Unraveling Iron Deposits in Parkinsonian Disorders

Published on August 5, 2022

Think of your brain as a kitchen with different pots and pans: the globus pallidus, putamen, caudate nucleus, red nucleus, substantia nigra, and dentate nucleus. Researchers used a technique called quantitative susceptibility mapping (QSM) to look for iron deposits in these brain regions in patients with Parkinson’s disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). They found that different regions showed distinct patterns of iron accumulation. By combining QSM values with levels of a protein called neurofilament light chain (NfL) in the blood, they were able to improve accuracy in distinguishing between PD and PSP. Interestingly, NfL levels alone were more effective at differentiating MSA from PD. These findings open up new avenues for using QSM and NfL as potential biomarkers for identifying specific parkinsonian disorders and could aid in developing targeted treatments. For more details, check out the original research article.

ObjectivesWe employed quantitative susceptibility mapping (QSM) to assess iron deposition in parkinsonian disorders and explored whether combining QSM values and neurofilament light (NfL) chain levels can improve the accuracy of distinguishing Parkinson’s disease (PD) from multiple system atrophy (MSA) and progressive supranuclear palsy (PSP).Materials and methodsForty-seven patients with PD, 28 patients with MSA, 18 patients with PSP, and 28 healthy controls (HC) were enrolled, and QSM data were reconstructed. Susceptibility values in the bilateral globus pallidus (GP), putamen (PUT), caudate nucleus (CN), red nucleus (RN), substantia nigra (SN), and dentate nucleus (DN) were obtained. Plasma NfL levels of 47 PD, 18 MSA, and 14 PSP patients and 22 HC were measured by ultrasensitive Simoa technology.ResultsThe highest diagnostic accuracy distinguishing MSA from PD patients was observed with increased susceptibility values in CN (AUC: 0.740). The susceptibility values in RN yielded the highest diagnostic performance for distinguishing PSP from PD patients (AUC: 0.829). Plasma NfL levels were significantly higher in the MSA and PSP groups than in PD and HC groups. Combining the susceptibility values in the RN and plasma NfL levels improved the diagnostic performance for PSP vs. PD (AUC: 0.904), whereas plasma NfL levels had higher diagnostic accuracy for MSA vs. PD (AUC: 0.877).ConclusionThe exploratory study indicates different patterns of iron accumulation in deep gray matter nuclei in Parkinsonian disorders. Combining QSM values with NfL levels may be a promising biomarker for distinguishing PSP from PD, whereas plasma NfL may be a reliable biomarker for differentiating MSA from PD. QSM and NfL measures appeared to have low accuracy for separating PD from controls.

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