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Research ArticleADULT BRAIN

Does Gadolinium Deposition Lead to Metabolite Alteration in the Dentate Nucleus? An MRS Study in Patients with MS

M. Mohammadzadeh, S. Kolahi, M.-M. Mehrabi Nejad, K. Firouznia, H. Naghibi, A. Mohammadzadeh, M. Shakiba, F. Mohebi, H. Komaki, H. Sharifian, H. Hashemi, M.H. Harirchian, A. Azimi, M.E. Adin and D.M. Yousem
American Journal of Neuroradiology September 2022, DOI: https://doi.org/10.3174/ajnr.A7623
M. Mohammadzadeh
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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S. Kolahi
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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M.-M. Mehrabi Nejad
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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K. Firouznia
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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H. Naghibi
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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A. Mohammadzadeh
cDepartment of Radiology (A.M.), Iran University of Medical Sciences, Tehran, Iran
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M. Shakiba
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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F. Mohebi
dHass School of Business (F.M.), University of California, Berkeley, Berkeley, California
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H. Komaki
eKhoury College of Computer Sciences (H.K.), Northeastern University, Boston, Massachusetts
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H. Sharifian
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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H. Hashemi
aFrom the Departments of Radiology (M.M., S.K., M.-M.M.N., K.F., H.N., M.S., H.S., H.H.)
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M.H. Harirchian
bNeurology (M.H.H., A.A.), Tehran University of Medical Sciences, Tehran, Iran
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A. Azimi
bNeurology (M.H.H., A.A.), Tehran University of Medical Sciences, Tehran, Iran
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M.E. Adin
fDepartment of Radiology and Biomedical Imaging (M.E.A.), Yale School of Medicine, New Haven, Connecticut
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D.M. Yousem
gDepartment of Radiology (D.M.Y.), Johns Hopkins University School of Medicine, Baltimore, Maryland
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Abstract

BACKGROUND AND PURPOSE: Repeat contrast-enhanced MR imaging exposes patients with relapsing-remitting MS to frequent administration of gadolinium-based contrast agents. We aimed to investigate the potential metabolite and neurochemical alterations of visible gadolinium deposition on unenhanced T1WI in the dentate nucleus using MRS.

MATERIALS AND METHODS: This prospective study was conducted in a referral university hospital from January 2020 to July 2021. The inclusion criteria for case and control groups were as follows: 1) case: patients with relapsing-remitting MS, visible gadolinium deposition in the dentate nucleus (ribbon sign), >5 contrast-enhanced MR images obtained; 2) control 1: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, >5 contrast-enhanced MR images obtained; 3) control 2: patients with relapsing-remitting MS without visible gadolinium deposition in the dentate nucleus, <5 contrast-enhanced-MR images obtained; and 4) control 3: adult healthy individuals, with no contrast-enhanced MR imaging. Dentate nucleus and pontine single-voxel 12 × 12 × 12 MRS were analyzed using short TEs.

RESULTS: Forty participants (10 per group; 27 [67.5%] female; mean age, 35.6 [SD, 9.6] years) were enrolled. We did not detect any significant alteration in the levels of NAA and choline between the studied groups. The mean concentrations of mIns were 2.7 (SD, 0.73) (case), 1.5 (SD, 0.8) (control 1), 2.4 (SD, 1.2) (control 2), and 1.7 (SD, 1.2) (control 3) (P = .04). The mean concentration of Cr and mIns (P = .04) and the relative metabolic concentration (dentate nucleus/pons) of lipid 1.3/Cr (P = .04) were significantly higher in the case-group than in healthy individuals (controls 1–3). Further analyses compared the case group with cumulative control 1 and 2 groups and showed a significant increase in lactate (P = .02), lactate/Cr (P = .04), and Cr (dentate nucleus/pons) (P = .03) in the case group.

CONCLUSIONS: Although elevated concentrations of Cr, lactate, mIns, and lipid in the dentate nucleus of the case group indicate a metabolic disturbance, NAA and choline levels were normal, implying no definite neuronal damage.

ABBREVIATIONS:

CE
contrast-enhanced
DN
dentate nucleus
GBCA
gadolinium-based contrast agent
Gd
gadolinium
RRMS
relapsing-remitting MS
SI
signal intensity

Footnotes

  • M. Mohammadzadeh and S. Kolahi had equal contribution as co-first authors.

  • Disclosure forms provided by the authors are available with the full text and PDF of this article at www.ajnr.org.

  • © 2022 by American Journal of Neuroradiology
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Does Gadolinium Deposition Lead to Metabolite Alteration in the Dentate Nucleus? An MRS Study in Patients with MS
M. Mohammadzadeh, S. Kolahi, M.-M. Mehrabi Nejad, K. Firouznia, H. Naghibi, A. Mohammadzadeh, M. Shakiba, F. Mohebi, H. Komaki, H. Sharifian, H. Hashemi, M.H. Harirchian, A. Azimi, M.E. Adin, D.M. Yousem
American Journal of Neuroradiology Sep 2022, DOI: 10.3174/ajnr.A7623

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Does Gadolinium Deposition Lead to Metabolite Alteration in the Dentate Nucleus? An MRS Study in Patients with MS
M. Mohammadzadeh, S. Kolahi, M.-M. Mehrabi Nejad, K. Firouznia, H. Naghibi, A. Mohammadzadeh, M. Shakiba, F. Mohebi, H. Komaki, H. Sharifian, H. Hashemi, M.H. Harirchian, A. Azimi, M.E. Adin, D.M. Yousem
American Journal of Neuroradiology Sep 2022, DOI: 10.3174/ajnr.A7623
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