Serial Susceptibility Weighted MRI Measures Brain Iron and Microbleeds in Dementia

Article type: Research Article

Authors: Kirsch, Wolff^{a; *} | McAuley, Grant^a | Holshouser, Barbara^b | Petersen, Floyd^c | Ayaz, Muhammad^d | Vinters, Harry V.^e | Dickson, Cindy^a | Haacke, E. Mark^d | Britt III, William^f | Larsen, James^g | Kim, Ivan^a | Mueller, Claudius^a | Schrag, Matthew^a | Kido, Daniel^b

Affiliations: [a] Neurosurgery Center for Research, Training, and Education, Loma Linda University, Loma Linda, CA, USA | [b] Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA | [c] Health Research Consulting Group, Loma Linda University, Loma Linda, CA, USA | [d] MRI Institute for Biomedical Research, Detroit, MI, USA | [e] Division of Neuropathology, UCLA Medical Center, Los Angeles, CA, USA | [f] Department of Psychiatry, Loma Linda University, Loma Linda, CA, USA | [g] Department of Medicine, Loma Linda University Health Care, Loma Linda, CA, USA

Correspondence: [*] Corresponding author: Wolff Kirsch, M.D., Neurosurgery Center for Research, Training, and Education, Loma Linda University, 11175 Campus Street, Suite 11113, Loma Linda, CA 92350, USA. Tel.: +1 909 558 7070; Fax: +1 909 558 0472; E-mail: wkirsch@llu.edu.

Note: [] Communicated by Othman Ghribi

Abstract: A new iron sensitive MR sequence (susceptibility weighted imaging – SWI) enabling the simultaneous quantitation of regional brain iron levels and brain microbleeds (BMB) has been acquired serially to study dementia. Cohorts of mildly cognitively impaired (MCI) elderly (n = 73) and cognitively normal participants (n = 33) have been serially evaluated for up to 50 months. SWI phase values (putative iron levels) in 14 brain regions were measured and the number of BMB were counted for each SWI study. SWI phase values showed a left putaminal mean increase of iron (decrease of phase values) over the study duration in 27 participants who progressed to dementia compared to Normals (p = 0.035) and stable MCI (p = 0.01). BMB were detected in 9 out of 26 (38%) MCI participants who progressed to dementia and are a significant risk factor for cognitive failure in MCI participants [risk ratio = 2.06 (95% confidence interval 1.37–3.12)]. SWI is useful to measure regional iron changes and presence of BMB, both of which may be important MR-based biomarkers for neurodegenerative diseases.

Keywords: Amyloid angiopathy, brain, cognitive impairment, dementia, globus pallidal iron, microbleeds, putaminal iron, susceptibility weighted imaging

DOI: 10.3233/JAD-2009-1073

Journal: Journal of Alzheimer's Disease, vol. 17, no. 3, pp. 599-609, 2009