• Qin Chen, Bradley F Boeve, Arvin Forghanian-Arani, Matthew L Senjem, Clifford R Jack, Scott A Przybelski, Timothy G Lesnick, Walter K Kremers, Julie A Fields, Christopher G Schwarz, Jeffrey L Gunter, Joshua D Trzasko, Jonathan Graff-Radford, Rodolfo Savica, David S Knopman, Dennis W Dickson, Tanis J Ferman, Neill Graff-Radford, Ronald C Petersen, and Kejal Kantarci.
• Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
• J Neuroimaging. 2021 Sep 1; 31 (5): 102010271020-1027.

Background And PurposeNeurodegeneration of the substantia nigra in Lewy body disease is associated with iron deposition, which increases the magnetic susceptibility of the substantia nigra on MRI. Our objective was to measure iron deposition in the substantia nigra in patients with probable dementia with Lewy bodies (pDLB) and patients who are at risk for pDLB by quantitative susceptibility mapping (QSM).MethodsParticipants included pDLB (n = 36), mild cognitive impairment with at least one core feature of DLB (MCI-LB; n = 15), idiopathic rapid eye movement sleep behavior disorder (iRBD; n = 11), and an age-and gender-matched clinically unimpaired control group (n = 102). QSM was derived from multi-echo 3D gradient recalled echo MRI at 3T, and groups were compared on mean susceptibility values of the substantia nigra and its relation to parkinsonism severity.ResultsPatients with pDLB had higher susceptibility in the substantia nigra compared to controls (p< 0.001) and MCI-LB (p = 0.043). The susceptibility of substantia nigra showed an increasing trend from controls to iRBD and MCI-LB, and to pDLB (p< 0.001). Parkinsonism severity was not associated with the mean susceptibility in the substantia nigra in the patient groups.ConclusionsOur data suggested that QSM is sensitive to the increased magnetic susceptibility due to higher iron content in the substantia nigra in pDLB. The trend of increasing susceptibility from controls to iRBD and MCI-LB, and to pDLB suggests that iron deposition in the substantia nigra starts to increase as early as the prodromal stage in DLB and continues to increase as the disease progresses, independent of parkinsonism severity.© 2021 American Society of Neuroimaging.

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