Neurodegeneration with brain iron accumulation - clinical syndromes and neuroimaging

Iron participates in a wide array of cellular functions and is essential for normal neural development and physiology. However, if inappropriately managed, the transition metal is capable of generating neurotoxic reactive oxygen species. A number of hereditary conditions perturb body iron homeostasis and some, collectively referred to as neurodegeneration with brain iron accumulation (NBIA), promote pathological deposition of the metal predominantly or exclusively within the central nervous system (CNS). In this article, we discuss seven NBIA disorders with emphasis on the clinical syndromes and neuroimaging. The latter primarily entails magnetic resonance scanning using iron-sensitive sequences. The conditions considered are Friedreich ataxia (FA), pantothenate kinase 2-associated neurodegeneration (PKAN), PLA2G6-associated neurodegeneration (PLAN), FA2H-associated neurodegeneration (FAHN), Kufor-Rakeb disease (KRD), aceruloplasminemia, and neuroferritinopathy. An approach to differential diagnosis and the status of iron chelation therapy for several of these entities are presented. This article is part of a Special Issue entitled: Imaging Brain Aging and Neurodegenerative disease.     

Improved measurement of brain deformation during mild head acceleration using a novel tagged MRI sequence

In vivo measurements of human brain deformation during mild acceleration are needed to help validate computational models of traumatic brain injury and to understand the factors that govern the mechanical response of the brain. Tagged magnetic resonance imaging is a powerful, noninvasive technique to track tissue motion in vivo which has been used to quantify brain deformation in live human subjects. However, these prior studies required from 72 to 144 head rotations to generate deformation data for a single image slice, precluding its use to investigate the entire brain in a single subject. Here, a novel method is introduced that significantly reduces temporal variability in the acquisition and improves the accuracy of displacement estimates. Optimization of the acquisition parameters in a gelatin phantom and three human subjects leads to a reduction in the number of rotations from 72 to 144 to as few as 8 for a single image slice. The ability to estimate accurate, well-resolved, fields of displacement and strain in far fewer repetitions will enable comprehensive studies of acceleration-induced deformation throughout the human brain in vivo.     

超顺磁性氧化铁在吞噬细胞标记和示踪领域的研究进展

超顺磁性氧化铁(SPIO)颗粒在磁共振分子影像中发挥重要作用,SPIO可标记巨噬细胞或其它细胞从而能够追踪标记细胞在体内分布和转化,成为生物医学研究的重要部分。此外,细胞的SPIO标记及示踪可用于肿瘤及炎症诊断、评价及鉴别诊断等多方面。因此,本文汇总近年来SPIO在吞噬细胞标记和示踪领域的研究进展情况,现报道如下。     

功能磁共振和脑电神经成像技术与大脑刺激相结合的研究进展

随着对神经机制问题阐述水平的迅速提高,所应用的神经成像技术、方法及各种工具的复杂程度也在不断提高．一方面是神经成像技术本身的不断发展,另一方面则是大脑直接刺激与神经成像技术同步记录方法的发展．经颅磁刺激-功能磁共振成像同步技术(TMS-fMRI)和经颅磁刺激-脑电技术(TMS-EEG)能为研究大脑网络的功能和有效连通性提供技术手段,该技术在多种认知领域的发展和应用,为神经科学、认知心理学、神经信息学等学科的研究者对人脑的研究开启了多条通道,更加有利于深入地理解人类大脑的工作机制．     

Unraveling of the E-helices and Disruption of 4-Fold Pores Are Associated with Iron Mishandling in a Mutant Ferritin Causing Neurodegeneration

Mutations in the coding sequence of the ferritin light chain (FTL) gene cause a neurodegenerative disease known as neuroferritinopathy or hereditary ferritinopathy, which is characterized by the presence of intracellular inclusion bodies containing the mutant FTL polypeptide and by abnormal accumulation of iron in the brain. Here, we describe the x-ray crystallographic structure and report functional studies of ferritin homopolymers formed from the mutant FTL polypeptide p.Phe167SerfsX26, which has a C terminus that is altered in amino acid sequence and length. The structure was determined and refined to 2.85 Å resolution and was very similar to the wild type between residues Ile-5 and Arg-154. However, instead of the E-helices normally present in wild type ferritin, the C-terminal sequences of all 24 mutant subunits showed substantial amounts of disorder, leading to multiple C-terminal polypeptide conformations and a large disruption of the normally tiny 4-fold axis pores. Functional studies underscored the importance of the mutant C-terminal sequence in iron-induced precipitation and revealed iron mishandling by soluble mutant FTL homopolymers in that only wild type incorporated iron when in direct competition in solution with mutant ferritin. Even without competition, the amount of iron incorporation over the first few minutes differed severalfold. Our data suggest that disruption at the 4-fold pores may lead to direct iron mishandling through attenuated iron incorporation by the soluble form of mutant ferritin and that the disordered C-terminal polypeptides may play a major role in iron-induced precipitation and formation of ferritin inclusion bodies in hereditary ferritinopathy.     

A Slantlet transform based intelligent system for magnetic resonance brain image classification

The present paper proposes the development of a new approach for automated diagnosis, based on classification of magnetic resonance (MR) human brain images. Wavelet transform based methods are a well-known tool for extracting frequency space information from non-stationary signals. In this paper, the proposed method employs an improved version of orthogonal discrete wavelet transform (DWT) for feature extraction, called Slantlet transform, which can especially be useful to provide improved time localization with simultaneous achievement of shorter supports for the filters. For each two-dimensional MR image, we have computed its intensity histogram and Slantlet transform has been applied on this histogram signal. Then a feature vector, for each image, is created by considering the magnitudes of Slantlet transform outputs corresponding to six spatial positions, chosen according to a specific logic. The features hence derived are used to train a neural network based binary classifier, which can automatically infer whether the image is that of a normal brain or a pathological brain, suffering from Alzheimer's disease. An excellent classification ratio of 100% could be achieved for a set of benchmark MR brain images, which was significantly better than the results reported in a very recent research work employing wavelet transform, neural networks and support vector machines.     

Transferrin response in normal and iron-deficient mice heterozygotic for hypotransferrinemia; effects on iron and manganese accumulation

Hypotransferrinemia is a genetic defect in mice resultingin 1% of normal plasma transferrin (Tf) concen-trations;heterozygotes for thismutation (+/hpx) have low circulating Tf concentrations. These mice providea unique opportunity toexamine the developmental pattern and response of Tf to iron-deficient diets, andfurthermore,to address the controversial role of Tf in Mn transport. Twenty-three weanling +/hpx miceandforty-five wild-type BALB/cJ mice were either killed at weaning or fed diets containing either13 or 72 mgkg Fe, and killed after four or eight weeks. Plasma Tfconcentrations were lower in +/hpx mice, plasmaTf nearly doubled and liver Tf was only 50% of normalin response to iron deficiency. Brain iron concen-trationdid not correlate significantlywith either plasma Tf or TIBC. However, iron accumulation into braincontinued with irondeficiency whereas most other organs had less iron. These results imply that eitherthereis a selected targeting of iron to the brain by plasma Tf or there is an alternative irondelivery system tothe brain. Furthermore, we observed no differences in tissuedistribution of Mn despite the differences incirculating Tf concentrationsand body iron stores; this suggests that there are non-Tf dependent mecha-nismsfor Mntransport.     

CT和MRI鉴定腹膜后间隙脂肪肉瘤与组织病理学特征相关

本研究选取2012年1月至2018年1月在我院治疗的腹膜后间隙脂肪肉瘤患者33例,分析患者术前CT、MRI图像及术后病理结果,旨在探讨不同类型腹膜后间隙脂肪肉瘤病理学及影像学特征。研究结果表明:33例患者中术后病理诊断为高分化脂肪肉瘤19例,去分化脂肪肉瘤7例,黏液性脂肪肉瘤7例;不同病理分型脂肪肉瘤病灶大小比较差异无统计学意义(p>0.05);高分化脂肪肉瘤其CT密度同皮下脂肪,CT值-10～-110 Hu,肿瘤内可见不规则增厚的间隔;去分化脂肪肉瘤部分区域呈脂肪密度(CT值-70～30 Hu),部分区域呈软组织肿块(CT值为30～50 Hu);黏液性脂肪肉瘤CT密度接近水,增强扫描时肿块呈网状、片状、延迟强化,CT值20～40 Hu;高分化脂肪肉瘤MRI信号同皮下脂肪;黏液性脂肪肉瘤MRI呈长T1,长T2信号,与水相似;CT和MRI诊断腹膜后间隙脂肪瘤准确率分别为69.70%和73.33%,差异比较无统计学意义(p>0.05)。本研究得出初步结论,不同病理类型腹膜后间隙脂肪肉瘤的CT、MRI表现有所差异;CT和MRI术前诊断腹膜后间隙脂肪肉瘤准确性相似。     

Role of mitochondrial calcium uniporter‐mediated Ca2+ and iron accumulation in traumatic brain injury

Previous studies have suggested that the cellular Ca²⁺ and iron homeostasis, which can be regulated by mitochondrial calcium uniporter (MCU), is associated with oxidative stress, apoptosis and many neurological diseases. However, little is known about the role of MCU‐mediated Ca²⁺ and iron accumulation in traumatic brain injury (TBI). Under physiological conditions, MCU can be inhibited by ruthenium red (RR) and activated by spermine (Sper). In the present study, we used RR and Sper to reveal the role of MCU in mouse and neuron TBI models. Our results suggested that the Ca²⁺ and iron concentrations were obviously increased after TBI. In addition, TBI models showed a significant generation of reactive oxygen species (ROS), decrease in adenosine triphosphate (ATP), deformation of mitochondria, up‐regulation of deoxyribonucleic acid (DNA) damage and increase in apoptosis. Blockage of MCU by RR prevented Ca²⁺ and iron accumulation, abated the level of oxidative stress, improved the energy supply, stabilized mitochondria, reduced DNA damage and decreased apoptosis both in vivo and in vitro. Interestingly, Sper did not increase cellular Ca²⁺ and iron concentrations, but suppressed the Ca²⁺ and iron accumulation to benefit the mice in vivo. However, Sper had no significant impact on TBI in vitro. Taken together, our data demonstrated for the first time that blockage of MCU‐mediated Ca²⁺ and iron accumulation was essential for TBI. These findings indicated that MCU could be a novel therapeutic target for treating TBI.     

Deciphering the role of docosahexaenoic acid in brain maturation and pathology with magnetic resonance imaging

Animal studies have found that deficits in brain docosahexaenoic acid (DHA, 22:6n-3) accrual during perinatal development leads to transient and enduring abnormalities in brain development and function. Determining the relevance of this evidence to brain disorders in humans has been hampered by an inability to determine antimortem brain DHA levels and limitations associated with a postmortem approach. Accordingly, there is a need for alternate or complementary approaches to better understand the role of DHA in cortical function and pathology, and conventional magnetic resonance imaging (MRI) techniques may be ideally suited for this application. A major advantage of neuroimaging is that it permits prospective evaluation of the effects of manipulating DHA status on both clinical and neuroimaging variables. Emerging evidence from MRI studies suggest that greater DHA status is associated with cortical structural and functional integrity, and suggest that reduced DHA status and abnormalities in cortical function observed in psychiatric disorders may be interrelated phenomenon. Preliminary evidence from animal MRI studies support a critical role of DHA in normal brain development. Neuroimaging research in both human and animals therefore holds tremendous promise for developing a better understanding of the role of DHA status in cortical function, as well as for elucidating the impact of DHA deficiency on neuropathological processes implicated in the etiology and progression of neurodevelopmental and psychiatric disorders.     

A Review on Convolutional Neural Networks for Brain Tumor Segmentation: Methods,Datasets, Libraries,and Future Directions

ObjectivesAccurate and reliable segmentation of brain tumors from MRI images helps in planning an enhanced treatment and increases the life expectancy of patients. However, the manual segmentation of brain tumors is subjective and more prone to errors. Nonetheless, the recent advances in convolutional neural network (CNN)-based methods have exhibited outstanding potential in robust segmentation of brain tumors. This article comprehensively investigates recent advances in CNN-based methods for automatic segmentation of brain tumors from MRI images. It examines popular deep learning (DL) libraries/tools for an expeditious and effortless implementation of CNN models. Furthermore, a critical assessment of current DL architectures is delineated along with the scope of improvement.MethodsIn this work, more than 50 scientific papers from 2014-2020 are selected using Google Scholar and PubMed. Also, the leading journals related to our work along with proceedings from major conferences such as MICCAI, MIUA and ECCV are retrieved. This research investigated various annual challenges too related to this work including Multimodal Brain Tumor Segmentation Challenge (MICCAI BRATS) and Ischemic Stroke Lesion Segmentation Challenge (ISLES).ResultAfter a systematic literature search pertinent to the theme, we found that principally there exist three variations of CNN architecture for brain tumor segmentation: single-path and multi-path, fully convolutional, and cascaded CNNs. The respective performances of most automated methods based on CNN are appraised on the BraTS dataset, provided as a part of the MICCAI Multimodal Brain Tumor Segmentation challenge held annually since 2012.ConclusionNotwithstanding the remarkable potential of CNN-based methods, reliable and robust segmentation of brain tumors continues to be an intractable challenge. This is due to the intricate anatomy of the brain, variability in its appearance, and imperfection in image acquisition. Moreover, owing to the small size of MRI datasets, CNN-based methods cannot operate with their full capacity, as demonstrated with large scale datasets, such as ImageNet.     

In vivo assessment of nodularin-induced hepatotoxicity in the rat using magnetic resonance techniques (MRI, MRS and EPR oximetry)

Acute nodularin-induced hepatotoxicity was assessed in vivo, in rats using magnetic resonance (MR) techniques, including MR imaging (MRI), MR spectroscopy (MRS), and electron paramagnetic resonance (EPR) oximetry. Nodularin is a cyclic hepatotoxin isolated from the cyanobacterium Nodularia spumigena. Three hours following the intraperitoneal (i.p.) administration of nodularin (LD50), a region of 'damage', characterized by an increase in signal intensity, was observed proximal to the porta hepatis (PH) region in T2-weighted MR images of rat liver. Image analysis of these regions of apparent 'damage' indicated a statistically significant increase in signal intensity around the PH region following nodularin administration, in comparison with controls and regions peripheral to the PH region. An increase in signal intensity was also observed proximal to the PH region in water chemical shift selective images (CSSI) of nodularin-treated rat livers, indicating that the increased signal observed by MRI is an oedematous response to the toxin. Microscopic assessment (histology and electron microscopy) and serum liver enzyme function tests (aminotransferase (ALT) and aspartate ALT (AST)) confirmed the nodularin-induced tissue injury observed by MRI. In vivo and in vitro MRS was used to detect alterations in metabolites, such as lipids, Glu+Gln, and choline, during the hepatotoxic response (2-3 h post-exposure). Biochemical assessment of perchloric acid extracts of nodularin-treated rat livers were used to confirm the MRS results. In vivo EPR oximetry was used to monitor decreasing hepatic pO2 (approximately 2-fold from controls) 2-3 h following nodularin exposure. In vivo MR techniques (MRI, MRS and EPR oximetry) are able to highlight effects that may not have been evident in single end point studies, and are ideal methods to follow tissue injury progression in longitudinally, increasing the power of a study through repeated measures, and decreasing the number of animals to perform a similar study using histological or biochemical techniques.     

Paretic muscle atrophy and non-contractile tissue content in individual muscles of the post-stroke lower extremity

Muscle atrophy is one of many factors contributing to post-stroke hemiparetic weakness. Since muscle force is a function of muscle size, the amount of muscle atrophy an individual muscle undergoes has implications for its overall force-generating capability post-stroke. In this study, post-stroke atrophy was determined bilaterally in fifteen leg muscles with volumes quantified using magnetic resonance imaging (MRI). All muscle volumes were adjusted to exclude non-contractile tissue content, and muscle atrophy was quantified by comparing the volumes between paretic and non-paretic sides. Non-contractile tissue or intramuscular fat was calculated by determining the amount of tissue excluded from the muscle volume measurement. With the exception of the gracilis, all individual paretic muscles examined had smaller volumes in the non-paretic side. The average decrease in volume for these paretic muscles was 23%. The gracilis volume, on the other hand, was approximately 11% larger on the paretic side. The amount of non-contractile tissue was higher in all paretic muscles except the gracilis, where no difference was observed between sides. To compensate for paretic plantar flexor weakness, one idea might be that use of the paretic gracilis actually causes the muscle to increase in size and not develop intramuscular fat. By eliminating non-contractile tissue from our volume calculations, we have presented volume data that more appropriately represents force-generating muscle tissue. Non-uniform muscle atrophy was observed across muscles and may provide important clues when assessing the effect of muscle atrophy on post-stroke gait.     

CT与MRI对肝硬化背景下小肝癌检出率的比较

目的:分析比较CT与MR对肝硬化背景下小肝癌检出情况,探究CT与MR在肝硬化背景下小肝癌的诊断价值。方法:选择2010年6月~2015年6月期间,我院收治确诊为肝硬化背景下小肝癌患者91例为研究对象,病理及临床相关方法确诊102个病灶,其中小肝癌69个和微小肝癌33个,患者均在不同时期或序列下行多排螺旋CT与MRI检查,分析比较两者对小肝癌和微小肝癌的检出率。结果:多排螺旋CT检查发现肝癌小病灶91个,其中66个小肝癌,25个微小肝癌;MRI检查发现95个病灶,小肝癌67个,微小肝癌28个;69个小肝癌病灶,检出率最高的为CT动脉期(92.75%)与LAVA动脉期(92.75%),检出率最低的为CT平扫(76.81%);33个微小肝癌病灶,检出率最高为LAVA动脉期(75.76%),检出率最低的为LAVA平衡期(36.36%);CT平扫、门静脉期、动脉期、平衡期、MRI-IN-PHASE、LAVA平衡期、LAVA平扫对小肝癌的检出率显著高于对微小肝癌的检出率(P0.05);CT对小肝癌的检出率显著高于微小肝癌的检出率(P0.05),MRI对小肝癌与微小肝癌的检出率无显著差异(P0.05);MRI与CT对小肝癌的检出率不存在差异(P0.05),但MRI对微小肝癌的检出率显著高于CT(P0.05)。结论:MRI-LAVA的动脉期序列对小肝癌病灶与微小肝癌病灶的检出率最高;CT与MRI在对小肝癌的检出率不存在差异,但MRI对微小肝癌的检出具有更明显的优势。     

Hepatic cellular distribution and degradation of iron oxide nanoparticles following single intravenous injection in rats: implications for magnetic resonance imaging

The purpose of this study was to determine the cellular distribution and degradation in rat liver following intravenous injection of superparamagnetic iron oxide nanoparticles used for magnetic resonance imaging (NC100150 Injection). Relaxometric and spectrophotometric methods were used to determine the concentration of the iron oxide nanoparticles and their degradation products in isolated rat liver parenchymal, endothelial and Kupffer cell fractions. An isolated cell phantom was also constructed to quantify the effect of the degradation products on the loss of MR signal in terms of decreased transverse relaxation times, T2*. The results of this study show that iron oxide nanoparticles found in the NC100150 Injection were taken up and distributed equally in both liver endothelial and Kupffer cells following a single 5 mg Fe/kg body wt. bolus injection in rats. Whereas endothelial and Kupffer cells exhibited similar rates of uptake and degradation, liver parenchymal cells did not take up the NC100150 Injection iron oxide particles. Light-microscopy methods did, however, indicate an increased iron load, presumably as ferritin/hemosiderin, within the hepatocytes 24 h post injection. The study also confirmed that compartmentalisation of ferritin/hemosiderin may cause a significant decrease in the MRI signal intensity of the liver. In conclusion, the combined results of this study imply that the prolonged presence of breakdown product in the liver may cause a prolonged imaging effect (in terms of signal loss) for a time period that significantly exceeds the half-life of NC100150 Injection iron oxide nanoparticles in liver.     

MRI在甲状腺肿瘤的肿块定位和良恶性判断中的应用研究

目的:总结甲状腺肿瘤的核磁共振成像(MRI)影像学表现,评价MRI在甲状腺肿瘤的肿块定位及良恶性判断中的应用价值。方法:选取我院外科收治的经MRI诊断为甲状腺癌的患者60例,总结所有患者的影像学资料,并将其与诊断金标准(病理学检查结果)相比较,分析MRI检查诊断累及组织和鉴别良恶性甲状腺肿瘤的准确率等。结果:MRI影像学结果清晰可见甲状腺肿瘤的部位、形态、密度、边界及是否有钙化等重要征象;MRI对良恶性肿瘤诊断准确性为95.0%。MRI对肿瘤累积膜外脂肪、肿瘤的淋巴结以及肿瘤的食管转移均有较高的准确性、敏感性与特异性。结论:MRI影像学检查清晰可见甲状腺肿瘤的部位、形态、密度、边界及是否有钙化等重要征象,对临床上甲状腺肿瘤的肿块定位及良恶性鉴别诊断具有重要的参考意义。     

Genetics and iron in the systems biology of Parkinson’s disease and some related disorders

The systems biology approach to complex diseases recognises that a potentially large number of biochemical network elements may be involved in disease progression, especially where positive feedback loops can be identified. Most of these network elements will be encoded by genes, for which different alleles may affect the network(s) differentially. A primary requirement is therefore to determine the relevant gene-network relationships. A corollary of this is that identification of the network should thereby allow one to ‘explain’ or account for any genetic associations.     

Magnetic resonance microscopy of prenatal dolphins (Mammalia, Odontoceti, Delphinidae) - Ontogenetic and phylogenetic implications

The structure of two preserved prenatal dolphins were visualized by 3D MR microscopy (isotropic nominal resolution up to 78.1 μm), which is a high-resolution 3D magnetic resonance imaging (MRI) technique. To determine the benefits and limitations of this method, the acquired 3D datasets were segmented manually and compared to histological sections of different specimens in corresponding developmental stages. The MR images visualize the external and internal morphology of both prenatal dolphins in detail. Various organ systems with their main components are clearly documented in the images, allowing a complete segmentation of the specimens and the calculation of volumes and surface areas of different organ systems. Due to its non-invasive character and the detailed imaging within its resolution range, MR microscopy proves to be a valuable tool in developmental biology for the visualization of the inner architecture of rare and delicate museum specimens, such as the small dolphin embryo and fetus examined. In these two prenatal dolphins, the profound structural modifications at the transition from the embryonic to the fetal stage reflect the adaptations of the mammalian bauplan to the requirements of a holaquatic cetacean life-style. However, the developmental pattern and sequence of the emerging tissues and organs in prenatal life do not resemble the hypothesized evolution of the structural and functional adaptations found in the fossil record.