Relationship Between Brain Iron Deposition and Mitochondrial Dysfunction in Idiopathic Parkinson’s Disease

BackgroundThe underlying pathophysiology of Parkinson's disease is complex, involving different molecular pathways, including brain iron deposition and mitochondrial dysfunction. At a molecular level, these disease mechanisms are likely interconnected. Therefore, they offer potential strategies for disease-modifying treatments. We aimed to investigate subcortical brain iron deposition as a potential predictor of the bioenergetic status in patients with idiopathic Parkinson’s disease. MethodsThirty patients with idiopathic Parkinson's disease underwent multimodal MR imaging (T1, susceptibility-weighted imaging, SWI) and 31Phosphorus Magnetic Resonance Spectroscopy Imaging. Contrast-to-noise ratios based on the SWI images of the putamen, caudate, globus pallidus, and thalamus for each hemisphere were used in a multiple linear regression model to predict in vivo metabolites. ResultsSubcortical brain iron deposition, particularly in the putamen and globus pallidus, was highly predictive of the region-specific amount of high-energy-containing phosphorus metabolites in our subjects. ConclusionsOur study suggests that brain iron deposition but not the variability of individual volumetric measurements are highly predictive of mitochondrial impairment in vivo. These findings offer the opportunity, e.g., by using chelating therapies, to improve mitochondrial bioenergetics in patients with idiopathic Parkinson's disease.