Subthalamic nuclear tissue contrast in inversion recovery MRI decreases with age in medically refractory Parkinson's

Subhendra N Sarkar1, Pooja R Sarkar2, Efstathios Papavassiliou3

  • 1Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215.

Abstract

Insights

Subthalamic nucleus (STN) MRI contrast using FSTIR sequences decreases with age in Parkinson's disease patients, unlike controls. This finding may offer insights into early brain pathology for deep brain stimulation targets.

Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Physics

Background:

  • Subthalamic nucleus (STN) MRI visualization is crucial for deep brain stimulation (DBS) in Parkinson's disease (PD).
  • Current STN MRI boundary depiction is often unreliable, hindering precise stereotactic targeting.

Purpose of the Study:

  • To objectively compare Fast Spin Echo T2 (FSE T2) and Fast Spin Echo Inversion Recovery (FSTIR) MRI sequences.
  • To evaluate STN tissue contrast and its reliability for DBS in refractory PD patients.

Main Methods:

  • 1.5 T MRI scans were acquired from 12 PD and 12 control patients using both FSE T2 and FSTIR sequences.
  • STN signal intensity was normalized using an internal thalamic tissue standard to account for MR contrast variations.
  • Normalized STN contrast was correlated with patient age in both groups.

Main Results:

  • Normalized FSTIR-weighted STN contrast significantly decreased with age in PD patients (Spearman correlation = -0.5).
  • STN contrast remained stable with age in control subjects (Spearman correlation ≈ 0).
  • FSE T2-weighted STN contrast showed minimal age-related changes in both PD and control groups (Spearman correlation ≈ -0.1).

Conclusions:

  • FSTIR MRI sequences reveal an age-dependent trend in normalized STN contrast in Parkinson's disease patients.
  • These findings suggest tissue relaxation-based changes in the STN that may be relevant for understanding early brain pathology in PD.
  • Further studies with larger cohorts are needed to validate these insights for DBS targeting in medically refractory PD.

Related Concept Videos

Parkinson Disease ll: Pathophysiology01:24

Parkinson Disease ll: Pathophysiology

Parkinson disease (PD) is a progressive neurodegenerative disorder primarily affecting movement, with additional non-motor features. Its pathophysiology involves complex interactions among genetic susceptibility, environmental exposures, and cellular dysfunction, including dopaminergic neuron loss, protein aggregation, and mitochondrial impairment.Selective NeurodegenerationA key feature is the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced...
28
Parkinson's Disease: Treatment01:24

Parkinson's Disease: Treatment

Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
1.4K
Parkinson Disease l: Introduction01:24

Parkinson Disease l: Introduction

Parkinson’s disease is a chronic, progressive neurodegenerative disorder that primarily affects movement. It is characterized by motor symptoms such as resting tremors, muscle rigidity, bradykinesia (slowness of movement), and postural instability. Patients may notice hand tremors at rest, stiffness during movement, or a shuffling gait. In addition to motor features, non-motor symptoms include sleep disturbances, mood and behavioral changes, constipation, and cognitive impairment, all of...
28
Neural Regulation01:37

Neural Regulation

Digestion begins with a cephalic phase that prepares the digestive system to receive food. When our brain processes visual or olfactory information about food, it triggers impulses in the cranial nerves innervating the salivary glands and stomach to prepare for food.
34.8K
Parkinson's Disease: Overview01:15

Parkinson's Disease: Overview

Neurodegenerative disorders are progressive diseases that cause irreversible damage and loss to neurons in specific brain areas. Examples of these disorders include Parkinson's disease, Alzheimer's disease, Multiple Sclerosis (MS), and Amyotrophic Lateral Sclerosis (ALS). These disorders share characteristics such as proteinopathies, selective neuronal vulnerability, and a complex interplay between genetic and environmental factors. The primary therapeutic goal for these conditions is...
2.2K
Alterations in Muscle Tone lll01:11

Alterations in Muscle Tone lll

Rigidity and myotonia are distinct abnormalities of muscle tone that affect resistance and relaxation during movement. Although both involve altered muscle contraction, they arise from different neurological and muscular mechanisms.CharacteristicsRigidity is characterized by uniform resistance to passive movement across the entire range, independent of speed, affecting flexors and extensors equally. It may appear as lead-pipe rigidity (smooth, constant resistance) or cogwheel rigidity...
29