrus, right thalamus, left superior parietal lobule and right putamen, whereas PD-ON vs. HCs elicited more consistent activation in the bilateral middle temporal gyrus, left occipital gyrus, right inferior frontal gyrus and right caudate. MACM revealed coactivation of the right putamen in the direct contrast of PD-OFF vs. PD-ON. Subtraction analysis of significant coactivation clusters for PD-OFF vs. PD-ON with the medium of HCs showed effects in the sensorimotor, top-down control, and visual networks. By overlapping the MACM maps of the two analytical strategies, we demonstrated that the coactivated brain region focused on the right putamen. CONCLUSIONS The convergence of local brain regions and co-activation neural networks are involved the putamen, suggesting its potential as a specific imaging biomarker to monitor treatment efficacy. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD CRD42022304150].
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Affiliation(s)
- Danyan Rong
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China
| | - Chuan-Peng Hu
- School of Psychology, Nanjing Normal University, No.122, Ninghai Road, Gulou District, Nanjing, Jiangsu 210024, China
| | - Jiaying Yang
- Department of Public Health, School of Medicine & Holistic Integrative Medicine, Nanjing University of Chinese Medicine, No.138, Xianlin Road, Nanjing, Jiangsu 210023, China
| | - Zhiying Guo
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China
| | - Weiguo Liu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China.
| | - Miao Yu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, No.264, Guangzhou Road, Gulou District, Nanjing, Jiangsu 210029, China.
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Circulating N-Acetylaspartate does not track brain NAA concentrations, cognitive function or features of small vessel disease in humans. Sci Rep 2022; 12:11530. [PMID: 35798828 PMCID: PMC9262942 DOI: 10.1038/s41598-022-15670-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/15/2022] [Indexed: 01/07/2023] Open
Abstract
N-acetylaspartate (NAA) is the second most abundant metabolite in the human brain; although it is assumed to be a proxy for a neuronal marker, its function is not fully elucidated. NAA is also detectable in plasma, but its relation to cerebral NAA levels, cognitive performance, or features of cerebral disease has not been investigated. To study whether circulating NAA tracks cerebral NAA levels, and whether circulating NAA correlates with cognitive function and features of cerebral small vessel disease (SVD). Two datasets were analyzed. In dataset 1, structural MRI was acquired in 533 subjects to assess four features of cerebral SVD. Cognitive function was evaluated with standardized test scores (N = 824). In dataset 2, brain 1H-MRS from the occipital region was acquired (N = 49). In all subjects, fasting circulating NAA was measured with mass spectrometry. Dataset 1: in univariate and adjusted for confounders models, we found no correlation between circulating NAA and the examined features of cerebral SVD. In univariate analysis, circulating NAA levels were associated inversely with the speed in information processing and the executive function score, however these associations were lost after accounting for confounders. In line with the negative findings of dataset 1, in dataset 2 there was no correlation between circulating and central NAA or total NAA levels. This study indicates that circulating NAA levels do not reflect central (occipital) NAA levels, cognitive function, or cerebral small vessel disease in man.
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Klietz M, Bronzlik P, Nösel P, Wegner F, Dressler DW, Dadak M, Maudsley AA, Sheriff S, Lanfermann H, Ding XQ. Altered Neurometabolic Profile in Early Parkinson's Disease: A Study With Short Echo-Time Whole Brain MR Spectroscopic Imaging. Front Neurol 2019; 10:777. [PMID: 31379726 PMCID: PMC6651356 DOI: 10.3389/fneur.2019.00777] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 07/03/2019] [Indexed: 12/11/2022] Open
Abstract
Objective: To estimate alterations in neurometabolic profile of patients with early stage Parkinson's disease (PD) by using a short echo-time whole brain magnetic resonance spectroscopic imaging (wbMRSI) as possible biomarker for early diagnosis and monitoring of PD. Methods: 20 PD patients in early stage (H&Y ≤ 2) without evidence of severe other diseases and 20 age and sex matched healthy controls underwent wbMRSI. In each subject brain regional concentrations of metabolites N-acetyl-aspartate (NAA), choline (Cho), total creatine (tCr), glutamine (Gln), glutamate (Glu), and myo-inositol (mIns) were obtained in atlas-defined lobar structures including subcortical basal ganglia structures (the left and right frontal lobes, temporal lobes, parietal lobes, occipital lobes, and the cerebellum) and compared between patients and matched healthy controls. Clinical characteristics of the PD patients were correlated with spectroscopic findings. Results: In comparison to controls the PD patients revealed altered lobar metabolite levels in all brain lobes contralateral to dominantly affected body side, i.e., decreases of temporal NAA, Cho, and tCr, parietal NAA and tCr, and frontal as well as occipital NAA. The frontal NAA correlated negatively with the MDS-UPDRS II (R = 22120.585, p = 0.008), MDS-UPDRS IV (R = −0.458, p = 0.048) and total MDS-UPDRS scores (R = −0.679, p = 0.001). Conclusion: In early PD stages metabolic alterations are evident in all contralateral brain lobes demonstrating that the neurodegenerative process affects not only local areas by dopaminergic denervation, but also the functional network within different brain regions. The wbMRSI-detectable brain metabolic alterations reveal the potential to serve as biomarkers for early PD.
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Affiliation(s)
- Martin Klietz
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Paul Bronzlik
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Patrick Nösel
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Florian Wegner
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Dirk W Dressler
- Department of Neurology, Hannover Medical School, Hanover, Germany
| | - Mete Dadak
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
| | - Andrew A Maudsley
- Department of Radiology, University of Miami School of Medicine, Miami, FL, United States
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami School of Medicine, Miami, FL, United States
| | | | - Xiao-Qi Ding
- Department of Neuroradiology, Hannover Medical School, Hanover, Germany
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Geiszler PC, Ugun-Klusek A, Lawler K, Pardon MC, Yuchun D, Bai L, Daykin CA, Auer DP, Bedford L. Dynamic metabolic patterns tracking neurodegeneration and gliosis following 26S proteasome dysfunction in mouse forebrain neurons. Sci Rep 2018; 8:4833. [PMID: 29555943 PMCID: PMC5859111 DOI: 10.1038/s41598-018-23155-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/02/2018] [Indexed: 01/23/2023] Open
Abstract
Metabolite profiling is an important tool that may better capture the multiple features of neurodegeneration. With the considerable parallels between mouse and human metabolism, the use of metabolomics in mouse models with neurodegenerative pathology provides mechanistic insight and ready translation into aspects of human disease. Using 400 MHz nuclear magnetic resonance spectroscopy we have carried out a temporal region-specific investigation of the metabolome of neuron-specific 26S proteasome knockout mice characterised by progressive neurodegeneration and Lewy-like inclusion formation in the forebrain. An early significant decrease in N-acetyl aspartate revealed evidence of neuronal dysfunction before cell death that may be associated with changes in brain neuroenergetics, underpinning the use of this metabolite to track neuronal health. Importantly, we show early and extensive activation of astrocytes and microglia in response to targeted neuronal dysfunction in this context, but only late changes in myo-inositol; the best established glial cell marker in magnetic resonance spectroscopy studies, supporting recent evidence that additional early neuroinflammatory markers are needed. Our results extend the limited understanding of metabolite changes associated with gliosis and provide evidence that changes in glutamate homeostasis and lactate may correlate with astrocyte activation and have biomarker potential for tracking neuroinflammation.
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Affiliation(s)
- Philippine C Geiszler
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Aslihan Ugun-Klusek
- School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - Karen Lawler
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | | | - Ding Yuchun
- School of Computing, University of Newcastle, Newcastle, UK
| | - Li Bai
- School of Computer Sciences, University of Nottingham, Nottingham, UK
| | - Clare A Daykin
- School of Pharmacy, University of Nottingham, Nottingham, UK.,Metaboconsult UK, Heanor, Derbyshire, UK
| | - Dorothee P Auer
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK. .,Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Lynn Bedford
- School of Life Sciences, University of Nottingham, Nottingham, UK.
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Cao H, Shi J, Cao B, Kang B, Zhang M, Qu Q. Evaluation of the Braak staging of brain pathology with 1 H-MRS in patients with Parkinson’s disease. Neurosci Lett 2017; 660:57-62. [DOI: 10.1016/j.neulet.2017.08.050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 08/08/2017] [Accepted: 08/20/2017] [Indexed: 11/17/2022]
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Schreiner SJ, Kirchner T, Wyss M, Van Bergen JM, Quevenco FC, Steininger SC, Griffith EY, Meier I, Michels L, Gietl AF, Leh SE, Brickman AM, Hock C, Nitsch RM, Pruessmann KP, Henning A, Unschuld PG. Low episodic memory performance in cognitively normal elderly subjects is associated with increased posterior cingulate gray matter N-acetylaspartate: a 1H MRSI study at 7 Tesla. Neurobiol Aging 2016; 48:195-203. [DOI: 10.1016/j.neurobiolaging.2016.08.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 08/03/2016] [Accepted: 08/24/2016] [Indexed: 11/30/2022]
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Using Tractography to Distinguish SWEDD from Parkinson's Disease Patients Based on Connectivity. PARKINSONS DISEASE 2016; 2016:8704910. [PMID: 27034889 PMCID: PMC4789533 DOI: 10.1155/2016/8704910] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/03/2016] [Accepted: 02/10/2016] [Indexed: 11/18/2022]
Abstract
Background. It is critical to distinguish between Parkinson's disease (PD) and scans without evidence of dopaminergic deficit (SWEDD), because the two groups are different and require different therapeutic approaches. Objective. The aim of this study was to distinguish SWEDD patients from PD patients using connectivity information derived from diffusion tensor imaging tractography. Methods. Diffusion magnetic resonance images of SWEDD (n = 37) and PD (n = 40) were obtained from a research database. Tractography, the process of obtaining neural fiber information, was performed using custom software. Group-wise differences between PD and SWEDD patients were quantified using the number of connected fibers between two regions, and correlation analyses were performed based on clinical scores. A support vector machine classifier (SVM) was applied to distinguish PD and SWEDD based on group-wise differences. Results. Four connections showed significant group-wise differences and correlated with the Unified Parkinson's Disease Rating Scale sponsored by the Movement Disorder Society. The SVM classifier attained 77.92% accuracy in distinguishing between SWEDD and PD using these identified connections. Conclusions. The connections and regions identified represent candidates for future research investigations.
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Algarni MA, Stoessl AJ. The role of biomarkers and imaging in Parkinson’s disease. Expert Rev Neurother 2016; 16:187-203. [DOI: 10.1586/14737175.2016.1135056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Mazuel L, Chassain C, Jean B, Pereira B, Cladière A, Speziale C, Durif F. Proton MR Spectroscopy for Diagnosis and Evaluation of Treatment Efficacy in Parkinson Disease. Radiology 2015; 278:505-13. [PMID: 26237591 DOI: 10.1148/radiol.2015142764] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess the neurochemical profile in the putamen of patients with parkinsonian syndromes undergoing L-3,4-dihydroxyphenylalanine (L-DOPA) treatment (drug-on) or after withdrawal of L-DOPA medication (drug-off) compared with healthy volunteers to identify dopaminergic therapy-sensitive biomarkers of Parkinson disease. MATERIALS AND METHODS The local institutional review board approved the study, and all participants gave informed consent. A short echo-time (29 msec) single-voxel (1-cm(3)) proton (hydrogen 1 [(1)H]) magnetic resonance (MR) spectroscopic approach was used at 3 T to explore the metabolic profile in the putamen of patients with Parkinson disease. Spectra obtained from 20 healthy volunteers were blindly compared with spectra obtained from 20 patients with parkinsonian syndromes in drug-on and drug-off conditions in a randomized permuted block study to assess the accuracy of diagnostic biomarkers for Parkinson disease and efficacy of L-DOPA therapy. The statistical tests were two sided, with a type-I error set at α of .05. Random-effects models were used to compare healthy subjects and patients with parkinsonian syndromes in drug-on or drug-off conditions. RESULTS Measured concentrations of putaminal total N-acetylaspartate (tNAA) (8.1 ± 0.2 vs 9.4 ± 0.4; P < .01), total creatine (tCr) (7.5 ± 0.2 vs 8.3 ± 0.3; P < .01), and myo-inositol (m-Ins) (3.8 ± 0.3 vs 5.6 ± 0.4; P < .001) were significantly lower in patients with parkinsonian syndromes in drug-off condition than in healthy volunteers. Moreover, L-DOPA therapy restored tNAA (9.1 ± 0.4 vs 8.1 ± 0.2; P < .01) and tCr (8.1 ± 0.3 vs 7.5 ± 0.2; P < .01) levels, whereas m-Ins levels remained unchanged. The combined glutamate and glutamine and choline showed no changes in drug-off or drug-on condition compared with those in control subjects. CONCLUSION tNAA, tCr, and m-Ins were identified as putative biomarkers of Parkinson disease in the putamen of patients. tNAA and tCr levels are responsive to L-DOPA therapy.
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Affiliation(s)
- Leslie Mazuel
- From the Department of UFR Medicine, Auvergne University, EA7280, Clermont-Ferrand, France (L.M., F.D.); Center for Magnetic Resonance Imaging (C.C., B.J., A.C., C.S.) and Department of Neurology (B.P., F.D.), CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France
| | - Carine Chassain
- From the Department of UFR Medicine, Auvergne University, EA7280, Clermont-Ferrand, France (L.M., F.D.); Center for Magnetic Resonance Imaging (C.C., B.J., A.C., C.S.) and Department of Neurology (B.P., F.D.), CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France
| | - Betty Jean
- From the Department of UFR Medicine, Auvergne University, EA7280, Clermont-Ferrand, France (L.M., F.D.); Center for Magnetic Resonance Imaging (C.C., B.J., A.C., C.S.) and Department of Neurology (B.P., F.D.), CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France
| | - Bruno Pereira
- From the Department of UFR Medicine, Auvergne University, EA7280, Clermont-Ferrand, France (L.M., F.D.); Center for Magnetic Resonance Imaging (C.C., B.J., A.C., C.S.) and Department of Neurology (B.P., F.D.), CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France
| | - Aurélie Cladière
- From the Department of UFR Medicine, Auvergne University, EA7280, Clermont-Ferrand, France (L.M., F.D.); Center for Magnetic Resonance Imaging (C.C., B.J., A.C., C.S.) and Department of Neurology (B.P., F.D.), CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France
| | - Claudine Speziale
- From the Department of UFR Medicine, Auvergne University, EA7280, Clermont-Ferrand, France (L.M., F.D.); Center for Magnetic Resonance Imaging (C.C., B.J., A.C., C.S.) and Department of Neurology (B.P., F.D.), CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France
| | - Franck Durif
- From the Department of UFR Medicine, Auvergne University, EA7280, Clermont-Ferrand, France (L.M., F.D.); Center for Magnetic Resonance Imaging (C.C., B.J., A.C., C.S.) and Department of Neurology (B.P., F.D.), CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France
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Öz G. MR Spectroscopy: A Longitudinal Biomarker for Substantia Nigra Pathology in Parkinson's Disease? Mov Disord 2015; 30:1304-5. [PMID: 26184363 DOI: 10.1002/mds.26322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/07/2015] [Indexed: 11/09/2022] Open
Affiliation(s)
- Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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Zanigni S, Testa C, Calandra-Buonaura G, Sambati L, Guarino M, Gabellini A, Evangelisti S, Cortelli P, Lodi R, Tonon C. The contribution of cerebellar proton magnetic resonance spectroscopy in the differential diagnosis among parkinsonian syndromes. Parkinsonism Relat Disord 2015; 21:929-37. [PMID: 26077167 DOI: 10.1016/j.parkreldis.2015.05.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/07/2015] [Accepted: 05/31/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The in vivo differential diagnosis between idiopathic Parkinson's disease (PD) and atypical parkinsonian syndromes (PS), such as multiple system atrophy [MSA with a cerebellar (C) and parkinsonian (P) subtype] and progressive supranuclear palsy - Richardson's Syndrome (PSP-RS) is often challenging. Previous brain MR proton spectroscopy ((1)H-MRS) studies showed biochemical alterations in PS, despite results are conflicting. Cerebellum plays a central role in motor control and its alterations has been already demonstrated in atypical PS. The main aim of this study was to evaluate diagnostic accuracy of cerebellar (1)H-MRS in the differential diagnosis between PD and atypical PS. METHODS We obtained (1)H-MRS spectra from the left cerebellar hemisphere of 57 PS (21 PD, and 36 atypical PS) and 14 unaffected controls by using a 1.5 T GE scanner. N-acetyl-aspartate (NAA)/Creatine (Cr), choline-containing compounds (Cho)/Cr, myoinositol (mI)/Cr, and NAA/mI ratios were calculated. RESULTS NAA/Cr and NAA/mI ratios were significantly lower (p < 0.01) in atypical PS compared to PD and controls, and in MSA-C compared to PD, MSA-P, PSP-RS and controls. PSP-RS group showed reduced NAA/Cr ratios compared to PD (p < 0.05) and controls (p < 0.05), and reduced NAA/mI compared to controls (p < 0.01). NAA/Cr ratio values higher than 1.016 showed 100% sensitivity and negative predictive value, 62% positive predictive value and 64% specificity in discriminating PD. CONCLUSION Cerebellar biochemical alterations detected by using (1)H-MRS could represent an adjunctive diagnostic tool to improve the differential diagnosis of PS.
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Affiliation(s)
- Stefano Zanigni
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy
| | - Claudia Testa
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna (IT), Via Altura 3, 40139 Bologna, Italy
| | - Luisa Sambati
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna (IT), Via Altura 3, 40139 Bologna, Italy
| | - Maria Guarino
- Neurology Unit, Policlinico S. Orsola - Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy
| | - Anna Gabellini
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna (IT), Via Altura 3, 40139 Bologna, Italy; Neurology Unit, Ospedale Maggiore, Bologna (IT), Via B. Nigrisoli 2, 40133 Bologna, Italy
| | - Stefania Evangelisti
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy
| | - Pietro Cortelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna (IT), Via Altura 3, 40139 Bologna, Italy
| | - Raffaele Lodi
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy.
| | - Caterina Tonon
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna (IT), Via Massarenti 9, 40138 Bologna, Italy; Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna (IT), Via U. Foscolo 7, 40123 Bologna, Italy
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Ciurleo R, Bonanno L, Di Lorenzo G, Bramanti P, Marino S. Metabolic changes in de novo Parkinson's disease after dopaminergic therapy: A proton magnetic resonance spectroscopy study. Neurosci Lett 2015; 599:55-60. [PMID: 26007705 DOI: 10.1016/j.neulet.2015.05.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 05/14/2015] [Accepted: 05/21/2015] [Indexed: 01/26/2023]
Abstract
The aim of this study was to assess metabolic changes in the motor cortex in de novo Parkinson's disease (PD) patients before and after therapy with ropinirole. Twenty de novo drug-naïve PD patients and 15 healthy controls underwent conventional magnetic resonance imaging and proton magnetic resonance spectroscopy imaging ((1)H-MRSI). The resonance intensities of N-acetylaspartate (NAA) and choline (Cho) were normalized for the resonance intensities of creatine (Cr). At baseline, lower NAA/Cr and NAA/Cho ratios and higher Cho/Cr ratios were found in the motor cortex of PD patients compared with controls (p<0.001). Ten months after ropinirole treatment, PD patients showed a significant clinical improvement in the UPDRS motor sub-scores (p<0.001) and an increase of NAA/Cr and NAA/Cho ratios (p<0.006 and p=0.01, respectively). A highly significant correlation between NAA/Cr and NAA/Cho ratios and UPDRS motor sub-scores was observed (r=-0.981 and r=-0.983, respectively). We could argue that the ropinirole efficacy to improve the motor performances is the result of partial restoration of neuronal functions, due to the increase of NAA in motor cortex.
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Affiliation(s)
| | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy
| | | | | | - Silvia Marino
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Italy; Department of Biomedical Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy.
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Lei S, Zavala-Flores L, Garcia-Garcia A, Nandakumar R, Huang Y, Madayiputhiya N, Stanton RC, Dodds ED, Powers R, Franco R. Alterations in energy/redox metabolism induced by mitochondrial and environmental toxins: a specific role for glucose-6-phosphate-dehydrogenase and the pentose phosphate pathway in paraquat toxicity. ACS Chem Biol 2014; 9:2032-48. [PMID: 24937102 PMCID: PMC4168797 DOI: 10.1021/cb400894a] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
![]()
Parkinson’s
disease (PD) is a multifactorial disorder with
a complex etiology including genetic risk factors, environmental exposures,
and aging. While energy failure and oxidative stress have largely
been associated with the loss of dopaminergic cells in PD and the
toxicity induced by mitochondrial/environmental toxins, very little
is known regarding the alterations in energy metabolism associated
with mitochondrial dysfunction and their causative role in cell death
progression. In this study, we investigated the alterations in the
energy/redox-metabolome in dopaminergic cells exposed to environmental/mitochondrial
toxins (paraquat, rotenone, 1-methyl-4-phenylpyridinium [MPP+], and 6-hydroxydopamine [6-OHDA]) in order to identify common and/or
different mechanisms of toxicity. A combined metabolomics approach
using nuclear magnetic resonance (NMR) and direct-infusion electrospray
ionization mass spectrometry (DI-ESI-MS) was used to identify unique
metabolic profile changes in response to these neurotoxins. Paraquat
exposure induced the most profound alterations in the pentose phosphate
pathway (PPP) metabolome. 13C-glucose flux analysis corroborated
that PPP metabolites such as glucose-6-phosphate, fructose-6-phosphate,
glucono-1,5-lactone, and erythrose-4-phosphate were increased by paraquat
treatment, which was paralleled by inhibition of glycolysis and the
TCA cycle. Proteomic analysis also found an increase in the expression
of glucose-6-phosphate dehydrogenase (G6PD), which supplies reducing
equivalents by regenerating nicotinamide adenine dinucleotide phosphate
(NADPH) levels. Overexpression of G6PD selectively increased paraquat
toxicity, while its inhibition with 6-aminonicotinamide inhibited
paraquat-induced oxidative stress and cell death. These results suggest
that paraquat “hijacks” the PPP to increase NADPH reducing
equivalents and stimulate paraquat redox cycling, oxidative stress,
and cell death. Our study clearly demonstrates that alterations in
energy metabolism, which are specific for distinct mitochondiral/environmental
toxins, are not bystanders to energy failure but also contribute significant
to cell death progression.
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Affiliation(s)
| | | | | | | | | | | | - Robert C. Stanton
- Research
Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02115, United States
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Magnetic resonance spectroscopy: an in vivo molecular imaging biomarker for Parkinson's disease? BIOMED RESEARCH INTERNATIONAL 2014; 2014:519816. [PMID: 25302300 PMCID: PMC4180390 DOI: 10.1155/2014/519816] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/14/2014] [Accepted: 08/31/2014] [Indexed: 11/17/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder caused by selective loss of dopaminergic neurons in the substantia nigra pars compacta which leads to dysfunction of cerebral pathways critical for the control of movements. The diagnosis of PD is based on motor symptoms, such as bradykinesia, akinesia, muscular rigidity, postural instability, and resting tremor, which are evident only after the degeneration of a significant number of dopaminergic neurons. Currently, a marker for early diagnosis of PD is still not available. Consequently, also the development of disease-modifying therapies is a challenge. Magnetic resonance spectroscopy is a quantitative imaging technique that allows in vivo measurement of certain neurometabolites and may produce biomarkers that reflect metabolic dysfunctions and irreversible neuronal damage. This review summarizes the abnormalities of cerebral metabolites found in MRS studies performed in patients with PD and other forms of parkinsonism. In addition, we discuss the potential role of MRS as in vivo molecular imaging biomarker for early diagnosis of PD and for monitoring the efficacy of therapeutic interventions.
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Ng TS, Lin AP, Koerte IK, Pasternak O, Liao H, Merugumala S, Bouix S, Shenton ME. Neuroimaging in repetitive brain trauma. ALZHEIMERS RESEARCH & THERAPY 2014; 6:10. [PMID: 25031630 PMCID: PMC3978843 DOI: 10.1186/alzrt239] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sports-related concussions are one of the major causes of mild traumatic brain injury. Although most patients recover completely within days to weeks, those who experience repetitive brain trauma (RBT) may be at risk for developing a condition known as chronic traumatic encephalopathy (CTE). While this condition is most commonly observed in athletes who experience repetitive concussive and/or subconcussive blows to the head, such as boxers, football players, or hockey players, CTE may also affect soldiers on active duty. Currently, the only means by which to diagnose CTE is by the presence of phosphorylated tau aggregations post-mortem. Non-invasive neuroimaging, however, may allow early diagnosis as well as improve our understanding of the underlying pathophysiology of RBT. The purpose of this article is to review advanced neuroimaging methods used to investigate RBT, including diffusion tensor imaging, magnetic resonance spectroscopy, functional magnetic resonance imaging, susceptibility weighted imaging, and positron emission tomography. While there is a considerable literature using these methods in brain injury in general, the focus of this review is on RBT and those subject populations currently known to be susceptible to RBT, namely athletes and soldiers. Further, while direct detection of CTE in vivo has not yet been achieved, all of the methods described in this review provide insight into RBT and will likely lead to a better characterization (diagnosis), in vivo, of CTE than measures of self-report.
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Affiliation(s)
- Thomas Sc Ng
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 4 Blackfan Circle, Boston, MA 02115, USA ; Keck School of Medicine of the University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA
| | - Alexander P Lin
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 4 Blackfan Circle, Boston, MA 02115, USA ; Psychiatric Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215, USA
| | - Inga K Koerte
- Psychiatric Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215, USA ; Institute for Clinical Radiology, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Munich, Germany
| | - Ofer Pasternak
- Psychiatric Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215, USA
| | - Huijun Liao
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 4 Blackfan Circle, Boston, MA 02115, USA
| | - Sai Merugumala
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 4 Blackfan Circle, Boston, MA 02115, USA
| | - Sylvain Bouix
- Psychiatric Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215, USA
| | - Martha E Shenton
- Psychiatric Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, 1249 Boylston Street, Boston, MA 02215, USA ; Research and Development, VA Boston Healthcare System, 850 Belmont Street, Brockton, MA 02130, USA
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Application of proton magnetic resonance spectroscopy on substantia nigra metabolites in Parkinson’s disease. Brain Imaging Behav 2013; 8:97-101. [DOI: 10.1007/s11682-013-9251-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nie K, Zhang Y, Huang B, Wang L, Zhao J, Huang Z, Gan R, Wang L. Marked N-acetylaspartate and choline metabolite changes in Parkinson's disease patients with mild cognitive impairment. Parkinsonism Relat Disord 2013; 19:329-34. [DOI: 10.1016/j.parkreldis.2012.11.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 11/15/2012] [Accepted: 11/22/2012] [Indexed: 11/30/2022]
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Levin BE, Katzen HL, Maudsley A, Post J, Myerson C, Govind V, Nahab F, Scanlon B, Mittel A. Whole-brain proton MR spectroscopic imaging in Parkinson's disease. J Neuroimaging 2012; 24:39-44. [PMID: 23228009 DOI: 10.1111/j.1552-6569.2012.00733.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 05/03/2012] [Accepted: 05/28/2011] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE To examine the distributions of proton magnetic resonance spectroscopy (MRS) observed metabolites in Parkinson's disease (PD) throughout the whole brain. METHODS Twelve PD patients and 18 age-matched controls were studied using neuropsychological testing, MRI and volumetric MR spectroscopic imaging. Average values of signal normalized metabolite values for N-acetyl-aspartate, total-creatine, and total-choline (NAA, total-Cre, total-Cho, respectively) and their ratios were calculated for gray matter (GM) and white matter (WM) in each lobar brain region. RESULTS Analyses revealed altered metabolite values in PD subjects relative to controls within the GM of the temporal lobe (right: elevated Cre, P = .027; decreased NAA/Cre, P = .019; decreased Cho/Cre, P = .001 and left: decreased NAA/Cre; P = .001, decreased Cho/Cre, P = .007); the right occipital lobe (decreased NAA, P = .032 and NAA/Cre, P = .016); and the total cerebrum GM (decreased NAA/Cre, P = .029). No meaningful correlations were obtained between abnormal metabolite values and the neuropsychological measures. CONCLUSIONS PD is associated with widespread alterations of brain metabolite concentrations, with a primary finding of increased creatine. Higher creatine values in our PD sample may reflect greater neuronal energy expenditure early in the disease process that is compensatory. This is the first whole brain MRS study of PD that has examined metabolite changes across a large fraction of the brain volume, including the cortical mantle.
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Affiliation(s)
- Bonnie E Levin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL; Department of Psychology, University of Miami, Coral Gables, FL
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Kim SY, Choe BY, Lee HS, Lee DW, Ryu KN, Park JS, Yin CS, Hong KS, Lee CH, Choi CB. Forelimb akinesia and metabolic alteration in the striatum following unilateral 6-hydroxydopamine lesion in rats: An in vivo proton magnetic resonance spectroscopy study. NEUROCHEM J+ 2011. [DOI: 10.1134/s1819712411040088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Planetta PJ, Prodoehl J, Corcos DM, Vaillancourt DE. Use of MRI to monitor Parkinson’s disease. Neurodegener Dis Manag 2011. [DOI: 10.2217/nmt.10.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
SUMMARY Objective biological markers of Parkinson’s disease (PD) are pivotal for confirming diagnosis, monitoring disease progression, and evaluating therapeutic interventions and disease-modifying agents. Structural and functional MRI provide an in vivo means to investigate the cortical and subcortical regions known to be affected in PD. In this article, we summarize how several MRI techniques, namely conventional MRI, iron-based MRI, volume-based MRI, diffusion tensor imaging, magnetic resonance spectroscopy and functional MRI have been used to assess the neurobiological changes related to the motor features of PD. We also discuss promising new research in which multiple MRI techniques are combined to achieve greater sensitivity and specificity of disease detection. Longitudinal research is necessary to establish MRI techniques as viable disease-state biomarkers of PD.
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Affiliation(s)
- Peggy J Planetta
- Department of Kinesiology & Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Janey Prodoehl
- Department of Kinesiology & Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Daniel M Corcos
- Department of Kinesiology & Nutrition, University of Illinois at Chicago, Chicago, IL, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David E Vaillancourt
- Department of Neurology & Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
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21
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Abstract
Parkinson's disease (PD) is a common disorder in which the primary features can be related to dopamine deficiency. Changes on structural imaging are limited, but a wealth of abnormalities can be detected using positron emission tomography, single photon emission computed tomography, or functional magnetic resonance imaging to detect changes in neurochemical pathology or functional connectivity. The changes detected on these studies may reflect the disease process itself and/or compensatory responses to the disease, or they may arise in association with disease- and/or treatment-related complications. This review will focus mainly on neurochemical and metabolic studies and reviews various approaches to the assessment of dopaminergic function as well as the function of other neurotransmitters that may be affected in PD. A number of clinical applications are highlighted, including diagnostic utility, identification of preclinical disease, changes associated with motor and nonmotor complications of PD, and the effects of various therapeutic interventions.
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Affiliation(s)
- A Jon Stoessl
- Pacific Parkinson's Research Centre, University of British Columbia & Vancouver Coastal Health, Vancouver, British Columbia, Canada.
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22
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Magnetic resonance spectroscopic methods for the assessment of metabolic functions in the diseased brain. Curr Top Behav Neurosci 2011; 11:169-98. [PMID: 22076698 DOI: 10.1007/7854_2011_166] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Magnetic resonance spectroscopy (MRS) is a non-invasive technique that can be used to detect and quantify multiple metabolites. This chapter will review some of the applications of MRS to the study of brain functions. Typically, (1)H-MRS can detect metabolites reflecting neuronal density and integrity, markers of energy metabolism or inflammation, as well as neurotransmitters. The complexity of the proton spectrum has however led to the development of other nuclei-based methods, such as (31)P- and (13)C-MRS, which offer a broader chemical shift range and therefore can provide more detailed information at the level of single metabolites. The versatility of MRS allows for a wide range of clinical applications, of which neurodegeneration is an interesting target for spectroscopy-based studies. In particular, MRS can identify patterns of altered brain chemistry in Alzheimer's patients and can help establish differential diagnosis in Alzheimer's and Parkinson's diseases. Using MRS to follow less abundant neurotransmitters is currently out of reach and will most likely depend on the development of methods such as hyperpolarization that can increase the sensitivity of detection. In particular, dynamic nuclear polarization has opened up a new and exciting area of medical research, with developments that could greatly impact on the real-time monitoring of in vivo metabolic processes in the brain.
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Choi CB, Kim SY, Lee SH, Jahng GH, Kim HY, Choe BY, Ryu KN, Yang DM, Yim SV, Choi WS. Assessment of metabolic changes in the striatum of a MPTP-intoxicated canine model: in vivo ¹H-MRS study of an animal model for Parkinson's disease. Magn Reson Imaging 2010; 29:32-9. [PMID: 20980117 DOI: 10.1016/j.mri.2010.03.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 12/29/2009] [Accepted: 03/11/2010] [Indexed: 01/16/2023]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of the dopaminergic neurons in the substantia nigra pars compacta, which projects to the striatum. We induced a selective loss of nigrostriatal dopamine neurons, by infusing the mitochondrial complex 1 inhibitor 1-methyl 4-phenyl 1,2,3,6-tetrahydropyridine (MPTP) into adult beagle dogs (N=5). Single voxel ¹H water suppressed magnetic resonance spectroscopy (¹H-MRS) at 3 T was used to assess the metabolic changes in the striatum of canine before and after MPTP intoxication. The metabolite spectra obtained from the striatum (voxel size: 2 cm³) showed a lower N-acetyl aspartate to total creatine (creatine+phosphocreatine) ratio after MPTP intoxication. There were no significant differences in other metabolite ratios such as glutamate+glutamine, choline-containing compounds (glycerophosphocholine+phophorylcholine and myo-inositol). Our findings indicated that ¹H-MRS is a sensitive, noninvasive measure of neural toxicity and biochemical alterations of the striatum in a canine model of PD, and further studies are needed to confirm brain metabolic changes in association with progression of MPTP-intoxication.
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Affiliation(s)
- Chi-Bong Choi
- Department of Radiology, Kyung Hee University Medical Center, School of Medicine, Kyung Hee University, Seoul 130-702, Republic of Korea
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Guevara CA, Blain CR, Stahl D, Lythgoe DJ, Leigh PN, Barker GJ. Quantitative magnetic resonance spectroscopic imaging in Parkinson's disease, progressive supranuclear palsy and multiple system atrophy. Eur J Neurol 2010; 17:1193-1202. [PMID: 20402762 DOI: 10.1111/j.1468-1331.2010.03010.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Magnetic resonance spectroscopy (MRS) allows the measurement of a number of brain tissue metabolites in vivo, including N-acetylaspartate (NAA), a putative marker of neuronal integrity. Unlike single voxel MRS, magnetic resonance spectroscopic imaging (MRSI) enables quantification of these metabolites simultaneously from multiple anatomically localized voxels. Both single voxel MRS and MRSI allow the absolute quantification of these metabolites and, when combined with tissue segmentation, can give accurate metabolite concentrations even in the presence of partial volume effects from nearby cerebrospinal fluid. METHODS Using MRSI with cubic voxels with a nominal volume of 1.0 cm(3), we tested the hypothesis that concentrations of NAA in the basal ganglia in multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) would show differences compared to Parkinson's disease (IPD). NAA values (in mM) from MRSI voxels centred to the putamen, pallidum and thalamus were obtained from 11 patients with IPD, 11 with MSA-P, six with MSA-C, 13 with PSP and 18 controls. The mean concentrations of NAA and its bulk grey and white matter values were also estimated over the whole brain slab. RESULTS N-acetylaspartate concentrations in the pallidum, putamen and lentiform nucleus were significantly lower in patients with MSA-P and PSP compared to IPD and controls. The putaminal values were also significantly reduced in PSP compared to MSA-P. There were no significant differences between groups in the thalamus and over the whole brain slab. CONCLUSION Our findings support the notion that MRSI can potentially quantify basal ganglia cellular pathology in MSA and PSP.
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Affiliation(s)
- C A Guevara
- Department of Clinical Neuroscience, King's College London, Institute of Psychiatry, London
| | - C R Blain
- Department of Clinical Neuroscience, King's College London, Institute of Psychiatry, London
| | - D Stahl
- Department of Biostatistics and Computing, King's College London, Institute of Psychiatry, London, UK
| | - D J Lythgoe
- Department of Clinical Neuroscience, King's College London, Institute of Psychiatry, London
| | - P N Leigh
- Department of Clinical Neuroscience, King's College London, Institute of Psychiatry, London
| | - G J Barker
- Department of Clinical Neuroscience, King's College London, Institute of Psychiatry, London
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Yoon SJ, Lyoo IK, Kim HJ, Kim TS, Sung YH, Kim N, Lukas SE, Renshaw PF. Neurochemical alterations in methamphetamine-dependent patients treated with cytidine-5'-diphosphate choline: a longitudinal proton magnetic resonance spectroscopy study. Neuropsychopharmacology 2010; 35:1165-73. [PMID: 20043005 PMCID: PMC2900914 DOI: 10.1038/npp.2009.221] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cytidine-5'-diphosphate choline (CDP-choline), as an important intermediate for major membrane phospholipids, may exert neuroprotective effects in various neurodegenerative disorders. This longitudinal proton magnetic resonance spectroscopy ((1)H-MRS) study aimed to examine whether a 4-week CDP-choline treatment could alter neurometabolite levels in patients with methamphetamine (MA) dependence and to investigate whether changes in neurometabolite levels would be associated with MA use. We hypothesized that the prefrontal levels of N-acetyl-aspartate (NAA), a neuronal marker, and choline-containing compound (Cho), which are related to membrane turnover, would increase with CDP-choline treatment in MA-dependent patients. We further hypothesized that this increase would correlate with the total number of negative urine results. Thirty-one treatment seekers with MA dependence were randomly assigned to receive CDP-choline (n=16) or placebo (n=15) for 4 weeks. Prefrontal NAA and Cho levels were examined using (1)H-MRS before medication, and at 2 and 4 weeks after treatment. Generalized estimating equation regression analyses showed that the rate of change in prefrontal NAA (p=0.005) and Cho (p=0.03) levels were greater with CDP-choline treatment than with placebo. In the CDP-choline-treated patients, changes in prefrontal NAA levels were positively associated with the total number of negative urine results (p=0.03). Changes in the prefrontal Cho levels, however, were not associated with the total number of negative urine results. These preliminary findings suggest that CDP-choline treatment may exert potential neuroprotective effects directly or indirectly because of reductions in drug use by the MA-dependent patients. Further studies with a larger sample size of MA-dependent patients are warranted to confirm a long-term efficacy of CDP-choline in neuroprotection and abstinence.
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Affiliation(s)
- Sujung J Yoon
- Department of Psychiatry, Catholic University of Korea School of Medicine, Seoul, South Korea
| | - In Kyoon Lyoo
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,Brain Imaging Center and Clinical Research Center, Seoul National University Hospital, Seoul, South Korea,Departments of Psychiatry and Neuroscience, Seoul National University College of Medicine, 28 Yongon-dong, Chongro-gu, Seoul 110-744, South Korea. Tel: +822 2072 2302; Fax: +822 3672 0677; E-mail:
| | - Hengjun J Kim
- Brain Imaging Center and Clinical Research Center, Seoul National University Hospital, Seoul, South Korea
| | - Tae-Suk Kim
- Department of Psychiatry, Catholic University of Korea School of Medicine, Seoul, South Korea
| | - Young Hoon Sung
- Department of Psychiatry and The Brain Institute, University of Utah, SLC, UT, USA,Department of Veterans Affairs VISN 19 MIRECC, SLC, UT, USA
| | - Namkug Kim
- Department of Psychiatry and The Brain Institute, University of Utah, SLC, UT, USA,Department of Veterans Affairs VISN 19 MIRECC, SLC, UT, USA
| | - Scott E Lukas
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA,McLean Hospital Brain Imaging Center, Belmont, MA, USA
| | - Perry F Renshaw
- Department of Psychiatry and The Brain Institute, University of Utah, SLC, UT, USA,Department of Veterans Affairs VISN 19 MIRECC, SLC, UT, USA
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Scherk H, Backens M, Schneider-Axmann T, Kraft S, Kemmer C, Usher J, Reith W, Falkai P, Meyer J, Gruber O. Dopamine transporter genotype influences N-acetyl-aspartate in the left putamen. World J Biol Psychiatry 2010; 10:524-30. [PMID: 17965994 DOI: 10.1080/15622970701586349] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Dopaminergic activity in the brain is modulated by the dopamine transporter (DAT). Several lines of evidence suggest that a variable number of tandem repeats (VNTR) polymorphism of the DAT1 gene (SLC6A3) influences its gene expression. The aim of this study was to determine whether the DAT1VNTR polymorphism alters the metabolic ratios NAA/Cho, NAA/Cr, Cho/Cr and Ins/Cr in the left dorsolateral prefrontal cortex, anterior cingulate cortex, and putamen in healthy subjects and psychiatric patients irrespective of clinical diagnosis. MATERIAL AND METHODS Sixty-four individuals (30 patients with bipolar disorder, 18 patients with obsessive-compulsive disorder, and 16 healthy subjects) participated in the study. The 3'-UTR VNTR polymorphism of DAT1 (SLC6A3) gene was genotyped in all individuals. (1)H-MRS was performed in the above-mentioned brain regions. RESULTS The individuals with the homozygous DAT1 10-repeat genotype presented significantly higher ratios of NAA/Cho and NAA/Cr in the left putamen compared to the group of individuals with the 9/9-repeat or 9/10-repeat genotype. CONCLUSION The VNTR polymorphism of the DAT1-gene modulates NAA/Cho and NAA/Cr in the left putamen independent of psychiatric diagnosis status. These results suggest an association of DAT1 VNTR polymorphism, dopaminergic activity, and neuronal function in putamen.
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Affiliation(s)
- Harald Scherk
- Department of Psychiatry and Psychotherapy, Georg-August-University Goettingen, Goettingen, Germany.
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27
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Lee SH, Kim SY, Woo DC, Choe BY, Ryu KN, Choi WS, Jahng GH, Yim SV, Kim HY, Choi CB. Differential neurochemical responses of the canine striatum with pentobarbital or ketamine anesthesia: a 3T proton MRS study. J Vet Med Sci 2010; 72:583-7. [PMID: 20103994 DOI: 10.1292/jvms.09-0103] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Although anesthetic agents are known to affect cerebral metabolism, pentobarbital and ketamine have been widely used for animal imaging studies. The purpose of this study is to evaluate alterations in striatum metabolites in dogs between anesthetized with pentobarbital and with ketamine in proton magnetic resonance spectroscopy ((1)H-MRS). (1)H-MRS was performed to ten healthy adult beagle dogs (9-11 kg) at a field strength of 3 T in order to identify metabolic changes after pentobarbital or ketamine administration in the striatum in vivo. Ten dogs were divided into 2 groups as follows: 5 as the pentobarbital-administered group (P group) and 5 as the ketamine-administered group (K group). We found that levels of Glx of the P group was significantly lower than that of the K group (6.90 +/- 0.99 (SD) vs 9.77 +/- 1.14 in 5 dogs, p= 0.003). In addition, the P group also has lower levels of Cr (6.29 +/- 0.44 vs 7.89 +/- 0.91 in 5 dogs, p=0.009) and NAA (5.02 +/- 0.65 vs 6.45 +/- 1.13 in 5 dogs, p=0.041) compared to the K group. However, there were no significant difference between the P group and the K group in striatal levels of Cho and Ins (p>0.1). We demonstrated that MRS-measured metabolites in the specific regions of the brain can be influenced by anesthetic agents.
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Affiliation(s)
- Sung-Ho Lee
- Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, Hwayang-Dong, Kwangjin-gu, Seoul, Korea
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Haga KK, Khor YP, Farrall A, Wardlaw JM. A systematic review of brain metabolite changes, measured with 1H magnetic resonance spectroscopy, in healthy aging. Neurobiol Aging 2009; 30:353-63. [PMID: 17719145 DOI: 10.1016/j.neurobiolaging.2007.07.005] [Citation(s) in RCA: 142] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Revised: 06/19/2007] [Accepted: 07/05/2007] [Indexed: 11/21/2022]
Abstract
BACKGROUND (1)H MR spectroscopy (MRS) can identify metabolite abnormalities in age-related, neurological diseases. However, there is little information on how metabolites change with healthy aging. METHODS We systematically reviewed the literature on MRS, from 1980 to 2006, for studies where healthy young subjects (<60 years) were compared to healthy older subjects (>60 years). We extracted metabolite data reported as "no change", "increase" or "decrease" for each metabolite by brain region and, where data were available, meta-analysed mean metabolite concentrations (mM) for young versus old subjects. RESULTS Eighteen studies met the inclusion criteria (total n=703 subjects, 284 >60 years old). Most data came from the frontal region, and reported "no change" in older subjects; however, a meta-analysis revealed a decrease in frontal NAA (p=0.05) and increases in parietal choline (p=0.003) and creatine (p<0.001). DISCUSSION These data suggest that NAA may decrease and choline and creatine increase with age. Therefore, more data are needed from older subjects to characterise age effects better and ratios in older subjects should be interpreted with caution.
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Affiliation(s)
- Kristin K Haga
- Division of Clinical Neurosciences, School of Molecular and Clinical Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK.
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29
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Kickler N, Lacombe E, Chassain C, Durif F, Krainik A, Farion R, Provent P, Segebarth C, Rémy C, Savasta M. Assessment of metabolic changes in the striatum of a rat model of parkinsonism: an in vivo (1)H MRS study. NMR IN BIOMEDICINE 2009; 22:207-212. [PMID: 19130495 DOI: 10.1002/nbm.1305] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Degeneration of the dopaminergic neurons of the substantia nigra pars compacta in Parkinson's disease induces an abnormal activation of the glutamatergic neurotransmission system within the basal ganglia network and related structures. The aim of this study was to use proton MRS to show metabolic changes in the striatum of 6-hydroxydopamine-lesioned rats, a rodent animal model of Parkinson's disease. Animals were examined before and after extensive lesioning of the nigral dopaminergic neurons and after acute administration of L-3,4-dihydroxyphenylalanine. No significant alterations in glutamate concentrations, assessed by the MR signal dominated by glutamate with minor contributions from glutamine and gamma-aminobutyric acid, could be measured. The total choline/total creatine ratio was found to be reduced in the striatum of the ipsilateral hemisphere.
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Affiliation(s)
- N Kickler
- INSERM U836, Grenoble Institut des Neurosciences, BP 170, F-38042 Grenoble Cedex 9, France.
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Henchcliffe C, Shungu DC, Mao X, Huang C, Nirenberg MJ, Jenkins BG, Beal MF. Multinuclear magnetic resonance spectroscopy for in vivo assessment of mitochondrial dysfunction in Parkinson's disease. Ann N Y Acad Sci 2009; 1147:206-20. [PMID: 19076443 DOI: 10.1196/annals.1427.037] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Parkinson's disease (PD) is a common and often devastating neurodegenerative disease affecting up to one million individuals in the United States alone. Multiple lines of evidence support mitochondrial dysfunction as a primary or secondary event in PD pathogenesis; a better understanding, therefore, of how mitochondrial function is altered in vivo in brain tissue in PD is a critical step toward developing potential PD biomarkers. In vivo study of mitochondrial metabolism in human subjects has previously been technically challenging. However, proton and phosphorus magnetic resonance spectroscopy ((1)H and (31)P MRS) are powerful noninvasive techniques that allow evaluation in vivo of lactate, a marker of anaerobic glycolysis, and high energy phosphates, such as adenosine triphosphate and phosphocreatine, directly reflecting mitochondrial function. This article reviews previous (1)H and (31)P MRS studies in PD, which demonstrate metabolic abnormalities consistent with mitochondrial dysfunction, and then presents recent (1)H MRS data revealing abnormally elevated lactate levels in PD subjects.
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Affiliation(s)
- Claire Henchcliffe
- Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY 10021, USA.
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Chernov MF, Ochiai T, Taira T, Ono Y, Nakamura R, Muragaki Y, Iseki H, Hori T, Takakura K. Serial (1)H-MRS of thalamus during deep brain stimulation of bilateral globus pallidus internus for primary generalized dystonia. Neuroradiology 2008; 50:1055-9. [PMID: 18825378 DOI: 10.1007/s00234-008-0458-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Accepted: 09/02/2008] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The physiological mechanisms of deep brain stimulation (DBS) are not completely clear. Our understanding of them may be facilitated with the use of proton magnetic resonance spectroscopy ((1)H-MRS). METHODS Serial (1)H-MRS of both thalami was performed during the course of DBS of bilateral globus pallidus internus in a patient with primary generalized dystonia. RESULTS Two days after microelectrode implantation, a pulse frequency of 185 Hz was applied for stimulation. It resulted in relief of symptoms and a decrease of Burke-Fahn-Marsden dystonia rating scale (BFMDRS) scores, and was accompanied by a prominent increase of N-acetylaspartate (NAA)/choline-containing compounds (Cho) ratio, a mild increase of NAA/creatine (Cr) ratio, and a moderate decrease of Cho/Cr ratio. Two weeks later, for a search of the optimal stimulation mode, the pulse frequency was switched to 60 Hz, which resulted in clinical deterioration and significant increase of BFMDRS scores. At that time, all investigated (1)H-MRS-detected metabolic parameters had nearly returned to the pretreatment levels. CONCLUSION Use of serial (1)H-MRS investigations of various brain structures during DBS in cases of movement disorders permits detailed evaluation of the treatment response, has a potential for its possible prediction, and may facilitate understanding of the physiological mechanisms of stimulation.
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Affiliation(s)
- Mikhail F Chernov
- Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan.
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Griffith HR, Okonkwo OC, O'Brien T, Hollander JAD. Reduced brain glutamate in patients with Parkinson's disease. NMR IN BIOMEDICINE 2008; 21:381-7. [PMID: 17907264 DOI: 10.1002/nbm.1203] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
An understanding of the role played by glutamate (Glu) in idiopathic Parkinson's disease (PD) has remained somewhat elusive. Animal models of PD suggest that over-activity of Glu receptors complicates the motor symptoms of PD and that Glu blockade may be a pharmacologic target in PD, whereas patient autopsy studies have proved less convincing for changes in Glu. No previous 1H MRS patient studies have documented changes in glutamate. All but one of these previous studies were performed at 1.5 T. We performed 3 T 1H MRS of the posterior cingulate gyrus in 12 non-demented patients with PD and 12 age-matched, neurologically normal control participants. Glu, N-acetylaspartate (NAA) and choline-containing compounds (Cho) measured in reference to creatine + phosphocreatine (Cr) were determined from single-voxel proton MR spectra measured by PRESS at TE of 80 ms. The results show that the Glu/Cr ratio was reduced in patients with PD compared with controls (t = 2.54; P = 0.019), whereas no differences were observed in NAA/Cr or Cho/Cr ratios. These findings suggest that a reduction in Glu occurs in the cerebral cortex of patients with PD. (1)H MRS at 3 T should be investigated in future studies as a means of tracking the course of metabolic brain changes in association with progression of disease in patients with PD.
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Affiliation(s)
- H Randall Griffith
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
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Lucetti C, Del Dotto P, Gambaccini G, Ceravolo R, Logi C, Berti C, Rossi G, Bianchi MC, Tosetti M, Murri L, Bonuccelli U. Influences of dopaminergic treatment on motor cortex in Parkinson disease: a MRI/MRS study. Mov Disord 2008; 22:2170-5. [PMID: 17722082 DOI: 10.1002/mds.21576] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The objective of this study was to investigate neurochemical and metabolic changes in the motor cortex in a group of de novo Parkinson's disease (PD) patients before and after 6 mo treatment with the dopamine agonist pergolide. Proton magnetic resonance spectroscopy (1H-MRS) has been used to study striatal and cortical metabolism in PD and other parkinsonisms. So far, no studies evaluating possible brain metabolic changes in PD patients before and after dopaminergic therapy have been reported. De novo PD patients (11) and controls (11) underwent clinical evaluation (UPDRS-III motor evaluation) and a first single-voxel 1H-MRS of the motor cortex. 1H-MRS studies were performed using the PROBE-SV System implemented on a 1.5 Tesla Scanner (GE Medical System, Milwaukee, WI). Pergolide was administered up to a dose of 1 mg t.i.d. After 6 mo follow-up, all patients were clinically evaluated and a second single-voxel 1H-MRS was performed. Lower values of Cho/Cr and NAA/Cr ratios were observed in the motor cortex of PD patients compared with controls (P < 0.02 and P < 0.01, respectively). After 6 mo therapy with pergolide (1 mg t.i.d), PD patients showed an improvement in motor performances (P < 0.05) and an increase in Cho/Cr ratios in the motor cortex at the second 1H-MRS evaluation (P < 0.05) was reported. In conclusion, cortical NAA/Cr and Cho/Cr ratios may be impaired in de novo PD. Dopaminergic therapy capable of improving motor function may restore the Cho/Cr ratio in the motor cortex.
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Storozheva ZI, Proshin AT, Sherstnev VV, Storozhevykh TP, Senilova YE, Persiyantseva NA, Pinelis VG, Semenova NA, Zakharova EI, Pomytkin IA. Dicholine salt of succinic acid, a neuronal insulin sensitizer, ameliorates cognitive deficits in rodent models of normal aging, chronic cerebral hypoperfusion, and beta-amyloid peptide-(25-35)-induced amnesia. BMC Pharmacol 2008; 8:1. [PMID: 18215309 PMCID: PMC2262060 DOI: 10.1186/1471-2210-8-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Accepted: 01/23/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Accumulated evidence suggests that insulin resistance and impairments in cerebral insulin receptor signaling may contribute to age-related cognitive deficits and Alzheimer's disease. The enhancement of insulin receptor signaling is, therefore, a promising strategy for the treatment of age-related cognitive disorders. The mitochondrial respiratory chain, being involved in insulin-stimulated H2O2 production, has been identified recently as a potential target for the enhancement of insulin signaling. The aim of the present study is to examine: (1) whether a specific respiratory substrate, dicholine salt of succinic acid (CS), can enhance insulin-stimulated insulin receptor autophosphorylation in neurons, and (2) whether CS can ameliorate cognitive deficits of various origins in animal models. RESULTS In a primary culture of cerebellar granule neurons, CS significantly enhanced insulin-stimulated insulin receptor autophosphorylation. In animal models, CS significantly ameliorated cognitive deficits, when administered intraperitoneally for 7 days. In 16-month-old middle-aged C57Bl/6 mice (a model of normal aging), CS enhanced spatial learning in the Morris water maze, spontaneous locomotor activity, passive avoidance performance, and increased brain N-acetylaspartate/creatine levels, as compared to the age-matched control (saline). In rats with chronic cerebral hypoperfusion, CS enhanced spatial learning, passive avoidance performance, and increased brain N-acetylaspartate/creatine levels, as compared to control rats (saline). In rats with beta-amyloid peptide-(25-35)-induced amnesia, CS enhanced passive avoidance performance and increased activity of brain choline acetyltransferase, as compared to control rats (saline). In all used models, CS effects lasted beyond the seven-day treatment period and were found to be significant about two weeks following the treatment. CONCLUSION The results of the present study suggest that dicholine salt of succinic acid, a novel neuronal insulin sensitizer, ameliorates cognitive deficits and neuronal dysfunctions in animal models relevant to age-related cognitive impairments, vascular dementia, and Alzheimer's disease.
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Affiliation(s)
- Zinaida I Storozheva
- P.K. Anokhin Institute of Normal Physiology, RAMS, Mohovaya 11-4, 125009, Moscow, Russia
| | - Andrey T Proshin
- P.K. Anokhin Institute of Normal Physiology, RAMS, Mohovaya 11-4, 125009, Moscow, Russia
| | - Vladimir V Sherstnev
- P.K. Anokhin Institute of Normal Physiology, RAMS, Mohovaya 11-4, 125009, Moscow, Russia
| | - Tatiana P Storozhevykh
- Scientific Centre for Children's Health, RAMS, Lomonosovsky prospect 2/62, 119991, Moscow, Russia
| | - Yana E Senilova
- Scientific Centre for Children's Health, RAMS, Lomonosovsky prospect 2/62, 119991, Moscow, Russia
| | - Nadezhda A Persiyantseva
- Scientific Centre for Children's Health, RAMS, Lomonosovsky prospect 2/62, 119991, Moscow, Russia
| | - Vsevolod G Pinelis
- Scientific Centre for Children's Health, RAMS, Lomonosovsky prospect 2/62, 119991, Moscow, Russia
| | - Natalia A Semenova
- Semenov Institute of Chemical Physics, RAS, Kosygina 4, 119991, Moscow, Russia
| | - Elena I Zakharova
- Institute of General Pathology and Pathophysiology, RAMS, Baltijskaya 8, 125315, Moscow, Russia
| | - Igor A Pomytkin
- Biosignal Ltd., M. Gruzinskaya 29-153, 123557, Moscow, Russia
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A metabolomic study of brain tissues from aged mice with low expression of the vesicular monoamine transporter 2 (VMAT2) gene. Neurochem Res 2007; 33:292-300. [PMID: 18041582 DOI: 10.1007/s11064-007-9542-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Accepted: 11/01/2007] [Indexed: 10/22/2022]
Abstract
The vesicular monoamine transporter 2 (VMAT2) sequesters monoamines into synaptic vesicles in preparation for neurotransmission. Samples of cerebellum, cortex, hippocampus, substantia nigra and striatum from VMAT2-deficient mice were compared to age-matched control mice. Multivariate statistical analyses of (1)H NMR spectral profiles separated VMAT2-deficient mice from controls for all five brain regions. Although the data show that metabolic alterations are region- and age-specific, in general, analyses indicated decreases in the concentrations of taurine and creatine/phosphocreatine and increases in glutamate and N-acetyl aspartate in VMAT2-deficient mouse brain tissues. This study demonstrates the efficacy of metabolomics as a functional genomics phenotyping tool for mouse models of neurological disorders, and indicates that mild reductions in the expression of VMAT2 affect normal brain metabolism.
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Abstract
Unlike traditional, tracer-based methods of molecular imaging, magnetic resonance spectroscopy (MRS) is based on the behavior of specific nuclei within a magnetic field and the general principle that the resonant frequency depends on the nucleus' immediate chemical environment. Most clinical MRS research has concentrated on the metabolites visible with proton spectroscopy and measured in specified tissue volumes in the brain. This methodology has been applied in various neurodegenerative disorders, most frequently utilizing measures of N-acetylaspartate as a neuronal marker. At short echo times, additional compounds can be quantified, including myo-inositol, a putative marker for neuroglia, the excitatory neurotransmitter glutamate and its metabolic counterpart glutamine, and the inhibitory neurotransmitter gamma-aminobutyric acid. 31P-MRS can be used to study high-energy phosphate metabolites, providing an in vivo assessment of tissue bioenergetic status. This review discusses the application of these techniques to patients with neurodegenerative disorders, including Parkinson's disease, Alzheimer's disease, and amyotrophic lateral sclerosis.
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Affiliation(s)
- W R Wayne Martin
- Movement Disorders Clinic, University of Alberta / Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
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Llumiguano C, Kovacs N, Usprung Z, Schwarcz A, Dóczi TP, Balas I. 1H-MRS experiences after bilateral DBS of the STN in Parkinson's disease. Parkinsonism Relat Disord 2007; 14:229-32. [PMID: 17913561 DOI: 10.1016/j.parkreldis.2007.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2006] [Revised: 06/23/2007] [Accepted: 08/21/2007] [Indexed: 11/29/2022]
Abstract
UNLABELLED The objective of this study was to evaluate the changes in the concentrations of certain brain metabolites in 13 patients with Parkinson's disease before and after bilateral subthalamic nucleus (STN DBS). The N-acetylaspartate (NAA)/choline (Chol), NAA/creatine (Cr), Chol/Cr ratios were determined by single voxel Proton magnetic resonance spectroscopy ((1)H-MRS) studies on 1.0T unit using short TE stimulated echo acquisition mode (STEAM) sequence. Spectra were obtained from the right and left globus pallidus, and left fronto-basal cortex. The patients were also assessed according to the UPDRS part III, in the "medication-on and off" conditions. CONCLUSIONS after STN DBS cortical NAA/Cho, NAA/Cr ratios increased significantly, which were highly correlated with the significant improvements of the UPDRS scores.
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Affiliation(s)
- C Llumiguano
- Department of Neurosurgery, University of Pecs, H-7623, Pecs, Ret Utca 2 sz, Hungary.
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Hermann D, Sartorius A, Welzel H, Walter S, Skopp G, Ende G, Mann K. Dorsolateral prefrontal cortex N-acetylaspartate/total creatine (NAA/tCr) loss in male recreational cannabis users. Biol Psychiatry 2007; 61:1281-9. [PMID: 17239356 DOI: 10.1016/j.biopsych.2006.08.027] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Revised: 08/11/2006] [Accepted: 08/15/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cannabinoids present neurotoxic and neuroprotective properties in in vitro studies, inconsistent alterations in human neuroimaging studies, neuropsychological deficits, and an increased risk for psychotic episodes. METHODS Proton magnetic resonance spectroscopy ((1)H-MRS), neuropsychological testing, and hair analysis for cannabinoids was performed in 13 male nontreatment-seeking recreational cannabis users and 13 male control subjects. RESULTS A significantly diminished N-acetylaspartate/total creatine (NAA/tCr) ratio in the dorsolateral prefrontal cortex (DLPFC) was observed in cannabis users (p = .0003). The NAA/tCr in the putamen/globus pallidum region correlated significantly with cannabidiol (R(2) = .66, p = .004). Results of the Wisconsin Card Sorting test, Trail making Test, and D2 test for attention were influenced by cannabinoids. CONCLUSIONS Chronic recreational cannabis use is associated with an indication of diminished neuronal and axonal integrity in the DLPFC in this study. As chronic cannabis use is a risk factor for psychosis, these results are interesting because diminished NAA/tCr ratios in the DLPFC and neuropsychological deficits were also reported in schizophrenia. The strong positive correlation of NAA/tCr and cannabidiol in the putamen/globus pallidum is in line with neuroprotective properties of cannabidiol, which were also observed in in vitro model studies of Parkinson's disease.
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Affiliation(s)
- Derik Hermann
- Central Institute of Mental Health, Mannheim, Germany
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Galanaud D, Nicoli F, Confort-Gouny S, Le Fur Y, Ranjeva JP, Viola A, Girard N, Cozzone PJ. [Indications for cerebral MR proton spectroscopy in 2007]. Rev Neurol (Paris) 2007; 163:287-303. [PMID: 17404517 DOI: 10.1016/s0035-3787(07)90402-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Magnetic resonance spectroscopy (MRS) is being increasingly performed alongside the more conventional MRI sequences in the exploration of neurological disorders. It is however important to clearly differentiate its clinical applications aiming at improving the differential diagnosis or the prognostic evaluation of the patient, from the research protocols, when MRS can contribute to a better understanding of the pathophysiology of the disease or to the evaluation of new treatments. The most important applications in clinical practice are intracranial space occupying lesions (especially the positive diagnosis of intracranial abscesses and gliomatosis cerebri and the differential diagnosis between edema and tumor infiltration), alcoholic, hepatic, and HIV-related encephalopathies and the exploration of metabolic diseases. Among the research applications, MRS is widely used in multiple sclerosis, ischemia and brain injury, epilepsy and neuro degenerative diseases.
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Affiliation(s)
- D Galanaud
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), UMR CNRS 6612, Faculté de Médecine et Hôpital La Timone, Marseille, France
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Kim EA, Cheong HK, Choi DS, Sakong J, Ryoo JW, Park I, Kang DM. Effect of occupational manganese exposure on the central nervous system of welders: 1H magnetic resonance spectroscopy and MRI findings. Neurotoxicology 2006; 28:276-83. [PMID: 16824604 DOI: 10.1016/j.neuro.2006.05.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 05/16/2006] [Accepted: 05/16/2006] [Indexed: 11/23/2022]
Abstract
This study investigated the relationship between long-term occupational manganese (Mn) exposure on the regional Mn concentration in the brain, neuronal loss, and neurobehavioral effects on welders. 1H MRS of the basal ganglia (BG) was performed on 20 male welders and 10 age- and gender-matched, non-office, control workers in a shipyard to assess the metabolic change, and the N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr and NAA/Cho ratios, by the level of Mn exposure. We also assessed the signal intensity of T1-weighted image of magnetic resonance imaging (MRI) on globus pallidus (GP) compared to that of the frontal white matter (pallidal index, PI). The welders had significantly higher signal intensity than the controls. PI showed a significant dose-response relationship with cumulative exposure index (CEI) (r=0.54, p=0.002). CEI and PI showed different relationships with NAA/Cr according to smoking status, and the correlation was evident only in non-smokers (r=-0.73 and -0.57, respectively). There were no significant differences between the welders and the controls in NAA/Cr, Cho/Cr, and NAA/Cho ratios obtained from BG. CEI was positively correlated with simple reaction time. PI was positively correlated with mean sway (MSWAY), sway area (SWAYA), and sway intensity (SWAYI), and negatively correlated with maximum frequency (MAXF). After categorizing the subjects into two groups according to NAA/Cr ratio level, the low NAA/Cr ratio group showed significantly lower score on digit span backward and significantly higher score on MSWAY, SWAYA and SWAYI in regression analysis than the high NAA/Cr ratio group. We speculated that the NAA/Cr ratio of MRS in BG seems to reflect the cumulative effect of Mn exposure on the human brain. Due to uneven distribution of smoking among the welders and the controls, in addition to the small number of subjects in our study, our findings are needed further studies with a larger number of subjects.
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Affiliation(s)
- Eun A Kim
- Occupational Safety and Health Research Institute, KOSHA, Incheon, Republic of Korea.
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Koga K, Mori A, Ohashi S, Kurihara N, Kitagawa H, Ishikawa M, Mitsumoto Y, Nakai M. H MRS identifies lactate rise in the striatum of MPTP-treated C57BL/6 mice. Eur J Neurosci 2006; 23:1077-81. [PMID: 16519673 DOI: 10.1111/j.1460-9568.2006.04610.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mitochondrial dysfunction has been implicated in the death of nigrostriatal dopaminergic neurons in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated experimental models of Parkinson's disease (PD). Here we utilized proton magnetic resonance spectroscopy ((1)H MRS) to identify changes in energy metabolism in the striatum of MPTP-treated C57BL/6 mice. Remarkable increases in lactate/creatine (Lac/Cr) ratio were observed at 2 h and then quickly returned to about the basal level by 7 h after injection of MPTP. Neurochemical and Western blot analyses revealed that dopamine contents and protein levels of tyrosine hydroxylase and dopamine transporter in the striatum were profoundly decreased at 3 days after MPTP treatment. Pretreatment with deprenyl, a monoamine oxidase B inhibitor, or GBR-12909, a dopamine uptake inhibitor, almost completely attenuated both the increases in striatal Lac/Cr ratio and the subsequent loss of dopaminergic nerve terminals in MPTP-treated mice. The present study indicates that (1)H MRS is a sensitive measure of biochemical alterations of the brain in a mouse model of PD, and further shows that the increases in striatal Lac/Cr ratio induced by MPTP may be associated with mitochondrial energy crisis, followed by dopaminergic neurotoxicity.
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Affiliation(s)
- Keiko Koga
- Laboratory of Bioenergetics Research, Tokushima Research Institute, Otsuka Pharmaceutical Co. Ltd, Tokushima 771-0192, Japan
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Magnetic resonance spectroscopy of neurodegenerative illness. NEURODEGENER DIS 2005. [DOI: 10.1017/cbo9780511544873.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Shiino A, Nishida Y, Yasuda H, Suzuki M, Matsuda M, Inubushi T. Magnetic resonance spectroscopic determination of a neuronal and axonal marker in white matter predicts reversibility of deficits in secondary normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 2004; 75:1141-8. [PMID: 15258216 PMCID: PMC1739148 DOI: 10.1136/jnnp.2003.019943] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Normal pressure hydrocephalus (NPH) is considered to be a treatable form of dementia, because cerebrospinal fluid (CSF) shunting can lessen symptoms. However, neuroimaging has failed to predict when shunting will be effective. OBJECTIVE To investigate whether 1H (proton) magnetic resonance (MR) spectroscopy could predict functional outcome in patients after shunting. METHODS Neurological state including Hasegawa's dementia scale, gait, continence, and the modified Rankin scale were evaluated in 21 patients with secondary NPH who underwent ventriculo-peritoneal shunting. Outcomes were measured postoperatively at one and 12 months and were classified as excellent, fair, or poor. MR spectra were obtained from left hemispheric white matter. RESULTS Significant preoperative differences in N-acetyl aspartate (NAA)/creatine (Cr) and NAA/choline (Cho) were noted between patients with excellent and poor outcome at one month (p = 0.0014 and 0.0036, respectively). Multiple regression analysis linked higher preoperative NAA/Cr ratio, gait score, and modified Rankin scale to better one month outcome. Predictive value, sensitivity, and specificity for excellent outcome following shunting were 95.2%, 100%, and 87.5%. Multiple regression analysis indicated that NAA/Cho had the best predictive value for one year outcome (p = 0.0032); predictive value, sensitivity, and specificity were 89.5%, 90.0%, and 88.9%. CONCLUSIONS MR spectroscopy predicted long term post-shunting outcomes in patients with secondary NPH, and it would be a useful assessment tool before lumbar drainage.
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Affiliation(s)
- A Shiino
- Department of Neurosurgery, Shiga University of Medical Science, Ohtsu, Japan.
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Abstract
OBJETIVO: Avaliar a doença de Parkinson pela ressonância magnética. MATERIAIS E MÉTODOS: De outubro de 1999 a outubro de 2002, foram estudados 42 pacientes com parkinsonismo, por meio de um aparelho de ressonância magnética de 1,5 T. Os pacientes foram divididos em dois grupos: grupo com doença de Parkinson (n = 26) e grupo com síndrome parkinsoniana atípica (n = 16), sendo os resultados comparados com um grupo controle (n = 18). Foram avaliadas as seguintes variáveis: espessura da pars compacta do mesencéfalo, grau de hipointensidade de sinal no putâmen, grau de atrofia cerebral, lesões no mesencéfalo, lesões na substância branca e a presença de lesão na borda póstero-lateral do putâmen. A análise estatística dos dados foi realizada, com a utilização do programa SPSS. RESULTADOS: A média de idade foi de 58,2 anos nos grupos com doença de Parkinson e controle, e 60,5 anos no grupo com síndrome parkinsoniana atípica. Os pacientes com doença de Parkinson e síndrome parkinsoniana atípica apresentaram redução da espessura da pars compacta e maior grau de hipointensidade de sinal no putâmen. O grau de atrofia cerebral foi maior nos pacientes com síndrome parkinsoniana atípica. As lesões no mesencéfalo e na substância branca foram semelhantes entre os grupos. O sinal hiperintenso na borda póstero-lateral do putâmen foi um achado pouco freqüente na população estudada, mas sugestivo de atrofia de múltiplos sistemas. CONCLUSÃO: Desta forma, a ressonância magnética detectou alterações morfológicas cerebrais que podem auxiliar no diagnóstico por imagem das síndromes parkinsonianas.
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Abstract
The neurophysiological basis of cognition is relatively unexplained, with most studies reporting weak relationships between cognition and measures of brain function, such as event-related potentials, brain size and cerebral blood flow. Magnetic resonance spectroscopy (MRS) is an in vivo method used to detect neurochemicals within the brain that are relevant to certain brain processes. The most widely used methods are 1H-MRS and 31P-MRS, which detect compounds that contain hydrogen and phosphorus, respectively. Recent studies have shown that the absolute concentrations or ratios of these neurochemicals, in particular N-acetyl aspartate (NAA), which is associated with neuronal viability, correlate with performance on neuropsychological tests or other measures of cognitive function in normal subjects. Many studies in adults and children have shown a relationship between neurometabolite values and cognitive status or extent of cognitive dysfunction in various neurological and neuropsychiatric disorders. We review these studies and conclude that MRS has potential applications for the study of cognitive processes in health and disease and may be used clinically for differential diagnosis, the early detection of pathology and the examination of longitudinal change.
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Affiliation(s)
- Amy J Ross
- School of Psychiatry, University of New South Wales, Kensington, New South Wales 2033, Australia.
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Bossuet C, Vaufrey F, Condé F, Chrétien F, Pichon J, Hantraye P, Le Grand R, Dormont D, Gras G. Up-regulation of glutamate concentration in the putamen and in the prefrontal cortex of asymptomatic SIVmac251-infected macaques without major brain involvement. J Neurochem 2004; 88:928-38. [PMID: 14756814 DOI: 10.1046/j.1471-4159.2003.02237.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We quantified putamen and prefrontal cortex metabolites in macaques with simian immunodeficiency virus infection and searched for virological and histological correlates. Fourteen asymptomatic macaques infected since 8-78 months (median: 38) were compared with eight uninfected ones. Absolute concentrations of acetate, alanine, aspartate, choline, creatine, GABA, glutamate, glutamine, lactate, myo-inositol, N-acetylaspartate, taurine and valine were determined by ex vivo proton magnetic resonance spectroscopy. Glutamate concentration in the CSF was determined by HPLC. Gliosis was assessed by glial fibrillary acidic protein and CD68 immunohistochemistry. Glutamate concentration was slightly increased in the prefrontal cortex (19%, p = 0.0152, t-test) and putamen (13%, p = 0.0354, t-test) of the infected macaques, and was unaffected in the CSF. Myo-inositol concentration was increased in the prefrontal cortex only (27%, p = 0.0136). The concentrations of glutamate and myo-inositol in the prefrontal cortex were higher in the animals with marked or intense microgliosis (p = 0.0114). The other studied metabolites, including N-acetylaspartate, were not altered. Glutamate concentration may thus increase in the cerebral parenchyma in asymptomatic animals, but is not accompanied by a detectable decrease in N-acetylaspartate concentration (neuronal dysfunction). Thus, there are probably compensatory mechanisms that may limit glutamate increase and/or counterbalance its effects.
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Affiliation(s)
- Christophe Bossuet
- Service de Neurovirologie, UMR-E1 CEA, Université Paris-Sud, Centre de Recherches du Service de Santé des Armées, Ecole Pratique des Hautes Etudes, Institut Paris-Sud Cytokines, Fontenay-aux-Roses, France
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Podell M, Hadjiconstantinou M, Smith MA, Neff NH. Proton magnetic resonance imaging and spectroscopy identify metabolic changes in the striatum in the MPTP feline model of parkinsonism. Exp Neurol 2003; 179:159-66. [PMID: 12618122 DOI: 10.1016/s0014-4886(02)00015-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We administered 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to adult, male cats to model Parkinson's disease (PD), and utilized proton magnetic resonance imaging (MRI) and spectroscopy (MRS) at a field strength of 1.5 T to identify metabolic degenerative changes in the striatum in vivo. Neurologic status and somatosensory-evoked potentials in vivo, as well as postmortem striatal histopathological and immunohistochemical parameters, were examined. Nine cats were equally divided into three groups and treated daily for 10 days as follows: saline, MPTP, and pargyline (a monoamine oxidase inhibitor) plus MPTP. The MPTP-treated cats displayed bradykinesia, head tremor, and reduced oculovestibular reflex activity. MRI showed a diffuse increase of the T2-weighted signal in the striatum of two MPTP-treated cats. Analysis of the MRS spectra indicated significantly lower N-acetylaspartate/creatine (CR) and glutamine-glutamate complex/CR ratios than the control baseline. Two MPTP-treated cats had low choline-containing compounds/CR ratio, whereas a lactate peak was present in all MPTP-treated cats. In the striatum of the MPTP-treated cats, there was a significant decline of tyrosine hydroxylase immunoreactivity and histological evidence for a diffuse cytotoxic reaction. Pretreatment with pargyline attenuated the MPTP-induced clinical signs, MRI and MRS changes, and the histopathological and immunoreactivity alterations. We conclude that proton MRI/MRS is a sensitive, noninvasive measure of neural toxicity and biochemical alteration of the striatum in a feline model of PD.
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Affiliation(s)
- Michael Podell
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH 43210, USA
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O'Neill J, Schuff N, Marks WJ, Feiwell R, Aminoff MJ, Weiner MW. Quantitative 1H magnetic resonance spectroscopy and MRI of Parkinson's disease. Mov Disord 2002; 17:917-27. [PMID: 12360540 DOI: 10.1002/mds.10214] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Magnetic resonance imaging (MRI) and (1)H magnetic resonance spectroscopy (MRS) of the substantia nigra, basal ganglia, and cerebral cortex were performed on 10 patients with Parkinson's disease (PD) and 13 age-matched, healthy control subjects. Compared to controls, PD patients had approximately 24% lower creatine in the region of the substantia nigra and smaller volumes of the putamen (11%), globus pallidus (16%), and prefrontal cortex (6%; all P < 0.05). No other significant between-group differences were found in nine regions examined. Thus, quantitative MRI may show regional neurodegenerative changes outside the substantia nigra in PD but PD-linked extranigral metabolic abnormalities, if they exist, may be difficult to detect with current (1)H MRS methods. In additional, exploratory tests, volumes of the caudate (r = -0.56), putamen (r = -0.66), and globus pallidus (r = -0.60; all P < 0.05) were negatively correlated with the volume of the substantia nigra pars compacta in controls. In PD these correlations did not hold. Instead, pallidal volume in PD was positively correlated with compacta volume (r = 0.64; P < 0.05). This relationship suggests that basal ganglia volumes may be influenced by dopaminergic innervation from the substantia nigra in normal and PD subjects.
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Affiliation(s)
- Joseph O'Neill
- Magnetic Resonance Unit, Department of Veterans Affairs Medical Center, University of California, San Francisco, California, USA.
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Axelson D, Bakken IJ, Susann Gribbestad I, Ehrnholm B, Nilsen G, Aasly J. Applications of neural network analyses to in vivo 1H magnetic resonance spectroscopy of Parkinson disease patients. J Magn Reson Imaging 2002; 16:13-20. [PMID: 12112498 DOI: 10.1002/jmri.10125] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To apply neural network analyses to in vivo magnetic resonance spectra of controls and Parkinson disease (PD) patients for the purpose of classification. MATERIALS AND METHODS Ninety-seven in vivo proton magnetic resonance spectra of the basal ganglia were recorded from 31 patients with (PD) and 14 age-matched healthy volunteers on a 1.5-T imager. The PD patients were grouped as follows: probable PD (N = 15), possible PD (N = 11), and atypical PD (N = 5). Total acquisition times of approximately five minutes were achieved with a TE (echo time) of 135 msec, a TR (repetition time) of 2000 msec, and 128 scan averages. Neural network (back propagation, Kohonen, probabilistic, and radial basis function) and related (generative topographic mapping) data analyses were performed. RESULTS Conventional data analysis showed no statistically significant differences in metabolite ratios based on measuring signal intensities. The trained networks could distinguish control from PD with considerable accuracy (true positive fraction 0.971, true negative fraction 0.933). When four classes were defined, approximately 88% of the predictions were correct. The multivariate analysis indicated metabolic changes in the basal ganglia in PD. CONCLUSION A variety of neural network and related approaches can be successfully applied to both qualitative visualization and classification of in vivo spectra of PD patients.
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Baik HM, Choe BY, Lee HK, Suh TS, Son BC, Lee JM. Metabolic alterations in Parkinson's disease after thalamotomy, as revealed by 1H MR spectroscopy. Korean J Radiol 2002; 3:180-8. [PMID: 12271163 PMCID: PMC2713882 DOI: 10.3348/kjr.2002.3.3.180] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2002] [Accepted: 06/08/2002] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine, using proton magnetic resonance spectroscopy (1H MRS) whether thalamotomy in patients with Parkinson's disease gives rise to significant changes in regional brain metabolism. MATERIALS AND METHODS Fifteen patients each underwent stereotactic thalamotomy for the control of medically refractory parkinsonian tremor. Single-voxel 1H MRS was performed on a 1.5T unit using a STEAM sequence (TR/TM/TE, 2000/14/20 msec), and spectra were obtained from substantia nigra, thalamus and putamen areas, with volumes of interest of 7-8 ml, before and after thalamotomy. NAA/Cho, NAA/Cr and Cho/Cr metabolite ratios were calculated from relative peak area measurements, and any changes were recorded and assessed. RESULTS In the substantia nigra and thalamus, NAA/Cho ratios were generally low. In the substantia nigra of 80% of patients (12/15) who showed clinical improvement, decreased NAA/Cho ratios were observed in selected voxels after thalamic surgery (p < 0.05). In the thalamus of 67% of such patients (10/15), significant decreases were also noted (p < 0.05). CONCLUSION Our results suggest that the NAA/Cho ratio may be a valuable criterion for the evaluation of Parkinson's disease patients who show clinical improvement following surgery. By highlighting variations in this ratio, 1H MRS may help lead to a better understanding of the pathophysiologic processes occurring in those with Parkinson's disease.
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Affiliation(s)
- Hyun-Man Baik
- Department of Biomedical Engineering, Kangnam St. Mary's Hospital College of Medicine, The Catholic University of Korea, Korea
| | - Bo-Young Choe
- Department of Biomedical Engineering, Kangnam St. Mary's Hospital College of Medicine, The Catholic University of Korea, Korea
| | - Hyoung-Koo Lee
- Department of Biomedical Engineering, Kangnam St. Mary's Hospital College of Medicine, The Catholic University of Korea, Korea
| | - Tae-Suk Suh
- Department of Biomedical Engineering, Kangnam St. Mary's Hospital College of Medicine, The Catholic University of Korea, Korea
| | - Byung-Chul Son
- Department of Neurosurgery, Kangnam St. Mary's Hospital College of Medicine, The Catholic University of Korea, Korea
| | - Jae-Mun Lee
- Department of Radiology, Kangnam St. Mary's Hospital College of Medicine, The Catholic University of Korea, Korea
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