This pilot study on manganese (Mn) neurotoxicity investigates the association between deficits in response selection and GABA and Glx levels in basal ganglia structures using MEGA-LASER 3D MRSI. Using a novel automated brain-structure-specific quantification approach for GABA+ and Glx, we studied three basal ganglia structures and the thalamus in Mn-exposed welders and controls. A modified Simon task was used to measure selection inhibition. GABA+ and Glx in putamen and globus pallidus were associated with response times in the most complicated experimental scenario in Mn-exposed subjects; whereas thalamic Glx levels were associated with response time for all subjects.
10 male welders (airborne [Mn]=0.11±0.01 mg/m3) and 9 age-matched male controls were recruited for the study. All the MRI/MRSI scans were performed on a Siemens 3T Tim Trio scanner with a 32-channel head coil. MPRAGE images were acquired for anatomical information. The volume of interest (VOI) of the MRSI acquisition (TR/TE=1600/68ms, acquisition resolution:14x14x14mm3,TA:19:44 min) was placed on the basal ganglia region including the thalamus. Metabolite quantification was performed using LCModel V6.3-1B6. GABA+, representing GABA and co-edited macromolecules, and glutamate+glutamine (Glx) quantified from difference spectra were normalized to total creatine (tCr) from edit-off spectra. Metabolite maps were generated using a Matlab-based (MathWorks,Inc.,Natick,MA,USA) package4 and interpolated and registered to MPRAGE images. MPRAGE images were processed with Freesurfer7,8 to segment the brain and generate structural masks of four basal ganglia structures: thalamus, caudate, putamen and globus pallidus. After registering the masks to the metabolite maps (Fig.1a), the mean GABA+/tCr and Glx/tCr for each brain structure was calculated. A modified Simon task5 was used to measure selection inhibition. The design of the experimental paradigm is displayed in Fig.1a. The subjects were asked to respond to the stimulus from each trial as fast and as accurately as possible. The positions of the left and right hands were either parallel to each other, or crossed. All types of stimuli and the corresponding definition of ‘correspondent’ and ‘non-correspondent’ trials are shown in Fig.1b. For each subject, mean response time (RT) was calculated for correct responses for the following four cases: correspondent and non-correspondent trials, each with parallel-hands and crossed-hands. Group differences between welders and controls in GABA+/tCr and Glx/tCr from both sides of the 4 brain regions, and in 4 types of RTs were tested using the Kruskal Wallis test. Age-controlled correlation between RTs and GABA+/tCr, as well as Glx/tCr was performed for welders and all subjects to investigate whether the relationship is specific to Mn-exposed welders. FDR correction for multiple comparisons with q-value of 0.1 was applied for all statistical analyses (SAS9.3(2011,SAS Institute Inc.,Cary,NC,USA))
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