Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-Analysis
Background: Parkinson's disease (PD) is a progressive neurodegenerative disease whose main neuropathological feature is the loss of dopaminergic neurons of the substantia nigra (SN). There is also an increase in iron content in the SN in postmortem and imaging studies using iron-sensitive MRI t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00366/full |
| _version_ | 1818061197670350848 |
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| author | Nadya Pyatigorskaya Nadya Pyatigorskaya Nadya Pyatigorskaya Clara B. Sanz-Morère Clara B. Sanz-Morère Clara B. Sanz-Morère Rahul Gaurav Rahul Gaurav Emma Biondetti Emma Biondetti Romain Valabregue Romain Valabregue Mathieu Santin Mathieu Santin Lydia Yahia-Cherif Lydia Yahia-Cherif Stéphane Lehéricy Stéphane Lehéricy Stéphane Lehéricy |
| author_facet | Nadya Pyatigorskaya Nadya Pyatigorskaya Nadya Pyatigorskaya Clara B. Sanz-Morère Clara B. Sanz-Morère Clara B. Sanz-Morère Rahul Gaurav Rahul Gaurav Emma Biondetti Emma Biondetti Romain Valabregue Romain Valabregue Mathieu Santin Mathieu Santin Lydia Yahia-Cherif Lydia Yahia-Cherif Stéphane Lehéricy Stéphane Lehéricy Stéphane Lehéricy |
| author_sort | Nadya Pyatigorskaya |
| collection | DOAJ |
| description | Background: Parkinson's disease (PD) is a progressive neurodegenerative disease whose main neuropathological feature is the loss of dopaminergic neurons of the substantia nigra (SN). There is also an increase in iron content in the SN in postmortem and imaging studies using iron-sensitive MRI techniques. However, MRI results are variable across studies.Objectives: We performed a systematic meta-analysis of SN iron imaging studies in PD to better understand the role of iron-sensitive MRI quantification to distinguish patients from healthy controls. We also studied the factors that may influence iron quantification and analyzed the correlations between demographic and clinical data and iron load.Methods: We searched PubMed and ScienceDirect databases (from January 1994 to December 2019) for studies that analyzed iron load in the SN of PD patients using T2*, R2*, susceptibility weighting imaging (SWI), or quantitative susceptibility mapping (QSM) and compared the values with healthy controls. Details for each study regarding participants, imaging methods, and results were extracted. The effect size and confidence interval (CI) of 95% were calculated for each study as well as the pooled weighted effect size for each marker over studies. Hence, the correlations between technical and clinical metrics with iron load were analyzed.Results: Forty-six articles fulfilled the inclusion criteria including 27 for T2*/R2* measures, 10 for SWI, and 17 for QSM (3,135 patients and 1,675 controls). Eight of the articles analyzed both R2* and QSM. A notable effect size was found in the SN in PD for R2* increase (effect size: 0.84, 95% CI: 0.60 to 1.08), for SWI measurements (1.14, 95% CI: 0.54 to 1.73), and for QSM increase (1.13, 95% CI: 0.86 to 1.39). Correlations between imaging measures and Unified Parkinson's Disease Rating Scale (UPDRS) scores were mostly observed for QSM.Conclusions: The consistent increase in MRI measures of iron content in PD across the literature using R2*, SWI, or QSM techniques confirmed that these measurements provided reliable markers of iron content in PD. Several of these measurements correlated with the severity of motor symptoms. Lastly, QSM appeared more robust and reproducible than R2* and more suited to multicenter studies. |
| first_indexed | 2024-12-10T13:44:29Z |
| format | Article |
| id | doaj.art-da0f9743ce1c4f5e86cca2a19a8e186e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T13:44:29Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-da0f9743ce1c4f5e86cca2a19a8e186e2022-12-22T01:46:30ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-05-011110.3389/fneur.2020.00366534085Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-AnalysisNadya Pyatigorskaya0Nadya Pyatigorskaya1Nadya Pyatigorskaya2Clara B. Sanz-Morère3Clara B. Sanz-Morère4Clara B. Sanz-Morère5Rahul Gaurav6Rahul Gaurav7Emma Biondetti8Emma Biondetti9Romain Valabregue10Romain Valabregue11Mathieu Santin12Mathieu Santin13Lydia Yahia-Cherif14Lydia Yahia-Cherif15Stéphane Lehéricy16Stéphane Lehéricy17Stéphane Lehéricy18Institut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceAssistance Publique Hôpitaux de Paris, Service de neuroradiologie, Hôpital Pitié-Salpêtrière, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceAssistance Publique Hôpitaux de Paris, Service de neuroradiologie, Hôpital Pitié-Salpêtrière, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceInstitut du Cerveau et de la Moelle épinière (ICM), Centre de NeuroImagerie de Recherche (CENIR), ICM, Paris, FranceSorbonne Université, UPMC Univ Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, FranceAssistance Publique Hôpitaux de Paris, Service de neuroradiologie, Hôpital Pitié-Salpêtrière, Paris, FranceBackground: Parkinson's disease (PD) is a progressive neurodegenerative disease whose main neuropathological feature is the loss of dopaminergic neurons of the substantia nigra (SN). There is also an increase in iron content in the SN in postmortem and imaging studies using iron-sensitive MRI techniques. However, MRI results are variable across studies.Objectives: We performed a systematic meta-analysis of SN iron imaging studies in PD to better understand the role of iron-sensitive MRI quantification to distinguish patients from healthy controls. We also studied the factors that may influence iron quantification and analyzed the correlations between demographic and clinical data and iron load.Methods: We searched PubMed and ScienceDirect databases (from January 1994 to December 2019) for studies that analyzed iron load in the SN of PD patients using T2*, R2*, susceptibility weighting imaging (SWI), or quantitative susceptibility mapping (QSM) and compared the values with healthy controls. Details for each study regarding participants, imaging methods, and results were extracted. The effect size and confidence interval (CI) of 95% were calculated for each study as well as the pooled weighted effect size for each marker over studies. Hence, the correlations between technical and clinical metrics with iron load were analyzed.Results: Forty-six articles fulfilled the inclusion criteria including 27 for T2*/R2* measures, 10 for SWI, and 17 for QSM (3,135 patients and 1,675 controls). Eight of the articles analyzed both R2* and QSM. A notable effect size was found in the SN in PD for R2* increase (effect size: 0.84, 95% CI: 0.60 to 1.08), for SWI measurements (1.14, 95% CI: 0.54 to 1.73), and for QSM increase (1.13, 95% CI: 0.86 to 1.39). Correlations between imaging measures and Unified Parkinson's Disease Rating Scale (UPDRS) scores were mostly observed for QSM.Conclusions: The consistent increase in MRI measures of iron content in PD across the literature using R2*, SWI, or QSM techniques confirmed that these measurements provided reliable markers of iron content in PD. Several of these measurements correlated with the severity of motor symptoms. Lastly, QSM appeared more robust and reproducible than R2* and more suited to multicenter studies.https://www.frontiersin.org/article/10.3389/fneur.2020.00366/fullsubstantia nigraironParkinson's diseaseQSMSWIR2* |
| spellingShingle | Nadya Pyatigorskaya Nadya Pyatigorskaya Nadya Pyatigorskaya Clara B. Sanz-Morère Clara B. Sanz-Morère Clara B. Sanz-Morère Rahul Gaurav Rahul Gaurav Emma Biondetti Emma Biondetti Romain Valabregue Romain Valabregue Mathieu Santin Mathieu Santin Lydia Yahia-Cherif Lydia Yahia-Cherif Stéphane Lehéricy Stéphane Lehéricy Stéphane Lehéricy Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-Analysis Frontiers in Neurology substantia nigra iron Parkinson's disease QSM SWI R2* |
| title | Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-Analysis |
| title_full | Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-Analysis |
| title_fullStr | Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-Analysis |
| title_short | Iron Imaging as a Diagnostic Tool for Parkinson's Disease: A Systematic Review and Meta-Analysis |
| title_sort | iron imaging as a diagnostic tool for parkinson s disease a systematic review and meta analysis |
| topic | substantia nigra iron Parkinson's disease QSM SWI R2* |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00366/full |
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