Absence of dentate nucleus resting-state functional connectivity changes in nonneurological patients with gadolinium-related hyperintensity on T1 -weighted images

Abstract

Background: The dentate nuclei of the cerebellum are the areas where gadolinium predominantly accumulates. It is not yet known whether gadolinium deposition affects brain functions.

Purpose/hypothesis: To assess whether gadolinium-dependent high signal intensity of the cerebellum on T₁ -weighted images of nonneurological adult patients with Crohn's disease is associated with modifications of resting-state functional connectivity (RSFC) of the cerebellum and dentate nucleus.

Study type: Observational, cross-sectional.

Population: Fifteen patients affected by Crohn's disease were compared with 16 healthy age- and gender-matched control subjects. All participants underwent neurological, neurocognitive-psychological assessment, and blood sampling.

Field strength/sequence: 1.5-T magnet blood oxygenation level-dependent (BOLD) functional MRI.

Assessment: High signal intensity on T₁ -weighted images, cerebellum functional connectivity, neurocognitive performance, and blood circulating gadolinium levels.

Statistical tests: An unpaired two-sample t-test (age and sex were nuisance variables) was used to investigate between-group differences in cerebellar and dentate nucleus functional connectivity. Z-statistical images were set using clusters determined by Z > 2.3 and a familywise error (FWE)-corrected cluster significance threshold of P = 0.05.

Results: Dentate nuclei RSFC was not different (P = n.s.) between patients with gadolinium-dependent high signal intensity on T₁ -weighted images and controls. Pre- and postcentral gyrus bilaterally and the right supplementary motor cortex showed a decrease of RSFC with the cerebellum hemispheres (P < 0.05 FWE-corrected) and was related to disease duration but not to gadodiamide cumulative doses (P = n.s.).

Data conclusion: Crohn's disease patients with gadolinium-dependent hyperintense dentate nuclei on unenhanced T₁ -weighted images do not show dentate nucleus RSFC changes.

Level of evidence: 2 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2019;50:445-455.

Keywords: Crohn's disease; brain connectivity; dentate nucleus; fMRI; gadolinium based contrast agents.