51
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Petiet A. Current and Emerging MR Methods and Outcome in Rodent Models of Parkinson's Disease: A Review. Front Neurosci 2021; 15:583678. [PMID: 33897339 PMCID: PMC8058186 DOI: 10.3389/fnins.2021.583678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 03/05/2021] [Indexed: 12/03/2022] Open
Abstract
Parkinson’s disease (PD) is a major neurodegenerative disease characterized by massive degeneration of the dopaminergic neurons in the substantia nigra pars compacta, α-synuclein-containing Lewy bodies, and neuroinflammation. Magnetic resonance (MR) imaging plays a crucial role in the diagnosis and monitoring of disease progression and treatment. A variety of MR methods are available to characterize neurodegeneration and other disease features such as iron accumulation and metabolic changes in animal models of PD. This review aims at giving an overview of how those physiopathological features of PD have been investigated using various MR methods in rodent models. Toxin-based and genetic-based models of PD are first described. MR methods for neurodegeneration evaluation, iron load, and metabolism alterations are then detailed, and the main findings are provided in those models. Ultimately, future directions are suggested for neuroinflammation and neuromelanin evaluations in new animal models.
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Affiliation(s)
- Alexandra Petiet
- Centre de Neuroimagerie de Recherche, Institut du Cerveau, Paris, France.,Inserm U1127, CNRS UMR 7225, Sorbonne Universités, Paris, France
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52
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Du T, Wang L, Liu W, Zhu G, Chen Y, Zhang J. Biomarkers and the Role of α-Synuclein in Parkinson's Disease. Front Aging Neurosci 2021; 13:645996. [PMID: 33833675 PMCID: PMC8021696 DOI: 10.3389/fnagi.2021.645996] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/05/2021] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the presence of α-synuclein (α-Syn)-rich Lewy bodies (LBs) and the preferential loss of dopaminergic (DA) neurons in the substantia nigra (SN) pars compacta (SNpc). However, the widespread involvement of other central nervous systems (CNS) structures and peripheral tissues is now widely documented. The onset of the molecular and cellular neuropathology of PD likely occurs decades before the onset of the motor symptoms characteristic of PD, so early diagnosis of PD and adequate tracking of disease progression could significantly improve outcomes for patients. Because the clinical diagnosis of PD is challenging, misdiagnosis is common, which highlights the need for disease-specific and early-stage biomarkers. This review article aims to summarize useful biomarkers for the diagnosis of PD, as well as the biomarkers used to monitor disease progression. This review article describes the role of α-Syn in PD and how it could potentially be used as a biomarker for PD. Also, preclinical and clinical investigations encompassing genetics, immunology, fluid and tissue, imaging, as well as neurophysiology biomarkers are discussed. Knowledge of the novel biomarkers for preclinical detection and clinical evaluation will contribute to a deeper understanding of the disease mechanism, which should more effectively guide clinical applications.
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Affiliation(s)
- Tingting Du
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Le Wang
- Molecular Biology Laboratory for Neuropsychiatric Diseases, Department of Neurobiology, Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Weijin Liu
- Key Laboratory for Neurodegenerative Disease of the Ministry of Education, Key Laboratory of Neural Regeneration and Repair, Beijing Key Laboratory on Parkinson’s Disease, Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Guanyu Zhu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yingchuan Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jianguo Zhang
- Department of Functional Neurosurgery, Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing Municipal Science and Technology Commission, Beijing, China
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53
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Song T, Li J, Mei S, Jia X, Yang H, Ye Y, Yuan J, Zhang Y, Lu J. Nigral Iron Deposition Is Associated With Levodopa-Induced Dyskinesia in Parkinson's Disease. Front Neurosci 2021; 15:647168. [PMID: 33828454 PMCID: PMC8019898 DOI: 10.3389/fnins.2021.647168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/16/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To investigate iron deposition in the substantia nigra (SN) of Parkinson’s disease (PD) patients associated with levodopa-induced dyskinesia (LID). Methods Seventeen PD patients with LID, 17 PD patients without LID, and 16 healthy controls were recruited for this study. The mean QSM values of the whole, left, and right SN were compared among the three groups. A multivariate logistic regression model was constructed to determine the factors associated with increased risk of LID. The receiver operating characteristic curve of the QSM value of SN in discriminating PD with and without LID was evaluated. Results The mean QSM values of the whole and right SN in the PD with LID were higher than those in the PD without LID (∗P = 0.03, ∗P = 0.03). Multivariate logistic regression analysis revealed that the QSM value of whole, left, or right SN was a predictor of the development of LID (∗P = 0.03, ∗P = 0.04, and ∗P = 0.04). The predictive accuracy of LID in adding the QSM value of the whole, left, and right SN to LID-related clinical risk factors was 70.6, 64.7, and 67.6%, respectively. The QSM cutoff values between PD with and without LID of the whole, left, and right SN were 148.3, 165.4, and 152.7 ppb, respectively. Conclusion This study provides the evidence of higher iron deposition in the SN of PD patients with LID than those without LID, suggesting that the QSM value of the SN may be a potential early diagnostic neuroimaging biomarker for LID.
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Affiliation(s)
- Tianbin Song
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Jiping Li
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shanshan Mei
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaofei Jia
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hongwei Yang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Yongquan Ye
- UIH America, Inc., Houston, TX, United States
| | - Jianmin Yuan
- Central Research Institute, UIH Group, Shanghai, China
| | - Yuqing Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
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54
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Ravanfar P, Loi SM, Syeda WT, Van Rheenen TE, Bush AI, Desmond P, Cropley VL, Lane DJR, Opazo CM, Moffat BA, Velakoulis D, Pantelis C. Systematic Review: Quantitative Susceptibility Mapping (QSM) of Brain Iron Profile in Neurodegenerative Diseases. Front Neurosci 2021; 15:618435. [PMID: 33679303 PMCID: PMC7930077 DOI: 10.3389/fnins.2021.618435] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/07/2021] [Indexed: 12/11/2022] Open
Abstract
Iron has been increasingly implicated in the pathology of neurodegenerative diseases. In the past decade, development of the new magnetic resonance imaging technique, quantitative susceptibility mapping (QSM), has enabled for the more comprehensive investigation of iron distribution in the brain. The aim of this systematic review was to provide a synthesis of the findings from existing QSM studies in neurodegenerative diseases. We identified 80 records by searching MEDLINE, Embase, Scopus, and PsycInfo databases. The disorders investigated in these studies included Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, Wilson's disease, Huntington's disease, Friedreich's ataxia, spinocerebellar ataxia, Fabry disease, myotonic dystrophy, pantothenate-kinase-associated neurodegeneration, and mitochondrial membrane protein-associated neurodegeneration. As a general pattern, QSM revealed increased magnetic susceptibility (suggestive of increased iron content) in the brain regions associated with the pathology of each disorder, such as the amygdala and caudate nucleus in Alzheimer's disease, the substantia nigra in Parkinson's disease, motor cortex in amyotrophic lateral sclerosis, basal ganglia in Huntington's disease, and cerebellar dentate nucleus in Friedreich's ataxia. Furthermore, the increased magnetic susceptibility correlated with disease duration and severity of clinical features in some disorders. Although the number of studies is still limited in most of the neurodegenerative diseases, the existing evidence suggests that QSM can be a promising tool in the investigation of neurodegeneration.
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Affiliation(s)
- Parsa Ravanfar
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Samantha M Loi
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Warda T Syeda
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Ashley I Bush
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience & Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Patricia Desmond
- Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, The University of Melbourne, Parkville, VIC, Australia.,Department of Radiology, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Darius J R Lane
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience & Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Carlos M Opazo
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Bradford A Moffat
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Melbourne Brain Centre Imaging Unit, Department of Medicine and Radiology, The University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
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55
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Zhou W, Shen B, Shen WQ, Chen H, Zheng YF, Fei JJ. Dysfunction of the Glymphatic System Might Be Related to Iron Deposition in the Normal Aging Brain. Front Aging Neurosci 2020; 12:559603. [PMID: 33408625 PMCID: PMC7779624 DOI: 10.3389/fnagi.2020.559603] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022] Open
Abstract
Objective: The study aims to detect the potential relationship between iron deposition and the function of the glymphatic system in the normal aging brain. Methods: We recruited 213 healthy participants. We evaluated the function of the glymphatic system using the index for diffusivity along the perivascular space (ALPS-index), assessed iron deposition on quantitative susceptibility mapping (QSM), and analyzed their relationship. Results: The mean age of participants was 60.1 ± 7.3, and 107 (50.2%) were female. The mean ALPS-index was 1.4 ± 0.2. The QSM values of the caudate nucleus, putamen, globus pallidus, thalamus, red nucleus, substantia nigra, and dentate nucleus were all related to the ALPS-index (all P < 0.001). Conclusions: The main finding of the current study is that the regional brain iron deposition was related to the function of the glymphatic system. Advances in knowledge: We first evaluated the relationship between deposition of brain iron and the dysfunction of the glymphatic system.
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Affiliation(s)
- Wei Zhou
- Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
| | - Bo Shen
- Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
| | - Wei-Qiang Shen
- Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
| | - Hao Chen
- Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
| | - Yi-Feng Zheng
- Department of Radiology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
| | - Jing-Jing Fei
- Department of Internal Medicine, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China
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56
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Improved targeting of the globus pallidus interna using quantitative susceptibility mapping prior to MR-guided focused ultrasound ablation in Parkinson's disease. Clin Imaging 2020; 68:94-98. [DOI: 10.1016/j.clinimag.2020.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/29/2020] [Accepted: 06/12/2020] [Indexed: 12/16/2022]
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57
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McDannold N, Jason White P, Rees Cosgrove G. Using Phase Data From MR Temperature Imaging to Visualize Anatomy During MRI-Guided Focused Ultrasound Neurosurgery. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3821-3830. [PMID: 32746127 PMCID: PMC7749411 DOI: 10.1109/tmi.2020.3005631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Neurosurgery targets in the thalamus can be challenging to identify during transcranial MRI-guided focused ultrasound (MRgFUS) thermal ablation due to poor image quality. They also neighbor structures that can result in side effects if damaged. Here we demonstrate that the phase data obtained during MRgFUS for MR temperature imaging (MRTI) contains anatomic information that could be useful in guiding this procedure. This approach was evaluated in 68 thalamotomies for essential tremor (ET). We found that we could readily visualize the red nucleus and subthalamic nucleus, and those nuclei were consistently aligned with the sonication target coordinates. We also could consistently visualize the internal capsule, which needs to be protected from thermal damage to prevent side effects. Preliminary results from four pallidotomies in Parkinson's disease patients suggest that this approach might also be useful in visualizing the optic tract in addition to the internal capsule. Overall, this approach can visualize anatomic landmarks that may be useful to refine atlas-based targeting for MRgFUS. Since the same data is used for MRTI and anatomic visualization, there are no errors induced by registration to previously obtained planning images or image distortion, and no additional time is needed.
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58
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Red nucleus structure and function: from anatomy to clinical neurosciences. Brain Struct Funct 2020; 226:69-91. [PMID: 33180142 PMCID: PMC7817566 DOI: 10.1007/s00429-020-02171-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 10/24/2020] [Indexed: 12/19/2022]
Abstract
The red nucleus (RN) is a large subcortical structure located in the ventral midbrain. Although it originated as a primitive relay between the cerebellum and the spinal cord, during its phylogenesis the RN shows a progressive segregation between a magnocellular part, involved in the rubrospinal system, and a parvocellular part, involved in the olivocerebellar system. Despite exhibiting distinct evolutionary trajectories, these two regions are strictly tied together and play a prominent role in motor and non-motor behavior in different animal species. However, little is known about their function in the human brain. This lack of knowledge may have been conditioned both by the notable differences between human and non-human RN and by inherent difficulties in studying this structure directly in the human brain, leading to a general decrease of interest in the last decades. In the present review, we identify the crucial issues in the current knowledge and summarize the results of several decades of research about the RN, ranging from animal models to human diseases. Connecting the dots between morphology, experimental physiology and neuroimaging, we try to draw a comprehensive overview on RN functional anatomy and bridge the gap between basic and translational research.
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Chen J, Cai T, Li Y, Chi J, Rong S, He C, Li X, Zhang P, Wang L, Zhang Y. Different iron deposition patterns in Parkinson's disease subtypes: a quantitative susceptibility mapping study. Quant Imaging Med Surg 2020; 10:2168-2176. [PMID: 33139996 DOI: 10.21037/qims-20-285] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder with various subtypes and uncertain pathogenesis. Iron deposition is considered to be involved in the pathological mechanisms of PD. The present study aimed to investigate the iron deposition in deep gray matter in patients with different PD subtypes using quantitative susceptibility mapping (QSM). Methods Forty-six PD patients and 22 healthy controls (HCs) were recruited for the study. PD patients were allocated to the tremor-dominant (TD) group (n=22), postural instability and gait disorder-dominant (PIGD) group (n=19), and intermediate group (n=5). Susceptibility values in deep gray matter nuclei measured by QSM among the PD-TD and PD-PIGD groups and the HCs, as well as the relationship between iron accumulation and clinical motor features, were investigated. Results Susceptibility values in the dentate nucleus (DN) were greater in the PD-TD (118.73±70.45) group than in the PD-PIGD (72.14±39.85, P=0.02) group and HCs (78.26±41.38, P=0.042). Further, a significant positive correlation was observed between the DN susceptibility values and tremor scores (r=0.324, P=0.028). Compared with the HCs (182.60±85.35), both the PD-TD (282.00±102.49, P=0.006) and PD-PIGD groups (284.91±118.54, P=0.007) exhibited greater susceptibility values in the substantia nigra (SN) pars reticulata. The susceptibility values in the SN pars compacta were also greater in the PD-PIGD group (164.51±89.44) than in the HCs (107.78±63.11, P=0.048). Conclusions The present study demonstrated various iron deposition patterns in different PD phenotypes. These findings give insight into the pathophysiology underlying different PD phenotypes, and potentially illustrate the involvement of iron deposition in the PD-TD and PD-PIGD subtypes.
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Affiliation(s)
- Junling Chen
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Neurology, Shantou Central Hospital, Shantou, China
| | - Tongtong Cai
- Department of Neurology, Shantou Central Hospital, Shantou, China
| | - Yan Li
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jieshan Chi
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Siming Rong
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chentao He
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaohong Li
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Piao Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lijuan Wang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yuhu Zhang
- Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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60
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Wu M, Wang C, Lin P, Chao T. Technical Note: Optimization of quantitative susceptibility mapping by streaking artifact detection. Med Phys 2020; 47:5715-5722. [DOI: 10.1002/mp.14460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ming‐Long Wu
- Department of Computer Science and Information Engineering National Cheng Kung University No. 1, University Road Tainan 70101 Taiwan
- Institute of Medical Informatics National Cheng Kung University No. 1, University Road Tainan 70101 Taiwan
| | - Chun‐Kun Wang
- Institute of Medical Informatics National Cheng Kung University No. 1, University Road Tainan 70101 Taiwan
| | - Po‐Yu Lin
- Department of Computer Science and Information Engineering National Cheng Kung University No. 1, University Road Tainan 70101 Taiwan
| | - Tzu‐Cheng Chao
- Department of Radiology Mayo Clinic 200 First St. SW Rochester MN 55905 USA
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61
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Grant ES, Clucas DB, McColl G, Hall LT, Simpson DA. Re-examining ferritin-bound iron: current and developing clinical tools. Clin Chem Lab Med 2020; 59:459-471. [PMID: 33090965 DOI: 10.1515/cclm-2020-1095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/01/2020] [Indexed: 12/11/2022]
Abstract
Iron is a highly important metal ion cofactor within the human body, necessary for haemoglobin synthesis, and required by a wide range of enzymes for essential metabolic processes. Iron deficiency and overload both pose significant health concerns and are relatively common world-wide health hazards. Effective measurement of total iron stores is a primary tool for both identifying abnormal iron levels and tracking changes in clinical settings. Population based data is also essential for tracking nutritional trends. This review article provides an overview of the strengths and limitations associated with current techniques for diagnosing iron status, which sets a basis to discuss the potential of a new serum marker - ferritin-bound iron - and the improvement it could offer to iron assessment.
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Affiliation(s)
- Erin S Grant
- School of Physics, University of Melbourne, Parkville, VIC, Australia
| | - Danielle B Clucas
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.,Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia.,Diagnostic Haematology, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Gawain McColl
- Melbourne Dementia Research Centre, Florey Institute of Neuroscience and Mental Health and the University of Melbourne, Parkville, VIC, Australia
| | - Liam T Hall
- School of Physics, University of Melbourne, Parkville, VIC, Australia
| | - David A Simpson
- School of Physics, University of Melbourne, Parkville, VIC, Australia
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Guan X, Guo T, Zhou C, Wu J, Gao T, Bai X, Wei H, Zhang Y, Xuan M, Gu Q, Huang P, Liu C, Zhang B, Pu J, Song Z, Yan Y, Cui F, Zhang M, Xu X. Asymmetrical nigral iron accumulation in Parkinson's disease with motor asymmetry: an explorative, longitudinal and test-retest study. Aging (Albany NY) 2020; 12:18622-18634. [PMID: 32986011 PMCID: PMC7585099 DOI: 10.18632/aging.103870] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/21/2020] [Indexed: 01/24/2023]
Abstract
Parkinson's disease (PD) is commonly characterized by asymmetrical motor impairment. This study aimed to clarify the iron distributions in PD patients with significant motor asymmetry and their longitudinal alterations. This study included 123 PD patients and 121 normal controls. Thirty-eight PD patients were revisited. PD patients with significant motor asymmetry were identified by using an objective criterion. Inter-group, inter-hemisphere and inter-visit differences of regional tissue susceptibility were analyzed. Iron accumulation in dominantly and non-dominantly affected substantia nigra (SN) were observed in PD patients with motor asymmetry compared with normal controls (p < 0.005, Bonferroni corrected). Iron accumulation in the dominantly affected SN was significantly higher than that in the non-dominantly affected SN (p < 0.01, Bonferroni corrected). After follow-up, time effect on the iron content in SN was observed, directing to decrease in PD patients with motor asymmetry without hemispherical difference (p < 0.05). In conclusion, asymmetrical iron accumulation in SN was associated with the motor asymmetry in PD at baseline, while along the disease evolution iron content in SN became longitudinally decreased. All these findings provide new evidence for PD pathogenesis that the abnormal iron metabolism in SN is complicated and not always unidirectional.
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Affiliation(s)
- Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Gao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueqin Bai
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hongjiang Wei
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yuyao Zhang
- School of Information Science and Technology, ShanghaiTech University, Shanghai, China
| | - Min Xuan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720, USA,Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720, USA
| | - Baorong Zhang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiali Pu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhe Song
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaping Yan
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Cui
- Department of Radiology, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Chougar L, Pyatigorskaya N, Degos B, Grabli D, Lehéricy S. The Role of Magnetic Resonance Imaging for the Diagnosis of Atypical Parkinsonism. Front Neurol 2020; 11:665. [PMID: 32765399 PMCID: PMC7380089 DOI: 10.3389/fneur.2020.00665] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/03/2020] [Indexed: 12/14/2022] Open
Abstract
The diagnosis of Parkinson's disease and atypical Parkinsonism remains clinically difficult, especially at the early stage of the disease, since there is a significant overlap of symptoms. Multimodal MRI has significantly improved diagnostic accuracy and understanding of the pathophysiology of Parkinsonian disorders. Structural and quantitative MRI sequences provide biomarkers sensitive to different tissue properties that detect abnormalities specific to each disease and contribute to the diagnosis. Machine learning techniques using these MRI biomarkers can effectively differentiate atypical Parkinsonian syndromes. Such approaches could be implemented in a clinical environment and improve the management of Parkinsonian patients. This review presents different structural and quantitative MRI techniques, their contribution to the differential diagnosis of atypical Parkinsonian disorders and their interest for individual-level diagnosis.
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Affiliation(s)
- Lydia Chougar
- Institut du Cerveau et de la Moelle épinière-ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UPMC Univ Paris 06, UMRS 1127, CNRS UMR 7225, Paris, France.,ICM, "Movement Investigations and Therapeutics" Team (MOV'IT), Paris, France.,ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,Service de Neuroradiologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Nadya Pyatigorskaya
- Institut du Cerveau et de la Moelle épinière-ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UPMC Univ Paris 06, UMRS 1127, CNRS UMR 7225, Paris, France.,ICM, "Movement Investigations and Therapeutics" Team (MOV'IT), Paris, France.,ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,Service de Neuroradiologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Bertrand Degos
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, MemoLife Labex, Paris, France.,Department of Neurology, Avicenne University Hospital, Sorbonne Paris Nord University, Bobigny, France
| | - David Grabli
- Département des Maladies du Système Nerveux, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Stéphane Lehéricy
- Institut du Cerveau et de la Moelle épinière-ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UPMC Univ Paris 06, UMRS 1127, CNRS UMR 7225, Paris, France.,ICM, "Movement Investigations and Therapeutics" Team (MOV'IT), Paris, France.,ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,Service de Neuroradiologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France
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64
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Kan H, Uchida Y, Arai N, Ueki Y, Aoki T, Kasai H, Kunitomo H, Hirose Y, Matsukawa N, Shibamoto Y. Simultaneous voxel-based magnetic susceptibility and morphometry analysis using magnetization-prepared spoiled turbo multiple gradient echo. NMR IN BIOMEDICINE 2020; 33:e4272. [PMID: 32043682 DOI: 10.1002/nbm.4272] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 01/21/2020] [Accepted: 01/24/2020] [Indexed: 06/10/2023]
Abstract
This study aimed to develop and test a simultaneous acquisition and analysis pipeline for voxel-based magnetic susceptibility and morphometry (VBMSM) on a single dataset using young volunteers, elderly healthy volunteers, and an Alzheimer's disease (AD) group. 3D T1 -weighted and multi-echo phase images for VBM and quantitative susceptibility mapping (QSM) were simultaneously acquired using a magnetization-prepared spoiled turbo multiple gradient echo sequence with inversion pulse for QSM (MP-QSM). The magnitude image was split into gray matter (GM) and white matter (WM) and was spatially normalized. The susceptibility map was reconstructed from the phase images. The segmented image and susceptibility map were compared with those obtained from conventional multiple spoiled gradient echo (mGRE) and MP-spoiled gradient echo (MP-GRE) in healthy volunteers to validate the availability of MP-QSM by numerical measurements. To assess the feasibility of the VBMSM analysis pipeline, voxel-based comparisons of susceptibility and morphometry in MP-QSM were conducted in volunteers with a bimodal age distribution, and in elderly volunteers and the AD group, using spatially normalized GM and WM volume images and a susceptibility map. GM/WM contrasts in MP-QSM, MP-GRE, and mGRE were 0.14 ± 0.011, 0.17 ± 0.015, and 0.045 ± 0.010, respectively. Segmented GM and WM volumes in the MP-QSM closely coincided with those in the MP-GRE. Region of interest analyses indicated that the mean susceptibility values in MP-QSM were completely in agreement with those in mGRE. In an evaluation of the aging effect, a significant increase and decrease in susceptibility and volume were found by VBMSM in deep GM and WM, respectively. Between the elderly volunteers and the AD group, the characteristic susceptibility and volume changes in GM and WM were observed. The proposed MP-QSM sequence makes it possible to acquire acceptable-quality images for simultaneous analysis and determine brain atrophy and susceptibility distribution without image registration by using voxel-based analyses.
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Affiliation(s)
- Hirohito Kan
- Department of Radiology, Nagoya City University Hospital, Nagoya City, Aichi, Japan
| | - Yuto Uchida
- Department of Neurology, Nagoya City University, Nagoya City, Aichi, Japan
- Department of Neurology, Toyokawa City Hospital, Toyokawa, Aichi, Japan
| | - Nobuyuki Arai
- Department of Radiology, Nagoya City University Hospital, Nagoya City, Aichi, Japan
| | - Yoshino Ueki
- Department of Rehabilitation Medicine, Nagoya City University, Nagoya City, Aichi, Japan
| | - Toshitaka Aoki
- Department of Radiology, Nagoya City University Hospital, Nagoya City, Aichi, Japan
| | - Harumasa Kasai
- Department of Radiology, Nagoya City University Hospital, Nagoya City, Aichi, Japan
| | - Hiroshi Kunitomo
- Department of Radiology, Nagoya City University Hospital, Nagoya City, Aichi, Japan
| | - Yasujiro Hirose
- Department of Radiology, Nagoya City University Hospital, Nagoya City, Aichi, Japan
| | - Noriyuki Matsukawa
- Department of Neurology, Nagoya City University, Nagoya City, Aichi, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Hospital, Nagoya City, Aichi, Japan
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65
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Genoud S, Senior AM, Hare DJ, Double KL. Meta-Analysis of Copper and Iron in Parkinson's Disease Brain and Biofluids. Mov Disord 2019; 35:662-671. [PMID: 31889341 DOI: 10.1002/mds.27947] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/30/2019] [Accepted: 11/20/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Variations in study quality and design complicate interpretation of the clinical significance of consistently reported changes in copper and iron levels in human Parkinson's disease brain and biofluids. METHODS We systematically searched literature databases for quantitative reports of biometal levels in the degenerating substantia nigra (SN), CSF, serum, and plasma in Parkinson's disease compared with healthy age-matched controls and assessed the quality of these publications. The primary outcomes of our analysis confirmed SN copper and iron levels are decreased and increased, respectively, in the Parkinson's disease brain. We applied a novel Quality Assessment Scale for Human Tissue to categorize the quality of individual studies and investigated the effects of study quality on our outcomes. We undertook a random-effects meta-analysis and meta-regression subgroup analysis. RESULTS In the 18 eligible studies identified (211 Parkinson's disease, 215 control cases), SN copper levels were significantly lower (d, -2.00; 95% CI, -2.81 to -1.19; P < 0.001), and iron levels were significantly higher (d, 1.31; 95% CI, 0.38-2.24; P < 0.01) in Parkinson's disease. No changes were detected in CSF, serum, or plasma for any metals (29 studies; 2443 Parkinson's disease and 2183 control cases) except serum iron, which was lower in Parkinson's disease (14 studies; 1177 Parkinson's disease and 1447 control cases). CONCLUSIONS Reductions in copper levels and elevations in iron were confirmed as characteristic of the degenerating SN of Parkinson's disease. Iron in serum was also changed, but in the opposite direction to that in the SN and to a lesser extent. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sian Genoud
- Brain and Mind Centre and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Alistair M Senior
- School of Life and Environmental Sciences and School of Mathematics and Statistics, Faculty of Science, The University of Sydney, Sydney, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Dominic J Hare
- Melbourne Dementia Research Centre at, The Florey Institute of Neuroscience and Mental Health and The University of Melbourne, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia.,Department of Clinical Pathology, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Kay L Double
- Brain and Mind Centre and Discipline of Pharmacology, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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66
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Kim S, Lee Y, Jeon CY, Jin YB, Oh S, Lee C. Observation of magnetic susceptibility changes within the thalamus: a comparative study between healthy and Parkinson’s disease afflicted cynomolgus monkeys using 7 T MRI. J Anal Sci Technol 2019. [DOI: 10.1186/s40543-019-0199-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Although the thalamus is known to modulate basal ganglia function related to motor control activity, the abnormal changes within the thalamus during distinct medical complications have been scarcely investigated. In order to explore the feasibility of assessing iron accumulation in the thalamus as an informative biomarker for Parkinson’s disease (PD), this study was designed to employ quantitative susceptibility mapping using a 7 T magnetic resonance imaging system in cynomolgus monkeys. A 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-injected cynomolgus monkey and a healthy control (HC) were examined by 7 T magnetic resonance imaging. Positron emission tomography with 18F-N-(3-fluoro propyl)-2ß-carboxymethoxy-3ß-(4-iodophenyl) nortropane was also employed to identify the relationship between iron deposits and dopamine depletion. All acquired values were averaged within the volume of interest of the nigrostriatal pathway.
Findings
Compared with the HC, the overall elevation of iron deposition within the thalamus in the Parkinson’s disease model (about 53.81% increase) was similar to that in the substantia nigra (54.81%) region. Substantial susceptibility changes were observed in the intralaminar part of the thalamus (about 70.78% increase). Additionally, we observed that in the Parkinson’s disease model, binding potential values obtained from positron emission tomography were considerably decreased in the thalamus (97.51%) and substantia nigra (92.48%).
Conclusions
The increased iron deposition in the thalamus showed negative correlation with dopaminergic activity in PD, supporting the idea that iron accumulation affects glutaminergic inputs and dopaminergic neurons. This investigation indicates that the remarkable susceptibility changes in the thalamus could be an initial major diagnostic biomarker for Parkinson’s disease-related motor symptoms.
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HU L, ZHANG R, WANG S, HONG H, HUANG P, ZHANG M. [Correlation of cardiovascular risk factors with brain iron deposition: A magnetic resonance imaging study]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2019; 48:644-650. [PMID: 31955539 PMCID: PMC8800666 DOI: 10.3785/j.issn.1008-9292.2019.12.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To study the correlation of common cardiovascular risk factors with brain iron deposition. METHODS Eighty-four elderly subjects without neurological diseases or brain trauma were included in the study. The cardiovascular risk factors were comprehensively assessed. MRI examination was performed to obtain high-resolution T1-weighted images and enhanced susceptibility weighted angiography (ESWAN) images, and R2* figure was obtained by post-processing the ESWAN sequence. High definition T1 images were segmented using computer segmentation technique. After registration to the ESWAN image, R2* values of each region of interest were extracted. Multiple linear regression analysis was used to analyze the relationship of R2* values in each area of interest with gender, age and vascular risk factors. RESULTS Smoking was associated with increased R2* values in the hippocampus, white matter and cortex (β=0.244, 0.317, 0.277, P<0.05 or P<0.01). Hypertension was correlated with the increase of R2* in the putamen (β=0.241, P=0.027). Hyperglycemia was associated with the increase of R2* in the thalamus (β=0.234, P<0.05). In the thalamus, the R2* value of males was higher than that of females (β=0.320, P<0.05). Age was correlated with the R2* values of thalamus, caudate nucleus, pallidus, white matter and cortex (β=-0.218、-0.254、0.216、-0.280 and -0.238, P<0.05 or P<0.01). CONCLUSIONS Common cardiovascular risk factors may lead to iron deposition in the brain, and the deposition patterns vary with the gender, age and different risk factors.
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Affiliation(s)
| | | | | | | | - Peiyu HUANG
- 黄沛钰(1985-), 男, 博士, 高级工程师, 硕士生导师, 主要从事神经影像学研究, E-mail:
;
https://orcid.org/0000-0003-4226-9369
| | - Minming ZHANG
- 张敏鸣(1957-), 女, 博士, 教授, 主任医师, 博士生导师, 主要从事神经退行性疾病的多模态影像和肿瘤精准影像学研究, E-mail:
;
https://orcid.org/0000-0003-0145-7558
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68
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Sun J, Lai Z, Ma J, Gao L, Chen M, Chen J, Fang J, Fan Y, Bao Y, Zhang D, Chan P, Yang Q, Ye C, Wu T, Ma T. Quantitative Evaluation of Iron Content in Idiopathic Rapid Eye Movement Sleep Behavior Disorder. Mov Disord 2019; 35:478-485. [PMID: 31846123 DOI: 10.1002/mds.27929] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/07/2019] [Accepted: 10/28/2019] [Indexed: 01/06/2023] Open
Affiliation(s)
- Junyan Sun
- Department of Neurobiology, Neurology and GeriatricsXuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics Beijing China
| | - Zhaoyu Lai
- School of Electronic and Information EngineeringHarbin Institute of Technology at Shenzhen Shenzhen Guangdong China
| | - Jinghong Ma
- Department of NeurologyXuanwu Hospital of Capital Medical University Beijing China
| | - Linlin Gao
- Department of Neurobiology, Neurology and GeriatricsXuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics Beijing China
| | - Meijie Chen
- Department of Neurobiology, Neurology and GeriatricsXuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics Beijing China
| | - Jie Chen
- Department of Neurobiology, Neurology and GeriatricsXuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics Beijing China
| | - Jiliang Fang
- Department of RadiologyGuang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing China
| | - Yangyang Fan
- Department of RadiologyGuang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing China
| | - Yan Bao
- Department of RadiologyGuang'anmen Hospital, China Academy of Chinese Medical Sciences Beijing China
| | - Dongling Zhang
- Department of Neurobiology, Neurology and GeriatricsXuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics Beijing China
| | - Piu Chan
- Department of Neurobiology, Neurology and GeriatricsXuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics Beijing China
- Clinical Center for Parkinson's DiseaseCapital Medical University Beijing China
- Key Laboratory for Neurodegenerative Disease of the Ministry of EducationBeijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders Beijing China
- National Clinical Research Center for Geriatric Disorders Beijing China
| | - Qi Yang
- Department of RadiologyXuanwu Hospital of Capital Medical University Beijing China
| | - Chenfei Ye
- School of Electronic and Information EngineeringHarbin Institute of Technology at Shenzhen Shenzhen Guangdong China
- Peng Cheng Laboratory Shenzhen Guangdong China
- Mindsgo Life Science Shenzhen Ltd Shenzhen Guangdong China
| | - Tao Wu
- Department of Neurobiology, Neurology and GeriatricsXuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics Beijing China
- Clinical Center for Parkinson's DiseaseCapital Medical University Beijing China
- Key Laboratory for Neurodegenerative Disease of the Ministry of EducationBeijing Key Laboratory for Parkinson's Disease, Parkinson Disease Center of Beijing Institute for Brain Disorders Beijing China
- National Clinical Research Center for Geriatric Disorders Beijing China
| | - Ting Ma
- School of Electronic and Information EngineeringHarbin Institute of Technology at Shenzhen Shenzhen Guangdong China
- National Clinical Research Center for Geriatric Disorders Beijing China
- Peng Cheng Laboratory Shenzhen Guangdong China
- Advanced Innovation Center for Human Brain ProtectionCapital Medical University Beijing China
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69
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van Zijl P, Knutsson L. In vivo magnetic resonance imaging and spectroscopy. Technological advances and opportunities for applications continue to abound. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2019; 306:55-65. [PMID: 31377150 PMCID: PMC6703925 DOI: 10.1016/j.jmr.2019.07.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 06/19/2019] [Accepted: 07/08/2019] [Indexed: 05/07/2023]
Abstract
Over the past decades, the field of in vivo magnetic resonance (MR) has built up an impressive repertoire of data acquisition and analysis technologies for anatomical, functional, physiological, and molecular imaging, the description of which requires many book volumes. As such it is impossible for a few authors to have an authoritative overview of the field and for a brief article to be inclusive. We will therefore focus mainly on data acquisition and attempt to give some insight into the principles underlying current advanced methods in the field and the potential for further innovation. In our view, the foreseeable future is expected to show continued rapid progress, for instance in imaging of microscopic tissue properties in vivo, assessment of functional and anatomical connectivity, higher resolution physiologic and metabolic imaging, and even imaging of receptor binding. In addition, acquisition speed and information content will continue to increase due to the continuous development of approaches for parallel imaging (including simultaneous multi-slice imaging), compressed sensing, and MRI fingerprinting. Finally, artificial intelligence approaches are becoming more realistic and will have a tremendous effect on both acquisition and analysis strategies. Together, these developments will continue to provide opportunity for scientific discovery and, in combination with large data sets from other fields such as genomics, allow the ultimate realization of precision medicine in the clinic.
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Affiliation(s)
- Peter van Zijl
- Department of Radiology, Johns Hopkins University, F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Linda Knutsson
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
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70
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The cortico-rubral and cerebello-rubral pathways are topographically organized within the human red nucleus. Sci Rep 2019; 9:12117. [PMID: 31431648 PMCID: PMC6702172 DOI: 10.1038/s41598-019-48164-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/11/2019] [Indexed: 02/03/2023] Open
Abstract
The Red Nucleus (RN) is a large nucleus located in the ventral midbrain: it is subdivided into a small caudal magnocellular part (mRN) and a large rostral parvocellular part (pRN). These distinct structural regions are part of functionally different networks and show distinctive connectivity features: the mRN is connected to the interposed nucleus, whilst the pRN is mainly connected to dentate nucleus, cortex and inferior olivary complex. Despite functional neuroimaging studies suggest RN involvement in complex motor and higher order functions, the pRN and mRN cannot be distinguished using conventional MRI. Herein, we employ high-quality structural and diffusion MRI data of 100 individuals from the Human Connectome Project repository and constrained spherical deconvolution tractography to perform connectivity-based segmentation of the human RN. In particular, we tracked connections of RN with the inferior olivary complex, the interposed nucleus, the dentate nucleus and the cerebral cortex. We found that the RN can be subdivided according to its connectivity into two clusters: a large ventrolateral one, mainly connected with the cerebral cortex and the inferior olivary complex, and a smaller dorsomedial one, mainly connected with the interposed nucleus. This structural topography strongly reflects the connectivity patterns of pRN and mRN respectively. Structural connectivity-based segmentation could represent a useful tool for the identification of distinct subregions of the human red nucleus on 3T MRI thus allowing a better evaluation of this subcortical structure in healthy and pathological conditions.
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71
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Pelzer EA, Florin E, Schnitzler A. Quantitative Susceptibility Mapping and Resting State Network Analyses in Parkinsonian Phenotypes-A Systematic Review of the Literature. Front Neural Circuits 2019; 13:50. [PMID: 31447651 PMCID: PMC6691025 DOI: 10.3389/fncir.2019.00050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 07/17/2019] [Indexed: 11/13/2022] Open
Abstract
An imbalance of iron metabolism with consecutive aggregation of α-synuclein and axonal degeneration of neurons has been postulated as the main pathological feature in the development of Parkinson’s disease (PD). Quantitative susceptibility mapping (QSM) is a new imaging technique, which enables to measure structural changes caused by defective iron deposition in parkinsonian brains. Due to its novelty, its potential as a new imaging technique remains elusive for disease-specific characterization of motor and non-motor symptoms (characterizing the individual parkinsonian phenotype). Functional network changes associated with these symptoms are however frequently described for both magnetoencephalography (MEG) and resting state functional magnetic imaging (rs-fMRI). Here, we performed a systematic review of the current literature about QSM imaging, MEG and rs-fMRI in order to collect existing data about structural and functional changes caused by motor and non-motor symptoms in PD. Whereas all three techniques provide an effect in the motor domain, the understanding of network changes caused by non-motor symptoms is much more lacking for MEG and rs-fMRI, and does not yet really exist for QSM imaging. In order to better understand the influence of pathological iron distribution onto the functional outcome, whole-brain QSM analyses should be integrated in functional analyses (especially for the non-motor domain), to enable a proper pathophysiological interpretation of MEG and rs-fMRI network changes in PD. Herewith, a better understanding of the relationship between neuropathological changes, functional network changes and clinical phenotype might become possible.
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Affiliation(s)
- Esther A Pelzer
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany.,Max-Planck Institute for Metabolism Research, Cologne, Germany
| | - Esther Florin
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University Duesseldorf, Düsseldorf, Germany
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72
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Li L, Lu J, Sun Y, Jin X. Acupuncture protects from 6-OHDA-induced neuronal damage by balancing the ratio of DMT1/Fpn1. Saudi J Biol Sci 2019; 26:1948-1955. [PMID: 31889778 PMCID: PMC6923499 DOI: 10.1016/j.sjbs.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/27/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023] Open
Abstract
Objective Acupuncture is a commonly used method to provide motor-symptomatic relief for patients with Parkinson s disease (PD). Our objective was to evaluate protective effects of acupuncture treatment and potential underlying mechanisms according to the “gut-brain axis” theory. Methods We employed a 6-OHDA-induced PD rat model. The effects of acupuncture on disease development were assessed by behavioural tests and immunohistochistry (IHC). ELISA, qPCR and western blot (WB) were employed to measure inflammatory parameters and Fe metabolism in the substantia nigra (SN), striatum, duodenum and blood, respectively. Results Our data show that acupuncture can significantly increase the expression of tyrosine hydroxylase (TH), compared with untreated and madopa treated rats (P < 0.01 and P < 0.05, respectively). Furthermore we could observe significantly decreased levels of pro-inflammatory markers in the duodenum and serum (P < 0.05), reduced deposition of Fe in the substantia nigra (P < 0.05) and but no change in transferrin expression after acupuncture treatment. The mRNA ratio of DMT1/Fpn1 in the SN of acupuncture treated rats (1.1) was comparable to that of the sham group (1.0) which differed both significantly from the untreated and madopa treated groups (P < 0.05). Furthermore, after acupuncture expression of α-synuclein was decreased in the duodenum. Conclusions Acupuncture can reduce iron accumulation in the SN and protect the loss of dopamine neurons by promoting balanced expression of the iron importer DMT1 and the iron exporter Fpn1. Furthermore CNS iron homeostasis may be affected by reduced systemic and intestinal inflammation.
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Affiliation(s)
- Lihong Li
- The Second Clinical College, Zhejiang Chinese Medical University, Hangzhou 310053, China.,Department of Acupuncture, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - Jun Lu
- School of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Yingying Sun
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Xiaoqing Jin
- Department of Acupuncture, Zhejiang Hospital, Hangzhou 310013, China
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Xu J, Zhang M. Use of Magnetic Resonance Imaging and Artificial Intelligence in Studies of Diagnosis of Parkinson's Disease. ACS Chem Neurosci 2019; 10:2658-2667. [PMID: 31083923 DOI: 10.1021/acschemneuro.9b00207] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder. It has a delitescent onset and a slow progress. The clinical manifestations of PD in patients are highly heterogeneous. Thus, PD diagnosis process is complex and mainly depends on the professional knowledge and experience of the physician. Magnetic resonance imaging (MRI) could detect the small changes in the brain of PD patients, and quantitative analysis of brain MRI may improve the clinical diagnosis efficiency. However, due to the complexity of clinical courses in PD and the high dimensionality in multimodal MRI data, traditional mathematical analysis could not effectively extract the huge information in them. Up to now, the accuracy of PD diagnosis in large sample size is still unsatisfying. As artificial intelligence (AI) is becoming more mature, varieties of statistical models and machine learning (ML) algorithms have been used for quantitative imaging data analysis to explore a diagnostic result. This review aims to state an overview of existing research recently that used statistical ML/AI methods to perform quantitative analysis of MR image data for the study of PD diagnosis. First we review the recent research in three subareas: diagnosis, differential diagnosis, and subtyping of PD. Then we described the overall workflow from MR image to classification result. Finally, we summarized a critical assessment of the current research and provide some recommendations for likely future research developments and trends.
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Affiliation(s)
- Jingjing Xu
- Department of Radiology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
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Chen Q, Chen Y, Zhang Y, Wang F, Yu H, Zhang C, Jiang Z, Luo W. Iron deposition in Parkinson's disease by quantitative susceptibility mapping. BMC Neurosci 2019; 20:23. [PMID: 31117957 PMCID: PMC6532252 DOI: 10.1186/s12868-019-0505-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/15/2019] [Indexed: 12/31/2022] Open
Abstract
Background Patients with Parkinson’s disease (PD) have elevated levels of brain iron, especially in the nigrostriatal dopaminergic system. The purpose of this study was to evaluate the iron deposition in the substantia nigra (SN) and other deep gray matter nuclei of PD patients using quantitative susceptibility mapping (QSM) and its clinical relationship, and to explore whether there is a gradient of iron deposition pattern in globus pallidus (GP)–fascicula nigrale (FN)–SN pathway. Methods Thirty-three PD patients and 26 age- and sex-matched healthy volunteers (HVs) were included in this study. Subjects underwent brain MRI and constructed QSM data. The differences in iron accumulation in the deep gray matter nuclei of the subjects were compared, including the PD group and the control group, the early-stage PD (EPD) group and the late-stage PD (LPD) group. The iron deposition pattern of the GP–FN–SN pathway was analyzed. Results The PD group showed increased susceptibility values in the FN, substantia nigra pars compacta (SNc), internal globus pallidus (GPi), red nucleus (RN), putamen and caudate nucleus compared with the HV group (P < 0.05). In both PD and HV group, iron deposition along the GP–FN–SN pathway did not show an increasing gradient pattern. The SNc, substantia nigra pars reticulata (SNr) and RN showed significantly increased susceptibility values in the LPD patients compared with the EPD patients. Conclusion PD is closely related to iron deposition in the SNc. The condition of PD patients is related to the SNc and the SNr. There is not an increasing iron deposition gradient along the GP–FN–SN pathway. The source and mechanism of iron deposition in the SN need to be further explored, as does the relationship between the iron deposition in the RN and PD.
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Affiliation(s)
- Qiqi Chen
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yiting Chen
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yue Zhang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Furu Wang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hongchang Yu
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Caiyuan Zhang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhen Jiang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Weifeng Luo
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, China.
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Evaluation of iron deposition in brain basal ganglia of patients with Parkinson's disease using quantitative susceptibility mapping. Eur J Radiol Open 2019; 6:169-174. [PMID: 31065578 PMCID: PMC6495059 DOI: 10.1016/j.ejro.2019.04.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 12/11/2022] Open
Abstract
Aim of the study Parkinson's disease is associated with iron deposition in the brain. The QSM (quantitative susceptibility mapping) is more sensitive than T2-weighted imaging, T2* and R2. Few studies have been used QSM to evaluate the iron in the basal ganglia of patients with Parkinson's disease. Our aim was to evaluate the iron deposition in the basal ganglia using QSM and determination of diagnostic value of this method and evaluation of the association between disease stage with QSM and age with QSM in all nuclei, separately. Materials and methods Thirty patients were tested using Hoehn and Yahr test in three different stages. Fifteen healthy subjects were considered as control group. MRI sequences were performed using SIEMENS 3 T scanner.The Signal Processing in NMR software was used to process and analyze the images. The QSM in every of the basal ganglia was measured separately. Results There was a significant difference for QSM in the Subtania Nigera, Red Nucleus, Thalamic Nucleus and Globus Pallidus nucleus between two groups. The relationship between disease stage with QSM was significant in Subtania Nigera, Red Nucleus, and Globus Pallidus nucleus. The QSM values had a significant association with disease stage in all nuclei. The results showed that QSM has a higher accuracy in Subtania Nigera, Globus Pallidus, Red Nucleus and Thalamic Nucleus, respectively. Conclusions Using QSM in Red Nucleus, Subtania Nigera, and Globus Pallidus nuclei can help diagnosis and staging the patients with Parkinson's disease. In future, studies with emphasis on the disease stage can be helpful in evaluation the different parts of these three nuclei.
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76
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T2*-weighted MRI values correlate with motor and cognitive dysfunction in Parkinson's disease. Neurobiol Aging 2019; 80:91-98. [PMID: 31103636 DOI: 10.1016/j.neurobiolaging.2019.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 11/20/2022]
Abstract
Brain iron load is one of the main neuropathologic hallmarks of Parkinson's disease (PD). Previous studies indicated that iron in the substantia nigra (SN) is related to disease duration and motor impairment. We explore, through a cross-sectional study, the association between brain iron distribution, evaluated by T2*-weighted magnetic resonance imaging (T2*), and clinical features in a cohort of patients with PD. Thirty-two patients with PD, compared with 10 control subjects, were evaluated for motor and cognitive features (attention and working memory, executive functions, language, memory, and visuospatial function). They underwent a magnetic resonance imaging protocol including T2* analysis of specific brain regions of interest to measure iron load compared with healthy control subjects. We found that iron content of the SN correlated positively with both disease duration and Unified Parkinson's Disease Rating Scale III off score. Montreal Cognitive Assessment, Spatial Span, and Graded Naming Test scores were inversely associated with iron load of the SN, whereas Wechsler Adult Intelligence Scale-IV Similarities score showed an inverse relationship with iron content in all the regions of interest examined. Our findings suggest a relationship between topographic brain iron distribution and cognitive domain impairment.
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77
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Guan X, Zhang Y, Wei H, Guo T, Zeng Q, Zhou C, Wang J, Gao T, Xuan M, Gu Q, Xu X, Huang P, Pu J, Zhang B, Liu C, Zhang M. Iron-related nigral degeneration influences functional topology mediated by striatal dysfunction in Parkinson's disease. Neurobiol Aging 2019; 75:83-97. [PMID: 30554085 PMCID: PMC6538269 DOI: 10.1016/j.neurobiolaging.2018.11.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/12/2018] [Accepted: 11/13/2018] [Indexed: 12/14/2022]
Abstract
In Parkinson's disease (PD), iron accumulation in the substantia nigra (SN) exacerbates oxidative stress and α-synuclein aggregation, leading to neuronal death. However, the influence of iron-related nigral degeneration on the subcortical function and global network configuration in PD remains unknown. Ninety PD patients and 38 normal controls underwent clinical assessments and multimodality magnetic resonance imaging scans. Iron accumulation in the inferior SN and disrupted functional connectivity between the bilateral striatums were observed in PD, and negative correlation between them was found in the whole population. The binarized functional network exhibited enhanced global efficiency and reduced local efficiency while the weighted functional network exhibited reduction in both, and both changes were correlated with nigral iron accumulation in PD. Mediation analysis demonstrated that the functional connectivity between bilateral striatums was a mediator between the nigral iron accumulation and weighted functional network alterations. In conclusion, our findings reveal that iron-related nigral degeneration possibly influences the functional topology mediated by striatal dysfunction, which extends the scientific understanding of PD pathogenesis.
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Affiliation(s)
- Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Yuyao Zhang
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Hongjiang Wei
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA
| | - Tao Guo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiaoling Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Cheng Zhou
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaqiu Wang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ting Gao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Min Xuan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Quanquan Gu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiali Pu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Baorong Zhang
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, CA, USA; Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA.
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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78
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Karsa A, Punwani S, Shmueli K. The effect of low resolution and coverage on the accuracy of susceptibility mapping. Magn Reson Med 2019; 81:1833-1848. [PMID: 30338864 PMCID: PMC6492151 DOI: 10.1002/mrm.27542] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/22/2018] [Accepted: 08/30/2018] [Indexed: 01/04/2023]
Abstract
PURPOSE Quantitative susceptibility mapping (QSM) has found increasing clinical applications. However, to reduce scan time, clinical acquisitions often use reduced resolution and coverage, particularly in the through-slice dimension. The effect of these factors on QSM has begun to be assessed using only balloon phantoms and downsampled brain images. Here, we investigate the effects (and their sources) of low resolution or coverage on QSM using both simulated and acquired images. METHODS Brain images were acquired at 1 mm isotropic resolution and full brain coverage, and low resolution (up to 6 mm slice thickness) or coverage (down to 20 mm) in 5 healthy volunteers. Images at reduced resolution or coverage were also simulated in these volunteers and in a new, anthropomorphic, numerical phantom. Mean susceptibilities in 5 brain regions, including white matter, were investigated over varying resolution and coverage. RESULTS The susceptibility map contrast decreased with increasing slice thickness and spacing, and with decreasing coverage below ~40 mm for 2 different QSM pipelines. Our simulations showed that calculated susceptibility values were erroneous at low resolution or very low coverage, because of insufficient sampling and overattenuation of the susceptibility-induced field perturbations. Susceptibility maps calculated from simulated and acquired images showed similar behavior. CONCLUSIONS Both low resolution and low coverage lead to loss of contrast and errors in susceptibility maps. The widespread clinical practice of using low resolution and coverage does not provide accurate susceptibility maps. Simulations in images of healthy volunteers and in a new, anthropomorphic numerical phantom were able to accurately model low-resolution and low-coverage acquisitions.
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Affiliation(s)
- Anita Karsa
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
| | - Shonit Punwani
- Centre for Medical ImagingUniversity College LondonLondonUnited Kingdom
| | - Karin Shmueli
- Department of Medical Physics and Biomedical EngineeringUniversity College LondonLondonUnited Kingdom
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79
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Sethi SK, Kisch SJ, Ghassaban K, Rajput A, Rajput A, Babyn PS, Liu S, Szkup P, Mark Haacke E. Iron quantification in Parkinson's disease using an age-based threshold on susceptibility maps: The advantage of local versus entire structure iron content measurements. Magn Reson Imaging 2019; 55:145-152. [DOI: 10.1016/j.mri.2018.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/29/2018] [Accepted: 10/06/2018] [Indexed: 01/09/2023]
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80
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Lin F, Prince MR, Spincemaille P, Wang Y. Patents on Quantitative Susceptibility Mapping (QSM) of Tissue Magnetism. Recent Pat Biotechnol 2018; 13:90-113. [PMID: 30556508 DOI: 10.2174/1872208313666181217112745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/04/2018] [Accepted: 12/11/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Quantitative susceptibility mapping (QSM) depicts biodistributions of tissue magnetic susceptibility sources, including endogenous iron and calcifications, as well as exogenous paramagnetic contrast agents and probes. When comparing QSM with simple susceptibility weighted MRI, QSM eliminates blooming artifacts and shows reproducible tissue susceptibility maps independent of field strength and scanner manufacturer over a broad range of image acquisition parameters. For patient care, QSM promises to inform diagnosis, guide surgery, gauge medication, and monitor drug delivery. The Bayesian framework using MRI phase data and structural prior knowledge has made QSM sufficiently robust and accurate for routine clinical practice. OBJECTIVE To address the lack of a summary of US patents that is valuable for QSM product development and dissemination into the MRI community. METHOD We searched the USPTO Full-Text and Image Database for patents relevant to QSM technology innovation. We analyzed the claims of each patent to characterize the main invented method and we investigated data on clinical utility. RESULTS We identified 17 QSM patents; 13 were implemented clinically, covering various aspects of QSM technology, including the Bayesian framework, background field removal, numerical optimization solver, zero filling, and zero-TE phase. CONCLUSION Our patent search identified patents that enable QSM technology for imaging the brain and other tissues. QSM can be applied to study a wide range of diseases including neurological diseases, liver iron disorders, tissue ischemia, and osteoporosis. MRI manufacturers can develop QSM products for more seamless integration into existing MRI scanners to improve medical care.
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Affiliation(s)
- Feng Lin
- School of Law, City University of Hong Kong, Hong Kong, China
| | - Martin R Prince
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
| | - Pascal Spincemaille
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
| | - Yi Wang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States.,Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY, United States
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81
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Acosta-Cabronero J, Milovic C, Mattern H, Tejos C, Speck O, Callaghan MF. A robust multi-scale approach to quantitative susceptibility mapping. Neuroimage 2018; 183:7-24. [PMID: 30075277 PMCID: PMC6215336 DOI: 10.1016/j.neuroimage.2018.07.065] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/29/2018] [Accepted: 07/29/2018] [Indexed: 12/11/2022] Open
Abstract
Quantitative Susceptibility Mapping (QSM), best known as a surrogate for tissue iron content, is becoming a highly relevant MRI contrast for monitoring cellular and vascular status in aging, addiction, traumatic brain injury and, in general, a wide range of neurological disorders. In this study we present a new Bayesian QSM algorithm, named Multi-Scale Dipole Inversion (MSDI), which builds on the nonlinear Morphology-Enabled Dipole Inversion (nMEDI) framework, incorporating three additional features: (i) improved implementation of Laplace's equation to reduce the influence of background fields through variable harmonic filtering and subsequent deconvolution, (ii) improved error control through dynamic phase-reliability compensation across spatial scales, and (iii) scalewise use of the morphological prior. More generally, this new pre-conditioned QSM formalism aims to reduce the impact of dipole-incompatible fields and measurement errors such as flow effects, poor signal-to-noise ratio or other data inconsistencies that can lead to streaking and shadowing artefacts. In terms of performance, MSDI is the first algorithm to rank in the top-10 for all metrics evaluated in the 2016 QSM Reconstruction Challenge. It also demonstrated lower variance than nMEDI and more stable behaviour in scan-rescan reproducibility experiments for different MRI acquisitions at 3 and 7 Tesla. In the present work, we also explored new forms of susceptibility MRI contrast making explicit use of the differential information across spatial scales. Specifically, we show MSDI-derived examples of: (i) enhanced anatomical detail with susceptibility inversions from short-range dipole fields (hereby referred to as High-Pass Susceptibility Mapping or HPSM), (ii) high specificity to venous-blood susceptibilities for highly regularised HPSM (making a case for MSDI-based Venography or VenoMSDI), (iii) improved tissue specificity (and possibly statistical conditioning) for Macroscopic-Vessel Suppressed Susceptibility Mapping (MVSSM), and (iv) high spatial specificity and definition for HPSM-based Susceptibility-Weighted Imaging (HPSM-SWI) and related intensity projections.
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Affiliation(s)
- Julio Acosta-Cabronero
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
| | - Carlos Milovic
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Hendrik Mattern
- Department of Biomedical Magnetic Resonance, Institute of Experimental Physics, Otto von Guericke University, Magdeburg, Germany
| | - Cristian Tejos
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Oliver Speck
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Department of Biomedical Magnetic Resonance, Institute of Experimental Physics, Otto von Guericke University, Magdeburg, Germany; Center for Behavioural Brain Sciences, Magdeburg, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Martina F Callaghan
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom
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Khan AR, Hiebert NM, Vo A, Wang BT, Owen AM, Seergobin KN, MacDonald PA. Biomarkers of Parkinson's disease: Striatal sub-regional structural morphometry and diffusion MRI. NEUROIMAGE-CLINICAL 2018; 21:101597. [PMID: 30472168 PMCID: PMC6412554 DOI: 10.1016/j.nicl.2018.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 10/14/2018] [Accepted: 11/12/2018] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is a progressive neurological disorder that has no reliable biomarkers. The aim of this study was to explore the potential of semi-automated sub-regional analysis of the striatum with magnetic resonance imaging (MRI) to distinguish PD patients from controls (i.e., as a diagnostic biomarker) and to compare PD patients at different stages of disease. With 3 Tesla MRI, diffusion- and T1-weighted scans were obtained on two occasions in 24 PD patients and 18 age-matched, healthy controls. PD patients completed one session on and the other session off dopaminergic medication. The striatum was parcellated into seven functionally disparate sub-regions. The segmentation was guided by reciprocal connections to distinct cortical regions. Volume, surface-based morphometry, and integrity of white matter connections were calculated for each striatal sub-region. Test-retest reliability of our volume, morphometry, and white matter integrity measures across scans was high, with correlations ranging from r = 0.452, p < 0.05 and r = 0.985, p < 0.001. Global measures of striatum such as total striatum, nucleus accumbens, caudate nuclei, and putamen were not significantly different between PD patients and controls, indicating poor sensitivity of these measures, which average across sub-regions that are functionally heterogeneous and differentially affected by PD, to act as diagnostic biomarkers. Further, these measures did not correlate significantly with disease severity, challenging their potential to serve as progression biomarkers. In contrast, a) decreased volume and b) inward surface displacement of caudal-motor striatum—the region first and most dopamine depleted in PD—distinguished PD patients from controls. Integrity of white matter cortico-striatal connections in caudal-motor and adjacent striatal sub-regions (i.e., executive and temporal striatum) was reduced for PD patients relative to controls. Finally, volume of limbic striatum, the only striatal sub-region innervated by the later-degenerating ventral tegmental area in PD, was reduced in later-stage compared to early stage PD patients a potential progression biomarker. Segmenting striatum based on distinct cortical connectivity provided highly sensitive MRI measures for diagnosing and staging PD. Using 3T structural and diffusion tensor MRI, we explored potential biomarkers in PD. Striatum was parcellated into 7 functional sub-regions based on cortical connectivity. Volume of caudal-motor region was significantly smaller in PDs compared to controls. Volume of limbic region was sensitive to PD disease progression. Striatal sub-regions provided sensitive measures of the presence and progression of PD.
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Affiliation(s)
- Ali R Khan
- Department of Medical Biophysics, University of Western Ontario, London, Ontario N6A5C1, Canada; Robarts Research Institute, University of Western Ontario, London, Ontario N6A 5B7, Canada
| | - Nole M Hiebert
- Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario N6A5C1, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario N6A5B7, Canada
| | - Andrew Vo
- Brain and Mind Institute, University of Western Ontario, London, Ontario N6A5B7, Canada; Department of Psychology, University of Western Ontario, London, Ontario N6A5C2, Canada
| | - Brian T Wang
- Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario N6A5C1, Canada; Robarts Research Institute, University of Western Ontario, London, Ontario N6A 5B7, Canada
| | - Adrian M Owen
- Brain and Mind Institute, University of Western Ontario, London, Ontario N6A5B7, Canada; Department of Psychology, University of Western Ontario, London, Ontario N6A5C2, Canada
| | - Ken N Seergobin
- Brain and Mind Institute, University of Western Ontario, London, Ontario N6A5B7, Canada
| | - Penny A MacDonald
- Brain and Mind Institute, University of Western Ontario, London, Ontario N6A5B7, Canada; Department of Psychology, University of Western Ontario, London, Ontario N6A5C2, Canada; Department of Clinical Neurological Sciences, University of Western Ontario, London, Ontario N6A5A5, Canada.
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83
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Vela D. The Dual Role of Hepcidin in Brain Iron Load and Inflammation. Front Neurosci 2018; 12:740. [PMID: 30374287 PMCID: PMC6196657 DOI: 10.3389/fnins.2018.00740] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/26/2018] [Indexed: 12/25/2022] Open
Abstract
Hepcidin is the major regulator of systemic iron metabolism, while the role of this peptide in the brain has just recently been elucidated. Studies suggest a dual role of hepcidin in neuronal iron load and inflammation. This is important since neuronal iron load and inflammation are pathophysiological processes frequently associated with neurodegeneration. Furthermore, manipulation of hepcidin activity has recently been used to recover neuronal damage due to brain inflammation in animal models and cultured cells. Therefore, understanding the mechanistic insights of hepcidin action in the brain is important to uncover its role in treating neuronal damage in neurodegenerative diseases.
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Affiliation(s)
- Driton Vela
- Department of Physiology, Faculty of Medicine, University of Pristina, Pristina, Kosovo
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84
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Zhang Y, Shi J, Wei H, Han V, Zhu WZ, Liu C. Neonate and infant brain development from birth to 2 years assessed using MRI-based quantitative susceptibility mapping. Neuroimage 2018; 185:349-360. [PMID: 30315906 DOI: 10.1016/j.neuroimage.2018.10.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 09/10/2018] [Accepted: 10/09/2018] [Indexed: 12/23/2022] Open
Abstract
The human brain rapidly develops during the first two years following birth. Quantitative susceptibility mapping (QSM) provides information of iron and myelin variations. It is considered to be a valuable tool for studying brain development in early life. In the present work, QSM is performed on neonates, 1-year and 2-year old infants, as well as a group of adults for the purpose of reference. Age-specific templates representing common brain structures are built for each age group. The neonate and infant QSM templates have shown some unique findings compared to conventional T1w and T2w imaging techniques. The contrast between the gray and white matters on the QSM images did not change through brain development from neonate to adult. A linear correlation was found between brain myelination determined in this study and the microscopic myelin degree determined by a previous autopsy study. Also, the magnetic susceptibility values of the cerebral spinal fluid (CSF) exhibit a gradually decreasing trend from birth to 2 years old and to adulthood. The findings suggest that the macromolecular content, myelin, and iron may play the most important contributing factors for the magnetic susceptibility of neonate and infant brain. QSM can be a powerful means to study early brain development and related pathologies that involve alterations in macromolecular content, iron, or brain myelination.
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Affiliation(s)
- Yuyao Zhang
- School of Information and Science and Technology, ShanghaiTech University, Shanghai, China
| | - Jingjing Shi
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongjiang Wei
- Electrical Engineering and Computer Science, University of California at Berkeley, CA, USA
| | - Victor Han
- Electrical Engineering and Computer Science, University of California at Berkeley, CA, USA
| | - Wen-Zhen Zhu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Chunlei Liu
- Electrical Engineering and Computer Science, University of California at Berkeley, CA, USA; Helen Wills Neuroscience Institute, University of California at Berkeley, CA, USA.
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85
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Mattern H, Sciarra A, Lüsebrink F, Acosta-Cabronero J, Speck O. Prospective motion correction improves high-resolution quantitative susceptibility mapping at 7T. Magn Reson Med 2018; 81:1605-1619. [PMID: 30298692 DOI: 10.1002/mrm.27509] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/12/2018] [Accepted: 08/06/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Recent literature has shown the potential of high-resolution quantitative susceptibility mapping (QSM) with ultra-high field MRI for imaging the anatomy, the vasculature, and investigating their magnetostatic properties. Higher spatial resolutions, however, translate to longer scans resulting, therefore, in higher vulnerability to, and likelihood of, subject movement. We propose a gradient-recalled echo sequence with prospective motion correction (PMC) to address such limitation. METHODS Data from 4 subjects were acquired at 7T. The effect of small and large motion on QSM with and without PMC was assessed qualitatively and quantitatively. Full brain QSM and QSM-based venograms with up to 0.33 mm isotropic voxel size were reconstructed. RESULTS With PMC, motion artifacts in QSM and QSM-based venograms were largely eliminated, enabling-in both large- and small-amplitude motion regimes-accurate depiction of the cortex, vasculature, and other small anatomical structures that are often blurred as a result of head movement or indiscernible at lower image resolutions. Quantitative analyses demonstrated that uncorrected motion could bias regional susceptibility distributions, a trend that was greatly reduced with PMC. CONCLUSION Qualitatively, PMC prevented image degradation because of motion artifacts, providing highly detailed QSM images and venograms. Quantitatively, PMC increased the reproducibility of susceptibility measures.
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Affiliation(s)
- Hendrik Mattern
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Alessandro Sciarra
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Falk Lüsebrink
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Julio Acosta-Cabronero
- Wellcome Centre for Human Neuroimaging, Institute of Neurology, University College London, London, United Kingdom.,German Center for Neurodegenerative Diseases, Magdeburg, Germany
| | - Oliver Speck
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany.,German Center for Neurodegenerative Diseases, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany.,Leibniz Institute for Neurobiology, Magdeburg, Germany
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Background field removal technique based on non-regularized variable kernels sophisticated harmonic artifact reduction for phase data for quantitative susceptibility mapping. Magn Reson Imaging 2018; 52:94-101. [DOI: 10.1016/j.mri.2018.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/17/2018] [Accepted: 06/10/2018] [Indexed: 01/09/2023]
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87
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88
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Yan F, He N, Lin H, Li R. Iron deposition quantification: Applications in the brain and liver. J Magn Reson Imaging 2018; 48:301-317. [PMID: 29897645 DOI: 10.1002/jmri.26161] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/02/2018] [Indexed: 01/01/2023] Open
Abstract
Iron has long been implicated in many neurological and other organ diseases. It is known that over and above the normal increases in iron with age, in certain diseases there is an excessive iron accumulation in the brain and liver. MRI is a noninvasive means by which to image the various structures in the brain in three dimensions and quantify iron over the volume of the object of interest. The quantification of iron can provide information about the severity of iron-related diseases as well as quantify changes in iron for patient follow-up and treatment monitoring. This article provides an overview of current MRI-based methods for iron quantification, specifically for the brain and liver, including: signal intensity ratio, R2 , R2*, R2', phase, susceptibility weighted imaging and quantitative susceptibility mapping (QSM). Although there are numerous approaches to measuring iron, R2 and R2* are currently preferred methods in imaging the liver and QSM has become the preferred approach for imaging iron in the brain. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018. J. MAGN. RESON. IMAGING 2018;48:301-317.
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Affiliation(s)
- Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huimin Lin
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruokun Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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89
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Quantifying iron content in magnetic resonance imaging. Neuroimage 2018; 187:77-92. [PMID: 29702183 DOI: 10.1016/j.neuroimage.2018.04.047] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 04/13/2018] [Accepted: 04/20/2018] [Indexed: 01/19/2023] Open
Abstract
Measuring iron content has practical clinical indications in the study of diseases such as Parkinson's disease, Huntington's disease, ferritinopathies and multiple sclerosis as well as in the quantification of iron content in microbleeds and oxygen saturation in veins. In this work, we review the basic concepts behind imaging iron using T2, T2*, T2', phase and quantitative susceptibility mapping in the human brain, liver and heart, followed by the applications of in vivo iron quantification in neurodegenerative diseases, iron tagged cells and ultra-small superparamagnetic iron oxide (USPIO) nanoparticles.
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90
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Shin C, Lee S, Lee JY, Rhim JH, Park SW. Non-Motor Symptom Burdens Are Not Associated with Iron Accumulation in Early Parkinson's Disease: a Quantitative Susceptibility Mapping Study. J Korean Med Sci 2018; 33:e96. [PMID: 29573246 PMCID: PMC5865060 DOI: 10.3346/jkms.2018.33.e96] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/21/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Quantitative susceptibility mapping (QSM) has been used to measure iron accumulation in the deep nuclei of patients with Parkinson's disease (PD). This study examined the relationship between non-motor symptoms (NMSs) and iron accumulation in the deep nuclei of patients with PD. METHODS The QSM data were acquired from 3-Tesla magnetic resonance imaging (MRI) in 29 patients with early PD and 19 normal controls. The Korean version of the NMS scale (K-NMSS) was used for evaluation of NMSs in patients. The patients were divided into high NMS and low NMS groups. The region-of-interest analyses were performed in the following deep nuclei: red nucleus, substantia nigra pars compacta, substantia nigra pars reticulata, dentate nucleus, globus pallidus, putamen, and head of the caudate nucleus. RESULTS Thirteen patients had high NMS scores (total K-NMSS score, mean = 32.1), and 16 had low NMS scores (10.6). The QSM values in the deep were not different among the patients with high NMS scores, low NMS scores, and controls. The QSM values were not correlated linearly with K-NMSS total score after adjusting the age at acquisition of brain MRI. CONCLUSION The study demonstrated that the NMS burdens are not associated with iron accumulation in the deep nuclei of patients with PD. These results suggest that future neuroimaging studies on the pathology of NMSs in PD should use more specific and detailed clinical tools and recruit PD patients with severe NMSs.
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Affiliation(s)
- Chaewon Shin
- Department of Neurology, Kyung Hee University Medical Center, Seoul, Korea
| | - Seon Lee
- Department of Mechanical and Aerospace Engineering, Seoul National University, Seoul, Korea
| | - Jee Young Lee
- Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Jung Hyo Rhim
- Department of Radiology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Sun Won Park
- Department of Radiology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
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91
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Neuroimaging in Parkinson's disease: focus on substantia nigra and nigro-striatal projection. Curr Opin Neurol 2018; 30:416-426. [PMID: 28537985 DOI: 10.1097/wco.0000000000000463] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW The diagnosis of Parkinson disease is based on clinical features; however, unmet need is an imaging signature for Parkinson disease and the early differential diagnosis with atypical parkinsonisms. A summary of the molecular imaging and MRI recent evidences for Parkinson disease diagnosis will be presented in this review. RECENT FINDINGS The nigro-striatal dysfunction explored by dopamine transporter imaging is not a mandatory diagnostic criterion for Parkinson disease, recent evidence supported its utility as in-vivo proof of degenerative parkinsonisms, and there might be compensatory mechanisms leading to an early overestimation. The visualization of abnormalities in substantia nigra by MRI has been recently described as sensitive and specific tool for Parkinson disease diagnosis, even in preclinical conditions, whereas it is not useful for distinguishing between Parkinson disease and atypical parkinsonisms. The relationship between the nigral anatomical changes, evaluated as structural alterations or neuromelanin signal decrease and the dopaminergic nigro-striatal function needs to be further clarified. SUMMARY With the hopeful advent of potential neuroprotective drugs for PD, it is crucial to have imaging measures that are able to detect at risk subjects. Moreover it is desirable to increase the knowledge about which measure better predicts the probability and the time of clinical conversion to PD.
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92
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Kee Y, Liu Z, Zhou L, Dimov A, Cho J, de Rochefort L, Seo JK, Wang Y. Quantitative Susceptibility Mapping (QSM) Algorithms: Mathematical Rationale and Computational Implementations. IEEE Trans Biomed Eng 2018; 64:2531-2545. [PMID: 28885147 DOI: 10.1109/tbme.2017.2749298] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Quantitative susceptibility mapping (QSM) solves the magnetic field-to-magnetization (tissue susceptibility) inverse problem under conditions of noisy and incomplete field data acquired using magnetic resonance imaging. Therefore, sophisticated algorithms are necessary to treat the ill-posed nature of the problem and are reviewed here. The forward problem is typically presented as an integral form, where the field is the convolution of the dipole kernel and tissue susceptibility distribution. This integral form can be equivalently written as a partial differential equation (PDE). Algorithmic challenges are to reduce streaking and shadow artifacts characterized by the fundamental solution of the PDE. Bayesian maximum a posteriori estimation can be employed to solve the inverse problem, where morphological and relevant biomedical knowledge (specific to the imaging situation) are used as priors. As the cost functions in Bayesian QSM framework are typically convex, solutions can be robustly computed using a gradient-based optimization algorithm. Moreover, one can not only accelerate Bayesian QSM, but also increase its effectiveness at reducing shadows using prior knowledge based preconditioners. Improving the efficiency of QSM is under active development, and a rigorous analysis of preconditioning needs to be carried out for further investigation.Quantitative susceptibility mapping (QSM) solves the magnetic field-to-magnetization (tissue susceptibility) inverse problem under conditions of noisy and incomplete field data acquired using magnetic resonance imaging. Therefore, sophisticated algorithms are necessary to treat the ill-posed nature of the problem and are reviewed here. The forward problem is typically presented as an integral form, where the field is the convolution of the dipole kernel and tissue susceptibility distribution. This integral form can be equivalently written as a partial differential equation (PDE). Algorithmic challenges are to reduce streaking and shadow artifacts characterized by the fundamental solution of the PDE. Bayesian maximum a posteriori estimation can be employed to solve the inverse problem, where morphological and relevant biomedical knowledge (specific to the imaging situation) are used as priors. As the cost functions in Bayesian QSM framework are typically convex, solutions can be robustly computed using a gradient-based optimization algorithm. Moreover, one can not only accelerate Bayesian QSM, but also increase its effectiveness at reducing shadows using prior knowledge based preconditioners. Improving the efficiency of QSM is under active development, and a rigorous analysis of preconditioning needs to be carried out for further investigation.
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Affiliation(s)
- Youngwook Kee
- Department of Radiology, Weill Cornell Medical College, New York, USA
| | - Zhe Liu
- Department of Biomedical Engineering, Cornell University, Ithaca, USA
| | - Liangdong Zhou
- Department of Radiology, Weill Cornell Medical College, New York, USA
| | - Alexey Dimov
- Department of Biomedical Engineering, Cornell University, Ithaca, USA
| | - Junghun Cho
- Department of Biomedical Engineering, Cornell University, Ithaca, USA
| | - Ludovic de Rochefort
- Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, 13284 Marseille, France
| | - Jin Keun Seo
- Department of Computational Science and Engineering, Yonsei University, Seoul, South Korea
| | - Yi Wang
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
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93
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Vela D. Hepcidin, an emerging and important player in brain iron homeostasis. J Transl Med 2018; 16:25. [PMID: 29415739 PMCID: PMC5803919 DOI: 10.1186/s12967-018-1399-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 01/31/2018] [Indexed: 02/08/2023] Open
Abstract
Hepcidin is emerging as a new important factor in brain iron homeostasis. Studies suggest that there are two sources of hepcidin in the brain; one is local and the other comes from the circulation. Little is known about the molecular mediators of local hepcidin expression, but inflammation and iron-load have been shown to induce hepcidin expression in the brain. The most important source of hepcidin in the brain are glial cells. Role of hepcidin in brain functions has been observed during neuronal iron-load and brain hemorrhage, where secretion of abundant hepcidin is related with the severity of brain damage. This damage can be reversed by blocking systemic and local hepcidin secretion. Studies have yet to unveil its role in other brain conditions, but the rationale exists, since these conditions are characterized by overexpression of the factors that stimulate brain hepcidin expression, such as inflammation, hypoxia and iron-overload.
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Affiliation(s)
- Driton Vela
- Department of Physiology, Faculty of Medicine, University of Prishtina, Martyr's Boulevard n.n., 10000, Prishtina, Kosova.
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94
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Guan X, Huang P, Zeng Q, Liu C, Wei H, Xuan M, Gu Q, Xu X, Wang N, Yu X, Luo X, Zhang M. Quantitative susceptibility mapping as a biomarker for evaluating white matter alterations in Parkinson’s disease. Brain Imaging Behav 2018; 13:220-231. [DOI: 10.1007/s11682-018-9842-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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95
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Xu H, Wang Y, Song N, Wang J, Jiang H, Xie J. New Progress on the Role of Glia in Iron Metabolism and Iron-Induced Degeneration of Dopamine Neurons in Parkinson's Disease. Front Mol Neurosci 2018; 10:455. [PMID: 29403352 PMCID: PMC5780449 DOI: 10.3389/fnmol.2017.00455] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 12/26/2017] [Indexed: 12/26/2022] Open
Abstract
It is now increasingly appreciated that glial cells play a critical role in the regulation of iron homeostasis. Impairment of these properties might lead to dysfunction of iron metabolism and neurodegeneration of neurons. We have previously shown that dysfunction of glia could cause iron deposit and enhance iron-induced degeneration of dopamine (DA) neurons in Parkinson’s disease (PD). There also has been a substantial growth of knowledge regarding the iron metabolism of glia and their effects on iron accumulation and degeneration of DA neurons in PD in recent years. Here, we attempt to describe the role of iron metabolism of glia and the effect of glia on iron accumulation and degeneration of DA neurons in the substantia nigra of PD. This could provide evidence to reveal the mechanisms underlying nigral iron accumulation of DA neurons in PD and provide the basis for discovering new potential therapeutic targets for PD.
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Affiliation(s)
- Huamin Xu
- Collaborative Innovation Center for Brain Science, Department of Physiology, Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Medical College of Qingdao University, Qingdao, China
| | - Youcui Wang
- Collaborative Innovation Center for Brain Science, Department of Physiology, Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Medical College of Qingdao University, Qingdao, China
| | - Ning Song
- Collaborative Innovation Center for Brain Science, Department of Physiology, Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Medical College of Qingdao University, Qingdao, China
| | - Jun Wang
- Collaborative Innovation Center for Brain Science, Department of Physiology, Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Medical College of Qingdao University, Qingdao, China
| | - Hong Jiang
- Collaborative Innovation Center for Brain Science, Department of Physiology, Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Medical College of Qingdao University, Qingdao, China
| | - Junxia Xie
- Collaborative Innovation Center for Brain Science, Department of Physiology, Shandong Provincial Collaborative Innovation Center for Neurodegenerative Disorders, Key Laboratory of Pathogenesis and Prevention of Neurological Disorders and State Key Disciplines: Physiology, Medical College of Qingdao University, Qingdao, China
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96
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Quantifying iron deposition within the substantia nigra of Parkinson's disease by quantitative susceptibility mapping. J Neurol Sci 2018; 386:46-52. [PMID: 29406966 DOI: 10.1016/j.jns.2018.01.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 12/08/2017] [Accepted: 01/08/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Iron deposition within the substantia nigra (SN) has been postulated to play a vital role in Parkinson's disease (PD). The aim of this study was to explore the inherent link of PD patients between their substantia nigra iron accumulation and clinical status using quantitative susceptibility mapping (QSM) which is now considered to be the only quantitative imaging technique of brain iron deposition. METHODS 44 PD patients and 31 age- and gender-matched healthy controls underwent quantitative susceptibility mapping (QSM) were recruited in this study. We firstly divided the patients into mild symptom severity (MSP) and advanced symptom severity (ASP) groups concerning their disease stage, aiming to illuminate the relationship between iron deposition in SN of PD and disease progression. Then, we classified the patients with Parkinson's disease into three subgroups: tremor-dominant PD (TD), akinetic/rigidity-dominant PD (AR), mixed-PD (M) according to their dominant motor symptoms in order to investigate whether there are any effects of SN iron accumulation to different subtypes of PD patients. RESULTS Compared to healthy controls, patients with PD have increased QSM magnetic values in the substantia nigra (138.039±37.320 vs 179.553±65.715; P=0.001). More prominent statistically significance of the difference of SN iron deposition between healthy controls (HC) and advanced symptom severity (ASP) subgroup was displayed (138.039±37.320 vs 232.827±92.040; P<0.001). Besides, among the three clinical phenotypes both TD and AR subgroup showed significant difference compared with healthy controls concerning the QSM values (138.039±37.320 vs 185.864±99.851; P=0.013; 188.148±52.958 vs 138.039±37.320; P=0.001). Furthermore, the iron content in the SN of PD patients was significantly correlated with the Hoehn-Yahr stage, the Unified Parkinson's Disease Rating Scale (UPDRS), Montgomery Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Scale (HAMA) scores (r=0.417, P=0.005; r=0.300, P=0.048; r=0.540, P<0.001; r=0.553, P<0.001). In MSP the significantly correlation was displayed only in MADRS, HAMA scores (r=0.429, P=0.013; r=0.492, P=0.004), when disease progressed into advanced severity stage all these clinical measures (Hoehn-Yahr stage, UPDRS-3, UPDRS, HAMA, and MADRS scores) we had recruited into this study shown prominent correlation to SN iron content (r=0.650, P=0.030; r=0.709, P=0.015; r=0.708, P=0.015; r=0.758, P=0.007; r=0.683, P=0.020). In the three phenotypes the correlation between iron content and MADRS, HAMA scores (r=0.686, P=0.002; r=0.633, P=0.006) was found in AR subgroups exclusively. CONCLUSIONS Patients with PD exhibited significantly higher magnetic susceptibility values, especially in those who are in advanced disease severity stage, which confirmed that iron accumulation in the SN is in line with Parkinson's disease progression. Furthermore, we testified that there are actually some inherent effects of substantia nigra iron deposition to the clinical symptoms of Parkinson's disease. Moreover, it seems that akinetic/rigidity-dominant PD subgroup was affected most by SN iron accumulation.
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97
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Kim EY, Sung YH, Shin HG, Noh Y, Nam Y, Lee J. Diagnosis of Early-Stage Idiopathic Parkinson's Disease Using High-Resolution Quantitative Susceptibility Mapping Combined with Histogram Analysis in the Substantia Nigra at 3 T. J Clin Neurol 2018; 14:90-97. [PMID: 29629545 PMCID: PMC5765262 DOI: 10.3988/jcn.2018.14.1.90] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 12/15/2022] Open
Abstract
Background and Purpose To test whether nigrosome-1 imaging using high-resolution quantitative susceptibility mapping (QSM) combined with histogram analysis can improve the diagnostic accuracy in early-stage idiopathic Parkinson's disease (IPD) patients. Methods Three-dimensional multiecho gradient-recalled echo images (0.5×0.5×1.0 mm3) were obtained at 3 T for QSM in 38 patients with IPD and 25 healthy subjects. To segment the substantia nigra (SN), regions of interest (ROIs) were semiautomatically drawn at the location below the red nucleus, and the normal-appearing nigrosome-1 was determined by manual correction. QSM histograms were obtained within the ROI. The segmented SN regions on the right and left that had higher mean susceptibility values and fewer voxels with susceptibility values lower than 60, 65, 70, 75, and 80 ppb were chosen for comparisons between the IPD patients and healthy subjects. These results were compared with those of the visual assessments of nigrosome-1 in susceptibility map-weighted imaging (SMWI) by analyzing receiver operating characteristics curves. Results The proportion of voxels with susceptibility values lower than 70 ppb showed the best diagnostic performance, with its value differing significantly between the IPD patients (median=0, interquartile range=0–0.23) and healthy subjects (median=10.67, interquartile range=5.98–21.57) (p<0.0001). The number of voxels with susceptibility values lower than 60, 65, 70, 75, and 80 ppb showed worse diagnostic performances but were still significantly better than that of the mean susceptibility value (p=0.0249, 0.0192, 0.0183, 0.0191, and 0.0186, respectively), which also differed significantly between the two groups: 125.81±16.27 ppb (mean±standard deviation) in IPD versus 98.41±11.70 ppb in healthy subjects (p<0.0001). Additionally, using the proportion of voxels with susceptibility values lower than 70 ppb provided significantly better diagnostic performance than did visual assessments of SMWI (p=0.0143). Conclusions High-spatial-resolution QSM combined with histogram analysis at 3 T can improve the diagnostic accuracy of early-stage IPD.
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Affiliation(s)
- Eung Yeop Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Young Hee Sung
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Hyeong Geol Shin
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Young Noh
- Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea
| | - Yoonho Nam
- Department of Radiology, Seoul St. Mary's Hospital, Seoul, Korea.
| | - Jongho Lee
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea.
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98
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Ex-vivo quantitative susceptibility mapping of human brain hemispheres. PLoS One 2017; 12:e0188395. [PMID: 29261693 PMCID: PMC5737971 DOI: 10.1371/journal.pone.0188395] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/18/2017] [Indexed: 12/30/2022] Open
Abstract
Ex-vivo brain quantitative susceptibility mapping (QSM) allows investigation of brain characteristics at essentially the same point in time as histopathologic examination, and therefore has the potential to become an important tool for determining the role of QSM as a diagnostic and monitoring tool of age-related neuropathologies. In order to be able to translate the ex-vivo QSM findings to in-vivo, it is crucial to understand the effects of death and chemical fixation on brain magnetic susceptibility measurements collected ex-vivo. Thus, the objective of this work was twofold: a) to assess the behavior of magnetic susceptibility in both gray and white matter of human brain hemispheres as a function of time postmortem, and b) to establish the relationship between in-vivo and ex-vivo gray matter susceptibility measurements on the same hemispheres. Five brain hemispheres from community-dwelling older adults were imaged ex-vivo with QSM on a weekly basis for six weeks postmortem, and the longitudinal behavior of ex-vivo magnetic susceptibility in both gray and white matter was assessed. The relationship between in-vivo and ex-vivo gray matter susceptibility measurements was investigated using QSM data from eleven older adults imaged both antemortem and postmortem. No systematic change in ex-vivo magnetic susceptibility of gray or white matter was observed over time postmortem. Additionally, it was demonstrated that, gray matter magnetic susceptibility measured ex-vivo may be well modeled as a linear function of susceptibility measured in-vivo. In conclusion, magnetic susceptibility in gray and white matter measured ex-vivo with QSM does not systematically change in the first six weeks after death. This information is important for future cross-sectional ex-vivo QSM studies of hemispheres imaged at different postmortem intervals. Furthermore, the linear relationship between in-vivo and ex-vivo gray matter magnetic susceptibility suggests that ex-vivo QSM captures information linked to antemortem gray matter magnetic susceptibility, which is important for translation of ex-vivo QSM findings to in-vivo.
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99
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Xuan M, Guan X, Gu Q, Shen Z, Yu X, Qiu T, Luo X, Song R, Jiaerken Y, Xu X, Huang P, Luo W, Zhang M. Different iron deposition patterns in early- and middle-late-onset Parkinson's disease. Parkinsonism Relat Disord 2017; 44:23-27. [DOI: 10.1016/j.parkreldis.2017.08.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/22/2017] [Accepted: 08/08/2017] [Indexed: 01/03/2023]
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100
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Naduthota RM, Honnedevasthana AA, Lenka A, Saini J, Geethanath S, Bharath RD, Christopher R, Yadav R, Gupta AK, Pal PK. Association of freezing of gait with nigral iron accumulation in patients with Parkinson's disease. J Neurol Sci 2017; 382:61-65. [PMID: 29111022 DOI: 10.1016/j.jns.2017.09.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/08/2017] [Accepted: 09/22/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE The objective of this work was to investigate whether patients with and without freezing of gait (FOG) in Parkinson's disease (PD) have differences in iron accumulation in substantia nigra using R2* relaxometry. MATERIALS AND METHODS This study included seventeen PD patients with FOG [FOG (+)], equal number of age and gender matched patients without FOG [FOG (-)] and 34 healthy controls (HC). T2* images were obtained from a 3-Tesla MRI system using multi-echo sequence. R2* values were extracted from Substantia Nigra (SN) and red nucleus and were compared among the three groups and correlated with clinical findings. RESULTS R2* values were increased in PD group as a whole compared to HC in rostral and caudal segments of Substantia Nigra pars compacta (SNc) and in Substantia Nigra pars reticulata (SNr) but not in red nucleus. Within PD subgroups, FOG (+) group had increased iron accumulation in SNc compared to FOG (-) and HC. FOG score positively correlated with R2* values in the caudal region of SNc in FOG (+) group. CONCLUSIONS Our study reveals higher nigral iron content in FOG (+) compared to FOG (-) and HCs. In addition, we observed positive correlation of FOG score with iron accumulation in SNc. Results of this study emphasize possible role of higher nigral iron content in the pathogenesis of FOG in PD.
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Affiliation(s)
- Rajini M Naduthota
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Arush Arun Honnedevasthana
- Medical Imaging Research Center, Dayanand Sagar Institutions, Kumara Swamy Layout, Bangalore 560078, India
| | - Abhishek Lenka
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India; Department of Clinical Neurosciences, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Sairam Geethanath
- Medical Imaging Research Center, Dayanand Sagar Institutions, Kumara Swamy Layout, Bangalore 560078, India
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Rita Christopher
- Department of Neurochemistry, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Ravi Yadav
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Arun Kumar Gupta
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India
| | - Pramod Kumar Pal
- Department of Neurology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore 560029, Karnataka, India.
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