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Assessing Mild Cognitive Impairment in Parkinson's Disease by Magnetic Resonance Quantitative Susceptibility Mapping
Yi Zhao1,2, Hang Qu2, Wei Wang2
1Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Background:
The relationship between iron accumulation in the central nervous system and cognitive decline in Parkinson's disease (PD) has not been fully elucidated. This study aimed to explore the value of quantitative susceptibility mapping in assessment of mild cognitive impairment (MCI) in PD.
Methods:
Sixteen PD patients with MCI (PD-MCI), sixteen normal cognition PD patients (PD-NC), and 28 healthy controls (HCs) were included. The differences in the magnetic susceptibility and Radiomic indicators among groups and their correlations with Montreal Cognitive Assessment-Basic (MoCA-B) scores and Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) were analyzed. Receiver operating characteristic curves were used to evaluate the diagnostic performance.
Results:
Higher iron deposition was observed in the cortical and subcortical structures of the PD patients compared with HCs, including limbic system, orbitofrontal cortex, cuneus, red nucleus, and substantia nigra. Combined magnetic susceptibility and texture index in hippocampus achieved the best diagnostic performance (area under curves: 0.828) in differentiating PD-MCI from PD-NC. The magnetic susceptibilities of the substantia nigra, red nucleus, putamen, globus pallidus, hippocampus, and thalamus were negatively correlated with the MoCA-B scores (all p < 0.05), and of the putamen and amygdala were positively correlated with the UPDRS-III scores (both p < 0.05).
Conclusion:
Higher iron deposition was observed in the cortical and subcortical structures of the PD-MCI and PD-NC groups. The susceptibility values of vulnerable brain subregions shown significant correlation with MoCA-B and UPDRS-III. Together with the texture index, magnetic susceptibility values could provide robust performance in distinguishing PD-MCI patients from PD-NC.
Insights
Iron buildup in the brain is linked to cognitive decline in Parkinson's disease (PD). Quantitative susceptibility mapping can help detect mild cognitive impairment (MCI) in PD patients by measuring iron levels.
Area of Science:
- Neuroimaging
- Neuroscience
- Radiology
Background:
- Iron accumulation in the central nervous system is implicated in cognitive decline in Parkinson's disease (PD).
- The precise relationship between iron deposition and mild cognitive impairment (MCI) in PD remains unclear.
- Quantitative susceptibility mapping (QSM) offers a potential method to assess iron levels in the brain.
Purpose of the Study:
- To investigate the utility of QSM in evaluating MCI in Parkinson's disease patients.
- To explore the correlation between iron deposition, cognitive function, and motor symptoms in PD.
Main Methods:
- A study included 16 PD patients with MCI (PD-MCI), 16 PD patients with normal cognition (PD-NC), and 28 healthy controls (HCs).
- Magnetic susceptibility and radiomic indicators were compared across groups.
- Correlations with cognitive (MoCA-B) and motor (UPDRS-III) scores were analyzed, with diagnostic performance assessed using ROC curves.
Main Results:
- PD patients (both PD-MCI and PD-NC) exhibited higher iron deposition in cortical and subcortical regions compared to HCs.
- Combined magnetic susceptibility and hippocampal texture index showed the highest diagnostic performance (AUC=0.828) for differentiating PD-MCI from PD-NC.
- Susceptibility values in several brain regions (substantia nigra, red nucleus, putamen, globus pallidus, hippocampus, thalamus) negatively correlated with MoCA-B scores.
- Putamen and amygdala susceptibility values positively correlated with UPDRS-III scores.
Conclusions:
- Elevated iron deposition is present in both PD-MCI and PD-NC groups.
- Brain region susceptibility values correlate significantly with cognitive and motor scores.
- QSM, combined with texture analysis, demonstrates robust performance in distinguishing PD-MCI from PD-NC, highlighting its potential for diagnosing cognitive impairment in Parkinson's disease.
