Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Avenue, Wuhan, 430030, China.
Department of CT & MRI, The First Affiliated Hospital, College of Medicine, Shihezi University, 107 North Second Road, Shihezi, China.
Eur Radiol. 2024 May;34(5):3074-3083. doi: 10.1007/s00330-023-10283-1. Epub 2023 Oct 19.
Iron deposition and mitochondrial dysfunction are closely associated with the genesis and progression of Parkinson's disease (PD). This study aims to extract susceptibility and oxygen extraction fraction (OEF) values of deep grey matter (DGM) to explore spatiotemporal progression patterns of brain iron-oxygen metabolism in PD.
Ninety-five PD patients and forty healthy controls (HCs) were included. Quantitative susceptibility mapping (QSM) and OEF maps were computed from MRI multi-echo gradient echo data. Analysis of covariance (ANCOVA) was used to compare mean susceptibility and OEF values in DGM between early-stage PD (ESP), advanced-stage PD (ASP) patients and HCs. Then Granger causality analysis on the pseudo-time-series of MRI data was applied to assess the causal effect of early altered nuclei on iron content and oxygen extraction in other DGM nuclei.
The susceptibility values in substantia nigra (SN), red nucleus, and globus pallidus (GP) significantly increased in PD patients compared with HCs, while the iron content in GP did not elevate obviously until the late stage. The mean OEF values for the caudate nucleus, putamen, and dentate nucleus were higher in ESP patients than in ASP patients or/and HCs. We also found that iron accumulation progressively expands from the midbrain to the striatum. These alterations were correlated with clinical features and improved AUC for early PD diagnosis to 0.824.
Abnormal cerebral iron deposition and tissue oxygen utilization in PD measured by QSM and OEF maps could reflect pathological alterations in neurodegenerative processes and provide valuable indicators for disease identification and management.
Noninvasive assessment of cerebral iron-oxygen metabolism may serve as clinical evidence of pathological changes in PD and improve the validity of diagnosis and disease monitoring.
• Quantitative susceptibility mapping and oxygen extraction fraction maps indicated the cerebral pathology of abnormal iron accumulation and oxygen metabolism in Parkinson's disease. • Iron deposition is mainly in the midbrain, while altered oxygen metabolism is concentrated in the striatum and cerebellum. • The susceptibility and oxygen extraction fraction values in subcortical nuclei were associated with clinical severity.
铁沉积和线粒体功能障碍与帕金森病（PD）的发生和发展密切相关。本研究旨在提取深部灰质（DGM）的易感性和氧摄取分数（OEF）值，以探索 PD 患者脑铁氧代谢的时空进展模式。
纳入 95 例 PD 患者和 40 例健康对照者（HCs）。从 MRI 多回波梯度回波数据中计算定量磁化率图（QSM）和 OEF 图。采用协方差分析（ANCOVA）比较早期 PD（ESP）、晚期 PD（ASP）患者与 HCs 之间 DGM 中平均磁化率和 OEF 值。然后对 MRI 数据的伪时间序列进行格兰杰因果分析，以评估早期改变核对其他 DGM 核中铁含量和氧摄取的因果影响。
与 HCs 相比，PD 患者黑质（SN）、红核和苍白球（GP）的磁化率值显著增加，而 GP 中的铁含量直到晚期才明显升高。ESP 患者的尾状核、壳核和齿状核的平均 OEF 值高于 ASP 患者和/或 HCs。我们还发现，铁积累从中脑逐渐扩展到纹状体。这些改变与临床特征相关，使早期 PD 诊断的 AUC 提高至 0.824。
QSM 和 OEF 图测量的 PD 患者脑内铁沉积和组织氧利用异常可反映神经退行性过程中的病理改变，并为疾病识别和管理提供有价值的指标。
对脑铁氧代谢的无创评估可能是 PD 患者病理改变的临床证据，并提高诊断和疾病监测的有效性。
定量磁化率图和氧摄取分数图表明帕金森病异常铁积聚和氧代谢的脑病理学。
铁沉积主要发生在中脑，而改变的氧代谢主要集中在纹状体和小脑。
皮质下核的易感性和氧摄取分数值与临床严重程度相关。
