Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886
Vol. 52, No. 3, 2004, pp. 332-337
Bioline Code: ni04110
Full paper language: English
Document available free of charge

Neurology India, Vol. 52, No. 3, 2004, pp. 332-337
T2-weighted MRI in Parkinson's disease; Substantia nigra pars compacta
hypointensity correlates with the clinical scores
Atasoy Huseyin Tugrul, Nuyan Oguz, Tunc Tugba, Yorubulut Mehmet, Unal
AysunE, Inan LeventE
Abstract

Background: Iron accumulation in substantia nigra pars compacta (SNpc)
and related intensity and volumetric changes in patients with
idiopathic Parkinson's disease (PD) has been reported previously. There
are only a few studies evaluating the relation between
neuroradiological findings and clinical scores, with contradictory
results.
Aims: In this study we aimed to measure the iron-rich brain areas of PD
patients and healthy subjects with T2-weighted magnetic resonance
imaging (MRI) and to evaluate the relation between the clinical scores
of PD patients and these imaging results.
Methods and Materials: T2-weighted MRI findings were studied in 20
patients with PD and 16 healthy controls. The width of SNpc, putamen
volume, and the intensity of the basal ganglia were measured. Unified
Parkinson's Disease Rating Scale (UPDRS) was used for evaluating the
clinical status.
Statistical Analyses: Mann Whitney U test for group comparisons,
Wilcoxon sign rank test for comparisons within the patient group, and
Spearman's rank correlation coefficient for analyses of correlations
were used.
Results: Mean SNpc and dentate nucleus intensities were lower in PD
patients than healthy subjects. Mean SNpc width and putamen volumes
were lower in patients. Decrease in the intensity of mean SNpc
correlated with high UPDRS and rigidity scores.
Conclusion: The results of our study reflect the increase in iron
accumulation and oxidative stress in the SNpc in Parkinson's disease.
The decrease in the intensity of SNpc correlates with poor clinical
scores.
Keywords
Parkinson's disease, magnetic resonance imaging, susbstantia nigra,
dentate nucleus, iron

© Copyright 2004 Neurology India.
Alternative site location: http://www.neurologyindia.com

Multiple Sclerosis Tied to Iron in Brain

Studies Point to Cause, Location of MS Brain Damage

By Daniel DeNoon
WebMD Medical News
Reviewed By Brunilda  Nazario, MD
on Wednesday, October 22, 2003

Oct. 22, 2003 -- Iron deposits deep in the brain may cause multiple
sclerosis, new imaging studies suggest.

The findings come from studies of computer-assisted brain scans using a

specialized magnetic resonance imaging (MRI) device. University at
Buffalo, N.Y., researchers Rohit Bakshi, MD, and colleagues are the
first to use this technique to study multiple sclerosis. Bakshi
reported
the findings at this week's annual meeting of the American Neurological

Association in San Francisco.

Multiple sclerosis has been considered a disease of the white matter in

the brain and spinal cord -- the neural pathways that allow areas of
gray matter to communicate with one another. But the new findings link
iron deposits in the gray matter to movement and thinking impairments
in
multiple sclerosis.

"If we're going to treat this disease, we have to know where the damage

is," Bakshi says in a news release. "Traditionally, we thought MS was
strictly a white-matter disease. ... We were able to visualize gray
matter structures deep in the brain of MS patients and found some to be

atrophied."

These areas of brain damage contained abnormally high levels of iron.
It's not yet clear that the iron is the cause of the brain damage. It
could be that dying brain cells leave a trail of iron behind.

Walking, Thinking, and Gray Matter

Bakshi's team put 41 multiple sclerosis patients through a walking
test.
They also gave tests of learning, speed of information processing, and
memory to 28 MS patients.

The more unnatural darkness the brain scans saw in a patient's gray
matter, the worse the patient's MS symptoms. It was the only factor
studied that independently predicted impaired walking and thinking.

"We suspect that MS patients have defective blood-brain barriers, the
cell layer that prevents potentially toxic substances from entering the

brain," Bakshi says. "Excessive iron entering the brain may damage the
deep gray matter structures."

Possible Treatment

If iron is indeed the culprit, it seems possible to do something about
it. Bakshi's team is exploring two ideas. The first is simply to remove

excess iron from patients' bodies, and then to devise a way to prevent
future iron build-up.

If that is impractical, it may be possible to prevent iron from killing

brain cells. The excess iron may be causing free radicals -- extremely
reactive molecules that damage brain cells. Antioxidants -- such as
vitamins C and E, or even more powerful agents -- might mop up free
radicals before they do their dirty work.

Even if the iron deposits are the effect, rather than the cause, of
brain cell death, the study still offers a way to measure the severity
of MS and the efficacy of new treatments.

http://health.webmd.com/cgi-bin21/DM/y/hbdj0fgLs0GC0Ojz0AW

http://tinyurl.com/d535u

<<snip>>
This study adds more weight to the notion that T2 hypointensity is a
clinically relevant marker of tissue damage in MS.
<<snip>>

Journal of the Neurological Sciences
Article in Press, Corrected Proof - Note to users

doi:10.1016/j.jns.2005.02.009
Copyright ? 2005 Elsevier B.V. All rights reserved.

MRI T2 hypointensity of the dentate nucleus is related to ambulatory
impairment in multiple sclerosis

C.W. Tjoaa, R.H.B. Benedicta, b, c, B. Weinstock-Guttmana, A.J.
Fabianoa and R. Bakshid, ,

aDepartment of Neurology, University at Buffalo, State University of
New York, Buffalo, NY, USA
bDepartment of Psychiatry University at Buffalo, State University of
New York, Buffalo, NY, USA
cDepartment of Psychology, University at Buffalo, State University of
New York, Buffalo, NY, USA
dDepartments of Neurology and Radiology, Center for Neurological
Imaging, Partners Multiple Sclerosis Center, Brigham & Women's
Hospital, Harvard Medical School, 77 Avenue Louis Pasteur-HIM 730
Boston, MA 02115, USA

Received 29 October 2004;  revised 24 January 2005;  accepted 18
February 2005.  Available online 22 April 2005.

Abstract
Objectives

MRI T2 hypointensity in multiple sclerosis (MS) gray matter, suggesting

iron deposition, is associated with physical disability, disease
course, lesion load, and brain atrophy. Ambulatory dysfunction limits
quality of life; however correlation with conventional MRI remains
poor.

Methods
Normalized intensity on T2-weighted images was obtained in the basal
ganglia, thalamus, red nucleus, and dentate nucleus in 47 MS patients
and 15 healthy controls. Brain T1-hypointense and FLAIR-hyperintense
lesion volume, third ventricle width, brain parenchymal fraction and
timed 25 foot walk (T25FW) were measured in the MS group.

Results
T2 hypointensity was present throughout gray matter in MS vs. controls
(all p < 0.01). Dentate T2 hypointensity was the only MRI variable
significantly correlated with T25FW (Pearson r = -0.355, p = 0.007) and

was also the best MRI correlate of physical disability (EDSS) score in
regression modeling (r = -0.463, R2 = 0.223, p = 0.004).

Conclusions
T2 hypointensity is present in subcortical gray matter nuclei in
patients with MS vs. normal controls. Dentate nucleus T2 hypointensity
is independently related to ambulatory impairment and disability,
accounting for more variance than conventional lesion and atrophy
measures. This study adds more weight to the notion that T2
hypointensity is a clinically relevant marker of tissue damage in MS.

Keywords: MRI; Multiple sclerosis; Iron; Gray matter; T2 shortening;
Ambulation

Corresponding author. Tel.: +1 617 732 8600; fax: +1

http://www.newhopeforparkinsons.com/web/pid/98/

High doses of riboflavin and the elimination of dietary red meat
promote the recovery of some motor functions in Parkinson's disease
patients.?

Who loves ya.
Tom

Jesus Was A Vegetarian!
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