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УДК: 616.8 DOI:10.33920/med-01-2202-05

Influence of iron accumulation in the basal ganglia on the function of the grey matter of the brain in Parkinson's disease

Buriak Andrei B. Neurologist of the Department of Neurology, North-Western State Medical University named after I. I. Mechnikov, Military medical academy of S.M. Kirov, Saint Petersburg, Russian Federation, https://orcid.org/0000-0001-7099-1311
Trufanov Artem G. D. Sc. (Medicine), Associate Professor of the Department of Neurology, Military medical academy of S. M. Kirov, Saint Petersburg, Russian Federation, +7 (911) 244‑47‑48, Е-mail: trufanovart@gmail.com, https://orcid.org/0000-0003-2905-9287
Yurin Anton A. Ph. D. Lecturer of the Department of Neurology, Military medical academy of S. M. Kirov, Saint Petersburg, Russian Federation, https://orcid.org/0000-0003-3758-9747
Vlasova Irina A. Neurologist of the Central policlinic, North-Western district scientific and clinical center named after L. G. Sokolov Federal Medical and Biological Agency, Saint Petersburg, Russian Federation, https://orcid.org/0000-0001-5796-9814
Efimtsev Aleksandr Y. Ph. D. Associate professor of the department of radiation diagnostics and medical imaging, Almazov National Medical Research Centr, Saint Petersburg, Russian Federation, https://orcid.org/0000-0003-2249-1405
Chakchir Oleg B. Ph. D. Head of the laboratory of nanobiotechnologies, University under the interparliamentary assembly of Eurasec, Saint Petersburg, Russian Federation, https://orcid.org/0000-0003-3853-9186
Miheev Alexei V. Ph. D. Reseacher of the laboratory of nanobiotechnologies, University under the interparliamentary assembly of Eurasec, Saint Petersburg, Russian Federation, https://orcid.org/0000-0003-3853-9186
Kuznetsova Evgeniya V. Lecturer at the department of organization of provision of troops (forces) with medical equipment, Military medical academy of S. M. Kirov, Saint Petersburg, Russian Federation, https://orcid.org/0000-0001-7612-792X
Odinak Miroslav M. D. Sc. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences, Professor of the Department of Neurology, Military medical academy of S. M. Kirov, Saint Petersburg, Russian Federation, Е-mail: https://orcid.org/0000-0002-7314-7711
Litvinenko Igor V. D. Sc. (Medicine), Professor, Head of the Department of Neurology, Military medical academy of S. M. Kirov, Russian Federation, Saint Petersburg, Russian Federation, https://orcid.org/0000-0001-8988-3011

Our goal was to evaluate the effects of iron accumulation in the basal ganglia on the functionality of the brain grey matter structures at stages II and III of PD using the combined use of SWI and DTMRI protocols. We examined 91 patients with PD with stages II (n=40) and III (n=51) according to Hoehn/Yar. Patients underwent a brain scan using a Magnetom TrioATim 3.0 Tesla MR tomograph (SIEMENS, Germany), using the SWI and DT-MRI protocols. Areas of interest on both sides: SN, RN, GP, head of the CN, putamen and GC of the cerebellum. Quantitative determination of the degree of iron deposition was carried out using the SPIN (signal processing in NMR) Software. The FA level was assessed in the regions of the cerebral cortex and subcortical nuclei. Quantitative variables were obtained using the AAL2 atlas in the DSI Studio software environment. Statistical processing was carried out in Statistica 12 media (StatSoft, USA). Spearman's test was used to determine correlations. The most significant areas of the cerebral cortex, which demonstrated a significant number of correlations with the structures of the extrapyramidal system in patients with stage II of PD, were the left middle frontal gyrus, the left middle occipital gyrus, and the right inferior temporal gyrus. Stage III PD was characterized by more divergent correlations between iron deposition in the basal ganglia and the level of FA in the grey matter of the brain. It has been established that the accumulation of iron in the basal ganglia plays an important role in the progression of the disease, which confirms the thesis about the role of ferroptosis in the genesis of neurodegenerative diseases. Thus, the combined use of SWI and DT-MRI expands the possibilities for studying the pathogenesis of PD.

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Problem Relevance. Parkinson's disease (PD) is a chronic progressive disease, in the pathogenesis of which the pathological deposition of alpha-synuclein protein in brain neurons plays a decisive role, leading to their damage and death. Along with various forms of multisystem atrophy, dementia with Lewy bodies, and several other neurodegenerative diseases, PD refers to synucleinopathies [1].

In addition to the pathological deposition of alpha-synuclein, some factors are involved in the pathogenesis of PD, one of which is oxidative stress. Direct damage to neurons through the formation of free radicals may be a key link in the development of the disease. The hydroxyl radical, one of the most reactive and short-lived of all reactive oxygen species, can cause lipid peroxidation, as well as oxidize carbohydrates, amino acids, and nucleic acids. The formation of the hydroxyl radical occurs during the Fenton reaction during the oxidation of Fe2+ to Fe3+ with the participation of hydrogen peroxide. Ferrous iron is a highly reactive metal and its presence can indirectly lead to damage to the neurons of the central nervous system (CNS) [2].

One of the experimental methods for visualizing the distribution of iron in the brain is Susceptibility Weighted Imaging (SWI), a magnetic resonance imaging (MRI) pulse sequence, described in detail by E. Haacke et al. in 2004, which is a method of forming images weighted by magnetic susceptibility [3]. The final SWI image is based on the combination of the original amplitude image with a "phase mask" obtained from the phase images. In this way, an increased contrast between tissues is achieved, and substances with paramagnetic properties (including iron) in SWI images will have a significantly lower signal [4]. Another high-tech neuroimaging method is diffusion tensor MRI (DT-MRI) (and MR tractography), which makes it possible to assess the level of fractional anisotropy (FA) of the white and grey matter of the brain. This parameter characterizes the integrity of the conductive structures of the CNS, and it can be used indirectly to judge the preservation of the function of the studied components.

Для Цитирования:
Buriak Andrei B., Trufanov Artem G., Yurin Anton A., Vlasova Irina A., Efimtsev Aleksandr Y., Chakchir Oleg B., Miheev Alexei V., Kuznetsova Evgeniya V., Odinak Miroslav M., Litvinenko Igor V., Influence of iron accumulation in the basal ganglia on the function of the grey matter of the brain in Parkinson's disease. Вестник неврологии, психиатрии и нейрохирургии. 2022;2.
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