Khormi Ibrahim, Fazlollahi Amir, Al-Iedani Oun, Vidyasagar Rishma, Ayton Scott, Alshehri Abdulaziz, Paton Bryan, Ramadan Saadallah, Lechner-Scott Jeannette
School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
Neuroradiol J. 2024 Dec 4:19714009241303123. doi: 10.1177/19714009241303123.
Multiple sclerosis (MS) is a long-term autoimmune inflammatory disorder that affects the central nervous system leading to neurodegeneration, and can involve a variety of symptoms. These symptoms can include fatigue, anxiety, depression, and cognitive decline, which may be silent. The objective of this study was to explore changes in brain iron deposition in people with relapsing-remitting MS (pw-RRMS) compared to healthy controls (HCs), with a particular focus on regions of fear circuit. Additionally, the study aimed to evaluate relationship between iron deposition in these areas and clinical measurements. Pw-RRMS and HCs participants underwent brain MRI scans using quantitative susceptibility mapping (QSM) to assess iron deposition in the fear circuit between the two groups. The study analyzed correlations between brain susceptibility changes and clinical measurements. We recruited 35 pw-RRMS (mean age = 46.7 ± 11 years; median EDSS = 2.5) and 18 HCs (mean age = 40.6 ± 17.8 years). Our research revealed significant increases in QSM signals relating to iron deposition in pw-RRMS compared to HCs, whole fear circuit (β = 5.82, < 0.001), caudate (β = 21.48, < 0.001), and putamen (β = 17.53, = 0.03), showing the greatest difference. The whole fear circuit and particularly the caudate are strongly associated with fatigue in pw-RRMS. QSM values in the anterior cingulate cortex significantly differed between pw-RRMS with normal and abnormal depression scores ( = 0.007). These results strengthen the relationship between increased iron deposition in fear circuit regions and specific silent symptoms in pw-RRMS. However, further studies are required to confirm these findings and clarify the implications of iron accumulation in MS pathophysiology.
多发性硬化症（MS）是一种长期的自身免疫性炎症性疾病，会影响中枢神经系统，导致神经退行性变，并可能出现多种症状。这些症状包括疲劳、焦虑、抑郁和认知能力下降，其中认知能力下降可能不明显。本研究的目的是探讨复发缓解型多发性硬化症患者（pw-RRMS）与健康对照者（HCs）相比脑铁沉积的变化，特别关注恐惧回路区域。此外，该研究旨在评估这些区域的铁沉积与临床测量指标之间的关系。pw-RRMS患者和HCs参与者接受了脑部MRI扫描，使用定量磁化率成像（QSM）来评估两组之间恐惧回路中的铁沉积。该研究分析了脑磁化率变化与临床测量指标之间的相关性。我们招募了35名pw-RRMS患者（平均年龄 = 46.7 ± 11岁；EDSS中位数 = 2.5）和18名HCs（平均年龄 = 40.6 ± 17.8岁）。我们的研究表明，与HCs相比，pw-RRMS患者中与铁沉积相关的QSM信号显著增加，整个恐惧回路（β = 5.82，< 0.001）、尾状核（β = 21.48，< 0.001）和壳核（β = 17.53，= 0.03），差异最为显著。整个恐惧回路，特别是尾状核，与pw-RRMS患者的疲劳密切相关。前扣带回皮质的QSM值在抑郁评分正常和异常的pw-RRMS患者之间有显著差异（= 0.007）。这些结果加强了恐惧回路区域铁沉积增加与pw-RRMS患者特定隐性症状之间的关系。然而，需要进一步的研究来证实这些发现，并阐明铁积累在MS病理生理学中的意义。
