title: Myelin breakdown and iron changes in Huntington's disease: pathogenesis and treatment implications.
abstract: BACKGROUND
  Postmortem and in vivo imaging data support the hypothesis that premature myelin breakdown and subsequent homeostatic remyelination attempts with increased oligodendrocyte and iron levels may contribute to Huntington's Disease (HD) pathogenesis and the symmetrical progress of neuronal loss from earlier-myelinating striatum to later-myelinating regions. A unique combination of in vivo tissue integrity and iron level assessments was used to examine the hypothesis.
  
  
  METHODS
  A method that uses two Magnetic resonance imaging (MRI) instruments operating at different field-strengths was used to quantify the iron content of ferritin molecules (ferritin iron) as well as tissue integrity in eight regions in 11 HD and a matched group of 27 healthy control subjects. Three white matter regions were selected based on their myelination pattern (early to later-myelinating) and fiber composition. These were frontal lobe white matter (Fwm) and splenium and genu of the corpus callosum (Swm and Gwm). In addition, gray matter structures were also chosen based on their myelination pattern and fiber composition. Three striatum structures were assessed [caudate, putamen, and globus pallidus (C, P, and G)] as well as two comparison gray matter regions that myelinate later in development and are relatively spared in HD [Hippocampus (Hipp) and Thalamus (Th)].
  
  
  RESULTS
  Compared to healthy controls, HD ferritin iron levels were significantly increased in striatum C, P, and G, decreased in Fwm and Gwm, and were unchanged in Hipp, Th, and Swm. Loss of tissue integrity was observed in C, P, Fwm, and especially Swm but not Hipp, Th, G, or Gwm. This pattern of findings was largely preserved when a small subset of HD subjects early in the disease process was examined.
  
  
  CONCLUSIONS
  The data suggest early in the HD process, myelin breakdown and changes in ferritin iron distribution underlie the pattern of regional toxicity observed in HD. Prospective studies are needed to verify myelin breakdown and increased iron levels are causal factors in HD pathogenesis. Tracking the effects of novel interventions that reduce myelin breakdown and iron accumulation in preclinical stages of HD could hasten the development of preventive treatments.
authors.affiliation: Department of Neurology, The David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. gbar@ucla.edu
authors.forename: George
authors.initials: G
authors.lastname: Bartzokis
authors.forename: Po H
authors.initials: PH
authors.lastname: Lu
authors.forename: Todd A
authors.initials: TA
authors.lastname: Tishler
authors.forename: Sophia M
authors.initials: SM
authors.lastname: Fong
authors.forename: Bolanle
authors.initials: B
authors.lastname: Oluwadara
authors.forename: J Paul
authors.initials: JP
authors.lastname: Finn
authors.forename: Danny
authors.initials: D
authors.lastname: Huang
authors.forename: Yvette
authors.initials: Y
authors.lastname: Bordelon
authors.forename: Jim
authors.initials: J
authors.lastname: Mintz
authors.forename: Susan
authors.initials: S
authors.lastname: Perlman
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D001923:Brain Chemistry / Q000502:physiology; D003627:Data Interpretation, Statistical; D005260:Female; D005293:Ferritins / Q000378:metabolism; D006801:Humans; D006816:Huntington Disease / Q000378:metabolism* / Q000473:pathology* / Q000628:therapy; D007091:Image Processing, Computer-Assisted; D007501:Iron / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009186:Myelin Sheath / Q000473:pathology*
chemical_list: D005293:Ferritins; D007501:Iron