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Monsivais H, Yeh CL, Edmondson A, Harold R, Snyder S, Wells EM, Schmidt-Wilcke T, Foti D, Zauber SE, Dydak U. Whole-brain mapping of increased manganese levels in welders and its association with exposure and motor function. Neuroimage 2024; 288:120523. [PMID: 38278427 PMCID: PMC11124758 DOI: 10.1016/j.neuroimage.2024.120523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/29/2023] [Accepted: 01/23/2024] [Indexed: 01/28/2024] Open
Abstract
Although manganese (Mn) is a trace metal essential for humans, chronic exposure to Mn can cause accumulation of this metal ion in the brain leading to an increased risk of neurological and neurobehavioral health effects. This is a concern for welders exposed to Mn through welding fumes. While brain Mn accumulation in occupational settings has mostly been reported in the basal ganglia, several imaging studies also revealed elevated Mn in other brain areas. Since Mn functions as a magnetic resonance imaging (MRI) T1 contrast agent, we developed a whole-brain MRI approach to map in vivo Mn deposition differences in the brains of non-exposed factory controls and exposed welders. This is a cross-sectional analysis of 23 non-exposed factory controls and 36 exposed full-time welders from the same truck manufacturer. We collected high-resolution 3D MRIs of brain anatomy and R1 relaxation maps to identify regional differences using voxel-based quantification (VBQ) and statistical parametric mapping. Furthermore, we investigated the associations between excess Mn deposition and neuropsychological and motor test performance. Our results indicate that: (1) Using whole-brain MRI relaxometry methods we can generate excess Mn deposition maps in vivo, (2) excess Mn accumulation due to occupational exposure occurs beyond the basal ganglia in cortical areas associated with motor and cognitive functions, (3) Mn likely diffuses along white matter tracts in the brain, and (4) Mn deposition in specific brain regions is associated with exposure (cerebellum and frontal cortex) and motor metrics (cerebellum and hippocampus).
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Affiliation(s)
| | - Chien-Lin Yeh
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Takeda Pharmaceutical Company Ltd, Cambridge, MA, USA
| | - Alex Edmondson
- Cincinnati Children's Hospital Medical Center, Imaging Research Center, Cincinnati, OH, USA; University of Cincinnati College of Medicine, Department of Environmental and Public Health Sciences, Cincinnati, OH USA
| | - Roslyn Harold
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Sandy Snyder
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Department of Speech, Language and Hearing Sciences, Purdue University, West Lafayette, IN, USA
| | - Ellen M Wells
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Tobias Schmidt-Wilcke
- Department of Neurology, St. Mauritius Therapieklinik, Meerbusch, Germany; Institute of Clinical Neuroscience and Medical Psychology, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Dan Foti
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - S Elizabeth Zauber
- Department of Neurology, Indiana University School of Medicine, Indianapolis, USA
| | - Ulrike Dydak
- School of Health Sciences, Purdue University, West Lafayette, IN, USA; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
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Lee EY, Kim J, Prado-Rico JM, Du G, Lewis MM, Kong L, Yanosky JD, Eslinger P, Kim BG, Hong YS, Mailman RB, Huang X. Effects of mixed metal exposures on MRI diffusion features in the medial temporal lobe. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.07.18.23292828. [PMID: 37503124 PMCID: PMC10371112 DOI: 10.1101/2023.07.18.23292828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Background Environmental exposure to metal mixtures is common and may be associated with increased risk for neurodegenerative disorders including Alzheimer's disease. Objective This study examined associations of mixed metal exposures with medial temporal lobe (MTL) MRI structural metrics and neuropsychological performance. Methods Metal exposure history, whole blood metal, and neuropsychological tests were obtained from subjects with/without a history of mixed metal exposure from welding fumes (42 exposed subjects; 31 controls). MTL structures (hippocampus, entorhinal and parahippocampal cortices) were assessed by morphologic (volume, cortical thickness) and diffusion tensor imaging [mean (MD), axial (AD), radial diffusivity (RD), and fractional anisotropy (FA)] metrics. In exposed subjects, correlation, multiple linear, Bayesian kernel machine regression, and mediation analyses were employed to examine effects of single- or mixed-metal predictor(s) and their interactions on MTL structural and neuropsychological metrics; and on the path from metal exposure to neuropsychological consequences. Results Compared to controls, exposed subjects had higher blood Cu, Fe, K, Mn, Pb, Se, and Zn levels (p's<0.026) and poorer performance in processing/psychomotor speed, executive, and visuospatial domains (p's<0.046). Exposed subjects displayed higher MD, AD, and RD in all MTL ROIs (p's<0.040) and lower FA in entorhinal and parahippocampal cortices (p's<0.033), but not morphological differences. Long-term mixed-metal exposure history indirectly predicted lower processing speed performance via lower parahippocampal FA (p=0.023). Higher whole blood Mn and Cu predicted higher entorhinal diffusivity (p's<0.043) and lower Delayed Story Recall performance (p=0.007) without overall metal mixture or interaction effects. Discussion Mixed metal exposure predicted MTL structural and neuropsychological features that are similar to Alzheimer's disease at-risk populations. These data warrant follow-up as they may illuminate the path for environmental exposure to Alzheimer's disease-related health outcomes.
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Affiliation(s)
- Eun-Young Lee
- Department of Health Care and Science, Dong-A University, Busan, South-Korea
| | - Juhee Kim
- Department of Health Care and Science, Dong-A University, Busan, South-Korea
| | - Janina Manzieri Prado-Rico
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
| | - Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
| | - Lan Kong
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
| | - Jeff D. Yanosky
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
| | - Paul Eslinger
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
| | - Byoung-Gwon Kim
- Department of Preventive Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - Young-Seoub Hong
- Department of Preventive Medicine, College of Medicine, Dong-A University, Busan, South Korea
| | - Richard B. Mailman
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA
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3
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Zahr N, Sullivan E, Pfefferbaum A. [WITHDRAWN] Serum biomarkers of liver fibrosis identify changes in striatal metabolite levels. RESEARCH SQUARE 2024:rs.3.rs-2729490. [PMID: 37034697 PMCID: PMC10081358 DOI: 10.21203/rs.3.rs-2729490/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
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4
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Kwong AJ, Zahr NM. Serum biomarkers of liver fibrosis identify globus pallidus vulnerability. Neuroimage Clin 2023; 37:103333. [PMID: 36868044 PMCID: PMC9996367 DOI: 10.1016/j.nicl.2023.103333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/12/2023] [Accepted: 01/19/2023] [Indexed: 01/28/2023]
Abstract
The CNS manifestation of chronic liver disease can include magnetic resonance (MR) signal hyperintensities in basal ganglia structures. Here, relations between liver (serum-derived fibrosis scores) and brain (regional T1-weighted signal intensities and volumes) integrity were evaluated in a sample of 457 individuals including those with alcohol use disorders (AUD), people living with human immunodeficiency virus (HIV), those comorbid for AUD and HIV, and healthy controls. Liver fibrosis was identified from cutoff scores as follows: aspartate aminotransferase to platelet ratio index (APRI) > 0.7 in 9.4% (n = 43) of the cohort; fibrosis score (FIB4) > 1.5 in 28.0% (n = 128) of the cohort; and non-alcoholic fatty liver disease fibrosis score (NFS) > -1.4 in 30.2% (n = 138) of the cohort. Presence of serum-derived liver fibrosis was associated with high signal intensities selective to basal ganglia (i.e., caudate, putamen, and pallidum) structures. High signal intensities in the pallidum, however, explained a significant portion of the variance in APRI (25.0%) and FIB4 (23.6%) cutoff scores. Further, among the regions evaluated, only the globus pallidus showed a correlation between greater signal intensity and smaller volume (r = -0.44, p <.0001). Finally, higher pallidal signal intensity correlated worse ataxia (eyes open ρ = -0.23, p =.0002; eyes closed ρ = -0.21, p =.0005). This study suggests that clinically relevant serum biomarkers of liver fibrosis such as the APRI may identify individuals vulnerable to globus pallidus pathology and contribute to problems with postural balance.
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Affiliation(s)
- Allison J Kwong
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, School of Medicine, Redwood City, CA 94063, USA
| | - Natalie M Zahr
- Department of Psychiatry & Behavioral Sciences, Stanford University, School of Medicine, 401 Quarry Rd. Stanford, CA 94305, USA; Neuroscience Program, SRI International, Menlo Park, CA 94025, USA.
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5
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Jensen N, Terrell R, Ramoju S, Shilnikova N, Farhat N, Karyakina N, Cline BH, Momoli F, Mattison D, Krewski D. Magnetic resonance imaging T1 indices of the brain as biomarkers of inhaled manganese exposure. Crit Rev Toxicol 2022; 52:358-370. [PMID: 36412542 DOI: 10.1080/10408444.2022.2128719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Excessive exposure to manganese (Mn) is linked to its accumulation in the brain and adverse neurological effects. Paramagnetic properties of Mn allow the use of magnetic resonance imaging (MRI) techniques to identify it in biological tissues. A critical review was conducted to evaluate whether MRI techniques could be used as a diagnostic tool to detect brain Mn accumulation as a quantitative biomarker of inhaled exposure. A comprehensive search was conducted in MEDLINE, EMBASE, and PubMed to identify potentially relevant studies published prior to 9 May 2022. Two reviewers independently screened identified references using a two-stage process. Of the 6452 unique references identified, 36 articles were retained for data abstraction. Eligible studies used T1-weighted MRI techniques and reported direct or indirect T1 measures to characterize Mn accumulation in the brain. Findings demonstrate that, in subjects exposed to high levels of Mn, deposition in the brain is widespread, accumulating both within and outside the basal ganglia. Available evidence indicates that T1 MRI techniques can be used to distinguish Mn-exposed individuals from unexposed. Additionally, T1 MRI may be useful for semi-quantitative evaluation of inhaled Mn exposure, particularly when interpreted along with other exposure indices. T1 MRI measures appear to have a nonlinear relationship to Mn exposure duration, with R1 signal only increasing after critical thresholds. The strength of the association varied depending on the regions of interest imaged and the method of exposure measurement. Overall, available evidence suggests potential for future clinical and risk assessment applications of MRI as a diagnostic tool.
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Affiliation(s)
- N Jensen
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - R Terrell
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - S Ramoju
- Risk Sciences International, Ottawa, Canada
| | - N Shilnikova
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - N Farhat
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,School of Mathematics and Statistics, Carleton University, Ottawa, Canada
| | - N Karyakina
- Risk Sciences International, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - B H Cline
- International Manganese Institute, Paris, France
| | - F Momoli
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - D Mattison
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - D Krewski
- Risk Sciences International, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.,School of Mathematics and Statistics, Carleton University, Ottawa, Canada
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6
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Mehrifar Y, Bahrami M, Sidabadi E, Pirami H. The effects of occupational exposure to manganese fume on neurobehavioral and neurocognitive functions: An analytical cross-sectional study among welders. EXCLI JOURNAL 2020; 19:372-386. [PMID: 32327958 PMCID: PMC7174571 DOI: 10.17179/excli2019-2042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/09/2020] [Indexed: 01/26/2023]
Abstract
This study aimed to measure concentrations of manganese fume in breathing zone (BZ) and blood among welders to assess neurocognitive and neurobehavioral functions among them. In this study 38 welders and 27 administrative employees participated. Q16 questionnaire was used to evaluate neurobehavioral symptoms. The computerized Stroop test and Continuous Performance Test (CPT) were used to assess neurocognitive functions. Sampling and analysis of manganese fumes in the BZ and blood samples were performed according to NIOSH-7300 and NIOSH-8005 methods, respectively. Average concentration of manganese in the welders' BZ and blood was 0.81 ± 0.21 mg/m3 and 18.33 ± 5.84 µg/l. Frequency of neurobehavioral symptoms was significantly higher in welders compared with control group. Spearman correlation test showed a moderate correlation between Mn concentrations in the BZ and blood Mn levels (rs = 0.352). There were statistical moderate and strong correlations between the frequency of neurobehavioral symptoms and manganese concentrations in the BZ (r=0.504) and blood Mn levels (r=0.643).The Pearson correlation coefficient (r=0.433-0.690) obtained on the psychological tests showed a moderate to strong correlation between manganese concentrations in the welders' BZ and blood and some indices of the Stroop test and CPT. The results of this study can confirm the effect of manganese inhalation on creating neurobehavioral and neurocognitive impairments in welders.
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Affiliation(s)
- Younes Mehrifar
- Department of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahshid Bahrami
- Department of Occupational Health Engineering, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmail Sidabadi
- Department of Occupational Health Engineering, Islamic Azad University, Sabzevar, Iran
| | - Hamideh Pirami
- Department of Occupational Health, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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7
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de Prado Bert P, Mercader EMH, Pujol J, Sunyer J, Mortamais M. The Effects of Air Pollution on the Brain: a Review of Studies Interfacing Environmental Epidemiology and Neuroimaging. Curr Environ Health Rep 2019; 5:351-364. [PMID: 30008171 PMCID: PMC6132565 DOI: 10.1007/s40572-018-0209-9] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Purpose of Review An emerging body of evidence has raised concern regarding the potentially harmful effects of inhaled pollutants on the central nervous system during the last decade. In the general population, traffic-related air pollution (TRAP) exposure has been associated with adverse effects on cognitive, behavior, and psychomotor development in children, and with cognitive decline and higher risk of dementia in the elderly. Recently, studies have interfaced environmental epidemiology with magnetic resonance imaging to investigate in vivo the effects of TRAP on the human brain. The aim of this systematic review was to describe and synthesize the findings from these studies. The bibliographic search was carried out in PubMed with ad hoc keywords. Recent Findings The selected studies revealed that cerebral white matter, cortical gray matter, and basal ganglia might be the targets of TRAP. The detected brain damages could be involved in cognition changes. Summary The effect of TRAP on cognition appears to be biologically plausible. Interfacing environmental epidemiology and neuroimaging is an emerging field with room for improvement. Future studies, together with inputs from experimental findings, should provide more relevant and detailed knowledge about the nature of the relationship between TRAP exposure and cognitive, behavior, and psychomotor disorders observed in the general population.
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Affiliation(s)
| | | | - Jesus Pujol
- MRI Research Unit, Department of Radiology, Hospital del Mar, Barcelona, Spain
- Centro Investigación Biomédica en Red de Salud Mental, CIBERSAM G21, Barcelona, Spain
| | - Jordi Sunyer
- Pompeu Fabra University, Barcelona, Catalonia, Spain
- ISGLOBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Institut Hospital del Mar d'Investigacions Mèdiques-Parc de Salut Mar, Barcelona, Catalonia, Spain
| | - Marion Mortamais
- Pompeu Fabra University, Barcelona, Catalonia, Spain.
- ISGLOBAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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8
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Bowler RM, Yeh CL, Adams SW, Ward EJ, Ma RE, Dharmadhikari S, Snyder SA, Zauber SE, Wright CW, Dydak U. Association of MRI T1 relaxation time with neuropsychological test performance in manganese- exposed welders. Neurotoxicology 2018; 64:19-29. [PMID: 28587807 PMCID: PMC5905426 DOI: 10.1016/j.neuro.2017.05.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 05/23/2017] [Accepted: 05/30/2017] [Indexed: 01/07/2023]
Abstract
This study examines the results of neuropsychological testing of 26 active welders and 17 similar controls and their relationship to welders' shortened MRI T1 relaxation time, indicative of increased brain manganese (Mn) accumulation. Welders were exposed to Mn for an average duration of 12.25 years to average levels of Mn in air of 0.11±0.05mg/m3. Welders scored significantly worse than controls on Fruit Naming and the Parallel Lines test of graphomotor tremor. Welders had shorter MRI T1 relaxation times than controls in the globus pallidus, substantia nigra, caudate nucleus, and the anterior prefrontal lobe. 63% of the variation in MRI T1 relaxation times was accounted for by exposure group. In welders, lower relaxation times in the caudate nucleus and substantia nigra were associated with lower neuropsychological test performance on tests of verbal fluency (Fruit Naming), verbal learning, memory, and perseveration (WHO-UCLA AVLT). Results indicate that verbal function may be one of the first cognitive domains affected by brain Mn deposition in welders as reflected by MRI T1 relaxation times.
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Affiliation(s)
- R M Bowler
- San Francisco State University, Department of Psychology, 1600 Holloway Ave., San Francisco, CA 94132, USA.
| | - C-L Yeh
- School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN 47907, USA; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 950 W. Walnut Street, Indianapolis, IN, 46202, USA
| | - S W Adams
- San Francisco State University, Department of Psychology, 1600 Holloway Ave., San Francisco, CA 94132, USA
| | - E J Ward
- School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN 47907, USA
| | - R E Ma
- School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN 47907, USA; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 950 W. Walnut Street, Indianapolis, IN, 46202, USA
| | - S Dharmadhikari
- Department of Radiology and Imaging Sciences, Emory University Hospital,1364 Clifton Road, Atlanta, GA, 30322, USA
| | - S A Snyder
- School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN 47907, USA; Department of Speech, Language and Hearing Sciences, Purdue University, 715 Clinic Drive, West Lafayette, IN 47907, USA
| | - S E Zauber
- Department of Neurology, Indiana University School of Medicine, 355 W 16th St, Indianapolis, IN 46202, USA
| | - C W Wright
- San Francisco State University, Department of Psychology, 1600 Holloway Ave., San Francisco, CA 94132, USA
| | - U Dydak
- School of Health Sciences, Purdue University, 550 Stadium Mall Drive, West Lafayette, IN 47907, USA; Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 950 W. Walnut Street, Indianapolis, IN, 46202, USA; Department of Speech, Language and Hearing Sciences, Purdue University, 715 Clinic Drive, West Lafayette, IN 47907, USA.
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9
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Bailey LA, Kerper LE, Goodman JE. Derivation of an occupational exposure level for manganese in welding fumes. Neurotoxicology 2018. [DOI: 10.1016/j.neuro.2017.06.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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10
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Akcan E, Özkurt S, Sahin G, Yalcin AU, Adapinar B. The relation between brain MRI findings and blood manganese levels in renal transplantation, hemodialysis, and peritoneal dialysis patients. Int Urol Nephrol 2017; 50:173-177. [PMID: 29071558 DOI: 10.1007/s11255-017-1731-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/16/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Various factors can affect blood and tissue levels of trace elements in patients with end-stage renal disease. There are a few studies showing hyperintensity of basal ganglia associated with manganese deposition in hemodialysis (HD) patients. The present study aimed to investigate the intensity changes as markers of manganese deposition in the basal ganglia and to demonstrate their association with blood manganese levels using ICP/MS technique in HD, peritoneal dialysis (PD), and renal transplant patients. METHODS The study included 20 HD, 20 PD, 20 renal transplant patients, and 20 healthy controls. Blood manganese levels were obtained, and cranial magnetic resonance images were evaluated for basal ganglia hyperintensity. RESULTS Blood manganese levels were similar across all study groups (p = 0.308), whereas symmetric basal ganglia hyperintensity indicating manganese deposition was detected only in HD patients (p = < 0.001). There was a significant relationship between manganese deposition and duration of dialysis (p = 0.05). CONCLUSION Imaging findings suggesting manganese deposition in the basal ganglia being present only in HD patients suggest that manganese deposition could be caused by the hemodialysis method itself rather than uremia and renal failure. Further studies are required in this regard, as previous studies have not clearly identified the mechanisms by which hemodialysis causes these changes.
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Affiliation(s)
- Esra Akcan
- Department of Radiology, Eskisehir State Hospital, Eskisehir, Turkey
| | - Sultan Özkurt
- Department of Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
| | - Garip Sahin
- Department of Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ahmet Ugur Yalcin
- Department of Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Baki Adapinar
- Private Acıbadem Eskisehir Hospital, Eskisehir, Turkey
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11
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Máté Z, Horváth E, Papp A, Kovács K, Tombácz E, Nesztor D, Szabó T, Szabó A, Paulik E. Neurotoxic effects of subchronic intratracheal Mn nanoparticle exposure alone and in combination with other welding fume metals in rats. Inhal Toxicol 2017; 29:227-238. [PMID: 28722486 DOI: 10.1080/08958378.2017.1350218] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Manganese (Mn) is a toxic heavy metal exposing workers in various occupational settings and causing, among others, nervous system damage. Metal fumes of welding, a typical source of Mn exposure, contain a complex mixture of metal oxides partly in nanoparticle form. As toxic effects of complex substances cannot be sufficiently understood by examining its components separately, general toxicity and functional neurotoxicity of a main pathogenic welding fume metal, Mn, was examined alone and combined with iron (Fe) and chromium (Cr), also frequently found in fumes. Oxide nanoparticles of Mn, Mn + Fe, Mn + Cr and the triple combination were applied, in aqueous suspension, to the trachea of young adult Wistar rats for 4 weeks. The decrease of body weight gain during treatment, caused by Mn, was counteracted by Fe, but not Cr. At the end of treatment, spontaneous and evoked cortical electrical activity was recorded. Mn caused a shift to higher frequencies, and lengthened evoked potential latency, which were also strongly diminished by co-application of Fe only. The interaction of the metals seen in body weight gain and cortical activity were not related to the measured blood and brain metal levels. Fe might have initiated protective, e.g. antioxidant, mechanisms with a more general effect.
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Affiliation(s)
- Zsuzsanna Máté
- a Department of Public Health, Faculty of Medicine , University of Szeged , Szeged , Hungary
| | - Edina Horváth
- a Department of Public Health, Faculty of Medicine , University of Szeged , Szeged , Hungary
| | - András Papp
- a Department of Public Health, Faculty of Medicine , University of Szeged , Szeged , Hungary
| | - Krisztina Kovács
- b Department of Physical Chemistry and Materials Science, Faculty of Science and Informatics , University of Szeged , Szeged , Hungary
| | - Etelka Tombácz
- b Department of Physical Chemistry and Materials Science, Faculty of Science and Informatics , University of Szeged , Szeged , Hungary
| | - Dániel Nesztor
- b Department of Physical Chemistry and Materials Science, Faculty of Science and Informatics , University of Szeged , Szeged , Hungary
| | - Tamás Szabó
- b Department of Physical Chemistry and Materials Science, Faculty of Science and Informatics , University of Szeged , Szeged , Hungary
| | - Andrea Szabó
- a Department of Public Health, Faculty of Medicine , University of Szeged , Szeged , Hungary
| | - Edit Paulik
- a Department of Public Health, Faculty of Medicine , University of Szeged , Szeged , Hungary
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12
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Ramoju SP, Mattison DR, Milton B, McGough D, Shilnikova N, Clewell HJ, Yoon M, Taylor MD, Krewski D, Andersen ME. The application of PBPK models in estimating human brain tissue manganese concentrations. Neurotoxicology 2017; 58:226-237. [PMID: 27989617 DOI: 10.1016/j.neuro.2016.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 12/01/2016] [Accepted: 12/01/2016] [Indexed: 01/16/2023]
Affiliation(s)
- Siva P Ramoju
- Risk Sciences International, 55 Metcalfe Street, Suite 700, K1P 6L5, Ottawa, Canada.
| | - Donald R Mattison
- Risk Sciences International, 55 Metcalfe Street, Suite 700, K1P 6L5, Ottawa, Canada; Samuel R. McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, 850 Peter Morand Crescent, Room 119, University of Ottawa, Ottawa, K1G 3Z7, Canada
| | - Brittany Milton
- Risk Sciences International, 55 Metcalfe Street, Suite 700, K1P 6L5, Ottawa, Canada
| | - Doreen McGough
- International Manganese Institute, 17 rue Duphot, 75001 Paris, France
| | - Natalia Shilnikova
- Risk Sciences International, 55 Metcalfe Street, Suite 700, K1P 6L5, Ottawa, Canada; Samuel R. McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, 850 Peter Morand Crescent, Room 119, University of Ottawa, Ottawa, K1G 3Z7, Canada
| | - Harvey J Clewell
- ScitoVation, 6 Davis Drive, PO Box 110566, Research Triangle Park, NC 27709,United States
| | - Miyoung Yoon
- ScitoVation, 6 Davis Drive, PO Box 110566, Research Triangle Park, NC 27709,United States
| | - Michael D Taylor
- Nickel Producers Environmental Research Association (NiPERA), 2525 Meridian Parkway, Suite 240, Durham, NC 27713, United States
| | - Daniel Krewski
- Risk Sciences International, 55 Metcalfe Street, Suite 700, K1P 6L5, Ottawa, Canada; Samuel R. McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, 850 Peter Morand Crescent, Room 119, University of Ottawa, Ottawa, K1G 3Z7, Canada
| | - Melvin E Andersen
- ScitoVation, 6 Davis Drive, PO Box 110566, Research Triangle Park, NC 27709,United States
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Longitudinal T1 relaxation rate (R1) captures changes in short-term Mn exposure in welders. Neurotoxicology 2016; 57:39-44. [PMID: 27567731 DOI: 10.1016/j.neuro.2016.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 08/14/2016] [Accepted: 08/22/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES We demonstrated recently that the T1 relaxation rate (R1) captured short-term Mn exposure in welders with chronic, relatively low exposure levels in a cross-sectional study. In the current study, we used a longitudinal design to examine whether R1 values reflect the short-term dynamics of Mn exposure. METHODS Twenty-nine welders were evaluated at baseline and 12 months. Occupational questionnaires estimated short-term welding exposure using welding hours in the 90days prior to each study visit (HrsW90). In addition, blood Mn levels, the pallidal index (PI; globus pallidus T1-weighted intensity (T1WI)/frontal white matter T1WI), and R1 values in brain regions of interest (ROIs) were determined as Mn biomarkers at each visit. Associations between changes in estimated welding exposure and changes in purported Mn biomarkers were assessed by Spearman's correlations with adjustment for age and baseline R1, HrsW90, and blood Mn values. RESULTS Changes in welding hours (HrsW90: the short-term welding exposure estimate), was associated significantly with changes in R1 values in the putamen (r=0.541, p=0.005), caudate (R=0.453, p=0.023), globus pallidus (R=0.430, p=0.032), amygdala (R=0.461, p=0.020), and hippocampus (R=0.447, p=0.025), but not with changes in blood Mn levels or the PI. DISCUSSION Changes in R1 values correlated with changes in the short-term welding exposure estimate, but not with more traditional measures of Mn exposure (blood Mn levels or PI). These results suggest that R1 may serve as a useful marker to capture the short-term dynamics in Mn brain accumulation related to welding exposure.
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14
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Li SJ, Li Y, Chen JW, Yuan ZX, Mo YH, Lu GD, Jiang YM, Ou CY, Wang F, Huang XW, Luo YN, Ou SY, Huang YN. Sodium Para-aminosalicylic Acid Protected Primary Cultured Basal Ganglia Neurons of Rat from Manganese-Induced Oxidative Impairment and Changes of Amino Acid Neurotransmitters. Biol Trace Elem Res 2016; 170:357-65. [PMID: 26286965 DOI: 10.1007/s12011-015-0472-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/07/2015] [Indexed: 12/22/2022]
Abstract
Manganese (Mn), an essential trace metal for protein synthesis and particularly neurotransmitter metabolism, preferentially accumulates in basal ganglia. However, excessive Mn accumulation may cause neurotoxicity referred to as manganism. Sodium para-aminosalicylic acid (PAS-Na) has been used to treat manganism with unclear molecular mechanisms. Thus, we aim to explore whether PAS-Na can inhibit Mn-induced neuronal injury in basal ganglia in vitro. We exposed basal ganglia neurons with 50 μM manganese chloride (MnCl2) for 24 h and then replaced with 50, 150, and 450 μM PAS-Na treatment for another 24 h. MnCl2 significantly decreased cell viability but increased leakage rate of lactate dehydrogenase and DNA damage (as shown by increasing percentage of DNA tail and Olive tail moment). Mechanically, Mn reduced glutathione peroxidase and catalase activity and interrupted amino acid neurotransmitter balance. However, PAS-Na treatment reversed the aforementioned Mn-induced toxic effects. Taken together, these results showed that PAS-Na could protect basal ganglia neurons from Mn-induced neurotoxicity.
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Affiliation(s)
- Shao-Jun Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Yong Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Jing-Wen Chen
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Zong-Xiang Yuan
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Yu-Huan Mo
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Guo-Dong Lu
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Yue-Ming Jiang
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China.
| | - Chao-Yan Ou
- Department of Toxicology, School of Public Health, Guilin Medical University, Guilin, 541004, China
| | - Fang Wang
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Xiao-Wei Huang
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Yi-Ni Luo
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Shi-Yan Ou
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
| | - Yan-Ni Huang
- Department of Toxicology, School of Public Health, Guangxi Medical University, 22 Shuang-yong Rd., Nanning, 530021, Guangxi, China
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15
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Marano M, Vespasiani Gentilucci U, Altamura C, Siotto M, Squitti R, Bucossi S, Quintiliani L, Migliore S, Greco F, Scarciolla L, Quattrocchi CC, Picardi A, Vernieri F. Altered metal metabolism in patients with HCV-related cirrhosis and hepatic encephalopathy. Metab Brain Dis 2015; 30:1445-52. [PMID: 26307419 DOI: 10.1007/s11011-015-9721-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 08/21/2015] [Indexed: 12/13/2022]
Abstract
Dysfunctional metal homeostasis contributes to oxidative stress and neuronal damage. These have been implicated in hepatic encephalopathy pathogenesis. To investigate whether altered metal metabolism is associated with hepatic encephalopathy. Twenty-one controls and 34 HCV-cirrhotic patients (ENC/NEC patients according to presence/absence of previous overt episodes of hepatic encephalopathy) and a control group were studied. Serum iron, copper, ceruloplasmin, ceruloplasmin activity, transferrin, and ceruloplasmin/transferrin ratio were determined. Neuropsychological tests were performed by the repeatable battery of neuropsychological status. Magnetic resonance assessed basal ganglia volumes and metal deposition (pallidal index and T2*). Cirrhotic patients performed worse than controls at cognitive tests, especially ENC patients,. At biochemical analysis copper concentrations, ceruloplasmin activity and transferrin levels were lower in ENC than in NEC patients and controls (p < 0.05 and p < 0.01, respectively). Ceruloplasmin/transferrin ratio was higher in ENC compared to NEC patients (p < 0.05), and controls (p < 0.01). By brain magnetic resonance, ENC patients showed reduced caudate and globus pallidus volumes compared to controls (p < 0.05), and ENC and NEC patients an increased pallidal index compared to controls (p < 0.01). In ENC patients, ceruloplasmin activity correlated with caudate volume and pallidal index (ρ = 0.773 and ρ = -0.683, p < 0.05). Altered metal metabolism likely contributes to cirrhotic hepatic encephalopathy.
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Affiliation(s)
- Massimo Marano
- Neurology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy.
| | - Umberto Vespasiani Gentilucci
- Internal Medicine and Hepatology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Claudia Altamura
- Neurology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | | | - Rosanna Squitti
- Fatebenefratelli Foundation, AFaR Division, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
- Laboratorio di Neurodegenerazione, IRCCS San Raffaele Pisana, Rome, Italy
| | - Serena Bucossi
- Laboratorio di Neurodegenerazione, IRCCS San Raffaele Pisana, Rome, Italy
| | - Livia Quintiliani
- Clinical psychology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Simone Migliore
- Clinical psychology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Federico Greco
- Radiology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Laura Scarciolla
- Radiology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Carlo Cosimo Quattrocchi
- Radiology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Antonio Picardi
- Internal Medicine and Hepatology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Fabrizio Vernieri
- Neurology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128, Rome, Italy
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16
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Bowler RM, Kornblith ES, Gocheva VV, Colledge MA, Bollweg G, Kim Y, Beseler CL, Wright CW, Adams SW, Lobdell DT. Environmental exposure to manganese in air: Associations with cognitive functions. Neurotoxicology 2015; 49:139-48. [PMID: 26096496 DOI: 10.1016/j.neuro.2015.06.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 06/12/2015] [Accepted: 06/12/2015] [Indexed: 12/17/2022]
Abstract
Manganese (Mn), an essential element, can be neurotoxic in high doses. This cross-sectional study explored the cognitive function of adults residing in two towns (Marietta and East Liverpool, Ohio, USA) identified as having high levels of environmental airborne Mn from industrial sources. Air-Mn site surface emissions method modeling for total suspended particulate (TSP) ranged from 0.03 to 1.61 μg/m(3) in Marietta and 0.01-6.32 μg/m(3) in East Liverpool. A comprehensive screening test battery of cognitive function, including the domains of abstract thinking, attention/concentration, executive function and memory was administered. The mean age of the participants was 56 years (±10.8 years). Participants were mostly female (59.1) and primarily white (94.6%). Significant relationships (p<0.05) were found between Mn exposure and performance on working and visuospatial memory (e.g., Rey-O Immediate β=-0.19, Rey-O Delayed β=-0.16) and verbal skills (e.g., Similarities β=-0.19). Using extensive cognitive testing and computer modeling of 10-plus years of measured air monitoring data, this study suggests that long-term environmental exposure to high levels of air-Mn, the exposure metric of this paper, may result in mild deficits of cognitive function in adult populations.
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Affiliation(s)
- Rosemarie M Bowler
- San Francisco State University, Department of Psychology, 1600 Holloway Ave., San Francisco, CA 94132, USA.
| | - Erica S Kornblith
- California School of Professional Psychology at Alliant International University, 1 Beach St., Suite 100, San Francisco, CA 94133, USA
| | - Vihra V Gocheva
- San Francisco State University, Department of Psychology, 1600 Holloway Ave., San Francisco, CA 94132, USA
| | - Michelle A Colledge
- Agency for Toxic Substances and Disease Registry, Region 5, 77W. Jackson Blvd., MS ATSD-4J, Chicago, IL 60604, USA
| | - George Bollweg
- U.S. EPA Region 5, 77W. Jackson Blvd., AR 18-J, Chicago, IL 60604, USA
| | - Yangho Kim
- Ulsan University Hospital, University of Ulsan College of Medicine, Department of Occupational and Environmental Medicine, Ulsan 682-060, South Korea
| | - Cheryl L Beseler
- Colorado State University, 1879 Campus Delivery, Fort Collins, CO 80523, USA
| | - Chris W Wright
- San Francisco State University, Department of Psychology, 1600 Holloway Ave., San Francisco, CA 94132, USA
| | - Shane W Adams
- San Francisco State University, Department of Psychology, 1600 Holloway Ave., San Francisco, CA 94132, USA
| | - Danelle T Lobdell
- U.S. EPA, National Health and Environmental Effects Research Laboratory, MD 58A, Research Triangle Park, NC 27711, USA
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Ex vivo magnetic resonance imaging in South African manganese mine workers. Neurotoxicology 2015; 49:8-14. [PMID: 25912463 DOI: 10.1016/j.neuro.2015.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/14/2015] [Accepted: 04/13/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Manganese (Mn) exposure is associated with increased T1-weighted magnetic resonance imaging (MRI) signal in the basal ganglia. T1 signal intensity has been correlated with occupational Mn exposure but not with clinical symptomatology or neuropathology. OBJECTIVES This study investigated predictors of ex vivo T1 MRI basal ganglia signal intensity in neuropathologic tissue obtained from deceased South African mine workers. METHODS A 3.0 T MRI was performed on ex vivo brain tissue obtained from 19 Mn mine workers and 10 race- and sex-matched mine workers of other commodities. Basal ganglia regions of interest were identified for each subject with T1-weighted intensity indices generated for each region. In a pathology subset, regional T1 indices were compared to neuronal and glial cell density and tissue metal concentrations. RESULTS Intensity indices were higher in Mn mine workers than non-Mn mine workers for the globus pallidus, caudate, anterior putamen, and posterior putamen with the highest values in subjects with the longest cumulative Mn exposure. Intensity indices were inversely correlated with the neuronal cell density in the caudate (p=0.040) and putamen (p=0.050). Tissue Mn concentrations were similar in Mn and non-Mn mine workers. Tissue iron (Fe) concentration trended lower across all regions in Mn mine workers. CONCLUSIONS Mn mine workers demonstrated elevated basal ganglia T1 indices when compared to non-Mn mine workers. Predictors of ex vivo T1 MRI signal intensity in Mn mine workers include duration of Mn exposure and neuronal density.
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18
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Hoet P, Roels HA. Significance and Usefulness of Biomarkers of Exposure to Manganese. MANGANESE IN HEALTH AND DISEASE 2014. [DOI: 10.1039/9781782622383-00355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Manganese (Mn) accomplishes functions essential to maintaining human health, but at the same time this trace element can be toxic at low levels of exposure and accurate estimation of internal exposure is needed. A biomarker of exposure to Mn is meaningful only if there is sufficient knowledge of the toxicokinetics determining its presence in a biological medium (e.g. whole blood, plasma, urine, hair, nail). Moreover, biological monitoring of exposure to Mn is useful only when the biomarker is sufficiently specific and sensitive to distinguish exposed from non-exposed subjects, when it is dose-related to the external exposure (current, recent, or time-integrated), and when it displays reasonable dose–effect/response relationships with the occurrence of adverse effects on the central nervous system, the critical target for Mn exposure. Human investigations in which biomarkers of Mn exposure meet all these criteria are hard to locate. Overall, the available studies report poor or no associations on an individual basis between external (Mn in air or drinking water) and internal (Mn in blood, urine, hair, or nail) Mn exposure indices. This may be to some extent explained by features inherent of the Mn metabolism (homeostatic control), the Mn biomarker's half-life with respect to the exposure window, and the variable nature of external exposure scenarios. Studies particularly dealing with Mn inhalation exposure, different or poorly described methodological approaches, or air sampling strategies may render direct comparison and interpretation of results a tedious task. Nevertheless, several studies report significant dose–effect associations between biomarkers of Mn exposure and subclinical deficits of psychomotor or neuropsychological test performances. Because directly associated with the site of toxic action and providing the magnetic resonance imaging is done no later than three months after Mn exposure ceased, the Mn T1 relaxation time is potentially the better biomarker of Mn exposure in a clinical context (e.g. after long-term parenteral nutrition, chronic liver failure, methcathinone drug abuse). Magnetic resonance imaging is, however, unpractical as a tool for biological monitoring of exposure to Mn in the occupational setting (inhalation) and in the general population (air, drinking water). In conclusion, it would be inappropriate to recommend, on the basis of the currently available evidence, a reliable well-validated biomarker of exposure to Mn, or to establish a health-based threshold value for subclinical neurotoxic effects.
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Affiliation(s)
- Perrine Hoet
- Université catholique de Louvain (UCL), Institut de Recherche Expérimentale et Clinique (IREC), Louvain Centre for Toxicology and Applied Pharmacology (LTAP) Bruxelles Belgium
| | - Harry A. Roels
- Université catholique de Louvain (UCL), Institut de Recherche Expérimentale et Clinique (IREC), Louvain Centre for Toxicology and Applied Pharmacology (LTAP) Bruxelles Belgium
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19
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Baker MG, Criswell SR, Racette BA, Simpson CD, Sheppard L, Checkoway H, Seixas NS. Neurological outcomes associated with low-level manganese exposure in an inception cohort of asymptomatic welding trainees. Scand J Work Environ Health 2014; 41:94-101. [PMID: 25380186 DOI: 10.5271/sjweh.3466] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Long-term, high-level exposure to manganese (Mn) is associated with impaired central nervous system (CNS) function. We quantitatively explored relations between low-level Mn exposure and selected neurological outcomes in a longitudinal inception cohort of asymptomatic welder trainees. METHODS Welders with no previous occupational Mn exposure were observed approximately every three months over the course of the five-quarter traineeship. Fifty-six welders were assessed for motor function using the Unified Parkinson Disease Rating Scale motor subsection part 3 (UPDRS3) and Grooved Pegboard tests. A subset of 17 also had MRI scans to assess T1-weighted indices. Personal exposure to Mn in welding fume was quantitatively assessed during the study period using a mixed model to obtain estimates of subject-specific exposure level by welding type. These estimates were summed to estimate cumulative exposure at the time of each neurological outcome test. RESULTS When adjusting for possible learning effects, there were no associations between cumulative exposure and UPDRS3 score or Grooved Pegboard time. T1-weighted indices of the basal ganglia (caudate, anterior putamen, posterior putamen, and combined basal ganglia, but not the pallidal index) exhibited statistically significant increases in signal intensity in relation to increased cumulative Mn exposure. CONCLUSIONS This study demonstrates that T1-weighted changes can be detected in the brain even at very low levels of exposure among humans before any clinically evident deficits. This suggests that with continued follow-up we could identify a T1 threshold of toxicity at which clinical symptoms begin to manifest.
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Affiliation(s)
- Marissa G Baker
- Department of Environmental and Occupational Health Sciences, 4225 Roosevelt Way NE, Suite 100, Seattle, WA 98105, USA.
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20
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Li SJ, Jiang L, Fu X, Huang S, Huang YN, Li XR, Chen JW, Li Y, Luo HL, Wang F, Ou SY, Jiang YM. Pallidal index as biomarker of manganese brain accumulation and associated with manganese levels in blood: a meta-analysis. PLoS One 2014; 9:e93900. [PMID: 24718592 PMCID: PMC3981755 DOI: 10.1371/journal.pone.0093900] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 03/09/2014] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The current study was designed to evaluate the sensitivity, feasibility, and effectiveness of the pallidal index (PI) serving as a biomarker of brain manganese (Mn) accumulation, which would be used as an early diagnosis criteria for Mn neurotoxicity. METHODS The weighted mean difference (WMD) of the PI between control and Mn-exposed groups was estimated by using a random-effects or fixed-effects meta-analysis with 95% confidence interval (CI) performed by STATA software version 12.1. Moreover, the R package "metacor" was used to estimate correlation coefficients between PI and blood Mn (MnB). RESULTS A total of eight studies with 281 occupationally Mn-exposed workers met the inclusion criteria. Results were pooled and performed with the Meta-analysis. Our data indicated that the PI of the exposed group was significantly higher than that of the control (WMD: 7.76; 95% CI: 4.86, 10.65; I2 = 85.7%, p<0.0001). A random effects model was used to perform meta-analysis. These findings were remarkably robust in the sensitivity analysis, and publication bias was shown in the included studies. Seven out of the eight studies reported the Pearson correlation (r) values. Significantly positive correlation between PI and MnB was observed (r = 0.42; 95% CI, 0.31, 0.52). CONCLUSIONS PI can be considered as a sensitive, feasible, effective and semi-quantitative index in evaluating brain Mn accumulation. MnB can also augment the evaluation of brain Mn accumulation levels in the near future. However, the results should be interpreted with caution.
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Affiliation(s)
- Shao-Jun Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Jiang
- Department of Radiotherapy, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xue Fu
- School of Health Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Shuang Huang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yan-Ni Huang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiang-Rong Li
- Department of Radiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jing-Wen Chen
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yong Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Hai-Lan Luo
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Fang Wang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Shi-Yan Ou
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yue-Ming Jiang
- Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- * E-mail:
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Baker MG, Simpson CD, Stover B, Sheppard L, Checkoway H, Racette BA, Seixas NS. Blood manganese as an exposure biomarker: state of the evidence. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2014; 11:210-7. [PMID: 24579750 PMCID: PMC3965573 DOI: 10.1080/15459624.2013.852280] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Despite evidence of adverse health effects resulting from exposure to manganese (Mn), biomarkers of exposure are poorly understood. To enhance understanding, mean blood Mn (MnB) and mean air Mn (MnA) were extracted from 63 exposure groups in 24 published papers, and the relationship was modeled using segmented regression. On a log/log scale, a positive association between MnA and MnB was observed among studies reporting MnA concentrations above about 10 μg/m(3), although interpretation is limited by largely cross-sectional data, study design variability, and differences in exposure monitoring methods. Based on the results of the segmented regression, we hypothesize that below the concentration of about 10 μg/m(3), Mn in the body is dominated by dietary Mn, and additional inhaled Mn only causes negligible changes in Mn levels unless the inhaled amount is substantial. However, stronger study designs are required to account for temporal characteristics of the MnA to MnB relationships that reflect the underlying physiology and toxicokinetics of Mn uptake and distribution. Thus, we present an inception cohort study design we have conducted among apprentice welders, and the analytical strengths this study design offers. To determine if blood could be a useful biomarker for Mn to be utilized by industrial hygienists in general industry requires additional time-specific analyses, which our inception cohort study design will allow.
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Affiliation(s)
- Marissa G. Baker
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Christopher D. Simpson
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Bert Stover
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
| | - Lianne Sheppard
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Harvey Checkoway
- Department of Family and Preventive Medicine, UC San Diego School of Medicine, San Diego, CA
| | - Brad A. Racette
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Parktown, Johannesburg, South Africa
| | - Noah S. Seixas
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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22
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Chang Y, Jin SU, Kim Y, Shin KM, Lee HJ, Kim SH, Ahn JH, Park SJ, Jeong KS, Weon YC, Lee H. Decreased brain volumes in manganese-exposed welders. Neurotoxicology 2013; 37:182-9. [PMID: 23685157 DOI: 10.1016/j.neuro.2013.05.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/26/2013] [Accepted: 05/04/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND A great deal of research has been devoted to identifying subclinical functional brain abnormalities in manganese (Mn)-exposed welders. However, no previous study has investigated morphological brain abnormalities, such as changes in brain volume, in welders. This study evaluates morphological changes in brain volume among welders, and investigates the relationship between structural brain abnormalities and subclinical dysfunction in this population. METHODS We used voxel-based morphometry (VBM) to assess differences in gray and white matter brain volumes between 40 welders with chronic Mn exposure and 26 age-matched control subjects. Correlation analyses were used to investigate the relationship between brain volume changes and decreased performance on neurobehavioral tests. RESULTS Brain volumes in the globus pallidus and cerebellar regions were significantly diminished in welders with chronic Mn exposure compared to controls (FDR-corrected P<0.05). These changes in brain volume were negatively correlated with cognitive performance and grooved pegboard scores. CONCLUSION There are measurable brain volume reductions in the globus pallidus and cerebellum of welders chronically exposed to Mn, and these volume reductions correlate with cognitive and motor neurobehavioral deficits. Our findings therefore indicate that volumetric measurement could be a useful subclinical marker among welders that show no signs of manganism.
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Affiliation(s)
- Yongmin Chang
- Department of Molecular Medicine, Kyungpook National University College of Medicine, Kyungpook National University Hospital, Daegu, South Korea
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Criswell SR, Perlmutter JS, Huang JL, Golchin N, Flores HP, Hobson A, Aschner M, Erikson KM, Checkoway H, Racette BA. Basal ganglia intensity indices and diffusion weighted imaging in manganese-exposed welders. Occup Environ Med 2012; 69:437-43. [PMID: 22447645 PMCID: PMC3651997 DOI: 10.1136/oemed-2011-100119] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Manganese exposure leads to diffuse cerebral metal deposition with the highest concentration in the globus pallidus associated with increased T1-weighted MRI signal. T1 signal intensity in extra-pallidal basal ganglia (caudate and putamen) has not been studied in occupationally exposed workers. Diffusion weighted imaging is a non-invasive measure of neuronal damage and may provide a quantification of neurotoxicity associated with welding and manganese exposure. This study investigated extra-pallidal T1 basal ganglia signal intensity as a marker of manganese exposure and basal ganglia diffusion weighted imaging abnormalities as a potential marker of neurotoxicity. METHODS A 3T MR case:control imaging study was performed on 18 welders and 18 age- and gender-matched controls. Basal ganglia regions of interest were identified for each subject. T1-weighted intensity indices and apparent diffusion coefficients were generated for each region. RESULTS All regional indices were higher in welders than controls (p ≤ 0.05). Combined basal ganglia (ρ = 0.610), caudate (ρ = 0.645), anterior (ρ = 0.595) and posterior putamen (ρ = 0.511) indices were more correlated with exposure than pallidal (ρ = 0.484) index. Welder apparent diffusion coefficient values were lower than controls for globus pallidus (p = 0.03) and anterior putamen (p = 0.004). CONCLUSIONS Welders demonstrated elevated T1 indices throughout the basal ganglia. Combined basal ganglia, caudate and putamen indices were more correlated with exposure than pallidal index suggesting more inclusive basal ganglia sampling results in better exposure markers. Elevated indices were associated with diffusion weighted abnormalities in the pallidum and anterior putamen suggesting neurotoxicity in these regions.
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Affiliation(s)
- Susan R Criswell
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
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Abstract
Manganese-induced parkinsonism has been recognized since 1837. It has been reported primarily in miners, grinders, and smelters since that time. More recently, isolated case reports involving welders have appeared in the medical literature. Manganism can be distinguished from other forms of parkinsonism by clinical presentation with support from laboratory and radiologic findings. The controversy regarding the risk of parkinsonism in welders is reviewed.
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Affiliation(s)
- Brent Furbee
- Indiana Poison Center, Indiana University School of Medicine, B408 Methodist Hospital, Indianapolis, IN 46206, USA.
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Sen S, Flynn MR, Du G, Tröster AI, An H, Huang X. Manganese accumulation in the olfactory bulbs and other brain regions of "asymptomatic" welders. Toxicol Sci 2011; 121:160-7. [PMID: 21307282 DOI: 10.1093/toxsci/kfr033] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Welding-generated metallic fumes contain a substantial amount of manganese (Mn), making welders susceptible to Mn toxicity. Although overt Mn toxicity manifests as a type of parkinsonism, the consequences of chronic, low-level Mn exposure are unknown. To explore region-specific Mn accumulation and its potential functional consequences at subclinical levels of Mn exposure, we studied seven welders without obvious neurological deficits and seven age- and gender-matched controls. Mn exposure for welders was estimated by an occupational questionnaire. High-resolution brain magnetic resonance imaging (MRI), Grooved Pegboard performance of both hands, Trail making, and olfactory function tests were obtained from all subjects. Compared with controls, the welders had a significantly higher T1 relaxation rate (R1) in the olfactory bulb (OB, p = 0.02), mean T1-weighted intensity at frontal white matter (FWM; p = 0.01), bilateral globus pallidus (GP; p = 0.03), and putamen (p = 0.03). The welders scored worse than the controls on the Grooved Pegboard test for both dominant (p = 0.06) and nondominant hand (p = 0.03). The dominant hand Grooved Pegboard scores correlated best with mean MRI intensity of FWM (R² = 0.51, p = 0.004), GP (R² = 0.51, p = 0.004), putamen (R² = 0.49, p= 0.006), and frontal gray matter (R² = 0.42, p = 0.01), whereas the nondominant hand scores correlated best with intensity of FWM (R² = 0.37, p = 0.02) and GP (R² = 0.28, p = 0.05). No statistical differences were observed in either the Trail-making test or the olfactory test between the two groups. This study suggests that Mn accumulates in OB and multiple other brain regions in "asymptomatic" welders and that MRI abnormalities correlate with fine motor but not cognitive deficits. Further investigations of subclinical Mn exposure are warranted.
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Affiliation(s)
- Suman Sen
- Department of Neurology, University of North Carolina at Chapel Hill, North Carolina 27599, USA
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26
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Kim Y, Jeong KS, Song HJ, Lee JJ, Seo JH, Kim GC, Lee HJ, Kim HJ, Ahn JH, Park SJ, Kim SH, Kwon YJ, Chang Y. Altered white matter microstructural integrity revealed by voxel-wise analysis of diffusion tensor imaging in welders with manganese exposure. Neurotoxicology 2010; 32:100-9. [PMID: 21111757 DOI: 10.1016/j.neuro.2010.11.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Revised: 11/16/2010] [Accepted: 11/18/2010] [Indexed: 01/01/2023]
Abstract
Chronic exposure to manganese (Mn), which can be an occupational hazard or can result from liver failure, is associated with adverse motor and cognitive outcomes. Evidence from previous neuroimaging and magnetic resonance spectroscopy studies suggested alteration of function in Mn-exposed brains. However, the effect of chronic exposure of the human brain to Mn on white matter (WM) structure has not yet been determined. In the present study, we used diffusion tensor imaging (DTI) to investigate whether welders exposed to Mn demonstrate differences in WM integrity, compared with control subjects. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured on a voxel-wise basis in 30 male welders with exposure to Mn and in 19 age- and gender-matched control subjects. Direct comparison between welders and controls using investigator-independent Statistical Parametric Mapping (SPM) voxel-wise analysis of DTI metrics revealed a reduction of FA in the corpus callosum (CC) and frontal WM in Mn-exposed welders. Further, marked increases in RD and negligible changes in AD suggested that the microstructural changes in the CC and frontal WM result from compromised radial directionality of fibers in these areas, caused primarily by demyelination. Correlation analysis with neurobehavioral performance also suggested that the microstructural abnormalities were associated with subtle motor and cognitive differences in welders.
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Affiliation(s)
- Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
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Zheng W, Fu SX, Dydak U, Cowan DM. Biomarkers of manganese intoxication. Neurotoxicology 2010; 32:1-8. [PMID: 20946915 DOI: 10.1016/j.neuro.2010.10.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 10/04/2010] [Accepted: 10/04/2010] [Indexed: 01/30/2023]
Abstract
Manganese (Mn), upon absorption, is primarily sequestered in tissue and intracellular compartments. For this reason, blood Mn concentration does not always accurately reflect Mn concentration in the targeted tissue, particularly in the brain. The discrepancy between Mn concentrations in tissue or intracellular components means that blood Mn is a poor biomarker of Mn exposure or toxicity under many conditions and that other biomarkers must be established. For group comparisons of active workers, blood Mn has some utility for distinguishing exposed from unexposed subjects, although the large variability in mean values renders it insensitive for discriminating one individual from the rest of the study population. Mn exposure is known to alter iron (Fe) homeostasis. The Mn/Fe ratio (MIR) in plasma or erythrocytes reflects not only steady-state concentrations of Mn or Fe in tested individuals, but also a biological response (altered Fe homeostasis) to Mn exposure. Recent human studies support the potential value for using MIR to distinguish individuals with Mn exposure. Additionally, magnetic resonance imaging (MRI), in combination with noninvasive assessment of γ-aminobutyric acid (GABA) by magnetic resonance spectroscopy (MRS), provides convincing evidence of Mn exposure, even without clinical symptoms of Mn intoxication. For subjects with long-term, low-dose Mn exposure or for those exposed in the past but not the present, neither blood Mn nor MRI provides a confident distinction for Mn exposure or intoxication. While plasma or erythrocyte MIR is more likely a sensitive measure, the cut-off values for MIR among the general population need to be further tested and established. Considering the large accumulation of Mn in bone, developing an X-ray fluorescence spectroscopy or neutron-based spectroscopy method may create yet another novel non-invasive tool for assessing Mn exposure and toxicity.
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Affiliation(s)
- Wei Zheng
- School of Health Sciences, Purdue University, West Lafayette, IN 47907, USA.
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