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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Neurologic manifestations in welders with pallidal MRI T1 hyperintensity
K A Josephs1, J E Ahlskog, K J Klos
1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. josephs.keith@mayo.edu
Neurology
|May 13, 2005
Summary
Welding fumes can cause manganese neurotoxicity, leading to parkinsonism and cognitive issues. Magnetic resonance imaging (MRI) shows basal ganglia T1 hyperintensity, a marker of manganese accumulation in welders lacking proper protection.
Area of Science:
- Neurology
- Occupational Health
- Toxicology
Background:
- Neurologic symptoms are linked to manganese fumes from welding.
- Increased T1 MRI signal in basal ganglia indicates manganese accumulation.
- Previous studies suggest a link between welding and parkinsonism, often lacking MRI evidence.
Purpose of the Study:
- To describe clinical and neuropsychological features of welders with basal ganglia T1 hyperintensity.
- To diagnose neurotoxicity from welding fumes in affected patients.
Main Methods:
- Review of medical records of welders with neurological problems and basal ganglia T1 hyperintensity.
- Referrals to the Department of Neurology.
Main Results:
- Eight male career welders presented with increased T1 basal ganglia signal on MRI.
- Identified syndromes included parkinsonism, multifocal myoclonus with cognitive impairment, vestibular-auditory dysfunction, and subjective cognitive impairment with anxiety/sleep apnea.
- Neuropsychometric testing indicated subcortical or frontal brain involvement.
- Poor ventilation or lack of respiratory protection was common.
Conclusions:
- Welding without adequate protection is associated with parkinsonism, myoclonus, cognitive impairment, and vestibular-auditory dysfunction.
- Basal ganglia T1 hyperintensity on MRI suggests manganese neurotoxicity as the cause.
