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      Neuromelanin-sensitive MRI as a noninvasive proxy measure of dopamine function in the human brain

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          Significance

          Neuromelanin-sensitive MRI (NM-MRI) purports to detect the content of neuromelanin (NM), a product of dopamine metabolism that accumulates in the substantia nigra (SN). Prior work has shown that NM-MRI provides a marker of SN integrity in Parkinson’s disease. Here, we show that it may additionally provide a marker of dopamine function in the human nigrostriatal pathway. Supporting this, we found that NM-MRI signal correlated with NM concentration, dopamine levels in the striatum, SN blood flow, and severity of psychosis in schizophrenia, all in the absence of neurodegeneration. Thus, noninvasive NM-MRI is a promising tool that could have diverse research and clinical applications to investigate in vivo the role of dopamine in neuropsychiatric illness.

          Abstract

          Neuromelanin-sensitive MRI (NM-MRI) purports to detect the content of neuromelanin (NM), a product of dopamine metabolism that accumulates with age in dopamine neurons of the substantia nigra (SN). Interindividual variability in dopamine function may result in varying levels of NM accumulation in the SN; however, the ability of NM-MRI to measure dopamine function in nonneurodegenerative conditions has not been established. Here, we validated that NM-MRI signal intensity in postmortem midbrain specimens correlated with regional NM concentration even in the absence of neurodegeneration, a prerequisite for its use as a proxy for dopamine function. We then validated a voxelwise NM-MRI approach with sufficient anatomical sensitivity to resolve SN subregions. Using this approach and a multimodal dataset of molecular PET and fMRI data, we further showed the NM-MRI signal was related to both dopamine release in the dorsal striatum and resting blood flow within the SN. These results suggest that NM-MRI signal in the SN is a proxy for function of dopamine neurons in the nigrostriatal pathway. As a proof of concept for its clinical utility, we show that the NM-MRI signal correlated to severity of psychosis in schizophrenia and individuals at risk for schizophrenia, consistent with the well-established dysfunction of the nigrostriatal pathway in psychosis. Our results indicate that noninvasive NM-MRI is a promising tool that could have diverse research and clinical applications to investigate in vivo the role of dopamine in neuropsychiatric illness.

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          Most cited references61

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          Melanized dopaminergic neurons are differentially susceptible to degeneration in Parkinson's disease.

          In idiopathic Parkinson's disease massive cell death occurs in the dopamine-containing substantia nigra. A link between the vulnerability of nigral neurons and the prominent pigmentation of the substantia nigra, though long suspected, has not been proved. This possibility is supported by evidence that N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and its metabolite MPP+, the latter of which causes destruction of nigral neurons, bind to neuromelanin. We have directly tested this hypothesis by a quantitative analysis of neuromelanin-pigmented neurons in control and parkinsonian midbrains. The findings demonstrate first that the dopamine-containing cell groups of the normal human midbrain differ markedly from each other in the percentage of neuromelanin-pigmented neurons they contain. Second, the estimated cell loss in these cell groups in Parkinson's disease is directly correlated (r = 0.97, P = 0.0057) with the percentage of neuromelanin-pigmented neurons normally present in them. Third, within each cell group in the Parkinson's brains, there is greater relative sparing of non-pigmented than of neuromelanin-pigmented neurons. This evidence suggests a selective vulnerability of the neuromelanin-pigmented subpopulation of dopamine-containing mesencephalic neurons in Parkinson's disease.
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            Neuromelanin magnetic resonance imaging of locus ceruleus and substantia nigra in Parkinson's disease.

            We carried out an investigation to identify neuromelanin-containing noradrenergic and dopaminergic neurons in the locus ceruleus and substantia nigra pars compacta of healthy volunteers and patients with Parkinson's disease using a newly developed magnetic resonance imaging technique that can demonstrate neuromelanin-related contrast. The high-resolution neuromelanin images obtained by a 3-T scanner revealed high signal areas in the brain stem and these corresponded well with the location of the locus ceruleus and substantia nigra pars compacta in gross specimens. In Parkinson's disease patients, the signal intensity in the locus ceruleus and substantia nigra pars compacta was greatly reduced, suggesting depletion of neuromelanin-containing neurons. We conclude that neuromelanin magnetic resonance imaging can be used for direct visualization of the locus ceruleus and substantia nigra pars compacta, and may help in detecting pathological changes in Parkinson's disease and related disorders.
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              Increased synaptic dopamine function in associative regions of the striatum in schizophrenia.

              A long-standing version of the dopamine hypothesis of schizophrenia postulates that hyperactivity of dopaminergic transmission at D(2) receptors in the limbic striatum is associated with the illness and that blockade of mesolimbic D(2) receptors is responsible for the antipsychotic action of D(2) receptor antagonists. To localize dopaminergic hyperactivity within the striatum in schizophrenia. Case-control study. Inpatient research unit. Eighteen untreated patients with schizophrenia and 18 healthy control subjects matched for age, sex, ethnicity, parental socioeconomic status, cigarette smoking, and weight. Percentage change in dopamine D(2) receptor availability in striatal subregions within each subject measured by positron emission tomography with carbon 11-labeled raclopride before and during pharmacologically induced dopamine depletion. In the associative striatum, acute dopamine depletion resulted in a larger increase in D(2) receptor availability in patients with schizophrenia (mean [SD], 15% [7%]) than in control subjects (10% [7%], P = .045), suggesting higher synaptic dopamine concentration. Within the associative striatum, this effect was most pronounced in the precommissural dorsal caudate (15% [8%] in patients vs 9% [8%] in controls, P = .03). No between-group differences were observed in the limbic and sensorimotor striatum. These findings suggest that schizophrenia is associated with elevated dopamine function in associative regions of the striatum. Because the precommissural dorsal caudate processes information from the dorsolateral prefrontal cortex, this observation also suggests that elevated subcortical dopamine function might adversely affect performance of the dorsolateral prefrontal cortex in schizophrenia. On the other hand, the absence of a group difference in the limbic striatum brings into question the therapeutic relevance of the mesolimbic selectivity of second-generation antipsychotic drugs.
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                Author and article information

                Journal
                Proc Natl Acad Sci U S A
                Proc. Natl. Acad. Sci. U.S.A
                pnas
                pnas
                PNAS
                Proceedings of the National Academy of Sciences of the United States of America
                National Academy of Sciences
                0027-8424
                1091-6490
                12 March 2019
                22 February 2019
                : 116
                : 11
                : 5108-5117
                Affiliations
                [1] aDepartment of Psychiatry, New York State Psychiatric Institute, Columbia University Medical Center , New York, NY 10032;
                [2] b University of Ottawa Institute of Mental Health Research, affiliated with The Royal , Ottawa, ON K1Z 8N3, Canada;
                [3] cInstitute of Biomedical Technologies, National Research Council of Italy , Segrate, 20090 Milan, Italy;
                [4] dDepartment of Psychiatry, Stony Brook University , Stony Brook, NY 11794;
                [5] eDepartment of Neurology, Columbia University Medical Center , New York, NY 10032;
                [6] fDepartment of Neurology and Neurosurgery, McGill University , Montreal, QC H3A 2B4, Canada
                Author notes
                1To whom correspondence may be addressed. Email: clifford.cassidy@ 123456theroyal.ca or horgag@ 123456nyspi.columbia.edu .

                Edited by Marcus E. Raichle, Washington University in St. Louis, St. Louis, MO, and approved January 22, 2019 (received for review May 9, 2018)

                Author contributions: C.M.C., D.S., L.Z., A.A.-D., and G.H. designed research; C.M.C., F.A.Z., R.R.G., S.C.B., J.J.W., M.E.S., C.B., A.V., N.V., L.S.K., G.B., U.J.K., L.Z., and G.H. performed research; C.M.C., F.A.Z., J.J.W., L.Z., and G.H. analyzed data; and C.M.C., F.A.Z., L.Z., and G.H. wrote the paper.

                Author information
                http://orcid.org/0000-0003-1230-1129
                Article
                PMC6421437 PMC6421437 6421437 201807983
                10.1073/pnas.1807983116
                6421437
                30796187
                f18ac5a4-ed32-4b7a-b286-954190381588
                Copyright @ 2019

                Published under the PNAS license.

                History
                Page count
                Pages: 10
                Funding
                Funded by: HHS | NIH | National Institute of Mental Health (NIMH) 100000025
                Award ID: K23-MH101637
                Award Recipient : Anissa Abi-Dargham Award Recipient : Guillermo Horga
                Funded by: HHS | NIH | National Institute of Mental Health (NIMH) 100000025
                Award ID: P50-MH086404
                Award Recipient : Anissa Abi-Dargham Award Recipient : Guillermo Horga
                Funded by: HHS | NIH | National Institute of Mental Health (NIMH) 100000025
                Award ID: R21-MH099509
                Award Recipient : Anissa Abi-Dargham Award Recipient : Guillermo Horga
                Funded by: Ministero dell'Istruzione, dell'Università e della Ricerca (MIUR) 501100003407
                Award ID: PB.P05
                Award Recipient : Fabio A. Zucca Award Recipient : Luigi Zecca
                Funded by: Ministero dell'Istruzione, dell'Università e della Ricerca (MIUR) 501100003407
                Award ID: 2015T778JW
                Award Recipient : Fabio A. Zucca Award Recipient : Luigi Zecca
                Funded by: HHS | NIH | National Institute on Drug Abuse (NIDA) 100000026
                Award ID: DA04718
                Award Recipient : David Sulzer
                Categories
                PNAS Plus
                Biological Sciences
                Neuroscience
                PNAS Plus

                neuromelanin,magnetic resonance imaging,Parkinson’s disease,dopamine,schizophrenia

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