Ghaderi Sadegh, Mohammadi Sana, Ahmadzadeh Amir Mahmoud, Darmiani Kimia, Arab Bafrani Melika, Jashirenezhad Nahid, Helfi Maryam, Alibabaei Sanaz, Azadi Sareh, Heidary Sahar, Fatehi Farzad
Neuromuscular Research Center, Department of Neurology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Magn Reson Imaging. 2025 Jan 20. doi: 10.1002/jmri.29698.
Quantitative Susceptibility Mapping (QSM) provides a non-invasive post-processing method to investigate alterations in magnetic susceptibility (χ), reflecting iron content within brain regions implicated in neurodegenerative diseases (NDDs).
To investigate alterations in thalamic χ in patients with NDDs using QSM.
Systematic review and meta-analysis.
A total of 696 patients with NDDs and 760 healthy controls (HCs) were included in 27 studies.
FIELD STRENGTH/SEQUENCE: Three-dimensional multi-echo gradient echo sequence for QSM at mostly 3 Tesla.
Studies reporting QSM values in the thalamus of patients with NDDs were included. Following PRISMA 2020, we searched the four major databases including PubMed, Scopus, Web of Science, and Embase for peer-reviewed studies published until October 2024.
Meta-analysis was conducted using a random-effects model to calculate the standardized mean difference (SMD) between patients and HCs.
The pooled SMD indicated a significant increase in thalamic χ in NDDs compared to HCs (SMD = 0.42, 95% CI: 0.05-0.79; k = 27). Notably, amyotrophic lateral sclerosis patients showed a significant increase in thalamic χ (1.09, 95% CI: 0.65-1.53, k = 2) compared to HCs. Subgroup analyses revealed significant χ alterations in younger patients (mean age ≤ 62 years; 0.56, 95% CI: 0.10-1.02, k = 11) and studies using greater coil channels (coil channels > 16; 0.64, 95% CI: 0.28-1.00, k = 9). Publication bias was not detected and quality assessment indicated that studies with a lower risk of bias presented more reliable findings (0.75, 95% CI: 0.32-1.18, k = 9). Disease type was the primary driver of heterogeneity, while other factors, such as coil type and geographic location, also contributed to variability.
Our findings support the potential of QSM for investigating thalamic involvement in NDDs. Future research should focus on disease-specific patterns, thalamic-specific nucleus analysis, and temporal evolution.
Our research investigated changes in iron levels within the thalamus, a brain region crucial for motor and cognitive functions, in patients with various neurodegenerative diseases (NDDs). The study utilized a specific magnetic resonance imaging technique called Quantitative Susceptibility Mapping (QSM) to measure iron content. It identified a significant increase in thalamic iron levels in NDD patients compared to healthy individuals. This increase was particularly prominent in patients with Amyotrophic Lateral Sclerosis, younger individuals, and studies employing advanced imaging equipment.
2 TECHNICAL EFFICACY: Stage 2.
定量磁化率图谱（QSM）提供了一种非侵入性的后处理方法，用于研究磁化率（χ）的变化，反映神经退行性疾病（NDDs）相关脑区内的铁含量。
使用QSM研究NDDs患者丘脑χ的变化。
系统评价和荟萃分析。
27项研究共纳入696例NDDs患者和760例健康对照（HCs）。
场强/序列：主要在3特斯拉下用于QSM的三维多回波梯度回波序列。
纳入报告NDDs患者丘脑QSM值的研究。遵循PRISMA 2020，我们在包括PubMed、Scopus、Web of Science和Embase在内的四个主要数据库中检索截至2024年10月发表的同行评审研究。
采用随机效应模型进行荟萃分析，以计算患者与HCs之间的标准化平均差（SMD）。
汇总的SMD表明，与HCs相比，NDDs患者丘脑χ显著增加（SMD = 0.42，95%CI：0.05 - 0.79；k = 27）。值得注意的是，与HCs相比，肌萎缩侧索硬化患者丘脑χ显著增加（1.09，95%CI：0.65 - 1.53，k = 2）。亚组分析显示，年轻患者（平均年龄≤62岁；0.56，95%CI：0.10 - 1.02，k = 11）和使用更多线圈通道的研究（线圈通道>16；0.64，95%CI：0.28 - 1.00，k = 9）中χ有显著变化。未检测到发表偏倚，质量评估表明偏倚风险较低的研究呈现出更可靠的结果（0.75，95%CI：0.32 - 1.18，k = 9）。疾病类型是异质性的主要驱动因素，而其他因素，如线圈类型和地理位置，也导致了变异性。
我们的研究结果支持QSM在研究丘脑参与NDDs方面的潜力。未来的研究应关注疾病特异性模式、丘脑特异性核分析和时间演变。
我们的研究调查了各种神经退行性疾病（NDDs）患者中，丘脑（对运动和认知功能至关重要的脑区）内铁水平的变化。该研究利用一种名为定量磁化率图谱（QSM）的特定磁共振成像技术来测量铁含量。研究发现，与健康个体相比，NDDs患者丘脑铁水平显著增加。这种增加在肌萎缩侧索硬化患者、年轻个体以及采用先进成像设备的研究中尤为明显。
2 技术效能：2级
