Susceptibility Weighted Imaging to Detect Nigral Iron Accumulation in Parkinson's Disease

Martín-Bastida, Antonio; Politis, Marios; Loane, Clare; Lao–Kaim, Nicholas P; Valle‐Guzman, Natalie; Kefalopoulou, Z; Paul, Gesine; Foltynie, Thomas; Barker, Roger A.; Piccini, Paola

doi:10.1136/jnnp-2015-312379.180

Cited by 2 publications

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“…It has been shown that abnormal metabolism of brain iron results in abnormal iron deposition in PD, which may contribute to the damage of dopaminergic neurons and the occurrence of typical clinicopathological lesions of PD. In addition, abnormal iron deposition can be detected using iron‐sensitive magnetic resonance imaging (MRI) . It is thought that, as the prodromal stage of α‐synucleinopathies, iRBD patients may also have increased iron deposition in the brain.…”

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“…In addition, abnormal iron deposition can be detected using iron-sensitive magnetic resonance imaging (MRI). [7][8][9][10] It is thought that, as the prodromal stage of α-synucleinopathies, iRBD patients may also have increased iron deposition in the brain. A recent susceptibility weighted-imaging (SWI) study found loss of dorsolateral nigral hyperintensity in two-thirds of iRBD patients.…”

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Quantitative Evaluation of Iron Content in Idiopathic Rapid Eye Movement Sleep Behavior Disorder

Sun

Lai

et al. 2019

Movement Disorders

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Background Idiopathic rapid eye movement sleep behavior disorder is an early sign of neurodegenerative disease. This study aimed to quantitatively evaluate iron content in idiopathic rapid eye movement sleep behavior disorder patients using quantitative susceptibility mapping and to examine the potential of this technique to identify the prodromal stage of α‐synucleinopathies. Methods Twenty‐five idiopathic rapid eye movement sleep behavior disorder patients, 32 Parkinson's disease patients, and 50 healthy controls underwent quantitative susceptibility mapping. The mean magnetic susceptibility values within the bilateral substantia nigra, globus pallidus, red nucleus, head of the caudate nucleus, and putamen were calculated and compared among groups. The relationships between the values and the clinical features of idiopathic rapid eye movement sleep behavior disorder and Parkinson's disease were measured using correlation analysis. Results Idiopathic rapid eye movement sleep behavior disorder patients had elevated iron in the bilateral substantia nigra compared with healthy controls. Parkinson's disease patients had increased iron in the bilateral substantia nigra, globus pallidus, and left red nucleus compared with healthy controls and had elevated iron levels in the bilateral substantia nigra compared with idiopathic rapid eye movement sleep behavior disorder patients. Mean magnetic susceptibility values were positively correlated with disease duration in the left substantia nigra in idiopathic rapid eye movement sleep behavior disorder patients. Conclusions Quantitative susceptibility mapping can detect increased iron in the substantia nigra in idiopathic rapid eye movement sleep behavior disorder, which becomes more significant as the disorder progresses. This technique has the potential to be an early objective neuroimaging marker for detecting α‐synucleinopathies. © 2019 International Parkinson and Movement Disorder Society

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Quantitative Evaluation of Iron Content in Idiopathic Rapid Eye Movement Sleep Behavior Disorder

Sun

Lai

et al. 2019

Movement Disorders

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“…Several histological and radiological studies have reported an increased iron concentration in the deep nuclei of patients with PD, especially the SN. [19][20][21] QSM allows for the quantification of tissue iron content and could be sensitive to microstructural abnormalities in neurodegenerative disease. 22 The STN is a key nucleus in the functional control of motor activity in the basal ganglia by receiving GABAergic inhibitory projections from the globus pallidus externa (GPe).…”

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Motoric impairment versus iron deposition gradient in the subthalamic nucleus in Parkinson’s disease

Huang

Ogbuji²,

Zhou

et al. 2020

Journal of Neurosurgery

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OBJECTIVEThe objective of this study was to investigate the correlation between the quantitative susceptibility mapping (QSM) signal gradient of the subthalamic nucleus (STN) and motor impairment in patients with Parkinson’s disease (PD).METHODSAll PD patients who had undergone QSM MRI for presurgical deep brain stimulation (DBS) planning were eligible for inclusion in this study. The entire STN and its three functional subdivisions, as well as the adjacent white matter (WM), were segmented and measured. The QSM value difference between the entire STN and adjacent WM (STN-WM), between the limbic and associative regions of the STN (L-A), and between the associative and motor regions of the STN (A-M) were obtained as measures of gradient and were input into an unsupervised k-means clustering algorithm to automatically categorize the overall boundary distinctness between the STN and adjacent WM and between STN subdivisions (gradient blur [GB] and gradient sharp [GS] groups). Statistical tests were performed to compare clinical and image measurements for discrimination between GB and GS groups.RESULTSOf the 39 study patients, 19 were categorized into the GB group and 20 into the GS group, based on quantitative cluster analysis. The GB group had a significantly higher presurgical off-medication Unified Parkinson’s Disease Rating Scale Part III score (51.289 ± 20.741) than the GS group (38.5 ± 16.028; p = 0.037). The GB group had significantly higher QSM values for the STN and its three subdivisions and adjacent WM than those for the GS group (p < 0.01). The GB group also demonstrated a significantly higher STN-WM gradient in the right STN (p = 0.01). The GB group demonstrated a significantly lower L-A gradient in both the left and the right STN (p < 0.02).CONCLUSIONSAdvancing PD with more severe motor impairment leads to more iron deposition in the STN and adjacent WM, as shown in the QSM signal. Loss of the STN inner QSM signal gradient should be considered as an image marker for more severe motor impairment in PD patients.

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Susceptibility Weighted Imaging to Detect Nigral Iron Accumulation in Parkinson's Disease

Cited by 2 publications

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Quantitative Evaluation of Iron Content in Idiopathic Rapid Eye Movement Sleep Behavior Disorder

Quantitative Evaluation of Iron Content in Idiopathic Rapid Eye Movement Sleep Behavior Disorder

Motoric impairment versus iron deposition gradient in the subthalamic nucleus in Parkinson’s disease

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