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Liu X, Li Y, Mo Y, Chen B, Hou X, Zhu J, Xu Y, Xue J, Wen H, Wang X, Wen Z. GABAergic imbalance in Parkinson's disease-related depression determined with MEGA-PRESS. Neuroimage Clin 2024; 43:103641. [PMID: 39032208 DOI: 10.1016/j.nicl.2024.103641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/10/2024] [Accepted: 07/10/2024] [Indexed: 07/22/2024]
Abstract
OBJECTIVE The pathogenesis of depression in patients with Parkinson's disease (PD) is poorly understood. Therefore, this study aimed to explore the changes in γ-aminobutyric acid (GABA) and glutamate plus glutamine (Glx) levels in patients with PD with or without depression determined using MEscher-GArwood Point Resolved Spectroscopy (MEGA-PRESS). MATERIALS AND METHODS A total of 83 patients with primary PD and 24 healthy controls were included. Patients with PD were categorized into depressed PD (DPD, n = 19) and nondepressed PD (NDPD, n = 64) based on the 17-item Hamilton Depression Rating Scale. All participants underwent T1-weighted imaging and MEGA-PRESS sequence to acquire GABA+ and Glx values. The MEGA-PRESS sequence was conducted using 18.48 mL voxels in the left thalamus and medial frontal cortex. The GABA+, Glx, and creatine values were quantified using Gannet 3.1 software. RESULTS The GABA+ and Glx values were not significantly disparate between patients with PD and controls in the thalamus and medial frontal cortex. However, the levels of N-acetyl aspartate/creatine and choline/creatine in the left thalamus were significantly lower in patients with PD than in controls (P = .031, P = .009). The GABA+/Water and GABA+/Creatine in the medial frontal cortex were higher in DPD than in NDPD (P = .001, P = .004). The effects of depression on Glx or other metabolite levels were not evident, and no significant difference in metabolite values was noted in the left thalamus among all groups (P > .05). CONCLUSIONS GABA+ levels increased in the medial frontal cortex in DPD, which may be more closely related to depressive pathology. Thus, alterations in GABAergic function in special brain structures may be related to the clinical manifestations of PD symptoms, and hence mediating this function might help in treating depression in PD.
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Affiliation(s)
- Xinzi Liu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuxin Li
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yixiang Mo
- Department of Functional Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Baoling Chen
- Department of Neurology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xusheng Hou
- Department of Functional Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianbin Zhu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | | | - Jingyue Xue
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Haitao Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xianlong Wang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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Derkaczew M, Martyniuk P, Osowski A, Wojtkiewicz J. Cyclitols: From Basic Understanding to Their Association with Neurodegeneration. Nutrients 2023; 15:2029. [PMID: 37432155 DOI: 10.3390/nu15092029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 07/12/2023] Open
Abstract
One of the most common cyclitols found in eukaryotic cells-Myo-inositol (MI) and its derivatives play a key role in many cellular processes such as ion channel physiology, signal transduction, phosphate storage, cell wall formation, membrane biogenesis and osmoregulation. The aim of this paper is to characterize the possibility of neurodegenerative disorders treatment using MI and the research of other therapeutic methods linked to MI's derivatives. Based on the reviewed literature the researchers focus on the most common neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, Huntington's disease and Spinocerebellar ataxias, but there are also works describing other seldom encountered diseases. The use of MI, d-pinitol and other methods altering MI's metabolism, although research on this topic has been conducted for years, still needs much closer examination. The dietary supplementation of MI shows a promising effect on the treatment of neurodegenerative disorders and can be of great help in alleviating the accompanying depressive symptoms.
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Affiliation(s)
- Maria Derkaczew
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland
- Students' Scientific Club of Pathophysiologists, Department of Human Physiology and Pathophysiology, School of Medicine, University of Warmia and Mazury, 10-082 Olsztyn, Poland
| | - Piotr Martyniuk
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland
- Students' Scientific Club of Pathophysiologists, Department of Human Physiology and Pathophysiology, School of Medicine, University of Warmia and Mazury, 10-082 Olsztyn, Poland
| | - Adam Osowski
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland
| | - Joanna Wojtkiewicz
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury, 10-082 Olsztyn, Poland
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Gu W, He C, Chen J, Li J. Proton Magnetic Resonance Spectroscopy for the Early Diagnosis of Parkinson Disease in the Substantia Nigra and Globus Pallidus: A Meta-Analysis With Trial Sequential Analysis. Front Neurol 2022; 13:838230. [PMID: 35785357 PMCID: PMC9244590 DOI: 10.3389/fneur.2022.838230] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the metabolic changes in globus pallidus (GP) and substantia nigra (SN) during the early stage of Parkinson disease (PD) using magnetic resonance spectroscopy (MRS). PubMed, Embase, Web of Science, and Chinese National Knowledge Infrastructure were searched till November 2018. Eligible trials comparing early metabolic changes in GP and SN in patients with PD vs. controls were included. The mean differences with 95% confidence intervals were estimated with either fixed- or random-effects models using Review Manager 5.3 software. Trial sequential analysis was performed using TSA 0.9.5.10 beta software. Finally, 16 studies were selected from the search. Overall, the N-acetyl aspartate-to-creatine ratio showed a significant difference between patients with early-stage PD and healthy controls. The overall heterogeneity was P < 0.00001, I2 = 94% in GP and P = 0.0002, I2 = 74% in SN. The results revealed that MRS could be a more sensitive imaging biomarker in the diagnosis of early-stage PD.
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Affiliation(s)
- Wenbin Gu
- Department of Radiology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Chen He
- Department of Radiology, Nantong Rich Hospital, Nantong, China
| | - Juping Chen
- Department of Radiology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Junchen Li
- Department of Radiology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
- *Correspondence: Junchen Li
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Abstract
CLINICAL/METHODICAL ISSUE Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. STANDARD RADIOLOGICAL METHODS In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. ACHIEVEMENTS In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. PRACTICAL RECOMMENDATIONS Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions.
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Affiliation(s)
- W Reith
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 1, 66424, Homburg/Saar, Deutschland.
| | - S Roumia
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 1, 66424, Homburg/Saar, Deutschland
| | - P Dietrich
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 1, 66424, Homburg/Saar, Deutschland
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Bian W, Li Y, Crane JC, Nelson SJ. Fully automated atlas-based method for prescribing 3D PRESS MR spectroscopic imaging: Toward robust and reproducible metabolite measurements in human brain. Magn Reson Med 2017; 79:636-642. [PMID: 28470861 DOI: 10.1002/mrm.26718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/07/2017] [Accepted: 03/27/2017] [Indexed: 11/10/2022]
Abstract
PURPOSE To implement a fully automated atlas-based method for prescribing 3D PRESS MR spectroscopic imaging (MRSI). METHODS The PRESS selected volume and outer-volume suppression bands were predefined on the MNI152 standard template image. The template image was aligned to the subject T1 -weighted image during a scan, and the resulting transformation was then applied to the predefined prescription. To evaluate the method, H-1 MRSI data were obtained in repeat scan sessions from 20 healthy volunteers. In each session, datasets were acquired twice without repositioning. The overlap ratio of the prescribed volume in the two sessions was calculated and the reproducibility of inter- and intrasession metabolite peak height and area ratios was measured by the coefficient of variation (CoV). The CoVs from intra- and intersession were compared by a paired t-test. RESULTS The average overlap ratio of the automatically prescribed selection volumes between two sessions was 97.8%. The average voxel-based intersession CoVs were less than 0.124 and 0.163 for peak height and area ratios, respectively. Paired t-test showed no significant difference between the intra- and intersession CoVs. CONCLUSION The proposed method provides a time efficient method to prescribe 3D PRESS MRSI with reproducible imaging positioning and metabolite measurements. Magn Reson Med 79:636-642, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Wei Bian
- Department of Radiology, Stanford University, Palo Alto, California, USA
| | - Yan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Jason C Crane
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Sarah J Nelson
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
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Al-Radaideh AM, Rababah EM. The role of magnetic resonance imaging in the diagnosis of Parkinson's disease: a review. Clin Imaging 2016; 40:987-96. [DOI: 10.1016/j.clinimag.2016.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 04/09/2016] [Accepted: 05/23/2016] [Indexed: 12/31/2022]
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Basic Principles and Clinical Applications of Magnetic Resonance Spectroscopy in Neuroradiology. J Comput Assist Tomogr 2016; 40:1-13. [PMID: 26484954 DOI: 10.1097/rct.0000000000000322] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Magnetic resonance spectroscopy is a powerful tool to assist daily clinical diagnostics. This review is intended to give an overview on basic principles of the technology, discuss some of its technical aspects, and present typical applications in daily clinical routine in neuroradiology.
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Algarni MA, Stoessl AJ. The role of biomarkers and imaging in Parkinson’s disease. Expert Rev Neurother 2016; 16:187-203. [DOI: 10.1586/14737175.2016.1135056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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9
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Proton MR Spectroscopy for Monitoring Pathologic Changes in the Substantia Nigra and Globus Pallidus in Parkinson Disease. AJR Am J Roentgenol 2016; 206:385-9. [PMID: 26797368 DOI: 10.2214/ajr.14.14052] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Seraji-Bozorgzad N, Bao F, George E, Krstevska S, Gorden V, Chorostecki J, Santiago C, Zak I, Caon C, Khan O. Longitudinal study of the substantia nigra in Parkinson disease: A high-field (1) H-MR spectroscopy imaging study. Mov Disord 2015; 30:1400-4. [PMID: 26228901 DOI: 10.1002/mds.26323] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 05/06/2015] [Accepted: 05/13/2015] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The value of biomarkers in early diagnosis and development of therapeutics in Parkinson's disease (PD) is well established. METHODS We used proton magnetic resonance spectroscopy in a prospective, longitudinal study of 23 patients with early PD, naïve to dopaminergic therapy, and six age-matched healthy controls to examine the temporal changes in metabolic profile of substantia nigra over a period of 3 months. RESULTS N-acetyl aspartate to creatine ratio at month 3 was compared with baseline values in the PD and control groups, as well as the side-to-side difference of the ratio at baseline. By month 3, n-acetyl aspartate to creatine ratio had decreased by 4.4% in patients with PD (P = 0.024), without a concomitant change in healthy controls. The side-to-side asymmetry was significantly higher in the PD group (16.7%) vs. healthy controls (1.6%, P = 0.0024). CONCLUSION Estimation of change in the n-acetyl aspartate to creatine ratio appears to be a fast, quantifiable, and reliable marker of dopaminergic neuronal viability in PD.
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Affiliation(s)
- Navid Seraji-Bozorgzad
- The Sastry Foundation Advanced Imaging Laboratory, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.,Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Fen Bao
- The Sastry Foundation Advanced Imaging Laboratory, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.,Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Edwin George
- The Sastry Foundation Advanced Imaging Laboratory, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.,Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Shana Krstevska
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA
| | - Veronica Gorden
- Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jessica Chorostecki
- The Sastry Foundation Advanced Imaging Laboratory, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.,Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Carla Santiago
- Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Imad Zak
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Christina Caon
- Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Omar Khan
- The Sastry Foundation Advanced Imaging Laboratory, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA.,Movement Disorders Program, Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
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Öz G. MR Spectroscopy: A Longitudinal Biomarker for Substantia Nigra Pathology in Parkinson's Disease? Mov Disord 2015; 30:1304-5. [PMID: 26184363 DOI: 10.1002/mds.26322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/07/2015] [Indexed: 11/09/2022] Open
Affiliation(s)
- Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA
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12
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Magnetic resonance spectroscopy: an in vivo molecular imaging biomarker for Parkinson's disease? BIOMED RESEARCH INTERNATIONAL 2014; 2014:519816. [PMID: 25302300 PMCID: PMC4180390 DOI: 10.1155/2014/519816] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 08/14/2014] [Accepted: 08/31/2014] [Indexed: 11/17/2022]
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder caused by selective loss of dopaminergic neurons in the substantia nigra pars compacta which leads to dysfunction of cerebral pathways critical for the control of movements. The diagnosis of PD is based on motor symptoms, such as bradykinesia, akinesia, muscular rigidity, postural instability, and resting tremor, which are evident only after the degeneration of a significant number of dopaminergic neurons. Currently, a marker for early diagnosis of PD is still not available. Consequently, also the development of disease-modifying therapies is a challenge. Magnetic resonance spectroscopy is a quantitative imaging technique that allows in vivo measurement of certain neurometabolites and may produce biomarkers that reflect metabolic dysfunctions and irreversible neuronal damage. This review summarizes the abnormalities of cerebral metabolites found in MRS studies performed in patients with PD and other forms of parkinsonism. In addition, we discuss the potential role of MRS as in vivo molecular imaging biomarker for early diagnosis of PD and for monitoring the efficacy of therapeutic interventions.
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Pyatigorskaya N, Gallea C, Garcia-Lorenzo D, Vidailhet M, Lehericy S. A review of the use of magnetic resonance imaging in Parkinson's disease. Ther Adv Neurol Disord 2014; 7:206-20. [PMID: 25002908 DOI: 10.1177/1756285613511507] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
To date, the most frequently used Parkinson's disease (PD) biomarkers are the brain imaging measures of dopaminergic dysfunction using positron emission tomography and single photon emission computed tomography. However, major advances have occurred in the development of magnetic resonance imaging (MRI) biomarkers for PD in the past decade. Although conventional structural imaging remains normal in PD, advanced techniques have shown changes in the substantia nigra and the cortex. The most well-developed MRI markers in PD include diffusion imaging and iron load using T2/T2* relaxometry techniques. Other quantitative biomarkers such as susceptibility-weighted imaging for iron load, magnetization transfer and ultra-high-field MRI have shown great potential. More sophisticated techniques such as tractography and resting state functional connectivity give access to anatomical and functional connectivity changes in the brain, respectively. Brain perfusion can be assessed using non-contrast-agent techniques such as arterial spin labelling and spectroscopy gives access to metabolites concentrations. However, to date these techniques are not yet fully validated and standardized quantitative metrics for PD are still lacking. This review presents an overview of new structural, perfusion, metabolic and anatomo-functional connectivity biomarkers, their use in PD and their potential applications to improve the clinical diagnosis of Parkinsonian syndromes and the quality of clinical trials.
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Affiliation(s)
- Nadya Pyatigorskaya
- Institut du Cerveau et de la Moelle épinière, Centre de Neuroimagerie de Recherche, Paris, France
| | - Cécile Gallea
- Institut du Cerveau et de la Moelle épinière, Centre de Neuroimagerie de Recherche, Paris, France
| | - Daniel Garcia-Lorenzo
- Institut du Cerveau et de la Moelle épinière, Centre de Neuroimagerie de Recherche, Paris, France
| | - Marie Vidailhet
- Université Pierre et Marie Curie (UPMC Univ Paris 6), Centre de Recherche de l'Institut du Cerveau et de la Moelle epiniere, Paris, France
| | - Stéphane Lehericy
- Service de neuroradiologie, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'hopital, 75651 Paris cedex 13, France
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Gröger A, Kolb R, Schäfer R, Klose U. Dopamine reduction in the substantia nigra of Parkinson's disease patients confirmed by in vivo magnetic resonance spectroscopic imaging. PLoS One 2014; 9:e84081. [PMID: 24416192 PMCID: PMC3885536 DOI: 10.1371/journal.pone.0084081] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 11/11/2013] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Metabolic changes in the substantia nigra of patients with Parkinson's disease were previously investigated in different molecular-pathological examinations. The aim of our study was the in vivo measurement of these alterations using three-dimensional magnetic resonance spectroscopic imaging. METHODS 21 patients with Parkinson's disease and 24 controls were examined using magnetic resonance spectroscopic imaging at 3 Tesla. The spectra of rostral and caudal substantia nigra regions were analyzed using LCModel. For spectral fitting, an adjusted basis data set with pathology-specific metabolites and macromolecules was used to better reproduce the in vivo spectra. To assess differences between both groups more accurately, especially in metabolites at lower concentrations, group-averaged spectra were evaluated in addition to the analysis of individual data. RESULTS We found significantly decreased N-acetylaspartate, choline, creatine, myo-inositol, glutathione and dopamine concentrations in patients with Parkinson's disease compared to controls, whereas glutamine+glutamate, γ-aminobutyric acid, and homovanillic acid were slightly increased. According to anatomical features, clear differences in the biochemical profiles were found between rostral and caudal substantia nigra voxels in both groups. CONCLUSIONS Reduced N-acetylaspartate and dopamine concentrations result from progressive degeneration of dopamine-producing neurons within the substantia nigra pars compacta. Decreased creatine levels can be interpreted as impaired energy metabolism due to mitochondrial dysfunction. Lower glutathione concentrations might be a cause or consequence of oxidative stress. Furthermore, slightly increased glutamine+glutamate and γ-aminobutyric acid levels are expected based on post mortem data in Parkinson's disease. To the best of our knowledge, this is the first non-invasive confirmation of these metabolic changes.
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Affiliation(s)
- Adriane Gröger
- Department of Diagnostic and Interventional Neuroradiology, Magnetic Resonance Research Group, University Hospital Tübingen, Tübingen, Germany
| | - Rupert Kolb
- Department of Diagnostic and Interventional Neuroradiology, Magnetic Resonance Research Group, University Hospital Tübingen, Tübingen, Germany
| | - Rita Schäfer
- Department of Diagnostic and Interventional Neuroradiology, Magnetic Resonance Research Group, University Hospital Tübingen, Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, Magnetic Resonance Research Group, University Hospital Tübingen, Tübingen, Germany
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Weiduschat N, Mao X, Beal MF, Nirenberg MJ, Shungu DC, Henchcliffe C. Usefulness of Proton and Phosphorus MR Spectroscopic Imaging for Early Diagnosis of Parkinson's Disease. J Neuroimaging 2013; 25:105-10. [DOI: 10.1111/jon.12074] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 08/16/2013] [Accepted: 09/29/2013] [Indexed: 12/21/2022] Open
Affiliation(s)
- Nora Weiduschat
- Department of Radiology; Weill Cornell Medical College; New York NY
| | - Xiangling Mao
- Department of Radiology; Weill Cornell Medical College; New York NY
| | - M. Flint Beal
- Department of Neurology; Weill Cornell Medical College; New York NY
| | | | - Dikoma C. Shungu
- Department of Radiology; Weill Cornell Medical College; New York NY
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Berardelli A, Wenning GK, Antonini A, Berg D, Bloem BR, Bonifati V, Brooks D, Burn DJ, Colosimo C, Fanciulli A, Ferreira J, Gasser T, Grandas F, Kanovsky P, Kostic V, Kulisevsky J, Oertel W, Poewe W, Reese JP, Relja M, Ruzicka E, Schrag A, Seppi K, Taba P, Vidailhet M. EFNS/MDS-ES/ENS [corrected] recommendations for the diagnosis of Parkinson's disease. Eur J Neurol 2013; 20:16-34. [PMID: 23279440 DOI: 10.1111/ene.12022] [Citation(s) in RCA: 334] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Accepted: 09/18/2012] [Indexed: 01/24/2023]
Abstract
BACKGROUND A Task Force was convened by the EFNS/MDS-ES Scientist Panel on Parkinson's disease (PD) and other movement disorders to systemically review relevant publications on the diagnosis of PD. METHODS Following the EFNS instruction for the preparation of neurological diagnostic guidelines, recommendation levels have been generated for diagnostic criteria and investigations. RESULTS For the clinical diagnosis, we recommend the use of the Queen Square Brain Bank criteria (Level B). Genetic testing for specific mutations is recommended on an individual basis (Level B), taking into account specific features (i.e. family history and age of onset). We recommend olfactory testing to differentiate PD from other parkinsonian disorders including recessive forms (Level A). Screening for pre-motor PD with olfactory testing requires additional tests due to limited specificity. Drug challenge tests are not recommended for the diagnosis in de novo parkinsonian patients. There is an insufficient evidence to support their role in the differential diagnosis between PD and other parkinsonian syndromes. We recommend an assessment of cognition and a screening for REM sleep behaviour disorder, psychotic manifestations and severe depression in the initial evaluation of suspected PD cases (Level A). Transcranial sonography is recommended for the differentiation of PD from atypical and secondary parkinsonian disorders (Level A), for the early diagnosis of PD and in the detection of subjects at risk for PD (Level A), although the technique is so far not universally used and requires some expertise. Because specificity of TCS for the development of PD is limited, TCS should be used in conjunction with other screening tests. Conventional magnetic resonance imaging and diffusion-weighted imaging at 1.5 T are recommended as neuroimaging tools that can support a diagnosis of multiple system atrophy (MSA) or progressive supranuclear palsy versus PD on the basis of regional atrophy and signal change as well as diffusivity patterns (Level A). DaTscan SPECT is registered in Europe and the United States for the differential diagnosis between degenerative parkinsonisms and essential tremor (Level A). More specifically, DaTscan is indicated in the presence of significant diagnostic uncertainty such as parkinsonism associated with neuroleptic exposure and atypical tremor manifestations such as isolated unilateral postural tremor. Studies of [(123) I]MIBG/SPECT cardiac uptake may be used to identify patients with PD versus controls and MSA patients (Level A). All other SPECT imaging studies do not fulfil registration standards and cannot be recommended for routine clinical use. At the moment, no conclusion can be drawn as to diagnostic efficacy of autonomic function tests, neurophysiological tests and positron emission tomography imaging in PD. CONCLUSIONS The diagnosis of PD is still largely based on the correct identification of its clinical features. Selected investigations (genetic, olfactory, and neuroimaging studies) have an ancillary role in confirming the diagnosis, and some of them could be possibly used in the near future to identify subjects in a pre-symptomatic phase of the disease.
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Affiliation(s)
- A Berardelli
- Dipartimento di Neurologia e Psichiatria and IRCCS NEUROMED Institute, Sapienza, Università di Roma, Rome, Italy.
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Boelmans K, Sedlacik J, Niehaus L, Jahn H, Münchau A. Recent advances in structural MRI in Parkinson’s disease and atypical parkinsonian syndromes. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY In the past 2 years, technical developments in conventional and advanced MRI, such as ultra-high-field MRI or mapping of brain mineralization, has allowed novel insights into the nature of Parkinson’s disease (PD) and atypical parkinsonian syndromes, which may aid diagnostic accuracy and differential diagnosis. In addition, sophisticated post-processing analyses, such as morphometry- and surface-based classifications and automated whole-brain analyses, have become available; in PD, this has led to direct visualization of structural substantia nigra abnormalities, monitoring disease progression or screening for brain atrophy associated with dementia. Based on conventional MRI, new MRI rating scales have been established for progressive supranuclear palsy and multiple system atrophy and have been further assessed with a view to their diagnostic accuracy. Clinicopathological series of patients with tauopathies imply that correlations between clinical syndromes, imaging patterns and underlying histopathology are not always strong. Here, some of the issues related to conventional and advanced MRI for the diagnostic accuracy of PD and atypical parkinsonian syndromes are reviewed.
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Affiliation(s)
- Kai Boelmans
- Department of Psychiatry, Memory Clinic, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
| | - Jan Sedlacik
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ludwig Niehaus
- Department of Neurology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Holger Jahn
- Department of Psychiatry, Memory Clinic, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
| | - Alexander Münchau
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Proton CSI without solvent suppression with strongly reduced field gradient related sideband artifacts. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2012; 26:183-92. [PMID: 22926685 DOI: 10.1007/s10334-012-0338-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 08/17/2012] [Accepted: 08/17/2012] [Indexed: 10/27/2022]
Abstract
OBJECT Non-water-suppressed MRSI (magnetic resonance spectroscopy imaging) offers a number of advantages; however, spectra are hampered by the sideband artifacts. The origin of those is associated with the vibration of the gradient coils, and most of the sidebands are assumed to be related to the crusher gradients. The aim was to examine the dependency between the physical direction of the crushers and the sidebands. Additionally, the possibilities of optimization of the point resolved spectroscopy sequence (PRESS) were investigated. MATERIALS AND METHODS For the assessment of the sidebands, spectra at short echo time (TE) were collected at 3 T from standard water phantom. A homemade agar phantom was used to test the optimal strength of the crusher gradients. Optimized PRESS sequence was tested in vivo. RESULTS The greatest sidebands were found to be associated with the crusher gradient in x-direction. Agar phantom and in vivo measurements revealed that reduction of the crusher's strength to 5 mT/m could provide a significant minimization of the sidebands without raising the unwanted signals produced by volume selection. CONCLUSION This study demonstrates that crusher gradients in different directions produce a unique pattern of the sidebands. Moreover, optimization of the strength of crushers has been found to decrease sidebands so, the remaining part could be reduced in postprocessing.
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Godau J, Hussl A, Lolekha P, Stoessl AJ, Seppi K. Neuroimaging: current role in detecting pre-motor Parkinson's disease. Mov Disord 2012; 27:634-43. [PMID: 22508281 DOI: 10.1002/mds.24976] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Convergent evidence suggests a pre-motor period in Parkinson's disease (PD) during which typical motor symptoms have not yet developed although dopaminergic neurons in the substantia nigra have started to degenerate. Advances in different neuroimaging techniques have allowed the detection of functional and structural changes in early PD. This review summarizes the state of the art knowledge concerning structural neuroimaging techniques including magnetic resonance imaging (MRI) and transcranial B-mode-Doppler-sonography (TCS) as well as functional neuroimaging techniques using radiotracer imaging (RTI) with different radioligands in detecting pre-motor PD.
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Affiliation(s)
- Jana Godau
- Center of Neurology, Hertie Institute for Clinical Brain Research, Department of Neurodegeneration and German Center of Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
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