Moon Yeonsil, Han Seol-Heui, Moon Won-Jin
Department of Neurology, Konkuk University Medical Center, Seoul, Republic of Korea.
Center for Geriatric Neuroscience Research, Institute of Biomedical Science, Konkuk Medical Science Research Center, Seoul, Republic of Korea.
J Alzheimers Dis. 2016;51(3):737-45. doi: 10.3233/JAD-151037.
Emerging evidence suggests that the excessive accumulation of iron in subcortical and deep gray matter has been related to dementia. However, the presence and pattern of iron accumulation in vascular dementia (VaD) and Alzheimer's disease (AD) are rarely investigated.
To examine and compare the pattern and presence of brain iron accumulation of VaD and AD using quantitative susceptibility mapping (QSM).
Twelve patients with VaD, 27 patients with AD, and 18 control subjects were recruited in this institutional review-board approved study. Susceptibility maps were reconstructed from a three-dimensional multiecho spoiled gradient-echo sequence. Four regions of interest were drawn manually on QSM images, namely the globus pallidus, putamen, caudate nucleus, and pulvinar nucleus of the thalamus. Comparisons of patient demographics, and iron concentrations among the VaD, AD, and control subjects were assessed using analysis of variance and post-hoc analyses. The relationships of age and cognitive state with susceptibility values were assessed using partial correlation analysis.
In VaD and AD, overall susceptibility values were higher than those of control subjects. A significant difference in susceptibility values was found in the putamen and caudate nucleus (p < 0.001 and p = 0.002, respectively). However, susceptibility values did not differ between VaD and AD. Age and cognitive deficit severity were not related to susceptibility values in the VaD and AD groups.
Increased iron deposition in the putamen and caudate nucleus in VaD and AD patients was not associated with age or the severity of cognitive deficits. Further evaluations are needed to determine the temporal changes in iron load and their diagnostic role in dementia pathology.
新出现的证据表明，铁在皮质下和深部灰质中的过度积累与痴呆症有关。然而，血管性痴呆（VaD）和阿尔茨海默病（AD）中铁积累的存在情况和模式鲜有研究。
使用定量磁化率成像（QSM）检查并比较VaD和AD患者脑铁积累的模式及存在情况。
本研究经机构审查委员会批准，招募了12例VaD患者、27例AD患者和18名对照者。通过三维多回波扰相梯度回波序列重建磁化率图。在QSM图像上手动绘制四个感兴趣区域，即苍白球、壳核、尾状核和丘脑枕核。使用方差分析和事后分析评估患者人口统计学特征以及VaD、AD和对照者之间的铁浓度。使用偏相关分析评估年龄和认知状态与磁化率值的关系。
在VaD和AD患者中，总体磁化率值高于对照者。壳核和尾状核的磁化率值存在显著差异（分别为p < 0.001和p = 0.002）。然而，VaD和AD患者的磁化率值无差异。年龄和认知缺陷严重程度与VaD和AD组的磁化率值无关。
VaD和AD患者壳核和尾状核中铁沉积增加与年龄或认知缺陷严重程度无关。需要进一步评估以确定铁负荷的时间变化及其在痴呆症病理学中的诊断作用。
