Application of Iron Related Magnetic Resonance Imaging in the Neurological Disorders

Tae-Hyoung Kim; Jae-Hyeok Lee

doi:10.14253/kjcn.2014.16.1.1

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Kim and Lee: Application of Iron Related Magnetic Resonance Imaging in the Neurological Disorders

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Korean J Community Nutr 2014;16(1):1-7.

Published online: 18 January 2014

DOI: https://doi.org/10.14253/kjcn.2014.16.1.1

Application of Iron Related Magnetic Resonance Imaging in the Neurological Disorders

Tae-Hyoung Kim, Jae-Hyeok Lee

Department of Neurology, Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea

Address for correspondence; Jae-Hyeok Lee Department of Neurology, Pusan National University Yangsan Hospital, Beomo-ri, Mulgum-eup, Yangsan 626-770, Korea Tel: +82-55-360-2453 Fax: +82-55-360-2152 E-mail: jhlee.neuro@pusan.ac.kr

Received 5 June 2014 Accepted 13 June 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Iron is an important element for brain oxygen transport, myelination, DNA synthesis and neurotransmission. However, excessive iron can generate reactive oxygen species and contribute neurotoxicity. Although brain iron deposition is the natural process with normal aging, excessive iron accumulation is also observed in various neurological disorders such as neurodegeneration with brain iron accumulation, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, Friedreich ataxia, and others. Magnetic resonance image (MRI) is a useful method for detecting iron deposits in the brain. It can be a powerful tool for diagnosis and monitoring, while furthering our understanding of the role of iron in the pathophysiology of a disease. In this review, we will introduce the mechanism of iron toxicity and the basics of several iron-related MRI techniques. Also, we will summarize the previous results concerning the clinical application of such MR imagings in various neurological disorders. (Korean J Clin Neurophysiol 2014;16:1-7)

Keywords: Iron, Neurodegenerative disorders, MRI

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Figure 1.

Axial T2-wighted image (A) corresponding magnitude (B), phase (C), and susceptibility-weighted image after postprocessing (D). The phase image here is for left hand system.

Table 1.

Iron related magnetic resonance imaging in the various neurological disorders

Disease	Field strength	Techniques	Results	References
NBIA		T2*, T2 FSE	T2* and T2 FSE hypointensity showed disease-specific iron deposition and its distribution in NBIAs	23
	1.5T	T1, T2, SWI	All patients with PKAN showed hyperintensity of the bilateral GP on T2WI and SWI.	54
	1.5T	T1, T2, SWI	SWI demonstrated iron deposition in the GP better than conventional imaging.	54
Parkinsonism	1.5T, 0.5T	FDRI	Earlier-onset PD patients had increased FDRI in SN, PUT and GP.	30
	3T	R2, R2*, R2'	Mean SN values for R2 was lower, and R2* and R2' were higher in PD patients than in controls. R2* and R2' values were correlated with motor performance.	31
	1.5T	PRIME sequence (R2, R2*, R2')	Mean SN values for R2* and R2 were higher in PD patients than in controls. R2 was lower in the PUT, and was correlated with disease duration.	32
	3T	SWI	Iron concentration of SN was significantly increased in PD patients, and was correlated with UPDRS scores.	33
	3T	SWI	SN iron concentration was increased in PD, and was correlated with Hoehn-Yahr scale, UPDRS scores, and serum ceruloplasmin levels.	34
	3T	SWI	Significanlty increased phase shift values (left hand system) of PUT in MSA, and GP and TH in PSP, and subregional differences of hypointensity in the PUT, GP and TH between MSA-p and PSP were observed.	35
	3T	R2*	PSP patients had higher R2* values in GP and CN, whereas MSA-p patients had higher R2* values in PUT than PD and controls. Increased R2* values were correlated with extent of atrophy which were observed in the most affected areas of each disorders.	36
AD	1.5T, 0.5T	FDRI	Increased FDRI in CN and PUT were observed in AD patients.	42
	1.5T	SWI	The iron concentrations in the bilateral HP, PC, PUT, CN, and DN subregions of patients with AD were significantly higher than the controls, Moreover, especially those in the PC at the early stages of AD, were positively correlated with the severity of patients' cognitive impairment.	43
		1.5T	R2 Increased R2 values in temporal lobe gray matter, especially in hippocampus, and significant correlation between R2 values and reference postmortem iron concentration in healthy controls were observed.	45
MS	1.5T	T2	T2 hypointensity in gray matter areas correlated with progression of brain atrophy.	49
	3T	R2*	R2* was inversely correlated with disease duration and higher total lesion load.	50
FA	1.5T	R2*	Higher R2* values in FA patients than in controls were observed. Treatment with deferiprone reduced R2* values significantly.	52
ALS	1.5	T2*	Hypointensities were found only in the precentral gyruses gray matter, and correlated with ALS. Functional Rating Scale.	53

NBIA; Neurodegeneration with brain iron accumulation, PD; Parkinsons disease, AD; Alzheimer's disease, MS; multiple sclerosis, FA; Friedreich ataxia, ALS; amyotrophic lateral sclerosis, MSA; multiple system atrophy, PKAN; pantothenate kinase-2 associated neurodegeneration, PSP; progressive supranuclear palsy, FSE; fast spin echo, SWI; susceptibility weighted image, FDRI; field dependent relaxivity increase, PRIME; partially refocused interleaved multiple echo, GP; globus pallidus, SN; substantia nigra, PUT; putamen, TH; thalamus, HP; hippocampus, PC; parietal cortex, CN; caudate nucleus, DN; dentate nucleus

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