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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

Martin-Bastida, A.; Lao-Kaim, N. P.; Loane, C.; Politis, M.; Roussakis, A. A.; Valle-Guzman, N.; Kefalopoulou, Z.; Paul-Visse, G. LU ; Widner, H. LU and Xing, Y., et al. (2017) In European Journal of Neurology 24(2). p.357-365
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... (More)

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.

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publication status
published
subject
keywords
Iron, Motor severity, Neurodegeneration, Parkinson's disease, SWI
in
European Journal of Neurology
volume
24
issue
2
pages
357 - 365
publisher
Wiley-Blackwell
external identifiers
  • scopus:85006963185
  • wos:000392804300023
ISSN
1351-5101
DOI
10.1111/ene.13208
language
English
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yes
id
d5064c01-8479-4117-b190-c467d0dff3cf
date added to LUP
2017-01-20 13:51:01
date last changed
2018-08-05 04:37:31
@article{d5064c01-8479-4117-b190-c467d0dff3cf,
  abstract     = {<p>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 &lt; 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 &lt; 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 &lt; 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.</p>},
  author       = {Martin-Bastida, A. and Lao-Kaim, N. P. and Loane, C. and Politis, M. and Roussakis, A. A. and Valle-Guzman, N. and Kefalopoulou, Z. and Paul-Visse, G. and Widner, H. and Xing, Y. and Schwarz, S. T. and Auer, D. P. and Foltynie, T. and Barker, R. A. and Piccini, P.},
  issn         = {1351-5101},
  keyword      = {Iron,Motor severity,Neurodegeneration,Parkinson's disease,SWI},
  language     = {eng},
  number       = {2},
  pages        = {357--365},
  publisher    = {Wiley-Blackwell},
  series       = {European Journal of Neurology},
  title        = {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},
  url          = {http://dx.doi.org/10.1111/ene.13208},
  volume       = {24},
  year         = {2017},
}