Application of Neuromelanin <scp>MR</scp> Imaging in Parkinson Disease

He, Naying; Chen, Yongsheng; LeWitt, Peter A.; Yan, Fuhua; Haacke, E. Mark

doi:10.1002/jmri.28414

Cited by 23 publications

(19 citation statements)

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“…To the best of our knowledge, we have presented the first, fully-automatic method for the segmentation of N1, which is a very promising biomarker for the early diagnosis of PD (Chau et al, 2020;Cheng et al, 2020;He et al, 2021He et al, , 2022Jokar et al, 2023). Indeed, recent studies have shown the potential of the N1 sign as a PD biomarker, as the loss of this sign has been associated with higher iron content in that area (Cheng et al, 2020), and PD patients with the highest iron content usually present bilateral loss of the N1 sign (He et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…We acknowledge some limitations in our study. Currently, most studies aiming at quantifying iron content through MRI utilize quantitative susceptibility mapping (QSM) rather than SWI (He et al, 2022). QSM models each voxel so that its intensity correlates with a physiological .…”

Section: Discussionmentioning

confidence: 99%

“…The fact that N1 is suffering the loss of dopaminergic neurons in PD long before any clinical symptoms are developed makes it a promising potential biomarker for early PD diagnosis (Damier et al, 1999b). The disappearance of the N1 sign in PD has been associated with the loss of dopaminergic NM-rich neurons and increased iron deposition in the lateral-ventral region of the SNc (Blazejewska et al, 2013;He et al, 2022;Huddleston et al, 2017;Jin et al, 2019; . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Introductionmentioning

confidence: 99%

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Automatic segmentation and quantification of nigrosome-1 neuromelanin and iron in MRI: a candidate biomarker for Parkinson’s disease

Ariz

Martínez

Álvarez

et al. 2023

Preprint

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The dopaminergic neuronal loss in the substantia nigra pars compacta (SNc) has been related to a reduction of neuromelanin (NM) and accumulation of iron in the nigrosome-1 (N1) in Parkinson's disease (PD). This suggests that N1 degeneration could be a promising early biomarker of PD. To date, only qualitative visual scales have been used to assess its degeneration in iron-sensitive images. Here we present the first fully-automatic method for the quantification of NM and iron content in the N1. Our method uses a multi-image atlas populated with healthy N1 structures that implements a customised label fusion strategy to segment the N1. NM-MRI and susceptibility-weighted images (SWI) of 71 PD patients and 30 healthy controls (HCs) were used in the study. Our quantification showed that N1's NM content was reduced and the iron content increased in PD patients compared with HCs. ROC analyses showed the high diagnostic potential of N1, and revealed that the N1 alone was more sensitive than the entire SNc to detect abnormal iron accumulations in PD patients. Multi-parametric binary logistic regression showed that computer-assisted diagnosis methods could benefit from the segmentation of the N1 to boost their performance. A significant correlation was also found between most N1 image parameters and both disease duration and the motor status scored with the Unified Parkinson's disease rating scale part III (UDPRS-III), suggesting a NM reduction along with an iron accumulation in N1 as the disease progresses. In addition, voxel-wise analyses revealed that this association was stronger for the N1 than for the entire SNc, highlighting the benefits of an accurate segmentation of the N1 to monitor disease course.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Automatic segmentation and quantification of nigrosome-1 neuromelanin and iron in MRI: a candidate biomarker for Parkinson’s disease

Ariz

Martínez

Álvarez

et al. 2023

Preprint

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“…This study was based on magnetic sensitivity-weighted imaging (SWI), which has highly sensitive for detecting iron deposition area and its scope ( 7 ). Neuromelanin magnetic resonance imaging (NM-MRI) can better show the distribution of neuromelanin in the substantia nigra ( 8 , 9 ), and T2 * mapping can be used to quantify iron deposition ( 10 ). In this study, these three sequences were fused in pairs, and the substantia nigra was divided into the upper, middle, and lower regions for analysis and comparison.…”

Section: Introductionmentioning

confidence: 99%

Application value of multiparametric MRI for evaluating iron deposition in the substantia nigra in Parkinson's disease

Cao

Huang²,

Tang³

et al. 2023

Front. Neurol.

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ObjectiveThis study aimed to investigate the application value of multi-parametric magnetic resonance imaging (MRI) in the diagnosis of iron deposition in the substantia nigra dense zone in Parkinson's disease (PD) and to evaluate the diagnostic value of the correlation among multi-parametric imaging indicators, clinical stage, and disease duration.Materials and methodsThirty-six patients with clinically confirmed PD and 36 healthy controls were enrolled. The disease course was recorded, and PD severity was graded using the Hoehn–Yahr (H–Y) scale. All subjects underwent magnetic sensitivity weighted imaging (SWI), neuromelanin magnetic resonance imaging (NM-MRI), and a T2*mapping sequence. Based on the fusion of the NM-MRI and SWI amplitude maps, phase maps, and T2*MAPPING value maps, NM-MRI was used to delineate the dense zone of the substantia nigra, which was divided into three sub-regions: upper, middle, and lower. In this way, the amplitude, phase, and R2* values of each sub-region and the average value of the sum of the three sub-regions were obtained simultaneously in the SWI amplitude, phase, and T2*MAPPING maps. The multi-parameter imaging indices were compared between the two groups, and the correlation between them and clinical indices was evaluated in the PD group.ResultsThe upper (amplitude, phase value, R2* value), middle, and lower (amplitude) right substantia nigra compact zones were significantly different between the PD and control groups. The upper (phase value, R2* value) and middle (amplitude) areas of the left substantia nigra compact zone were also significantly different between the two groups (all P < 0.05). The mean values (amplitude, phase value, R2* value) of the right substantia nigra densification zone and the mean values (phase value) of the left substantia nigra densification zone were also significantly different (all P < 0.05). Amplitudes in the middle and lower parts of the right substantia nigra dense zone were negatively correlated with the H–Y grade (middle: r = −0.475, P = 0.003; lower: r = −0.331, P = 0.049). Amplitudes of the middle and lower parts of the dense zone of the left substantia nigra were negatively correlated with the H–Y grade (middle: r = −0.342, P = 0.041; lower: r = −0.399, P = 0.016). The average amplitude of the right substantia nigra compact zone was negatively correlated with the H–Y grade (r = −0.367, P = 0.027). The average R2* value of the compact zone of the left substantia nigra was positively correlated with the H–Y grade (r = 0.345, P = 0.040).ConclusionMultiparametric MRI sequence examination has application value in the evaluation of iron deposition in the dense zone of the substantia nigra in PD. Combined with NM-MRI, fusion analysis is beneficial for accurately locating the substantia nigra compact zone and quantitatively analyzing the iron deposition in different sub-regions. Quantitative iron deposition in the middle and lower parts of the substantia nigra dense zone may become an imaging biological indicator for early diagnosis, severity evaluation, and follow-up evaluation of PD and is thus conducive for clinical diagnosis and treatment evaluation.

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With great interest, I read the review article by He et al 1 As cited in page 8, we showed 2 that the contrast of "the locus ceruleus (LC) is associated with high water content." This observation of longer T1 and higher proton density in LC than in adjacent brain regions was confirmed by the authors as well.

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confidence: 99%