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Quantitative Analysis of Deep Nuclei in Patients with Parkinson’s disease (PD) using STrategically Acquired Gradient Echo (STAGE) Imaging1Peking Union Medical College Hospital, Bejing, China, 2Peking university first hospital, Bejing, China, 3SpinTech, Inc., Bingham Farms, MI, United States, 4Wayne State University, Detroit, MI, United States
Synopsis
Patients with Parkinson’s disease (PD) showed increased iron deposition in the substantia nigra, red nucleus, dentate nucleus and globus pallidus compared with healthy controls. Besides, the T1 value, T2* value and R2* value of deep nucleus also altered in PD patients. Which suggested the STrategically Acquired Gradient Echo (STAGE) imaging could provide a good performance in quantitative analysis in multi-modal parameters.
Introduction
Parkinson’s disease (PD) is one of the most common neurodegenerative diseases[1].The principal pathogenesis of PD is the loss of dopaminergic neurons in the substantia nigra secondary degenerative changes in the basal ganglia[2]. Cerebral iron plays an important role in physiologic functions, such as the synthesis of neurotransmitters[3]. However excessive iron content would promote apoptosis of neurons due to the iron-related oxidative reaction and neurotoxicity[4]. Therefore investigating iron deposition in deep nuclei is important. Previous studies[5-6] used quantitative susceptibility mapping (QSM ) or R2* MRI to evaluate iron content in deep nuclei. However, these techniques took relatively long scan time. Here, we used STrategically Acquired Gradient Echo (STAGE) imaging which can provide multi-modal parameters simultaneously in a short time, in order to investigate the patterns of QSM, T1 value, T2* value and R2* value of cerebral deep nuclei in patients with PD.Methods
Twenty PD patients (12 males, 66.4 ± 8.5 years, range 53 to 84 years) diagnosed according to the published criteria [7] and ten healthy controls (HCs) (6 males, 67.4 ± 3.2 years, range 63 to 73 years ) were recruited in our study. All subjects underwent STAGE sequence[8-9] scanned on a 3.0T MRI scanner with an 8-channel head coil. Strategically acquired gradient echo (STAGE) imaging includes two fully flow compensated double echo gradient echo acquisition. Data set was collected using two flip angles each with multiple echoes. (The parameters are as the table 1). QSM map, T1 map, T2*map and R2*map were acquired through processing (Figure1). ROIs in the deep gray matter were manually defined based on the reconstructed QSM map including bilateral caudate nucleus (CN), putamen (PUT), globus pallidus (GP), thalamus (TH), substantia nigra(SN), red nucleus(RN) and dentate nucleus (DN)(Figure2). The each ROI in QSM map were copied to T1 map, T2*map and R2*map, and the value of QSM, T1, T2*and R2*of each ROI for each subject were measured and compared between group using a 2-tailed independent sample t-test.Results
PD patients showed significantly increased QSM values in the left SN (68.84± 14.07 vs 46.94± 5.96, p <0.0001), the right SN (71.12±13.9 vs 42.65±9.19, p <0.0001), left RN (60.71±12.78 vs 44.35±8.96, p =0.001), right RN (58.94±12.64 vs 39.72±7.2), right DN (38.99±13.57 vs 28.57±7.21, p = 0.032) and right GP (45.90±11.25 vs 36.73±10.33, p = 0.039) compared to the HCs. The T1 values in the left CN were significantly longer in PD patients than that in HCs (1352.49±65.02 vs 1281.32±89.29, p = 0.019). The R2* values in the left SN (40.77±6=5.91 vs 36.06±2.67, p = 0.024) and the right DN (34.15±6.83 vs 29.44±3.16, p = 0.049) were significantly larger than that in HCs. The T2* values in the left SN (26.36±3.77 vs 29.25±1.77, p = 0.029), right SN (25.94±3.76 vs 30.70±2.07, p = 0.0009), right RN (30.07±3.66 vs 32.87±2.89, p = 0.044) and right DN (31.54±5.72 vs 35.89±3.44, p = 0.036) were significantly shorter than that in HCs.Conclusion
Though STAGE imaging, multi-modal parameters can be obtained simultaneously in a short period of time. PD patients had different pattern of iron accumulation in SN, RN, GP and DN. The T1、T2* and R2*in deep nuclei also altered in PD patients. Especially, the SN and DN may play important roles in the pathology of PD.Summary of Main Findings
STAGE imaging provide a good performance in quantitative analysis in multi-modal parameters of QSM, T1, T2* and R2 in deep nuclei in PD patients.Acknowledgements
The authors would like to thank the subjects who participated in this trial and their families, as well as the staff at all investigational sites.References
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