Chen Junling, Cai Tongtong, Li Yan, Chi Jieshan, Rong Siming, He Chentao, Li Xiaohong, Zhang Piao, Wang Lijuan, Zhang Yuhu
Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Department of Neurology, Shantou Central Hospital, Shantou, China.
Quant Imaging Med Surg. 2020 Nov;10(11):2168-2176. doi: 10.21037/qims-20-285.
Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder with various subtypes and uncertain pathogenesis. Iron deposition is considered to be involved in the pathological mechanisms of PD. The present study aimed to investigate the iron deposition in deep gray matter in patients with different PD subtypes using quantitative susceptibility mapping (QSM).
Forty-six PD patients and 22 healthy controls (HCs) were recruited for the study. PD patients were allocated to the tremor-dominant (TD) group (n=22), postural instability and gait disorder-dominant (PIGD) group (n=19), and intermediate group (n=5). Susceptibility values in deep gray matter nuclei measured by QSM among the PD-TD and PD-PIGD groups and the HCs, as well as the relationship between iron accumulation and clinical motor features, were investigated.
Susceptibility values in the dentate nucleus (DN) were greater in the PD-TD (118.73±70.45) group than in the PD-PIGD (72.14±39.85, P=0.02) group and HCs (78.26±41.38, P=0.042). Further, a significant positive correlation was observed between the DN susceptibility values and tremor scores (r=0.324, P=0.028). Compared with the HCs (182.60±85.35), both the PD-TD (282.00±102.49, P=0.006) and PD-PIGD groups (284.91±118.54, P=0.007) exhibited greater susceptibility values in the substantia nigra (SN) pars reticulata. The susceptibility values in the SN pars compacta were also greater in the PD-PIGD group (164.51±89.44) than in the HCs (107.78±63.11, P=0.048).
The present study demonstrated various iron deposition patterns in different PD phenotypes. These findings give insight into the pathophysiology underlying different PD phenotypes, and potentially illustrate the involvement of iron deposition in the PD-TD and PD-PIGD subtypes.
帕金森病（PD）是一种异质性神经退行性疾病，具有多种亚型且发病机制不明。铁沉积被认为参与了PD的病理机制。本研究旨在使用定量磁化率成像（QSM）研究不同PD亚型患者深部灰质中的铁沉积情况。
招募了46例PD患者和22名健康对照者（HCs）进行研究。PD患者被分为震颤为主型（TD）组（n = 22）、姿势不稳和步态障碍为主型（PIGD）组（n = 19）和中间型组（n = 5）。研究了PD-TD组和PD-PIGD组以及HCs之间通过QSM测量的深部灰质核团的磁化率值，以及铁蓄积与临床运动特征之间的关系。
PD-TD组（118.73±70.45）齿状核（DN）的磁化率值高于PD-PIGD组（72.14±39.85，P = 0.02）和HCs（78.26±41.38，P = 0.042）。此外，DN磁化率值与震颤评分之间存在显著正相关（r = 0.324，P = 0.028）。与HCs（182.60±85.35）相比，PD-TD组（282.00±102.49，P = 0.006）和PD-PIGD组（284.91±118.54，P = 0.007）黑质网状部的磁化率值均更高。PD-PIGD组致密部黑质的磁化率值（164.51±89.44）也高于HCs（107.78±63.11，P = 0.048）。
本研究证明了不同PD表型中铁沉积模式各异。这些发现有助于深入了解不同PD表型的病理生理学，并可能阐明铁沉积在PD-TD和PD-PIGD亚型中的作用。
