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.

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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.
Authors: Martin-Bastida, A
Lao-Kaim, NP
Loane, C
Politis, M
Roussakis, AA
Valle-Guzman, N
Kefalopoulou, Z
Paul-Visse, G
Widner, H
Xing, Y
Schwarz, ST
Auer, DP
Foltynie, T
Barker, RA
Piccini, P
Item Type: Journal Article
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.
Issue Date: 16-Dec-2016
Date of Acceptance: 24-Oct-2016
ISSN: 1468-1331
Publisher: Wiley
Start Page: 357
End Page: 365
Journal / Book Title: European Journal of Neurology
Volume: 24
Issue: 2
Copyright Statement: © 2016 EAN. This is the accepted version of the following article, which has been published in final form at;jsessionid
Sponsor/Funder: Commission of the European Communities
Parkinson's UK
Funder's Grant Number: 242003
PaMIR-RB4811 / J-1204
Keywords: SWI
Parkinson's disease
motor severity
Neurology & Neurosurgery
1103 Clinical Sciences
1109 Neurosciences
Publication Status: Published
Conference Place: England
Appears in Collections:Department of Medicine
Faculty of Medicine

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