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Peeters J, Van Bogaert T, Boogers A, Gransier R, Wouters J, De Vloo P, Vandenberghe W, Barbe MT, Visser-Vandewalle V, Nuttin B, Dembek TA, Mc Laughlin M. Electrophysiological sweet spot mapping in deep brain stimulation for Parkinson's disease patients. Brain Stimul 2024; 17:794-801. [PMID: 38821395 DOI: 10.1016/j.brs.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/16/2024] [Accepted: 05/26/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Subthalamic deep brain stimulation (STN-DBS) is a well-established therapy to treat Parkinson's disease (PD). However, the STN-DBS sub-target remains debated. Recently, a white matter tract termed the hyperdirect pathway (HDP), directly connecting the motor cortex to STN, has gained interest as HDP stimulation is hypothesized to drive DBS therapeutic effects. Previously, we have investigated EEG-based evoked potentials (EPs) to better understand the neuroanatomical origins of the DBS clinical effect. We found a 3-ms peak (P3) relating to clinical benefit, and a 10-ms peak (P10) suggesting nigral side effects. Here, we aimed to investigate the neuroanatomical origins of DBS EPs using probabilistic mapping. METHODS EPs were recorded using EEG whilst low-frequency stimulation was delivered at all DBS-contacts individually. Next, EPs were mapped onto the patients' individual space and then transformed to MNI standard space. Using voxel-wise and fiber-wise probabilistic mapping, we determined hotspots/hottracts and coldspots/coldtracts for P3 and P10. Topography analysis was also performed to determine the spatial distribution of the DBS EPs. RESULTS In all 13 patients (18 hemispheres), voxel- and fiber-wise probabilistic mapping resulted in a P3-hotspot/hottract centered on the posterodorsomedial STN border indicative of HDP stimulation, while the P10-hotspot/hottract covered large parts of the substantia nigra. CONCLUSION This study investigated EP-based probabilistic mapping in PD patients during STN-DBS, revealing a P3-hotspot/hottract in line with HDP stimulation and P10-hotspot/hottract related to nigral stimulation. Results from this study provide key evidence for an electrophysiological measure of HDP and nigral stimulation.
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Affiliation(s)
- Jana Peeters
- Experimental Oto-rhino-laryngology, Department of Neurosciences, KU Leuven, Belgium
| | - Tine Van Bogaert
- Experimental Oto-rhino-laryngology, Department of Neurosciences, KU Leuven, Belgium
| | - Alexandra Boogers
- Experimental Oto-rhino-laryngology, Department of Neurosciences, KU Leuven, Belgium; Department of Neurology, UZ Leuven, Belgium
| | - Robin Gransier
- Experimental Oto-rhino-laryngology, Department of Neurosciences, KU Leuven, Belgium
| | - Jan Wouters
- Experimental Oto-rhino-laryngology, Department of Neurosciences, KU Leuven, Belgium
| | - Philippe De Vloo
- Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, KU Leuven, Belgium; Department of Neurosurgery, UZ Leuven, Belgium
| | - Wim Vandenberghe
- Department of Neurology, UZ Leuven, Belgium; Laboratory for Parkinson Research, Department of Neurosciences, KU Leuven, Belgium
| | - Michael T Barbe
- University of Cologne, Faculty of Medicine, Department of Neurology, Cologne, Germany
| | - Veerle Visser-Vandewalle
- University of Cologne, Faculty of Medicine, Department of Stereotactic & Functional Neurosurgery, Cologne, Germany
| | - Bart Nuttin
- Experimental Neurosurgery and Neuroanatomy, Department of Neurosciences, KU Leuven, Belgium; Department of Neurosurgery, UZ Leuven, Belgium
| | - Till A Dembek
- University of Cologne, Faculty of Medicine, Department of Neurology, Cologne, Germany
| | - Myles Mc Laughlin
- Experimental Oto-rhino-laryngology, Department of Neurosciences, KU Leuven, Belgium.
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Wang Y, Ma L, Wang J, Liu N, Men W, Tan S, Gao JH, Qin S, He Y, Dong Q, Tao S. Association of emotional and behavioral problems with the development of the substantia nigra, subthalamic nucleus, and red nucleus volumes and asymmetries from childhood to adolescence: A longitudinal cohort study. Transl Psychiatry 2024; 14:117. [PMID: 38403656 PMCID: PMC10894865 DOI: 10.1038/s41398-024-02803-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
The substantia nigra (SN), subthalamic nucleus (STN), and red nucleus (RN) have been widely studied as important biomarkers of degenerative diseases. However, how they develop in childhood and adolescence and are affected by emotional behavior has not been studied thus far. This population-based longitudinal cohort study used data from a representative sample followed two to five times. Emotional and behavioral problems were assessed with the Strengths and Difficulties Questionnaire (SDQ). Linear mixed models were used to map developmental trajectories and behavioral regulation. Using an innovative automated image segmentation technique, we quantified the volumes and asymmetries of the SN, STN and RN with 1226 MRI scans of a large longitudinal sample of 667 subjects aged 6-15 years and mapped their developmental trajectories. The results showed that the absolute and relative volumes of the bilateral SN and right STN showed linear increases, while the absolute volume of the right RN and relative volume of the bilateral RN decreased linearly, these effects were not affected by gender. Hyperactivity/inattention weakened the increase in SN volume and reduced the absolute volume of the STN, conduct problems impeded the RN volume from decreasing, and emotional symptoms changed the direction of SN lateralization. This longitudinal cohort study mapped the developmental trajectories of SN, STN, and RN volumes and asymmetries from childhood to adolescence, and found the association of emotional symptoms, conduct problems, and hyperactivity/inattention with these trajectories, providing guidance for preventing and intervening in cognitive and emotional behavioral problems.
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Affiliation(s)
- Yanpei Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Leilei Ma
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Jiali Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Ningyu Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Weiwei Men
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Shuping Tan
- Psychiatry Research Center, Beijing HuiLongGuan Hospital, Peking University, Beijing, 100096, China
| | - Jia-Hong Gao
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Qi Dong
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China
| | - Sha Tao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, 100875, China.
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, 100875, China.
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Lao G, Liu Q, Li Z, Guan X, Xu X, Zhang Y, Wei H. Sub-voxel quantitative susceptibility mapping for assessing whole-brain magnetic susceptibility from ages 4 to 80. Hum Brain Mapp 2023; 44:5953-5971. [PMID: 37721369 PMCID: PMC10619378 DOI: 10.1002/hbm.26487] [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: 05/06/2023] [Revised: 08/17/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
The evolution of magnetic susceptibility of the brain is mainly determined by myelin in white matter (WM) and iron deposition in deep gray matter (DGM). However, existing imaging techniques have limited abilities to simultaneously quantify the myelination and iron deposition within a voxel throughout brain development and aging. For instance, the temporal trajectories of iron in the brain WM and myelination in DGM have not been investigated during the aging process. This study aimed to map the age-related iron and myelin changes in the whole brain, encompassing myelin in DGM and iron deposition in WM, using a novel sub-voxel quantitative susceptibility mapping (QSM) method. To achieve this, a cohort of 494 healthy adults (18-80 years old) was studied. The sub-voxel QSM method was employed to obtain the paramagnetic and diamagnetic susceptibility based on the approximatedR 2 ' map from acquiredR 2 * map. The linear relationship betweenR 2 * andR 2 ' maps was established from the regression coefficients on a small cohort data acquired with both 3D gradient recalled echo data andR 2 mapping. Large cohort sub-voxel susceptibility maps were used to create longitudinal and age-specific atlases via group-wise registration. To explore the differential developmental trajectories in the DGM and WM, we employed nonlinear models including exponential and Poisson functions, along with generalized additive models. The constructed atlases reveal the iron accumulation in the posterior part of the putamen and the gradual myelination process in the globus pallidus with aging. Interestingly, the developmental trajectories show that the rate of myelination differs among various DGM regions. Furthermore, the process of myelin synthesis is paralleled by an associated pattern of iron accumulation in the primary WM fiber bundles. In summary, our study offers significant insights into the distinctive developmental trajectories of iron in the brain's WM and myelination/demyelination in the DGM in vivo. These findings highlight the potential of using sub-voxel QSM to uncover new perspectives in neuroscience and improve our understanding of whole-brain myelination and iron deposit processes across the lifespan.
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Affiliation(s)
- Guoyan Lao
- School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
| | - Qiangqiang Liu
- Department of Neurosurgery, Clinical Neuroscience Center Comprehensive Epilepsy Unit, Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhenghao Li
- School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital of Zhejiang UniversityZhejiang University School of MedicineHangzhouChina
| | - Xiaojun Xu
- Department of Radiology, The Second Affiliated Hospital of Zhejiang UniversityZhejiang University School of MedicineHangzhouChina
| | - Yuyao Zhang
- School of Information and Science and TechnologyShanghaiTech UniversityShanghaiChina
| | - Hongjiang Wei
- School of Biomedical EngineeringShanghai Jiao Tong UniversityShanghaiChina
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Pinto SN, Chiang J, Qaddoumi I, Livingston D, Bag A. Pediatric diencephalic tumors: a constellation of entities and management modalities. Front Oncol 2023; 13:1180267. [PMID: 37519792 PMCID: PMC10374860 DOI: 10.3389/fonc.2023.1180267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
The diencephalon is a complex midline structure consisting of the hypothalamus, neurohypophysis, subthalamus, thalamus, epithalamus, and pineal body. Tumors arising from each of these diencephalic components differ significantly in terms of biology and prognosis. The aim of this comprehensive review is to describe the epidemiology, clinical symptoms, imaging, histology, and molecular markers in the context of the 2021 WHO classification of central nervous system neoplasms. We will also discuss the current management of each of these tumors.
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Affiliation(s)
- Soniya N. Pinto
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Jason Chiang
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Ibrahim Qaddoumi
- Departments of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - David Livingston
- Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Asim Bag
- Department of Diagnostic Imaging, St. Jude Children’s Research Hospital, Memphis, TN, United States
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Baumgartner AJ, Thompson JA, Kern DS, Ojemann SG. Novel targets in deep brain stimulation for movement disorders. Neurosurg Rev 2022; 45:2593-2613. [PMID: 35511309 DOI: 10.1007/s10143-022-01770-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/01/2021] [Accepted: 03/08/2022] [Indexed: 12/26/2022]
Abstract
The neurosurgical treatment of movement disorders, primarily via deep brain stimulation (DBS), is a rapidly expanding and evolving field. Although conventional targets including the subthalamic nucleus (STN) and internal segment of the globus pallidus (GPi) for Parkinson's disease and ventral intermediate nucleus of the thalams (VIM) for tremor provide substantial benefit in terms of both motor symptoms and quality of life, other targets for DBS have been explored in an effort to maximize clinical benefit and also avoid undesired adverse effects associated with stimulation. These novel targets primarily include the rostral zona incerta (rZI), caudal zona incerta (cZI)/posterior subthalamic area (PSA), prelemniscal radiation (Raprl), pedunculopontine nucleus (PPN), substantia nigra pars reticulata (SNr), centromedian/parafascicular (CM/PF) nucleus of the thalamus, nucleus basalis of Meynert (NBM), dentato-rubro-thalamic tract (DRTT), dentate nucleus of the cerebellum, external segment of the globus pallidus (GPe), and ventral oralis (VO) complex of the thalamus. However, reports of outcomes utilizing these targets are scattered and disparate. In order to provide a comprehensive resource for researchers and clinicians alike, we have summarized the existing literature surrounding these novel targets, including rationale for their use, neurosurgical techniques where relevant, outcomes and adverse effects of stimulation, and future directions for research.
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Affiliation(s)
| | - John A Thompson
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
- University of Colorado Hospital, 12631 East 17th Avenue, PO Box 6511, Aurora, CO, 80045, USA
| | - Drew S Kern
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
- University of Colorado Hospital, 12631 East 17th Avenue, PO Box 6511, Aurora, CO, 80045, USA
| | - Steven G Ojemann
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
- University of Colorado Hospital, 12631 East 17th Avenue, PO Box 6511, Aurora, CO, 80045, USA.
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Leal-Galicia P, Chávez-Hernández ME, Mata F, Mata-Luévanos J, Rodríguez-Serrano LM, Tapia-de-Jesús A, Buenrostro-Jáuregui MH. Adult Neurogenesis: A Story Ranging from Controversial New Neurogenic Areas and Human Adult Neurogenesis to Molecular Regulation. Int J Mol Sci 2021; 22:11489. [PMID: 34768919 PMCID: PMC8584254 DOI: 10.3390/ijms222111489] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/16/2022] Open
Abstract
The generation of new neurons in the adult brain is a currently accepted phenomenon. Over the past few decades, the subventricular zone and the hippocampal dentate gyrus have been described as the two main neurogenic niches. Neurogenic niches generate new neurons through an asymmetric division process involving several developmental steps. This process occurs throughout life in several species, including humans. These new neurons possess unique properties that contribute to the local circuitry. Despite several efforts, no other neurogenic zones have been observed in many years; the lack of observation is probably due to technical issues. However, in recent years, more brain niches have been described, once again breaking the current paradigms. Currently, a debate in the scientific community about new neurogenic areas of the brain, namely, human adult neurogenesis, is ongoing. Thus, several open questions regarding new neurogenic niches, as well as this phenomenon in adult humans, their functional relevance, and their mechanisms, remain to be answered. In this review, we discuss the literature and provide a compressive overview of the known neurogenic zones, traditional zones, and newly described zones. Additionally, we will review the regulatory roles of some molecular mechanisms, such as miRNAs, neurotrophic factors, and neurotrophins. We also join the debate on human adult neurogenesis, and we will identify similarities and differences in the literature and summarize the knowledge regarding these interesting topics.
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Affiliation(s)
- Perla Leal-Galicia
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico; (M.E.C.-H.); (F.M.); (J.M.-L.); (L.M.R.-S.); (A.T.-d.-J.)
| | - María Elena Chávez-Hernández
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico; (M.E.C.-H.); (F.M.); (J.M.-L.); (L.M.R.-S.); (A.T.-d.-J.)
| | - Florencia Mata
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico; (M.E.C.-H.); (F.M.); (J.M.-L.); (L.M.R.-S.); (A.T.-d.-J.)
| | - Jesús Mata-Luévanos
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico; (M.E.C.-H.); (F.M.); (J.M.-L.); (L.M.R.-S.); (A.T.-d.-J.)
| | - Luis Miguel Rodríguez-Serrano
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico; (M.E.C.-H.); (F.M.); (J.M.-L.); (L.M.R.-S.); (A.T.-d.-J.)
- Laboratorio de Neurobiología de la Alimentación, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico
| | - Alejandro Tapia-de-Jesús
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico; (M.E.C.-H.); (F.M.); (J.M.-L.); (L.M.R.-S.); (A.T.-d.-J.)
| | - Mario Humberto Buenrostro-Jáuregui
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico; (M.E.C.-H.); (F.M.); (J.M.-L.); (L.M.R.-S.); (A.T.-d.-J.)
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Lee H, Cho H, Lee MJ, Kim TH, Roh J, Lee JH. Differential Effect of Iron and Myelin on Susceptibility MRI in the Substantia Nigra. Radiology 2021; 301:682-691. [PMID: 34609198 DOI: 10.1148/radiol.2021210116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background The heterogeneous composition of substantia nigra (SN), including iron, nigrosome-1 substructure, and myelinated white matter, complicates the interpretation of MRI signals. Purpose To investigate R2* and quantitative susceptibility mapping (QSM) in the SN subdivisions of participants with Parkinson disease and healthy control subjects. Materials and Methods In this prospective study conducted from November 2018 to November 2019, participants with Parkinson disease and sex-matched healthy control subjects underwent 3-T MRI. R2* and QSM values were measured and compared in the anterior SN and posterior SN at the rostral (superior) and caudal (inferior) levels. Postmortem MRI and histology correlation of midbrain tissues was evaluated to investigate the effect of myelin and iron in the SN on R2* and QSM values. Results Forty individuals were evaluated: 20 healthy control subjects (mean age, 61 years ± 3 [standard deviation]; 10 men) and 20 participants with Parkinson disease (mean age, 61 years ± 4; 10 men). The R2* values of participants with Parkinson disease were higher in all subdivisions of the SN compared with R2* values in healthy control subjects (all P < .05). For QSM, no evidence of a difference was found in the rostral posterior SN (healthy control subjects, 54.1 ppb ± 21.0; Parkinson disease, 62.2 ppb ± 19.8; P = .49). The combination of rostral R2* and caudal QSM values resulted in an area under the receiver operating characteristic curve of 0.84. R2* values showed higher correlation with QSM values at the caudal level than at the rostral level within each group (all P < .001). Postmortem investigation demonstrated that R2* and QSM values showed weak correlation in the myelin-rich areas (r = 0.22 and r = 0.36, P < .001) and strong correlation in myelin-scanty areas (r ranged from approximately 0.52 to approximately 0.78, P < .001) in the SN. Conclusion Considering the iron and myelin distribution in the substantia nigra subdivisions, the subdivisional analysis of substantia nigra using R2* and quantitative susceptibility mapping might aid in specifically differentiating individuals with Parkinson disease from healthy control subjects. © RSNA, 2021 Online supplemental material is available for this article.
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Affiliation(s)
- Hansol Lee
- From the Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea (H.L., H.J.C.); Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea (M.J.L); and Research Institute for Convergence of Biomedical Science and Technology (T.H.K.) and Departments of Radiology (J.R.) and Neurology (J.H.L.), Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea
| | - HyungJoon Cho
- From the Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea (H.L., H.J.C.); Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea (M.J.L); and Research Institute for Convergence of Biomedical Science and Technology (T.H.K.) and Departments of Radiology (J.R.) and Neurology (J.H.L.), Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea
| | - Myung Jun Lee
- From the Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea (H.L., H.J.C.); Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea (M.J.L); and Research Institute for Convergence of Biomedical Science and Technology (T.H.K.) and Departments of Radiology (J.R.) and Neurology (J.H.L.), Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea
| | - Tae-Hyung Kim
- From the Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea (H.L., H.J.C.); Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea (M.J.L); and Research Institute for Convergence of Biomedical Science and Technology (T.H.K.) and Departments of Radiology (J.R.) and Neurology (J.H.L.), Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea
| | - Jieun Roh
- From the Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea (H.L., H.J.C.); Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea (M.J.L); and Research Institute for Convergence of Biomedical Science and Technology (T.H.K.) and Departments of Radiology (J.R.) and Neurology (J.H.L.), Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea
| | - Jae-Hyeok Lee
- From the Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, South Korea (H.L., H.J.C.); Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, South Korea (M.J.L); and Research Institute for Convergence of Biomedical Science and Technology (T.H.K.) and Departments of Radiology (J.R.) and Neurology (J.H.L.), Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, South Korea
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Moreno-Gambín MI, Tembl JI, Mazón M, Cañada-Martínez AJ, Martí-Bonmatí L, Sevilla T, Vázquez-Costa JF. Role of the nigrosome 1 absence as a biomarker in amyotrophic lateral sclerosis. J Neurol 2021; 269:1631-1640. [PMID: 34379200 PMCID: PMC8857168 DOI: 10.1007/s00415-021-10729-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The absence of nigrosome 1 on brain MRI and the hyperechogenicity of substantia nigra (SNh) by transcranial sonography are two useful biomarkers in the diagnosis of parkinsonisms. We aimed to evaluate the absence of nigrosome 1 in amyotrophic lateral sclerosis (ALS) and to address its meaning. METHODS 136 ALS patients were recruited, including 16 progressive muscular atrophy (PMA) and 22 primary lateral sclerosis (PLS) patients. The SNh area was measured planimetrically by standard protocols. The nigrosome 1 status was qualitatively assessed by two blind evaluators in susceptibility weight images of 3T MRI. Demographic and clinical data were collected and the C9ORF72 expansion was tested in all patients. RESULTS Nigrosome 1 was absent in 30% of ALS patients (36% of PLS, 29% of classical ALS and 19% of PMA patients). There was no relationship between radiological and clinical laterality, nor between nigrosome 1 and SNh area. Male sex (OR = 3.63 [1.51, 9.38], p = 0.005) and a higher upper motor neuron (UMN) score (OR = 1.10 [1.02, 1.2], p = 0.022) were independently associated to nigrosome 1 absence, which also was an independent marker of poor survival (HR = 1.79 [1.3, 2.8], p = 0.013). CONCLUSION In ALS patients, the absence of nigrosome 1 is associated with male sex, UMN impairment and shorter survival. This suggests that constitutional factors and the degree of pyramidal involvement are related to the substantia nigra involvement in ALS. Thus, nigrosome 1 could be a marker of a multisystem degeneration, which in turn associates to poor prognosis.
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Affiliation(s)
- María Isabel Moreno-Gambín
- Neurosonology Laboratory, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - José I Tembl
- Neurosonology Laboratory, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Miguel Mazón
- Radiology and Biomedical Imaging Research Group (GIBI230), Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Luis Martí-Bonmatí
- Radiology and Biomedical Imaging Research Group (GIBI230), Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Teresa Sevilla
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Juan F Vázquez-Costa
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain. .,Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain. .,Department of Medicine, University of Valencia, Valencia, Spain.
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9
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Emmi A, Antonini A, Macchi V, Porzionato A, De Caro R. Anatomy and Connectivity of the Subthalamic Nucleus in Humans and Non-human Primates. Front Neuroanat 2020; 14:13. [PMID: 32390807 PMCID: PMC7189217 DOI: 10.3389/fnana.2020.00013] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/13/2020] [Indexed: 02/02/2023] Open
Abstract
The Subthalamic Nucleus (STh) is an oval-shaped diencephalic structure located ventrally to the thalamus, playing a fundamental role in the circuitry of the basal ganglia. In addition to being involved in the pathophysiology of several neurodegenerative disorders, such as Huntington’s and Parkinson’s disease, the STh is one of the target nuclei for deep brain stimulation. However, most of the anatomical evidence available derives from non-human primate studies. In this review, we will present the topographical and morphological organization of the nucleus and its connections to structurally and functionally related regions of the basal ganglia circuitry. We will also highlight the importance of additional research in humans focused on validating STh connectivity, cytoarchitectural organization, and its functional subdivision.
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Affiliation(s)
- Aron Emmi
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Neurology Clinic, Department of Neuroscience, University of Padua, Padua, Italy
| | - Veronica Macchi
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
| | - Andrea Porzionato
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
| | - Raffaele De Caro
- Institute of Human Anatomy, Department of Neuroscience, University of Padua, Padua, Italy
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10
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Chen Q, Chen Y, Zhang Y, Wang F, Yu H, Zhang C, Jiang Z, Luo W. Iron deposition in Parkinson's disease by quantitative susceptibility mapping. BMC Neurosci 2019; 20:23. [PMID: 31117957 PMCID: PMC6532252 DOI: 10.1186/s12868-019-0505-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 05/15/2019] [Indexed: 12/31/2022] Open
Abstract
Background Patients with Parkinson’s disease (PD) have elevated levels of brain iron, especially in the nigrostriatal dopaminergic system. The purpose of this study was to evaluate the iron deposition in the substantia nigra (SN) and other deep gray matter nuclei of PD patients using quantitative susceptibility mapping (QSM) and its clinical relationship, and to explore whether there is a gradient of iron deposition pattern in globus pallidus (GP)–fascicula nigrale (FN)–SN pathway. Methods Thirty-three PD patients and 26 age- and sex-matched healthy volunteers (HVs) were included in this study. Subjects underwent brain MRI and constructed QSM data. The differences in iron accumulation in the deep gray matter nuclei of the subjects were compared, including the PD group and the control group, the early-stage PD (EPD) group and the late-stage PD (LPD) group. The iron deposition pattern of the GP–FN–SN pathway was analyzed. Results The PD group showed increased susceptibility values in the FN, substantia nigra pars compacta (SNc), internal globus pallidus (GPi), red nucleus (RN), putamen and caudate nucleus compared with the HV group (P < 0.05). In both PD and HV group, iron deposition along the GP–FN–SN pathway did not show an increasing gradient pattern. The SNc, substantia nigra pars reticulata (SNr) and RN showed significantly increased susceptibility values in the LPD patients compared with the EPD patients. Conclusion PD is closely related to iron deposition in the SNc. The condition of PD patients is related to the SNc and the SNr. There is not an increasing iron deposition gradient along the GP–FN–SN pathway. The source and mechanism of iron deposition in the SN need to be further explored, as does the relationship between the iron deposition in the RN and PD.
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Affiliation(s)
- Qiqi Chen
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yiting Chen
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yue Zhang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Furu Wang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hongchang Yu
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Caiyuan Zhang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhen Jiang
- Department of Radiology, the Second Affiliated Hospital of Soochow University, Suzhou, China.
| | - Weifeng Luo
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, China.
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11
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Jonkman LE, Kenkhuis B, Geurts JJG, van de Berg WDJ. Post-Mortem MRI and Histopathology in Neurologic Disease: A Translational Approach. Neurosci Bull 2019; 35:229-243. [PMID: 30790214 DOI: 10.1007/s12264-019-00342-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/29/2018] [Indexed: 01/28/2023] Open
Abstract
In this review, combined post-mortem brain magnetic resonance imaging (MRI) and histology studies are highlighted, illustrating the relevance of translational approaches to define novel MRI signatures of neuropathological lesions in neuroinflammatory and neurodegenerative disorders. Initial studies combining post-mortem MRI and histology have validated various MRI sequences, assessing their sensitivity and specificity as diagnostic biomarkers in neurologic disease. More recent studies have focused on defining new radiological (bio)markers and implementing them in the clinical (research) setting. By combining neurological and neuroanatomical expertise with radiological development and pathological validation, a cycle emerges that allows for the discovery of novel MRI biomarkers to be implemented in vivo. Examples of this cycle are presented for multiple sclerosis, Alzheimer's disease, Parkinson's disease, and traumatic brain injury. Some applications have been shown to be successful, while others require further validation. In conclusion, there is much to explore with post-mortem MRI and histology studies, which can eventually be of high relevance for clinical practice.
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Affiliation(s)
- Laura E Jonkman
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
| | - Boyd Kenkhuis
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Wilma D J van de Berg
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
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12
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Jakobson Mo S, Axelsson J, Jonasson L, Larsson A, Ögren MJ, Ögren M, Varrone A, Eriksson L, Bäckström D, Af Bjerkén S, Linder J, Riklund K. Dopamine transporter imaging with [ 18F]FE-PE2I PET and [ 123I]FP-CIT SPECT-a clinical comparison. EJNMMI Res 2018; 8:100. [PMID: 30443684 PMCID: PMC6238014 DOI: 10.1186/s13550-018-0450-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/17/2018] [Indexed: 11/26/2022] Open
Abstract
Background Dopamine transporter (DAT) imaging may be of diagnostic value in patients with clinically suspected parkinsonian disease. The purpose of this study was to compare the diagnostic performance of DAT imaging with positron emission computed tomography (PET), using the recently developed, highly DAT-selective radiopharmaceutical [18F]FE-PE2I (FE-PE2I), to the commercially available and frequently used method with [123I]FP-CIT (FP-CIT) single-photon emission computed tomography (SPECT) in early-stage idiopathic parkinsonian syndrome (PS). Methods Twenty-two patients with a clinical de novo diagnosis of PS and 28 healthy controls (HC) participating in an on-going clinical trial of FE-PE2I were analyzed in this study. Within the trial protocol, participants are clinically reassessed 2 years after inclusion. A commercially available software was used for automatic calculation of FP-CIT-specific uptake ratio (SUR). MRI-based volumes of interest combined with threshold PET segmentation were used for FE-PE2I binding potential relative to non-displaceable binding (BPND) quantification and specific uptake value ratios (SUVR). Results PET with FE-PE2I revealed significant differences between patients with a clinical de novo diagnosis of PS and healthy controls in striatal DAT availability (p < 0.001), with excellent accuracy of predicting dopaminergic deficit in early-stage PS. The effect sizes were calculated for FE-PE2I BPND (Glass’s Δ = 2.95), FE-PE2I SUVR (Glass’s Δ = 2.57), and FP-CIT SUR (Glass’s Δ = 2.29). The intraclass correlation (ICC) between FE-PE2I BPND FP-CIT SUR was high in the caudate (ICC = 0.923), putamen (ICC = 0.922), and striatum (ICC = 0.946), p < 0.001. Five of the 22 patients displayed preserved striatal DAT availability in the striatum with both methods. At follow-up, a non-PS clinical diagnosis was confirmed in three of these, while one was clinically diagnosed with corticobasal syndrome. In these patients, FE-PE2I binding was also normal in the substantia nigra (SN), while significantly reduced in the remaining patients. FE-PE2I measurement of the mean DAT availability in the putamen was strongly correlated with BPND in the SN (R = 0.816, p < 0.001). Olfaction and mean putamen DAT availability was correlated using both FE-PE2I BPND and FP-CIT SUR (R ≥ 0.616, p < 0.001). Conclusion DAT imaging with FE-PE2I PET yields excellent basic diagnostic differentiation in early-stage PS, at least as good as FP-CIT SPECT.
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Affiliation(s)
- Susanna Jakobson Mo
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden. .,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.
| | - Jan Axelsson
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.,Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Lars Jonasson
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.,Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - Anne Larsson
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.,Department of Radiation Sciences, Radiation Physics, Umeå University, Umeå, Sweden
| | - Mattias J Ögren
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Margareta Ögren
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden
| | - Andrea Varrone
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Linda Eriksson
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - David Bäckström
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Sara Af Bjerkén
- Department of Integrative Medical Biology, Umeå University, Umeå, Sweden.,Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Jan Linder
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden.,Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Katrine Riklund
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.,Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
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13
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Lewis MM, Du G, Baccon J, Snyder AM, Murie B, Cooper F, Sica C, Mailman RB, Connor JR, Huang X. Susceptibility MRI captures nigral pathology in patients with parkinsonian syndromes. Mov Disord 2018; 33:1432-1439. [PMID: 29756231 PMCID: PMC6185787 DOI: 10.1002/mds.27381] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/21/2018] [Accepted: 02/13/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Parkinsonisms are neurodegenerative disorders characterized pathologically by α-synuclein-positive (e.g., PD, diffuse Lewy body disease, and MSA) and/or tau-positive (e.g., PSP, cortical basal degeneration) pathology. Using R2* and quantitative susceptibility mapping, susceptibility changes have been reported in the midbrain of living parkinsonian patients, although the exact underlying pathology of these alterations is unknown. OBJECTIVE The current study investigated the pathological correlates of these susceptibility MRI measures. METHODS In vivo MRIs (T1- and T2-weighted, and T2*) and pathology were obtained from 14 subjects enrolled in an NINDS PD Biomarker Program (PDBP). We assessed R2* and quantitative susceptibility mapping values in the SN, semiquantitative α-synuclein, tau, and iron values, as well as neuronal and glial counts. Data were analyzed using age-adjusted Spearman correlations. RESULTS R2* was associated significantly with nigral α-synuclein (r = 0.746; P = 0.003). Quantitative susceptibility mapping correlated significantly with Perls' (r = 0.758; P = 0.003), but not with other pathological measurements. Neither measurement correlated with tau or glial cell counts (r ≤ 0.11; P ≥ 0.129). CONCLUSIONS Susceptibility MRI measurements capture nigral pathologies associated with parkinsonian syndromes. Whereas quantitative susceptibility mapping is more sensitive to iron, R2* may reflect pathological aspects of the disorders beyond iron such as α-synuclein. They may be invaluable tools in diagnosing differential parkinsonian syndromes, and tracking in living patients the dynamic changes associated with the pathological progression of these disorders. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Jennifer Baccon
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pathology and Laboratory Medicine, Akron Children’s Hospital, Akron, OH 44308
| | - Amanda M. Snyder
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Ben Murie
- Department of Pathology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Felicia Cooper
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Christopher Sica
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Richard B. Mailman
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - James R. Connor
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
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14
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Lewis MM, Sterling NW, Du G, Lee EY, Shyu G, Goldenberg M, Allen T, Stetter C, Kong L, Snipes SA, Jones BC, Chen H, Mailman RB, Huang X. Lateralized Basal Ganglia Vulnerability to Pesticide Exposure in Asymptomatic Agricultural Workers. Toxicol Sci 2017; 159:170-178. [PMID: 28633499 PMCID: PMC5837257 DOI: 10.1093/toxsci/kfx126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Pesticide exposure is linked to Parkinson's disease, a neurodegenerative disorder marked by dopamine cell loss in the substantia nigra of the basal ganglia (BG) that often presents asymmetrically. We previously reported that pesticide-exposed agricultural workers (AW) have nigral diffusion tensor imaging (DTI) changes. The current study sought to confirm this finding, and explore its hemisphere and regional specificity within BG structures using an independent sample population. Pesticide exposure history, standard neurological exam, high-resolution magnetic resonance imaging (T1/T2-weighted and DTI), and [123I]ioflupane SPECT images (to quantify striatal dopamine transporters) were obtained from 20 AW with chronic pesticide exposure and 11 controls. Based on median cumulative days of pesticide exposure, AW were subdivided into high (AWHi, n = 10) and low (AWLo, n = 10) exposure groups. BG (nigra, putamen, caudate, and globus pallidus [GP]) fractional anisotropy (FA), mean diffusivity (MD), and striatal [123I]ioflupane binding in each hemisphere were quantified, and compared across exposure groups using analysis of variance. Left, but not right, nigral and GP FA were significantly lower in AW compared with controls (p's < .029). None of the striatal (putamen and caudate) DTI or [123I]ioflupane binding measurements differed between AW and controls. Subgroup analyses indicated that significant left nigral and GP DTI changes were present only in the AWHi (p ≤ .037) but not the AWLo subgroup. AW, especially those with higher pesticide exposure history, demonstrate lateralized microstructural changes in the nigra and GP, whereas striatal areas appear relatively unaffected. Future studies should elucidate how environmental toxicants cause differential lateralized- and regionally specific brain vulnerability.
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Affiliation(s)
| | | | | | | | | | | | - Thomas Allen
- Department of Radiology, and Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033
| | - Christy Stetter
- Department of Radiology, and Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033
| | - Lan Kong
- Department of Radiology, and Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033
| | - Shedra Amy Snipes
- Department of Biobehavioral Health, Pennsylvania State University University Park, Pennsylvania 16802
| | - Byron C Jones
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, Tennessee 38163
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan 48824
| | | | - Xuemei Huang
- Department of Neurology
- Department of Pharmacology
- Department of Radiology, and Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033
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15
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Massey LA, Miranda MA, Al-Helli O, Parkes HG, Thornton JS, So PW, White MJ, Mancini L, Strand C, Holton J, Lees AJ, Revesz T, Yousry TA. 9.4 T MR microscopy of the substantia nigra with pathological validation in controls and disease. Neuroimage Clin 2016; 13:154-163. [PMID: 27981030 PMCID: PMC5144755 DOI: 10.1016/j.nicl.2016.11.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/14/2016] [Accepted: 11/16/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The anatomy of the substantia nigra on conventional MRI is controversial. Even using histological techniques it is difficult to delineate with certainty from surrounding structures. We sought to define the anatomy of the SN using high field spin-echo MRI of pathological material in which we could study the anatomy in detail to corroborate our MRI findings in controls and Parkinson's disease and progressive supranuclear palsy. METHODS 23 brains were selected from the Queen Square Brain Bank (10 controls, 8 progressive supranuclear palsy, 5 Parkinson's disease) and imaged using high field 9.4 Tesla spin-echo MRI. Subsequently brains were cut and stained with Luxol fast blue, Perls stain, and immunohistochemistry for substance P and calbindin. Once the anatomy was defined on histology the dimensions and volume of the substantia nigra were determined on high field magnetic resonance images. RESULTS The anterior border of the substantia nigra was defined by the crus cerebri. In the medial half it was less distinct due to the deposition of iron and the interdigitation of white matter and the substantia nigra. The posterior border was flanked by white matter bridging the red nucleus and substantia nigra and seen as hypointense on spin-echo magnetic resonance images. Within the substantia nigra high signal structures corresponded to confirmed nigrosomes. These were still evident in Parkinson's disease but not in progressive supranuclear palsy. The volume and dimensions of the substantia nigra were similar in Parkinson's disease and controls, but reduced in progressive supranuclear palsy. CONCLUSIONS We present a histologically validated anatomical description of the substantia nigra on high field spin-echo high resolution magnetic resonance images and were able to delineate all five nigrosomes. In accordance with the pathological literature we did not observe changes in the nigrosome structure as manifest by volume or signal characteristics within the substantia nigra in Parkinson's disease whereas in progressive supranuclear palsy there was microarchitectural destruction.
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Affiliation(s)
- LA Massey
- Sara Koe Progressive Supranuclear Palsy Research Centre, UCL Institute of Neurology, London, United Kingdom
- Queen Square Brain Bank for Neurological Disorders, Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - MA Miranda
- Division of Radiology, Department of Medicine, School of Medicine, University of Panama, Panama City, Panama
| | - O Al-Helli
- Sara Koe Progressive Supranuclear Palsy Research Centre, UCL Institute of Neurology, London, United Kingdom
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom
| | - HG Parkes
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom
| | - JS Thornton
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - P-W So
- Institute of Psychiatry, Psychology and Neuroscience, King's College, University of London, London, United Kingdom
| | - MJ White
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - L Mancini
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
| | - C Strand
- Queen Square Brain Bank for Neurological Disorders, Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - J Holton
- Queen Square Brain Bank for Neurological Disorders, Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - AJ Lees
- Sara Koe Progressive Supranuclear Palsy Research Centre, UCL Institute of Neurology, London, United Kingdom
- Queen Square Brain Bank for Neurological Disorders, Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
- Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London, United Kingdom
| | - T Revesz
- Queen Square Brain Bank for Neurological Disorders, Department of Molecular Neuroscience, UCL Institute of Neurology, London, United Kingdom
| | - TA Yousry
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, United Kingdom
- Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
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16
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Fu KA, Nathan R, Dinov ID, Li J, Toga AW. T2-Imaging Changes in the Nigrosome-1 Relate to Clinical Measures of Parkinson's Disease. Front Neurol 2016; 7:174. [PMID: 27812347 PMCID: PMC5071353 DOI: 10.3389/fneur.2016.00174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/27/2016] [Indexed: 01/23/2023] Open
Abstract
Background The nigrosome-1 region of the substantia nigra (SN) undergoes the greatest and earliest dopaminergic neuron loss in Parkinson’s disease (PD). As T2-weighted magnetic resonance imaging (MRI) scans are often collected with routine clinical MRI protocols, this investigation aims to determine whether T2-imaging changes in the nigrosome-1 are related to clinical measures of PD and to assess their potential as a more clinically accessible biomarker for PD. Methods Voxel intensity ratios were calculated for T2-weighted MRI scans from 47 subjects from the Parkinson’s Progression Markers Initiative database. Three approaches were used to delineate the SN and nigrosome-1: (1) manual segmentation, (2) automated segmentation, and (3) area voxel-based morphometry. Voxel intensity ratios were calculated from voxel intensity values taken from the nigrosome-1 and two areas of the remaining SN. Linear regression analyses were conducted relating voxel intensity ratios with the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) sub-scores for each subject. Results For manual segmentation, linear regression tests consistently identified the voxel intensity ratio derived from the dorsolateral SN and nigrosome-1 (IR2) as predictive of nBehav (p = 0.0377) and nExp (p = 0.03856). For automated segmentation, linear regression tests identified IR2 as predictive of Subscore IA (nBehav) (p = 0.01134), Subscore IB (nExp) (p = 0.00336), Score II (mExp) (p = 0.02125), and Score III (mSign) (p = 0.008139). For the voxel-based morphometric approach, univariate simple linear regression analysis identified IR2 as yielding significant results for nBehav (p = 0.003102), mExp (p = 0.0172), and mSign (p = 0.00393). Conclusion Neuroimaging biomarkers may be used as a proxy of changes in the nigrosome-1, measured by MDS-UPDRS scores as an indicator of the severity of PD. The voxel intensity ratio derived from the dorsolateral SN and nigrosome-1 was consistently predictive of non-motor complex behaviors in all three analyses and predictive of non-motor experiences of daily living, motor experiences of daily living, and motor signs of PD in two of the three analyses. These results suggest that T2 changes in the nigrosome-1 may relate to certain clinical measures of PD. T2 changes in the nigrosome-1 may be considered when developing a more accessible clinical diagnostic tool for patients with suspected PD.
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Affiliation(s)
- Katherine A Fu
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Romil Nathan
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Ivo D Dinov
- Statistics Online Computational Resource, Health Behavior and Biological Sciences, University of Michigan , Ann Arbor, MI , USA
| | - Junning Li
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, University of Southern California , Los Angeles, CA , USA
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17
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Zwirner J, Möbius D, Bechmann I, Arendt T, Hoffmann KT, Jäger C, Lobsien D, Möbius R, Planitzer U, Winkler D, Morawski M, Hammer N. Subthalamic nucleus volumes are highly consistent but decrease age-dependently-a combined magnetic resonance imaging and stereology approach in humans. Hum Brain Mapp 2016; 38:909-922. [PMID: 27726278 DOI: 10.1002/hbm.23427] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 09/08/2016] [Accepted: 09/26/2016] [Indexed: 01/03/2023] Open
Abstract
The subthalamic nucleus (STN) is a main target structure of deep brain stimulation (DBS) in idiopathic Parkinson's disease. Nevertheless, there is an ongoing discussion regarding human STN volumes and neuron count, which could potentially have an impact on STN-DBS. Moreover, a suspected functional subdivision forms the basis of the tripartite hypothesis, which has not yet been morphologically substantiated. In this study, it was aimed to investigate the human STN by means of combined magnetic resonance imaging (MRI) and stereology. STN volumes were obtained from 14 individuals (ranging from 65 to 96 years, 25 hemispheres) in 3 T MRI and in luxol-stained histology slices. Neuron number and cell densities were investigated stereologically over the entire STN and in pre-defined subregions in anti-human neuronal protein HuC/D-stained slices. STN volumes measured with MRI were smaller than in stereology but appeared to be highly consistent, measuring on average 99 ± 6 mm3 (MRI) and 132 ± 20 mm3 (stereology). The neuron count was 431,088 ± 72,172. Both STN volumes and cell count decreased age-dependently. Neuron density was different for the dorsal, medial and ventral subregion with significantly higher values ventrally than dorsally. Small variations in STN volumes in both MRI and stereology contradict previous findings of large variations in STN size. Age-dependent decreases in STN volumes and neuron numbers might influence the efficacy of STN-DBS in a geriatric population. Though the study is limited in sample size, site-dependent differences for the STN subregions form a morphological basis for the tripartite theory. Hum Brain Mapp 38:909-922, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Johann Zwirner
- Faculty of Medicine, Institute of Anatomy University of Leipzig, Leipzig, Germany
| | - Dustin Möbius
- Faculty of Medicine, Institute of Anatomy University of Leipzig, Leipzig, Germany
| | - Ingo Bechmann
- Faculty of Medicine, Institute of Anatomy University of Leipzig, Leipzig, Germany
| | - Thomas Arendt
- Paul-Flechsig-Institute for Brain Research University of Leipzig, Leipzig, Germany
| | - Karl-Titus Hoffmann
- Department of Neuroradiology, University Clinic of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Carsten Jäger
- Paul-Flechsig-Institute for Brain Research University of Leipzig, Leipzig, Germany
| | - Donald Lobsien
- Department of Neuroradiology, University Clinic of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Robert Möbius
- Faculty of Medicine, Institute of Anatomy University of Leipzig, Leipzig, Germany
| | - Uwe Planitzer
- Department of Neurosurgery, University Clinic of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Dirk Winkler
- Department of Neurosurgery, University Clinic of Leipzig, Faculty of Medicine, Leipzig, Germany
| | - Markus Morawski
- Paul-Flechsig-Institute for Brain Research University of Leipzig, Leipzig, Germany
| | - Niels Hammer
- Faculty of Medicine, Institute of Anatomy University of Leipzig, Leipzig, Germany.,Department of Anatomy, University of Otago, Dunedin, New Zealand
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Azuma M, Hirai T, Yamada K, Yamashita S, Ando Y, Tateishi M, Iryo Y, Yoneda T, Kitajima M, Wang Y, Yamashita Y. Lateral Asymmetry and Spatial Difference of Iron Deposition in the Substantia Nigra of Patients with Parkinson Disease Measured with Quantitative Susceptibility Mapping. AJNR Am J Neuroradiol 2016; 37:782-8. [PMID: 26822728 DOI: 10.3174/ajnr.a4645] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/03/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Quantitative susceptibility mapping is useful for assessing iron deposition in the substantia nigra of patients with Parkinson disease. We aimed to determine whether quantitative susceptibility mapping is useful for assessing the lateral asymmetry and spatial difference in iron deposits in the substantia nigra of patients with Parkinson disease. MATERIALS AND METHODS Our study population comprised 24 patients with Parkinson disease and 24 age- and sex-matched healthy controls. They underwent 3T MR imaging by using a 3D multiecho gradient-echo sequence. On reconstructed quantitative susceptibility mapping, we measured the susceptibility values in the anterior, middle, and posterior parts of the substantia nigra, the whole substantia nigra, and other deep gray matter structures in both hemibrains. To identify the more and less affected hemibrains in patients with Parkinson disease, we assessed the severity of movement symptoms for each hemibrain by using the Unified Parkinson's Disease Rating Scale. RESULTS In the posterior substantia nigra of patients with Parkinson disease, the mean susceptibility value was significantly higher in the more than the less affected hemibrain substantia nigra (P < .05). This value was significantly higher in both the more and less affected hemibrains of patients with Parkinson disease than in controls (P < .05). Asymmetry of the mean susceptibility values was significantly greater for patients than controls (P < .05). Receiver operating characteristic analysis showed that quantitative susceptibility mapping of the posterior substantia nigra in the more affected hemibrain provided the highest power for discriminating patients with Parkinson disease from the controls. CONCLUSIONS Quantitative susceptibility mapping is useful for assessing the lateral asymmetry and spatial difference of iron deposition in the substantia nigra of patients with Parkinson disease.
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Affiliation(s)
- M Azuma
- From the Departments of Diagnostic Radiology (M.A., M.T., Y.I., M.K., Y.Y.)
| | - T Hirai
- Department of Radiology (T.H.), Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | | | - S Yamashita
- Neurology (S.Y., Y.A.), Graduate School of Medical Sciences
| | - Y Ando
- Neurology (S.Y., Y.A.), Graduate School of Medical Sciences
| | - M Tateishi
- From the Departments of Diagnostic Radiology (M.A., M.T., Y.I., M.K., Y.Y.)
| | - Y Iryo
- From the Departments of Diagnostic Radiology (M.A., M.T., Y.I., M.K., Y.Y.)
| | - T Yoneda
- Department of Medical Physics in Advanced Biomedical Sciences (T.Y.), Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - M Kitajima
- From the Departments of Diagnostic Radiology (M.A., M.T., Y.I., M.K., Y.Y.)
| | - Y Wang
- Department of Radiology (Y.W.), Weill Cornell Medical College, New York, New York
| | - Y Yamashita
- From the Departments of Diagnostic Radiology (M.A., M.T., Y.I., M.K., Y.Y.)
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19
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Barbagallo G, Sierra-Peña M, Nemmi F, Traon APL, Meissner WG, Rascol O, Péran P. Multimodal MRI assessment of nigro-striatal pathway in multiple system atrophy and Parkinson disease. Mov Disord 2015; 31:325-34. [PMID: 26676922 DOI: 10.1002/mds.26471] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/02/2015] [Accepted: 10/05/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) and multiple system atrophy (MSA) are two neurodegenerative alpha-synucleinopathies characterized by severe impairment of the nigro-striatal pathway. Based on T1-, T2*-, and diffusion-weighted magnetic resonance imaging (MRI), macro-structural and micro-structural abnormalities in these diseases can be detected. OBJECTIVE This study was undertaken to compare the nigro-striatal changes that occur in patients with PD with those in patients with both variants of MSA (the parkinsonian variant, MSA-P, and the cerebellar variant, MSA-C), and to explore correlations between different MRI parameters and clinical data. METHODS We simultaneously measured volume, T2* relaxation rates, and mean diffusivity in nigro-striatal structures (substantia nigra, caudate nucleus, and putamen) of 26 patients with PD and 29 patients with MSA (16 with MSA-P and 13 with MSA-C). RESULTS Significant changes in the putamina in patients with MSA were observed compared with patients with PD. Patients with MSA-P had higher mean diffusivity values in their putamina than did patients with PD or MSA-C. The putamina of both subgroups of MSA had higher T2* relaxation rates values than PD. Remarkably, discriminant analysis showed that using two measurements of microstructural damage (T2* relaxation rates and mean diffusivity in the putamen) allowed 96% accuracy to distinguish patients with PD from those with MSA-P. Correlation analyses between MRI findings and clinical variables revealed that patients with PD showed significant correlations only at the nigra. In patients with MSA, clinical variables correlated with MRI findings in both the nigra and striatum. CONCLUSIONS Multimodal MRI reveals different pattern of nigro-striatal involvement in patients with PD and patients with MSA.
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Affiliation(s)
- Gaetano Barbagallo
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059, Toulouse, France.,Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France.,Institute of Neurology, University Magna Graecia, Catanzaro, Italy
| | - Maria Sierra-Peña
- Service of Neurology, University Hospital "Marqués de Valdecilla (IFIMAV)," University of Cantabria and "Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED),", Santander, Spain
| | - Federico Nemmi
- Neuroscience Department, Retzius vag 8, Karolinska Institutet, Stockholm, Sweden
| | - Anne Pavy-Le Traon
- Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Wassilios G Meissner
- Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Bordeaux, Pessac, France.,Service de Neurologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France.,Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France.,CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France
| | - Olivier Rascol
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059, Toulouse, France.,Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France.,Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Département de Pharmacologie Clinique, INSERM CIC1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Patrice Péran
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059, Toulouse, France.,Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France
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20
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Du G, Liu T, Lewis MM, Kong L, Wang Y, Connor J, Mailman RB, Huang X. Quantitative susceptibility mapping of the midbrain in Parkinson's disease. Mov Disord 2015; 31:317-24. [PMID: 26362242 DOI: 10.1002/mds.26417] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 07/30/2015] [Accepted: 08/05/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) is marked pathologically by dopamine neuron loss and iron overload in the substantia nigra pars compacta. Midbrain iron content is reported to be increased in PD based on magnetic resonance imaging (MRI) R2* changes. Because quantitative susceptibility mapping is a novel MRI approach to measure iron content, we compared it with R2* for assessing midbrain changes in PD. METHODS Quantitative susceptibility mapping and R2* maps were obtained from 47 PD patients and 47 healthy controls. Midbrain susceptibility and R2* values were analyzed by using both voxel-based and region-of-interest approaches in normalized space, and analyzed along with clinical data, including disease duration, Unified Parkinson's Disease Rating Scale (UPDRS) I, II, and III subscores, and levodopa-equivalent daily dosage. All studies were done while PD patients were "on drug." RESULTS Compared with controls, PD patients showed significantly increased susceptibility values in both right (cluster size = 106 mm(3)) and left (164 mm(3)) midbrain, located ventrolateral to the red nucleus that corresponded to the substantia nigra pars compacta. Susceptibility values in this region were correlated significantly with disease duration, UPDRS II, and levodopa-equivalent daily dosage. Conversely, R2* was increased significantly only in a much smaller region (62 mm(3)) of the left lateral substantia nigra pars compacta and was not significantly correlated with clinical parameters. CONCLUSION The use of quantitative susceptibility mapping demonstrated marked nigral changes that correlated with clinical PD status more sensitively than R2*. These data suggest that quantitative susceptibility mapping may be a superior imaging biomarker to R2* for estimating brain iron levels in PD.
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Affiliation(s)
- Guangwei Du
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Tian Liu
- MedImageMetric LLC, New York, New York, United States
| | - Mechelle M Lewis
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Lan Kong
- Department of Public Health Sciences, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Yi Wang
- Department of Radiology, Weill Cornell Medical College, New York, New York, United States
| | - James Connor
- Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Richard B Mailman
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
| | - Xuemei Huang
- Department of Neurology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Pharmacology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Neurosurgery, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Radiology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States.,Department of Kinesiology, Penn State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
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21
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Fernández-Seara MA, Mengual E, Vidorreta M, Castellanos G, Irigoyen J, Erro E, Pastor MA. Resting state functional connectivity of the subthalamic nucleus in Parkinson's disease assessed using arterial spin-labeled perfusion fMRI. Hum Brain Mapp 2015; 36:1937-50. [PMID: 25641065 DOI: 10.1002/hbm.22747] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 12/02/2014] [Accepted: 01/13/2015] [Indexed: 12/24/2022] Open
Abstract
Neurophysiological changes within the cortico-basal ganglia-thalamocortical circuits appear to be a characteristic of Parkinson's disease (PD) pathophysiology. The subthalamic nucleus (STN) is one of the basal ganglia components showing pathological neural activity patterns in PD. In this study, perfusion imaging data, acquired noninvasively using arterial spin-labeled (ASL) perfusion MRI, were used to assess the resting state functional connectivity (FC) of the STN in 24 early-to-moderate PD patients and 34 age-matched healthy controls, to determine whether altered FC in the very low frequency range of the perfusion time signal occurs as a result of the disease. Our results showed that the healthy STN was functionally connected with other nuclei of the basal ganglia and the thalamus, as well as with discrete cortical areas including the insular cortex and the hippocampus. In PD patients, connectivity of the STN was increased with two cortical areas involved in motor and cognitive processes. These findings suggest that hyperconnectivity of the STN could underlie some of the motor and cognitive deficits often present even at early stages of the disease. The FC measures provided good discrimination between controls and patients, suggesting that ASL-derived FC metrics could be a putative PD biomarker.
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Affiliation(s)
- María A Fernández-Seara
- Neuroimaging Laboratory, Division of Neuroscience, Center for Applied Medical Research (CIMA), University of Navarra, Pamplona, Spain; CIBERNED, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Spain
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22
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Bosemani T, Anghelescu C, Boltshauser E, Hoon AH, Pearl PL, Craiu D, Johnston MV, Huisman TAGM, Poretti A. Subthalamic nucleus involvement in children: a neuroimaging pattern-recognition approach. Eur J Paediatr Neurol 2014; 18:249-56. [PMID: 24149100 DOI: 10.1016/j.ejpn.2013.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 09/17/2013] [Accepted: 09/30/2013] [Indexed: 12/28/2022]
Abstract
A neuroimaging-based pattern-recognition approach has been shown to be very helpful in the diagnosis of a wide range of pediatric central nervous system diseases. Few disorders may selectively affect the subthalamic nucleus in children including Leigh syndrome, succinic semialdehyde dehydrogenase deficiency, kernicterus, chronic end-stage liver failure and near total hypoxic-ischemic injury in the full-term neonates. The consideration of the constellation of clinical history and findings as well as additional neuroimaging findings should allow planning the appropriate diagnostic tests to make the correct diagnosis in children with involvement of the subthalamic nucleus.
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Affiliation(s)
- Thangamadhan Bosemani
- Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Eugen Boltshauser
- Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland
| | - Alexander H Hoon
- Kennedy Krieger Institute, Baltimore, MD, USA; Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Phillip L Pearl
- Division of Neurology, Children's National Medical Center, Washington, DC, USA
| | - Dana Craiu
- Pediatric Neurology Clinic, Alexandru Obregia Hospital, Bucharest, Romania; Department of Neurology, Pediatric Neurology, Neurosurgery, Psychiatry, "Carol Davila" University of Medicine, Bucharest, Romania
| | - Michael V Johnston
- Kennedy Krieger Institute, Baltimore, MD, USA; Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thierry A G M Huisman
- Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrea Poretti
- Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pediatric Neurology, University Children's Hospital, Zurich, Switzerland.
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23
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Schwedt TJ, Chong CD, Chiang CC, Baxter L, Schlaggar BL, Dodick DW. Enhanced pain-induced activity of pain-processing regions in a case-control study of episodic migraine. Cephalalgia 2014; 34:947-58. [PMID: 24627432 DOI: 10.1177/0333102414526069] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to identify brain regions having aberrant pain-induced activation in migraineurs, thereby gaining insight into particular aspects of pain processing that are atypical in migraineurs. METHODS Functional magnetic resonance imaging assessed whole brain responses to painful heat in 24 adult episodic migraineurs who were at least 48 hours pain free and 27 healthy controls. Regions differentially activated in migraineurs compared to controls were identified. Activation intensities in these regions were correlated with headache frequency, number of migraine years, and time to next migraine attack. RESULTS Migraineurs had greater pain-induced activation of lentiform nucleus, fusiform gyrus, subthalamic nucleus, hippocampus, middle cingulate cortex, premotor cortex, somatosensory cortex, and dorsolateral prefrontal cortex, and less activation in precentral gyrus and superior temporal gyrus. There were significant correlations between activation strength and headache frequency for middle cingulate (r = 0.627, p = 0.001), right dorsolateral prefrontal cortex (r = 0.568, p = 0.004), left fusiform gyrus (r = 0.487, p = 0.016), left precentral gyrus (r = 0.415, p = 0.044), and left hippocampus (r = 0.404, p = 0.050) and with number of migraine years for left fusiform gyrus (r = 0.425, p = 0.038). There were no significant correlations between activation strength and time to next migraine attack. CONCLUSIONS The majority of regions with enhanced pain-induced activation in headache-free migraineurs participate in cognitive aspects of pain perception such as attending to pain and pain memory. Enhanced cognitive pain processing by migraineurs might reflect cerebral hypersensitivity related to high expectations and hypervigilance for pain.
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24
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Cosottini M, Frosini D, Pesaresi I, Costagli M, Biagi L, Ceravolo R, Bonuccelli U, Tosetti M. MR imaging of the substantia nigra at 7 T enables diagnosis of Parkinson disease. Radiology 2014; 271:831-8. [PMID: 24601752 DOI: 10.1148/radiol.14131448] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the anatomy of the substantia nigra (SN) in healthy subjects by performing 7-T magnetic resonance (MR) imaging of the SN, and to prospectively define the accuracy of 7-T MR imaging in distinguishing Parkinson disease (PD) patients from healthy subjects on an individual basis. MATERIALS AND METHODS The 7-T MR imaging protocol was approved by the Italian Ministry of Health and by the local competent ethics committee. SN anatomy was described ex vivo on a gross brain specimen by using highly resolved proton-density (spin-echo proton density) and gradient-recalled-echo (GRE) images, and in vivo in eight healthy subjects (mean age, 40.1 years) by using GRE three-dimensional multiecho susceptibility-weighted images. After training on appearance of SN in eight healthy subjects, the SN anatomy was evaluated twice by two blinded observers in 13 healthy subjects (mean age, 54.7 years) and in 17 PD patients (mean age, 56.9 years). Deviations from normal SN appearance were described and indicated as abnormal, and both diagnostic accuracy and intra- and interobserver agreement for diagnosis of PD with 7-T MR imaging were calculated. RESULTS Three-dimensional multiecho susceptibility-weighted 7-T MR imaging reveals a three-layered organization of the SN allowing readers to distinguish pars compacta ventralis and dorsalis from pars reticulata. The abnormal architecture of the SN allowed a discrimination between PD patients and healthy subjects with sensitivity and specificity of 100% and 96.2% (range, 92.3%-100%), respectively. Intraobserver agreement (κ = 1) and interobserver agreement (κ = 0.932) were excellent. CONCLUSION MR imaging at 7-T allows a precise characterization of the SN and visualization of its inner organization. Three-dimensional multiecho susceptibility-weighted images can be used to accurately differentiate healthy subjects from PD patients, which provides a novel diagnostic opportunity.
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Affiliation(s)
- Mirco Cosottini
- From the IMAGO7 Foundation, Pisa, Italy (M. Cosottini, M. Costagli); Department of Translational Research and New Surgical and Medical Technologies (M. Cosottini) and Neurology Unit, Department of Clinical and Experimental Medicine (D.F., R.C., U.B.), University of Pisa, Pisa, Italy; Neuroradiology Unit, Department of Diagnostic and Interventional Radiology, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy (I.P.); and Stella Maris Scientific Institute, Pisa, Italy (L.B., M.T.)
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25
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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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26
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Du G, Lewis MM, Sterling NW, Kong L, Chen H, Mailman RB, Huang X. Microstructural changes in the substantia nigra of asymptomatic agricultural workers. Neurotoxicol Teratol 2013; 41:60-4. [PMID: 24334261 DOI: 10.1016/j.ntt.2013.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 10/23/2013] [Accepted: 12/02/2013] [Indexed: 11/17/2022]
Abstract
Parkinson's disease (PD) is marked by the loss of dopamine neurons in the substantia nigra (SN). Although the exact etiology is unknown, sporadic PD is hypothesized to be a result of genetic susceptibility interacting with environmental insult. Epidemiological studies suggest that pesticide exposure is linked to higher PD risk, but there are no studies demonstrating SN changes with chronic pesticide exposure in human subjects. Thus, high resolution T2-weighted magnetic resonance imaging (MRI) and diffusion tensor (DTI) images were obtained from 12 agricultural workers with chronic pesticide exposure, 12 controls, and 12 PD subjects. Neither controls nor pesticide-exposed subjects, had any parkinsonian symptoms. Exposure history to pesticides was assessed by a structured questionnaire. DTI measures in the SN, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), were obtained for all subjects and compared among groups. Compared to controls, PD patients showed the expected significant changes in all DTI measurements in the SN. The pesticide-exposed subjects, compared to controls, had significantly lower FA values (p=0.022, after multiple comparisons correction), but no significant differences in RD, MD, or AD measures. The study is the first to demonstrate microstructural changes in the SN of human subjects with chronic pesticide exposure. The changes detected by MRI may mark "one of the hits" leading to PD, and underlie the increased risk of PD in pesticide users found in epidemiological studies. Further human studies assisted by these imaging markers may be useful in understanding the etiology of PD.
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Affiliation(s)
- Guangwei Du
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Mechelle M Lewis
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Departments of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Nicholas W Sterling
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Lan Kong
- Departments of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Honglei Chen
- National Institute of Environmental Health Sciences, Research Triangle Park, NC 27705, USA
| | - Richard B Mailman
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Departments of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Xuemei Huang
- Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Departments of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Departments of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Departments of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Departments of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA; Departments of Bioengineering, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
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Camlidag I, Kocabicak E, Sahin B, Jahanshahi A, Incesu L, Aygun D, Yildiz O, Temel Y, Belet U. Volumetric analysis of the subthalamic and red nuclei based on magnetic resonance imaging in patients with Parkinson's disease. Int J Neurosci 2013; 124:291-5. [PMID: 24020352 DOI: 10.3109/00207454.2013.843091] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is associated with degeneration of the dopaminergic neurons in the substantia nigra. The subthalamic nucleus (STN) plays a pivotal role in the pathogenesis. However, there is not much known about the morphological changes in the STN. The red nucleus (RN) has many connections with the motor coordinating pathways although it is not primarily involved in the pathogenesis. In this study we aimed to compare the volumes of the STN and RN measured by magnetic resonance imaging in PD patients and controls to investigate how these structures are affected at the morphological level. Twenty patients with PD and twenty age/sex matched controls were enrolled in this study. Severity score was determined by Hoehn & Yahr staging: 6 at stage II and 14 at stage III in med-off state. Imaging was performed by a 1.5 Tesla (T) MR scanner. Measurements of total brain and normalized STN and RN volumes were performed by manual planimetry using Image J software. No statistically significant differences were observed between two groups based on age or gender and disease stage and nuclei volumes. The total estimated brain volumes were not different between PD patients and controls. However, normalized volumes of the STN and RN were 14% and 16% larger, respectively, in PD patients compared to the controls (p < 0.05). Our findings suggest that the volumes of the STN and RN are increased in patients with PD. These changes possibly reflect the altered metabolic activity of these regions demonstrated by neurophysiological studies.
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Affiliation(s)
- Ilkay Camlidag
- 1Department of Radiology, Ondokuz Mayis University , Samsun , Turkey
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28
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Blazejewska AI, Schwarz ST, Pitiot A, Stephenson MC, Lowe J, Bajaj N, Bowtell RW, Auer DP, Gowland PA. Visualization of nigrosome 1 and its loss in PD: pathoanatomical correlation and in vivo 7 T MRI. Neurology 2013; 81:534-40. [PMID: 23843466 DOI: 10.1212/wnl.0b013e31829e6fd2] [Citation(s) in RCA: 192] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study assessed whether high-resolution 7 T MRI allowed direct in vivo visualization of nigrosomes, substructures of the substantia nigra pars compacta (SNpc) undergoing the greatest and earliest dopaminergic cell loss in Parkinson disease (PD), and whether any disease-specific changes could be detected in patients with PD. METHODS Postmortem (PM) midbrains, 2 from healthy controls (HCs) and 1 from a patient with PD, were scanned with high-resolution T2*-weighted MRI scans, sectioned, and stained for iron and neuromelanin (Perl), TH, and calbindin. To confirm the identification of nigrosomes in vivo on 7 T T2*-weighted scans, we assessed colocalization with neuromelanin-sensitive T1-weighted scans. We then assessed the ability to depict PD pathology on in vivo T2*-weighted scans by comparing data from 10 patients with PD and 8 age- and sex-matched HCs. RESULTS A hyperintense, ovoid area within the dorsolateral border of the otherwise hypointense SNpc was identified in the HC brains on in vivo and PM T2*-weighted MRI. Location, size, shape, and staining characteristics conform to nigrosome 1. Blinded assessment by 2 neuroradiologists showed consistent bilateral absence of this nigrosome feature in all 10 patients with PD, and bilateral presence in 7/8 HC. CONCLUSIONS In vivo and PM MRI with histologic correlation demonstrates that high-resolution 7 T MRI can directly visualize nigrosome 1. The absence of nigrosome 1 in the SNpc on MRI scans might prove useful in developing a neuroimaging diagnostic test for PD.
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Affiliation(s)
- Anna I Blazejewska
- Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, UK
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29
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Ziegler DA, Corkin S. New MRI Biomarkers Advance the Characterization of Parkinson Disease. EUROPEAN NEUROLOGICAL REVIEW 2013; 8:85-89. [PMID: 24999373 DOI: 10.17925/enr.2013.08.02.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The pathophysiology of idiopathic Parkinson disease (PD) is traditionally characterized as substantia nigra degeneration, but careful examination of the widespread neuropathological changes suggests individual differences in neuronal vulnerability. A major limitation to studies of disease progression in PD has been that conventional MRI techniques provide relatively poor contrast for the structures that are affected by the disease, and thus are not typically used in experimental or clinical studies. Here, we review the current state of structural MRI as applied to the analysis of the PD brain. We also describe a new multispectral MRI method that provides improved contrast for the substantia nigra and basal forebrain, which we recently used to show that these structures display different trajectories of volume loss early in the disease.
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Affiliation(s)
- David A Ziegler
- Department of Neurology and the Center for Integrative Neuroscience, University of California San Francisco, San Francisco, CA
| | - Suzanne Corkin
- Department of Brain & Cognitive Sciences, MIT, Cambridge, MA
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Du G, Lewis MM, Sen S, Wang J, Shaffer ML, Styner M, Yang QX, Huang X. Imaging nigral pathology and clinical progression in Parkinson's disease. Mov Disord 2012; 27:1636-43. [PMID: 23008179 PMCID: PMC3510346 DOI: 10.1002/mds.25182] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 08/02/2012] [Accepted: 08/08/2012] [Indexed: 11/12/2022] Open
Abstract
The pattern of dopamine cell loss in Parkinson's disease (PD) is known to be prominent in the ventrolateral and caudal substantia nigra (SN), but less severe in the dorsal and rostral region. Both diffusion tensor imaging (DTI) and R2* relaxometry of the SN have been reported as potential markers for PD, but their relative ability to mark disease progression and differences in pathophysiological bases remains unclear. High-resolution T2-weighted, R2*, and DTI were obtained from 28 controls and 40 PD subjects [15 early stage [disease duration ≤1 year], 14 mid stage [duration 2-5 years], and 11 late stage [duration >5 years]). Fractional anisotropy and R2* values in both rostral and caudal SN were obtained for all subjects, and clinical measures (e.g., disease duration, levodopa-equivalent daily dosage, and "off"-drug UPDRS motor score) were obtained for Parkinson's subjects. There was no correlation between fractional anisotropy and clinical measures, whereas R2* was strongly associated with disease progression. Compared to controls, fractional anisotropy in caudal SN was significantly decreased in PD patients of all stages, whereas in rostral SN, it was decreased significantly only in the late-stage group. R2* in both SN regions was significantly increased in the mid- and late-stage, but not early-stage, of PD subjects. These findings suggest that fractional anisotropy changes may mark early pathological changes in caudal SN, whereas the changes in R2* may more closely track PD's clinical progression after symptom onset.
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Affiliation(s)
- Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Suman Sen
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Jianli Wang
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Michele L. Shaffer
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Martin Styner
- Department of Computer Science, University of North Carolina, Chapel Hill, NC 27599
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599
| | - Qing X. Yang
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Bioengineering, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Bioengineering, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033
- Department of Neurology, University of North Carolina, Chapel Hill, NC 27599
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31
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Kwon DH, Kim JM, Oh SH, Jeong HJ, Park SY, Oh ES, Chi JG, Kim YB, Jeon BS, Cho ZH. Seven-Tesla magnetic resonance images of the substantia nigra in Parkinson disease. Ann Neurol 2012; 71:267-77. [PMID: 22367998 DOI: 10.1002/ana.22592] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate anatomical changes in the substantia nigra (SN) of Parkinson disease (PD) patients with age-matched controls by using ultra-high field magnetic resonance imaging (MRI). METHODS We performed 7T MRI in 10 PD and 10 age-matched control subjects. Magnetic resonance images of the SN were obtained from a 3-dimensional (3D) T(2)*-weighted gradient echo sequence. Region of interest-based 3D shape analysis was performed to quantitatively compare images from the 2 groups. RESULTS The boundary between the SN and crus cerebri was not smooth in PD subjects. Undulation in the lateral surface of the SN appeared more intense in the side contralateral to that with the more severe symptoms, and more prominent at the rostral level of the SN than at the intermediate or caudal levels. In addition to the lateral surface, there was a striking difference in the dorsomedial aspects of the SN between PD and control subjects. In control subjects, a brighter signal region was observed along the dorsomedial surface of the lateral portion of SN, whereas in PD subjects, this region was observed as a dark region containing a hypointense signal in T(2)*-weighted images. The measurement of SN volumes, normalized to the intracranial volumes, showed higher values in PD subjects than in control subjects. INTERPRETATION This study demonstrates that 3D 7T MRI can definitively visualize anatomical alterations occurring in the SN of PD subjects. Further pathological studies are required to elucidate the nature of these anatomical alterations.
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Affiliation(s)
- Dae-Hyuk Kwon
- Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, South Korea
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32
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Du G, Lewis MM, Shaffer ML, Chen H, Yang QX, Mailman RB, Huang X. Serum cholesterol and nigrostriatal R2* values in Parkinson's disease. PLoS One 2012; 7:e35397. [PMID: 22530017 PMCID: PMC3328461 DOI: 10.1371/journal.pone.0035397] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 03/15/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The occurrence of Parkinson's disease (PD) is known to be associated both with increased nigrostriatal iron content and with low serum cholesterol and PD, but there has been no study to determine a potential relationship between these two factors. METHODS High-resolution MRI (T1-, T2, and multiple echo T2*-weighted imaging) and fasting lipid levels were obtained from 40 patients with PD and 29 healthy controls. Iron content was estimated from mean R2* values (R2* = 1/T2*) calculated for each nigrostriatal structure including substantia nigra, caudate, putamen, and globus pallidus. This was correlated with serum cholesterol levels after controlling for age, gender, and statin use. RESULTS In patients with PD, higher serum cholesterol levels were associated with lower iron content in the substantia nigra (R = -0.43, p = 0.011 for total-cholesterol, R = -0.31, p = 0.080 for low-density lipoprotein) and globus pallidus (R = -0.38, p = 0.028 for total-cholesterol, R = -0.27, p = 0.127 for low-density lipoprotein), but only a trend toward significant association of higher total-cholesterol with lower iron content in the striatum (R = -0.34, p = 0.052 for caudate; R = -0.32, p = 0.061 for putamen). After adjusting for clinical measures, the cholesterol-iron relationships held or became even stronger in the substantia nigra and globus pallidus, but weaker in the caudate and putamen. There was no significant association between serum cholesterol levels and nigrostriatal iron content for controls. CONCLUSIONS The data show that higher serum total-cholesterol concentration is associated with lower iron content in substantia nigra and globus pallidus in Parkinson's disease patients. Further studies should investigate whether this is mechanistic or epiphenomenological relationship.
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Affiliation(s)
- Guangwei Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
| | - Mechelle M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
| | - Michele L. Shaffer
- Department of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
| | - Honglei Chen
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, United States of America
| | - Qing X. Yang
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
| | - Richard B. Mailman
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
| | - Xuemei Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America
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Lenglet C, Abosch A, Yacoub E, De Martino F, Sapiro G, Harel N. Comprehensive in vivo mapping of the human basal ganglia and thalamic connectome in individuals using 7T MRI. PLoS One 2012; 7:e29153. [PMID: 22235267 PMCID: PMC3250409 DOI: 10.1371/journal.pone.0029153] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 11/21/2011] [Indexed: 11/19/2022] Open
Abstract
Basal ganglia circuits are affected in neurological disorders such as Parkinson's disease (PD), essential tremor, dystonia and Tourette syndrome. Understanding the structural and functional connectivity of these circuits is critical for elucidating the mechanisms of the movement and neuropsychiatric disorders, and is vital for developing new therapeutic strategies such as deep brain stimulation (DBS). Knowledge about the connectivity of the human basal ganglia and thalamus has rapidly evolved over recent years through non-invasive imaging techniques, but has remained incomplete because of insufficient resolution and sensitivity of these techniques. Here, we present an imaging and computational protocol designed to generate a comprehensive in vivo and subject-specific, three-dimensional model of the structure and connections of the human basal ganglia. High-resolution structural and functional magnetic resonance images were acquired with a 7-Tesla magnet. Capitalizing on the enhanced signal-to-noise ratio (SNR) and enriched contrast obtained at high-field MRI, detailed structural and connectivity representations of the human basal ganglia and thalamus were achieved. This unique combination of multiple imaging modalities enabled the in-vivo visualization of the individual human basal ganglia and thalamic nuclei, the reconstruction of seven white-matter pathways and their connectivity probability that, to date, have only been reported in animal studies, histologically, or group-averaged MRI population studies. Also described are subject-specific parcellations of the basal ganglia and thalamus into sub-territories based on their distinct connectivity patterns. These anatomical connectivity findings are supported by functional connectivity data derived from resting-state functional MRI (R-fMRI). This work demonstrates new capabilities for studying basal ganglia circuitry, and opens new avenues of investigation into the movement and neuropsychiatric disorders, in individual human subjects.
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Affiliation(s)
- Christophe Lenglet
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States of America.
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Massey LA, Miranda MA, Zrinzo L, Al-Helli O, Parkes HG, Thornton JS, So PW, White MJ, Mancini L, Strand C, Holton JL, Hariz MI, Lees AJ, Revesz T, Yousry TA. High resolution MR anatomy of the subthalamic nucleus: imaging at 9.4 T with histological validation. Neuroimage 2011; 59:2035-44. [PMID: 22036997 DOI: 10.1016/j.neuroimage.2011.10.016] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 09/21/2011] [Accepted: 10/05/2011] [Indexed: 11/24/2022] Open
Abstract
Using conventional MRI the subthalamic nucleus (STN) is not clearly defined. Our objective was to define the anatomy of the STN using 9.4 T MRI of post mortem tissue with histological validation. Spin-echo (SE) and 3D gradient-echo (GE) images were obtained at 9.4 T in 8 post mortem tissue blocks and compared directly with corresponding histological slides prepared with Luxol Fast Blue/Cresyl Violet (LFB/CV) in 4 cases and Perl stain in 3. The variability of the STN anatomy was studied using internal reference points. The anatomy of the STN and surrounding structures was demonstrated in all three anatomical planes using 9.4 T MR images in concordance with LFB/CV stained histological sections. Signal hypointensity was seen in 6/8 cases in the anterior and medial STN that corresponded with regions of more intense Perl staining. There was significant variability in the volume, shape and location of the borders of the STN. Using 9.4 T MRI, the internal signal characteristics and borders of the STN are clearly defined and significant anatomical variability is apparent. Direct visualisation of the STN is possible using high field MRI and this is particularly relevant, given its anatomical variability, for planning deep brain stimulation.
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Affiliation(s)
- L A Massey
- Sara Koe PSP Research Centre, UCL Institute of Neurology, London, UK.
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35
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Schäfer A, Forstmann BU, Neumann J, Wharton S, Mietke A, Bowtell R, Turner R. Direct visualization of the subthalamic nucleus and its iron distribution using high-resolution susceptibility mapping. Hum Brain Mapp 2011; 33:2831-42. [PMID: 21932259 DOI: 10.1002/hbm.21404] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 05/20/2011] [Accepted: 06/09/2011] [Indexed: 11/07/2022] Open
Abstract
Histological studies have shown a relatively high iron concentration in the subthalamic nucleus (STN). T2- and T2*-weighted sequences have previously been used to visualize the STN in vivo. The phase information of gradient-echo images reflects the magnetic tissue properties more directly, e.g., iron is more paramagnetic than water. Unfortunately, phase images suffer from non-local effects and orientation dependency. The goal of this study is to delineate the STN more precisely using susceptibility maps, calculated from phase images, which directly index magnetic tissue properties while removing the non-local effects and orientation dependency. Use of 7T MRI enables high spatial resolution with good signal to noise ratio (SNR). Eight healthy subjects were scanned at 7T using a high-resolution 3D gradient-echo sequence. Susceptibility maps were calculated from phase data using a thresholding Fourier approach and a regularization approach using spatial priors. The susceptibility maps clearly distinguish the STN from the adjacent substantia nigra (SN). Their susceptibilities are quantitatively different (0.06 and 0.1 ppm for the STN and SN, respectively). These maps allowed the STN, SN, and the red nucleus to be manually segmented, thus providing 3D visualization of their boundaries. In sum, the STN can be more clearly distinguished from adjacent structures in susceptibility maps than in T2*-weighted images or phase images.
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Affiliation(s)
- Andreas Schäfer
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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36
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Gröger A, Chadzynski G, Godau J, Berg D, Klose U. Three-dimensional magnetic resonance spectroscopic imaging in the substantia nigra of healthy controls and patients with Parkinson's disease. Eur Radiol 2011; 21:1962-9. [PMID: 21484351 DOI: 10.1007/s00330-011-2123-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 02/04/2011] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To investigate the substantia nigra in patients with Parkinson's disease three-dimensional magnetic resonance spectroscopic imaging with high spatial resolution at 3 Tesla was performed. Regional variations of spectroscopic data between the rostral and caudal regions of the substantia nigra as well as the midbrain tegmentum areas were evaluated in healthy controls and patients with Parkinson's disease. METHODS Nine patients with Parkinson's disease and eight age- and gender-matched healthy controls were included in this study. Data were acquired by using three-dimensional magnetic resonance spectroscopic imaging measurements. The ratios between rostral and caudal voxels of the substantia nigra as well as the midbrain tegmentum areas were calculated for the main-metabolites N-acetyl aspartate, creatine, choline, and myo-inositol. Additionally, the metabolite/creatine ratios were calculated. RESULTS In all subjects spectra of acceptable quality could be obtained with a nominal voxel size of 0.252 ml. The calculated rostral-to-caudal ratios of the metabolites as well as of the metabolite/creatine ratios showed with exception of choline/creatine ratio significant differences between healthy controls and patients with Parkinson's disease. CONCLUSIONS The findings from this study indicate that regional variations in N-acetyl aspartate/creatine ratios in the regions of the substantia nigra may differentiate patients with Parkinson's disease and healthy controls.
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Affiliation(s)
- Adriane Gröger
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research and German Center for Neurodegenerative Disease (DZNE), University of Tuebingen, Tuebingen, Germany.
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Baudrexel S, Witte T, Seifried C, von Wegner F, Beissner F, Klein JC, Steinmetz H, Deichmann R, Roeper J, Hilker R. Resting state fMRI reveals increased subthalamic nucleus-motor cortex connectivity in Parkinson's disease. Neuroimage 2011; 55:1728-38. [PMID: 21255661 DOI: 10.1016/j.neuroimage.2011.01.017] [Citation(s) in RCA: 195] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 12/15/2010] [Accepted: 01/09/2011] [Indexed: 11/24/2022] Open
Abstract
Parkinson's disease (PD) is associated with abnormal hypersynchronicity in basal ganglia-thalamo-cortical loops. The clinical effectiveness of subthalamic nucleus (STN) high frequency stimulation indicates a crucial role of this nucleus within the affected motor networks in PD. Here we investigate alterations in the functional connectivity (FC) profile of the STN using resting state BOLD correlations on a voxel-by-voxel basis in functional magnetic resonance imaging (fMRI). We compared early stage PD patients (n=31) during the medication-off state with healthy controls (n=44). The analysis revealed increased FC between the STN and cortical motor areas (BA 4 and 6) in PD patients in accordance with electrophysiological studies. Moreover, FC analysis of the primary motor cortex (M1) hand area revealed that the FC increase was primarily found in the STN area within the basal ganglia. These findings are in good agreement with recent experimental data, suggesting that an increased STN-motor cortex synchronicity mediated via the so called hyperdirect motor cortex-subthalamic pathway might play a fundamental role in the pathophysiology of PD. An additional subgroup analysis was performed according to the presence (n=16) or absence (n=15) of tremor in patients. Compared to healthy controls tremor patients showed increased STN FC specifically in the hand area of M1 and the primary sensory cortex. In non-tremor patients, increased FC values were also found between the STN and midline cortical motor areas including the SMA. Taken together our results underline the importance of the STN as a key node for the modulation of BG-cortical motor network activity in PD patients.
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Affiliation(s)
- Simon Baudrexel
- Department of Neurology, University Hospital, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
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Péran P, Cherubini A, Assogna F, Piras F, Quattrocchi C, Peppe A, Celsis P, Rascol O, Démonet JF, Stefani A, Pierantozzi M, Pontieri FE, Caltagirone C, Spalletta G, Sabatini U. Magnetic resonance imaging markers of Parkinson's disease nigrostriatal signature. ACTA ACUST UNITED AC 2010; 133:3423-33. [PMID: 20736190 DOI: 10.1093/brain/awq212] [Citation(s) in RCA: 300] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
One objective of modern neuroimaging is to identify markers that can aid in diagnosis, disease progression monitoring and long-term drug impact analysis. In this study, Parkinson-associated physiopathological modifications were characterized in six subcortical structures by simultaneously measuring quantitative magnetic resonance parameters sensitive to complementary tissue characteristics (i.e. volume atrophy, iron deposition and microstructural damage). Thirty patients with Parkinson's disease and 22 control subjects underwent 3-T magnetic resonance imaging with T₂*-weighted, whole-brain T₁-weighted and diffusion tensor imaging scans. The mean R₂* value, mean diffusivity and fractional anisotropy in the pallidum, putamen, caudate nucleus, thalamus, substantia nigra and red nucleus were compared between patients with Parkinson's disease and control subjects. Comparisons were also performed using voxel-based analysis of R₂*, mean diffusivity and fractional anisotropy maps to determine which subregion of the basal ganglia showed the greater difference for each parameter. Averages of each subregion were then used in a logistic regression analysis. Compared with control subjects, patients with Parkinson's disease displayed significantly higher R₂* values in the substantia nigra, lower fractional anisotropy values in the substantia nigra and thalamus, and higher mean diffusivity values in the thalamus. Voxel-based analyses confirmed these results and, in addition, showed a significant difference in the mean diffusivity in the striatum. The combination of three markers was sufficient to obtain a 95% global accuracy (area under the receiver operating characteristic curve) for discriminating patients with Parkinson's disease from controls. The markers comprising discriminating combinations were R₂* in the substantia nigra, fractional anisotropy in the substantia nigra and mean diffusivity in the putamen or caudate nucleus. Remarkably, the predictive markers involved the nigrostriatal structures that characterize Parkinson's physiopathology. Furthermore, highly discriminating combinations included markers from three different magnetic resonance parameters (R₂*, mean diffusivity and fractional anisotropy). These findings demonstrate that multimodal magnetic resonance imaging of subcortical grey matter structures is useful for the evaluation of Parkinson's disease and, possibly, of other subcortical pathologies.
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Affiliation(s)
- Patrice Péran
- Department of Radiology, I.R.C.C.S. Foundation Santa Lucia, Via Ardeatina 306, 00179 Rome.
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