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Lili Gao1, Zhihong Jiang1, Zhaocheng Cai2
1Department of Neurology, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning 116000, P.R. China.
Abstract:
The aim of the present study was to analyze brain and body iron levels among patients with mild cognitive impairment (MCI), Alzheimer's disease (AD), and normal controls (NCs). A total of 90 participants (30 MCI, 30 AD, 30 NC) were enrolled. Brain iron content was quantified using susceptibility weighted imaging (SWI). Phase values were used to calculate bilateral iron content in the hippocampus (HP), substantia nigra, red nucleus (RN), dentate nucleus (DN), caudate nucleus (CN), globus pallidus (GP), putamen (PUT), frontal white matter, temporal cortex (TC), and parietal cortex. Body iron indices, including serum iron, serum transferrin, ferritin and total iron binding capacity, were measured. Phase values of the left (L)‑DN, L‑CN, and bilateral PUT in the MCI group were significantly lower compared with NC group. Phase values of the right (R)‑RN, bilateral DN, and bilateral PUT in the AD group were significantly lower compared with the MCI group. Phase values of the bilateral HP, DN, RN, CN, GP, PUT, and L‑TC in the AD group were significantly lower compared with the NC group. Serum ferritin levels in the MCI and AD groups were significantly lower compared with the NC group. Only serum iron in the AD group was positively associated with iron content in the R‑HP. Brain iron deposition and body iron levels both increased in MCI and AD patients, however, excessive brain iron accumulation may have no association with body iron level. SWI was particularly effective at recognizing the presence of brain iron in the MCI and AD groups.
Insights
Brain iron levels decrease in mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients, with SWI effectively detecting these changes. Body iron levels also changed, but brain iron accumulation may not correlate with body iron.
Area of Science:
- Neuroimaging
- Biochemistry
- Neurology
Background:
- Iron accumulation in the brain is implicated in neurodegenerative diseases.
- Understanding iron dysregulation in mild cognitive impairment (MCI) and Alzheimer's disease (AD) is crucial for diagnosis and treatment.
- Previous studies suggest altered iron metabolism in AD, but comprehensive analysis in MCI is needed.
Purpose of the Study:
- To investigate and compare brain and body iron levels in patients with MCI, AD, and normal controls (NCs).
- To evaluate the utility of susceptibility weighted imaging (SWI) in assessing brain iron deposition in these groups.
- To explore the relationship between brain iron content and systemic body iron indices.
Main Methods:
- Quantitative analysis of brain iron content using SWI phase values in specific brain regions (hippocampus, substantia nigra, red nucleus, dentate nucleus, caudate nucleus, globus pallidus, putamen, white matter, cortex).
- Measurement of body iron indices: serum iron, serum transferrin, ferritin, and total iron binding capacity.
- Comparison of iron levels between 30 MCI patients, 30 AD patients, and 30 NCs.
Main Results:
- Significantly lower phase values (indicating altered iron content) were observed in the dentate nucleus, caudate nucleus, and putamen in MCI patients compared to NCs.
- AD patients showed significantly lower phase values in the red nucleus, dentate nucleus, and putamen compared to MCI patients.
- AD patients exhibited significantly lower phase values across multiple brain regions, including the hippocampus, dentate nucleus, red nucleus, caudate nucleus, globus pallidus, putamen, and left temporal cortex, compared to NCs.
- Serum ferritin levels were significantly lower in both MCI and AD groups compared to NCs.
- A positive association was found only between serum iron and right hippocampus iron content in the AD group.
- SWI demonstrated effectiveness in detecting brain iron alterations in MCI and AD.
Conclusions:
- Brain iron deposition is altered in both MCI and AD, with distinct patterns observed between the groups and compared to normal controls.
- While body iron levels (specifically serum ferritin) are also altered in MCI and AD, the relationship between excessive brain iron accumulation and systemic body iron levels appears complex and potentially weak.
- SWI is a valuable tool for identifying brain iron changes associated with cognitive decline in MCI and AD.
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