The Clinical Study Of ESWAN-R2~*Evaluate The Brain Iron Concentration In Patients With Parkinson’s Disease

Objectives①To explore the feasibility of quantifying brain iron by using ESWAN-R2*in normal person.②To study the characteristics of brain iron deposition in PD patients using ESWAN-R2*, and investigate the correlation of brain iron content with the clinical status in PD patients.Subjects and Methods35PD patients and18age-and sex-matched healthy controls underwent the routine MR plain scan and ESWAN scan. The result of UPDRS motor score, modified Hoehn-Yahr stage, the most affected brain side and its duration was recorded in PD groups. The red nucleus (RN), substantia nigra (SN), the head of caudate nucleus(CA), globus pallidus (GP), putamen (PU) and thalamus (TH) were drawn by hand and the R2*values were measured by ESWAN. The middle2slices of red nucleus and substantia nigra(SN), and the median3slices of globus pallidus(GP), thalamus, the head of caudate nucleus and putamen were drawn the outline of nucleus. The final results were the average value of the media slices. Statistical analysis was performed by using SPSS19.0.Results①There was a statistically significant positive correlation between R2*values and previously published regional iron concentrations in normal controls (r=0.905, P=0.013).②In normal controls, there were neither significant differences with regards to R2*values between hemispheres nor gender(P>0.05).③The R2*values of substantia nigra and globus pallidus were significantly higher in PD groups than those in normal controls(P<0.05), there were no significant R2*value differences in other nucleus (P>0.05).④There were no significant differences in R2*values of all regions of interest between early PD patients (modified Hoehn-Yahr stage1-2) and late PD patients (modified Hoehn-Yahr stage2.5-4)(P>0.05).⑤There were no significant differences in R2*values between men and women in PD patients (P>0.05).⑥In PD groups, the R2*values of substantia nigra and globus pallidus were significantly higher in the most affected brain side than those in the least affected brain side(P<0.05).⑦The R2*values of substantia nigra, globus pallidus, the head of caudate nucleus and putamen were significantly higher in the most affected brain side of PD patients than those in normal controls(P<0.05).⑧There was a positive correlation between the R2*values in the substantia nigra of the clinically most affected brain side in PD and the UPDRS motor score of the more serious side of motor symptoms(r=0.405, P=0.016), The R2*values in the rest of nuclei and the UPDRS motor score had no significant correlation(P>0.05).⑨There was a statistically positive correlation between the R2*values in the substantia nigra (r=0.415, P=0.013) and globus pallidus (r=0.351, P=0.036) of the clinically most affected brain side in PD and its duration.Conclusions There was a statistically significant positive correlation between R2*values and regional brain iron content. Unnormal increased brain iron concentrated in selected nucleus, which correlates with progress of PD diease. And those more affected sides were more than those less affected opposite sides in patients, which correlates with the degree of affected side limbs dyskinesia and the progress of PD. ESWAN-R2*can be used to monitor PD clinical condition.