Quantitative susceptibility mapping and blood neurofilament light chain differentiate between parkinsonian disorders

Piao Zhang; Junling Chen; Tongtong Cai; Chentao He; Yan Li; Xiaohong Li; Zhenzhen Chen; Lijuan Wang; Yuhu Zhang

doi:10.3389/fnagi.2022.909552

Quantitative susceptibility mapping and blood neurofilament light chain differentiate between parkinsonian disorders

Front Aging Neurosci. 2022 Aug 5:14:909552. doi: 10.3389/fnagi.2022.909552. eCollection 2022.

Authors

Piao Zhang^{1

2}, Junling Chen³, Tongtong Cai³, Chentao He², Yan Li², Xiaohong Li², Zhenzhen Chen², Lijuan Wang², Yuhu Zhang^{1

2}

Affiliations

¹ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
² Department of Neurology, Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
³ Department of Neurology, Shantou Central Hospital, Shantou, China.

Abstract

Objectives: We employed quantitative susceptibility mapping (QSM) to assess iron deposition in parkinsonian disorders and explored whether combining QSM values and neurofilament light (NfL) chain levels can improve the accuracy of distinguishing Parkinson's disease (PD) from multiple system atrophy (MSA) and progressive supranuclear palsy (PSP).

Materials and methods: Forty-seven patients with PD, 28 patients with MSA, 18 patients with PSP, and 28 healthy controls (HC) were enrolled, and QSM data were reconstructed. Susceptibility values in the bilateral globus pallidus (GP), putamen (PUT), caudate nucleus (CN), red nucleus (RN), substantia nigra (SN), and dentate nucleus (DN) were obtained. Plasma NfL levels of 47 PD, 18 MSA, and 14 PSP patients and 22 HC were measured by ultrasensitive Simoa technology.

Results: The highest diagnostic accuracy distinguishing MSA from PD patients was observed with increased susceptibility values in CN (AUC: 0.740). The susceptibility values in RN yielded the highest diagnostic performance for distinguishing PSP from PD patients (AUC: 0.829). Plasma NfL levels were significantly higher in the MSA and PSP groups than in PD and HC groups. Combining the susceptibility values in the RN and plasma NfL levels improved the diagnostic performance for PSP vs. PD (AUC: 0.904), whereas plasma NfL levels had higher diagnostic accuracy for MSA vs. PD (AUC: 0.877).

Conclusion: The exploratory study indicates different patterns of iron accumulation in deep gray matter nuclei in Parkinsonian disorders. Combining QSM values with NfL levels may be a promising biomarker for distinguishing PSP from PD, whereas plasma NfL may be a reliable biomarker for differentiating MSA from PD. QSM and NfL measures appeared to have low accuracy for separating PD from controls.

Keywords: Parkinson’s disease; iron deposition; multiple system atrophy; neurofilament light chain; progressive supranuclear palsy; quantitative susceptibility mapping.