Brain regional iron contents in progressive supranuclear palsy
Parkinsonism & Related Disorders
Available online 28 September 2017
Parkinsonism & Related Disorders
Seung Ha Lee Chul Hyoung Lyoo Sung Jun Ahn Juha O. Rinne Myung Sik Lee
https://doi.org/10.1016/j.parkreldis.2017.09.020
Highlights
•
The major lesion sites responsible for specific motor deficits are obscured in PSP.
•
Iron depositions in subcortical nuclei coincide with pathological burdens of PSP.
•
Iron contents in the lenticular nuclei correlate with rigidity severity.
•
Nigro-striato-pallidal and dentate iron contents are associated with tremor severity.
•
Bradykinesia and axial motor deficits seem to be associated with widespread lesions.
Abstract
Introduction
To determine motor-related brain regions in which iron contents correlate with the degree of motor deficits of progressive supranuclear palsy (PSP).
Methods
Twenty-four patients with probable PSP and 20 controls were included. Using a 3.0T magnetic resonance imaging scanner, R2* values were measured in the putamen, globus pallidus (GP), substantia nigra (SN), subthalamic nucleus, and dentate nucleus. After
adjustment for disease duration and age at examination, correlations between regional brain R2* values and Unified Parkinson Disease Rating Scale (UPDRS) total motor scores or subscores for bradykinesia, rigidity, tremor, or axial motor deficits were
investigated.
Results
Compared to controls, patients with PSP had significantly higher R2* values in all of the five brain regions. UPDRS total motor scores and subscores for bradykinesia and axial motor deficits did not correlate with R2* values of the five brain regions.
However, UPDRS subscores for unilateral rigidity were correlated with R2* values of the contralateral putamen and GP. In addition, unilateral UPDRS subscores for tremor were associated with R2* values of the ipsilateral dentate nucleus, contralateral
putamen, GP, and SN.
Conclusion
In PSP, excessive iron accumulation occurs in motor-related subcortical regions. Iron-related PSP pathologies in the lenticular nucleus are associated with rigidity severity, while those in the nigro-striato-pallidal unit and dentate nucleus are
associated with tremor severity. Bradykinesia and axial motor deficits of PSP seem to be associated with widespread pathologies in the cerebrum, brainstem, cerebellum, as well as the basal ganglia.
Keywords
Iron Basal ganglia Progressive supranuclear palsy
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