Journal Article

Reduced cerebrospinal fluid motion in patients with Parkinson’s disease revealed by magnetic resonance imaging with low b-value diffusion weighted imaging

Han, Caleb, Hett, Kilian, Richerson, Wesley T., Elenberger, Jason, Song, Alexander K., Pierobon Mays, Gabriela, Eisma, Jarrod, Donahue, Manus J., McKnight, Colin D., Considine, Ciaran, Stark, Adam, Claassen, Daniel O.

2024

Overview

Background Parkinson’s disease is characterized by dopamine-responsive symptoms as well as aggregation of α-synuclein protofibrils. New diagnostic methods assess α-synuclein aggregation characteristics from cerebrospinal fluid (CSF) and recent pathophysiologic mechanisms suggest that CSF circulation disruptions may precipitate α-synuclein retention. Here, diffusion-weighted MRI with low-to-intermediate diffusion-weightings was applied to test the hypothesis that CSF motion is reduced in Parkinson’s disease relative to healthy participants. Methods Multi-shell diffusion weighted MRI (spatial resolution = 1.8 × 1.8 × 4.0 mm) with low-to-intermediate diffusion weightings ( b -values = 0, 50, 100, 200, 300, 700, and 1000 s/mm 2 ) was applied over the approximate kinetic range of suprasellar cistern fluid motion at 3 Tesla in Parkinson’s disease ( n  = 27; age = 66 ± 6.7 years) and non-Parkinson’s control ( n  = 32; age = 68 ± 8.9 years) participants. Wilcoxon rank-sum tests were applied to test the primary hypothesis that the noise floor-corrected decay rate of CSF signal as a function of b -value, which reflects increasing fluid motion, is reduced within the suprasellar cistern of persons with versus without Parkinson’s disease and inversely relates to choroid plexus activity assessed from perfusion-weighted MRI (significance-criteria: p  < 0.05). Results Consistent with the primary hypothesis, CSF decay rates were higher in healthy ( D  = 0.00673 ± 0.00213 mm 2 /s) relative to Parkinson’s disease ( D  = 0.00517 ± 0.00110 mm 2 /s) participants. This finding was preserved after controlling for age and sex and was observed in the posterior region of the suprasellar cistern ( p  < 0.001). An inverse correlation between choroid plexus perfusion and decay rate in the voxels within the suprasellar cistern (Spearman’s- r =-0.312; p  = 0.019) was observed. Conclusions Multi-shell diffusion MRI was applied to identify reduced CSF motion at the level of the suprasellar cistern in adults with versus without Parkinson’s disease; the strengths and limitations of this methodology are discussed in the context of the growing literature on CSF flow.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Age / Aged / Biomedical and Life Sciences / Biomedicine / Cerebrospinal fluid / Cerebrospinal Fluid - diagnostic imaging / Cerebrospinal Fluid - physiology / Choroid plexus / Diffusion Magnetic Resonance Imaging - methods / Dopamine / DWI / Female / Glymphatic / Hematology / Humans / Hypotheses / Magnetic resonance imaging / Male / Medical imaging / Middle Aged / Motion / Neurobiology / Neurodegenerative diseases / Neuropsychology / Neurosciences / Parkinson Disease - cerebrospinal fluid / Parkinson Disease - diagnostic imaging / Parkinson Disease - physiopathology / Parkinson's disease / Parkinson’s / Perfusion / Spatial discrimination / Suprasellar cistern / Synuclein / Veins & arteries / α-synuclein