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August 06, 2013; 81 (6) Article

Visualization of nigrosome 1 and its loss in PD

Pathoanatomical correlation and in vivo 7 T MRI

Anna I. Blazejewska, Stefan T. Schwarz, Alain Pitiot, Mary C. Stephenson, James Lowe, Nin Bajaj, Richard W. Bowtell, Dorothee P. Auer, Penny A. Gowland
First published July 10, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31829e6fd2
Anna I. Blazejewska
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Stefan T. Schwarz
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Alain Pitiot
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Mary C. Stephenson
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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James Lowe
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Nin Bajaj
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Richard W. Bowtell
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Dorothee P. Auer
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Penny A. Gowland
From the Sir Peter Mansfield Magnetic Resonance Centre (A.I.B., M.C.S., R.W.B., P.A.G.), Division of Radiological and Imaging Sciences (S.T.S., D.P.A.), and School of Psychology (A.P.), University of Nottingham, Nottingham; and Divisions of Pathology (J.L.) and Neurology (N.B.), Nottingham University Hospitals NHS Trust, Nottingham, UK.
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Citation
Visualization of nigrosome 1 and its loss in PD
Pathoanatomical correlation and in vivo 7 T MRI
Anna I. Blazejewska, Stefan T. Schwarz, Alain Pitiot, Mary C. Stephenson, James Lowe, Nin Bajaj, Richard W. Bowtell, Dorothee P. Auer, Penny A. Gowland
Neurology Aug 2013, 81 (6) 534-540; DOI: 10.1212/WNL.0b013e31829e6fd2

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Abstract

Objective: This study assessed whether high-resolution 7 T MRI allowed direct in vivo visualization of nigrosomes, substructures of the substantia nigra pars compacta (SNpc) undergoing the greatest and earliest dopaminergic cell loss in Parkinson disease (PD), and whether any disease-specific changes could be detected in patients with PD.

Methods: Postmortem (PM) midbrains, 2 from healthy controls (HCs) and 1 from a patient with PD, were scanned with high-resolution T2*-weighted MRI scans, sectioned, and stained for iron and neuromelanin (Perl), TH, and calbindin. To confirm the identification of nigrosomes in vivo on 7 T T2*-weighted scans, we assessed colocalization with neuromelanin-sensitive T1-weighted scans. We then assessed the ability to depict PD pathology on in vivo T2*-weighted scans by comparing data from 10 patients with PD and 8 age- and sex-matched HCs.

Results: A hyperintense, ovoid area within the dorsolateral border of the otherwise hypointense SNpc was identified in the HC brains on in vivo and PM T2*-weighted MRI. Location, size, shape, and staining characteristics conform to nigrosome 1. Blinded assessment by 2 neuroradiologists showed consistent bilateral absence of this nigrosome feature in all 10 patients with PD, and bilateral presence in 7/8 HC.

Conclusions: In vivo and PM MRI with histologic correlation demonstrates that high-resolution 7 T MRI can directly visualize nigrosome 1. The absence of nigrosome 1 in the SNpc on MRI scans might prove useful in developing a neuroimaging diagnostic test for PD.

GLOSSARY

FFE=
fast field echo;
FOV=
field of view;
FSE=
fast spin echo;
HC=
healthy controls;
MT=
magnetization transfer;
NSA=
number of signal averages;
PD=
Parkinson disease;
PM=
postmortem;
RN=
red nucleus;
SN=
substantia nigra;
SNpc=
substantia nigra pars compacta;
SNpr=
substantia nigra pars reticulata;
TE=
echo time;
TR=
repetition time;
VTA=
ventral tegmental area

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at www.neurology.org

  • Received January 11, 2013.
  • Accepted in final form April 17, 2013.
  • © 2013 American Academy of Neurology
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Letters: Rapid online correspondence

  • Visualisation of nigrosome 1 in SWI 3T MRI
    • Anna I. Blazejewska, SPMMRC, University of Nottingham, UKania.blazejewska@gmail.com
    • Anna I Blazejewska, Seattle, WA; Stefan T Schwarz, Nottingham, UK; Nin Bajaj, Nottingham, UK; Dorothee P Auer, Nottingham, UK; Penny A Gowland, Nottingham, UK.
    Submitted January 22, 2014
  • Hyperintense nigral sign on SWI at 3.0T MRI
    • Christoph Mueller, Department of Neurology, Innsbruck Medical University, Innsbruck, Austriachristoph.mueller@i-med.ac.at
    • Bernadette Pinter, Innsbruck, Austria; Eva Reiter, Innsbruck, Austria; Michael Schocke, Innsbruck, Austria; Werner Poewe, Innsbruck, Austria; Klaus Seppi, Innsbruck, Austria
    Submitted October 18, 2013
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