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Serial susceptibility weighted MRI measures brain iron and microbleeds in dementia
Wolff Kirsch1, Grant McAuley, Barbara Holshouser
1Neurosurgery Center for Research, Training, and Education, Loma Linda University, 11175 Campus Street, Suite 11113, Loma Linda, CA 92350, USA. wkirsch@llu.edu
Abstract:
A new iron sensitive MR sequence (susceptibility weighted imaging - SWI) enabling the simultaneous quantitation of regional brain iron levels and brain microbleeds (BMB) has been acquired serially to study dementia. Cohorts of mildly cognitively impaired (MCI) elderly (n = 73) and cognitively normal participants (n = 33) have been serially evaluated for up to 50 months. SWI phase values (putative iron levels) in 14 brain regions were measured and the number of BMB were counted for each SWI study. SWI phase values showed a left putaminal mean increase of iron (decrease of phase values) over the study duration in 27 participants who progressed to dementia compared to Normals (p = 0.035) and stable MCI (p = 0.01). BMB were detected in 9 out of 26 (38%) MCI participants who progressed to dementia and are a significant risk factor for cognitive failure in MCI participants [risk ratio = 2.06 (95% confidence interval 1.37-3.12)]. SWI is useful to measure regional iron changes and presence of BMB, both of which may be important MR-based biomarkers for neurodegenerative diseases.
Insights
Susceptibility weighted imaging (SWI) can quantify brain iron and microbleeds. Increased iron in the putamen and the presence of microbleeds are linked to dementia progression in individuals with mild cognitive impairment.
Area of Science:
- Neuroimaging
- Neurology
- Biomarkers
Background:
- Alzheimer's disease and related dementias are a growing public health concern.
- Accurate biomarkers for early detection and monitoring of neurodegenerative diseases are crucial.
- Assessing regional brain iron levels and microbleeds may offer insights into disease mechanisms.
Purpose of the Study:
- To evaluate the utility of susceptibility weighted imaging (SWI) for serial quantitation of regional brain iron and detection of brain microbleeds (BMB).
- To investigate the association of iron levels and BMB with cognitive decline and dementia progression in elderly individuals.
Main Methods:
- Serial acquisition of SWI in cohorts of mildly cognitively impaired (MCI) and cognitively normal participants over up to 50 months.
- Quantification of SWI phase values (putative iron levels) in 14 brain regions.
- Counting of BMB for each SWI study.
Main Results:
- A significant increase in left putaminal iron (decrease in SWI phase values) was observed in participants who progressed to dementia compared to controls (p = 0.035) and stable MCI (p = 0.01).
- Brain microbleeds (BMB) were detected in 38% of MCI participants who progressed to dementia.
- BMB were identified as a significant risk factor for cognitive failure in MCI participants (risk ratio = 2.06).
Conclusions:
- SWI is a valuable tool for measuring regional iron changes and detecting BMB in the brain.
- Iron accumulation and BMB may serve as important MR-based biomarkers for neurodegenerative diseases.
- These findings support the potential of SWI in the early detection and monitoring of dementia.
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