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Eur J Neurol. 2017 Feb;24(2):357-365. doi: 10.1111/ene.13208. Epub 2016 Dec 16.

Motor associations of iron accumulation in deep grey matter nuclei in Parkinson's disease: a cross-sectional study of iron-related magnetic resonance imaging susceptibility.

Author information

1
Centre for Neurodegeneration and Neuroinflammation, Division of Brain Sciences, Imperial College London, London, UK.
2
Memory Research Group, Nuffield Department of Clinical Neurosciences, Medical Science Division, University of Oxford, Oxford, UK.
3
Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
4
John Van Geest Centre for Brain Repair, University of Cambridge, Cambridge, UK.
5
Sobell Department of Motor Neuroscience, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
6
Translational Neurology Group, Department of Clinical Sciences, Wallenberg Neuroscience Centre, Lund University, Lund, Sweden.
7
Division of Neurology, Department of Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
8
Radiological Sciences, Division of Clinical Neuroscience, University of Nottingham, Queen's Medical Centre Nottingham, Nottingham, UK.
9
Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK.
10
MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.

Abstract

BACKGROUND AND PURPOSE:

To determine whether iron deposition in deep brain nuclei assessed using high-pass filtered phase imaging plays a role in motor disease severity in Parkinson's disease (PD).

METHODS:

Seventy patients with mild to moderate PD and 20 age- and gender-matched healthy volunteers (HVs) underwent susceptibility-weighted imaging on a 3 T magnetic resonance imaging scanner. Phase shifts (radians) in deep brain nuclei were derived from high-pass filtered phase images and compared between groups. Analysis of clinical laterality and correlations with motor severity (Unified Parkinson's Disease Rating Scale, Part III, UPDRS-III) were performed. Phase shifts (in radians) were compared between HVs and three PD subgroups divided according to UPDRS-III scores using analysis of covariance, adjusting for age and regional area.

RESULTS:

Parkinson's disease patients had significantly (P < 0.001) higher radians than HVs bilaterally in the putamen, globus pallidus and substantia nigra (SN). The SN contralateral to the most affected side showed higher radians (P < 0.001) compared to the less affected side. SN radians positively correlated with UPDRS-III and bradykinesia-rigidity subscores, but not with tremor subscores. ancova followed by post hoc Bonferroni-adjusted pairwise comparisons revealed that SN radians were significantly greater in the PD subgroup with higher UPDRS-III scores compared to both lowest UPDRS-III PD and HV groups (P < 0.001).

CONCLUSIONS:

Increased nigral iron accumulation in PD appears to be stratified according to disease motor severity and correlates with symptoms related to dopaminergic neurodegeneration. This semi-quantitative in vivo iron assessment could prove useful for objectively monitoring PD progression, especially in clinical trials concerning iron chelation therapies.

KEYWORDS:

SWI ; Parkinson's disease; iron; motor severity; neurodegeneration

PMID:
27982501
DOI:
10.1111/ene.13208
[Indexed for MEDLINE]
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