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Yang K, Wu Z, Long J, Li W, Wang X, Hu N, Zhao X, Sun T. White matter changes in Parkinson's disease. NPJ Parkinsons Dis 2023; 9:150. [PMID: 37907554 PMCID: PMC10618166 DOI: 10.1038/s41531-023-00592-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease (AD). It is characterized by a progressive loss of dopaminergic neurons in the substantia nigra pars compacta (SNc) and the formation of Lewy bodies (LBs). Although PD is primarily considered a gray matter (GM) disease, alterations in white matter (WM) have gained increasing attention in PD research recently. Here we review evidence collected by magnetic resonance imaging (MRI) techniques which indicate WM abnormalities in PD, and discuss the correlations between WM changes and specific PD symptoms. Then we summarize transcriptome and genome studies showing the changes of oligodendrocyte (OLs)/myelin in PD. We conclude that WM abnormalities caused by the changes of myelin/OLs might be important for PD pathology, which could be potential targets for PD treatment.
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Affiliation(s)
- Kai Yang
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China.
| | - Zhengqi Wu
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China
| | - Jie Long
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China
| | - Wenxin Li
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China
| | - Xi Wang
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China
| | - Ning Hu
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China
| | - Xinyue Zhao
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China
| | - Taolei Sun
- School of Chemistry, Chemical Engineering and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China.
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Wuhan University of Technology, 122 Luoshi Road, Wuhan, 430070, People's Republic of China.
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Mortezazadeh T, Seyedarabi H, Mahmoudian B, Islamian JP. Imaging modalities in differential diagnosis of Parkinson’s disease: opportunities and challenges. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00454-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Parkinson’s disease (PD) diagnosis is yet largely based on the related clinical aspects. However, genetics, biomarkers, and neuroimaging studies have demonstrated a confirming role in the diagnosis, and future developments might be used in a pre-symptomatic phase of the disease.
Main text
This review provides an update on the current applications of neuroimaging modalities for PD diagnosis. A literature search was performed to find published studies that were involved on the application of different imaging modalities for PD diagnosis. An organized search of PubMed/MEDLINE, Embase, ProQuest, Scopus, Cochrane, and Google Scholar was performed based on MeSH keywords and suitable synonyms. Two researchers (TM and JPI) independently and separately performed the literature search. Our search strategy in each database was done by the following terms: ((Parkinson [Title/Abstract]) AND ((“Parkinsonian syndromes ”[Mesh]) OR Parkinsonism [Title/Abstract])) AND ((PET [Title/Abstract]) OR “SPECT”[Mesh]) OR ((Functional imaging, Transcranial sonography [Title/Abstract]) OR “Magnetic resonance spectroscopy ”[Mesh]). Database search had no limitation in time, and our last update of search was in February 2021. To have a comprehensive search and to find possible relevant articles, a manual search was conducted on the reference list of the articles and limited to those published in English.
Conclusion
Early diagnosis of PD could be vital for early management and adequate neuroprotection. Recent neuroimaging modalities such as SPECT and PET imaging using radiolabeled tracers, MRI, and CT are used to discover the disease. By the modalities, it is possible to early diagnose dopaminergic degeneration and also to differentiate PD from others parkinsonian syndromes, to monitor the natural progression of the disease and the effect of neuroprotective treatments on the progression. In this regard, functional imaging techniques have provided critical insights and roles on PD.
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3
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Arribarat G, Péran P. Quantitative MRI markers in Parkinson's disease and parkinsonian syndromes. Curr Opin Neurol 2020; 33:222-229. [DOI: 10.1097/wco.0000000000000796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Priovoulos N, Poser BA, Ivanov D, Verhey FRJ, Jacobs HIL. In vivo imaging of the nucleus of the solitary tract with Magnetization Transfer at 7 Tesla. Neuroimage 2019; 201:116071. [PMID: 31398435 DOI: 10.1016/j.neuroimage.2019.116071] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 01/22/2023] Open
Abstract
The nucleus of the solitary tract (NTS) is a nuclei complex with, among others, a high concentration of noradrenergic neurons (including the noradrenergic subnuclei named A1 and A2) in the medulla. The NTS regulates several cognitive, neuroendocrine and autonomic functions. No method currently exists to anatomically visualize the NTS in vivo. Several noradrenergic and dopaminergic nuclei have been successfully imaged using Magnetization Transfer (MT) contrast manipulation. We therefore hypothesized that an efficient, high-resolution MT-weighted sequence at 7 T might successfully image the NTS. In this study, we found a hyperintensity, similar to hyperintensities found in other noradrenergic and dopaminergic nuclei, consistent with the expected NTS location, and specific to the MT-weighted images. The localization of the hyperintensity was found to be consistent between individuals and slices and in good correspondence to a histological atlas and a meta-analytic map of fMRI-based NTS activation. We conclude that the method may, for the first time, achieve NTS imaging in vivo and within a clinically-feasible acquisition time. To facilitate NTS research at lower field strengths, an NTS template was created and made publicly available.
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Affiliation(s)
- Nikos Priovoulos
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.
| | - Benedikt A Poser
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Dimo Ivanov
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Frans R J Verhey
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Heidi I L Jacobs
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands; Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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5
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T2*-weighted MRI values correlate with motor and cognitive dysfunction in Parkinson's disease. Neurobiol Aging 2019; 80:91-98. [PMID: 31103636 DOI: 10.1016/j.neurobiolaging.2019.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 11/20/2022]
Abstract
Brain iron load is one of the main neuropathologic hallmarks of Parkinson's disease (PD). Previous studies indicated that iron in the substantia nigra (SN) is related to disease duration and motor impairment. We explore, through a cross-sectional study, the association between brain iron distribution, evaluated by T2*-weighted magnetic resonance imaging (T2*), and clinical features in a cohort of patients with PD. Thirty-two patients with PD, compared with 10 control subjects, were evaluated for motor and cognitive features (attention and working memory, executive functions, language, memory, and visuospatial function). They underwent a magnetic resonance imaging protocol including T2* analysis of specific brain regions of interest to measure iron load compared with healthy control subjects. We found that iron content of the SN correlated positively with both disease duration and Unified Parkinson's Disease Rating Scale III off score. Montreal Cognitive Assessment, Spatial Span, and Graded Naming Test scores were inversely associated with iron load of the SN, whereas Wechsler Adult Intelligence Scale-IV Similarities score showed an inverse relationship with iron content in all the regions of interest examined. Our findings suggest a relationship between topographic brain iron distribution and cognitive domain impairment.
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De Micco R, Russo A, Tessitore A. Structural MRI in Idiopathic Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:405-438. [PMID: 30314605 DOI: 10.1016/bs.irn.2018.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Among modern neuroimaging modalities, magnetic resonance imaging (MRI) is a widely available, non-invasive, and cost-effective method to detect structural and functional abnormalities related to neurodegenerative disorders. In the last decades, MRI have been widely implemented to support PD diagnosis as well as to provide further insights into motor and non-motor symptoms pathophysiology, complications and treatment-related effects. Different aspects of the brain morphology and function may be derived from a single scan, by applying different analytic approaches. Biomarkers of neurodegeneration as well as tissue microstructural changes may be extracted from structural MRI techniques. In this chapter, we analyze the role of structural imaging to differentiate PD patients from controls and to define neural substrates of motor and non-motor PD symptoms. Evidence collected in the premotor PD phase will be also critically discussed. White matter as well as gray matter integrity imaging studies has been reviewed, aiming to highlight points of strength and limits to their potential application in clinical settings.
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Affiliation(s)
- Rosa De Micco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Antonio Russo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy.
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Georgiopoulos C, Warntjes M, Dizdar N, Zachrisson H, Engström M, Haller S, Larsson EM. Olfactory Impairment in Parkinson's Disease Studied with Diffusion Tensor and Magnetization Transfer Imaging. JOURNAL OF PARKINSONS DISEASE 2018; 7:301-311. [PMID: 28482644 PMCID: PMC5438470 DOI: 10.3233/jpd-161060] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background: Olfactory impairment is an early manifestation of Parkinson’s disease (PD). Diffusion Tensor Imaging (DTI) and Magnetization Transfer (MT) are two imaging techniques that allow noninvasive detection of microstructural changes in the cerebral white matter. Objective: To assess white matter alterations associated with olfactory impairment in PD, using a binary imaging approach with DTI and MT. Methods: 22 PD patients and 13 healthy controls were examined with DTI, MT and an odor discrimination test. DTI data were first analyzed with tract-based spatial statistics (TBSS) in order to detect differences in fractional anisotropy, mean, radial and axial diffusivity between PD patients and controls. Voxelwise randomized permutation was employed for the MT analysis, after spatial and intensity normalization. Additionally, ROI analysis was performed on both the DTI and MT data, focused on the white matter adjacent to olfactory brain regions. Results: Whole brain voxelwise analysis revealed decreased axial diffusivity in the left uncinate fasciculus and the white matter adjacent to the left olfactory sulcus of PD patients. ROI analysis demonstrated decreased axial diffusivity in the right orbitofrontal cortex, as well as decreased mean diffusivity and axial diffusivity in the white matter of the left entorhinal cortex of PD patients. There were no significant differences regarding fractional anisotropy, radial diffusivity or MT between patients and controls. Conclusions: ROI analysis of DTI could detect microstructural changes in the white matter adjacent to olfactory areas in PD patients, whereas MT imaging could not.
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Affiliation(s)
- Charalampos Georgiopoulos
- Department of Radiology and Department ofMedical and Health Sciences, Linköping University, Linköping, Sweden.,Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Marcel Warntjes
- Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden.,SyntheticMR AB, Linköping, Sweden
| | - Nil Dizdar
- Department of Neurologyand Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Helene Zachrisson
- Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Clinical Physiology and Departmentof Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Maria Engström
- Center for Medical ImageScience and Visualization (CMIV), Linköping University, Linköping, Sweden.,Department of Medical andHealth Sciences, Linköping University, Linköping, Sweden
| | - Sven Haller
- Affidea CDRC Centre de Diagnostic Radiologiquede Carouge SA, Geneva, Switzerland.,Departmentof Surgical Sciences/Radiology, Uppsala University, AkademiskaSjukhuset, Uppsala, Sweden
| | - Elna-Marie Larsson
- Departmentof Surgical Sciences/Radiology, Uppsala University, AkademiskaSjukhuset, Uppsala, Sweden
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8
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Pool size ratio of the substantia nigra in Parkinson's disease derived from two different quantitative magnetization transfer approaches. Neuroradiology 2017; 59:1251-1263. [PMID: 28986653 DOI: 10.1007/s00234-017-1911-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 08/22/2017] [Indexed: 12/27/2022]
Abstract
PURPOSE We sought to measure quantitative magnetization transfer (qMT) properties of the substantia nigra pars compacta (SNc) in patients with Parkinson's disease (PD) and healthy controls (HCs) using a full qMT analysis and determine whether a rapid single-point measurement yields equivalent results for pool size ratio (PSR). METHODS Sixteen different MT-prepared MRI scans were obtained at 3 T from 16 PD patients and eight HCs, along with B1, B0, and relaxation time maps. Maps of PSR, free and macromolecular pool transverse relaxation times ([Formula: see text], [Formula: see text]) and rate of MT exchange between pools (k mf ) were generated using a full qMT model. PSR maps were also generated using a single-point qMT model requiring just two MT-prepared images. qMT parameter values of the SNc, red nucleus, cerebral crus, and gray matter were compared between groups and methods. RESULTS PSR of the SNc was the only qMT parameter to differ significantly between groups (p < 0.05). PSR measured via single-point analysis was less variable than with the full MT model, provided slightly better differentiation of PD patients from HCs (area under curve 0.77 vs. 0.75) with sensitivity of 0.75 and specificity of 0.87, and was better than transverse relaxation time in distinguishing PD patients from HCs (area under curve 0.71, sensitivity 0.87, and specificity 0.50). CONCLUSION The increased PSR observed in the SNc of PD patients may provide a novel biomarker of PD, possibly associated with an increased macromolecular content. Single-point PSR mapping with reduced variability and shorter scan times relative to the full qMT model appears clinically feasible.
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9
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Tummala S, Roy B, Park B, Kang DW, Woo MA, Harper RM, Kumar R. Associations between brain white matter integrity and disease severity in obstructive sleep apnea. J Neurosci Res 2016; 94:915-923. [PMID: 27315771 PMCID: PMC4990476 DOI: 10.1002/jnr.23788] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/18/2016] [Accepted: 05/20/2016] [Indexed: 12/27/2022]
Abstract
Obstructive sleep apnea (OSA) is characterized by recurrent upper airway blockage, with continued diaphragmatic efforts to breathe during sleep. Brain structural changes in OSA appear in various regions, including white matter sites that mediate autonomic, mood, cognitive, and respiratory control. However, the relationships between brain white matter changes and disease severity in OSA are unclear. This study examines associations between an index of tissue integrity, magnetization transfer (MT) ratio values (which show MT between free and proton pools associated with tissue membranes and macromolecules), and disease severity (apnea-hypopnea index [AHI]) in OSA subjects. We collected whole-brain MT imaging data from 19 newly diagnosed, treatment-naïve OSA subjects (50.4 ± 8.6 years of age, 13 males, AHI 39.7 ± 24.3 events/hr], using a 3.0-Tesla MRI scanner. With these data, whole-brain MT ratio maps were calculated, normalized to common space, smoothed, and correlated with AHI scores by using partial correlation analyses (covariates, age and gender; P < 0.005). Multiple brain sites in OSA subjects, including superior and inferior frontal regions, ventral medial prefrontal cortex and nearby white matter, midfrontal white matter, insula, cingulate and cingulum bundle, internal and external capsules, caudate nuclei and putamen, basal forebrain, hypothalamus, corpus callosum, and temporal regions, showed principally lateralized negative correlations (P < 0.005). These regions showed significant correlations even with correction for multiple comparisons (cluster-level, family-wise error, P < 0.05), except for a few superior frontal areas. Predominantly negative correlations emerged between local MT values and OSA disease severity, indicating potential usefulness of MT imaging for examining the OSA condition. These findings indicate that OSA severity plays a significant role in white matter injury. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sudhakar Tummala
- Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Bhaswati Roy
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Bumhee Park
- Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Daniel W. Kang
- Department of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Mary A. Woo
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Ronald M. Harper
- Department of Neurobiology, University of California at Los Angeles, Los Angeles, CA 90095, USA
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA 90095, USA
| | - Rajesh Kumar
- Department of Anesthesiology, University of California at Los Angeles, Los Angeles, CA 90095, USA
- Brain Research Institute, University of California at Los Angeles, Los Angeles, CA 90095, USA
- Department of Radiological Sciences, University of California at Los Angeles, Los Angeles, CA 90095, USA
- Department of Bioengineering, University of California at Los Angeles, Los Angeles, CA 90095, USA
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10
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Al-Radaideh AM, Rababah EM. The role of magnetic resonance imaging in the diagnosis of Parkinson's disease: a review. Clin Imaging 2016; 40:987-96. [DOI: 10.1016/j.clinimag.2016.05.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 04/09/2016] [Accepted: 05/23/2016] [Indexed: 12/31/2022]
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11
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Tuite P. Magnetic resonance imaging as a potential biomarker for Parkinson's disease. Transl Res 2016; 175:4-16. [PMID: 26763585 DOI: 10.1016/j.trsl.2015.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/09/2015] [Accepted: 12/10/2015] [Indexed: 01/01/2023]
Abstract
Although a magnetic resonance imaging (MRI) biomarker for Parkinson's disease (PD) remains an unfulfilled objective, there have been numerous developments in MRI methodology and some of these have shown promise for PD. With funding from the National Institutes of Health and the Michael J Fox Foundation there will be further validation of structural, diffusion-based, and iron-focused MRI methods as possible biomarkers for PD. In this review, these methods and other strategies such as neurochemical and metabolic MRI have been covered. One of the challenges in establishing a biomarker is in the selection of individuals as PD is a heterogeneous disease with varying clinical features, different etiologies, and a range of pathologic changes. Additionally, longitudinal studies are needed of individuals with clinically diagnosed PD and cohorts of individuals who are at great risk for developing PD to validate methods. Ultimately an MRI biomarker will be useful in the diagnosis of PD, predicting the course of PD, providing a means to track its course, and provide an approach to select and monitor treatments.
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Affiliation(s)
- Paul Tuite
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota.
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12
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Sterling N, Lewis M, Du G, Huang X. Structural Imaging and Parkinson's Disease: Moving Toward Quantitative Markers of Disease Progression. JOURNAL OF PARKINSON'S DISEASE 2016; 6:557-67. [PMID: 27258697 PMCID: PMC5008231 DOI: 10.3233/jpd-160824] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is a progressive age-related neurodegenerative disorder. Although the pathological hallmark of PD is dopaminergic cell death in the substantia nigra pars compacta, widespread neurodegenerative changes occur throughout the brain as disease progresses. Postmortem studies, for example, have demonstrated the presence of Lewy pathology, apoptosis, and loss of neurotransmitters and interneurons in both cortical and subcortical regions of PD patients. Many in vivo structural imaging studies have attempted to gauge PD-related pathology, particularly in gray matter, with the hope of identifying an imaging biomarker. Reports of brain atrophy in PD, however, have been inconsistent, most likely due to differences in the studied populations (i.e. different disease stages and/or clinical subtypes), experimental designs (i.e. cross-sectional vs. longitudinal), and image analysis methodologies (i.e. automatic vs. manual segmentation). This review attempts to summarize the current state of gray matter structural imaging research in PD in relationship to disease progression, reconciling some of the differences in reported results, and to identify challenges and future avenues.
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Affiliation(s)
- N.W. Sterling
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - M.M. Lewis
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - G. Du
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
| | - X. Huang
- Department of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
- Department of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA, USA
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13
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Brooks DJ, Tambasco N. Imaging synucleinopathies. Mov Disord 2016; 31:814-29. [PMID: 26879635 DOI: 10.1002/mds.26547] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 12/18/2015] [Accepted: 12/20/2015] [Indexed: 01/05/2023] Open
Abstract
In this review the structural and functional imaging changes associated with the synucleinopathies PD, MSA, and dementias associated with Lewy bodies are reviewed. The role of imaging for supporting differential diagnosis, detecting subclinical disease, and following disease progression is discussed and its potential use for monitoring disease progression is debated. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- David J Brooks
- Dept of Nuclear Medicine, Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Dept of Medicine, Imperial College London, London, United Kingdom.,Division of Neurology, Newcastle University, Newcastle, United Kingdom
| | - Nicola Tambasco
- Dept of Neurology, Azienda Ospedaliera e Universitaria di Perugia, Perugia, Italy
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14
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Tambasco N, Nigro P, Romoli M, Simoni S, Parnetti L, Calabresi P. Magnetization transfer MRI in dementia disorders, Huntington's disease and parkinsonism. J Neurol Sci 2015; 353:1-8. [PMID: 25891828 DOI: 10.1016/j.jns.2015.03.025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 02/21/2015] [Accepted: 03/16/2015] [Indexed: 01/10/2023]
Abstract
Magnetic resonance imaging is the most used technique of neuroimaging. Using recent advances in magnetic resonance application it is possible to investigate several changes in neurodegenerative disease. Among different techniques, magnetization-transfer imaging (MTI), a magnetic resonance acquisition protocol assessing the magnetization exchange between protons bound to water and those bound to macromolecules, is able to identify microstructural brain tissue changes peculiar of neurodegenerative diseases. This review provides a report on the MTI technique and its use in the dementia disorders, Huntington's disease and parkinsonisms, comprehensive of the predictive values of MTI in the identification of early-phase disease.
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Affiliation(s)
- Nicola Tambasco
- Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy.
| | - Pasquale Nigro
- Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy
| | - Michele Romoli
- Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy
| | - Simone Simoni
- Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy
| | - Lucilla Parnetti
- Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy
| | - Paolo Calabresi
- Clinica Neurologica, Azienda Ospedaliera-Università di Perugia, Perugia, Italy; IRCCS Fondazione Santa Lucia, Roma, Italy
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15
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Wittmann BC, D'Esposito M. Levodopa administration modulates striatal processing of punishment-associated items in healthy participants. Psychopharmacology (Berl) 2015; 232:135-44. [PMID: 24923987 PMCID: PMC4265314 DOI: 10.1007/s00213-014-3646-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 05/28/2014] [Indexed: 11/26/2022]
Abstract
RATIONALE Appetitive and aversive processes share a number of features such as their relevance for action and learning. On a neural level, reward and its predictors are associated with increased firing of dopaminergic neurons, whereas punishment processing has been linked to the serotonergic system and to decreases in dopamine transmission. Recent data indicate, however, that the dopaminergic system also responds to aversive stimuli and associated actions. OBJECTIVES In this pharmacological functional magnetic resonance imaging study, we investigated the contribution of the dopaminergic system to reward and punishment processing in humans. METHODS Two groups of participants received either placebo or the dopamine precursor levodopa and were scanned during alternating reward and punishment anticipation blocks. RESULTS Levodopa administration increased striatal activations for cues presented in punishment blocks. In an interaction with individual personality scores, levodopa also enhanced striatal activation for punishment-predictive compared with neutral cues in participants scoring higher on the novelty-seeking dimension. CONCLUSIONS These data support recent indications that dopamine contributes to punishment processing and suggest that the novelty-seeking trait is a measure of susceptibility to drug effects on motivation. These findings are also consistent with the possibility of an inverted U-shaped response function of dopamine in the striatum, suggesting an optimal level of dopamine release for motivational processing.
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Affiliation(s)
- Bianca C Wittmann
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, 94720, USA,
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Trujillo P, Smith AK, Summers PE, Mainardi LM, Cerutti S, Smith SA, Costa A. High-resolution quantitative imaging of the substantia nigra. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:5428-5431. [PMID: 26737519 DOI: 10.1109/embc.2015.7319619] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
There is a growing interest in identifying neuroimaging-based biomarkers for Parkinson's disease (PD), a progressive neurodegenerative disorder in which the major pathologic substrate is the loss of pigmented dopaminergic neurons in the substantia nigra (SN). Recently, an MRI technique dubbed "neuromelanin-sensitive MRI" (NM-MRI), has been found to provide notable contrast between the SN and surrounding brain tissues with potential applications as biomarker of PD. The contrast in NM-MRI has been associated with magnetization transfer (MT) effects, and thus the goal of this study was to characterize the impact of MT on NM-MRI, and to demonstrate the feasibility of performing quantitative MT (qMT) imaging in human SN. The results of this study demonstrate that high-resolution rapid qMT imaging of the SN can be reliably obtained within reasonable scan times, thereby can be translatable into clinical practice.
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Pyatigorskaya N, Gallea C, Garcia-Lorenzo D, Vidailhet M, Lehericy S. A review of the use of magnetic resonance imaging in Parkinson's disease. Ther Adv Neurol Disord 2014; 7:206-20. [PMID: 25002908 DOI: 10.1177/1756285613511507] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
To date, the most frequently used Parkinson's disease (PD) biomarkers are the brain imaging measures of dopaminergic dysfunction using positron emission tomography and single photon emission computed tomography. However, major advances have occurred in the development of magnetic resonance imaging (MRI) biomarkers for PD in the past decade. Although conventional structural imaging remains normal in PD, advanced techniques have shown changes in the substantia nigra and the cortex. The most well-developed MRI markers in PD include diffusion imaging and iron load using T2/T2* relaxometry techniques. Other quantitative biomarkers such as susceptibility-weighted imaging for iron load, magnetization transfer and ultra-high-field MRI have shown great potential. More sophisticated techniques such as tractography and resting state functional connectivity give access to anatomical and functional connectivity changes in the brain, respectively. Brain perfusion can be assessed using non-contrast-agent techniques such as arterial spin labelling and spectroscopy gives access to metabolites concentrations. However, to date these techniques are not yet fully validated and standardized quantitative metrics for PD are still lacking. This review presents an overview of new structural, perfusion, metabolic and anatomo-functional connectivity biomarkers, their use in PD and their potential applications to improve the clinical diagnosis of Parkinsonian syndromes and the quality of clinical trials.
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Affiliation(s)
- Nadya Pyatigorskaya
- Institut du Cerveau et de la Moelle épinière, Centre de Neuroimagerie de Recherche, Paris, France
| | - Cécile Gallea
- Institut du Cerveau et de la Moelle épinière, Centre de Neuroimagerie de Recherche, Paris, France
| | - Daniel Garcia-Lorenzo
- Institut du Cerveau et de la Moelle épinière, Centre de Neuroimagerie de Recherche, Paris, France
| | - Marie Vidailhet
- Université Pierre et Marie Curie (UPMC Univ Paris 6), Centre de Recherche de l'Institut du Cerveau et de la Moelle epiniere, Paris, France
| | - Stéphane Lehericy
- Service de neuroradiologie, Groupe Hospitalier Pitié-Salpêtrière, 47 boulevard de l'hopital, 75651 Paris cedex 13, France
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Holtbernd F, Eidelberg D. The utility of neuroimaging in the differential diagnosis of parkinsonian syndromes. Semin Neurol 2014; 34:202-9. [PMID: 24963679 DOI: 10.1055/s-0034-1381733] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The differential diagnosis of parkinsonian syndromes can be challenging, particularly in early disease stages. However, prognosis and therapeutic regimes are not alike in Parkinson disease and atypical parkinsonism, and thus a correct diagnosis at the earliest possible stage is desirable. Over the past two decades, magnetic resonance imaging and radiotracer-based imaging techniques have proven to be helpful tools to enhance the accuracy of clinical diagnosis in these disorders. Here, we review recent advances in neuroimaging for the differential diagnosis of parkinsonian syndromes.
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Affiliation(s)
- Florian Holtbernd
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, New York
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Bulganin L, Bach DR, Wittmann BC. Prior fear conditioning and reward learning interact in fear and reward networks. Front Behav Neurosci 2014; 8:67. [PMID: 24624068 PMCID: PMC3940965 DOI: 10.3389/fnbeh.2014.00067] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/17/2014] [Indexed: 01/22/2023] Open
Abstract
The ability to flexibly adapt responses to changes in the environment is important for survival. Previous research in humans separately examined the mechanisms underlying acquisition and extinction of aversive and appetitive conditioned responses. It is yet unclear how aversive and appetitive learning interact on a neural level during counterconditioning in humans. This functional magnetic resonance imaging (fMRI) study investigated the interaction of fear conditioning and subsequent reward learning. In the first phase (fear acquisition), images predicted aversive electric shocks or no aversive outcome. In the second phase (counterconditioning), half of the CS+ and CS− were associated with monetary reward in the absence of electric stimulation. The third phase initiated reinstatement of fear through presentation of electric shocks, followed by CS presentation in the absence of shock or reward. Results indicate that participants were impaired at learning the reward contingencies for stimuli previously associated with shock. In the counterconditioning phase, prior fear association interacted with reward representation in the amygdala, where activation was decreased for rewarded compared to unrewarded CS− trials, while there was no reward-related difference in CS+ trials. In the reinstatement phase, an interaction of previous fear association and previous reward status was observed in a reward network consisting of substantia nigra/ventral tegmental area (SN/VTA), striatum and orbitofrontal cortex (OFC), where activation was increased by previous reward association only for CS− but not for CS+ trials. These findings suggest that during counterconditioning, prior fear conditioning interferes with reward learning, subsequently leading to lower activation of the reward network.
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Affiliation(s)
- Lisa Bulganin
- Department of Psychology and Sports Science, University of Giessen Giessen, Germany
| | - Dominik R Bach
- Psychiatric Hospital, University of Zurich Zurich, Switzerland ; Wellcome Trust Centre for Neuroimaging, University College London London, UK
| | - Bianca C Wittmann
- Department of Psychology and Sports Science, University of Giessen Giessen, Germany
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Wittmann BC, Tan GC, Lisman JE, Dolan RJ, Düzel E. Reprint of: DAT genotype modulates striatal processing and long-term memory for items associated with reward and punishment. Neuropsychologia 2013; 51:2469-77. [PMID: 24139823 DOI: 10.1016/j.neuropsychologia.2013.09.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Previous studies have shown that appetitive motivation enhances episodic memory formation via a network including the substantia nigra/ventral tegmental area (SN/VTA), striatum and hippocampus. This functional magnetic resonance imaging (fMRI) study now contrasted the impact of aversive and appetitive motivation on episodic long-term memory. Cue pictures predicted monetary reward or punishment in alternating experimental blocks. One day later, episodic memory for the cue pictures was tested. We also investigated how the neural processing of appetitive and aversive motivation and episodic memory were modulated by dopaminergic mechanisms. To that end, participants were selected on the basis of their genotype for a variable number of tandem repeat polymorphism of the dopamine transporter (DAT) gene. The resulting groups were carefully matched for the 5-HTTLPR polymorphism of the serotonin transporter gene. Recognition memory for cues from both motivational categories was enhanced in participants homozygous for the 10-repeat allele of the DAT, the functional effects of which are not known yet, but not in heterozygous subjects. In comparison with heterozygous participants, 10-repeat homozygous participants also showed increased striatal activity for anticipation of motivational outcomes compared to neutral outcomes. In a subsequent memory analysis, encoding activity in striatum and hippocampus was found to be higher for later recognized items in 10-repeat homozygotes compared to 9/10-repeat heterozygotes. These findings suggest that processing of appetitive and aversive motivation in the human striatum involve the dopaminergic system and that dopamine plays a role in memory for both types of motivational information. In accordance with animal studies, these data support the idea that encoding of motivational events depends on dopaminergic processes in the hippocampus.
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Affiliation(s)
- Bianca C Wittmann
- Wellcome Trust Centre for Neuroimaging, University College London, London, WC1N 3BG, UK; Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720, USA; Department of Psychology, University of Giessen, 35394 Giessen, Germany.
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Wittmann BC, Tan GC, Lisman JE, Dolan RJ, Düzel E. DAT genotype modulates striatal processing and long-term memory for items associated with reward and punishment. Neuropsychologia 2013; 51:2184-93. [PMID: 23911780 PMCID: PMC3809516 DOI: 10.1016/j.neuropsychologia.2013.07.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 07/22/2013] [Accepted: 07/24/2013] [Indexed: 11/30/2022]
Abstract
Previous studies have shown that appetitive motivation enhances episodic memory formation via a network including the substantia nigra/ventral tegmental area (SN/VTA), striatum and hippocampus. This functional magnetic resonance imaging (fMRI) study now contrasted the impact of aversive and appetitive motivation on episodic long-term memory. Cue pictures predicted monetary reward or punishment in alternating experimental blocks. One day later, episodic memory for the cue pictures was tested. We also investigated how the neural processing of appetitive and aversive motivation and episodic memory were modulated by dopaminergic mechanisms. To that end, participants were selected on the basis of their genotype for a variable number of tandem repeat polymorphism of the dopamine transporter (DAT) gene. The resulting groups were carefully matched for the 5-HTTLPR polymorphism of the serotonin transporter gene. Recognition memory for cues from both motivational categories was enhanced in participants homozygous for the 10-repeat allele of the DAT, the functional effects of which are not known yet, but not in heterozygous subjects. In comparison with heterozygous participants, 10-repeat homozygous participants also showed increased striatal activity for anticipation of motivational outcomes compared to neutral outcomes. In a subsequent memory analysis, encoding activity in striatum and hippocampus was found to be higher for later recognized items in 10-repeat homozygotes compared to 9/10-repeat heterozygotes. These findings suggest that processing of appetitive and aversive motivation in the human striatum involve the dopaminergic system and that dopamine plays a role in memory for both types of motivational information. In accordance with animal studies, these data support the idea that encoding of motivational events depends on dopaminergic processes in the hippocampus.
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Affiliation(s)
- Bianca C Wittmann
- Wellcome Trust Centre for Neuroimaging, University College London, London, WC1N 3BG, UK; Helen Wills Neuroscience Institute, University of California, Berkeley, CA 94720, USA; Department of Psychology, University of Giessen, 35394 Giessen, Germany.
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Structural integrity of the substantia nigra and subthalamic nucleus predicts flexibility of instrumental learning in older-age individuals. Neurobiol Aging 2013; 34:2261-70. [PMID: 23623600 PMCID: PMC3713434 DOI: 10.1016/j.neurobiolaging.2013.03.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 03/11/2013] [Accepted: 03/24/2013] [Indexed: 12/30/2022]
Abstract
Flexible instrumental learning is required to harness the appropriate behaviors to obtain rewards and to avoid punishments. The precise contribution of dopaminergic midbrain regions (substantia nigra/ventral tegmental area [SN/VTA]) to this form of behavioral adaptation remains unclear. Normal aging is associated with a variable loss of dopamine neurons in the SN/VTA. We therefore tested the relationship between flexible instrumental learning and midbrain structural integrity. We compared task performance on a probabilistic monetary go/no-go task, involving trial and error learning of: “go to win,” “no-go to win,” “go to avoid losing,” and “no-go to avoid losing” in 42 healthy older adults to previous behavioral data from 47 younger adults. Quantitative structural magnetization transfer images were obtained to index regional structural integrity. On average, both some younger and some older participants demonstrated a behavioral asymmetry whereby they were better at learning to act for reward (“go to win” > “no-go to win”), but better at learning not to act to avoid punishment (“no-go to avoid losing” > “go to avoid losing”). Older, but not younger, participants with greater structural integrity of the SN/VTA and the adjacent subthalamic nucleus could overcome this asymmetry. We show that interindividual variability among healthy older adults of the structural integrity within the SN/VTA and subthalamic nucleus relates to effective acquisition of competing instrumental responses.
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Abstract
Recent developments in brain imaging methods are on the verge of changing the evaluation of people with Parkinson's disease (PD). This includes an assortment of techniques ranging from diffusion tensor imaging (DTI) to iron-sensitive methods such as T2*, as well as adiabatic methods R1ρ and R2ρ, resting-state functional MRI, and magnetic resonance spectroscopy (MRS). Using a multi-modality approach that ascertains different aspects of the pathophysiology or pathology of PD, it may be possible to better characterize disease phenotypes as well as provide a surrogate of disease and a potential means to track disease progression.
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Affiliation(s)
- Paul J Tuite
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Silvia Mangia
- Department of Radiology, Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, 55455 USA
| | - Shalom Michaeli
- Department of Radiology, Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, MN, 55455 USA
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Boelmans K, Sedlacik J, Niehaus L, Jahn H, Münchau A. Recent advances in structural MRI in Parkinson’s disease and atypical parkinsonian syndromes. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY In the past 2 years, technical developments in conventional and advanced MRI, such as ultra-high-field MRI or mapping of brain mineralization, has allowed novel insights into the nature of Parkinson’s disease (PD) and atypical parkinsonian syndromes, which may aid diagnostic accuracy and differential diagnosis. In addition, sophisticated post-processing analyses, such as morphometry- and surface-based classifications and automated whole-brain analyses, have become available; in PD, this has led to direct visualization of structural substantia nigra abnormalities, monitoring disease progression or screening for brain atrophy associated with dementia. Based on conventional MRI, new MRI rating scales have been established for progressive supranuclear palsy and multiple system atrophy and have been further assessed with a view to their diagnostic accuracy. Clinicopathological series of patients with tauopathies imply that correlations between clinical syndromes, imaging patterns and underlying histopathology are not always strong. Here, some of the issues related to conventional and advanced MRI for the diagnostic accuracy of PD and atypical parkinsonian syndromes are reviewed.
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Affiliation(s)
- Kai Boelmans
- Department of Psychiatry, Memory Clinic, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
| | - Jan Sedlacik
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ludwig Niehaus
- Department of Neurology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Holger Jahn
- Department of Psychiatry, Memory Clinic, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany
| | - Alexander Münchau
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lehéricy S, Sharman MA, Dos Santos CL, Paquin R, Gallea C. Magnetic resonance imaging of the substantia nigra in Parkinson's disease. Mov Disord 2012; 27:822-30. [PMID: 22649063 DOI: 10.1002/mds.25015] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Revised: 03/15/2012] [Accepted: 03/26/2012] [Indexed: 12/30/2022] Open
Abstract
Until recently, conventional magnetic resonance imaging (MRI) was most often negative in Parkinson's disease or showed nonspecific findings. Recent developments in structural MRI, including relaxometry, magnetization transfer, and neuromelanin imaging, have demonstrated improved contrast and enabled more accurate visualization of deep brain nuclei, in particular, the substantia nigra. Meanwhile, diffusion imaging has provided useful biomarkers of substantia nigra degeneration, showing reduced anisotropy and anatomical connectivity with the striatum and thalamus. These advances in structural imaging are complemented by findings of magnetic resonance spectroscopy on brain metabolism and resting-state functional MRI on functional connectivity. This article presents an overview of these new structural, metabolic, and resting-state functional MRI techniques and their implications for Parkinson's disease. The techniques are reviewed in the context of their potential for better understanding the disease in terms of diagnosis and pathophysiology and as biomarkers of its progression.
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Affiliation(s)
- Stéphane Lehéricy
- Centre de NeuroImagerie de Recherche-CENIR, Groupe Hospitalier Pitie-Salpetriere, Paris, France.
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