Assessing the Association Between Gadolinium-Based Contrast Agents and Parkinson Disease: Insights From the Korean National Health Insurance Service Database

Investigative Radiology, Год журнала: 2025, Номер unknown

Опубликована: Янв. 22, 2025

Objectives This study aimed to investigate the association between use of linear and macrocyclic gadolinium-based contrast agents (GBCAs) subsequent development Parkinson disease (PD). Methods In this retrospective cohort study, data were extracted from Korean National Health Insurance Service database, comprising 1,038,439 individuals. From population, 175,125 adults aged 40 60 years with no history brain identified. All patients including 3835 who administered GBCA at least once monitored until 2022 for onset PD. Propensity score (PS) matching was employed compare incidence PD those exposed GBCAs (either or macrocyclic) not (no-GBCA group). Results The final consisted 1175 subjects GBCAs, 2334 171,616 unexposed any After PS matching, significantly higher in group compared no-GBCA (0.9% vs 0.0%, P = 0.002) also than (0.5% 0.04%, 0.003). No significant difference observed groups. Conclusions Exposure linked an increased risk developing large population-based study. did differ GBCAs.

Язык: Английский

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Novel Magnetic Resonance Imaging Tools for the Diagnosis of Degenerative Disc Disease: A Narrative Review

Diagnostics, Год журнала: 2022, Номер 12(2), С. 420 - 420

Опубликована: Фев. 6, 2022

Low back pain (LBP) is one of the leading causes disability worldwide, with a significant socioeconomic burden on healthcare systems. It mainly caused by degenerative disc disease (DDD), progressive, chronic, and age-related process. With its capacity to accurately characterize intervertebral (IVD) spinal morphology, magnetic resonance imaging (MRI) has been established as most valuable tools in diagnosing DDD. However, existing technology cannot detect subtle changes IVD tissue composition cell metabolism. In this review, we summarized state art regarding innovative quantitative MRI modalities that have shown discriminate quantify matrix integrity, well biomechanical early stages Validation implementation new clinical setting will allow for an diagnosis DDD ideally guide conservative regenerative treatments may prevent progression process rather than intervene at latest disease.

Язык: Английский

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The plasticity of biocompatibility

Biomaterials, Год журнала: 2023, Номер 296, С. 122077 - 122077

Опубликована: Март 9, 2023

Biocompatibility concerns the phenomena that occur within interactions between biomaterials and human patients, which ultimately control performance of many facets medical technology. It involves aspects materials science, different forms engineering nanotechnology, chemistry, biophysics, molecular cellular biology, immunology, pathology a myriad clinical applications. is not surprising an overarching framework mechanisms biocompatibility has been difficult to elucidate validate. This essay discusses one fundamental reason for this; we have tended consider pathways as essentially linear sequences events follow well-understood processes science biology. The reality, however, may involve great deal plasticity, in additional idiosyncratic factors, including those genetic, epigenetic viral origin, exert influence, do complex mechanical, physical pharmacological variables. Plasticity inherent core feature synthetic materials; here more recent biological applications plasticity concepts into sphere pathways. A straightforward pathway result successful outcomes patients; describe this terms classic In other situations, usually command much attention because their unsuccessful outcomes, these plasticity-driven alternative pathways; often, variability with identical technologies due rather than material or device deficiency.

Язык: Английский

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Use of gadolinium-based contrast agents in multiple sclerosis: a review by the ESMRMB-GREC and ESNR Multiple Sclerosis Working Group

European Radiology, Год журнала: 2023, Номер 34(3), С. 1726 - 1735

Опубликована: Сен. 2, 2023

Язык: Английский

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Off-label intrathecal use of gadobutrol: safety study and comparison of administration protocols

Neuroradiology, Год журнала: 2020, Номер 63(1), С. 51 - 61

Опубликована: Авг. 15, 2020

Abstract Purpose Magnetic resonance imaging (MRI) contrast agents have been used off-label for diagnosis of cerebrospinal fluid (CSF) leaks and lately also assessment the glymphatic system meningeal lymphatic drainage. The purpose this study was to further evaluate short- long-term safety profile intrathecal MRI agents. Methods In prospective study, we compared different administration protocols gadobutrol (Gadovist TM ; 1.0 mmol/ml). Gadobutrol administered in a dose 0.5 mmol, with or without iodixanol (Visipaque 270 mg I/ml; 3 ml). addition, subgroup given 0.25 mmol. Adverse events were assessed at 1 days, 4 weeks, after 12 months. Results Among 149 patients, no serious adverse seen patients history prior events. combination did not increase occurrence non-serious days 1–3. Intrathecal mmol caused less severity nausea, as clinical major determinant gadobutrol. Conclusion This showed that is safe. Non-serious lesser degree affected by protocols, though preliminary data are side effects dose-dependent.

Язык: Английский

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Neurologic Effects of Gadolinium Retention in the Brain after Gadolinium-based Contrast Agent Administration

Radiology, Год журнала: 2021, Номер 302(3), С. 676 - 683

Опубликована: Дек. 21, 2021

Background Concerns over the neurotoxic potential of retained gadolinium in brain tissues after intravenous gadolinium-based contrast agent (GBCA) administration have led to pronounced worldwide use changes, yet clinical sequelae retention remain undefined. Purpose To assess and neurologic effects neurotoxicity rats various GBCAs. Materials Methods From March 2017 through July 2018, 183 male Wistar received 20 injections 2.5 mmol per kilogram body weight (80 human equivalent doses) GBCAs (gadodiamide, gadobenate, gadopentetate, gadoxetate, gadobutrol, gadoterate, gadoteridol) or saline 4 weeks. Rats were evaluated 6 34 weeks injection with five behavioral tests, inductively coupled plasma mass spectrometry, transmission electron microscopy, histopathology performed on urine, serum, cerebrospinal fluid (CSF), basal ganglia, dentate nucleus, kidney samples. Dunnett post hoc test Wilcoxon rank sum used compare differences between treatment groups. Results No evidence any was observed GBCA-exposed control animals at either (P = .08 P .99). Gadolinium concentrations both neuroanatomic locations higher linear than macrocyclic < .001). clearance time varied among GBCAs, gadobutrol having largest (median: 62% for 70% dentate) gadodiamide no substantial clearance. At weeks, largely cleared from CSF serum gadodiamide-, gadobenate-, gadoterate-, gadobutrol-exposed rats, especially agents (range: 70%–98% removal CSF, 34%–94% serum), nearly completely removed urine 96%–99% removal). Transmission microscopy detect foci tissue, but histopathologic GBCA. Conclusion In this rat model, exposure supradiagnostic doses. © RSNA, 2022 Online supplemental material is available article.

Язык: Английский

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Development and Evaluation of the Magnetic Properties of a New Manganese (II) Complex: A Potential MRI Contrast Agent

International Journal of Molecular Sciences, Год журнала: 2023, Номер 24(4), С. 3461 - 3461

Опубликована: Фев. 9, 2023

Magnetic resonance imaging (MRI) is a non-invasive powerful modern clinical technique that extensively used for the high-resolution of soft tissues. To obtain high-definition pictures tissues or whole organism this enhanced by use contrast agents. Gadolinium-based agents have an excellent safety profile. However, over last two decades, some specific concerns surfaced. Mn(II) has different favorable physicochemical characteristics and good toxicity profile, which makes it alternative to Gd(III)-based MRI currently in clinics. Mn(II)-disubstituted symmetrical complexes containing dithiocarbamates ligands were prepared under nitrogen atmosphere. The magnetic measurements on Mn carried out with phantom at 1.5 T resonance. Relaxivity values, contrast, stability evaluated appropriate sequences. Studies conducted evaluate properties paramagnetic water using showed produced complex [Mn(II)(L’)2] × 2H2O (L’ = 1.4-dioxa-8-azaspiro[4.5]decane-8-carbodithioate), comparable gadolinium medicine as agent.

Язык: Английский

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Prospective Safety Study of Intrathecal Gadobutrol in Different Doses

American Journal of Neuroradiology, Год журнала: 2023, Номер 44(5), С. 511 - 516

Опубликована: Апрель 6, 2023

BACKGROUND AND PURPOSE:

In our clinical practice, we increasingly use intrathecal contrast-enhanced glymphatic MR imaging to assess CSF disturbances. However, because contrast agents such as gadobutrol (Gadovist; 1.0 mmol/mL) are used off-label, a thorough understanding of the safety profile is required.

MATERIALS METHODS:

We performed prospective study from August 2020 June 2022 gadobutrol, including consecutive patients who received either 0.50, 0.25, or 0.10 mmol. Serious and nonserious adverse events were recorded systematically at 1–3 days, 4 weeks, >6 months after administration.

RESULTS:

The included 196 assessed for idiopathic normal pressure hydrocephalus (iNPH, n = 144) examined other disorders (non-iNPH cohort; 52). doses 0.50 mmol (n 56), 0.25 111), 29). No serious observed. Nonserious on days were, some degree, dose-dependent but mild-to-moderate, severe headache, nausea, and/or dizziness in 6/196 (6.3%) patients, they more common non-iNPH than iNPH cohort. At none reported events, 9/179 (5.0%) had mild-to-moderate symptoms. After months, 2 mild headache.

CONCLUSIONS:

present adds accumulating evidence that up safe.

Язык: Английский

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Skin Toxicity After Exposure to Gadolinium-Based Contrast Agents in Normal Renal Function, Using Clinical Approved Doses

Investigative Radiology, Год журнала: 2023, Номер unknown

Опубликована: Апрель 24, 2023

Objectives The aim of this study was to summarize the current preclinical and clinical evidence on association between exposure gadolinium (Gd) compounds skin toxicity in a setting similar practice. Materials Methods A search MEDLINE PubMed references from January 2000 December 2022 performed using keywords related deposition its effects skin, such as “gadolinium,” “gadolinium-based contrast agents,” “skin,” “deposition,” “toxicity.” In addition, cross-referencing added when appropriate. For vitro studies, we included all studies that analyzed response human dermal fibroblasts various compounds. animal only those animals or patients with preserved renal function (estimated glomerular filtration rate >30 mL/min/1.73 m 2 ), dosage gadolinium-based agents (GBCAs) commonly applied (0.1 mmol/kg). Results Forty were selected. Preclinical findings suggest Gd can produce profibrotic responses vitro, through activation proliferation promoting their myofibroblast differentiation. Gadolinium influences process collagen production content by increasing levels matrix metalloproteinase-1 tissue inhibitor metalloproteinase-1. show deposit higher concentrations linear GBCAs are applied. However, these deposits decrease over time not associated obvious macroscopic histological modifications. relevance inducing small fiber neuropathy remains be determined. Clinical is detectable hair subjects normal after intravenous administration compared macrocyclic GBCA. cutaneous Also, subclinical involvement GBCA may brain MRI. There no conclusive support causal relationship at dose manifestations function. Conclusions especially acting fibroblasts, shown studies. even used, confirmed both proof date cause-effect doses consequences Multiple factors, yet determined, should considered for sporadic who develop temporally administration.

Язык: Английский

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Gadolinium Toxicity: Mechanisms, Clinical Manifestations, and Nanoparticle Role

Опубликована: Апрель 29, 2025

Gadolinium-based contrast agents (GBCAs), essential for MRI, are facing renewed scrutiny due to gadolinium (Gd) retention and emerging toxicity profiles. While the link between less stable Nephrogenic Systemic Fibrosis (NSF) in renal impairment is established, deposition also observed brain, bone, skin across all GBCA classes, even patients with normal function. This finding has raised concerns led controversial concept of Gadolinium Deposition Disease (GDD). The present review synthesizes current evidence on clinical manifestations underlying mechanisms. It highlights pathways beyond traditional transmetallation, particularly endogenous nanoparticle formation as a key mechanism Gd release retention, potentially challenging stability assumptions macrocyclic agents. Structural factors (linear/macrocyclic; ionic/non-ionic) parameters (thermodynamic log K; kinetic kobs) influencing risk evaluated alongside regulatory responses. GBCAs should be viewed not inert diagnostics but complex, cumulative biological interactions. Future research focus developing non-gadolinium alternatives, validating biomarkers early detection conducting controlled trials chelation therapy efficacy. Clinicians must balance diagnostic benefits potential long-term risks, ensuring informed patient consent judicious use.

Язык: Английский

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