Li Xiaolu, Bu Shuting, Pang Huize, Yu Hongmei, Zhao Mengwan, Wang Juzhou, Jiang Yueluan, Nittka Mathias, Liu Yu, Fan Guoguang
Department of Radiology, The First Hospital of China Medical University, Shenyang, China.
Department of Neurology, The First Hospital of China Medical University, Shenyang, China.
J Magn Reson Imaging. 2025 Jun 1. doi: 10.1002/jmri.29832.
Myelin degeneration and iron accumulation are key features of Parkinson's disease (PD), yet their interrelationship and contribution to disease severity remain unclear.
To assess alterations in myelin content and iron deposition in PD, investigate their interrelationship and associations with disease severity.
Retrospective.
Fifty-three PD patients (27 females; median age 67 years) and 30 age- and sex-matched healthy controls (HCs) (14 females; median age 64 years).
FIELD STRENGTH/SEQUENCE: 3-T, two-dimensional section-selective steady-state free precession for MR fingerprinting, three-dimensional multiecho gradient-recalled echo for quantitative susceptibility mapping (QSM), and 3D T1-weighted gradient echo sequence.
Cognitive impairment was evaluated using the Montreal Cognitive Assessment (MoCA), while motor dysfunction was evaluated with the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III). Thirty-five white and gray matter regions of interest (ROIs) were defined using the MNI atlas. Myelin water fraction (MWF) was quantified using multicomponent relaxometry, and iron deposition was assessed via QSM.
Voxel-wise comparisons were performed between PD and HCs. Stepwise regression analyses explored associations between significantly altered imaging metrics and disease severity. A corrected p < 0.05 was considered statistically significant.
PD patients showed significantly reduced MWF and increased susceptibility in multiple predefined ROIs. MoCA scores were significantly associated with MWF and T1 in the left thalamus (β = 104.213; β = -0.015), and susceptibility in the left thalamic radiation (β = -107.346). MDS-UPDRS III scores were significantly associated with MWF in the contralateral uncinate fasciculus (β = -130.751) and susceptibility in the internal capsule (β = 267.798). Notably, MWF in the right internal capsule (β = -0.213) and nucleus accumbens (β = -0.302), and T1 in the right internal capsule (β = 0.001) were significantly correlated with susceptibility.
This study may provide quantitative evidence of myelin loss and iron accumulation in PD. The observed associations between MRF, susceptibility, and disease severity could offer insights into PD pathophysiology.
2: Technical Efficacy: Stage 1.
髓鞘变性和铁蓄积是帕金森病（PD）的关键特征，但其相互关系以及对疾病严重程度的影响仍不明确。
评估PD患者髓鞘含量和铁沉积的变化，研究它们之间的相互关系以及与疾病严重程度的关联。
回顾性研究。
53例PD患者（27例女性；中位年龄67岁）和30例年龄及性别匹配的健康对照者（HCs）（14例女性；中位年龄64岁）。
场强/序列：3-T，用于磁共振指纹识别的二维层面选择稳态自由进动序列、用于定量磁化率成像（QSM）的三维多回波梯度回波序列以及三维T1加权梯度回波序列。
使用蒙特利尔认知评估量表（MoCA）评估认知功能障碍，使用运动障碍协会赞助修订的统一帕金森病评定量表第三部分（MDS-UPDRS III）评估运动功能障碍。使用MNI图谱定义35个白质和灰质感兴趣区（ROI）。使用多成分弛豫测量法对髓鞘水分数（MWF）进行定量，并通过QSM评估铁沉积。
对PD患者和HCs进行体素水平的比较。逐步回归分析探索显著改变的影像学指标与疾病严重程度之间的关联。校正后p<0.05被认为具有统计学意义。
PD患者在多个预定义ROI中显示MWF显著降低且磁化率增加。MoCA评分与左侧丘脑的MWF和T1显著相关（β=104.213；β=-0.015），以及左侧丘脑辐射的磁化率显著相关（β=-107.346）。MDS-UPDRS III评分与对侧钩束的MWF显著相关（β=-130.751）以及内囊的磁化率显著相关（β=267.798）。值得注意的是，右侧内囊（β=-0.213）和伏隔核（β=-0.302）的MWF以及右侧内囊的T1（β=0.001）与磁化率显著相关。
本研究可能为PD患者髓鞘丢失和铁蓄积提供定量证据。观察到的MRF、磁化率与疾病严重程度之间的关联可为PD的病理生理学提供见解。
2：技术效能：1级。
