Investigation of cerebral iron deposition in aged patients with ischemic cerebrovascular disease using susceptibility-weighted imaging

Abstract

ObjectiveThe aim of this study was to investigate focal iron deposition level in the brain in patients with ischemic cerebrovascular disease and its correlation with cerebral small vessel disease imaging markers.Patients and methodsSeventy-four patients with first-ever transient ischemic attack (median age: 69 years; 30 males and 44 females) and 77 patients with positive ischemic stroke history (median age: 72 years; 43 males and 34 females) were studied retrospectively. On phase image of susceptibility-weighted imaging and regions of interest were manually drawn at the bilateral head of the caudate nucleus, lenticular nucleus (LN), thalamus (TH), frontal white matter, and occipital white matter. The correlation between iron deposition level and the clinical and imaging variables was also investigated.ResultsIron deposition level at LN was significantly higher in patients with previous stroke history. It linearly correlated with the presence and number of cerebral microbleeds (CMBs) but not with white matter hyperintensity and lacunar infarct. Multiple linear regression analysis showed that deep structure CMBs were the most relevant in terms of iron deposition at LN.ConclusionIron deposition at LN may increase in cases of more severe ischemia in aged patients with transient ischemic attack, and it may be an imaging marker for CMB of ischemic origin.

Characterizing Brain Iron Deposition in Patients with Subcortical Vascular Mild Cognitive Impairment Using Quantitative Susceptibility Mapping: A Potential Biomarker

“…Iron is implicated in the pathogenesis of WMHs given that iron concentrations in the basal ganglia affect the severity of WMHs (Yan et al, 2013). However, other studies have suggested that iron accumulation is closely associated with the formation of cerebral microbleeds, but not with WMHs in SVD (Gattringer et al, 2016; Liu et al, 2016). Therefore, the precise mechanisms of higher iron concentration in svMCI still remain unclear and require further research.…”

Long‐term sequelae of hippocampal lesions in patients with transient global amnesia: A multiparametric MRI study

“…In an animal study in which rat forebrain ischemia was induced by four‐vessel occlusion for 20 minutes, iron deposition in the CA1 began 1 week after postischemic recirculation and gradually increased by 8 weeks and, moreover, iron deposition was coupled with delayed pyramidal cell death . Iron deposition at the lenticular nucleus was significantly higher in patients with previous ischemic stroke and linearly correlated with the presence and number of cerebral microbleeds . The underlying mechanisms for iron deposition after ischemia may include the formation of Fe 2+ from degradation of hemoglobin, transportation of Fe 2+ from the damaged blood–brain barrier, and the release of Fe 2+ stimulated by the increase of oxidative stress in the hypoxia state .…”

“…36 Iron deposition at the lenticular nucleus was significantly higher in patients with previous ischemic stroke and linearly correlated with the presence and number of cerebral microbleeds. 37 The underlying mechanisms for iron deposition after ischemia may include the formation of Fe 21 from degradation of hemoglobin, transportation of Fe 21 from the damaged blood-brain barrier, and the release of Fe 21 stimulated by the increase of oxidative stress in the hypoxia state. 16 Increased expressions of iron regulatory proteins and transferrin receptors may also be involved in iron acquisition.…”

Increased iron deposition of deep cerebral gray matter structures in hemodialysis patients: A longitudinal study using quantitative susceptibility mapping

“…The second reason for the abnormal cerebral iron deposition may be that it is well known that HD can cause cerebral small-vessel diseases such as white matter hyperintensity, stroke, cerebral microbleeds, or hemorrhage 25,26 and this can lead to abnormal iron accumulation in brain tissue. [25][26][27] Third, it has been shown that cerebral atrophy of gray matter nuclei is correlated with increased iron deposition and that HD patients had more severe pathological cerebral atrophy compared with HCs. 28 Therefore, the cerebral atrophy in HD patients may be another factor for the increased iron content where the volume changes but iron is not removed, therefore making the iron concentration effectively higher.…”