To Research The Difference Of Distribution Of Brain Iron In Patients With Parkinson’s Disease And The Mechanism Of Iron Chelation Of α-lipoic Acid Treatment By The Susceptibility Weighted Imaging(SWI)

Objective:1. To evaluate the phase value of patients with Parkinson disease(PD) in substantia nigra, red nucleus, caudate nucleus, putamen(head) phase, the globus pallidus, thalamus, frontal and temporal brain regions values by the susceptibility weighted imaging(SWI), to understand the differences in the distribution of iron in different brain regions and whether it will produce brain interval migration.2.To understand the α-lipoic acid(LA) in the treatment of Parkinson’s disease(PD) and the effect of iron chelation mechanism by 3.0T MR susceptibility weighted imaging(SWI).Methods:1.40 PD patients as research group and 20 age, sex matched patients as normal control group which were examed by 3.0T MR head conventional and SWI in our hospital from 2013 April to 2014 September, the PD patients according to Hoehn- Yahr(H&Y) classification divided into 0 to 5, to observe the SWI image performance, direct measured for the first time, measured after high-pass filtering correction phase diagram for the second time, to measure the substantia nigra and red nucleus, caudate nucleus(head), putamen, globus pallidus, thalamus, frontal and temporal lobe phase values, then calculated phase correction value, and then analyzed statistically.2. 40 patients of PD were averagely divided into test group and control group in our hospital treatment.At the same time of foundation treatment,the research group was treated with LA and monosialotetrahexosylganglioside(GM1), the control group only was treated with GM1, the changes of substantia nigra phase value of two groups before and after treatment were observed. Results:(1) After high pass filtering correction phase image of the measured phase values were more accurate than without filtering, image display iron deposition in brain regions was more clear,could show more nucleis and V smaller interference,could quantitative measure the width of SNc.(2)The phase values between PD group and normal control group of substantia nigra, red nucleus and temporal lobe, putamen of each brain region were measured by the independent samples t-test, which was statistical significance.The right substantia nigral,the left substantia nigral,the right red nucleus,the right putamen,the left putamen,the right temporal lobe,and the left temporal lobe P<0.05,with significant difference.The phase value of substantia nigra, right red nucleus was lower than the normal controls,the iron deposition was greater than the normal group.The phase value of putamen and temporal was higher than the normal controls,the iron deposition was fewer than the normal group.The caudate nucleus, globus pallidus, thalamus and frontal P>0.05, there was no difference between the two groups of phase value,no significant difference of iron deposition.(3)The phase values of PD between H&Y classification≤2.5 and >2.5 with various brain regions were measured by t-test, the right putamen, the left frontal lobe,the right temporal lobe P<0.05, the difference was statistically significant;Nigra,frontal lobe,temporal lobe average phase values(P<0.05),there was statistical significance,the iron deposition of H&Y classification >2.5 was increased, the remaining parts of the phase values had no obvious statistical significance,iron deposition was the same.(4)The PD group and the control group with SNc width, SN width, SNc/midbrain diameter were respectively in the left and right sides,and the average values were lower than those in the control group,which were significantly decreased. SN area had no significant difference between two groups.(5)The right and left brain regions of PD patients were compared with P>0.05, no significant difference, the left and right regions of brain iron deposition showed no significant difference.(6)The right and left brain regions of control were compared with P>0.05, the difference was not statistically significant, iron deposition in the left and right regions of brain showed no significant difference.(7)The left and right of the disease onset had bilateral brain areas were compared, the iron deposition of brain had no significant difference between the left and right sides.(8)The iron deposition was no significant difference between male and female in PD group.(9)The iron deposition was no significant difference between male and female in control group.(10) The left and right of the disease onset were compared, the left and right sides of SNc width, SN width, SNc/ in diameter, SN area had no significant difference.(11)As much as the total iron content in the brain between PD and control.2.(1)The substantia nigra phase value of treatment group increased,iron deposition reduced compared with before treatment;the substantia nigra phase values of control group before and after treatment had no significant changes;the two groups had significant difference(P<0.05),that LA could chelate iron in Parkinson’s Disease.(2) The SNc width and area of SN did not change obviously after short time of LA treatment.Conclusion:1.After high pass filtering correction phase image of the measured phase values were more accurate than without filtering, image display iron deposition in brain regions is more clear,could show more nucleis and smaller interference,could quantitative measure the width of SNc.2.There was a certain correlation between the severity of disease and iron deposition,the phase value could assist the early diagnosis of PD patients.SWI also could achieve the quantitative assessment of PD severity level.3.Iron deposition in substantia nigra of the midbrain of PD patients was increased,and reduced in the temporal,the total iron content had no significant change in brain,suggesting that iron could be translated in cerebral interval with PD patients.4.The iron deposition was no significant difference between male and female in PD and control groups.5.The iron deposition of left and right regions of brain showed no significant difference with PD patients and controls.6.The iron deposition in the substantia nigra of PD patients was reduced after treatment with LA,their clinical symptoms improved, LA was a metal chelating agent that was safe and effective in the treatment of PD.