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MRI Signal Intensity and Parkinsonism in Manganese-Exposed Workers

Susan R Criswell1, Susan Searles Nielsen, Mark N Warden

  • 1Department of Neurology, Washington University School of Medicine, St. Louis, Missouri (Dr Criswell, Dr Nielsen, Mr Warden, Mr Flores, Mr Lenox-Krug, Ms Racette, and Dr Racette); Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Seattle, Washington (Dr Sheppard); Department of Biostatistics, University of Washington, School of Public Health, Seattle, Washington (Dr Sheppard); Department of Family Medicine and Public Health, UC San Diego School of Medicine, La Jolla, California (Dr Checkoway); Department of Neurosciences, UC San Diego School of Medicine, La Jolla, California (Dr Checkoway); School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa (Dr Racette).

Journal of Occupational and Environmental Medicine
|July 27, 2019
PubMed
Abstract

Insights

T1-weighted MRI can measure manganese (Mn) exposure in workers. Higher Mn exposure and pallidal index (PI) on MRI scans correlate with increased parkinsonism symptoms.

Area of Science:

  • Neuroimaging
  • Occupational Health
  • Toxicology

Background:

  • Manganese (Mn) exposure can lead to neurotoxicity.
  • T1-weighted brain MRI offers a noninvasive method to assess Mn exposure.
  • The basal ganglia are particularly susceptible to Mn toxicity.

Purpose of the Study:

  • To investigate the association between occupational manganese exposure and T1-weighted MRI signals in the basal ganglia.
  • To determine if MRI-based measures can serve as biomarkers for Mn neurotoxicity and parkinsonism.

Main Methods:

  • Acquired T1-weighted MRI scans from Mn-exposed workers and nonexposed controls.
  • Calculated T1-weighted intensity indices (pallidal index - PI) for basal ganglia regions.
  • Estimated cumulative Mn exposure and assessed parkinsonism using the Unified Parkinson's Disease Rating Scale motor subsection 3 (UPDRS3).

Main Results:

  • A positive dose-response relationship was found between cumulative Mn exposure and the pallidal index (PI).
  • The PI showed a positive association with UPDRS3 scores, indicating increased parkinsonism severity.
  • T1-weighted MRI signals in the basal ganglia reflect Mn exposure levels.

Conclusions:

  • T1-weighted MRI of the basal ganglia is a valuable tool for assessing occupational manganese exposure.
  • The pallidal signal on MRI is linked to both Mn exposure and the clinical severity of parkinsonism.
  • This imaging technique may aid in early detection and monitoring of Mn-induced neurotoxicity.

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