1
|
Ravanfar P, Syeda WT, Rushmore RJ, Moffat B, Lyall AE, Merritt AH, Devenyi GA, Chakravarty MM, Desmond P, Cropley VL, Makris N, Shenton ME, Bush AI, Velakoulis D, Pantelis C, Walterfang M. Investigation of Brain Iron in Niemann-Pick Type C: A 7T Quantitative Susceptibility Mapping Study. AJNR Am J Neuroradiol 2023:ajnr.A7894. [PMID: 37348967 PMCID: PMC10337610 DOI: 10.3174/ajnr.a7894] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/03/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND PURPOSE While brain iron dysregulation has been observed in several neurodegenerative disorders, its association with the progressive neurodegeneration in Niemann-Pick type C is unknown. Systemic iron abnormalities have been reported in patients with Niemann-Pick type C and in animal models of Niemann-Pick type C. In this study, we examined brain iron using quantitative susceptibility mapping MR imaging in individuals with Niemann-Pick type C compared with healthy controls. MATERIALS AND METHODS A cohort of 10 patients with adolescent- and adult-onset Niemann-Pick type C and 14 age- and sex-matched healthy controls underwent 7T brain MR imaging with T1 and quantitative susceptibility mapping acquisitions. A probing whole-brain voxelwise comparison of quantitative susceptibility mapping between groups was conducted. Mean quantitative susceptibility mapping in the ROIs (thalamus, hippocampus, putamen, caudate nucleus, and globus pallidus) was further compared. The correlations between regional volume, quantitative susceptibility mapping values, and clinical features, which included disease severity on the Iturriaga scale, cognitive function, and the Social and Occupational Functioning Assessment Scale, were explored as secondary analyses. RESULTS We observed lower volume in the thalamus and voxel clusters of higher quantitative susceptibility mapping in the pulvinar nuclei bilaterally in patients with Niemann-Pick type C compared with the control group. In patients with Niemann-Pick type C, higher quantitative susceptibility mapping in the pulvinar nucleus clusters correlated with lower volume of the thalamus on both sides. Moreover, higher quantitative susceptibility mapping in the right pulvinar cluster was associated with greater disease severity. CONCLUSIONS Our findings suggest iron deposition in the pulvinar nucleus in Niemann-Pick type C disease, which is associated with thalamic atrophy and disease severity. This preliminary evidence supports the link between iron and neurodegeneration in Niemann-Pick type C, in line with existing literature on other neurodegenerative disorders.
Collapse
Affiliation(s)
- P Ravanfar
- From Melbourne Neuropsychiatry Centre (P.R., W.T.S., A.H.M., V.L.C., D.V., C.P., M.W.), the Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Psychiatry Neuroimaging Laboratory (P.R., R.J.R., A.E.L., N.M., M.E.S.)
| | - W T Syeda
- From Melbourne Neuropsychiatry Centre (P.R., W.T.S., A.H.M., V.L.C., D.V., C.P., M.W.), the Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - R J Rushmore
- Psychiatry Neuroimaging Laboratory (P.R., R.J.R., A.E.L., N.M., M.E.S.)
- Center for Morphometric Analysis (R.J.R., N.M.), Massachusetts General Hospital, Charlestown, Massachusetts
- Department of Anatomy and Neurobiology (R.J.R.), Boston University School of Medicine, Boston, Massachusetts
| | - B Moffat
- Melbourne Brain Centre Imaging Unit (B.M.), Department of Radiology, University of Melbourne, Parkville, Victoria, Australia
| | - A E Lyall
- Psychiatry Neuroimaging Laboratory (P.R., R.J.R., A.E.L., N.M., M.E.S.)
- Department of Psychiatry (A.E.L., M.E.S.)
- Department of Psychiatry (A.E.L., M.E.S.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - A H Merritt
- From Melbourne Neuropsychiatry Centre (P.R., W.T.S., A.H.M., V.L.C., D.V., C.P., M.W.), the Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - G A Devenyi
- Cerebral Imaging Center (G.A.D., M.M.C.), Douglas Research Centre, Montreal, Quebec, Canada
- Departments of Psychiatry (G.A.D., M.M.C.)
| | - M M Chakravarty
- Cerebral Imaging Center (G.A.D., M.M.C.), Douglas Research Centre, Montreal, Quebec, Canada
- Departments of Psychiatry (G.A.D., M.M.C.)
- Biomedical Engineering (M.M.C.), McGill University, Montreal, Quebec, Canada
| | | | - V L Cropley
- From Melbourne Neuropsychiatry Centre (P.R., W.T.S., A.H.M., V.L.C., D.V., C.P., M.W.), the Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
| | - N Makris
- Psychiatry Neuroimaging Laboratory (P.R., R.J.R., A.E.L., N.M., M.E.S.)
- Center for Morphometric Analysis (R.J.R., N.M.), Massachusetts General Hospital, Charlestown, Massachusetts
| | - M E Shenton
- Psychiatry Neuroimaging Laboratory (P.R., R.J.R., A.E.L., N.M., M.E.S.)
- Department of Psychiatry (A.E.L., M.E.S.)
- Department of Radiology (M.E.S.), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry (A.E.L., M.E.S.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - A I Bush
- Melbourne Dementia Research Centre (A.I.B.)
| | - D Velakoulis
- From Melbourne Neuropsychiatry Centre (P.R., W.T.S., A.H.M., V.L.C., D.V., C.P., M.W.), the Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Neuropsychiatry (D.V., M.W.), Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - C Pantelis
- From Melbourne Neuropsychiatry Centre (P.R., W.T.S., A.H.M., V.L.C., D.V., C.P., M.W.), the Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health (C.P.), The University of Melbourne, Parkville, Victoria, Australia
| | - M Walterfang
- From Melbourne Neuropsychiatry Centre (P.R., W.T.S., A.H.M., V.L.C., D.V., C.P., M.W.), the Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Neuropsychiatry (D.V., M.W.), Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
2
|
Mani A, Chohedri E, Ravanfar P, Mowla A, Nikseresht A. Efficacy of group cognitive rehabilitation therapy in multiple sclerosis. Acta Neurol Scand 2018; 137:589-597. [PMID: 29411360 DOI: 10.1111/ane.12904] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cognitive impairment occurs in 40%-65% of patients with multiple sclerosis (MS). Several techniques for cognitive rehabilitation (CR) in these patients have been evaluated; however, the results have been controversial. In this study, we investigated the efficacy of group compensatory CR in patients with MS-related cognitive impairment. MATERIALS AND METHODS Thirty-four female patients with diagnosed relapsing-remitting MS and evidence of impaired cognitive function were included and randomized to intervention (n = 17) and control (n = 17) groups. CR intervention consisted of eight 2-hour sessions of comprehensive group CR over a 4-week period that focused on improvement of memory, attention, and executive function. As placebo, the control group received the same number of non-therapeutic group sessions. Assessment of cognitive function was performed before intervention (pretest), at the end of intervention (post-test), and 3 months later (follow-up). RESULTS The study population included 34 patients with a mean age of 35.5 years. Statistical comparison of memory assessments at 3-month follow-up showed significantly higher scores in the CR group than in the control group (93.33 vs 86.40 for Addenbrooke's Cognitive Examination test and 16.58 vs 12.00 for visual memory, 19.32 vs 14.05 for verbal memory, and 51.28 vs 44.41 for general scores on the Memory Functioning Questionnaire test, respectively). Wisconsin card sorting test score comparison showed significantly lower total time consumption in the CR group than in the control group (308.1 vs 340.8 seconds, respectively). Behavior rating inventory of executive function-adult scores in all four subtests were significantly higher in the CR group than in the control group (40.25 vs 55.4 for behavioral regulation index, 51.16 vs 68.6 for metacognition index, and 97.41 vs 124.00 for global executive composite, respectively). Attention was the only domain in which we did not observe any significant variation between groups in terms of post-test and follow-up scores. CONCLUSION This study supports the efficacy of group CR in the improvement of cognitive function in patients with MS.
Collapse
Affiliation(s)
- A. Mani
- Research Center for Psychiatry and Behavioral Sciences; Shiraz University of Medical Sciences; Shiraz Iran
| | - E. Chohedri
- Research Center for Psychiatry and Behavioral Sciences; Shiraz University of Medical Sciences; Shiraz Iran
| | - P. Ravanfar
- Research Center for Psychiatry and Behavioral Sciences; Shiraz University of Medical Sciences; Shiraz Iran
| | - A. Mowla
- Substance Abuse and Mental Health Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - A. Nikseresht
- Clinical Neurology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| |
Collapse
|