Iron Accumulation in the Substantia Nigra of Patients With Alzheimer Disease and Parkinsonism
Iron Accumulation in the Substantia Nigra of Patients With Alzheimer Disease and Parkinsonism
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DOI：
10.1001/archneurol.2008.586
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发表时间：
2009-03-01
影响因子：
--
通讯作者：
Zimmerman, Earl A.
中科院分区：
文献类型：
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作者：
Brar, Sonia;Henderson, David;Zimmerman, Earl A.
背景：初步研究表明，无痴呆的帕金森病患者黑质中铁的蓄积增加，而阿尔茨海默病(AD)和非帕金森病患者的海马铁蓄积相反。目的：确定帕金森病患者黑质中铁的水平(磁共振图像上测量的T2缩短)是否高于单纯AD患者。设计：病例对照研究。地点：纽约奥尔巴尼医学院。参与者：15名仅患有AD的患者(对照组)和18名AD患者以及帕金森病患者，年龄56-89岁，临床痴呆症总评分为5.0至11.5。根据疾病的纯度选择患者；帕金森病统一评定量表运动评分为15或更高的患者被认为患有帕金森病。主要观察指标：仅患有AD的患者与发展为帕金森病的AD患者的短T2曲线下面积(30毫秒)。结果：伴有痴呆的帕金森病患者的黑质中铁含量显著高于单独患有AD的患者(P=0.03，两样本t检验)。结论：铁积累可能是帕金森病的预测因素。帕金森病在AD病程中的发展似乎与铁的积累有关，铁的积累反过来可能有助于神经功能下降的发病机制。
Background: Preliminary studies have shown an increase in iron accumulation in the substantia nigra but not in the hippocampus in patients with Parkinson disease without dementia and the reverse in patients with Alzheimer disease (AD) and no parkinsonism.Objective: To determine whether iron levels (measured as T2 shortening on magnetic resonance images) are greater in the substantia nigra of patients with AD who have parkinsonism than in those with AD alone.Design: Case-control study.Setting: Albany Medical College, Albany, New York.Participants: Fifteen patients with only AD (controls) and 18 with AD as well as parkinsonism, aged 56 to 89 years, and with a total Clinical Dementia Rating of 5.0 to 11.5. Patients were selected according to the purity of their disease; patients with a Unified Parkinson's Disease Rating Scale motor score of 15 or greater were considered to have parkinsonism.Main Outcome Measure: Area under the curve for short T2 (30 milliseconds) in patients with only AD vs patients with AD who developed parkinsonism.Results: Patients who developed parkinsonism along with their existing dementia had significantly more iron in their substantia nigra than did patients with AD alone (P = .03, 2-sample t test).Conclusions: Iron accumulation may be a predictor of parkinsonism. The development of parkinsonism during the course of AD appears to be associated with the accumulation of iron, which in turn may contribute to the pathogenesis of neurologic decline.