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Cao Q, Han X, Tang D, Qian H, Yan K, Shi X, Li Y, Zhang J. Diagnostic value of combined magnetic resonance imaging techniques in the evaluation of Parkinson disease. Quant Imaging Med Surg 2023; 13:6503-6516. [PMID: 37869346 PMCID: PMC10585559 DOI: 10.21037/qims-23-87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 08/08/2023] [Indexed: 10/24/2023]
Abstract
Background The incidence of Parkinson disease (PD) has been increasing each year. The development of new magnetic resonance imaging (MRI) technology can help understand its pathogenesis and identify more effective imaging-based biological indicators. Methods The clinical and MRI imaging data of 40 patients with PD and 40 healthy controls were analyzed. All participants underwent susceptibility-weighted imaging (SWI), neuromelanin-sensitive magnetic resonance imaging (NM-MRI), and T2*mapping sequence examination. The diagnostic value of single and combined multiparameter indicators was analyzed using the receiver operating characteristic curve. Results Compared with the healthy control group, the PD group showed significant differences in the disappearance of bilateral "swallow tail sign", the distribution volume of melanocytes in the substantia nigra and the smaller volume in the bilateral substantia nigra, the maximum signal of the locus coeruleus and the smaller and average volume in the bilateral substantia nigra, and the values of T2* and R2* in the bilateral substantia nigra (P<0.01). The maximum and smaller value and the average value of the bilateral locus coeruleus signal were negatively correlated with the disease course duration (P<0.05), and the smaller distribution volume of the melanin neurons in the bilateral substantia nigra was negatively correlated with Hoehn and Yahr (H-Y) grade (P<0.05). In the joint diagnosis with multiple indicators, some composite parameters were found to be negatively correlated with H-Y grading (P<0.05), while others were negatively correlated with disease course duration (P<0.05). Joint use of multiple parameter indicators greatly improved diagnostic efficacy [area under the curve (AUC) =0.958]. Conclusions The distribution volume of melanin in substantia nigra and the maximum value of locus coeruleus signal may be the biological imaging indicators for the early diagnosis, severity, and follow-up evaluation of PD. Compared with a single indicator, composite indicators used in combination with multiple techniques have a significantly better diagnostic efficacy for PD.
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Affiliation(s)
- Qing Cao
- Department of Radiology, Guangzhou Xinhai Hospital, Guangzhou, China
| | - Xiaowei Han
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Dongping Tang
- Department of Science and Education, Guangzhou Xinhai Hospital, Guangzhou, China
| | - Hao Qian
- Department of Neurology, Guangzhou Xinhai Hospital, Guangzhou, China
| | - Kun Yan
- Department of Neurology, Guangzhou Xinhai Hospital, Guangzhou, China
| | - Xun Shi
- Department of Nuclear Medicine, The First People’s Hospital of Yancheng, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
| | - Yaowei Li
- Department of Radiology, Guangzhou Xinhai Hospital, Guangzhou, China
| | - Jiangong Zhang
- Department of Nuclear Medicine, The First People’s Hospital of Yancheng, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
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Wang M, Wang H, Wang J, Lu S, Li C, Zhong X, Wang N, Ge R, Zheng Q, Chen J, Wang H. Modified Iron Deposition in Nigrosomes by Pharmacotherapy for the Management of Parkinson’s Disease. Front Mol Biosci 2022; 9:908298. [PMID: 35874610 PMCID: PMC9301007 DOI: 10.3389/fmolb.2022.908298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Increased iron deposition in nigrosome as assessed by susceptibility-weighted imaging (SWI) is involved in the pathogenesis of Parkinson’s disease (PD). This study investigated the effects of antiparkinson drugs on iron deposition in the nigrosome of PD patients. Methods: Based on the retrospective analysis of clinical data, alterations in iron deposition in the substantia nigra were investigated in 51 PD patients across different types of therapies and in nine Parkinson-plus syndrome patients. The Movement Disorder Society revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part Ⅲ/Ⅳ (UPDRS Ⅲ/Ⅳ) was utilized to evaluate motor function and complications. SWI (slice = 0.6 mm) was used to detect iron deposition in the nigrosome and substantia nigra. Nigrosome loss was scored on a 1-point nigrosome visibility scale. Visual assessment of dorsolateral nigral hyperintensity (DNH) was separately performed for each side of the nigrosome with SWI. Results: Increased UPDRS Ⅲ scores were correlated with low nigrosome scores based on correlation analysis at a disease duration of 6–12 months (r = −0.8420). The loss of the nigrosome on SWI was clearly inhibited in PD patients with a 3–5-year duration of administration of antiparkinson medications compared with no treatment. Decreased UPDRS Ⅲ scores and increased nigrosome scores were observed in the regular treatment of PD patients with a 6–7-year disease duration. For patients with Parkinson-plus syndromes, such as multiple system atrophy, iron accumulation was apparent in the corpus striatum and substantia nigra compared with that for patients with progressive supranuclear palsy. Conclusions: Early and regular treatment with antiparkinson drugs not only alleviates the chance of PD disability but also prevents the loss of DNH, namely, iron accumulation in the nigrosome.
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Affiliation(s)
- Mengdi Wang
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, China
| | - Hongxia Wang
- Department of Radiology, Binzhou Medical University Hospital, Binzhou, China
| | - Jing Wang
- Department of Radiology, Binzhou Medical University Hospital, Binzhou, China
- *Correspondence: Jing Wang, ; Qi Zheng, ; Jinbo Chen, ; Hongcai Wang,
| | - Shujun Lu
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, China
| | - Chen Li
- Medical Research Center, Binzhou Medical University Hospital, Binzhou, China
| | - Xiaofei Zhong
- Department of Radiology, Binzhou Medical University Hospital, Binzhou, China
| | - Nan Wang
- Medical Research Center, Binzhou Medical University Hospital, Binzhou, China
| | - Ruli Ge
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, China
| | - Qi Zheng
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, China
- *Correspondence: Jing Wang, ; Qi Zheng, ; Jinbo Chen, ; Hongcai Wang,
| | - Jinbo Chen
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, China
- *Correspondence: Jing Wang, ; Qi Zheng, ; Jinbo Chen, ; Hongcai Wang,
| | - Hongcai Wang
- Department of Neurology, Binzhou Medical University Hospital, Binzhou, China
- *Correspondence: Jing Wang, ; Qi Zheng, ; Jinbo Chen, ; Hongcai Wang,
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