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Trujillo P, Aumann MA, Claassen DO. Reply: Neuromelanin? MRI of catecholaminergic neurons. Brain 2024; 147:e27-e28. [PMID: 37979197 DOI: 10.1093/brain/awad394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 11/20/2023] Open
Affiliation(s)
- Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Megan A Aumann
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, 37212, USA
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Trujillo P, Aumann MA, Claassen DO. Neuromelanin-sensitive MRI as a promising biomarker of catecholamine function. Brain 2024; 147:337-351. [PMID: 37669320 PMCID: PMC10834262 DOI: 10.1093/brain/awad300] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/17/2023] [Accepted: 08/20/2023] [Indexed: 09/07/2023] Open
Abstract
Disruptions to dopamine and noradrenergic neurotransmission are noted in several neurodegenerative and psychiatric disorders. Neuromelanin-sensitive (NM)-MRI offers a non-invasive approach to visualize and quantify the structural and functional integrity of the substantia nigra and locus coeruleus. This method may aid in the diagnosis and quantification of longitudinal changes of disease and could provide a stratification tool for predicting treatment success of pharmacological interventions targeting the dopaminergic and noradrenergic systems. Given the growing clinical interest in NM-MRI, understanding the contrast mechanisms that generate this signal is crucial for appropriate interpretation of NM-MRI outcomes and for the continued development of quantitative MRI biomarkers that assess disease severity and progression. To date, most studies associate NM-MRI measurements to the content of the neuromelanin pigment and/or density of neuromelanin-containing neurons, while recent studies suggest that the main source of the NM-MRI contrast is not the presence of neuromelanin but the high-water content in the dopaminergic and noradrenergic neurons. In this review, we consider the biological and physical basis for the NM-MRI contrast and discuss a wide range of interpretations of NM-MRI. We describe different acquisition and image processing approaches and discuss how these methods could be improved and standardized to facilitate large-scale multisite studies and translation into clinical use. We review the potential clinical applications in neurological and psychiatric disorders and the promise of NM-MRI as a biomarker of disease, and finally, we discuss the current limitations of NM-MRI that need to be addressed before this technique can be utilized as a biomarker and translated into clinical practice and offer suggestions for future research.
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Affiliation(s)
- Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Megan A Aumann
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37212, USA
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3
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Stark AJ, Song AK, Petersen KJ, Hay KR, Lin YC, Trujillo P, Kang H, Collazzo JM, Donahue MJ, Zald DH, Claassen DO. Accentuated Paralimbic and Reduced Mesolimbic D 2/3-Impulsivity Associations in Parkinson's Disease. J Neurosci 2023; 43:8733-8743. [PMID: 37852792 PMCID: PMC10727183 DOI: 10.1523/jneurosci.1037-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/31/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023] Open
Abstract
Impulsivity is a behavioral trait that is elevated in many neuropsychiatric disorders. Parkinson's disease (PD) patients can exhibit a specific pattern of reward-seeking impulsive-compulsive behaviors (ICBs), as well as more subtle changes to generalized trait impulsivity. Prior studies in healthy controls (HCs) suggest that trait impulsivity is regulated by D2/3 autoreceptors in mesocorticolimbic circuits. While altered D2/3 binding is noted in ICB+ PD patients, there is limited prior assessment of the trait impulsivity-D2/3 relationship in PD, and no prior direct comparison with patterns in HCs. We examined 54 PD (36 M; 18 F) and 31 sex- and age-matched HC (21 M; 10 F) subjects using [18F]fallypride, a high-affinity D2/3 receptor ligand, to measure striatal and extrastriatal D2/3 nondisplaceable binding potential (BPND). Subcortical and cortical assessment exclusively used ROI or exploratory-voxelwise methods, respectively. All completed the Barratt Impulsiveness Scale, a measure of trait impulsivity. Subcortical ROI analyses indicated a negative relationship between trait impulsivity and D2/3 BPND in the ventral striatum and amygdala of HCs but not in PD. By contrast, voxelwise methods demonstrated a positive trait impulsivity-D2/3 BPND correlation in ventral frontal olfactocentric-paralimbic cortex of subjects with PD but not HCs. Subscale analysis also highlighted different aspects of impulsivity, with significant interactions between group and motor impulsivity in the ventral striatum, and attentional impulsivity in the amygdala and frontal paralimbic cortex. These results suggest that dopamine functioning in distinct regions of the mesocorticolimbic circuit influence aspects of impulsivity, with the relative importance of regional dopamine functions shifting in the neuropharmacological context of PD.SIGNIFICANCE STATEMENT The biological determinants of impulsivity have broad clinical relevance, from addiction to neurodegenerative disorders. Here, we address biomolecular distinctions in Parkinson's disease. This is the first study to evaluate a large cohort of Parkinson's disease patients and age-matched healthy controls with a measure of trait impulsivity and concurrent [18F]fallypride PET, a method that allows quantification of D2/3 receptors throughout the mesocorticolimbic network. We demonstrate widespread differences in the trait impulsivity-dopamine relationship, including (1) loss of subcortical relationships present in the healthy brain and (2) emergence of a new relationship in a limbic cortical area. This illustrates the loss of mechanisms of behavioral regulation present in the healthy brain while suggesting a potential compensatory response and target for future investigation.
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Affiliation(s)
- Adam J Stark
- School of Medicine, Vanderbilt University, Nashville, Tennessee 37232
| | - Alexander K Song
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Kalen J Petersen
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri 63310
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Ya-Chen Lin
- Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee 37232
- Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Hakmook Kang
- Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee 37232
- Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Jenna M Collazzo
- School of Medicine, Temple University, Philadelphia, Pennsylvania 19140
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - David H Zald
- Department of Psychiatry, Rutgers University, Piscataway, New Jersey 08901
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
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4
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Mann LG, Servant M, Hay KR, Song AK, Trujillo P, Yan B, Kang H, Zald D, Donahue MJ, Logan GD, Claassen DO. The Role of a Dopamine-Dependent Limbic-Motor Network in Sensory Motor Processing in Parkinson Disease. J Cogn Neurosci 2023; 35:1806-1822. [PMID: 37677065 PMCID: PMC10594953 DOI: 10.1162/jocn_a_02048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Limbic and motor integration is enabled by a mesial temporal to motor cortex network. Parkinson disease (PD) is characterized by a loss of dorsal striatal dopamine but relative preservation of mesolimbic dopamine early in disease, along with changes to motor action control. Here, we studied 47 patients with PD using the Simon conflict task and [18F]fallypride PET imaging. Additionally, a cohort of 16 patients participated in a single-blinded dextroamphetamine (dAMPH) study. Task performance was evaluated using the diffusion model for conflict tasks, which allows for an assessment of interpretable action control processes. First, a voxel-wise examination disclosed a negative relationship, such that longer non-decision time is associated with reduced D2-like binding potential (BPND) in the bilateral putamen, left globus pallidus, and right insula. Second, an ROI analysis revealed a positive relationship, such that shorter non-decision time is associated with reduced D2-like BPND in the amygdala and ventromedial OFC. The difference in non-decision time between off-dAMPH and on-dAMPH trials was positively associated with D2-like BPND in the globus pallidus. These findings support the idea that dysfunction of the traditional striatal-motor loop underlies action control deficits but also suggest that a compensatory parallel limbic-motor loop regulates motor output.
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Affiliation(s)
- Leah G. Mann
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Mathieu Servant
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive, Université de Franche-Comté, 25000 Besançon, France
| | - Kaitlyn R. Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Alexander K. Song
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Bailu Yan
- Deparment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Hakmook Kang
- Deparment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - David Zald
- Department of Psychiatry, Rutgers University, Piscataway, NJ 08854, USA
| | - Manus J. Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Gordon D. Logan
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA
| | - Daniel O. Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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5
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Trujillo P, Darby RR. The Cerebellum as the Central Hub of a Widespread Network in Essential Tremor. Neurology 2023; 101:639-640. [PMID: 37596039 DOI: 10.1212/wnl.0000000000207778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 08/20/2023] Open
Affiliation(s)
- Paula Trujillo
- From the Department of Neurology, Vanderbilt University Medical Center, Nashville, TN.
| | - R Ryan Darby
- From the Department of Neurology, Vanderbilt University Medical Center, Nashville, TN
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6
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Franco G, Trujillo P, Lopez AM, Aumann MA, Englot DJ, Hainline A, Kang H, Konrad PE, Dawant BM, Claassen DO, Bick SK. Structural brain differences in essential tremor and Parkinson's disease deep brain stimulation patients. J Clin Neurosci 2023; 115:121-128. [PMID: 37549435 PMCID: PMC10530137 DOI: 10.1016/j.jocn.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/24/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Essential tremor (ET) and Parkinson's disease (PD) are the most common tremor disorders and are common indications for deep brain stimulation (DBS). In some patients, PD and ET symptoms overlap and diagnosis can be challenging based on clinical criteria alone. The objective of this study was to identify structural brain differences between PD and ET DBS patients to help differentiate these disorders and improve our understanding of the different brain regions involved in these pathologic processes. METHODS We included ET and PD patients scheduled to undergo DBS surgery in this observational study. Patients underwent 3T brain MRI while under general anesthesia as part of their procedure. Cortical thicknesses and subcortical volumes were quantified from T1-weighted images using automated multi-atlas segmentation. We used logistic regression analysis to identify brain regions associated with diagnosis of ET or PD. RESULTS 149 ET and 265 PD patients were included. Smaller volumes in the pallidum and thalamus and reduced thickness in the anterior orbital gyrus, lateral orbital gyrus, and medial precentral gyrus were associated with greater odds of ET diagnosis. Conversely, reduced volumes in the caudate, amygdala, putamen, and basal forebrain, and reduced thickness in the orbital part of the inferior frontal gyrus, supramarginal gyrus, and posterior cingulate were associated with greater odds of PD diagnosis. CONCLUSIONS These findings identify structural brain differences between PD and ET patients. These results expand our understanding of the different brain regions involved in these disorders and suggest that structural MRI may help to differentiate patients with these two disorders.
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Affiliation(s)
- Giulia Franco
- Department of Neurology, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA; IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Center, Neuroscience Section, Department of Pathophysiology and Transplantation, University of Milan, Italy
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA.
| | - Alexander M Lopez
- Department of Neurology, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA.
| | - Megan A Aumann
- Department of Neurology, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA.
| | - Dario J Englot
- Department of Neurosurgery, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA.
| | - Allison Hainline
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37203, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, 2525 West End Ave, Nashville, TN 37203, USA.
| | - Peter E Konrad
- Department of Neurosurgery, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA; Department of Neurosurgery, Rockefeller Neuroscience Institute, West Virginia University, 33 Medical Center Drive, Morgantown, WV 26505, USA.
| | - Benoit M Dawant
- Department of Electrical and Computer Engineering, Vanderbilt University, PMB 351662, Nashville, TN 37235-1662, USA.
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA.
| | - Sarah K Bick
- Department of Neurosurgery, Vanderbilt University Medical Center, 1500 21st Avenue South, Nashville, TN 37232, USA; Department of Biomedical Engineering, Vanderbilt University, 5824 Stevenson Center, Nashville, TN 37232, USA; Department of Psychiatry, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA.
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7
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Song AK, Hay KR, Trujillo P, Aumann M, Stark AJ, Yan Y, Kang H, Donahue MJ, Zald DH, Claassen DO. Amphetamine-induced dopamine release and impulsivity in Parkinson's disease. Brain 2022; 145:3488-3499. [PMID: 34951464 DOI: 10.1093/brain/awab487] [Citation(s) in RCA: 4] [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] [Received: 10/01/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Impulsive-compulsive behaviours manifest in a substantial proportion of subjects with Parkinson's disease. Reduced ventral striatum dopamine receptor availability, and increased dopamine release is noted in patients with these symptoms. Prior studies of impulsivity suggest that midbrain D2 autoreceptors regulate striatal dopamine release in a feedback inhibitory manner, and in healthy populations, greater impulsivity is linked to poor proficiency of this inhibition. This has not been assessed in a Parkinson's disease population. Here, we applied 18F-fallypride PET studies to assess striatal and extrastriatal D2-like receptor uptake in a placebo-controlled oral dextroamphetamine sequence. We hypothesized that Parkinson's disease patients with impulsive-compulsive behaviours would have greater ventral striatal dopaminergic response to dextroamphetamine, and that an inability to attenuate ventral striatal dopamine release via midbrain D2 autoreceptors would underlie this response. Twenty patients with Parkinson's disease (mean age = 64.1 ± 5.8 years) both with (n = 10) and without (n = 10) impulsive-compulsive behaviours, participated in a single-blind dextroamphetamine challenge (oral; 0.43 mg/kg) in an OFF dopamine state. All completed PET imaging with 18F-fallypride, a high-affinity D2-like receptor ligand, in the placebo and dextroamphetamine state. Both voxelwise and region of interest analyses revealed dextroamphetamine-induced endogenous dopamine release localized to the ventral striatum, and the caudal-medial orbitofrontal cortex. The endogenous dopamine release observed in the ventral striatum correlated positively with patient-reported participation in reward-based behaviours, as quantified by the self-reported Questionnaire for Impulsivity in Parkinson's disease Rating Scale. In participants without impulsive-compulsive behaviours, baseline midbrain D2 receptor availability negatively correlated with ventral striatal dopamine release; however, this relationship was absent in those with impulsive-compulsive behaviours. These findings emphasize that reward-based behaviours in Parkinson's disease are regulated by ventral striatal dopamine release, and suggest that loss of inhibitory feedback from midbrain autoreceptors may underlie the manifestation of impulsive-compulsive behaviours.
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Affiliation(s)
- Alexander K Song
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Megan Aumann
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Vanderbilt Brain Institute, Department of Psychology, Vanderbilt University, Nashville, TN 37232, USA
| | - Adam J Stark
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Yan Yan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA.,Department of Psychiatry, Rutgers University, Piscataway, NJ 08854, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
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8
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Grignola Rial J, Calabuig A, Trujillo P, Bravo C, Casas G, Azpiroz F, Lopez Messeguer M, Domingo E. Differences in the respiratory swings in COPD and ILD candidates for lung transplantation: a critical concern interpreting central pulmonary pressures. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In different clinical scenarios (i.e., obesity, COPD, exercise, mechanical ventilation), the swings in intrathoracic pressure are much larger, and end-expiratory (Pee) pressure can be significantly greater than atmospheric pressure. In these scenarios, the intravascular (Piv) pulmonary pressure can overestimate the true transmural (tm) value and it is recommended to read the average of Piv over a few respiratory cycles (Pmrc) [1–3].
Purpose
To analyze the respiratory swings and the effect of esophageal pressure (PES) (as a surrogate of intrathoracic pressure) on the reading of Piv tracings during the RHC at rest in COPD and interstitial lung disease (ILD) candidates for lung transplantation (LTx).
Methods
Thirty-one COPD (15) and ILD (16) candidates for LTx underwent RHC. End-expiratory and mean respiratory cycle measurements were obtained. The respiratory swing was estimated as the difference between maximum-minimum values of Piv. Ten patients (5 COPD/5 ILD) underwent simultaneous RHC and PES (Micro-balloon Esophageal Catheter, LATITUDE) to assess the Ptm (Piv − PES) [4].
Results
Both demographic (11F/20M, 60±7 yrs, 25±4 kg/m2) and hemodynamic data (mPAP 24±9 mmHg, pulmonary arterial occlusion pressure [PAOP] 8.6±4 mmHg, right atrial pressure [RAP] 5.2±3.9 mmHg, pulmonary vascular resistance 3.5±2.6 Wu) did not show significant differences between ILD and COPD except the cardiac index (ILD: 2.8±0.8 vs. COPD: 2.4±0.3 L/min/m2). Intravascular RAPee and PAOPee were higher than mrc values in both groups (Fig 1). However, transmural RAPee and PAOPee were similar to and correlated with (r=0.62 and 0.69, respectively; p<0.05) transmural Pmrc values. PESee values were positive in COPD and ILD (3.0±2.2 vs. 3.3±2.0 mmHg, NS). All ILD had negative PESmrc values and were lower than COPD patients (−1.76±1.7 vs. 0.78±1.6 mmHg, p<0.05). ILD PES swings were higher than COPD (10.9±3.7 vs. 8.3±1.4 mmHg), although it did not reach statistical significance (p=0.08). The lower forced vital capacity (%), the more negative the PESmrc (Fig 2A). ILD pts showed higher transmural to intravascular Pmrc (p<0.05) (Fig 2B).
Conclusion
End-expiratory intravascular RAP and PAOP overestimates the mean respiratory cycle pressures in COPD and ILD candidates for LTx. Averaging pulmonary vascular pressure tracings over the respiratory cycle would be accurate in COPD but could underestimate transmural values in ILD candidates for LTx. The reading of mean respiratory cycle pressure could not be enough to correct the pulmonary pressures measurement error associated with the presence of large swings of intrathoracic pressure.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- J Grignola Rial
- Hospital de Clínicas, Facultad de Medicina. Universidad de la República, Fisiopatología , Montevideo , Uruguay
| | - A Calabuig
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - P Trujillo
- Hospital de Clínicas, Facultad de Medicina. Universidad de la República, Cardiología. Centro Cardiovascular Universitario. , Montevideo , Uruguay
| | - C Bravo
- University Hospital Vall d'Hebron, Pneumology , Barcelona , Spain
| | - G Casas
- University Hospital Vall d'Hebron, Echocardiography , Barcelona , Spain
| | - F Azpiroz
- University Hospital Vall d'Hebron, Gastroenterology , Barcelona , Spain
| | | | - E Domingo
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
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9
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Mann LG, Hay KR, Song AK, Errington SP, Trujillo P, Zald DH, Yan Y, Kang H, Logan GD, Claassen DO. D 2-Like Receptor Expression in the Hippocampus and Amygdala Informs Performance on the Stop-Signal Task in Parkinson's Disease. J Neurosci 2021; 41:10023-10030. [PMID: 34750225 PMCID: PMC8638685 DOI: 10.1523/jneurosci.0968-21.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/23/2021] [Accepted: 10/25/2021] [Indexed: 02/05/2023] Open
Abstract
The stop-signal task is a well-established assessment of response inhibition, and in humans, proficiency is linked to dorsal striatum D2 receptor availability. Parkinson's disease (PD) is characterized by changes to efficiency of response inhibition. Here, we studied 17 PD patients (6 female and 11 male) using the stop-signal paradigm in a single-blinded d-amphetamine (dAMPH) study. Participants completed [18F]fallypride positron emission topography (PET) imaging in both placebo and dAMPH conditions. A voxel-wise analysis of the relationship between binding potential (BPND) and stop-signal reaction time (SSRT) revealed that faster SSRT is associated with greater D2-like BPND in the amygdala and hippocampus (right cluster qFDR-corr = 0.026, left cluster qFDR-corr = 0.002). A region of interest (ROI) examination confirmed this association in both the amygdala (coefficient = -48.26, p = 0.005) and hippocampus (coefficient = -104.94, p = 0.007). As healthy dopaminergic systems in the dorsal striatum appear to regulate response inhibition, we interpret our findings in PD to indicate either nigrostriatal damage unmasking a mesolimbic contribution to response inhibition, or a compensatory adaptation from the limbic and mesial temporal dopamine systems. These novel results expand the conceptualization of action-control networks, whereby limbic and motor loops may be functionally connected.SIGNIFICANCE STATEMENT While Parkinson's disease (PD) is characteristically recognized for its motor symptoms, some patients develop impulsive and compulsive behaviors (ICBs), manifested as repetitive and excessive participation in reward-driven activities, including sex, gambling, shopping, eating, and hobbyism. Such cognitive alterations compel a consideration of response inhibition in PD. To investigate inhibitory control and assess the brain regions that may participate, we assessed PD patients using a single-blinded d-amphetamine (dAMPH) study, with [18F]fallypride positron emission topography (PET) imaging, and stop-signal task performance. We find a negative relationship between D2-like binding in the mesial temporal region and top-signal reaction time (SSRT), with greater BPND associated with a faster SSRT. These discoveries indicate a novel role for mesolimbic dopamine in response inhibition, and advocate for limbic regulation of action control in this clinical population.
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Affiliation(s)
- Leah G Mann
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, Tennessee 37232
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Alexander K Song
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Steven P Errington
- Department of Psychology, Vanderbilt University, Nashville, Tennessee 37240
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - David H Zald
- Department of Psychology, Vanderbilt University, Nashville, Tennessee 37240
- Department of Psychiatry, Rutgers University, Piscataway, New Jersey 08854
| | - Yan Yan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee 37203
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee 37203
| | - Gordon D Logan
- Department of Psychology, Vanderbilt University, Nashville, Tennessee 37240
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232
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10
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Janssen B, Trujillo P, Grignola Rial J. Role of echocardiography to avoid misclassification of pulmonary hypertension associated with left heart disease as precapillary pulmonary hypertension. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The proportion of patients (pts) diagnosed with pulmonary arterial hypertension (PAH) at a more advanced age and/or with more risk factors for left ventricular diastolic dysfunction is increasing. Therefore, it can be challenging to differentiate PH associated with left heart disease (PH-LHD, PHpost) from other precapillary forms of PH (PHpre).
Purpose
We analyzed the performance of the Opotowsky (OS), D'Alto (DS), and simplified D'Alto (sDS) echocardiographic scores according to the pretest probability (before right heart catheterization – RHC) of PH-LHD in pts with suspected PH submitted to RHC to identify the hemodynamic phenotype.
Methods
37 consecutive stable pts (3/2018–3/2020) with a tricuspid regurgitation peak velocity >2.8 m/s were prospectively included (21F, 49±17 yrs). Blinded transthoracic echocardiography was performed within 2 hours of RHC. We assessed OS (−2 to 2 points) and DS/sDS (0 to 34/7 points). We estimated cardiac index (thermodilution) and hemodynamic parameters using standard formulas. If PA occlusion pressure (PAOP) cannot properly be measured at end-expiration, we assessed left ventricular end-diastolic pressure (LVEDP). PH was defined as a mean PA pressure (mPAP) ≥25 mmHg. PAOP/LVEDP >15 mmHg defined PHpost. If the PAOP/LVEDP was between 13–15 mmHg in an I pt, a volume challenge was done. We categorized pts according to the pretest probability of PH-LHD proposed in the 6th WSPH based on the combination of 7 noninvasive variables (age, presence of CV comorbidities, presence of current or paroxysmal atrial fibrillation, prior cardiac intervention, presence of structural LHD, presence of left bundle branch/LV hypertrophy or RV strain in ECG, presence of left atrial dilatation/grade >2 mitral flow in Echo). The individual average probability was calculated by assigning a score of 1, 2, and 3 for each variable (1 = low (L), 2 = intermediate (I), and 3 = high (H) probability) rounding the average of the sum of values allocated for each variable to the nearest integer. Nonparametric ROC plots assessed the performance of echo-scores.
Results
All pts had PH. 19 pts showed PHpost, 10/19 with PVR >3Wu (Combined PHpost). All scores were lower in PHpost compared to PHpre pts (p<0.05) (Table 1). ROC area was >0.9 with a similar Youden index (0.83) among the three scores (p<0.05) (Figure 1). 17 PHpost with H pts were correctly identified by all scores (94–100%). In 15 PHpre with L pts OS performed better than DS/sDS (93 vs. 80%). In 3 PHpre and 2 PHpost with I pts, DS/sDS performed better than OS (100 vs. 80%).
Conclusion
The use of simple echo-scores could facilitate the screening of the hemodynamic phenotype in pts with PH, regardless of the pretest probability of PH-LHD. D'Alto scores might have some advantage compared to OS to classify the intermediate pretest probability of PH pts correctly.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Centro Cardiovascular Universitario. Hospital de Clínicas. Facultad de Medicina. Universidad de la República Table 1. Echo & Hemodynamic DataFigure 1. ROC curves of Echo scores
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Affiliation(s)
- B Janssen
- Hospital de Clínicas, Facultad de Medicina. Universidad de la República, Cardiología. Centro Cardiovascular Universitario., Montevideo, Uruguay
| | - P Trujillo
- Hospital de Clínicas, Facultad de Medicina. Universidad de la República, Cardiología. Centro Cardiovascular Universitario., Montevideo, Uruguay
| | - J Grignola Rial
- Hospital de Clínicas, Facultad de Medicina. Universidad de la República, Fisiopatología, Montevideo, Uruguay
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11
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Johnson SE, McKnight CD, Jordan LC, Claassen DO, Waddle S, Lee C, Garza M, Patel NJ, Davis LT, Pruthi S, Trujillo P, Chitale R, Fusco M, Donahue MJ. Choroid plexus perfusion in sickle cell disease and moyamoya vasculopathy: Implications for glymphatic flow. J Cereb Blood Flow Metab 2021; 41:2699-2711. [PMID: 33906512 PMCID: PMC8504961 DOI: 10.1177/0271678x211010731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Cerebrospinal fluid (CSF) and interstitial fluid exchange have been shown to increase following pharmacologically-manipulated increases in cerebral arterial pulsatility, consistent with arterial pulsatility improving CSF circulation along perivascular glymphatic pathways. The choroid plexus (CP) complexes produce CSF, and CP activity may provide a centralized indicator of perivascular flow. We tested the primary hypothesis that elevated cortical cerebral blood volume and flow, present in sickle cell disease (SCD), is associated with fractionally-reduced CP perfusion relative to healthy adults, and the supplementary hypothesis that reduced arterial patency, present in moyamoya vasculopathy, is associated with elevated fractional CP perfusion relative to healthy adults. Participants (n = 75) provided informed consent and were scanned using a 3-Tesla arterial-spin-labeling MRI sequence for CP and cerebral gray matter (GM) perfusion quantification. ANOVA was used to calculate differences in CP-to-GM perfusion ratios between groups, and regression analyses applied to evaluate the dependence of the CP-to-GM perfusion ratio on group after co-varying for age and sex. ANOVA yielded significant (p < 0.001) group differences, with CP-to-GM perfusion ratios increasing between SCD (ratio = 0.93 ± 0.28), healthy (ratio = 1.04 ± 0.32), and moyamoya (ratio = 1.29 ± 0.32) participants, which was also consistent with regression analyses. Findings are consistent with CP perfusion being inversely associated with cortical perfusion.
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Affiliation(s)
- Skylar E Johnson
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lori C Jordan
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Spencer Waddle
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chelsea Lee
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maria Garza
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niral J Patel
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Taylor Davis
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sumit Pruthi
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rohan Chitale
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew Fusco
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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12
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McKnight CD, Trujillo P, Lopez AM, Petersen K, Considine C, Lin YC, Yan Y, Kang H, Donahue MJ, Claassen DO. Diffusion along perivascular spaces reveals evidence supportive of glymphatic function impairment in Parkinson disease. Parkinsonism Relat Disord 2021; 89:98-104. [PMID: 34271425 PMCID: PMC8429254 DOI: 10.1016/j.parkreldis.2021.06.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/25/2021] [Accepted: 06/06/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Reduced diffusion along perivascular spaces in adults with Alzheimer's-disease-related-dementias has been reported and attributed to reduced glymphatic function. OBJECTIVES To apply quantitative measures of diffusion along, and orthogonal to, perivascular spaces in a cohort of older adults with and without clinical symptoms of alpha-synuclein related neurodegeneration. METHODS 181 adults with Parkinson disease (PD) or essential tremor (ET) additionally sub-classified by the presence of cognitive impairment underwent 3 T MRI. Diffusion-tensor-imaging (spatial resolution = 2x2x2 mm; b-value = 1000 s/mm2; directions = 33) measures of diffusion (mm2/s) parallel and orthogonal to perivascular spaces at the level of the medullary veins, and the ratio of these measures (ALPS-index), were calculated. Regions were identified by a board-certified neuroradiologist from T1-weighted and T2-weighted MRI. Evaluations of motor impairment and mild cognitive impairment (MCI) were interpreted by a board-certified neurologist and neuropsychologist, respectively. Multiple regression with false discovery rate correction was applied to understand how diffusion metrics related to (i) disease category (PD vs. ET), (ii) cognition (MCI status), and (iii) white matter disease severity from the Fazekas score. RESULTS The ALPS-index was reduced in PD compared to ET participants (p = 0.037). No association between the ALPS-index and MCI status, but an inverse association between the ALPS-index and Fazekas score (p = 0.002), was observed. The ALPS-index was inversely associated with age (p = 0.007). CONCLUSION Diffusion aberrations near perivascular spaces are evident in patients with alpha-synuclein related neurodegenerative disorders, and are related to age and white matter disease severity.
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Affiliation(s)
- Colin D McKnight
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alexander M Lopez
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kalen Petersen
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ciaran Considine
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yan Yan
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
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13
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Hay KR, Kukreti N, Trujillo P, Lin YC, Kang H, Claassen DO. Symptoms of Medication Withdrawal in Parkinson's Disease: Considerations for Informed Consent in Patient-Oriented Research. Pharmaceut Med 2021; 35:163-167. [PMID: 33914276 PMCID: PMC8721843 DOI: 10.1007/s40290-021-00387-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Dopamine medication withdrawal in Parkinson's disease (PD) is commonly employed in clinical practice and can be required for participation in research studies. When asked to withdraw from medications, participants often enquire as to what symptoms they should expect. OBJECTIVES This study sought to improve the informed consent process by identifying patient-reported symptoms when dopamine treatment is withheld. We also sought to provide clinical guidance regarding the extent of these symptoms and consider participant willingness to undergo these assessments. METHODS Participants were recruited from community-based PD programs and support groups in Nashville, Tennessee, USA. A patient-based questionnaire determined the frequency and severity of motor and nonmotor symptoms. The questionnaire also assessed whether patients would be willing to abstain from medication at a future date and under what circumstances. RESULTS A total of 31/90 participants reported willingness to withdraw from dopaminergic medications for clinical or research purposes. Tremor, walking, and balance were the most common motor symptoms that worsened during this time. Sleep dysfunction, constipation, and tremor were noted as the most severe symptoms. Of note, 10% of participants indicated that they would not be willing to go off medications again, suggesting that a minority of patients find this to be most discomforting. When prompted for a reason why participants would be willing to come off of their medications again, "for clinical purposes" was selected the most. CONCLUSIONS Study teams should list these symptoms in the applications to their institutional review board and in the informed consent to provide guidance for participants.
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Affiliation(s)
- Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Neevi Kukreti
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA.
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14
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Hett K, Lyu I, Trujillo P, Lopez AM, Aumann M, Larson KE, Hedera P, Dawant B, Landman BA, Claassen DO, Oguz I. Anatomical texture patterns identify cerebellar distinctions between essential tremor and Parkinson's disease. Hum Brain Mapp 2021; 42:2322-2331. [PMID: 33755270 PMCID: PMC8090778 DOI: 10.1002/hbm.25331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/25/2020] [Accepted: 12/16/2020] [Indexed: 01/15/2023] Open
Abstract
Voxel-based morphometry is an established technique to study focal structural brain differences in neurologic disease. More recently, texture-based analysis methods have enabled a pattern-based assessment of group differences, at the patch level rather than at the voxel level, allowing a more sensitive localization of structural differences between patient populations. In this study, we propose a texture-based approach to identify structural differences between the cerebellum of patients with Parkinson's disease (n = 280) and essential tremor (n = 109). We analyzed anatomical differences of the cerebellum among patients using two features: T1-weighted MRI intensity, and a texture-based similarity feature. Our results show anatomical differences between groups that are localized to the inferior part of the cerebellar cortex. Both the T1-weighted intensity and texture showed differences in lobules VIII and IX, vermis VIII and IX, and middle peduncle, but the texture analysis revealed additional differences in the dentate nucleus, lobules VI and VII, vermis VI and VII. This comparison emphasizes how T1-weighted intensity and texture-based methods can provide a complementary anatomical structure analysis. While texture-based similarity shows high sensitivity for gray matter differences, T1-weighted intensity shows sensitivity for the detection of white matter differences.
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Affiliation(s)
- Kilian Hett
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Ilwoo Lyu
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Paula Trujillo
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Alexander M. Lopez
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Megan Aumann
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Kathleen E. Larson
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Peter Hedera
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennesseeUSA,Department of NeurologyUniversity of LouisvilleLouisvilleKentuckyUSA
| | - Benoit Dawant
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Bennett A. Landman
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
| | - Daniel O. Claassen
- Department of NeurologyVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Ipek Oguz
- Department of Electrical Engineering and Computer ScienceVanderbilt UniversityNashvilleTennesseeUSA
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15
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Trujillo P, Roman OC, Hay KR, Juttukonda MR, Yan Y, Kang H, Paranjape SY, Garland EM, Shibao CA, Biaggioni I, Donahue MJ, Claassen DO. Elevated cerebral blood flow in patients with pure autonomic failure. Clin Auton Res 2021; 31:405-414. [PMID: 33677714 DOI: 10.1007/s10286-021-00792-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 02/24/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE Pure autonomic failure (PAF) results from an impaired peripheral autonomic nervous system, and clinical symptoms present with orthostatic hypotension. While the impact on cardiovascular indices of orthostatic intolerance are well-characterized, more limited information is available regarding cerebral hemodynamic dysfunction in PAF. The objective of this study was to test the hypothesis that cerebral blood flow (CBF) is reduced in PAF, and to quantify the relationship between CBF and clinical indicators of disease severity, including peripheral supine arterial blood pressure. METHODS Participants with PAF (n = 17) and age- and sex-matched normotensive healthy controls (n = 17) were examined using established clinical rating scales, cardiovascular autonomic function tests, and 3T MRI measurements of CBF. CBF-weighted images were also used to determine the prevalence of venous hyperintensities from the major dural sinuses as evidence of abnormal capillary flow. Nonparametric tests and general linear models were used to evaluate differences and correlations between study variables. RESULTS Gray matter CBF was higher in PAF (51.1 ± 13.4 mL/100 g/min) compared to controls (42.9 ± 6.5 mL/100 g/min, p = 0.007). Venous hyperintensities were more prevalent in PAF relative to controls, and the presence and degree of venous hyperintensities was associated with higher mean CBF (p = 0.027). In PAF participants, CBF and supine systolic blood pressure were inversely related (Spearman's rho = -0.545, p = 0.024). CONCLUSIONS Findings suggest that PAF patients may exhibit elevated CBF and provide evidence that this condition exerts a hemodynamic impact in the central nervous system.
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Affiliation(s)
- Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Olivia C Roman
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kaitlyn R Hay
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
| | - Meher R Juttukonda
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Yan Yan
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Sachin Y Paranjape
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emily M Garland
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cyndya A Shibao
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Italo Biaggioni
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, 1161 21st Ave South A-0118, Nashville, TN, 37232, USA.
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16
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Menzie-Suderam JM, Modi J, Xu H, Bent A, Trujillo P, Medley K, Jimenez E, Shen J, Marshall M, Tao R, Prentice H, Wu JY. Granulocyte-colony stimulating factor gene therapy as a novel therapeutics for stroke in a mouse model. J Biomed Sci 2020; 27:99. [PMID: 33126859 PMCID: PMC7596942 DOI: 10.1186/s12929-020-00692-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background Global ischemia is the resulting effect of a cardiopulmonary arrest (CPA). Presently there is no effective treatment to address neurological deficits in patients who survived a CPA. Granulocyte-colony stimulating factor is a growth factor (G-CSF) with a plethora of beneficial effects, including neuroprotection. Clinical application of human G-CSF (hG-CSF) is limited due to its plasma half-life of 4 h. Therefore, novel approaches need to be investigated that would (1) enable prolonged manifestation of hG-CSF and (2) demonstrate G-CSF efficacy from studying the underlying protective mechanisms of hG-CSF. In our previous work, we used the self-complementary adeno-associated virus (stereotype2: scAAV2) as a vector to transfect the hG-CSF gene into the global ischemic brain of a mouse. As an extension of that work, we now seek to elucidate the protective mechanisms of hG-CSF gene therapy against endoplasmic reticulum induced stress, mitochondrial dynamics and autophagy in global ischemia. Method A single drop of either AAV-CMV-hG-CSF or AAV-CMV-GFP was dropped into the conjunctival sac of the Swiss Webster mouse’s left eye, 30–60 min after bilateral common artery occlusion (BCAO). The efficacy of the expressed hG-CSF gene product was analyzed by monitoring the expression levels of endoplasmic reticulum stress (ER), mitochondrial dynamics and autophagic proteins over 4- and 7-days post-BCAO in vulnerable brain regions including the striatum, overlying cortex (frontal brain regions) and the hippocampus (middle brain regions). Statistical analysis was performed using mostly One-Way Analysis of variance (ANOVA), except for behavioral analysis, which used Repeated Measures Two-Way ANOVA, post hoc analysis was performed using the Tukey test. Results Several biomarkers that facilitated cellular death, including CHOP and GRP78 (ER stress) DRP1 (mitochondrial dynamics) and Beclin 1, p62 and LC3-ll (autophagy) were significantly downregulated by hG-CSF gene transfer. hG-CSF gene therapy also significantly upregulated antiapoptotic Bcl2 while downregulating pro-apoptotic Bax. The beneficial effects of hG-CSF gene therapy resulted in an overall improvement in functional behavior. Conclusion Taken together, this study has substantiated the approach of sustaining the protein expression of hG-CSF by eye drop administration of the hG-CSF gene. In addition, the study has validated the efficacy of using hG-CSF gene therapy against endoplasmic reticulum induced stress, mitochondrial dynamics and autophagy in global ischemia.
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Affiliation(s)
- Janet M Menzie-Suderam
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA.,Program in Integrative Biology, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Jigar Modi
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA.,Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, USA
| | - Hongyaun Xu
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Andrew Bent
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Paula Trujillo
- Program in Integrative Biology, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Kristen Medley
- College of Medicine, New York University, New York, NY, 10003, USA
| | - Eugenia Jimenez
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Jessica Shen
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | | | - Rui Tao
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA.
| | - Howard Prentice
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA. .,Program in Integrative Biology, Florida Atlantic University, Boca Raton, FL, 33431, USA. .,Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, USA.
| | - Jang-Yen Wu
- Department of Biomedical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, 33431, USA. .,Program in Integrative Biology, Florida Atlantic University, Boca Raton, FL, 33431, USA. .,Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, USA.
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17
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Lopez AM, Trujillo P, Hernandez AB, Lin YC, Kang H, Landman BA, Englot DJ, Dawant BM, Konrad PE, Claassen DO. Structural Correlates of the Sensorimotor Cerebellum in Parkinson's Disease and Essential Tremor. Mov Disord 2020; 35:1181-1188. [PMID: 32343870 DOI: 10.1002/mds.28044] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/15/2019] [Accepted: 02/28/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Parkinson's disease (PD) and essential tremor (ET) are commonly encountered movement disorders. Pathophysiologic processes that localize to the cerebellum are described in both. There are limited studies investigating cerebellar structural changes in these conditions, largely because of inherent challenges in the efficiency of segmentation. METHODS We applied a novel multiatlas cerebellar segmentation method to T1-weighted images in 282 PD and 111 essential tremor patients to define 26 cerebellar lobule volumes. The severity of postural and resting tremor in both populations and gait and postural instability in PD patients were defined using subscores of the UPDRS and Washington Heights-Inwood Genetic Study motor scales. These clinical measurements were related to lobule volume size. Multiple comparisons were controlled using a false discovery rate method. RESULTS Group differences were identified between ET and PD patients, with reductions in deep cerebellar nucleus volume in ET versus reduced lobule VI volume in PD. In ET patients, lobule VIII was negatively correlated with the severity of postural tremor. In PD patients, lobule IV was positively correlated with resting tremor and total tremor severity. We observed differences in cerebellar structure that localized to sensorimotor lobules of the cerebellum. Lobule volumes appeared to differentially relate to clinical symptoms, suggesting important clinicopathologic distinctions between these conditions. These results emphasize the role of the cerebellum in tremor symptoms and should foster future clinical and pathologic investigations of the sensorimotor lobules of the cerebellum. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alexander M Lopez
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adreanna B Hernandez
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Bennett A Landman
- Department of Radiology/Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dario J Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Benoit M Dawant
- Department of Radiology/Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Peter E Konrad
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Trujillo P, Petersen KJ, Cronin MJ, Lin YC, Kang H, Donahue MJ, Smith SA, Claassen DO. Quantitative magnetization transfer imaging of the human locus coeruleus. Neuroimage 2019; 200:191-198. [PMID: 31233908 PMCID: PMC6934172 DOI: 10.1016/j.neuroimage.2019.06.049] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/17/2019] [Accepted: 06/19/2019] [Indexed: 12/14/2022] Open
Abstract
The locus coeruleus (LC) is the major origin of norepinephrine in the central nervous system, and is subject to age-related and neurodegenerative changes, especially in disorders such as Parkinson's disease and Alzheimer's disease. Previous studies have shown that neuromelanin (NM)-sensitive MRI can be used to visualize the LC, and it is hypothesized that magnetization transfer (MT) effects are the primary source of LC contrast. The aim of this study was to characterize the MT effects in LC imaging by applying high spatial resolution quantitative MT (qMT) imaging to create parametric maps of the macromolecular content of the LC and surrounding tissues. Healthy volunteers (n = 26; sex = 17 F/9M; age = 41.0 ± 19.1 years) underwent brain MRI on a 3.0 T scanner. qMT data were acquired using a 3D MT-prepared spoiled gradient echo sequence. A traditional NM scan consisting of a T1-weighted turbo spin echo sequence with MT preparation was also acquired. The pool-size ratio (PSR) was estimated for each voxel using a single-point qMT approach. The LC was semi-automatically segmented on the MT-weighted images. The MT-weighted images provided higher contrast-ratio between the LC and surrounding pontine tegmentum (PT) (0.215 ± 0.031) than the reference images without MT-preparation (-0.005 ± 0.026) and the traditional NM images (0.138 ± 0.044). The PSR maps showed significant differences between the LC (0.090 ± 0.009) and PT (0.188 ± 0.025). The largest difference between the PSR values in the LC and PT was observed in the central slices, which also correspond to those with the highest contrast-ratio. These results highlight the role of MT in generating NM-related contrast in the LC, and should serve as a foundation for future studies aiming to quantify pathological changes in the LC and surrounding structures in vivo.
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Affiliation(s)
- Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Kalen J Petersen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew J Cronin
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ya-Chen Lin
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Seth A Smith
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
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Betts MJ, Kirilina E, Otaduy MCG, Ivanov D, Acosta-Cabronero J, Callaghan MF, Lambert C, Cardenas-Blanco A, Pine K, Passamonti L, Loane C, Keuken MC, Trujillo P, Lüsebrink F, Mattern H, Liu KY, Priovoulos N, Fliessbach K, Dahl MJ, Maaß A, Madelung CF, Meder D, Ehrenberg AJ, Speck O, Weiskopf N, Dolan R, Inglis B, Tosun D, Morawski M, Zucca FA, Siebner HR, Mather M, Uludag K, Heinsen H, Poser BA, Howard R, Zecca L, Rowe JB, Grinberg LT, Jacobs HIL, Düzel E, Hämmerer D. Locus coeruleus imaging as a biomarker for noradrenergic dysfunction in neurodegenerative diseases. Brain 2019; 142:2558-2571. [PMID: 31327002 PMCID: PMC6736046 DOI: 10.1093/brain/awz193] [Citation(s) in RCA: 179] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/12/2019] [Accepted: 05/01/2019] [Indexed: 12/20/2022] Open
Abstract
Pathological alterations to the locus coeruleus, the major source of noradrenaline in the brain, are histologically evident in early stages of neurodegenerative diseases. Novel MRI approaches now provide an opportunity to quantify structural features of the locus coeruleus in vivo during disease progression. In combination with neuropathological biomarkers, in vivo locus coeruleus imaging could help to understand the contribution of locus coeruleus neurodegeneration to clinical and pathological manifestations in Alzheimer's disease, atypical neurodegenerative dementias and Parkinson's disease. Moreover, as the functional sensitivity of the noradrenergic system is likely to change with disease progression, in vivo measures of locus coeruleus integrity could provide new pathophysiological insights into cognitive and behavioural symptoms. Locus coeruleus imaging also holds the promise to stratify patients into clinical trials according to noradrenergic dysfunction. In this article, we present a consensus on how non-invasive in vivo assessment of locus coeruleus integrity can be used for clinical research in neurodegenerative diseases. We outline the next steps for in vivo, post-mortem and clinical studies that can lay the groundwork to evaluate the potential of locus coeruleus imaging as a biomarker for neurodegenerative diseases.
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Affiliation(s)
- Matthew J Betts
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Evgeniya Kirilina
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Center for Cognitive Neuroscience, Free University Berlin, Berlin, Germany
| | - Maria C G Otaduy
- Laboratory of Magnetic Resonance LIM44, Department and Institute of Radiology, Medical School of the University of São Paulo, Brazil
| | - Dimo Ivanov
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, MD, Maastricht, The Netherlands
| | | | - Martina F Callaghan
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK
| | - Christian Lambert
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK
| | - Arturo Cardenas-Blanco
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Kerrin Pine
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK
| | - Luca Passamonti
- Department of Clinical Neurosciences, University of Cambridge, UK
- Consiglio Nazionale delle Ricerche, Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Milan, Italy
| | - Clare Loane
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Max C Keuken
- University of Amsterdam, Integrative Model-based Cognitive Neuroscience research unit, Amsterdam, The Netherlands
- University of Leiden, Cognitive Psychology, Leiden, The Netherlands
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Falk Lüsebrink
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
| | - Hendrik Mattern
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Nikos Priovoulos
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Klaus Fliessbach
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin J Dahl
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Anne Maaß
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Christopher F Madelung
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark
| | - David Meder
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Alexander J Ehrenberg
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Integrative Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Oliver Speck
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Department of Biomedical Magnetic Resonance, Institute for Physics, Otto-von-Guericke-University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Nikolaus Weiskopf
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK
| | - Raymond Dolan
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK
- Max Planck Centre for Computational Psychiatry and Ageing, University College London, UK
| | - Ben Inglis
- Henry H. Wheeler, Jr. Brain Imaging Center, University of California, Berkeley, CA, USA
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California - San Francisco, San Francisco, CA, USA
| | - Markus Morawski
- Paul Flechsig Institute of Brain Research, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Fabio A Zucca
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, Milan, Italy
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Mara Mather
- Leonard Davis School of Gerontology and Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Kamil Uludag
- Centre for Neuroscience Imaging Research, Institute for Basic Science and Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
- Techna Institute and Koerner Scientist in MR Imaging, University Health Network, Toronto, Canada
| | - Helmut Heinsen
- University of São Paulo Medical School, São Paulo, Brazil
- Clinic of Psychiatry, University of Würzburg, Wurzburg, Germany
| | - Benedikt A Poser
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, MD, Maastricht, The Netherlands
| | - Robert Howard
- Division of Psychiatry, University College London, London, UK
| | - Luigi Zecca
- Institute of Biomedical Technologies, National Research Council of Italy, Segrate, Milan, Italy
- Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, USA
| | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Lea T Grinberg
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- University of São Paulo Medical School, São Paulo, Brazil
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Heidi I L Jacobs
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, MD, Maastricht, The Netherlands
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Dorothea Hämmerer
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, London, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
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Trujillo P, van Wouwe NC, Lin YC, Stark AJ, Petersen KJ, Kang H, Zald DH, Donahue MJ, Claassen DO. Dopamine effects on frontal cortical blood flow and motor inhibition in Parkinson's disease. Cortex 2019; 115:99-111. [PMID: 30776736 DOI: 10.1016/j.cortex.2019.01.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/15/2018] [Accepted: 01/17/2019] [Indexed: 12/31/2022]
Abstract
Parkinson's disease (PD) is characterized by dysfunction in frontal cortical and striatal networks that regulate action control. We investigated the pharmacological effect of dopamine agonist replacement therapy on frontal cortical activity and motor inhibition. Using Arterial Spin Labeling MRI, we examined 26 PD patients in the off- and on-dopamine agonist medication states to assess the effect of dopamine agonists on frontal cortical regional cerebral blood flow. Motor inhibition was measured by the Simon task in both medication states. We applied the dual process activation suppression model to dissociate fast response impulses from motor inhibition of incorrect responses. General linear regression model analyses determined the medication effect on regional cerebral blood flow and motor inhibition, and the relationship between regional cerebral blood flow and motor inhibitory proficiency. We show that dopamine agonist administration increases frontal cerebral blood flow, particularly in the pre-supplementary motor area (pre-SMA) and the dorsolateral prefrontal cortex (DLPFC). Higher regional blood flow in the pre-SMA, DLPFC and motor cortex was associated with better inhibitory control, suggesting that treatments which improve frontal cortical activity could ameliorate motor inhibition deficiency in PD patients.
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Affiliation(s)
- Paula Trujillo
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Ya-Chen Lin
- Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam J Stark
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kalen J Petersen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David H Zald
- Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J Donahue
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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21
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Juttukonda MR, Franco G, Englot DJ, Lin YC, Petersen KJ, Trujillo P, Hedera P, Landman BA, Kang H, Donahue MJ, Konrad PE, Dawant BM, Claassen DO. White matter differences between essential tremor and Parkinson disease. Neurology 2018; 92:e30-e39. [PMID: 30504432 DOI: 10.1212/wnl.0000000000006694] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/05/2018] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess white matter integrity in patients with essential tremor (ET) and Parkinson disease (PD) with moderate to severe motor impairment. METHODS Sedated participants with ET (n = 57) or PD (n = 99) underwent diffusion tensor imaging (DTI) and fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity values were computed. White matter tracts were defined using 3 well-described atlases. To determine candidate white matter regions that differ between ET and PD groups, a bootstrapping analysis was applied using the least absolute shrinkage and selection operator. Linear regression was applied to assess magnitude and direction of differences in DTI metrics between ET and PD populations in the candidate regions. RESULTS Fractional anisotropy values that differentiate ET from PD localize primarily to thalamic and visual-related pathways, while diffusivity differences localized to the cerebellar peduncles. Patients with ET exhibited lower fractional anisotropy values than patients with PD in the lateral geniculate body (p < 0.01), sagittal stratum (p = 0.01), forceps major (p = 0.02), pontine crossing tract (p = 0.03), and retrolenticular internal capsule (p = 0.04). Patients with ET exhibited greater radial diffusivity values than patients with PD in the superior cerebellar peduncle (p < 0.01), middle cerebellar peduncle (p = 0.05), and inferior cerebellar peduncle (p = 0.05). CONCLUSIONS Regionally, distinctive white matter microstructural values in patients with ET localize to the cerebellar peduncles and thalamo-cortical visual pathways. These findings complement recent functional imaging studies in ET but also extend our understanding of putative physiologic features that account for distinctions between ET and PD.
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Affiliation(s)
- Meher R Juttukonda
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Giulia Franco
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Dario J Englot
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Ya-Chen Lin
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Kalen J Petersen
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Paula Trujillo
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Peter Hedera
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Bennett A Landman
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Hakmook Kang
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Manus J Donahue
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Peter E Konrad
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Benoit M Dawant
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN
| | - Daniel O Claassen
- From the Departments of Radiology and Radiological Sciences (M.R.J., M.J.D.), Neurological Surgery (D.J.E., P.E.K.), Biostatistics (Y.-C.L., H.K.), Neurology (P.T., P.H., M.J.D.), and Psychiatry (M.J.D.), Vanderbilt University Medical Center, Nashville, TN; Department of Pathophysiology and Transplantation (G.F.) University of Milan, Italy; and Chemical and Physical Biology Program (K.J.P.) and Departments of Electrical Engineering (B.A.L., B.M.D.), Computer Engineering (B.A.L., B.M.D.), Computer Science and Biomedical Engineering (B.A.L., B.M.D.), and Neurology (D.O.C.), Vanderbilt University, Nashville, TN.
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22
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Petersen KJ, Reid JA, Chakravorti S, Juttukonda MR, Franco G, Trujillo P, Stark AJ, Dawant BM, Donahue MJ, Claassen DO. Structural and functional connectivity of the nondecussating dentato-rubro-thalamic tract. Neuroimage 2018; 176:364-371. [PMID: 29733955 PMCID: PMC6002752 DOI: 10.1016/j.neuroimage.2018.04.074] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/04/2018] [Accepted: 04/30/2018] [Indexed: 12/20/2022] Open
Abstract
The dentato-rubro-thalamic tract (DRTT) regulates motor control, connecting the cerebellum to the thalamus. This tract is modulated by deep-brain stimulation in the surgical treatment of medically refractory tremor, especially in essential tremor, where high-frequency stimulation of the thalamus can improve symptoms. The DRTT is classically described as a decussating pathway, ascending to the contralateral thalamus. However, the existence of a nondecussating (i.e. ipsilateral) DRTT in humans was recently demonstrated, and these tracts are arranged in distinct regions of the superior cerebellar peduncle. We hypothesized that the ipsilateral DRTT is connected to specific thalamic nuclei and therefore may have unique functional relevance. The goals of this study were to confirm the presence of the decussating and nondecussating DRTT pathways, identify thalamic termination zones of each tract, and compare whether structural connectivity findings agree with functional connectivity. Diffusion-weighted imaging was used to perform probabilistic tractography of the decussating and nondecussating DRTT in young healthy subjects from the Human Connectome Project (n = 91) scanned using multi-shell diffusion-weighted imaging (270 directions; TR/TE = 5500/89 ms; spatial resolution = 1.25 mm isotropic). To define thalamic anatomical landmarks, a segmentation procedure based on the Morel Atlas was employed, and DRTT targeting was quantified based on the proportion of streamlines arriving at each nucleus. In parallel, functional connectivity analysis was performed using resting-state functional MRI (TR/TE = 720/33 ms; spatial resolution = 2 mm isotropic). It was found that the decussating and nondecussating DRTTs have significantly different thalamic endpoints, with the former preferentially targeting relatively anterior and lateral thalamic nuclei, and the latter connected to more posterior and medial nuclei (p < 0.001). Functional and structural connectivity measures were found to be significantly correlated (r = 0.45, p = 0.031). These findings provide new insight into pathways through which unilateral cerebellum can exert bilateral influence on movement and raise questions about the functional implications of ipsilateral cerebellar efferents.
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Affiliation(s)
- Kalen J Petersen
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Srijata Chakravorti
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Meher R Juttukonda
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Giulia Franco
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paula Trujillo
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Adam J Stark
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Benoit M Dawant
- Department of Electrical Engineering and Computer Science, Vanderbilt University, Nashville, TN, USA
| | - Manus J Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Daniel O Claassen
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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Stark AJ, Smith CT, Petersen KJ, Trujillo P, van Wouwe NC, Donahue MJ, Kessler RM, Deutch AY, Zald DH, Claassen DO. [ 18F]fallypride characterization of striatal and extrastriatal D 2/3 receptors in Parkinson's disease. Neuroimage Clin 2018; 18:433-442. [PMID: 29541577 PMCID: PMC5849871 DOI: 10.1016/j.nicl.2018.02.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/15/2018] [Accepted: 02/07/2018] [Indexed: 12/11/2022]
Abstract
Parkinson's disease (PD) is characterized by widespread degeneration of monoaminergic (especially dopaminergic) networks, manifesting with a number of both motor and non-motor symptoms. Regional alterations to dopamine D2/3 receptors in PD patients are documented in striatal and some extrastriatal areas, and medications that target D2/3 receptors can improve motor and non-motor symptoms. However, data regarding the combined pattern of D2/3 receptor binding in both striatal and extrastriatal regions in PD are limited. We studied 35 PD patients off-medication and 31 age- and sex-matched healthy controls (HCs) using PET imaging with [18F]fallypride, a high affinity D2/3 receptor ligand, to measure striatal and extrastriatal D2/3 nondisplaceable binding potential (BPND). PD patients completed PET imaging in the off medication state, and motor severity was concurrently assessed. Voxel-wise evaluation between groups revealed significant BPND reductions in PD patients in striatal and several extrastriatal regions, including the locus coeruleus and mesotemporal cortex. A region-of-interest (ROI) based approach quantified differences in dopamine D2/3 receptors, where reduced BPND was noted in the globus pallidus, caudate, amygdala, hippocampus, ventral midbrain, and thalamus of PD patients relative to HC subjects. Motor severity positively correlated with D2/3 receptor density in the putamen and globus pallidus. These findings support the hypothesis that abnormal D2/3 expression occurs in regions related to both the motor and non-motor symptoms of PD, including areas richly invested with noradrenergic neurons.
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Affiliation(s)
- Adam J Stark
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Kalen J Petersen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Paula Trujillo
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Nelleke C van Wouwe
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Manus J Donahue
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States; Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Robert M Kessler
- Radiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ariel Y Deutch
- Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Pharmacology, Vanderbilt University, Nashville, TN, United States
| | - David H Zald
- Psychology, Vanderbilt University, Nashville, TN, United States; Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Daniel O Claassen
- Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
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Franco G, Trujillo P, Plassard A, Hainline A, Landman B, Hedera P, Kang H, Claassen D. Volumetric magnetic resonance imaging differences in essential tremor compared to Parkinson’s disease. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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25
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Trujillo P, Mastropietro A, Scano A, Chiavenna A, Mrakic-Sposta S, Caimmi M, Molteni F, Rizzo G. Quantitative EEG for Predicting Upper Limb Motor Recovery in Chronic Stroke Robot-Assisted Rehabilitation. IEEE Trans Neural Syst Rehabil Eng 2017; 25:1058-1067. [DOI: 10.1109/tnsre.2017.2678161] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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26
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Trujillo P, Summers PE, Ferrari E, Zucca FA, Sturini M, Mainardi LT, Cerutti S, Smith AK, Smith SA, Zecca L, Costa A. Contrast mechanisms associated with neuromelanin-MRI. Magn Reson Med 2016; 78:1790-1800. [DOI: 10.1002/mrm.26584] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/28/2016] [Accepted: 11/23/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Paula Trujillo
- Department of Neuroradiology; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico; Milan Italy
- Department of Electronics; Information and Bioengineering, Politecnico di Milano; Milan Italy
| | - Paul E. Summers
- Department of Neuroradiology; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico; Milan Italy
| | - Emanuele Ferrari
- Institute of Biomedical Technologies; National Research Council of Italy; Segrate Italy
| | - Fabio A. Zucca
- Institute of Biomedical Technologies; National Research Council of Italy; Segrate Italy
| | | | - Luca T. Mainardi
- Department of Electronics; Information and Bioengineering, Politecnico di Milano; Milan Italy
| | - Sergio Cerutti
- Department of Electronics; Information and Bioengineering, Politecnico di Milano; Milan Italy
| | - Alex K. Smith
- Vanderbilt University Institute of Imaging Science; Vanderbilt University; Nashville Tennessee USA
- Department of Biomedical Engineering; Vanderbilt University; Nashville Tennessee USA
| | - Seth A. Smith
- Vanderbilt University Institute of Imaging Science; Vanderbilt University; Nashville Tennessee USA
- Department of Biomedical Engineering; Vanderbilt University; Nashville Tennessee USA
- Department of Radiology and Radiological Sciences; Vanderbilt University; Nashville Tennessee USA
| | - Luigi Zecca
- Institute of Biomedical Technologies; National Research Council of Italy; Segrate Italy
| | - Antonella Costa
- Department of Neuroradiology; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico; Milan Italy
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27
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Isaias IU, Trujillo P, Summers P, Marotta G, Mainardi L, Pezzoli G, Zecca L, Costa A. Neuromelanin Imaging and Dopaminergic Loss in Parkinson's Disease. Front Aging Neurosci 2016; 8:196. [PMID: 27597825 PMCID: PMC4992725 DOI: 10.3389/fnagi.2016.00196] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 08/02/2016] [Indexed: 11/18/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder in which the major pathologic substrate is a loss of dopaminergic neurons from the substantia nigra. Our main objective was to determine the correspondence between changes in the substantia nigra, evident in neuromelanin and iron sensitive magnetic resonance imaging (MRI), and dopaminergic striatal innervation loss in patients with PD. Eighteen patients and 18 healthy control subjects were included in the study. Using neuromelanin-MRI, we measured the volume of the substantia nigra and the contrast-to-noise-ratio between substantia nigra and a background region. The apparent transverse relaxation rate and magnetic susceptibility of the substantia nigra were calculated from dual-echo MRI. Striatal dopaminergic innervation was measured as density of dopamine transporter (DAT) by means of single-photon emission computed tomography and [123I] N-ω-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) tropane. Patients showed a reduced volume of the substantia nigra and contrast-to-noise-ratio and both positively correlated with the corresponding striatal DAT density. The apparent transverse relaxation rate and magnetic susceptibility values of the substantia nigra did not differ between patients and healthy controls. The best predictor of DAT reduction was the volume of the substantia nigra. Clinical and imaging correlations were also investigated for the locus coeruleus. Our results suggest that neuromelanin-MRI can be used for quantifying substantia nigra pathology in PD where it closely correlates with dopaminergic striatal innervation loss. Longitudinal studies should further explore the role of Neuromelanin-MRI as an imaging biomarker of PD, especially for subjects at risk of developing the disease.
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Affiliation(s)
- Ioannis U Isaias
- Department of Neurology, University Hospital WuerzburgWürzburg, Germany; Centro Parkinson, Pini-CTOMilan, Italy
| | - Paula Trujillo
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilan, Italy; Department of Electronics, Information and Bioengineering, Politecnico di MilanoMilan, Italy
| | - Paul Summers
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy
| | - Giorgio Marotta
- Department of Nuclear Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy
| | - Luca Mainardi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano Milan, Italy
| | | | - Luigi Zecca
- Italian National Research Council, Institute of Biomedical Technologies Segrate, Italy
| | - Antonella Costa
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy
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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. Annu Int Conf IEEE Eng Med Biol Soc 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] [What about the content of this article? (0)] [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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29
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Waliszewski SM, Infanzon RM, Arroyo SG, Pietrini RV, Carvajal O, Trujillo P, Hayward-Jones PM. Persistent organochlorine pesticides levels in blood serum lipids in women bearing babies with undescended testis. Bull Environ Contam Toxicol 2005; 75:952-9. [PMID: 16400584 DOI: 10.1007/s00128-005-0842-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Accepted: 08/16/2005] [Indexed: 05/06/2023]
Affiliation(s)
- S M Waliszewski
- Institute of Forensic Medicine, University of Veracruz, SS Juan Pablo II s/n, Boca del Rio, Mexico
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30
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Waliszewski SM, Bermudez MT, Infanzon RM, Silva CS, Carvajal O, Trujillo P, Gomez Arroyo S, Villalobos Pietrini R, Saldaña VA, Melo G, Esquivel S, Castro F, Ocampo H, Torres J, Hayward-Jones PM. Persistent organochlorine pesticide levels in breast adipose tissue in women with malignant and benign breast tumors. Bull Environ Contam Toxicol 2005; 75:752-9. [PMID: 16400557 DOI: 10.1007/s00128-005-0815-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2005] [Accepted: 07/22/2005] [Indexed: 05/06/2023]
Affiliation(s)
- S M Waliszewski
- Institute of Forensic Medicine, University of Veracruz, and the Mexican Institute of Social Security (IMSS Hospital), Veracruz, Mexico
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31
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Waliszewski SM, Carvajal O, Infanzon RM, Trujillo P, Hart MM. Copartition ratios of persistent organochlorine pesticides between human adipose tissue and blood serum lipids. Bull Environ Contam Toxicol 2004; 73:732-738. [PMID: 15389340 DOI: 10.1007/s00128-004-0487-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- S M Waliszewski
- Institute of Forensic Medicine, University of Veracruz, SS Juan Pablo II s/n, Boca del Río, Veracruz C.P. 94290, Mexico
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Waliszewski SM, Gomez-Arroyo S, Infanzon RM, Carvajal O, Villalobos-Pietrini R, Trujillo P, Maxwell M. Persistent organochlorine pesticide levels in bovine fat from Mexico. ACTA ACUST UNITED AC 2004; 21:774-80. [PMID: 15370828 DOI: 10.1080/02652030410001712736] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Organochlorine pesticides have been used in Mexico in agriculture as a seed dresser, in sanitation, in malaria control programmes and in livestock to combat ectoparasites. The pesticides applied drift to areas where cattle graze and plants grow. Because of their chemical stability, they accumulate in the lipid-rich tissues of the body. In the body, they circulate throughout all compartments and accumulate in adipose fat. The aim was to monitor the organochlorine pesticide levels in bovine muscle fat and kidney fat from cows living in an endemic malaria zone, where the environmental contamination can be suspected as being higher. Two hundred samples (100 muscle fat, 100 kidney fat) were analysed by gas chromatography. From the pesticides, only hexachlorobenzene (HCB), beta-hexachlorocyclohexane (HCH), gamma-HCH, pp'-1.1.1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT), op'-DDT and pp'-DDE, were detected frequently and at levels above the detection limits. The HCB mean level was low at 0.009 mg kg(-1) on a fat basis. From the HCH isomers, beta-HCH mean concentration was 0.039 mg kg(-1) and gamma-HCH was 0.025 mg kg(-1) on a fat basis. Among DDTs, pp'-DDT was the major constituent (0.032 mg kg(-1) on a fat basis) followed by pp'-DDE (0.025 mg kg(-1) on a fat basis) and op'-DDT (0.023 mg kg(-1) on a fat basis). The DDT total (sigma DDT) level was 0.067 mg kg(-1) on a fat basis. Comparing the previous study (1994) and the present one (2002-03), organochlorine pesticide levels were decreased. HCB decreased 3.7 times from 0.033 to 0.009 mg kg(-1) on a fat basis; beta-HCH decreased 3.8 times from 0.149 to 0.039 mg kg(-1) on a fat basis; pp'-DDE did not reveal a significant difference at 0.026 versus 0.025 mg kg(-1) on a fat basis. However, pp'-DDT decreased substantially, 6.7 times from 0.215 to 0.032 mg kg(-1) on a fat basis. The DDT total decreased 3.5 times from 0.236 to 0.067 mg kg(-1) on a fat basis. The tendency for reduced concentrations in organochlorine pesticide levels in Mexican cows is caused by their substitution with pyrethroids used in agriculture and by the Mexican Ministry of Health in sanitary programmes.
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Affiliation(s)
- S M Waliszewski
- Institute of Forensic Medicine, University of Veracruz, SS Juan Pablo II s/n, 94290-Boca del Río, Veracruz, Mexico.
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Donoso A, Molina P, Trujillo P, Vásquez C, Díaz V. [Cognitive stimulation workshops in old age: preliminary experience]. Rev Med Chil 1999; 127:319-22. [PMID: 10436716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
OBJECTIVE To test the utility of cognitive stimulation in a group of healthy older people. DESIGN A pilot study in 11 healthy women from Conchali council. All of them were evaluated before and after stimulation using Minimental State Examination of Folstein (MM), Memory Wechsler Scale (MW) and Geriatric Depression Scale (GDS). PARTICIPANTS Were selected from a group of regularly participants in center for seniors, aged 60 years or more (mean 66.6 years old), able to read and write (mean scholarship 5.3 years). INTERVENTION 16 workshop of 90 minutes, twice a week during 2 months. They had motivation pantomime plays, memory activities and so on. RESULTS Wilcoxon signed rank pre and post workshop for MM was -2.633 (p = 0.008), for MW was -2.938 (p = 0.003) and for GDS was -2.943 (p = 0.03). CONCLUSIONS Cognitive stimulation could be useful in older people. It is necessary to increase the sample.
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Affiliation(s)
- A Donoso
- Departamento de Neurología y Neurocirugía, Hospital Clínico de la Universidad de Chile
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34
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Ntshaykolo B, Trujillo P, Bussone M. [Giant retroperitoneal lipoma]. J Chir (Paris) 1996; 133:148-9. [PMID: 8763581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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35
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Trujillo P, Bussone M, Besnard M, Nauzyciel M. [Umbilical fistula through the urachal sinus, a cause of omphalitis]. Presse Med 1994; 23:49. [PMID: 8127817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Trujillo P, Stein P, Campbell E. The preservation and storage of urine samples for the determination of mercury. Am Ind Hyg Assoc J 1974; 35:257-61. [PMID: 4831030 DOI: 10.1080/0002889748507031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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