Iron Levels in Brain May Predict Severity of Parkinson’s
A study by a research team at the University College London has found that the severity of classic Parkinson’s symptoms, the likely cognitive decline, and the risk to develop dementia could be tracked by measuring the amount of iron content in the brain.
To evaluate if changes in iron levels in the brain related to cognitive changes in Parkinson’s patients, researchers used a cutting-edge magnetic resonance imaging (MRI) technique called quantitative susceptibility mapping (QSM).
What Can QSM Teach?
The role of iron has long been established in Parkison’s, as apart from the loss of dopamine-producing neurons, iron accumulation is seen in two brain regions, the globus pallidus and the substantia nigra.
By projecting magnetic rays that realign protons in your brain and using a radio receiver to pick up frequencies emitted, magnetic resonance for brain mapping is a tool that produces extremely clear depictions of the brain.
QSM is a particularly novel MRI technique which can easily detect variations in the content of brain iron, and in other substances such as fats or calcium.
One hundred thirty-seven people in the study underwent a QSM exam and had their cognitive skills assessed using the Montreal Cognitive Assessment (MoCA), which can assess the risk of cognitive decline in Parkinson’s.
Findings regarding Iron
The exams found higher iron content in brain tissue of the prefrontal cortex and putamen of people with Parkinson’s, compared to people in the study that did not have the condition.
The prefrontal cortex is involved in planning complex cognitive behaviour and in personality expression and decision-making, while the putamen regulates body movement and influences learning.
Higher iron levels in the hippocampus (a region involved in learning and memory), and in the thalamus (involved in sensory signalling, motor activity and memory) were found to generate poorer memory and thinking scores.
Higher dementia risk scores were related to greater QSM changes in three brain regions: the parietal, frontal and medial occipital cortices.
Researchers believe that key clinical indices of Parkinson’s activity can be identified. These include reduced cognitive performance related to iron level changes in the hippocampus region of the brain, dementia risk linked to increased iron levels in the parietal and frontal cortices as well as noticing motor symptom severity with raised iron levels in the putamen region.
By tracking the progression of Parkinson’s, neurologists and treatment teams can possibly devise better treatment strategies, based on how iron levels are changing in the brain.
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Tracking the Progress of Parkinson's
Developed by the European Parkinson's Disease Association (EPDA), the Parkinson’s Disease Composite Scale (PDCS) is a simple new rating scale, meant to be used primarily by healthcare professionals.
The scale measures the severity of symptoms experienced by people with Parkinson’s, by looking at the severity of 17 different motor and non-motor symptoms.
Severity is measured on five different levels - absent, mild, moderate, severe, and very severe.
While a score of 0 is considered the absence of the specific disorder, some items range from 0 to 4 and others from 0 to 7 to account for the different levels of impact each symptom entails.
A total score can be calculated for the PDCS in this way.
Although the PDCS is meant for professional use, we believe that people with Parkinson’s or their carers may find it useful in keeping track of the condition or simply learn about the varied motor and non-motor symptoms involved with a PD diagnosis.
Please do not self-assess yourself and instead talk to your GP or treating team before making any changes.
Download the PDCS here, if you like.