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Speculating the timing of iron deposition in the putamen in multiple system atrophy

Myung Jun Lee1, Tae-Hyung Kim2, Seung Joo Kim3

  • 1Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Republic of Korea.

Parkinsonism & Related Disorders
|March 3, 2019
PubMed
Abstract

Insights

Iron accumulation in the putamen of multiple system atrophy (MSA) patients appears secondary to neurodegeneration, occurring after volume atrophy or increased MD. This clarifies the timing of iron deposition in MSA progression.

Area of Science:

  • Neuroimaging
  • Neurodegenerative Diseases
  • Iron Metabolism

Background:

  • Iron accumulation is linked to neurodegeneration, but its timing in Multiple System Atrophy (MSA) is unknown.
  • Investigating putaminal iron deposition patterns in MSA is crucial for understanding disease progression.

Purpose of the Study:

  • To determine the temporal sequence of iron deposition in the putamen of MSA patients.
  • To elucidate the relationship between iron accumulation and other MRI markers of neurodegeneration.

Main Methods:

  • Simultaneous measurement of putaminal R2*, volume, and Mean Diffusivity (MD) in 39 MSA patients and 22 controls.
  • Calculation of conditional probabilities (CPs) to assess the temporal relationship between MRI changes.
  • Definition of significant MRI changes based on control group cut-off values.

Main Results:

  • The conditional probability of R2* (iron) changes without accompanying MD or volume changes was significantly lower than vice versa.
  • Non-linear (exponential and quadratic) associations were observed between R2* and volume/MD values.
  • Putaminal iron accumulation appears to occur subsequent to volume atrophy or increased MD.

Conclusions:

  • Putaminal iron deposition in MSA is likely a secondary consequence of neurodegeneration.
  • Iron accumulation occurs after or concurrently with other neurodegenerative changes like atrophy and altered diffusivity.
  • Findings suggest iron deposition is a byproduct, not a primary driver, of MSA pathogenesis.
Keywords:
Conditional probability modelingIron depositionMagnetic resonance imagingMultimodal imagingMultiple system atrophy

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