Influence of regional iron on the motor impairments of Parkinson's disease: A quantitative susceptibility mapping study
Journal of Magnetic Resonance Imaging
Xiaojun Guan MD, Min Xuan MD, Quanquan Gu PhD, Xiaojun Xu MD, Peiyu Huang PhD, Nian Wang PhD, Zhujing Shen MD, Jingjing Xu MD, Wei Luo MD, PhD, Minming Zhang MD, PhD
First published: 22 August 2016Full publication history
DOI: 10.1002/jmri.25434

Abstract

Purpose

Because the roles of striatal-thalamo-cortical and cerebello-thalamo-cortical circuits in the heterogeneous motor impairments of Parkinson's disease (PD) are becoming recognized, this study was designed to investigate the relationships between regional
iron in the cardinal subcortical nuclei in these circuits and the different motor impairments.
Materials and Methods

Sixty-two PD patients and 40 normal subjects were included and accepted for Enhanced T2-Star Weighted Angiography Scanning (3.0T). According to the Unified Parkinson's Disease Rating Scale, patients were divided into tremor-dominant (PD-TD) and akinetic/
rigid-dominant groups (PD-AR). The intergroup differences of magnetic susceptibility in those cardinal nuclei were measured. Correlation analyses between magnetic susceptibility and motor impairments were performed in all patients.
Results

Nigral magnetic susceptibility significantly increased for each PD group compared with controls (P < 0.001 for PD-TD; P = 0.001 for PD-AR). Magnetic susceptibility in the dentate nucleus (DN) and red nucleus (RN) for the PD-TD patients were
significantly increased compared with controls (P < 0.001 and P = 0.004, respectively). Magnetic susceptibility in these regions was also significantly correlated with tremor severity (r = 0.444, P = 0.001 for DN; r = 0.418, P = 0.001
for RN). Significant correlation between caudate magnetic susceptibility and akinetic/rigid severity were observed (r = –0.322, P = 0.015).
Conclusion

This study provides evidence that nigral iron accumulation is a common characteristic in PD, while iron accumulation in the DN and RN is correlated with tremor symptoms. Our data also indicate that caudate iron content may be a potential marker for
akinetic/rigid progression. J. Magn. Reson. Imaging 2016

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Time-Specific Pattern of Iron Deposition in Different Regions in Parkinson's Disease Measured by Quantitative Susceptibility Mapping
Xiaodi Fu 1, Wenbin Deng 1, Xiangqin Cui 1, Xiao Zhou 2, Weizheng Song 3, Mengqiu Pan 4, Xiao Chi 1, Jinghui Xu 5, Ying Jiang 5, Qun Wang 1, Yunqi Xu Front Neurol
. 2021 Aug 4;12:631210. doi: 10.3389/fneur.2021.631210. eCollection 2021.
PMID: 34421781 PMCID: PMC8371047 DOI: 10.3389/fneur.2021.631210
Abstract
Studies have shown the spatial specificity of cranial iron deposition in different regions in Parkinson's disease (PD). However, the time-specific patterns of iron deposition are not yet clear. The purpose of this study was to investigate the time
pattern of iron variations and its clinical relevance in multiple gray matter nuclei in PD using quantitative susceptibility mapping (QSM). Thirty controls and 33 PD patients were enrolled, namely, 11 cases of early stage of PD (ESP) and 22 cases of
advanced stage of PD (ASP) according to the Hoehn-Yahr stages. The iron content in the subcortical nuclei covering substantia nigra (SN), red nucleus (RN), head of the caudate nucleus (CN), globus pallidus (GP), and putamen (PT) was measured using QSM,
and the clinical symptoms of PD were evaluated by various rating scales. The QSM values in SN, RN, GP, and PT significantly increased in PD patients compared with the controls. Further subgroup comparison with the controls indicated that the iron content
in SN and GP (paleostriatum) gradually elevated in the whole disease duration and was related to clinical features. While the iron content in RN and PT (neostriatum) only elevated significantly in ESP patients, further iron deposition was not obvious in
ASP patients. Our study confirmed that QSM could be used as a disease biomarker and could be suitable for longitudinal monitoring. However, considering the temporal characteristics of iron deposition in neostriatum, iron deposition in the neostriatum
should be paid more attention in the early stage of the disease, even in the preclinical stage, in future research.

Keywords: hoehn-yahr stage; iron deposition; parkinson's disease; quantitative susceptibility mapping; unified parkinson's disease rating scale.

Copyright © 2021 Fu, Deng, Cui, Zhou, Song, Pan, Chi, Xu, Jiang, Wang and Xu.


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