Quantitative susceptibility mapping of the midbrain in Parkinson's disease

• Published in: Movement disorders 2016-03, Vol.31 (3), p.317-324
• Main Authors: Du, Guangwei, Liu, Tian, Lewis, Mechelle M., Kong, Lan, Wang, Yi, Connor, James, Mailman, Richard B., Huang, Xuemei
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - analysis; Female; Humans; Image Processing, Computer-Assisted; iron; Iron - metabolism; Levodopa - therapeutic use; magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Mesencephalon - drug effects; Mesencephalon - metabolism; Middle Aged; Movement disorders; Parkinson Disease - drug therapy; Parkinson Disease - metabolism; Parkinson's disease; quantitative susceptibility mapping; substantia nigra
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.26417

Background Parkinson's disease (PD) is marked pathologically by dopamine neuron loss and iron overload in the substantia nigra pars compacta. Midbrain iron content is reported to be increased in PD based on magnetic resonance imaging (MRI) R2* changes. Because quantitative susceptibility mapping is a novel MRI approach to measure iron content, we compared it with R2* for assessing midbrain changes in PD. Methods Quantitative susceptibility mapping and R2* maps were obtained from 47 PD patients and 47 healthy controls. Midbrain susceptibility and R2* values were analyzed by using both voxel‐based and region‐of‐interest approaches in normalized space, and analyzed along with clinical data, including disease duration, Unified Parkinson's Disease Rating Scale (UPDRS) I, II, and III subscores, and levodopa‐equivalent daily dosage. All studies were done while PD patients were “on drug.” Results Compared with controls, PD patients showed significantly increased susceptibility values in both right (cluster size = 106 mm3) and left (164 mm3) midbrain, located ventrolateral to the red nucleus that corresponded to the substantia nigra pars compacta. Susceptibility values in this region were correlated significantly with disease duration, UPDRS II, and levodopa‐equivalent daily dosage. Conversely, R2* was increased significantly only in a much smaller region (62 mm3) of the left lateral substantia nigra pars compacta and was not significantly correlated with clinical parameters. Conclusion The use of quantitative susceptibility mapping demonstrated marked nigral changes that correlated with clinical PD status more sensitively than R2*. These data suggest that quantitative susceptibility mapping may be a superior imaging biomarker to R2* for estimating brain iron levels in PD. © 2015 Movement Disorder Society