Related Experiment Video
Updated: Jul 12, 2026
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
Background:
Neurologic symptoms have been attributed to manganese fumes generated during welding. Increased T1 MRI signal in the basal ganglia is a biologic marker of manganese accumulation. Recent studies have associated welding and parkinsonism, but generally without MRI corroboration.
Objective:
To characterize the clinical and neuropsychological features of patients with MRI basal ganglia T1 hyperintensity, who were ultimately diagnosed with neurotoxicity from welding fumes.
Methods:
The medical records of welders referred to the Department of Neurology with neurologic problems and basal ganglia T1 hyperintensity were reviewed.
Results:
All eight patients were male career welders with increased T1 basal ganglia signal on MRI of the brain. Several different clinical syndromes were recognized: a parkinsonian syndrome (three patients), a syndrome of multifocal myoclonus and limited cognitive impairment (two patients), a mixed syndrome with vestibular-auditory dysfunction (two patients), and minor subjective cognitive impairment, anxiety, and sleep apnea (one patient). Neuropsychometric testing suggested subcortical or frontal involvement. Inadequate ventilation or lack of personal respiratory protection during welding was a common theme.
Conclusions:
Welding without proper protection was associated with syndromes of parkinsonism, multifocal myoclonus, mild cognitive impairment, and vestibular-auditory dysfunction. The MRI T1 hyperintensity in the basal ganglia suggests that these may have been caused by manganese neurotoxicity.
Insights
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.
