Susceptibility MRI captures nigral pathology in patients with parkinsonian syndromes

Lewis, Mechelle M.; Du, Guangwei; Baccon, Jennifer; Snyder, A. Peter; Murie, Ben; Cooper, Felicia; Stetter, Christy; Kong, Lan; Sica, Christopher T.; Mailman, Richard B.; Connor, James R.; Huang, Xuemei

doi:10.1002/mds.27381

Cited by 44 publications

(41 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The fact that R2* changes in the SNc persisted even after adjusting for QSM suggests that R2* may capture, in addition to iron, the complex microstructural changes occurring during PD progression. Consistent with this, Lewis et al demonstrated that R2* also may reflect α‐synuclein and possibly neuronal cell loss in the SN.…”

Section: Discussionmentioning

confidence: 67%

“…In recent years, both R2* and the newer quantitative susceptibility mapping (QSM) measures have been used to estimate iron content in brain tissue, with the latter reported to be more sensitive . Of the 2 sequences, Lewis et al confirms that in vivo QSM correlates better with iron content in postmortem brain tissue, whereas R2* may also capture other aspects of PD‐related pathology, such as α‐synuclein and possibly neuronal cell loss, in addition to tissue iron content. Several cross‐sectional studies have demonstrated higher R2* and QSM in the SN of PD patients and fueled enthusiasm for using these susceptibility MRI metrics to gauge PD progression.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Distinct progression pattern of susceptibility MRI in the substantia nigra of Parkinson's patients

Lewis

Sica

et al. 2018

Movement Disorders

Self Cite

View full text Add to dashboard Cite

Susceptibility MRI revealed distinct patterns of PD progression in the substantia nigra pars compacta and substantia nigra pars reticulata. The different patterns are particularly clear in later-stage patients. These findings may resolve past controversies and have implications in the pathophysiological processes during PD progression. © 2018 International Parkinson and Movement Disorder Society.

show abstract

Section: Discussionmentioning

confidence: 67%

mentioning

confidence: 99%

Distinct progression pattern of susceptibility MRI in the substantia nigra of Parkinson's patients

Lewis

Sica

et al. 2018

Movement Disorders

Self Cite

View full text Add to dashboard Cite

show abstract

“…29 In a recent autopsy cohort of 14 subjects, we found non-movement disorder specialists can predict pathology in less than 50% of cases. 30 There is a clear need for an early detection marker in PD patients that has high accuracy and translational value. The current best marker is proposed by Nalls et al, 31 who used a combination of clinical and genetic information and found an AUC=0.926 for classifying PD patients from controls.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance T1w/T2w ratio: A parsimonious marker for Parkinson disease

Lewis

Sica

et al. 2018

Annals of Neurology

Self Cite

View full text Add to dashboard Cite

Objective: Newer MRI techniques have shown promise in capturing early Parkinson’s disease (PD)-related changes in the substantia nigra pars compacta (SNc), the key pathological loci. Their translational value, however, is hindered by technical complexity and inconsistent results. Methods: A novel yet simple MRI contrast, the T1w/T2w ratio, was used to study 76 PD patients and 70 controls. The T1w/T2w ratio maps were analyzed using both voxel-based and region-of-interest approaches in normalized space. The sensitivity and specificity of the SN T1w/T2w ratio in discriminating between PD and controls also were assessed. In addition, its diagnostic performance was tested in a subgroup of PD patients with disease duration ≤2 years (PDE). A second independent cohort of 73 PD and 49 controls was used for validation. Results: Compared to controls, PD patients showed a higher T1w/T2w ratio in both the right (cluster size=164 mm3, p<0.0001) and left (cluster size=213 mm3, p<0.0001) midbrain that was located ventrolateral to the red nucleus and corresponded to the SNc. The region-of-interest approach confirmed the group difference in the SNc T1w/T2w ratio between PD and controls (p<0.0001). The SNc T1w/T2w ratio had high sensitivity (0.908) and specificity (0.80) to separate PD and controls (AUC=0.926), even for PDE patients (AUC=0.901, sensitivity=0.857, specificity=0.857). These results were validated in the second cohort. Interpretation: The T1w/T2w ratio can detect PD-related changes in the SN and may be used as a novel, parsimonious in vivo biomarker for the disease, particularly early stage patients, with high translational value for clinical practice and research.

show abstract

“…Lewis and colleagues provide a unique study to compare susceptibility measurements from a T2*‐weighted multigradient‐echo sequence and pathology from tissue in the same individuals. The authors compared R2* and quantitative susceptibility mapping (QSM) of the SN directly with pathology, including SN cell counts, α‐synuclein, tau, and iron quantification.…”

mentioning

confidence: 95%

“…Three types of biomarkers were investigated that can investigate iron load, neuromelanin content, and microstructural changes using diffusion imaging in the SN. The findings from these articles use different designs and cut across pathological validation and longitudinal progression of MRI iron‐sensitive markers in the SN, the relationship between neuromelanin changes in the SN and brain stem atrophy in PSP, and diffusion changes in a novel at‐risk cohort …”

mentioning

confidence: 99%