Clinical features and dysfunctions of iron metabolism in Parkinson disease patients with hyper echogenicity in substantia nigra: a cross-sectional study
Shu-yang Yu,
Chen-jie Cao,
Li-jun Zuo,
Ze-jie Chen,
Teng-hong Lian,
Fang Wang,
Yang Hu,
Ying-shan Piao,
Li-xia Li,
Peng Guo,
Li Liu,
Qiu-jin Yu,
Rui-dan Wang,
Piu Chan,
Sheng-di Chen,
Xiao-min Wang,
Wei Zhang
Affiliations
Shu-yang Yu
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Chen-jie Cao
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
Li-jun Zuo
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Ze-jie Chen
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
Teng-hong Lian
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
Fang Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
Yang Hu
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Ying-shan Piao
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Li-xia Li
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Peng Guo
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Li Liu
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Qiu-jin Yu
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
Rui-dan Wang
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University
Piu Chan
Department of Neurobiology, Beijing Xuanwu Hospital, Capital Medical University
Sheng-di Chen
Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine
Xiao-min Wang
Center of Parkinson Disease, Beijing Institute for Brain Disorders
Wei Zhang
Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University
Abstract Background Transcranial ultrasound is a useful tool for providing the evidences for the early diagnosis and differential diagnosis of Parkinson disease (PD). However, the relationship between hyper echogenicity in substantia nigra (SN) and clinical symptoms of PD patients remains unknown, and the role of dysfunction of iron metabolism on the pathogenesis of SN hyper echogenicity is unclear. Methods PD patients was detected by transcranial sonography and divided into with no hyper echogenicity (PDSN-) group and with hyper echogenicity (PDSN+) group. Motor symptoms (MS) and non-motor symptoms (NMS) were evaluated, and the levels of iron and related proteins in serum and cerebrospinal fluid (CSF) were detected for PD patients. Data comparison between the two groups and correlation analyses were performed. Results PDSN+ group was significantly older, and had significantly older age of onset, more advanced Hohen-Yahr stage, higher SCOPA-AUT score and lower MoCA score than PDSN- group (P < 0.05). Compared with PDSN- group, the levels of transferrin and light-ferritin in serum and iron level in CSF were significantly elevated (P < 0.05), but ferroportin level in CSF was significantly decreased in PDSN+ group (P < 0.05). Conclusions PD patients with hyper echogenicity in SN are older, at more advanced disease stage, have severer motor symptoms, and non-motor symptoms of cognitive impairment and autonomic dysfunction. Hyper echogenicity of SN in PD patients is related to dysfunction of iron metabolism, involving increased iron transport from peripheral system to central nervous system, reduction of intracellular iron release and excessive iron deposition in brain.
