Yujian Diao1, Catarina Tristão Pereira2, Carole Poitry-Yamate1, Ting Yin1, Analina Raquel da Silva1, Rolf Gruetter1, and Ileana Ozana Jelescu1
1Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland, 2Faculdade de Ciências da Universidade de Lisboa, Lisbon, Portugal
Synopsis
Impaired
brain glucose consumption is a possible trigger of Alzheimer’s disease (AD).
Animal models can help characterize each contributor to the cascade
independently. Here we report a comprehensive longitudinal study of functional
connectivity, white matter microstructure and brain glucose metabolism using resting-state
fMRI, diffusion MRI and FDG-PET in the intracerebroventricular-streptozotocin
rat model of AD. Our study highlights the dynamics of how brain insulin
resistance affects brain structure and function, and identifies potent
MRI-derived biomarkers to track neurodegeneration in human AD and diabetic
populations.
Introduction
Impaired
brain glucose consumption is a possible trigger of Alzheimer’s disease (AD)1, along with amyloid plaques
and neurofibrillary tangles of tau. It has been shown that brain insulin
resistance can be induced in rats and monkeys by an intracerebroventricular (icv) injection of
streptozotocin (STZ) and several studies have reported AD-like features in
icv-STZ animals2–4.
However, the effects of brain insulin resistance on
neurodegeneration are not fully understood.
Here,
we performed a first-time longitudinal study in the icv-STZ rat model to characterize
alterations in functional connectivity (FC) and white matter (WM)
microstructure using functional and diffusion MRI, and compare them to changes
in brain glucose metabolism using
FDG-PET. Our study highlights the dynamics of how insulin resistance affects
brain structure and function, and identifies potent MRI-derived biomarkers to
track neurodegeneration in human AD and diabetic populations.Methods
All
experiments were approved by the local Service for Veterinary Affairs. Male
Wistar rats (N=17) (236±11
g at baseline) underwent a bilateral icv-injection of either streptozotocin (3
mg/kg, STZ group, N=9) or buffer (CTL group, N=8). MRI: Rats were scanned at 4
timepoints following surgery (Figure 1), on a 14T Varian system. Briefly, rats were anesthetized using isoflurane for initial setup
and switched to medetomidine sedation (bolus: 0.1mg/kg, perfusion: 0.1mg/kg/h).
Resting-state (rs-)fMRI data were acquired using a two-shot gradient-echo EPI
sequence (TE/TR=10/800ms; Matrix: 64x64; FOV: 23x23mm2;
8 1.12-mm slices; 370 repetitions; TA=10’). Diffusion
data were acquired using a PGSE-EPI sequence (4 b=0 and 3 b-shells b=0.8/1.3/2 ms/μm2
with 12/16/30 directions; δ/Δ=4/27ms; TE/TR=48/2500ms, 9 1-mm slices,
FOV=23x17mm2, matrix=128x64). PET: List-mode data were acquired on a
LabPET-4 small-animal scanner (Gamma Medica-Ideas Inc.) following tail vein
delivery of 18FDG (~50MBq) in non-fasted rats. Data between 30 and 50 minutes
post-injection were reconstructed and Standardized Uptake Value (SUV)-normalized
to generate a steady-state image.
Data
processing for rs-fMRI included denoising5, distortion correction6, slice-timing correction, spatial
smoothing7, and removal of physiological noise
following independent component (IC) analysis decomposition8. FC matrices between 28
atlas-based ROIs were computed, co-varying for the global signal. Group
differences at each timepoint were tested using non-parametric permutation
tests (N=5000) with NBS9.
Diffusion
MRI images were denoised10, Gibbs-ringing corrected11 and EDDY-corrected12. Diffusion and kurtosis
tensors were calculated13 and the WMTI-Watson model14 was estimated in WM voxels. Corpus
callosum, cingulum and fimbria were automatically segmented using atlas-based
registration. Average diffusion metrics in each ROI were compared between CTL
and STZ groups using two-tailed t-tests at each timepoint. Within-group
longitudinal changes were assessed using one-way ANOVA and Tukey-Cramer correction.
PET
datasets were registered to their corresponding MRI anatomical image with
cross-correlation15 using ANTs16 and 26 ROIs were segmented. SUV
images were normalized to mean SUV over the brain to correct for inter-rat
experimental variability17. Regional differences in SUV
between STZ and CTL were evaluated using one-tailed t-test (STZ<CTL) at each timepoint.Results
FC was affected in the STZ group
at 2, 13 and 21 weeks, in different spatial patterns (Figure 2). Main hub at 2
and 13 weeks was ACC, with altered connections to regions involved in AD (RSC,
PPC, Hip, Sub) but also to sensory and motor areas (Au, V, S1/S2) and striatum.
The FC alteration at 21 weeks evolved towards the posterior and temporal brain
regions, involving mainly RSC, PPC, MTL, Hip, V and Au, but also motor and
somatosensory cortex. A non-monotonic trend with temporary recovery at 6 weeks
was evident.
WM degeneration was very marked
in the corpus callosum and fimbria of the hippocampus, and more mildly in the
cingulum (Figure 3). White matter modeling improved the characterization of the
damage compared to DTI and suggested the most prominent on-going process was
axonal injury followed by axonal loss. Non-monotonic trends with partial
recovery at 6 weeks were also found.
FDG-PET highlighted reduced SUV
in STZ rats, in a more stable pattern over time (Figure 4). Regions with
reduced SUV broadly agreed with regions of altered FC: ACC, RSC, PPC, MTL, Hip,
Au, V S1/S2 and M. Discussion and Conclusions
FC
was altered in STZ rats in varying spatio-temporal patterns, with early ACC
involvement, temporary recovery at 6 weeks and later posterior/temporal
involvement. WM degeneration agreed with changes in FC, with marked acute and
chronic changes in corpus callosum, fimbria and cingulum at 2 and 13 weeks, and
fewer differences at 6 weeks. FDG-PET showed impaired glucose uptake in icv-STZ
rats in regions typically involved in AD, remarkably with most pronounced
differences at 6 weeks. This suggests that the brain may solicit other
forms of energy (e.g. ketone bodies18) to compensate for the lack of
glucose and restore normal FC past the acute phase, which is consistent with
reduced body weight in STZ vs CTL rats (~100g difference). In the chronic phase,
neurodegeneration resumes. The succession of acute change, remission and
chronic degeneration has also been reported in memory performance of icv-STZ
rats2, as well as in
dynamics of several biomarkers of AD19,20. MRI-derived
biomarkers of FC and WM degeneration in animal models of brain insulin
resistance have therefore great potential for the investigation of
neurodegeneration in the context of AD and diabetes.Acknowledgements
The authors thank Mario Lepore and Stefan Mitrea for assistance with animal setup and monitoring. This work was supported by the Centred'Imagerie BioMedicale (CIBM) of the University of Lausanne, the Swiss Federal Institute of Technology Lausanne, the University of Geneva, the CentreHospitalier Universitaire Vaudois and the Hôpitaux Universitaires de Genève.References
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