Chi-Hyeon Yoo1, Nisha Rani1, Frederick Bagdasarian1, Sarah Reid1, Changning Wang1, and Hsiao-Ying Wey1
1Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
Synopsis
The goal of this study was to investigate
relationship between hemodynamic responses and underlying neurochemistry targeting
cannabinoid receptor 1 (CB1R) in response to the injection of rimonabant in non-human
primates using simultaneous positron emission tomography (PET) and function
magnetic resonance imaging (fMRI). Following the rimonabant injection, fast and
slow hemodynamic responses were identified throughout the brain. The CB1R occupancy
estimates suggested that the radiotracer binding to CB1R was blocked by rimonabant
highly in cerebellum and several brain regions. Future PET/fMRI studies with other
CB1R-agonists/antagonists and more accurate occupancy estimates will provide further
understanding about neurovascular coupling to CB1R.
Introduction
Simultaneous acquisition of
magnetic resonance image (MRI) and positron emission tomography (PET) has been
used to provide novel insight into brain function.1 Especially, by
utilizing the complementary measures of function MRI (fMRI) and PET, the
molecular basis of the fMRI signal changes evoked by an injection of ligands
for target neuroreceptors can be investigated.2 Cannabinoids have
been used for its potential therapeutic and medicinal properties such as
modulation of the processes of pain, whose effects are mediated by cannabinoid
receptor 1 (CB1R) and 2.3 Despite its potential as a novel treatment
target, cannabis cause negative health implications, such as cachexia,
nausea/vomiting, and spasticity.3 These complicated nature of cannabinoids
highlights deeper understanding of how cannabinoids act in the brain as
important research targets for future development of therapeutically viable cannabinoid-based
drugs. To the best of our knowledge, functional measures of the brain while
modulating CB1R occupancy has not been compared. The goal of this study was to
investigate relationship between hemodynamic responses and underlying neurochemistry,
as measured by changes in receptor occupancy, in response to the injection of
rimonabant (CB1R inverse agonist) in NHPs. Materials and Methods
PET and
MRI image of the NHP brain (n = 2) were acquired with a 3T Siemens TIM-Trio
with a BrainPET insert using a custom 8-channel array coil. A high-resolution
anatomical scan was obtained by using multi-echo MPRAGE sequence (TR = 2530 ms,
TE1/TE2/TE3/TE4 = 1.64/3.5/5.36/7.22 ms, TI = 1200 ms, flip angle = 7°, and 1
mm isotropic). To improve sensitivity of fMRI, ferumoxytol was employed to
measure cerebral blood volume (CBV)-weighted fMRI was used. Functional scan
using multislice echo-planar imaging sequence (TR = 3000 ms, TE = 22 ms, flip
angle = 90°, and 1.3 mm isotropic) was acquired for ~110 min with rimonabant (1
and 3 mg/kg) injection during the fMRI scan. Dynamic PET data were acquired
from the NHPs using the predetermined bolus-plus-infusion (BI) protocol with
bolus injection of ~250 MBq, constant infusion of ~160 MBq of [11C]OMAR radiotracer
and stored in list mode for 100 min. Functional MR images were motion
corrected, brain extracted, and affine registered to the INIA19 template.4
To calculate the percentage CBV change (%CBV), a baseline functional scan of ~5
min was separately acquired when ferumoxytol was administered intravenously at
10 mg/kg. The anatomical MRI was masked by a PET-derived binary mask of body contour,
bias-corrected and intensity-normalized, and brain extracted. The dynamic PET
images were reconstructed using the 3D-OSEM algorithm into the identical
intervals with detector efficiency, decay, dead time, AC, and scatter
corrections. Reconstructed PET image was registered to INIA19 template using
the preprocessed anatomical MR image. For a region-based comparison, 17 gray
matter, 1 cerebellum, 1 white matter, 1 whole brain regions of interest (ROIs)
obtained from the INIA19 template. For the region-, and voxel-based analysis of
fMRI, the %CBV change map was calculated using the GLM toolbox of the Fastmap
software, as described in the previous studies.5,6 To assess the
CB1R occupancy, the percentage occupancy (%Occ) map was calculated by dividing
the difference between average uptake of before (0-40 min) and after challenge
(60-100 min) by that of the average uptake of before challenge. Results
Figure 1 illustrates representative anatomical and baseline fMR
images and the INIA19 template used in this study, and PET image overlaid with the
template. Figure 2 shows the %CBV change maps and time-courses of the percentage
fMRI signal change (drift corrected) from two representative ROIs from the NHPs
after injecting (a) 1 mg/kg and (b) 3 mg/kg of rimonabant. Figure 3
demonstrates the %Occ maps and time-courses of
the PET signal change induced by (a) 1
mg/kg and (b) 3 mg/kg of rimonabant. The summary of region-based analysis of the
%CBV change fitted by the (a) fast and (b) slow response, and (c) %Occ for all
ROIs was listed in Figure 4.Discussion and Conclusion
In
this study, we compared the hemodynamic responses and CB1R
occupancy in the NHP brains following the rimonabant injection, spatially and
temporally using simultaneous PET/fMRI. Following the rimonabant injection, fast
and slow hemodynamic responses were identified from the fMRI signal change
throughout the brain. The %CBV change maps were computed by using these fast
and slow response regressors. Excepting cerebellum, initial short increase of %CBV
was followed by long decrease of %CBV. Interestingly, cerebellum showed
opposite %CBV change for the fast response. After the challenge, the PET uptake
began to decrease most obviously in cerebellum. The CB1R occupancy estimates
showed that the radiotracer binding to CB1R was blocked by rimonabant highly in
cerebellum and several brain regions. By comparing the %CBV change and %Occ, we found interesting results that
the %CBV change and %Occ are inconsistent in thalamus, and cerebellum, showing
the highest CB1R occupancy, had opposite %CBV change compared to other regions
of brain for the fast response. Few limitations of this study,
such as only single antagonist was used or the occupancy was not estimated from
the binding potential, hindered further explanation of these observations. However,
future PET/fMRI studies with other CB1R agonists/antagonists with different
dose and more accurate occupancy estimates using the binding potential are
expected to provide further understanding. Acknowledgements
No acknowledgement found.References
- Quick HH. Integrated PET/MR. J
Magn Reson Imaging. 2014;39(2):243-58. doi: 10.1002/jmri.24523.
- Sander CY, Hooker JM, Catana
C, Normandin MD, Alpert NM, Knudsen GM, Vanduffel W, Rosen BR, Mandeville JB.
Neurovascular coupling to D2/D3 dopamine receptor occupancy using simultaneous
PET/functional MRI. Proc Natl Acad Sci U S A. 2013;110(27):11169-74. doi:
10.1073/pnas.1220512110.
- Page RL 2nd, Allen LA, Kloner
RA, Carriker CR, Martel C, Morris AA, Piano MR, Rana JS, Saucedo JF; American
Heart Association Clinical Pharmacology Committee and Heart Failure and
Transplantation Committee of the Council on Clinical Cardiology; Council on
Basic Cardiovascular Sciences; Council on Cardiovascular and Stroke Nursing;
Council on Epidemiology and Prevention; Council on Lifestyle and
Cardiometabolic Health; and Council on Quality of Care and Outcomes Research.
Medical Marijuana, Recreational Cannabis, and Cardiovascular Health: A
Scientific Statement From the American Heart Association. Circulation. 2020 Sep
8;142(10):e131-e152. doi: 10.1161/CIR.0000000000000883.
- Rohlfing T, Kroenke CD,
Sullivan EV, Dubach MF, Bowden DM, Grant KA, Pfefferbaum A. The INIA19 Template
and NeuroMaps Atlas for Primate Brain Image Parcellation and Spatial Normalization.
Front Neuroinform. 2012;6:27. doi: 10.3389/fninf.2012.00027.
- Mandeville JB. IRON fMRI
measurements of CBV and implications for BOLD signal. Neuroimage. 2012;62(2):1000-8.
doi: 10.1016/j.neuroimage.2012.01.070.
- Liu CH, Greve DN, Dai G,
Marota JJ, Mandeville JB. Remifentanil administration reveals biphasic phMRI
temporal responses in rat consistent with dynamic receptor regulation.
Neuroimage. 2007;34(3):1042-53. doi: 10.1016/j.neuroimage.2006.10.028.