Understanding the relationship between beta-amyloid plaque pathology in AD and the associated MRI contrast is fundamentally important for MRI study of AD pathology. This work demonstrates the ability to image Aβ plaques in histology sections of both human AD and amyloid-generating APP/PS1 transgenic mice brains. The histological MR images taken at a field strength of 7.0 T clearly show high resolution details of Aβ plaques in human and animal samples. Previous MRI studies of Aβ plaques have been carried out with blocks of human AD brain tissue samples (
1). With this approach, accurately matching histological sections of the whole tissue block with the MRI image slice is difficult. Using the histological RF coil, MRI and histological analyses were performed on the same tissue sample so that tissue pathology and associated MRI contrast changes could be precisely compared. This capability allowed us to establish a one-to-one relationship between MRI parameters and histology data acquired from human AD and APP/PS1 transgenic mouse tissue samples. Such a relationship is important for the interpretation of MRI findings in the AD brain and its animal models. Additionally, the information acquired with this technology is valuable in the development of potential therapies for AD research and investigations of other pathologies.
The MR imaging of amyloid plaques in transgenic APP/PS1 mice has been pioneered by several groups using both
in vivo and
ex vivo imaging methodologies (
4,
15,
16). The hypo-intensities in the MR images of APP/PS1 animal tissue that coincide with the plaques are similar in signal dropout and size compared to MR images of human AD plaques ( and ). The cause for the hypo-intensities seen in T
2* and T
2 weighted images of APP/PS1 mice thus has been believed to be caused by high iron accumulation in the plaques (
4,
15,
16). However, when viewing the iron and Aβ stained images in and , the iron concentration is significantly reduced in the APP/PS1 Aβ plaques compared to the human AD tissue in , while Aβ-plaques in APP/PS1 and human AD samples are perceptibly the same when viewed with MR images. To confirm that the staining methods did not cause aberrant interactions with one another, independent iron and amyloid stains were performed yielding the same appearance as co-staining procedures. To understand this unexpected result, notice that APP/PS1 plaques in and show an extremely dense nature, which suggested that the current traditional Perl’s staining method might not be able to stain the iron inside these plaques. The hydrophobic nature of the plaques coupled with the acidic aqueous based Perl’s stain could prevent the Prussian blue reaction from occurring if the stain cannot infiltrate into the plaque. A modified Perl’s stain (
8) was tested that utilizes protein degradation and detergents to break down the outer surface of the plaques to allow better peripheral penetration of the aqueous stain. With the modified stain, the images in indeed exposed minute focal iron distributions within the APP/PS1 transgenic animal plaques, but much less than that in the human AD plaques. As a control condition, application of the modified stain to human AD tissues resulted in dark brown staining throughout the entire tissue sample (not shown). This could be due to staining of not only the free labile iron pool but additionally iron bound inside ferritin cores that can be stained only when the proteins are digested open with the modified staining procedure. The above observations suggested that iron in the animal plaques is significantly less than that in the human plaques and the plaques in the animals are much denser than those in human samples. Since MR images of the plaques in both human and animals appeared essentially the same, the differing characteristics of the animal plaques raised a fundamental question as to the cause of the MR image contrast associated with the animal plaques.
It is well known that T
2 and T
2* relaxation and contrast can be altered in a variety of manners. Iron bound within the ferrihydrite-like core of ferritin, hemosiderin and assorted a number of iron oxide mineral deposits are found in sufficient quantities in the brain to alter MRI contrast (
20–
24). As a ferromagnetic ion, ferric iron (Fe
+3) is known to cause a shortening of T
2 relaxation due to the creation of microscopic magnetic field inhomogeneities that de-phase the signal of water protons in the vicinity (
19,
25,
26). Thus, ferric iron in brain tissue acts as a natural contrast agent causing faster proton T
2 and T
2* relaxation. There is some evidence to support that small amounts of ferrous iron (Fe
+2) is also stained with the Perl’s stain reaction (
27). The effect of ferrous iron on T
2* and T
2 relaxation is much less pronounced than that caused by the ferric form (
28) (our laboratory’s unpublished data). Thus, the signal hypo-intensities seen in the MR images associated with focal iron regions is likely dominated by the ferric form. One other important factor associated with the MRI appearance of plaques is their size under given experimental conditions (pixel resolution, TE/TR times, etc.). The minimal plaque size viewable in our MR images of the APP/PS1 mice was similar to the AD tissue images, about 40 µm and 38 µm, respectively. Thus, due to the similarity in the plaque size for both species, plaque diameter alone does not account for the hypo-intensities seen in the APP/PS1 data. This is also supported by the fact that human AD plaques of a similar diameter with low observable iron are marginally visible on the MR images, while APP/PS1 plaques with a significantly less iron association are clearly discernable on the MR images. Magnification of the thioflavin-S positive plaques (100x seen in and figure 6000x & figure 46000x in ) shows a distinct difference in plaque morphology between AD and APP/PS1 mice. Differences between human AD and the APP/PS1 Aβ plaques are most noticeable in the TEM magnifications. The human AD plaques consist of fragmented patches with random fibrillar orientation in the amyloid core while the structure of transgenic mouse plaques appears to be a highly packed aggregation of long and oriented fibrils. The decreased density of the amyloid core creates gaps that are prevalent in the human AD plaques while rarely found in the transgenic mouse plaques. The APP/PS1 mice Thioflavin-S data illustrates that, while the plaques are a similar size to those in AD tissue, the plaques have a larger center core of dense compact amyloid. In previous studies, comparison of the structure of the amyloid fibril in the transgenic APP/PS1 model and human AD is subtly different due to post-translational modifications leading to alterations in the Aβ molecule (
29–
31). Plaques found in the APP/PS1 mouse model have a variable distribution of both human and mouse amyloid in the plaques. Diffuse plaques have an intermingled distribution of both human and mouse amyloid while dense plaques are composed of human amyloid cores surrounded by mouse amyloid (
32). Thioflavin-S is known to bind to fibrillar but not to diffuse Aβ deposits (
33,
34). The difference in Thioflavin-S staining between human AD and APP/PS1 mice could be due to the different primary fibrillar or diffuse composition of the plaques. Many of the amino-acid residue positions within the Aβ protein are hydrophobic and are sufficient for amyloidal fibril formation (
35,
36). With the additional two hydrophobic amino acids found in the Aβ
42, it aggregates more readily than Aβ
40 (
37). These views suggest that the hydrophobic regions are at least partially responsible for the fibril formation (
38). The morphology of the mouse plaques with their large globular nature and the dense center core seem to be responsible for the T
2* relaxation associated with these plaques. Unlike smaller proteins, the amyloid mass found in the animal plaques is rigid and fixed in the tissue resulting in a situation where the protein mass would behave similar to a polymer-like solid. This creates a number of consequences that may affect relaxation in the plaques. First, it sets up an environment where a large amount of available surface area is present inside the plaque mass along the component Aβ fibrils. Water molecules then become bound to the hydrophilic regions of the fibril axis while repelled by the hydrophobic regions. Water in the immediate vicinity of the hydrophilic regions is bound via hydrogen bonding such that it is rotationally or irrotationally bound. Layers of water are affected as they diffuse near the bound water. Cross-relaxation between the protons of bound water and the protein molecules by proton-proton magnetization exchange could lead to a more rapid relaxation of water proton. As such, the relaxation of bound water on the Aβ fibril chains would act as a relaxation sink for water moving in the surrounding area (
39,
40). As a result, T
2 relaxation shortening occurs. Secondly, the magnetic susceptibility differences between the highly compact Aβ protein mass and surrounding issues could induce static dephasing in addition to that caused by deposited iron. Thirdly, tissue hydration could be also a significant contributing factor for plaque contrast. The dense formation of the animal plaques as indicated in the TEM image limits free water from accessing their core. As shown by histology results, staining iron in the plaques in the APP/PS1 mouse was difficult following standard methodology without protein degradation treatment. These experimental data suggest that access of free water molecules to the animal plaque is very limited. For human samples, the gaps seen between the Aβ patches () would accommodate more free water pools. The transverse relaxation of these water molecules is shortened by the magnetic inhomogeneities caused by ferromagnetic iron in the plaques. Thus, with these observations we would suggest a dual relaxation mechanism for the generation Aβ plaques T
2* contrast associated with both the compact fibrillar protein mass and iron deposition. The focal iron concentration could play a dominant role for rapid T
2* relaxation in human AD plaques while the increased fibrillar density and compacted morphology would be more likely a major factor for T
2* shortening in the APP/PS1 transgenic plaques. Although the potential relaxation mechanisms in Aβ plaques discussed above are preliminary and speculative, it is important to realize that alternative relaxation mechanisms must be considered. To thoroughly develop and validate the model of relaxation in Aβ plaques, more experimental studies are required in future investigations. In addition, caution should be used when comparing
ex vivo R
2* contrast obtained in the fixed tissue samples and extrapolating this to
in vivo conditions (
5).
The quantitative comparison of the R2* maps from different tissue types supports our hypothesis in regard to the relaxation mechanism associated with Aβ plaques. The mean R2* for the selected amyloid plaques in the AD tissues () is on average 90% greater than that from the ROI’s without plaques and control tissue. Regions in AD gray matter with no Aβ plaques and in control tissue samples () have no statistical difference in relaxation time. However, there is a trend of faster R2* relaxation rates in regions without plaques throughout the Alzheimer’s tissue compared to control tissue samples. This is indicative of a higher overall iron concentration in the AD neural tissue compared to the control tissue, possibly due to a systemic inability to regulate iron properly within the brain. Iron staining of the tissue samples supports this, which shows an overall increase in high focal iron in the AD tissue samples that is not seen in the control tissue. In the mouse tissue samples (), the mean R2* for the selected amyloid plaques is on average 56% higher than that in the ROI’s without plaques and in the control tissue. The mean R2* of regions without plaques and of control tissue are nearly identical, indicative of similar tissue fixation across tissue sub-types and consistent preparation of tissue samples. This information alleviates the confounding possibility that separate tissue handling procedures are the source of the observed MR contrast differences. Comparison of R2* in ROI’s with plaques in both human and APP/PS1 animals tissues reveal that the human plaques have a significantly higher R2* value. It is conceivable that human plaques have a duality of relaxation where both high focal iron concentration and fibrillar Aβ masses cause rapid proton transverse magnetization decay. APP/PS1 plaques exhibiting slower decay due to the reduced concentration of iron is a reasonable explanation for this result. The R2* for normal human tissues also appeared to be higher than that of animal tissue. This is consistent with the overall higher iron content in human neural tissue compared to the APP/PS1 animal samples. Iron staining for regions without plaques in the gray matter of APP/PS1 tissue and mouse control tissue samples exhibit similar patterns of iron staining.
These findings generate several important questions regarding the difference between Aβ plaques found naturally occurring in the human Alzheimer’s brain and transgenically introduced into the APP/PS1 animal model. Previous studies have revealed that Aβ-plaques in APP/PSI animal show numerous differences from human AD plaques, including plaque morphology and composition (
31,
41). The difference in morphology and the reduction of iron staining in the plaques raises the question for translating the APP/PS1 model’s data to human AD as it is hypothesized that there is a link between Aβ plaques and elevated iron in the brain tissue as the cause of oxidative stress leading to cellular neurotoxicity (
42,
43). The relationship of iron to plaque generation is not currently well understood within the literature and is a subject of much investigation. An imbalance in the iron regulatory system and a dysfunctional difference in mineralization of iron within the ferritin core in AD subjects has been previously demonstrated (
11,
44). It is largely unknown whether the initial generation of the plaque causes the aggregation of iron or if aberrant regulation of extra- or intra-cellular iron stores cause the formation of the Aβ protein around it. There is general agreement that the location of Aβ plaques in human AD brain tissue coincides with focal iron deposits. Iron associated with plaques can accumulate from a number of potential sources. As a metalloprotein, free iron will bind to Aβ fibrils and collect within the plaques. Iron from ferritin, and its degradation to hemosiderin, can originate from nearby neurons and microglial cells that have migrated to the Aβ plaques and can become part of the plaque mass (
45–
47). Biogenic magnetite found proportionally higher in AD ferritin cores than normal aged human neural tissue is known to be accumulate within Aβ plaques (
10,
11). While it is unknown precisely how Aβ plaque aggregation occurs, it is known that metal ions do play a role in Aβ fibril formation. The conversion of Aβ’s secondary protein structure to a β-sheet has been shown to occur in the presence of divalent metal ions, including ferrous iron (
48). The component fibrils of the Aβ plaques are known metalloproteins and possess metal chelation regions in their amino-acid sequence (
49). The MR and histological images in demonstrate that Aβ plaques are consistently associated with elevated iron load in and around their vicinity in human AD brain tissue. Research has shown that the co-localization of iron with the human Aβ plaques is accompanied by endoplasmic reticulum stress induced apoptosis, DNA oxidation and cellular damage in cells adjacent to plaques. Conversely, in regions where Aβ plaques accumulate alone without iron there is no indication of oxidative stress or apoptosis pathway activation (
50). It has been demonstrated that the toxicity of Aβ is amplified upon the direct interaction of iron ions with the Aβ peptide, while unbound iron itself has no effect upon toxicity (
51). This strongly suggests that Aβ plaques by themselves are not toxic to cells adjacent to plaques, whereas iron accumulation in and around plaques is essential for neuronal damage. The morphology and associated iron dissimilarity between the human AD and transgenic APP/PS1 plaques raises a question regarding differing amyloidal genesis processes for each species. In the APP/PSI mouse model used here, plaques are produced in the brain as early as six months after birth and are believed to continually grow throughout the life span of the animal (
52). Current understanding of human amyloidal genesis suggests that plaque generation occurs over years, perhaps decades, and places the plaques into discrete classes based upon the morphology of the plaque and surrounding tissue. It is hypothesized that plaques start out as a seed formations of Aβ peptide and eventually become much more compact and dense over time (
53). The APP/PS1 model generates plaques at a rapid pace and iron staining indicates a reduced amount of iron associated with these plaques compared to AD tissue. It is plausible that the rapid fibrillarization from Aβ oligomers into compacted fibrillar plaques could lead to less of iron deposition within the plaques in the APP/PS1 model.
In summary, imaging of thin slices of tissue samples with the aid of the histological coil allows the one-to-one comparison of tissue pathology as seen in histological stains and different MRI methodologies. With this technique, the relaxation mechanisms for Aβ plaques in human Alzheimer’s disease and the APP/PS1 mouse model were investigated with respect to their morphology and relationship with iron deposition. The histology stains of AD and APP/PS1 tissue samples were directly compared to T
2*-weighted images and R
2* parametric maps. The histological iron stains presented here support the hypothesis that iron associated with the Aβ plaques in the human AD samples plays a major role in generation of MRI T
2* contrast. Histological data from previous studies using post mortem human AD tissue (
14,
45,
54,
55) also support the notion that focal iron load in Aβ plaques is the dominant cause for faster T
2 and T
2* decay. The electron microscopy and histology data revealed that there are important differences in plaque morphology and associated iron concentration between transgenic APP/PS1 mice and human AD tissue samples. In the Alzheimer’s tissue, beta-amyloid plaques with high iron concentration are clearly visible in the T
2*-weighted images while others of similar size with less focal iron are not as discernable. In the APP/PS1 animal tissue, large plaques are equally observable as human plaques in MR imaging while iron load is significantly less than human plaques. This suggests that there is a degree of difference between the amyloid plaques in the APP/PS1 mouse model and human Alzheimer’s, in respect to their morphology and relationship with
in vivo iron stores. The increased transverse proton relaxation rate in Aβ plaques in animals is likely caused mainly by the interactions of water with the highly compacted amyloid fibril mass. The improved resolution of the
ex vivo data set allows for the detailed comparison between tissue histology and MR contrast that is not possible with current lower resolution clinically based protocols. The extrapolation of microscopic MR images to
in vivo applications is promising in the near future considering the rapid increase in achievable image resolution with the development of higher magnetic fields and the usage of parallel imaging technology (
56). The data presented in this report are essential for understanding the histo-pathological underpinning of MRI measurement of Aβ plaques in humans and animal models for both current and future MR applications.