T2* MRI of minimal hepatic encephalopathy and cognitive correlates in vivo

Liu, Jianying; Ding, Jing; Lin, Dong; He, Yu; Dai, Zhi; Chen, Caizhong; Cheng, Wei; Wang, He; Zhou, Ji; Wang, Xin

doi:10.1002/jmri.23811

Cited by 16 publications

(19 citation statements)

References 43 publications

(15 reference statements)

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“…Susceptibility weighted phase imaging had been used to quantify brain iron content in healthy population [22], [27] and in patients with Parkinson’s disease, Alzheimer’s disease or multiple sclerosis [25], [36], [37]. We reported that patients with HBV-related hepatic cirrhosis had excessive brain iron accumulation in the basal ganglia, which was consistent with our previous research [16].…”

Section: Discussionsupporting

confidence: 90%

“…Excessive brain iron deposition was found in Parkinson’s disease [10], Alzheimer’s disease [11], multiple sclerosis [12], Friedreich’s ataxias [13], neuroferritinopathy [14], and Hallervorden-Spatz syndrome [15]. Our previous study revealed that excessive iron accumulation in the frontal cortical-basal ganglial circuit independently contributed to cognitive impairments in minimal hepatic encephalopathy patients [16]. However, the underlying mechanism remains unclear.…”

Section: Introductionmentioning

confidence: 96%

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Decreased Serum Hepcidin Concentration Correlates with Brain Iron Deposition in Patients with HBV-Related Cirrhosis

et al. 2013

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PurposeExcessive brain iron accumulation contributes to cognitive impairments in hepatitis B virus (HBV)-related cirrhotic patients. The underlying mechanism remains unclear. Hepcidin, a liver-produced, 25-aminoacid peptide, is the major regulator of systemic iron metabolism. Abnormal hepcidin level is a key factor in some body iron accumulation or deficiency disorders, especially in those associated with liver diseases. Our study was aimed to explore the relationship between brain iron content in patients with HBV-related cirrhosis and serum hepcidin level.MethodsSeventy HBV-related cirrhotic patients and forty age- sex-matched healthy controls were enrolled. Brain iron content was quantified by susceptibility weighted phase imaging technique. Serum hepcidin as well as serum iron, serum transferrin, ferritin, soluble transferrin receptor, total iron binding capacity, and transferrin saturation were tested in thirty cirrhotic patients and nineteen healthy controls. Pearson correlation analysis was performed to investigate correlation between brain iron concentrations and serum hepcidin, or other iron parameters.ResultsCirrhotic patients had increased brain iron accumulation compared to controls in the left red nuclear, the bilateral substantia nigra, the bilateral thalamus, the right caudate, and the right putamen. Cirrhotic patients had significantly decreased serum hepcidin concentration, as well as lower serum transferring level, lower total iron binding capacity and higher transferrin saturation, compared to controls. Serum hepcidin level negatively correlated with the iron content in the right caudate, while serum ferritin level positively correlated with the iron content in the bilateral putamen in cirrhotic patients.ConclusionsDecreased serum hepcidin level correlated with excessive iron accumulation in the basal ganglia in HBV-related cirrhotic patients. Our results indicated that systemic iron overload underlined regional brain iron repletion. Serum hepcidin may be a clinical biomarker for brain iron deposition in cirrhotic patients, which may have therapeutic potential.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 96%

Decreased Serum Hepcidin Concentration Correlates with Brain Iron Deposition in Patients with HBV-Related Cirrhosis

et al. 2013

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“…A whole class of diseases termed neurodegeneration with brain iron accumulation (NBIA), for example, are exclusively diagnosed by abnormal high concentrations, typically in the basal ganglia and many with psychomotor symptoms beginning in earlier life (Schipper, 2012; Gregory and Hayflick, 2014). Other iron-dependent diseases, such as hematic encephalopathy associated with cirrhosis of the liver, also present with abnormal brain iron content and associated cognitive deficits (Liu et al, 2013; Xia et al, 2015). …”

Section: Brain Iron In Neurodegenerative Disordersmentioning

confidence: 99%

Appraising the Role of Iron in Brain Aging and Cognition: Promises and Limitations of MRI Methods

2015

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Age-related increase in frailty is accompanied by a fundamental shift in cellular iron homeostasis. By promoting oxidative stress, the intracellular accumulation of non-heme iron outside of binding complexes contributes to chronic inflammation and interferes with normal brain metabolism. In the absence of direct non-invasive biomarkers of brain oxidative stress, iron accumulation estimated in vivo may serve as its proxy indicator. Hence, developing reliable in vivo measurements of brain iron content via magnetic resonance imaging (MRI) is of significant interest in human neuroscience. To date, by estimating brain iron content through various MRI methods, significant age differences and age-related increases in iron content of the basal ganglia have been revealed across multiple samples. Less consistent are the findings that pertain to the relationship between elevated brain iron content and systemic indices of vascular and metabolic dysfunction. Only a handful of cross-sectional investigations have linked high iron content in various brain regions and poor performance on assorted cognitive tests. The even fewer longitudinal studies indicate that iron accumulation may precede shrinkage of the basal ganglia and thus predict poor maintenance of cognitive functions. This rapidly developing field will benefit from introduction of higher-field MRI scanners, improvement in iron-sensitive and -specific acquisition sequences and post-processing analytic and computational methods, as well as accumulation of data from long-term longitudinal investigations. This review describes the potential advantages and promises of MRI-based assessment of brain iron, summarizes recent findings and highlights the limitations of the current methodology.

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“…Abnormalities in the iron and manganese of the brain have been suggested as possible metabolic sources of the neurological manifestations of chronic hepatic dysfunction, including in liver cirrhosis patients . Given that the liver is a central organ for the metabolism of the two metals and that the places iron and manganese are commonly deposited overlap, such as in the GP, we postulated an interaction between iron and manganese in the brains of advanced liver cirrhosis patients.…”

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Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping: Relationship with pallidal T₁ hyperintensity

Lee

Nam

Jang

et al. 2017

Magnetic Resonance Imaging

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T2* MRI of minimal hepatic encephalopathy and cognitive correlates in vivo

Abstract: Decreased phase values in the frontal cortical-basal ganglial circuits independently contribute to cognitive impairments in MHE patients.

Cited by 16 publications

References 43 publications

Decreased Serum Hepcidin Concentration Correlates with Brain Iron Deposition in Patients with HBV-Related Cirrhosis

Decreased Serum Hepcidin Concentration Correlates with Brain Iron Deposition in Patients with HBV-Related Cirrhosis

Appraising the Role of Iron in Brain Aging and Cognition: Promises and Limitations of MRI Methods

Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping: Relationship with pallidal T₁ hyperintensity

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T2* MRI of minimal hepatic encephalopathy and cognitive correlates in vivo

Abstract: Decreased phase values in the frontal cortical-basal ganglial circuits independently contribute to cognitive impairments in MHE patients.

Cited by 16 publications

References 43 publications

Decreased Serum Hepcidin Concentration Correlates with Brain Iron Deposition in Patients with HBV-Related Cirrhosis

Decreased Serum Hepcidin Concentration Correlates with Brain Iron Deposition in Patients with HBV-Related Cirrhosis

Appraising the Role of Iron in Brain Aging and Cognition: Promises and Limitations of MRI Methods

Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping: Relationship with pallidal T1 hyperintensity

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Deep gray matter iron measurement in patients with liver cirrhosis using quantitative susceptibility mapping: Relationship with pallidal T₁ hyperintensity