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Trujillo P, Aumann MA, Claassen DO. Neuromelanin-sensitive MRI as a promising biomarker of catecholamine function. Brain 2024; 147:337-351. [PMID: 37669320 PMCID: PMC10834262 DOI: 10.1093/brain/awad300] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/17/2023] [Accepted: 08/20/2023] [Indexed: 09/07/2023] Open
Abstract
Disruptions to dopamine and noradrenergic neurotransmission are noted in several neurodegenerative and psychiatric disorders. Neuromelanin-sensitive (NM)-MRI offers a non-invasive approach to visualize and quantify the structural and functional integrity of the substantia nigra and locus coeruleus. This method may aid in the diagnosis and quantification of longitudinal changes of disease and could provide a stratification tool for predicting treatment success of pharmacological interventions targeting the dopaminergic and noradrenergic systems. Given the growing clinical interest in NM-MRI, understanding the contrast mechanisms that generate this signal is crucial for appropriate interpretation of NM-MRI outcomes and for the continued development of quantitative MRI biomarkers that assess disease severity and progression. To date, most studies associate NM-MRI measurements to the content of the neuromelanin pigment and/or density of neuromelanin-containing neurons, while recent studies suggest that the main source of the NM-MRI contrast is not the presence of neuromelanin but the high-water content in the dopaminergic and noradrenergic neurons. In this review, we consider the biological and physical basis for the NM-MRI contrast and discuss a wide range of interpretations of NM-MRI. We describe different acquisition and image processing approaches and discuss how these methods could be improved and standardized to facilitate large-scale multisite studies and translation into clinical use. We review the potential clinical applications in neurological and psychiatric disorders and the promise of NM-MRI as a biomarker of disease, and finally, we discuss the current limitations of NM-MRI that need to be addressed before this technique can be utilized as a biomarker and translated into clinical practice and offer suggestions for future research.
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Affiliation(s)
- Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Megan A Aumann
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212, USA
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2
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Alves M, Pita Lobo P, Azevedo Kauppila L, Rebordão L, Cruz MM, Guerreiro C, Ferro JM, Ferreira JJ, Reimão S. Neuroimaging cerebrovascular biomarkers in Parkinson's disease. Neuroradiol J 2021; 35:490-496. [PMID: 34872414 PMCID: PMC9437505 DOI: 10.1177/19714009211059118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND PURPOSE The cardiovascular risk in Parkinson's disease (PD) remains uncertain and controversial. Some studies suggest PD patients present an increased risk of cerebrovascular disease. We aimed to study the prevalence of neuroimaging cerebrovascular biomarkers in PD patients compared to controls, using an accurate and complete magnetic resonance (MR) imaging evaluation. MATERIAL AND METHODS Neuroimaging sub-study within a larger cross-sectional case-control study. An enriched subgroup of PD patients (≤10 years since diagnosis) with at least a moderate cardiovascular mortality risk based on a Systematic COronary Risk Evaluation (SCORE) was compared to community-based controls regarding neuroimaging biomarkers. Patients underwent a high-resolution T1-weighted MR imaging sequence at 3.0 T to visualize neuromelanin. A 3D SWI FFE, sagittal 3D T1-weighted, axial FLAIR and diffusion-weighted image sequences were obtained. RESULTS The study included 47 patients, 24 with PD and 23 controls. PD patients presented a reduced area and signal intensity of the substantia nigra and locus coeruleus on neuromelanin-sensitive MR. The median SCORE was 5% in both groups. No significant differences regarding white matter hyperintensities (OR 4.84, 95% CI 0.50, 47.06), lacunes (OR 0.43, 95% CI 0.07, 2.63), microbleeds (OR 0.64, 95% CI 0.13, 3.26), or infarcts (0.95, 95% CI 0.12, 7.41) was found. The frequency of these neuroimaging biomarkers was very low in both groups. CONCLUSION The present study does not support an increased prevalence of neuroimaging cerebrovascular biomarkers in PD patients.
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Affiliation(s)
- Mariana Alves
- Serviço de Medicina III, 70896Hospital Pulido Valente (CHULN), Lisboa, Portugal.,Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal
| | - Patrícia Pita Lobo
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,Departamento de Neurociências e Saúde Mental, CHULN, Lisbon, Portugal
| | | | | | - M Manuela Cruz
- Unidade de Saúde Familiar Benfica Jardim, 89237ACES Lisboa Norte, Lisbon, Portugal
| | - Carla Guerreiro
- Neurological Imaging Department, 89237Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal
| | - José M Ferro
- Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,Departamento de Neurociências e Saúde Mental, CHULN, Lisbon, Portugal
| | - Joaquim J Ferreira
- Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,CNS - Campus Neurológico Sénior, Lisbon, Portugal
| | - Sofia Reimão
- Avenida Professor Egas Moniz, Faculty of Medicine, 89237University of Lisbon, Lisbon, Portugal.,Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisbon, Lisbon, Portugal.,Neurological Imaging Department, 89237Centro Hospitalar Universitário de Lisboa Norte, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina, 89237Universidade de Lisboa, Lisbon, Portugal
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3
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Kusama M, Sato N, Kimura Y, Miyagi K. Quick MR Neuromelanin Imaging Using a Chemical Shift Selective Pulse. Magn Reson Med Sci 2021; 20:106-111. [PMID: 32074593 PMCID: PMC7952205 DOI: 10.2463/mrms.tn.2019-0167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Not only magnetization transfer contrast (MTC) pulse, but also chemical shift selective (CHESS) pulse would be a useful additional one for shortening the scan time of neuromelanin imaging. We compared three sequences among turbo-spin echo (TSE) images with CHESS, MTC, and without an additional pulse in the same short time, 3 min 20 s. The TSE with CHESS image was the most useful for the diagnosis of neuromelanin within the limited time.
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Affiliation(s)
- Midori Kusama
- Department of Radiology, National Center of Neurology and Psychiatry
| | - Noriko Sato
- Department of Radiology, National Center of Neurology and Psychiatry
| | - Yukio Kimura
- Department of Radiology, National Center of Neurology and Psychiatry
| | - Kenji Miyagi
- Department of Radiology, National Center of Neurology and Psychiatry
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4
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He N, Ghassaban K, Huang P, Jokar M, Wang Y, Cheng Z, Jin Z, Li Y, Sethi SK, He Y, Chen Y, Gharabaghi S, Chen S, Yan F, Haacke EM. Imaging iron and neuromelanin simultaneously using a single 3D gradient echo magnetization transfer sequence: Combining neuromelanin, iron and the nigrosome-1 sign as complementary imaging biomarkers in early stage Parkinson's disease. Neuroimage 2021; 230:117810. [PMID: 33524572 DOI: 10.1016/j.neuroimage.2021.117810] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/15/2021] [Accepted: 01/23/2021] [Indexed: 10/22/2022] Open
Abstract
Diagnosing early stage Parkinson's disease (PD) is still a clinical challenge. Previous studies using iron, neuromelanin (NM) or the Nigrosome-1 (N1) sign in the substantia nigra (SN) by themselves have been unable to provide sufficiently high diagnostic performance for these methods to be adopted clinically. Our goal in this study was to extract the NM complex volume, iron content and volume representing the entire SN, and the N1 sign as potential complementary imaging biomarkers using a single 3D magnetization transfer contrast (MTC) gradient echo sequence and to evaluate their diagnostic performance and clinical correlations in early stage PD. A total of 40 early stage idiopathic PD subjects and 40 age- and sex-matched healthy controls (HCs) were imaged at 3T. NM boundaries (representing the SN pars compacta (SNpc) and parabrachial pigmented nucleus) and iron boundaries representing the total SN (SNpc and SN pars reticulata) were determined semi-automatically using a dynamic programming (DP) boundary detection algorithm. Receiver operating characteristic analyses were performed to evaluate the utility of these imaging biomarkers in diagnosing early stage PD. A correlation analysis was used to study the relationship between these imaging measures and the clinical scales. We also introduced the concept of NM and total iron overlap volumes to demonstrate the loss of NM relative to the iron containing SN. Furthermore, all 80 cases were evaluated for the N1 sign independently. The NM and SN volumes were lower while the iron content was higher in the SN for PD subjects compared to HCs. Interestingly, the PD subjects with bilateral loss of the N1 sign had the highest iron content. The area under the curve (AUC) values for the average of both hemispheres for single measures were: .960 for NM complex volume; .788 for total SN volume; .740 for SN iron content and .891 for the N1 sign. Combining NM complex volume with each of the following measures through binary logistic regression led to AUC values for the averaged right and left sides of: .976 for total iron content; .969 for total SN volume, .965 for overlap volume and .983 for the N1 sign. We found a negative correlation between SN volume and UPDRS-III (R2 = .22, p = .002). While the N1 sign performed well, it does not contain any information about iron content or NM quantitatively, therefore, marrying this sign with the NM and iron measures provides a better physiological explanation of what is happening when the N1 sign disappears in PD subjects. In summary, the combination of NM complex volume, SN volume, iron content and the N1 sign as derived from a single MTC sequence provides complementary information for understanding and diagnosing early stage PD.
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Affiliation(s)
- Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
| | - Kiarash Ghassaban
- Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; Department of Biomedical Engineering, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA
| | - Pei Huang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Ying Wang
- Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; SpinTech, Inc., Bingham Farms, Michigan 48025, USA
| | - Zenghui Cheng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Zhijia Jin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Sean K Sethi
- Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; SpinTech, Inc., Bingham Farms, Michigan 48025, USA
| | - Yixi He
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, 4201 St. Antoine, Detroit, Michigan 48201, USA
| | | | - Shengdi Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China; Department of Radiology, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; Department of Biomedical Engineering, Wayne State University, 3990 John R, Detroit, Michigan 48201, USA; SpinTech, Inc., Bingham Farms, Michigan 48025, USA; Department of Neurology, Wayne State University, 4201 St. Antoine, Detroit, Michigan 48201, USA
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Simões RM, Castro Caldas A, Grilo J, Correia D, Guerreiro C, Pita Lobo P, Valadas A, Fabbri M, Correia Guedes L, Coelho M, Rosa MM, Ferreira JJ, Reimão S. A distinct neuromelanin magnetic resonance imaging pattern in parkinsonian multiple system atrophy. BMC Neurol 2020; 20:432. [PMID: 33243166 PMCID: PMC7694430 DOI: 10.1186/s12883-020-02007-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/19/2020] [Indexed: 12/21/2022] Open
Abstract
Background Parkinsonian variant of multiple system atrophy is a neurodegenerative disorder frequently misdiagnosed as Parkinson’s disease. No early imaging biomarkers currently differentiate these disorders. Methods Simple visual imaging analysis of the substantia nigra and locus coeruleus in neuromelanin-sensitive magnetic resonance imaging and nigrosome 1 in susceptibility-weighted sequences was performed in thirty patients with parkinsonian variant of multiple system atrophy fulfilling possible/probable second consensus diagnostic criteria. The neuromelanin visual pattern was compared to patients with Parkinson’s disease with the same disease duration (n = 10) and healthy controls (n = 10). Substantia nigra semi-automated neuromelanin area/signal intensity was compared to the visual data. Results Groups were similar in age, sex, disease duration, and levodopa equivalent dose. Hoehn & Yahr stage was higher in parkinsonian multiple system atrophy patients, 69% of whom had normal neuromelanin size/signal, significantly different from Parkinson’s disease patients, and similar to controls. Nigrosome 1 signal was lost in 74% of parkinsonian multiple system atrophy patients. Semi-automated neuromelanin substantia nigra signal, but not area, measurements were able to differentiate groups. Conclusions In patients with parkinsonism, simple visual magnetic resonance imaging analysis showing normal neuromelanin substantia nigra and locus coeruleus, combined with nigrosome 1 loss, allowed the distinction of the parkinsonian variant of multiple system atrophy from Parkinson’s disease and healthy controls. This easy and widely available method was superior to semi-automated measurements in identifying specific imaging changes in substantia nigra and locus coeruleus. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-020-02007-5.
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Affiliation(s)
- Rita Moiron Simões
- Neurology Department, Hospital Beatriz Ângelo, Loures, Portugal.,CNS-Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Ana Castro Caldas
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal
| | - Joana Grilo
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Institute for Systems and Robotics (LARSyS), Department of Bioengineering, Instituto Superior Técnico, University of Lisbon, Lisbon, Portugal
| | - Daisy Correia
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Carla Guerreiro
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Department of Neurological Imaging, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Patrícia Pita Lobo
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Department of Neurosciences and Mental Health, Serviço de Neurologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - Anabela Valadas
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Department of Neurosciences and Mental Health, Serviço de Neurologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - Marguerita Fabbri
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Department of Neurosciences, clinical investigation center CIC 1436, Parkinson Toulouse expert center, NS-Park/FCRIN network and NeuroToul COEN center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Leonor Correia Guedes
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Department of Neurosciences and Mental Health, Serviço de Neurologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - Miguel Coelho
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.,Department of Neurosciences and Mental Health, Serviço de Neurologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - Mario Miguel Rosa
- Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Department of Neurosciences and Mental Health, Serviço de Neurologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - Joaquim J Ferreira
- CNS-Campus Neurológico Sénior, Torres Vedras, Portugal. .,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal. .,Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
| | - Sofia Reimão
- Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Department of Neurological Imaging, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.,Imaging University Clinic, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
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Cho SJ, Bae YJ, Kim JM, Kim D, Baik SH, Sunwoo L, Choi BS, Kim JH. Diagnostic performance of neuromelanin-sensitive magnetic resonance imaging for patients with Parkinson's disease and factor analysis for its heterogeneity: a systematic review and meta-analysis. Eur Radiol 2020; 31:1268-1280. [PMID: 32886201 DOI: 10.1007/s00330-020-07240-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/12/2020] [Accepted: 08/28/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine the diagnostic performance of neuromelanin-sensitive magnetic resonance imaging discriminating between patients with Parkinson's disease and normal healthy controls and to identify factors causing heterogeneity influencing the diagnostic performance. METHODS A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before February 17, 2020. The pooled sensitivity and specificity values with their 95% confidence intervals were calculated using bivariate random-effects modeling. Subgroup and meta-regression analyses were also performed to determine factors influencing heterogeneity. RESULTS Twelve articles including 403 patients with Parkinson's disease and 298 control participants were included in this systematic review and meta-analysis. Neuromelanin-sensitive magnetic resonance imaging showed a pooled sensitivity of 89% (95% confidence interval, 86-92%) and a pooled specificity of 83% (95% confidence interval, 76-88%). In the subgroup and meta-regression analysis, a disease duration longer than 5 and 10 years, comparisons using measured volumes instead of signal intensities, a slice thickness in terms of magnetic resonance imaging parameters of more than 2 mm, and semi-/automated segmentation methods instead of manual segmentation improved the diagnostic performance. CONCLUSION Neuromelanin-sensitive magnetic resonance imaging had a favorable diagnostic performance in discriminating patients with Parkinson's disease from healthy controls. To improve diagnostic accuracy, further investigations directly comparing these heterogeneity-affecting factors and optimizing these parameters are necessary. KEY POINTS • Neuromelanin-sensitive MRI favorably discriminates patients with Parkinson's disease from healthy controls. • Disease duration, parameters used for comparison, magnetic resonance imaging slice thickness, and segmentation methods affected heterogeneity across the studies.
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Affiliation(s)
- Se Jin Cho
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Yun Jung Bae
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea.
| | - Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Donghyun Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 75, Bokji-ro, Busanjin-gu, Busan, 47392, Republic of Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Leonard Sunwoo
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Byung Se Choi
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
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Balážová Z, Nováková M, Minsterová A, Rektorová I. Structural and Functional Magnetic Resonance Imaging of Dementia With Lewy Bodies. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 144:95-141. [PMID: 30638458 DOI: 10.1016/bs.irn.2018.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dementia with Lewy bodies (DLB) is the second most common cause of neurodegenerative dementia after Alzheimer's disease (AD). Although diagnosis may be challenging, there is increasing evidence that the use of biomarkers according to 2017 revised criteria for diagnosis and management of dementia with Lewy bodies can increase diagnostic accuracy. Apart from nuclear medicine techniques, various magnetic resonance imaging (MRI) techniques have been utilized in attempt to enhance diagnostic accuracy. This chapter reviews structural, functional and diffusion MRI studies in DLB cohorts being compared to healthy controls, AD or dementia in Parkinson's disease (PDD). We also included relatively new MRI methods that may have potential to identify early DLB subjects and aim at examining brain iron and neuromelanin.
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Affiliation(s)
- Zuzana Balážová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; Department of Radiology and Nuclear Medicine, University Hospital Brno, Faculty of Medicine, Brno, Czech Republic
| | - Marie Nováková
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Alžběta Minsterová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Irena Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology, CEITEC MU, Masaryk University, Brno, Czech Republic; St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
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8
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Abstract
Qualitative and quantitative structural magnetic resonance imaging offer objective measures of the underlying neurodegeneration in atypical parkinsonism. Regional changes in tissue volume, signal changes and increased deposition of iron as assessed with different structural MRI techniques are surrogate markers of underlying neurodegeneration and may reflect cell loss, microglial proliferation and astroglial activation. Structural MRI has been explored as a tool to enhance diagnostic accuracy in differentiating atypical parkinsonian disorders (APDs). Moreover, the longitudinal assessment of serial structural MRI-derived parameters offers the opportunity for robust inferences regarding the progression of APDs. This review summarizes recent research findings as (1) a diagnostic tool for APDs as well as (2) as a tool to assess longitudinal changes of serial MRI-derived parameters in the different APDs.
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9
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Pyatigorskaya N, Magnin B, Mongin M, Yahia-Cherif L, Valabregue R, Arnaldi D, Ewenczyk C, Poupon C, Vidailhet M, Lehéricy S. Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease. AJNR Am J Neuroradiol 2018; 39:1460-1467. [PMID: 29954816 DOI: 10.3174/ajnr.a5702] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/29/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Several new MR imaging techniques have shown promising results in patients with Parkinson disease; however, the comparative diagnostic values of these measures at the individual level remain unclear. Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers. MATERIALS AND METHODS Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed. RESULTS There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively). CONCLUSIONS The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.
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Affiliation(s)
- N Pyatigorskaya
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France .,UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France.,Service de neuroradiologie (N.P., B.M., S.L.)
| | - B Magnin
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France.,UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France.,Service de neuroradiologie (N.P., B.M., S.L.)
| | - M Mongin
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France.,UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France
| | - L Yahia-Cherif
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France.,UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France
| | - R Valabregue
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France
| | - D Arnaldi
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France.,Clinical Neurology (D.A.), Department of Neuroscience, University of Genoa, Genoa, Italy.,Centre d'Investigation Clinique (D.A., M.V.), Hôpital Pitié-Salpêtrière, Paris, France
| | - C Ewenczyk
- Département des Maladies du Système Nerveux (C.E., M.V.), Clinique des mouvements anormaux, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - C Poupon
- NeuroSpin (C.P.), Commissariat à l'Energie Atomique, Gif-Sur-Yvette, France
| | - M Vidailhet
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France.,UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France.,Département des Maladies du Système Nerveux (C.E., M.V.), Clinique des mouvements anormaux, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Centre d'Investigation Clinique (D.A., M.V.), Hôpital Pitié-Salpêtrière, Paris, France
| | - S Lehéricy
- From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France.,UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France.,Service de neuroradiologie (N.P., B.M., S.L.)
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10
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Heim B, Krismer F, De Marzi R, Seppi K. Magnetic resonance imaging for the diagnosis of Parkinson's disease. J Neural Transm (Vienna) 2017; 124:915-964. [PMID: 28378231 PMCID: PMC5514207 DOI: 10.1007/s00702-017-1717-8] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/22/2017] [Indexed: 12/11/2022]
Abstract
The differential diagnosis of parkinsonian syndromes is considered one of the most challenging in neurology and error rates in the clinical diagnosis can be high even at specialized centres. Despite several limitations, magnetic resonance imaging (MRI) has undoubtedly enhanced the diagnostic accuracy in the differential diagnosis of neurodegenerative parkinsonism over the last three decades. This review aims to summarize research findings regarding the value of the different MRI techniques, including advanced sequences at high- and ultra-high-field MRI and modern image analysis algorithms, in the diagnostic work-up of Parkinson's disease. This includes not only the exclusion of alternative diagnoses for Parkinson's disease such as symptomatic parkinsonism and atypical parkinsonism, but also the diagnosis of early, new onset, and even prodromal Parkinson's disease.
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Affiliation(s)
- Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Roberto De Marzi
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
- Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria.
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11
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Tuite P. Brain Magnetic Resonance Imaging (MRI) as a Potential Biomarker for Parkinson's Disease (PD). Brain Sci 2017; 7:E68. [PMID: 28621758 PMCID: PMC5483641 DOI: 10.3390/brainsci7060068] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/09/2017] [Accepted: 06/13/2017] [Indexed: 12/14/2022] Open
Abstract
Magnetic resonance imaging (MRI) has the potential to serve as a biomarker for Parkinson's disease (PD). However, the type or types of biomarker it could provide remain to be determined. At this time there is not sufficient sensitivity or specificity for MRI to serve as an early diagnostic biomarker, i.e., it is unproven in its ability to determine if a single individual is normal, has mild PD, or has some other forms of degenerative parkinsonism. However there is accumulating evidence that MRI may be useful in staging and monitoring disease progression (staging biomarker), and also possibly as a means to monitor pathophysiological aspects of disease and associated response to treatments, i.e., theranostic marker. As there are increasing numbers of manuscripts that are dedicated to diffusion- and neuromelanin-based imaging methods, this review will focus on these topics cursorily and will delve into pharmacodynamic imaging as a means to get at theranostic aspects of PD.
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Affiliation(s)
- Paul Tuite
- Neurology Department, University of Minnesota, MMC 295, 420 Delaware St SE, Minneapolis, MN 55455, USA.
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