Nigral iron deposition in common tremor disorders

Mov Disord. 2019 Jan;34(1):129-132. doi: 10.1002/mds.27549. Epub 2018 Dec 10.

Abstract

Objective: We investigated R2* relaxation rates as a marker of iron content in the substantia nigra in patients with common tremor disorders and explored their diagnostic properties.

Methods: Mean nigral R2* rates were measured in 40 patients with tremor-dominant Parkinson's disease (PD), 15 with tremor in dystonia, 25 with essential tremor, and 25 healthy controls.

Results: Tremor-dominant PD patients had significantly higher nigral R2* values (34.1 ± 5.7) than those with tremor in dystonia (30.0 ± 3.9), essential tremor (30.6 ± 4.8), and controls (30.0 ± 2.8). An R2* threshold of 31.15 separated tremor-dominant PD from controls with a sensitivity and specificity of 67.5% and 72%. The sensitivity and specificity for discrimination between PD and non-PD tremor patients was 67.5% and 60%.

Conclusion: Iron content in the substantia nigra is significantly higher in tremor-dominant PD than in tremor in dystonia, essential tremor, and controls. Because of the considerable overlap, nigral R2* cannot be suggested as a useful diagnostic tool. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Keywords: R2 Star; brain iron accumulation; essential tremor; tremor in dystonia; tremor-dominant Parkinson's disease.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / analysis
  • Female
  • Humans
  • Iron / metabolism*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis
  • Parkinson Disease / metabolism
  • Substantia Nigra / metabolism*
  • Substantia Nigra / physiopathology
  • Tremor / metabolism*
  • Tremor / physiopathology

Substances

  • Biomarkers
  • Iron