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Shukla D, Goel A, Mandal PK, Joon S, Punjabi K, Arora Y, Kumar R, Mehta VS, Singh P, Maroon JC, Bansal R, Sandal K, Roy RG, Samkaria A, Sharma S, Sandhilya S, Gaur S, Parvathi S, Joshi M. Glutathione Depletion and Concomitant Elevation of Susceptibility in Patients with Parkinson's Disease: State-of-the-Art MR Spectroscopy and Neuropsychological Study. ACS Chem Neurosci 2023; 14:4383-4394. [PMID: 38050970 PMCID: PMC10739611 DOI: 10.1021/acschemneuro.3c00717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
Parkinson's disease (PD) is characterized by extrapyramidal motor disturbances and nonmotor cognitive impairments which impact activities of daily living. Although the etiology of PD is still obscure, autopsy reports suggest that oxidative stress (OS) is one of the important factors in the pathophysiology of PD. In the current study, we have investigated the impact of OS in PD by measuring the antioxidant glutathione (GSH) levels from the substantia nigra (SN), left hippocampus (LH) and neurotransmitter γ-amino butyric acid (GABA) levels from SN region. Concomitant quantitative susceptibility mapping (QSM) from SN and LH was also acquired from thirty-eight PD patients and 30 age-matched healthy controls (HC). Glutathione levels in the SN region decreased significantly and susceptibility increased significantly in PD compared to HC. Nonsignificant depletion of GABA was observed in the SN region. GSH levels in the LH region were depleted significantly, but LH susceptibility did not alter in the PD cohort compared to HC. Neuropsychological and physical assessment demonstrated significant impairment of cognitive functioning in PD patients compared to HC. GSH depletion was negatively correlated to motor function performance. Multivariate receiver operating characteristic (ROC) curve analysis on the combined effect of GSH, GABA, and susceptibility in the SN region yielded an improved diagnostic accuracy of 86.1% compared to individual diagnostic accuracy based on GSH (65.8%), GABA (57.5%), and susceptibility (69.6%). This is the first comprehensive report in PD demonstrating significant GSH depletion as well as concomitant iron enhancement in the SN region.
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Affiliation(s)
- Deepika Shukla
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Anshika Goel
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Pravat K. Mandal
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
- Florey
Institute of Neuroscience and Mental Health, Melbourne, VIC 3052, Australia
- Department
of Neurosurgery, University of Pittsburgh
Medical School, Pittsburgh, Pennsylvania 15213, United States
| | - Shallu Joon
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Khushboo Punjabi
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Yashika Arora
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Rajnish Kumar
- Department
of Neurology, Paras Hospitals, Gurgaon, Haryana 122002, India
| | - Veer Singh Mehta
- Department
of Neurosurgery, Paras Hospitals, Gurgaon, Haryana 122002, India
| | - Padam Singh
- Department
of Biostatistics, Medanta Medicity, Gurgaon, Haryana 122001, India
| | - Joseph C. Maroon
- Department
of Neurosurgery, University of Pittsburgh
Medical School, Pittsburgh, Pennsylvania 15213, United States
| | - Rishu Bansal
- Department
of Neurology, Medanta Medicity, Gurgaon, Haryana 122001, India
| | - Kanika Sandal
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Rimil Guha Roy
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Avantika Samkaria
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Shallu Sharma
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Sandhya Sandhilya
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - Shradha Gaur
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
| | - S. Parvathi
- Department
of Biostatistics, Medanta Medicity, Gurgaon, Haryana 122001, India
| | - Mallika Joshi
- Neuroimaging
and Neurospectroscopy Laboratory (NINS), NBRC, Gurgaon 122051, India
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