Quantitative Susceptibility Mapping in Parkinson's Disease

• Published in: PloS one Vol. 11; no. 9; p. e0162460
• Main Authors: Langkammer, Christian, Pirpamer, Lukas, Seiler, Stephan, Deistung, Andreas, Schweser, Ferdinand, Franthal, Sebastian, Homayoon, Nina, Katschnig-Winter, Petra, Koegl-Wallner, Mariella, Pendl, Tamara, Stoegerer, Eva Maria, Wenzel, Karoline, Fazekas, Franz, Ropele, Stefan, Reichenbach, Jürgen Rainer, Schmidt, Reinhold, Schwingenschuh, Petra
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 06.09.2016; Public Library of Science (PLoS)
• Subjects: Age; Aged; Antiparkinson Agents - therapeutic use; Biology and Life Sciences; Brain Mapping - methods; Brain research; Care and treatment; Case-Control Studies; Diagnostic imaging; Disease control; Dopamine receptors; Ethics; Female; Gene mapping; Globus pallidus; Globus Pallidus - diagnostic imaging; Globus Pallidus - drug effects; Globus Pallidus - metabolism; Globus Pallidus - pathology; Health physics; Histology; Humans; Image Interpretation, Computer-Assisted; Informed consent; Iron; Iron - metabolism; Levodopa; Levodopa - therapeutic use; Magnetic Resonance Imaging; Magnetic susceptibility; Male; Mapping; Medicine and Health Sciences; Middle Aged; Movement disorders; Multiple sclerosis; Neurodegenerative diseases; Neurology; Nuclei; Parkinson disease; Parkinson Disease - diagnostic imaging; Parkinson Disease - drug therapy; Parkinson Disease - metabolism; Parkinson Disease - pathology; Parkinson's disease; Patients; Red nucleus; Red Nucleus - diagnostic imaging; Red Nucleus - drug effects; Red Nucleus - metabolism; Red Nucleus - pathology; Research and Analysis Methods; Sensitivity; Severity of Illness Index; Substantia grisea; Substantia nigra; Substantia Nigra - diagnostic imaging; Substantia Nigra - drug effects; Substantia Nigra - metabolism; Substantia Nigra - pathology; Thalamus; Thalamus - diagnostic imaging; Thalamus - drug effects; Thalamus - metabolism; Thalamus - pathology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0162460

Quantitative susceptibility mapping (QSM) and R2* relaxation rate mapping have demonstrated increased iron deposition in the substantia nigra of patients with idiopathic Parkinson's disease (PD). However, the findings in other subcortical deep gray matter nuclei are converse and the sensitivity of QSM and R2* for morphological changes and their relation to clinical measures of disease severity has so far been investigated only sparsely. The local ethics committee approved this study and all subjects gave written informed consent. 66 patients with idiopathic Parkinson's disease and 58 control subjects underwent quantitative MRI at 3T. Susceptibility and R2* maps were reconstructed from a spoiled multi-echo 3D gradient echo sequence. Mean susceptibilities and R2* rates were measured in subcortical deep gray matter nuclei and compared between patients with PD and controls as well as related to clinical variables. Compared to control subjects, patients with PD had increased R2* values in the substantia nigra. QSM also showed higher susceptibilities in patients with PD in substantia nigra, in the nucleus ruber, thalamus, and globus pallidus. Magnetic susceptibility of several of these structures was correlated with the levodopa-equivalent daily dose (LEDD) and clinical markers of motor and non-motor disease severity (total MDS-UPDRS, MDS-UPDRS-I and II). Disease severity as assessed by the Hoehn & Yahr scale was correlated with magnetic susceptibility in the substantia nigra. The established finding of higher R2* rates in the substantia nigra was extended by QSM showing superior sensitivity for PD-related tissue changes in nigrostriatal dopaminergic pathways. QSM additionally reflected the levodopa-dosage and disease severity. These results suggest a more widespread pathologic involvement and QSM as a novel means for its investigation, more sensitive than current MRI techniques.