BACKGROUND: Iron deposition plays a crucial role in the pathophysiology of Parkinson's disease (PD), yet the distribution pattern of iron deposition in the subcortical nuclei has been inconsistent across previous studies. We aimed to assess the difference patterns of iron deposition detected by quantitative iron-sensitive magnetic resonance imaging (MRI) between patients with PD and patients with atypical parkinsonian syndromes (APSs), and between patients with PD and healthy controls (HCs). METHODS: A systematic literature search was conducted on PubMed, Embase, and Web of Science databases to identify studies investigating the iron content in PD patients using the iron-sensitive MRI techniques (R2 * and quantitative susceptibility mapping [QSM]), up until May 1, 2023. The quality assessment of case-control and cohort studies was performed using the Newcastle-Ottawa Scale, whereas diagnostic studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. Standardized mean differences and summary estimates of sensitivity, specificity, and area under the curve (AUC) were calculated for iron content, using a random effects model. We also conducted the subgroup-analysis based on the MRI sequence and meta-regression. RESULTS: Seventy-seven studies with 3192 PD, 209 multiple system atrophy (MSA), 174 progressive supranuclear palsy (PSP), and 2447 HCs were included. Elevated iron content in substantia nigra (SN) pars reticulata ( P <0.001) and compacta ( P <0.001), SN ( P <0.001), red nucleus (RN, P <0.001), globus pallidus ( P <0.001), putamen (PUT, P = 0.021), and thalamus ( P = 0.029) were found in PD patients compared with HCs. PD patients showed lower iron content in PUT ( P <0.001), RN ( P = 0.003), SN ( P = 0.017), and caudate nucleus ( P = 0.017) than MSA patients, and lower iron content in RN ( P = 0.001), PUT ( P <0.001), globus pallidus ( P = 0.004), SN ( P = 0.015), and caudate nucleus ( P = 0.001) than PSP patients. The highest diagnostic accuracy distinguishing PD from HCs was observed in SN (AUC: 0.85), and that distinguishing PD from MSA was found in PUT (AUC: 0.90). In addition, the best diagnostic performance was achieved in the RN for distinguishing PD from PSP (AUC: 0.86). CONCLUSIONS: Quantitative iron-sensitive MRI could quantitatively detect the iron content of subcortical nuclei in PD and APSs, while it may be insufficient to accurately diagnose PD. Future studies are needed to explore the role of multimodal MRI in the diagnosis of PD. REGISTRISION PROSPERO (CRD42022344413).
Humans ; Parkinson Disease/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Iron/metabolism*

Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide, highlighting the urgent need for improved diagnostic and therapeutic strategies. Biomarkers from cerebrospinal fluid (CSF), blood, and peripheral tissue hold promise for early PD detection. In addition, neuroimaging techniques, including magnetic resonance imaging (MRI), single-photon emission computed tomography (SPECT), and positron emission tomography (PET), allow for detailed visualization of neurodegeneration and associated structural and functional brain changes. This review summarizes recent advances in PD biomarkers and neuroimaging, highlighting their diagnostic potential and implications for future research.

Deep brain stimulation (DBS) is an effective way to treat many movement disorders.The volume of tissue activated (VTA) by DBS refers to the region regulated by pulses,which is generated by the electrode contacts.It is associated with the therapeutic effect and side effects;as a result,precise regulation of VTA plays an important role in patient-specific treatment.This article summarizes the factors which affect VTA.

Objective To observe the clinical efficacy using curette and stripping wire method in treating diabetic foot. Methods 36 hospitalized patients diagnosed as diabetic foot were enrolled, and 18 of them were chosen as the experimental group according to random digital table method who was treated with medical therapy plus curette and stripping wire method in treating diabetic foot. The other 18 patients were named as the control group who were treated by medical treatment and routine treatment. The granulation tissue maturity, wound healing, and the differences on curative effect were compared. Results 10 cases′wound granulation tissue maturity in the experimental group got++and+++on the 10th day while 4 cases in control group. Wound healing rate of the experimental group at the 10th and 14th day were (78.6±10.5)%and (82.7±8.4)%while the control group were (43.2±8.7)%and (66.2±10.1)%. Cure rate of the experimental group was 14/18 four weeks after treatment, the inefficiency was 0, while the control group was 6/18 and 3/18. Conclusions Curette and stripping wire method is a good method to promote the dressing diabetic foot wound healing. It is superior to traditional methods, worthy of clinical application.