1
|
Ghaderi S, Fatehi F, Kalra S, Mohammadi S, Batouli SAH. Quantitative susceptibility mapping in amyotrophic lateral sclerosis: automatic quantification of the magnetic susceptibility in the subcortical nuclei. Amyotroph Lateral Scler Frontotemporal Degener 2024:1-12. [PMID: 38957123 DOI: 10.1080/21678421.2024.2372648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/14/2024] [Indexed: 07/04/2024]
Abstract
Objective: Previous studies have suggested a link between dysregulation of cortical iron levels and neuronal loss in amyotrophic lateral sclerosis (ALS) patients. However, few studies have reported differences in quantitative susceptibility mapping (QSM) values in subcortical nuclei between patients with ALS and healthy controls (HCs). Methods: MRI was performed using a 3 Tesla Prisma scanner (64-channel head coil), including 3D T1-MPRAGE and multi-echo 3D GRE for QSM reconstruction. Automated QSM segmentation was used to measure susceptibility values in the subcortical nuclei, which were compared between the groups. Correlations with clinical scales were analyzed. Group comparisons were performed using independent t-tests, with p < 0.05 considered significant. Correlations were assessed using Pearson's correlation, with p < 0.05 considered significant. Cohen's d was reported to compare the standardized mean difference (SMD) of QSM. Results: Twelve patients with limb-onset ALS (mean age 48.7 years, 75% male) and 13 age-, sex-, and handedness-matched HCs (mean age 44.6 years, 69% male) were included. Compared to HCs, ALS patients demonstrated significantly lower susceptibility in the left caudate nucleus (CN) (SMD = -0.845), right CN (SMD = -0.851), whole CN (SMD = -1.016), and left subthalamic nucleus (STN) (SMD = -1.000). Susceptibility in the left putamen (SMD = -0.857), left thalamus (SMD = -1.081), and whole thalamus (SMD = -0.968) was significantly higher in the patients. The susceptibility of the substantia nigra (SN), CN, and pulvinar was positively correlated with disease duration. Conclusions: QSM detects abnormal iron accumulation patterns in the subcortical gray matter of ALS patients, which correlates with disease characteristics, supporting its potential as a neuroimaging biomarker.
Collapse
Affiliation(s)
- Sadegh Ghaderi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Fatehi
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Neurology Department, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sanjay Kalra
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada, and
- Department of Medicine, Division of Neurology, University of Alberta, Edmonton, Canada
| | - Sana Mohammadi
- Department of Neurology, Neuromuscular Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Hossein Batouli
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Nikolova S, Chong C, Li J, Wu T, Dumkrieger G, Ross K, Starling A, Schwedt TJ. Brain structural and functional abnormalities associated with acute post-traumatic headache: iron deposition and functional connectivity. J Headache Pain 2024; 25:88. [PMID: 38807070 PMCID: PMC11134688 DOI: 10.1186/s10194-024-01797-0] [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: 03/25/2024] [Accepted: 05/21/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The purpose of this study was to interrogate brain iron accumulation in participants with acute post-traumatic headache (PTH) due to mild traumatic brain injury (mTBI), and to determine if functional connectivity is affected in areas with iron accumulation. We aimed to examine the correlations between iron accumulation and headache frequency, post-concussion symptom severity, number of mTBIs, and time since most recent TBI. METHODS Sixty participants with acute PTH and 60 age-matched healthy controls (HC) underwent 3T magnetic resonance imaging including quantitative T2* maps and resting-state functional connectivity imaging. Between group T2* differences were determined using T-tests (p < 0.005, cluster size threshold of 90 voxels). For regions with T2* differences, two analyses were conducted. First, the correlations with clinical variables including headache frequency, number of lifetime mTBIs, time since most recent mTBI, and Sport Concussion Assessment Tool (SCAT) symptom severity scale scores were investigated using linear regression. Second, the functional connectivity of these regions with the rest of the brain was examined (significance of p < 0.05 with family wise error correction for multiple comparisons). RESULTS The acute PTH group consisted of 60 participants (22 male, 38 female) with average age of 42 ± 14 years. The HC group consisted of 60 age-matched controls (17 male, 43 female, average age of 42 ± 13). PTH participants had lower T2* values compared to HC in the left posterior cingulate and the bilateral cuneus. Stronger functional connectivity was observed between bilateral cuneus and right cerebellar areas in PTH compared to HC. Within the PTH group, linear regression showed negative associations of T2* in the left posterior cingulate with SCAT symptom severity score (p = 0.05) and T2* in the left cuneus with headache frequency (p = 0.04). CONCLUSIONS Iron accumulation in posterior cingulate and cuneus was observed in those with acute PTH relative to HC; stronger functional connectivity was detected between the bilateral cuneus and the right cerebellum. The correlations of decreased T2* (suggesting higher iron content) with headache frequency and post mTBI symptom severity suggest that the iron accumulation that results from mTBI might reflect the severity of underlying mTBI pathophysiology and associate with post-mTBI symptom severity including PTH.
Collapse
Affiliation(s)
- Simona Nikolova
- Department of Neurology, Mayo Clinic, 5777 East Mayo Blvd Phoenix, Phoenix, AZ, 85054, USA
| | - Catherine Chong
- Department of Neurology, Mayo Clinic, 5777 East Mayo Blvd Phoenix, Phoenix, AZ, 85054, USA
- ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Phoenix, AZ, USA
| | - Jing Li
- School of Industrial and Systems Engineering, Georgia Tech, Georgia, GA, USA
| | - Teresa Wu
- School of Computing, Informatics, Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
- ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA
| | - Gina Dumkrieger
- Department of Neurology, Mayo Clinic, 5777 East Mayo Blvd Phoenix, Phoenix, AZ, 85054, USA
| | | | - Amaal Starling
- Department of Neurology, Mayo Clinic, 5777 East Mayo Blvd Phoenix, Phoenix, AZ, 85054, USA
| | - Todd J Schwedt
- Department of Neurology, Mayo Clinic, 5777 East Mayo Blvd Phoenix, Phoenix, AZ, 85054, USA.
- ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA.
| |
Collapse
|
3
|
Nikolova S, Chong C, Li J, Wu T, Dumkrieger G, Ross K, Starling A, Schwedt TJ. Brain Structural and Functional Abnormalities Associated with Acute Post-Traumatic Headache: Iron Deposition and Functional Connectivity. RESEARCH SQUARE 2024:rs.3.rs-4165756. [PMID: 38585756 PMCID: PMC10996812 DOI: 10.21203/rs.3.rs-4165756/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Background The purpose of this study was to interrogate brain iron accumulation in participants with acute post-traumatic headache (PTH) due to mild traumatic brain injury (mTBI), and to determine if functional connectivity is affected in areas with iron accumulation. We aimed to examine the correlations between iron accumulation and headache frequency, post-concussion symptom severity, number of mTBIs and time since most recent TBI. Methods Sixty participants with acute PTH and 60 age-matched healthy controls (HC) underwent 3T magnetic resonance imaging including quantitative T2* maps and resting-state functional connectivity imaging. Between group T2* differences were determined using T-tests (p < 0.005, cluster size threshold of 10 voxels). For regions with T2* differences, two analyses were conducted. First, the correlations with clinical variables including headache frequency, number of lifetime mTBIs, time since most recent mTBI, and Sport Concussion Assessment Tool (SCAT) symptom severity scale scores were investigated using linear regression. Second, the functional connectivity of these regions with the rest of the brain was examined (significance of p < 0.05 with family wise error correction for multiple comparisons). Results The acute PTH group consisted of 60 participants (22 male, 38 female) with average age of 42 ± 14 years. The HC group consisted of 60 age-matched controls (17 male, 43 female, average age of 42 ± 13). PTH participants had lower T2* values compared to HC in the left posterior cingulate and the bilateral cuneus. Stronger functional connectivity was observed between bilateral cuneus and right cerebellar areas in PTH compared to HC. Within the PTH group, linear regression showed negative associations of T2* and SCAT symptom severity score in the left posterior cingulate (p = 0.05) and with headache frequency in the left cuneus (p = 0.04). Conclusions Iron accumulation in posterior cingulate and cuneus was observed in those with acute PTH relative to HC; stronger functional connectivity was detected between the bilateral cuneus and the right cerebellum. The correlations of decreased T2* (suggesting higher iron content) with headache frequency and post mTBI symptom severity suggest that the iron accumulation that results from mTBI might reflect the severity of underlying mTBI pathophysiology and associate with post-mTBI symptom severity including PTH.
Collapse
|
4
|
Xu X, Zhou M, Wu X, Zhao F, Luo X, Li K, Zeng Q, He J, Cheng H, Guan X, Huang P, Zhang M, Liu K. Increased iron deposition in nucleus accumbens associated with disease progression and chronicity in migraine. BMC Med 2023; 21:136. [PMID: 37024948 PMCID: PMC10080952 DOI: 10.1186/s12916-023-02855-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/29/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Migraine is one of the world's most prevalent and disabling diseases. Despite huge advances in neuroimaging research, more valuable neuroimaging markers are still urgently needed to provide important insights into the brain mechanisms that underlie migraine symptoms. We therefore aim to investigate the regional iron deposition in subcortical nuclei of migraineurs as compared to controls and its association with migraine-related pathophysiological assessments. METHODS A total of 200 migraineurs (56 chronic migraine [CM], 144 episodic migraine [EM]) and 41 matched controls were recruited. All subjects underwent MRI and clinical variables including frequency/duration of migraine, intensity of migraine, 6-item Headache Impact Test (HIT-6), Migraine Disability Assessment (MIDAS), and Pittsburgh Sleep Quality Index (PSQI) were recorded. Quantitative susceptibility mapping was employed to quantify the regional iron content in subcortical regions. Associations between clinical variables and regional iron deposition were studied as well. RESULTS Increased iron deposition in the putamen, caudate, and nucleus accumbens (NAC) was observed in migraineurs more than controls. Meanwhile, patients with CM had a significantly higher volume of iron deposits compared to EM in multiple subcortical nuclei, especially in NAC. Volume of iron in NAC can be used to distinguish patients with CM from EM with a sensitivity of 85.45% and specificity of 71.53%. As the most valuable neuroimaging markers in all of the subcortical nuclei, higher iron deposition in NAC was significantly associated with disease progression, and higher HIT-6, MIDAS, and PSQI. CONCLUSIONS These findings provide evidence that iron deposition in NAC may be a biomarker for migraine chronicity and migraine-related dysfunctions, thus may help to understand the underlying vascular and neural mechanisms of migraine. TRIAL REGISTRATION ClinicalTrials.gov, number NCT04939922.
Collapse
Affiliation(s)
- Xiaopei Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Mengting Zhou
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Xiao Wu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Fangling Zhao
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Xiao Luo
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Kaicheng Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Qingze Zeng
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Jiahui He
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Hongrong Cheng
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Xiaojun Guan
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Peiyu Huang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China
| | - Minming Zhang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China.
| | - Kaiming Liu
- Department of Neurology, The Second Affiliated Hospital, Zhejiang University School of Medicine, No 88 Jiefang Road, Hangzhou, Zhejiang, China.
| |
Collapse
|
5
|
Xu WJ, Barisano G, Phung D, Chou B, Pinto SN, Lerner A, Sheikh-Bahaei N. Structural MRI in Migraine: A Review of Migraine Vascular and Structural Changes in Brain Parenchyma. J Cent Nerv Syst Dis 2023; 15:11795735231167868. [PMID: 37077432 PMCID: PMC10108417 DOI: 10.1177/11795735231167868] [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: 08/18/2022] [Accepted: 03/15/2023] [Indexed: 04/21/2023] Open
Abstract
Migraine is a complex and common disorder that affects patients around the world. Despite recent advances in this field, the exact pathophysiology of migraine is still not completely understood. Structural MRI sequences have revealed a variety of changes to brain parenchyma associated with migraine, including white matter lesions, volume changes, and iron deposition. This Review highlights different structural imaging findings in various types of migraine and their relationship to migraine characteristics and subtypes in order to improve our understanding of migraine, its pathophysiologic mechanisms, and how to better diagnose and treat it.
Collapse
Affiliation(s)
- Wilson J Xu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Daniel Phung
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendon Chou
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Alexander Lerner
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nasim Sheikh-Bahaei
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Nasim Sheikh-Bahaei, Keck School of Medicine, University of Southern California, 1520 San Pablo St, Lower Level Imaging L1451, Los Angeles, CA 90033, USA.
| |
Collapse
|
6
|
Liu M, Sun Y, Li X, Chen Z. Hypoperfusion in nucleus accumbens in chronic migraine using 3D pseudo-continuous arterial spin labeling imaging MRI. J Headache Pain 2022; 23:72. [PMID: 35761188 PMCID: PMC9235082 DOI: 10.1186/s10194-022-01444-6] [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: 04/09/2022] [Accepted: 06/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Nucleus accumbens (NAcc) played an important role in pain mediation, and presents changes of neuronal plasticity and functional connectivity. However, less is known about altered perfusion of NAcc in chronic migraine (CM). The aim of this study is to investigate the altered perfusion of the NAcc in CM using a MR three-dimensional pseudo-continuous arterial spin labeling (3D PCASL) imaging. Methods Thirteen CM patients and 15 normal controls (NC) were enrolled and underwent 3D PCASL and brain structural imaging. The cerebral blood flow (CBF) images were co-registered with the brain structural images, and the volume and CBF value of NAcc were extracted from the raw brain structural images and co-registered CBF images using an individual NAcc mask, which was obtained from the AAL3 template under transformation by the inverse deformation field generated from the segmentation of the brain structural images. The independent sample t test and receiver operating characteristic (ROC) curve was used to investigate the altered volume and perfusion of the NAcc in CM patients. Results There was no significant difference for the volume of bilateral NAccs between CM and NC (p > 0.05). CM presented a lower CBF value (49.34 ± 6.09 ml/100 mg/min) compared with that of NC (55.83 ± 6.55 ml/100 mg/min) in left NAcc (p = 0.01), while right NAcc showed no significant difference between CM and NC (p = 0.11). ROC analysis identified that the area under the curve was 0.73 (95CI% 0.53–0.88) with cut-off value 48.63 ml/100 mg/min with sensitivity 50.00% and specificity 93.33%. The correlation analysis found a negative correlation between the CBF value of the left NAcc and VAS score (r = -0.61, p = 0.04). Conclusion Hypoperfusion of the left NAcc was observed in CM, which could be considered as a potential diagnostic imaging biomarker in CM.
Collapse
Affiliation(s)
- Mengqi Liu
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China.,Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yijie Sun
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China
| | - Xin Li
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China.,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Zhiye Chen
- Department of Radiology, Hainan Hospital of Chinese PLA General Hospital, Sanya, 572013, China. .,The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
| |
Collapse
|