E09 Magnetic resonance imaging visual analysis of neuromelanin and nigrosome-1 for the assessment of striatonigral disfunction in huntington’s disease

Carla Guerreiro, L. Guedes, Madalena Rosário, G. Galati, David Berhanu, R. Simões, J. Ferreira, S. Reimão
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Abstract

Background Nigrostriatal dopaminergic neuron degeneration with loss of Substantia Nigra (SN) and Locus Coeruleus (LC) neurons, as well as disruption of iron homeostasis, have been reported in Huntington’s Disease (HD), but literature is still scarce. Recently developed magnetic resonance imaging (MRI) biomarkers, such as neuromelanin-sensitive MRI (NM-MRI) and Nigrosome-1 (N1) visualization on susceptibility-weighted imaging (SWI), permit in vivo evaluation of changes in NM containing neurons of the SN and LC and in iron deposition. Aim The aim of this study was to use these novel MRI methods to further clarify SN and LC involvement in HD, through visual analysis. Methods Cross-sectional comparative study analyzing NM and N1 in HD patients and healthy controls (HC). Visual analysis of the SN and LC NM and of the N1 was performed. Fisher’s exact test was used to compare visual analysis ratings between groups. Additionally, SN NM area was obtained using semi-automatic segmentation and median area was used for non-parametric analysis. Results Twelve HD patients and 13 HC were included. LC and SN NM signal intensity were found to be consistently reduced in HD. Visual and semi-quantitative analysis of the SN-NM area did not show significant differences between the groups. No significant differences were found in the analysis of the N1. Conclusions Reduction of LC and SN NM signal on NM-MRI corroborates previous neuropathological findings suggesting striatonigral dysfunction in symptomatic HD patients. Our results suggest that visual analysis may be useful for the evaluation of NM-MRI and N1 in HD patients in clinical settings.
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神经黑色素和黑素体-1的磁共振成像视觉分析评估亨廷顿病纹状体功能障碍
黑质纹状体多巴胺能神经元变性伴黑质(SN)和蓝斑(LC)神经元丧失,以及铁稳态破坏,已在亨廷顿病(HD)中报道,但文献仍然很少。最近开发的磁共振成像(MRI)生物标志物,如神经黑色素敏感MRI (NM-MRI)和黑素体-1 (N1)在敏感性加权成像(SWI)上的可视化,允许在体内评估SN和LC中含有NM的神经元和铁沉积的变化。目的本研究的目的是利用这些新的MRI方法,通过视觉分析进一步阐明HD的SN和LC受累情况。方法对HD患者和健康对照(HC)的NM和N1进行横断面比较研究。对SN、LC NM和N1进行了目测分析。采用Fisher精确检验比较各组间的视觉分析评分。采用半自动分割得到SN NM区域,采用中值区域进行非参数分析。结果12例HD, 13例HC。LC和SN NM信号强度在HD中一致降低。视觉和半定量分析显示,两组间SN-NM区无显著差异。在N1的分析中没有发现显著差异。结论NM- mri上LC和SN NM信号的减少证实了先前的神经病理学发现,提示有症状的HD患者存在纹状核功能障碍。我们的研究结果表明,视觉分析可能有助于在临床环境中评估HD患者的NM-MRI和N1。
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