Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Radiology, Medical Imaging Center, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China.
Eur Neurol. 2022;85(4):280-290. doi: 10.1159/000522329. Epub 2022 Mar 21.
The relationship between iron accumulation in the central nervous system and cognitive decline in Parkinson's disease (PD) has not been fully elucidated. This study aimed to explore the value of quantitative susceptibility mapping in assessment of mild cognitive impairment (MCI) in PD.
Sixteen PD patients with MCI (PD-MCI), sixteen normal cognition PD patients (PD-NC), and 28 healthy controls (HCs) were included. The differences in the magnetic susceptibility and Radiomic indicators among groups and their correlations with Montreal Cognitive Assessment-Basic (MoCA-B) scores and Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) were analyzed. Receiver operating characteristic curves were used to evaluate the diagnostic performance.
Higher iron deposition was observed in the cortical and subcortical structures of the PD patients compared with HCs, including limbic system, orbitofrontal cortex, cuneus, red nucleus, and substantia nigra. Combined magnetic susceptibility and texture index in hippocampus achieved the best diagnostic performance (area under curves: 0.828) in differentiating PD-MCI from PD-NC. The magnetic susceptibilities of the substantia nigra, red nucleus, putamen, globus pallidus, hippocampus, and thalamus were negatively correlated with the MoCA-B scores (all p < 0.05), and of the putamen and amygdala were positively correlated with the UPDRS-III scores (both p < 0.05).
Higher iron deposition was observed in the cortical and subcortical structures of the PD-MCI and PD-NC groups. The susceptibility values of vulnerable brain subregions shown significant correlation with MoCA-B and UPDRS-III. Together with the texture index, magnetic susceptibility values could provide robust performance in distinguishing PD-MCI patients from PD-NC.
铁在中枢神经系统中的积累与帕金森病（PD）认知能力下降之间的关系尚未完全阐明。本研究旨在探讨定量磁化率成像在评估 PD 轻度认知障碍（MCI）中的价值。
纳入 16 例 PD-MCI 患者、16 例认知正常 PD 患者（PD-NC）和 28 例健康对照者（HCs）。分析组间磁化率和 Radiomic 指标的差异及其与蒙特利尔认知评估-基础量表（MoCA-B）评分和统一帕金森病评定量表第三部分（UPDRS-III）的相关性。采用受试者工作特征曲线评估诊断性能。
与 HCs 相比，PD 患者皮质和皮质下结构（包括边缘系统、眶额皮质、楔前叶、红核和黑质）铁沉积更高。联合海马体的磁化率和纹理指数在区分 PD-MCI 与 PD-NC 方面具有最佳的诊断性能（曲线下面积：0.828）。黑质、红核、壳核、苍白球、海马体和丘脑的磁化率与 MoCA-B 评分呈负相关（均 p < 0.05），壳核和杏仁核的磁化率与 UPDRS-III 评分呈正相关（均 p < 0.05）。
PD-MCI 和 PD-NC 组皮质和皮质下结构的铁沉积更高。易损脑区的磁化率值与 MoCA-B 和 UPDRS-III 显著相关。结合纹理指数，磁化率值在区分 PD-MCI 患者与 PD-NC 方面具有良好的性能。
