Locus Coeruleus Magnetic Resonance Imaging in Neurological Diseases
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(2021) 21:2
NEUROIMAGING (N. PAVESE, SECTION EDITOR)
Locus Coeruleus Magnetic Resonance Imaging in Neurological Diseases Alessandro Galgani 1 & Francesco Lombardo 2 & Daniele Della Latta 3 & Nicola Martini 3 & Ubaldo Bonuccelli 1 & Francesco Fornai 4,5 & Filippo Sean Giorgi 1,4 Accepted: 17 November 2020 # The Author(s) 2020
Abstract Purpose of Review Locus coeruleus (LC) is the main noradrenergic nucleus of the brain, and its degeneration is considered to be key in the pathogenesis of neurodegenerative diseases. In the last 15 years,MRI has been used to assess LC in vivo, both in healthy subjects and in patients suffering from neurological disorders. In this review, we summarize the main findings of LC-MRI studies, interpreting them in light of preclinical and histopathological data, and discussing its potential role as diagnostic and experimental tool. Recent findings LC-MRI findings were largely in agreement with neuropathological evidences; LC signal showed to be not significantly affected during normal aging and to correlate with cognitive performances. On the contrary, a marked reduction of LC signal was observed in patients suffering from neurodegenerative disorders, with specific features. Summary LC-MRI is a promising tool, which may be used in the future to explore LC pathophysiology as well as an early biomarker for degenerative diseases. Keywords Locus coeruleus . Magnetic resonance imaging . Neuromelanin . Noradrenaline . Alzheimer’s disease . Parkinson’s disease
Introduction The locus coeruleus (LC) is the main noradrenergic (NA) nucleus of the central nervous system and its fibers widely innervate cortical and subcortical structures [1]. LC contributes to several brain functions. In particular, it plays a key role in sleep-waking cycle [2], modulates the neuro-glial homeostasis [3], regulates neurovascular unit proper functioning [4], This article is part of the Topical Collection on Neuroimaging * Filippo Sean Giorgi [email protected]; [email protected] 1
Neurology Unit, Pisa University Hospital, Pisa, Italy
2
U.O.C. “Risonanza Magnetica Specialistica e Neuroradiologia”, Fondazione “G. Monasterio”- National Research Council/Tuscany Region, Pisa, Italy
3
Deep Health Unit, Fondazione “G. Monasterio”- National Research Council/Tuscany Region, Pisa, Italy
4
Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
5
IRCCS Neuromed, Pozzilli, Italy
and is key in specific neuropsychological processes, such as novelty-oriented attention and learning [5]. A significant LC degeneration occurs in the early stages of some neurodegenerative disorders (NDD), such as Parkinson’s Disease (PD)(reviewed in [6]) and Alzheimer’s Disease (AD) [7]; this has been suggested to be not just a mere epiphenomenon but to play a key pathogenetic role. The mechanisms through which LC degenerates in PD and AD differ: in AD, it is related to progressive accumulation of Tau pathology, starting from hyperphosphorylated TAU (pTAU) up to neurofibrillary tang
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