Objective: To evaluate iron deposition with susceptibility weighted imaging (SWI) MRI in the basal ganglia of patients affected by Parkinson’s Disease Dementia (PDD) and Dementia with Lewy Bodies (DLB) compared to patients with idiopathic Parkinson’s disease (iPD) and healthy controls.

Background: Patients with PD have demonstrated increased iron deposition in the basal ganglia at post-mortem, which is linked to neurodegeneration and alpha-synuclein aggregation. In vivo imaging of alpha-synuclein pathology is currently unavailable, but iron concentration can be measured with SWI MRI. We hypothesize that iron concentrations, as measured by SWI, will be increased in patients with PDD and DLB compared to iPD and healthy controls.

Method: We enrolled 11 PDD/DLB patients (5 PDD and 6 DLB), 11 iPD patients, matched for disease duration with the PDD/DLB patients, and 22 age- and gender-matched healthy controls.

Results: PDD/DLB patients demonstrated increased iron deposition in caudate nucleus and putamen compared to iPD patients (caudate: P=0.014, putamen: P=0.015) and compared to healthy controls (caudate: P=0.017, putamen: P=0.036). A trend of increase in striatal iron deposition has been found between iPD and healthy controls (+9%) and between DLB and PDD patients (+5%).

Conclusion: Our findings demonstrate that SWI iron can be used as a marker of basal ganglia pathology in alpha-synuclein disease and that PDD and DLB patients have a higher burden of striatal pathology compared to PD patients and healthy controls. This abstract was also submitted for presentation at the 2019 European Academy of Neurology conference.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/in-vivo-increased-striatal-iron-deposition-in-parkinsons-disease-dementia-and-dementia-with-lewy-body/