Normative Values of Neuromelanin-Sensitive MRI Signal in Older Adults Obtained Using a Turbo Spin Echo Sequence

Background The integrity and function of catecholamine neurotransmitter systems can be assessed using neuromelanin-sensitive MRI (NM-MRI). The relevance of this method to neurodegenerative and psychiatric disorders is becoming increasingly evident, and it has potential as a clinical biomarker. Purpose To support future application of NM-MRI as a clinical biomarker by defining the normative range of NM-MRI signal and volume metrics in cognitively normal older adults. Study Type Prospective. Population A total of 152 cognitively normal older adults aged 53-86 years old, including 41 participants who had follow-up NM-MRI data collected 9-16 months later. Field Strength/Sequence A 3.0 T; NM-MRI turbo spin echo and T1-weighted magnetization-prepared rapid acquisition with gradient echo sequences. Assessment NM-MRI images were processed to yield summary measures of volume and signal (contrast-to-noise ratio, CNR) for the substantia nigra (SN) and locus coeruleus (LC) using a recently developed software employing a fully automated algorithm. Change in these metrics over time was also assessed. Statistical Tests Mean and standard deviation of NM-MRI metrics were calculated; change over time was tested for significance using 1-sample t-tests. P values < 0.05 were considered statistically significant. Results At baseline SN signal (CNR) was 10.02% (left) and 10.28% (right) and LC signal was 24.71% (left) and 20.42% (right). Baseline SN volume was 576 mm(3) (left) and 540 mm(3) (right) and LC volume was 6.31 mm(3) (left) and 6.30 mm(3) (right). The only NM-MRI metric showing significant change was a decrease in left SN volume (t(40) = -2.57, P = 0.014). Data Conclusion We report normative values for NM-MRI signal and volume in the SN and LC of cognitively normal older adults and explore their change over time. These values may help future efforts to use NM-MRI as a clinical biomarker by facilitating identification of patients with extreme NM-MRI values. Level of Evidence 2. Technical Efficacy Stage 1.

Automated summary

This study aims to support the use of NM-MRI as a clinical biomarker by establishing the normal range of NM-MRI signal and volume metrics in cognitively normal older adults. The results indicate that the only significant change in NM-MRI metrics in older adults is a decrease in left substantia nigra volume.