Relationship Between Brain Iron Deposition By Susceptibility Weighted Imaging And Serum Iron Content In Parkinson Disease

OBJECTIVE: Changes in intracranial iron deposition in patients with Parkinson’s disease(PD)through magnetic susceptibility weighted imaging(SWI)and Quantitative susceptibility mapping(QSM).To investigate the changes of iron metabolism in the blood of Parkinson’s disease patients.It provides the basis for the early diagnosis of PD.METHODS: This study selected outpatient and hospitalized patients in Senyang General Hospital from June 2017-February 2018.A total of 21 patients with Parkinson’s disease(PD group),20 cases of healthy control group(group NC)matched by age and sex.PD patients with Unified Parkinson’s s Rating Scale(UPDRS)score and Hoehn-Yahr grading.PD group according to the Hoehn-Yahr classification level is less than or equal to 2.5 in PD group,and more than 2.5 level in the late PD group.The PD group were divided according to duration of disease less than 4 years and more than or equal to 4 years group.According to the UPDRS-III score,both sides of the PD group were seriously ill on the high score side,whereas the light side was on the contrary.All subjects underwent 3.0T head MRI and SWI imaging.The width of substantia nigra compacta(SNc)and substantia nigra reticulata(SNr)and the diameters of Midbrain were measured on the amplitude map.Generate QSM imaging with Neuspin software.Magnetic susceptibility in the substantia nigra(SN),red nucleus(RN)and parietal white matter were measured on QSM imaging.All patients were tested for serum iron metabolism,inculding serum iron(Fe),total iron binding capacity(TIBC),transferrin saturation(TS),ferritin(Fer),hemoglobin(HGB).Compare the two groups of the magnetic susceptibility in the SN,RN and parietal white matter,andnormalized SNc width,normalized SNr width,SNc / SNr,SN susceptibility/ Fe,SN susceptibility/ Fer,SN susceptibility/ HGB.Results:(1)Comparison of imaging related indexes of PD group and NC group : Magnetic susceptibility in the SN(33.06±23.62,19.18±4.89,p< 0.05)and parietal white matter(-3.01±5.92,4.56±6.39,p< 0.05),normalized SNc width(0.12±0.03,0.17±0.03,p<0.01),SNc/SNr(0.39±0.12,0.59±0.15,p< 0.01),had significant difference;RN susptibility,normalized SNr width,no statistical significance(p> 0.05).(2)Comparison of the imaging related indexes between the seriously side and the lightly side of the PD:the SN,RN,SNc width,SNr width,SNc / SNr were not statistically significant(p> 0.05).(3)PD group of different duration of two groups(less than 4 years and more than or equal to 4 years)imaging-related indicators of the comparison : Magnetic susceptibility in the SN,RN,normalized SNc width,normalized SNr width and SNr /SNc,no statistical significance(p> 0.05).(4)PD group of different Hoehn-Yahr grading(less than or equal to 2.5 and more than 2.5)imaging-related indicators of the comparison : Magnetic susceptibility in the SN,RN,normalized SNc width,normalized SNr width and SNr / SNc,no statistical significance(p> 0.05).(5)The correlation between UPDRS-Ⅲ and SN susceptibility in PD group: p >0.05,no significant correlation.(6)The comparison of Fe,TIBC,TS,Fer and HGB between PD and NC group :had no statistical significance(p> 0.05).(7)Comparison of SN susceptibility/ Fe,SN susceptibility/ Fer,SN susceptibility/ HGB between PD group and NC group: SN susceptibility/ Fe(2.49±2.17,1.08±0.29,p < 0.01),SN susceptibility/ Fer(0.59±0.74,0.13±0.07,p =0.01)and SN susceptibility/ HGB(0.25±0.18,0.14±0.04,p < 0.01),had significant difference;CONCLUSIONS: Parkinson’s disease patients with abnormal iron metabolism in the brain,iron redistribution in the brain and preferentially gathered in the substantia nigra.Magnetic susceptibility in SWI-QSM imaging can be directly expressed brain iron content,provide the basis for the early diagnosis of Parkinson’s disease.