title: Globus pallidus magnetization transfer ratio, T(1) and T(2) in primary biliary cirrhosis: relationship with disease stage and age.
abstract: OBJECTIVE
  To determine whether the magnetization transfer ratio (MTR) of the globus pallidus (GP) in patients with primary biliary cirrhosis (PBC) correlates with age, disease stage, and fatigue, using T(1) and T(2) mapping to determine whether the mechanism of change is consistent with manganese deposition in the GP as suggested by previous reports.
  
  
  METHODS
  In all, 30 early-stage PBC patients, four end-stage PBC patients, and 14 female controls were recruited to age-matched groups. MTR, T(1) and T(2) measurements were performed. A bilateral region of interest (ROI)-based analysis was used to calculate GP MTR, T(1), and T(2) values. These were correlated with age, disease status, and fatigue.
  
  
  RESULTS
  MTR measurements showed a significant, negative correlation with age for controls and early-stage PBC patients, a positive correlation with T(2), and no correlation with T(1). Only GP T(2) is significantly lower in early-stage PBC patients than controls, while end-stage patients demonstrated a simultaneous reduction in T(1) and MTR, consistent with GP manganese deposition.
  
  
  CONCLUSIONS
  MTR measurements correlate with age in both early-stage patient and control groups, but are not associated with manganese deposition or fatigue severity: only the end-stage disease group shows changes in MTR, T(1), T(2) that are consistent with manganese deposition.
authors.affiliation: Newcastle Magnetic Resonance Centre, Newcastle University, UK. k.g.hollingsworth@ncl.ac.uk
authors.forename: Kieren G
authors.initials: KG
authors.lastname: Hollingsworth
authors.forename: David E
authors.initials: DE
authors.lastname: Jones
authors.forename: Benjamin S
authors.initials: BS
authors.lastname: Aribisala
authors.forename: Peter E
authors.initials: PE
authors.lastname: Thelwall
authors.forename: Roy
authors.initials: R
authors.lastname: Taylor
authors.forename: Julia L
authors.initials: JL
authors.lastname: Newton
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Blamire
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002908:Chronic Disease; D005221:Fatigue / Q000097:blood / Q000209:etiology* / Q000473:pathology; D005260:Female; D005917:Globus Pallidus / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008345:Manganese / Q000097:blood*; D008875:Middle Aged; D012720:Severity of Illness Index
chemical_list: D008345:Manganese