Analysis and imaging of metal-ion accumulation in neurodegenerative disease

Lead Research Organisation: Keele University
Department Name: Inst for Science and Tech in Medicine

Abstract

In many neurodegenerative diseases, brain iron concentrations are abnormally high. For example, in Parkinson's disease (PD), iron levels are doubled in the region containing the neurons responsible for motor control, and typically 80% of the motor control neurons are known to have died prior to the onset of clinical symptoms. Magnetic resonance imaging (MRI) of iron accumulations may provide an ideal method for early diagnosis, but in practice we do not know enough about the state of the iron. This hinders progress in understanding underlying disease mechanisms, in interpreting MRI images, and in determining the effects of chelation treatments to remove excess iron.The role of iron in neurodegeneration is not fully understood, partly because conventional research techniques do not provide enough information about the type of iron accumulations. This is critical, because unless iron is managed properly and stored in a relatively inert form, it can partake in chemical reactions that create a toxic environment for cells. Our proposed research will enable substantial progress in these areas, by directly correlating information from a new synchrotron x-ray approach with MRI.We will study the basal ganglia, which exhibits the most significant iron accumulation, in two relevant and incurable diseases: PD, and Neurodegeneration with Brain Iron Accumulation (NBIA), which is very rare, but shares many features with PD. With our synchrotron x-ray imaging approach, it is possible to look directly at autopsy tissue sections and determine the forms that the iron accumulations take, and their relationships with other metal accumulations and disease pathology. This information will be used to explain features seen in MRI analysis of the same tissue samples, and transferred to MRI analysis of PD and NBIA patients and healthy controls to understand what is present in vivo. We will support this research by quantifying iron compounds in autopsy tissue with magnetometry, and then extracting the iron compounds and examining them with electron microscopy to confirm their properties in detail. Keele University will be the host institution for this research, where there is access to world-class expertise directly relevant to this proposal, and the overseas portion of the Fellowship will be held at University of Florida. The synchrotron x-ray imaging and analysis of autopsy tissue will be performed at the Advanced Photon Source in Chicago, where University of Florida has regular access to facilities purpose-built for the type of research proposed. We will also develop the synchrotron analysis approach at the new UK synchrotron, DIAMOND, ensuring that world-class research in this new and expanding area can in the future be achieved in the UK. The MRI work will involve imaging of autopsy tissue sections, and a clinical study of Parkinson's disease patients, NBIA patients, and healthy age- and sex-matched controls. All this will be performed at the outstanding MRI facilities at the University of Florida McKnight Brain Institute, and for sample characterisation there will be direct access to world-class facilities at the National High Magnetic Field laboratory in Tallahassee, through University of Florida. The magnetometry and electron microscopy work will be performed in the UK, working with existing collaborators at University College London and at Cambridge University. These collaborations ensure access to excellent facilities, as well as providing frequent opportunities for academic discussion with experts in the respective fields.We will use a unique combination of physical sciences techniques to characterise iron accumulations in critical regions of the brain in PD and NBIA. This knowledge will be used to determine the potential of iron accumulations for early diagnosis using MRI, to further our understanding of PD pathogenesis, and to support the development of safe iron chelation therapies.

Publications

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Description In many neurodegenerative diseases, there is evidence for alterations in the distribution and form of brain iron. Iron levels increase in certain cell types and brain regions, and in some cases the way that the iron is stored or bound also appears altered. For example, in Parkinson's disease, iron concentrations are significantly increased in the brain cells responsible for making an essential neurotransmitter, dopamine, and detecting this change early so that the cells can be protected is a high priority. Presently, the majority of the dopamine-producing cells are lost in Parkinson's disease patients, and there is evidence that the additional iron loading increases the vulnerability of these cells (Oakley et al, Neurology, 2007).

Magnetic resonance imaging (MRI) of altered brain iron may provide an ideal method to support non-invasive early diagnosis, but we still need to learn more about the iron that is present, as this information can help us in understanding underlying disease mechanisms, in interpreting MRI images, and in determining the effects of chelation treatments to remove excess iron.

The role of iron in neurodegeneration is not fully understood, partly because conventional research techniques do not provide enough information about the type of iron accumulations. This is critical, because unless iron is managed properly and stored in a relatively inert form, it can partake in chemical reactions that create a toxic environment for cells.
Our research under this Award has enabled progress by directly correlating high-resolution spatial mapping of iron in human brain tissue with quantitative high resolution mapping of MRI parameters. We studied those regions of the brain associated with iron accumulation and disrupted iron handling in several relevant and incurable diseases including Parkinson's disease, Brain Iron Accumulation, Multiple System Atrophy, and Alzheimer's disease, and achieved the first correlations by these methods in tissues that had not been chemically fixed. This is significant because chemical fixation of tissue provides a vehicle for mobilization of iron within tissue, potentially altering the property being studies. Using synchrotron X-ray microfocus analysis, we looked directly at autopsy tissue sections to determine the various forms of iron accumulation present, and their relationship with other metal ion distributions and disease pathology. We related quantifiable features in MRI micro-imaging of autopsy tissues with synchrotron analysis of metals in the same tissues, and presented the new approach at international meetings (Movement Disorders Congress 2008, International Conference on Alzheimer's Disease 2008). In particular, our metal-ion-analysis in Alzheimer's disease amyloid plaque pathology (Collingwood et al, JAD, 2008) encouraged us to test whether the iron status in the Alzheimer's disease hippocampus alters relative to healthy brains in a manner that can be reliably detected by MRI. The hippocampus is particularly vulnerable to cell loss in Alzheimer's disease, and exhibits extensive amyloid plaque pathology. The same Alzheimer's disease plaques in which we observed magnetite (Collingwood et al, JAD, 2008) have been shown by others to give rise to signal drop-out (hypointensity artefacts) in MRI measurements of the transverse relaxation parameter T2 and the susceptibility-related T2*, and many groups have attributed this observed parameter-shortening to iron inclusions in the plaques. We showed an increase in variance in quantitative T2 and T2* maps (consistent with plaques in the tissue) in Alzheimer's disease hippocampus compared to healthy hippocampus, and by applying methods developed in the course of this EPSRC Fellowship Award, achieved the first microscopy-level-resolution direct correlation between iron, and T2 and T2* shortening, in unfixed human tissue (Antharam, Collingwood et al, Neuroimage, 2012).

In the synchrotron analysis of autopsy tissue, we also obtained detailed information about the distribution of copper and zinc in the tissues analysed at the synchrotrons, and these data led within the Award period to additional experiments to explore the influence of copper on pathological protein aggregation in AD, in the context of spherulite formation (House et al, JAD, 2009; Exley et al, JAD, 2010).

Meanwhile, quantitative analysis of iron in parkinsonism disorders (including analysis of the magnetic properties and total iron content of tissue from various regions of the brain), allowed us to - in collaboration with colleagues at University of Toronto - identify key indicators of disease-specific modes of iron dysregulation in Parkinson's disease and Multiple System Atrophy (Visanji et al, JPD, 2013).

During the Award period, on the basis of our autopsy tissue findings, we extended the work to include a multi-modal clinical imaging study (managed at University of Florida by Dr Keith White) of Parkinson's patients and age-matched healthy individuals. The imaging was performed using a 3 T MRI clinical scanner, to determine if the information obtained at clinical resolution could be related to the information obtained from autopsy tissues. While we observed shifts in the relaxation parameters consistent with our expectations, we discovered inherent constraints in the approach using multi-echo sequences which limited some aspects of the quantitative analysis that could be performed. However, during this pilot study at University of Florida, resting-state data were obtained from the participants in a component of the work led by Dr Frank Skidmore, which generated two collaborative papers (Skidmore et al, Neuroimage, 2013) reporting the scope for utilization of resting state analysis to distinguish Parkinson's from healthy controls, and also to distinguish features (apathy, depression, and motor symptoms) in Parkinson's disease.

In summary, we used a unique combination of physical sciences techniques to characterize iron accumulations in critical regions of the brain in group of related neurodegenerative disorders.
Exploitation Route This knowledge will be used to further determine the potential of iron accumulations for early diagnosis using MRI, and to further our understanding of iron-associated pathogenesis and the impact of chelation on the brain. Following the initial clinical pilot work at University of Florida, we recently used this experience to trial single-echo and field-dependent approaches in MRI analysis of healthy volunteers, to ensure we could obtain a robust relationship between MRI parameters and brain iron in the clinical setting. This work was presented at the International Society for Magnetic Resonance in Medicine in 2014, and is informing our current efforts to improve methods for early diagnosis of neurodegenerative disorders. Meanwhile, synchrotron X-ray fluorescence analysis is increasingly being adopted by those interested in non-destructive spatial analysis of trace elements in tissues, and work performed under this EPSRC Award catalyzed an invitation to contribute an article to Frontiers in Pharmacology, where we reviewed the contribution of synchrotron science to the study of iron in neurodegenerative disorders, showcasing how many advanced synchrotron techniques that are typically the domain of the physical sciences are increasingly being applied to progress our understanding of disease (http://community.frontiersin.org/people/JoannaCollingwood/121804).
Sectors Healthcare,Pharmaceuticals and Medical Biotechnology,Other

 
Description In addition to the key findings from this Award attracting over 200 citations in a broad range of discipline areas, some of our Large Facility use under this Award (such as at the Diamond Light Source) led to protocol sharing: for example, the methods developed for synchrotron X-ray Fluorescence mapping of trace metals in tissues being adopted by others, including orthopedic surgeon Professor Alister Hart in his work investigating debris in tissues following the failure of metal-on-metal hip implants; research which contributed to policy change on the use of this type of hip implant. The MRI protocols developed at the National High Magnetic Field Laboratory have also been used in subsequent and current projects with clinicians (primarily at University Hospitals Coventry and Warwickshire) to look at methods to facilitate detection of altered patterns of brain iron deposition in neurodegenerative disorders. Our findings are also now being used in work with LGC Group for the analysis of trace metals in tissues.
First Year Of Impact 2008
Sector Healthcare,Pharmaceuticals and Medical Biotechnology,Other
Impact Types Economic,Policy & public services

 
Description EPSRC First Grant
Amount £99,934 (GBP)
Funding ID EP/K035193/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 12/2013 
End 12/2015
 
Description PhD studentship
Amount £75,000 (GBP)
Organisation Alzheimer's Society 
Sector Charity/Non Profit
Country United Kingdom
Start 10/2009 
End 12/2012