Diaz-Galvan Patricia, Przybelski Scott A, Lesnick Timothy G, Murray Melissa E, Nguyen Aivi, Reichard Ross R, Dickson Dennis W, Ono Daisuke, Senjem Matthew L, Schwarz Christopher G, Gunter Jeffrey, Lowe Val, Forsberg Leah K, Fields Julie A, Savica Rodolfo, Graff-Radford Jonathan, Ramanan Vijay K, Jones David, Botha Hugo, St Louis Erik K, Knopman David, Day Gregory S, Graff-Radford Neill, Kremers Walter, Petersen Ronald C, Jack Clifford R, Ferman Tanis J, Boeve Bradley F, Kantarci Kejal
Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
Mov Disord. 2025 Jun 23. doi: 10.1002/mds.30265.
To compare iron deposition in the substantia nigra (SN) as measured with quantitative susceptibility mapping (QSM) on antemortem magnetic resonance imaging (MRI) between individuals with and without Lewy-related pathology at autopsy.
We performed a retrospective cohort study including 54 participants who underwent autopsy and antemortem MRI with QSM. Cases were classified as Lewy body disease (LBD)-present (n = 13) if they had Lewy-related pathology and LBD-absent (n = 41) if they did not have Lewy-related pathology. QSM was calculated for the whole SN and the two subregions: pars compacta (SNc) and pars reticulata (SNr). Nonparametric Wilcoxon rank-sum tests were used to compare SN QSM values between LBD-present and LBD-absent cases. Area under the receiver operating characteristic (ROC) curve (AUC) analyses tested the accuracy of SN QSM values to distinguish the two groups. Associations of QSM values in the SN and its subregions with clinical features were tested with Spearman's correlations.
The LBD-present group had higher QSM values in the SNc (P = 0.008) than the LBD-absent group with no differences in SNr. QSM values of the SNc distinguished LBD-present and LBD-absent cases with good accuracy (AUC = 0.74) and correlated with the presence of parkinsonism and parkinsonism severity.
This study provides neuropathological confirmation of the utility of SNc QSM as an in vivo biomarker of Lewy-related pathology. Imaging evidence of abnormal iron deposition in the SNc could potentially serve as a biomarker for inclusion in emerging research frameworks aimed at defining individuals with LBD based on their biological characteristics. Ultimately, this could facilitate more precise diagnoses and guide treatment strategies in LBD. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
比较生前磁共振成像（MRI）利用定量磁化率成像（QSM）测量的黑质（SN）铁沉积情况，这些个体在尸检时有无路易体相关病理改变。
我们进行了一项回顾性队列研究，纳入54名接受尸检和QSM的生前MRI检查的参与者。如果病例有路易体相关病理改变，则分类为路易体病（LBD）存在组（n = 13）；如果没有路易体相关病理改变，则分类为LBD不存在组（n = 41）。计算整个SN以及两个亚区域：致密部（SNc）和网状部（SNr）的QSM。采用非参数Wilcoxon秩和检验比较LBD存在组和LBD不存在组之间的SN QSM值。受试者操作特征（ROC）曲线下面积（AUC）分析检验SN QSM值区分两组的准确性。用Spearman相关性检验SN及其亚区域的QSM值与临床特征的关联。
LBD存在组SNc的QSM值高于LBD不存在组（P = 0.008），而SNr无差异。SNc的QSM值能够较好地区分LBD存在组和LBD不存在组（AUC = 0.74），并与帕金森综合征的存在及严重程度相关。
本研究为SNc QSM作为路易体相关病理改变的体内生物标志物的实用性提供了神经病理学证实。SNc中铁沉积异常的影像学证据可能作为生物标志物，纳入旨在根据生物学特征定义LBD个体的新兴研究框架。最终，这有助于LBD的更精确诊断并指导治疗策略。© 2025作者。《运动障碍》由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版。
