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Updated: May 4, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Imaging brain iron and diffusion patterns: a follow-up study of Parkinson's disease in the initial stages
Maija Elina Rossi1, Hanna Ruottinen2, Tiia Saunamäki2
1Department of Radiology, Medical Imaging Centre, Tampere University Hospital, Teiskontie 35, Post Box 2000, 33520 Tampere, Finland.
Rationale And Objectives:
The aim of this study was to examine changes of brain iron content and diffusion patterns longitudinally in early-stage Parkinson's disease (PD) patients using T2- and T2*-based magnetic resonance imaging (MRI) over 2-year follow-up.
Materials And Methods:
We imaged 32 PD patients with tremor and 19 healthy controls. A follow-up study (median 25 months, range 22-31 months) was accomplished for 25 patients (men:women = 11:14; age range 44-87 years, median 73 years). All patients and healthy volunteers underwent clinical, neuropsychological, and MRI examinations on the same day. Three different MRI sequences were used and their results were compared: T2-weighted imaging, susceptibility-weighted imaging, and T2* mapping. Additionally, we evaluated diffusion tensor data between groups using tract-based spatial statistics.
Results:
Over the 2-year follow-up, the iron-related relaxation increased in the globus pallidus anterior and the caudate nucleus and slightly in the substantia nigra pars compacta (SNc). In the globus pallidus anterior and medial SNc, the change was associated with mild cognitive impairment. In the caudate nucleus, the increase was pronounced in patients with disease onset at 67 years or older. In the SNc, medial transverse relaxation was increased, and in the thalamus, it was decreased, in patients with PD compared with healthy volunteers at 2-year follow-up. Tract-based spatial statistical data did not differ between groups based on gender or Unified Parkinson's Disease Rating Scale, but a slight tendency to decreasing fractional anisotropy (P < .10) in the genu of corpus callosum and bilaterally in corona radiata was seen over 2 years.
Conclusions:
PD-related changes were found in putative iron content over 2 years. Although mild in the initial stages, these changes were consistent over MRI sequences. Rather than correlating with disease duration, the rate of changes was associated with individual characters, such as cognitive decline and age.
Insights
Longitudinal MRI reveals increasing brain iron in early Parkinson's disease (PD). These changes, linked to cognitive decline and age, offer insights into PD progression.
Area of Science:
- Neuroimaging
- Neurology
- Biochemistry
Background:
- Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms.
- Iron accumulation in the brain is implicated in PD pathogenesis, but its longitudinal changes in early stages are not well understood.
Purpose of the Study:
- To longitudinally assess changes in brain iron content and diffusion patterns in early-stage Parkinson's disease (PD) patients over a 2-year period.
- To investigate the relationship between these neuroimaging changes and clinical factors such as cognitive status and age.
Main Methods:
- Utilized T2- and T2*-based magnetic resonance imaging (MRI) sequences, including T2-weighted imaging, susceptibility-weighted imaging, and T2* mapping.
- Evaluated diffusion tensor imaging (DTI) data using tract-based spatial statistics (TBSS) in 32 PD patients and 19 healthy controls.
- Conducted a 2-year follow-up on 25 PD patients, comparing MRI findings with clinical and neuropsychological assessments.
Main Results:
- Observed increased iron-related relaxation (indicating iron accumulation) in the anterior globus pallidus and caudate nucleus, and slightly in the substantia nigra pars compacta (SNc) over 2 years.
- Associated these iron changes with mild cognitive impairment and found a pronounced increase in the caudate nucleus in patients with later disease onset (≥67 years).
- Noted differences in relaxation rates in the SNc and thalamus between PD patients and controls at follow-up, with subtle decreases in fractional anisotropy in specific white matter tracts.
Conclusions:
- Confirmed PD-related changes in brain iron content over 2 years, consistent across MRI sequences even in early disease stages.
- Demonstrated that the rate of these neuroimaging changes is associated with individual characteristics like cognitive decline and age, rather than disease duration.
- These findings highlight the potential of longitudinal MRI to track PD progression and identify factors influencing its trajectory.
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