Modified Iron Deposition in Nigrosomes by Pharmacotherapy for the Management of Parkinson's Disease

Mengdi Wang; Hongxia Wang; Jing Wang; Shujun Lu; Chen Li; Xiaofei Zhong; Nan Wang; Ruli Ge; Qi Zheng; Jinbo Chen; Hongcai Wang

doi:10.3389/fmolb.2022.908298

Modified Iron Deposition in Nigrosomes by Pharmacotherapy for the Management of Parkinson's Disease

Front Mol Biosci. 2022 Jul 7:9:908298. doi: 10.3389/fmolb.2022.908298. eCollection 2022.

Authors

Mengdi Wang¹, Hongxia Wang², Jing Wang², Shujun Lu¹, Chen Li³, Xiaofei Zhong², Nan Wang³, Ruli Ge¹, Qi Zheng¹, Jinbo Chen¹, Hongcai Wang¹

Affiliations

¹ Department of Neurology, Binzhou Medical University Hospital, Binzhou, China.
² Department of Radiology, Binzhou Medical University Hospital, Binzhou, China.
³ Medical Research Center, Binzhou Medical University Hospital, Binzhou, China.

Abstract

Background: Increased iron deposition in nigrosome as assessed by susceptibility-weighted imaging (SWI) is involved in the pathogenesis of Parkinson's disease (PD). This study investigated the effects of antiparkinson drugs on iron deposition in the nigrosome of PD patients. Methods: Based on the retrospective analysis of clinical data, alterations in iron deposition in the substantia nigra were investigated in 51 PD patients across different types of therapies and in nine Parkinson-plus syndrome patients. The Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part Ⅲ/Ⅳ (UPDRS Ⅲ/Ⅳ) was utilized to evaluate motor function and complications. SWI (slice = 0.6 mm) was used to detect iron deposition in the nigrosome and substantia nigra. Nigrosome loss was scored on a 1-point nigrosome visibility scale. Visual assessment of dorsolateral nigral hyperintensity (DNH) was separately performed for each side of the nigrosome with SWI. Results: Increased UPDRS Ⅲ scores were correlated with low nigrosome scores based on correlation analysis at a disease duration of 6-12 months (r = -0.8420). The loss of the nigrosome on SWI was clearly inhibited in PD patients with a 3-5-year duration of administration of antiparkinson medications compared with no treatment. Decreased UPDRS Ⅲ scores and increased nigrosome scores were observed in the regular treatment of PD patients with a 6-7-year disease duration. For patients with Parkinson-plus syndromes, such as multiple system atrophy, iron accumulation was apparent in the corpus striatum and substantia nigra compared with that for patients with progressive supranuclear palsy. Conclusions: Early and regular treatment with antiparkinson drugs not only alleviates the chance of PD disability but also prevents the loss of DNH, namely, iron accumulation in the nigrosome.

Keywords: Parkinson’s disease; dorsolateral nigral hyperintensity; iron accumulation; levodopa; nigrosome.