NRU
Benzodiazepine Receptor (BZR) Atlas
Overview
Gamma-aminobutyric
acid (GABA) is the main inhibitory neurotransmitter in the human brain and
plays a key role in several brain functions and neuropsychiatric disorders such
as anxiety, epilepsy, and depression. The binding of benzodiazepines to the
benzodiazepine receptor sites (BZR) located on GABAA receptors (GABAARs)
potentiates the inhibitory effect of GABA leading to the anxiolytic,
anticonvulsant and sedative effects used for treatment of those disorders.
However, the function of GABAARs and the expression of BZR protein
is largely determined by each GABAAR subunit stoichiometry (19 genes coding for
individual subunits), and it is not well understood how these mechanisms may
vary between individuals and across different brain regions.
Here,
we present a quantitative high-resolution in vivo atlas of the human brain
BZRs, generated on the basis of [11C]flumazenil Positron Emission
Tomography (PET). Next, based on autoradiography data, we transform the
PET-generated atlas from binding values into BZR protein density. Finally, we
examine the brain regional association with mRNA expression for the 19 subunits
in the GABAAR, including an estimation of the minimally required
expression of mRNA levels for each subunit to translate into BZR protein.
This
represents the first publicly available quantitative high-resolution in vivo
atlas of the spatial distribution of BZR densities in the healthy human brain.
The atlas provides a unique neuroscientific tool as well as novel insights into
the association between mRNA expression for individual subunits in the GABAAR
and the BZR density at each location in the brain.
Data
All
participants included in this study were healthy controls from the Cimbi
database (Knudsen et al., 2015); the data analysis was restricted to include
individuals aged between 18 and 45 years. Participants were recruited by
advertisement for different research protocols approved by the Ethics Committee
of Copenhagen and Frederiksberg, Denmark. A total of 26 PET scans and
corresponding structural MRI were acquired for 16 individual participants; 7
subjects had only 1 scan, 8 subjects had 2 scans, and a single had 3 scans.
Methods
PET
data was acquired in list-mode on a Siemens HRRT scanner operating in
3D-acquisition mode, with an approximate in-plane resolution of 2 mm (1.4 mm in
the center of the field of view and 2.4 mm in cortex) (Olesen et al., 2009).
The radioligand was given either as a bolus or as a bolus-infusion protocol.
PET frames were reconstructed using a 3D-OSEM-PSF algorithm (Comtat et al.,
2008; Sureau et al., 2008). Scan time was 90 minutes divided into 35 frames
(6x5, 10x15, 4x30, 5x120, 5x300, 5x600 seconds). Dynamic PET frames were
realigned using AIR 5.2.5 (Woods et al., 1992). The PET data was quantified to
estimate total distribution volumes (VT) for each brain region using
steady-state analysis for the bolus-infusion protocol and Logan analysis for
the bolus protocol, corrected for radio metabolites (Feng et al. 2016).
T1-weighted structural MRI were acquired on two different 3T Siemens scanners
with standard parameters. For further details on structural MRI acquisition
parameters, see Knudsen et al. (2015).
Please
see Figure 1 for a full overview of the methodology.

Figure
1: Flowchart
of the processing of the MRI and PET data using the radioligand [11C]Flumazenil,
ranging from motion correction, matching of structural MRI using FreeSurfer (v.
6.0), kinetic modeling with arterial sampling, and finally establishing the
association between postmortem human brain autoradiography from Braestrup et
al. 1977 and the regional total distribution volumes (VT).
Atlas
maps
The
BZR density (pmol per gram protein) was obtained by normalizing VT
with the corresponding postmortem human brain [3H]diazepam
autoradiography data from Braestrup et al. 1977. The non-displaceable
distribution volume (VND) was estimated as the intercept (Figure
2B). The atlas was transformed to represent protein densities in pmol/ml
(Figure 2A). Finally, the association between protein density and mRNA
expression for the 19 GABAAR subunits was assessed using the Allen
Human Brain atlas (Hawrylycz et al. 2012). The association between the BZR
density and the three commonly expressed subunits (a1,
b2, and g2) can be found in Figure 3. The
association between the BZR density and all the 19 subunits can be found in Figure
4.

Figure
2: (A) High
resolution atlas of GABAAR density (pmol/ml) in MNI152 space (left)
and in fsaverage space (right) (B) Average regional distribution volumes
(VT) and benzodiazepine receptor density for the GABAAR.
The regional VT's determined by PET were matched to the
corresponding regions from the [3H]diazepam autoradiography data.
The regression is shown as the black line, and the intercept is the
non-displaceable distribution volume (VND). The shaded area is the
95% confidence interval.

Figure
3: (A-C) Association
between mRNA expression (log2 intensity) and BZR density for the subunits of
the GABAAR most commonly represented in the BZR, a1 in (A), b2
in (B), and g2 in (C). The points
are regional estimates for subcortex (squares) and cortex (round dots), and are
color coded according to the density, green (<800 pmol/ml), blue (800-900
pmol/ml), red (900-1.000 pmol/ml), and black (>1.000 pmol/ml). (D)
Biplot of the (scaled) first two principal components (% variance explained) of
a PCA of the 19 subunits and BZR. (E-F) The spatial distribution of BZR
density according to the specified color coding shown on the lateral and medial
surface of the brain.



















Figure
4: Association
between mRNA expression (log2 intensity) and BZR density (pmol/ml) for the 19 subunits
of the GABAAR.
Publications
The
following publications should be referenced when using this atlas:
A
High-Resolution In Vivo Atlas of the Human Brain's Benzodiazepine Binding Site
of GABAA Receptors. Martin Norgaard, Vincent Beliveau, Melanie Ganz, Claus
Svarer, Lars H Pinborg, Sune H Keller, Peter S Jensen, Douglas N. Greve, Gitte M. Knudsen. bioRxiv 2020.04.10.035352; doi: https://doi.org/10.1101/2020.04.10.035352
Downloads
All
the atlas data, and the supplementary data can be found here (9.3 MB)
Bibliography
Braestrup,
C., Albrechtsen, R., & Squires, R. (1977). High densities of benzodiazepine
receptors in human cortical areas. Nature, 269(October), 702-704.
Comtat
C, Sureau FC, Sibomana M, Hong IK, Sjoholm N, Trebossen R (2008) Image based
resolution modeling for the HRRT OSEM reconstructions software. In: 2008 IEEE
Nuclear Science Symposium Conference Record, pp 4120-4123. IEEE.
Feng,
L., Svarer, C., Madsen, K., Ziebell, M., Dyssegaard, A., Ettrup, A., Pinborg,
L. H. (2016). Design of Infusion Schemes for Neuroreceptor Imaging: Application
to [11C]Flumazenil-PET Steady-State Study. BioMed Research International, 2016.
Hawrylycz,
M. J., Lein, E. S., Guillozet-Bongaarts, A. L., Shen, E. H., Ng, L., Miller, J.
A., Jones, A. R. (2012). An anatomically comprehensive atlas of the adult
human brain transcriptome. Nature, 489(7416), 391-399.
Knudsen GM et al. (2015) The Center for Integrated Molecular Brain Imaging
(Cimbi) Database. Neuroimage:1-7.
Olesen OV, Sibomana M, Keller SH, Andersen F, Jensen J, Holm S, Svarer C,
Hojgaard L (2009) Spatial resolution of the HRRT PET scanner using 3D-OSEM PSF
reconstruction. IEEE Nucl Sci Symp Conf Rec:3789-3790.
Sureau FC, Reader AJ, Comtat C, Leroy C, Ribeiro M-J, Buvat I, Trebossen R
(2008) Impact of image-space resolution modeling for studies with the
high-resolution research tomograph. J Nucl Med 49:1000-1008.
Woods RP, Cherry SR, Mazziotta JC (1992) Rapid automated algorithm for aligning
and reslicing PET images. J
Comput Assist Tomogr 16:620-633.
Contacts
For
questions related to the NRU BZR atlas, contact Martin Norgaard (martin.noergaard(a)nru.dk)
or Gitte M. Knudsen (gmk(a)nru.dk).
Copyright
Copyright
(c) 2016, Neurobiology Research Unit, Rigshospital. All rights reserved
according to CC 4.0 BY-NC-SA
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