Abstract
ObjectivesBrain iron deposition and microstructural changes in brain tissue are associated with Parkinson’s disease (PD). However, the correlation between these factors in Parkinson’s disease has been little studied. This study aimed to use quantitative susceptibility mapping combined with diffusion kurtosis imaging to investigate the effects of iron deposition on microstructural tissue alterations in the brain.MethodsQuantitative susceptibility mapping and diffusion kurtosis imaging were performed on 24 patients with early PD, 13 patients with advanced PD, and 25 healthy controls. The mean values of magnetic susceptibility and diffusion kurtosis were calculated for the bilateral substantia nigra, red nucleus, putamen, globus pallidus, and caudate nucleus, and compared between the groups. Correlation analyses between the diffusion kurtosis of each nucleus and its magnetic susceptibility parameters in PD patients and healthy controls were performed.ResultsThe study found a significant increase in iron deposition in the substantia nigra, red nucleus, putamen and globus pallidus, bilaterally, in patients with PD. Mean kurtosis values were increased in the substantia nigra but decreased in the globus pallidus; axial kurtosis values were decreased in both the substantia nigra and red nucleus; radial kurtosis values were increased in the substantia nigra but showed an opposite trend in the globus pallidus and caudate nucleus. In the substantia nigra of patients with PD, magnetic susceptibility was positively correlated with mean and radial kurtosis values, and negatively correlated with axial kurtosis. None of these correlations were significantly different in the control group. In the putamen, magnetic susceptibility was positively correlated with mean, axial, and radial kurtosis only in patients with advanced-stage PD.ConclusionOur study provides new evidence for brain iron content and microstructural alterations in patients with PD. Iron deposition may be a common mechanism for microstructural alterations in the substantia nigra and putamen of patients with PD. Tracking the dynamic changes in iron content and microstructure throughout the course of PD will help us to better understand the dynamics of iron metabolism and microstructural alterations in the pathogenesis of PD and to develop new approaches to monitor and treat PD.
Highlights
Parkinson’s disease (PD) is characterized clinically by rest tremor, bradykinesia, rigidity, and postural instability
The results of the intraclass correlation coefficient (ICC) analysis of the Quantitative susceptibility mapping (QSM) and DKI parameter values for the left and right Regions of interest (ROIs) of healthy control (HC) and patients with PD are shown in Supplementary Table 1
The results showed that the ICC values for both the HC and PD groups were >0.75, so the consistency of measurement was reliable enough to continue with the subsequent statistical analysis
Summary
Parkinson’s disease (PD) is characterized clinically by rest tremor, bradykinesia, rigidity, and postural instability. Quantitative susceptibility mapping (QSM) is a new post-processing technique that provides a robust magnetization measurement that correlates significantly with brain iron content, enabling quantitative tissue magnetization measurement (He et al, 2015; Du et al, 2016). This approach detects magnetic tissue properties more sensitively than traditional quantitative-based iron imaging techniques (R2, R2∗, and R2’) and has been used to identify several human brain substructures that are partially indistinguishable when using Gradient Echo (GRE)-based comparisons (Wieler et al, 2015; Guan et al, 2017b)
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