Zeighami, Y.; Moqadam, R.; Sanches, L.; Frigon, E.-M.; Tremblay, C.; Adame Gonzalez, W.; Mirault, D.; Alasmar, Z.; Franco Piredda, G.; Turecki, G.; Maranzano, J.; Chakravarty, M.; Mechawar, N.; Dadar, M.

Introduction: Postmortem human brain magnetic resonance imaging (MRI) offers a unique opportunity to study finer neuroanatomical details and enables direct correlations with gold standard histological and immunohistochemical assessments. However, to prevent tissue decay, postmortem brains are preserved in fixative solutions which can alter tissue properties and exert substantial impacts on the MRI signals. The present study investigates the impact of formalin fixation, the most commonly used solution for postmortem human brain preservation, on different quantitative MRI contrasts. Methods: 142 intact human brain hemispheres immersed in 10% formalin for a range of fixation durations (between 0 days and 20 years) were imaged in a 3T MRI scanner. A subset of 10 brains were further scanned repeatedly at days 0, 3, 10, 20, 30, 60, 90, and 120 to allow for better characterization of the initial transient effects of fixation. Voxel-wise T1 and T2* relaxation, T1/T2 ratio, and myelin water fraction (MWF) maps were generated for each specimen and timepoint, and linear and nonlinear models were used to examine the spatiotemporal changes associated with progressive fixation. Results: All investigated metrics were significantly impacted by formalin fixation, albeit at different rates and with differing regional patterns. T1 and T2* relaxation time decreased as a result of progressive fixation, whereas T1/T2 ratio and MWF measures increased. T1 relaxation and T1/T2 ratio showed nonlinear patterns with initially accelerated changes that decelerate in the first few months, whereas T2* relaxation and MWF changes followed a more linear trend. Conclusion: Formaldehyde fixation exerts systematic changes on quantitative MRI signals that can be modeled and adjusted for to allow for harmonized comparisons of MRI metrics across brains fixed for differing durations. The distinct temporal trajectories observed across metrics highlight the need to account for fixation duration in study design and downstream analyses, particularly when integrating datasets acquired under heterogeneous conditions. Our findings provide a quantitative framework for correcting fixation-induced biases, thereby improving the interpretability and reproducibility of postmortem MRI studies.