Time-Specific Pattern of Iron Deposition in Different Regions in Parkinson's Disease Measured by Quantitative Susceptibility Mapping.

Xiaodi Fu,Xiao Zhou,Jinghui Xu,Wenbin Deng,Weizheng Song,Xiangqin Cui,Yunqi Xu,Mengqiu Pan,Ying Jiang,Qun Wang,Xiao Chi

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.

Highlights

Parkinson’s disease (PD) is the second most common neurodegenerative disease and commonly manifested by typical motor symptoms such as bradykinesia, resting tremor, rigidity, postural instability, and an array of non-motor symptoms, which seriously affect the quality of life and exacerbate the disability of PD patients
The quantitative susceptibility mapping (QSM) values of substantia nigra (SN), globus pallidus (GP), red nucleus (RN), and PT in the PD group exhibited a significant increase compared with the control group, whereas the QSM values of head of the caudate nucleus (CN) showed no significant difference
We reported the time-specific patterns of regional iron deposition in PD

Summary

Introduction

Parkinson’s disease (PD) is the second most common neurodegenerative disease and commonly manifested by typical motor symptoms such as bradykinesia, resting tremor, rigidity, postural instability, and an array of non-motor symptoms, which seriously affect the quality of life and exacerbate the disability of PD patients. The major pathology features of PD are characterized by the loss of dopaminergic neurons in the substantia nigra (SN), the accumulation of Lewy bodies and Lewy neurites [1], and excessive iron deposition in specific brain regions [2]. Studies have shown that iron deposition in the SN had a pivotal role in the necrosis of dopaminergic neurons [3] and the aggregation of α-synuclein [4, 5] and promoted the progress of the disease [6]. Considering that PD is a highly heterogeneous disease, it is not clear whether the cranial iron deposition in different regions had a similar time sequence

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