Longitudinal changes in pallidal index and their associations with urinary manganese and CaNa₂EDTA chelation

IF 3.8 3区医学 Q2 NEUROSCIENCES

Neurotoxicology Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI:10.1016/j.neuro.2026.103397

Tuğba Akkale , Nuriye Kayalı Şendur , Süleyman Filiz , Nilüfer Merve Çelik

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引用次数: 0

Abstract

Objectives

In this study, the evaluation of the change in pallidal index (PI) (ΔPI) between baseline and follow-up magnetic resonance imaging; the examination of the relationship between ΔPI and spot urine manganese (Mn) levels and baseline PI values; and the investigation of the possible effect of CaNa₂EDTA chelation therapy administered during the follow-up period on pallidal Mn accumulation were aimed.

Methods

In 27 participants monitored due to occupational Mn exposure, right and left PI were measured from T1-weighted images using standard protocols. ΔPI was calculated as the difference between the baseline and follow-up measurements. During CaNa₂EDTA treatment, whole blood and spot urine Mn levels were measured on the first day of each treatment course and on rest days, while 24-hour urinary Mn levels were assessed on the third day of treatment. In individuals treated with CaNa₂EDTA, the pre- and post-treatment change in PI was evaluated as a secondary analysis. Associations between ΔPI and Mn biomarkers were analyzed using the Spearman rho coefficient.

Results

It was determined that both right and left PI significantly decreased during the follow-up period. A negative correlation was found between spot urine Mn levels and ΔPI (right: ρ = –0.59; left: ρ = –0.45; p < 0.05), indicating that the reduction in PI is more limited in individuals with higher current exposure. The positive correlation of ΔPI with the initial PI (right: ρ = 0.51; left: ρ = 0.74; p < 0.05) suggests that the initial accumulation level is a determining factor in the amount of reduction. Following CaNa₂EDTA treatment, blood Mn levels significantly

Decreased in parallel with the observed reduction in PI.

Conclusion

PI is a dynamic imaging biomarker sensitive to changes in Mn accumulation, reflecting both the exposure level and the response to chelation therapy. The integration of MRI-based measurements with biological exposure markers can provide significant contributions to the monitoring and evaluation of treatment efficacy in populations exposed to Mn.

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苍白指数的纵向变化及其与尿锰和can2edta螯合的关系

目的评价基线期和随访期磁共振成像患者苍白质指数（PI）（ΔPI）的变化；检查ΔPI与尿锰（Mn）水平和基线PI值之间的关系；并探讨在随访期间给予can2edta螯合治疗对白斑Mn积累的可能影响。方法27例职业性锰暴露监测对象，采用标准方案从t1加权图像测量左、右PI。ΔPI计算为基线和随访测量值之间的差异。在can2 EDTA治疗期间，在每个疗程的第一天和休息日测量全血和斑点尿锰水平，在治疗的第三天评估24小时尿锰水平。在接受can2edta治疗的个体中，评估治疗前和治疗后PI的变化作为次要分析。使用Spearman rho系数分析ΔPI和Mn生物标志物之间的关联。结果随访期间左、右PI均明显降低。当场尿锰水平与ΔPI呈负相关（右：ρ = -0.59；左：ρ = -0.45; p <； 0.05），表明在高电流暴露的个体中，PI的降低更为有限。ΔPI与初始PI呈正相关（右：ρ = 0.51；左：ρ = 0.74; p <； 0.05）表明初始积累水平是减少量的决定因素。在can2edta治疗后，血锰水平显著下降，与观察到的PI降低平行。结论pi是对锰积累变化敏感的动态成像生物标志物，反映了暴露水平和对螯合治疗的反应。基于核磁共振成像的测量与生物暴露标记的整合可以为监测和评估Mn暴露人群的治疗效果提供重要贡献。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurotoxicology 医学-毒理学

CiteScore

6.80

自引率

5.90%

发文量

161

审稿时长

70 days

期刊介绍： NeuroToxicology specializes in publishing the best peer-reviewed original research papers dealing with the effects of toxic substances on the nervous system of humans and experimental animals of all ages. The Journal emphasizes papers dealing with the neurotoxic effects of environmentally significant chemical hazards, manufactured drugs and naturally occurring compounds.