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      Parkinson's disease and Parkinsonism syndromes: Evaluating iron deposition in the putamen using magnetic susceptibility MRI techniques - A systematic review and literature analysis

      research-article
      Author(s): a , b , *
      Publication date (Electronic):
      Journal: Heliyon
      Publisher: Elsevier
      Keywords: QSM, SWI, Putamen, Iron, Parkinson's disease, Parkinsonism

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          Abstract

          Magnetic resonance imaging (MRI) techniques, such as quantitative susceptibility mapping (QSM) and susceptibility-weighted imaging (SWI), can detect iron deposition in the brain. Iron accumulation in the putamen (PUT) can contribute to the pathogenesis of Parkinson's disease (PD) and atypical Parkinsonian disorders. This systematic review aimed to synthesize evidence on iron deposition in the PUT assessed by MRI susceptibility techniques in PD and Parkinsonism syndromes. The PubMed and Scopus databases were searched for relevant studies. Thirty-four studies from January 2007 to October 2023 that used QSM, SWI, or other MRI susceptibility methods to measure putaminal iron in PD, progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and healthy controls (HCs) were included. Most studies have found increased putaminal iron levels in PD patients versus HCs based on higher quantitative susceptibility. Putaminal iron accumulation correlates with worse motor scores and cognitive decline in patients with PD. Evidence regarding differences in susceptibility between PD and atypical Parkinsonism is emerging, with several studies showing greater putaminal iron deposition in PSP and MSA than in PD patients. Alterations in putaminal iron levels help to distinguish these disorders from PD. Increased putaminal iron levels appear to be associated with increased disease severity and progression. Thus, magnetic susceptibility MRI techniques can detect abnormal iron accumulation in the PUT of patients with Parkinsonism. Moreover, quantifying putaminal susceptibility may serve as an MRI biomarker to monitor motor and cognitive changes in PD and aid in the differential diagnosis of Parkinsonian disorders.

          Highlights

          • •

            QSM and SWI detect abnormal iron accumulation in the putamen of Parkinsonism.

          • •

            Comparative analysis unveils iron differences in PD vs. atypical Parkinsonism.

          • •

            Increased putaminal iron in PD linked to disease severity and cognitive decline.

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          Most cited references113

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          The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

          Matthew J L Page, Joanne E McKenzie, Patrick Bossuyt … (2025)
          The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.
          Article 0 comments Cited 14790 times – based on 0 reviews     Review now
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            Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments

            Carson Lo, Dominik Mertz, Mark Loeb (2014)
            Background Lack of appropriate reporting of methodological details has previously been shown to distort risk of bias assessments in randomized controlled trials. The same might be true for observational studies. The goal of this study was to compare the Newcastle-Ottawa Scale (NOS) assessment for risk of bias between reviewers and authors of cohort studies included in a published systematic review on risk factors for severe outcomes in patients infected with influenza. Methods Cohort studies included in the systematic review and published between 2008–2011 were included. The corresponding or first authors completed a survey covering all NOS items. Results were compared with the NOS assessment applied by reviewers of the systematic review. Inter-rater reliability was calculated using kappa (K) statistics. Results Authors of 65/182 (36%) studies completed the survey. The overall NOS score was significantly higher (p < 0.001) in the reviewers’ assessment (median = 6; interquartile range [IQR] 6–6) compared with those by authors (median = 5, IQR 4–6). Inter-rater reliability by item ranged from slight (K = 0.15, 95% confidence interval [CI] = −0.19, 0.48) to poor (K = −0.06, 95% CI = −0.22, 0.10). Reliability for the overall score was poor (K = −0.004, 95% CI = −0.11, 0.11). Conclusions Differences in assessment and low agreement between reviewers and authors suggest the need to contact authors for information not published in studies when applying the NOS in systematic reviews.
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              The role of iron in brain ageing and neurodegenerative disorders.

              Roberta J. Ward, Fabio A Zucca, Jeff H. Duyn … (2014)
              In the CNS, iron in several proteins is involved in many important processes such as oxygen transportation, oxidative phosphorylation, myelin production, and the synthesis and metabolism of neurotransmitters. Abnormal iron homoeostasis can induce cellular damage through hydroxyl radical production, which can cause the oxidation and modification of lipids, proteins, carbohydrates, and DNA. During ageing, different iron complexes accumulate in brain regions associated with motor and cognitive impairment. In various neurodegenerative diseases, such as Alzheimer's disease and Parkinson's disease, changes in iron homoeostasis result in altered cellular iron distribution and accumulation. MRI can often identify these changes, thus providing a potential diagnostic biomarker of neurodegenerative diseases. An important avenue to reduce iron accumulation is the use of iron chelators that are able to cross the blood-brain barrier, penetrate cells, and reduce excessive iron accumulation, thereby affording neuroprotection.
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                Author and article information

                Contributors
                Sana Mohammadi
                Sadegh Ghaderi
                Journal
                Journal ID (nlm-ta): Heliyon
                Journal ID (iso-abbrev): Heliyon
                Title: Heliyon
                Publisher: Elsevier
                ISSN (Electronic): 2405-8440
                Publication date PMC-release: 26 March 2024
                Publication date Collection: 15 April 2024
                Publication date (Electronic): 26 March 2024
                Volume: 10
                Issue: 7
                Electronic Location Identifier: e27950
                Affiliations
                [a ]Department of Medical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
                [b ]Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
                Author notes
                [* ]Corresponding author. Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Eastern side of Tehran University, Italy St, No. 88, 1417755469, Iran. s_ghaderi@ 123456razi.tums.ac.ir
                Article
                Publisher Item ID: S2405-8440(24)03981-1 Publisher ID: e27950
                DOI: 10.1016/j.heliyon.2024.e27950
                PMC ID: 11059419
                PubMed ID: 38689949
                SO-VID: 1233934c-ecad-4667-8769-6aca453c6873
                Copyright © © 2024 The Author(s)
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 10 December 2023
                Date revision received : 29 February 2024
                Date accepted : 8 March 2024
                Categories
                Subject: Research Article

                Keywords: qsm,swi,putamen,iron,parkinson's disease,parkinsonism
                Data availability:
                Keywords: qsm, swi, putamen, iron, parkinson's disease, parkinsonism

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